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According to the World Health Organization about half of the world’s adult population has had a headache at least once in the past year. Prolonged use of electronic devices has greatly contributed to this problem. For many people, these headaches are infrequent and do not often affect daily life.  But what about when your headache occurs frequently or is so severe it prevents you from going about your day to day activities? Some types of headaches are more easily treated and managed than others.

There are two types of headaches: primary and secondary. Primary headaches occur without an underlying disease and include migraines and tension-type headaches.  Secondary headaches can be associated with serious disease, requiring emergency care, or can be referred from other structures of the body such as the cervical spine (neck). 

Headaches symptoms that may constitute a medical emergency are: vomiting, seizures, fever, muscle pain, night sweat, weight loss, and neurologic symptoms such as blurred vision.  If you are experiencing any of these symptoms, if your headache worsens, or your symptoms change it is recommended that you seek medical attention. Any headache that is unusual for you and does not resolve itself in a reasonable time should be brought to your primary care physician’s attention.

Primary Headaches:

Migraines: Migraines are a primary form of headache that typically lasts from four to seventy two hours, can range from moderate to severe pain, and typically are located on only one side of the head.  Often they can be accompanied by an aura, nausea or vomiting, sensitivity to sound, or light sensitivity.  Migraines can be aggravated by routine physical activity such as going up stairs. This type of headache is thought to occur in the central nervous system and is related to blood vessels.

Tension-type: Tension-type headaches are the most common primary headache disorder and can last anywhere from thirty minutes to seven days.  These can often have a pressing or tightening quality that occurs on both sides of the head.  Here there is no nausea, vomiting, light sensitivity, or aggravation with physical activity. This type of headache is thought to occur in the central nervous system but can have a hereditary component and is usually associated with muscle tender points. Tension – type headaches can be treated with relaxation techniques such as Progressive Muscle Relaxation (PMR), medications, and physical therapy.

Secondary Headaches:

The most common secondary headache that is not related to a serious medical condition is a cervicogenic headache (originating from the neck).

Cervicogenic Headache: The length of time a cervicogenic headache can last varies.  Here the pain is on one side and usually starts in the neck.  This type of headache is aggravated or preceded by head postures or movements of the neck.  Due to the nerves of the neck and face sharing common connections, pain signals sent from one region can lead to discomfort in the other.  Physical therapy can be an effective treatment to help relieve symptoms. For example: posture, exercise, ergonomics, massage, manual techniques, traction, trigger point, and acupressure.

A cervicogenic headache can be caused by an accident or trauma or can stem from neck movement or sustained postures.  Sustained postures could mean sitting in front of a computer at work or looking down at your phone.  Changing these postures throughout the day could help reduce symptoms.  Changing postures could mean bringing your phone closer to you using pillows or another supportive surface when reading or checking social media.  If you are someone who works at a desk, it could involve taking breaks or getting a standing desk.  However your life requires you to move, there are some simple and effective exercises you can perform throughout the day to help cervicogenic headache symptoms.

5 TIPS FOR TENSION HEADACHES

Progressive Muscle Relaxation: PMR is an effective method for reducing tension throughout the body.  With this method you first tense a muscle group, such as at the neck or shoulder, and then relax the muscles noting the difference between the two.  This helps reduce both stress and tension. For more information or to learn how to do PMR, refer to podcast at: https://www.psychologies.co.uk/try-progressive-muscle-relaxation

Manage your stress level: While stressors vary from person to person, one method for managing stress is with exercise.  Any form of exercise can help reduce stress, but a cost free method is aerobic exercise such as walking or running.  A less time consuming method could be to perform deep breathing exercises throughout the day.

Heat or cold: When feeling sore or stiff, applying a hot or cold pack or taking a hot shower can help ease a tension headache. 

Posture: Some tips for posture are to make sure your head is over your shoulders rather than sitting forward and making sure you are sitting or standing up straight with your shoulders back. 

Over the counter medications: Talk to your doctor or pharmacist for additional information.

5 TIPS FOR CERVICAL HEADACHES

Posture: See tips listed under tension headaches.

Ergonomics: If your job or hobbies require you to sit for extended periods it may be beneficial to change positions throughout the day or consider getting a standing desk. Also, limit time on electronic devices. When sitting make sure the monitor is at eye level, your legs are able to fit under your desk, and you are close to the keyboard and monitor.  If you are working with a laptop or phone, avoid putting it on your lap. Instead, bring your laptop closer to you by putting pillows on your lap.

Exercise: Some exercises to help relieve symptoms are chin tucks, shoulder blade pinches, and back extension.  These exercises can be performed multiple times throughout the day in sitting or standing.

Physical Therapy: Physical therapy may include massage, manual techniques, stretching, traction/ decompression and exercise.  A physical therapist can assess your posture and provide strategies specific to you.

Over the counter medications: While medication may not cure cervicogenic headaches, they may help relieve pain. Talk to your doctor or pharmacist for additional information.

Contibutor: Alexa Rzucidlo, PT, DPT

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

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

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

As more of us become more comfortable living with COVID 19, travel plans have exploded. For 2 ½ years many have put air travel for family vacations on hold and we are eager to get back to air travel. As you may have gathered from my previous columns, travel is one of my passions. My family and I have been fortunate to have visited many spiritual places of natural wonder and beauty that we call our National Parks. Many of the parks are on the west coast and require some preparation to endure the many hours of travel by airplane through different time zones. Moreover, travel to other countries and continents, often requiring 8, 10, 16 or more non-stop hours on a plane can really take a toll on your mind and body and gave new meaning to the term “jet lag.”  

WHAT IS JET LAG?

According to the Mayo Clinic, jet lag, also known as jet lag disorder, is a sleep disorder that can occur in people who travel through different time zones in a short period of time, such as a flight from New York City to Los Angeles. Obviously, the further the distance traveled and the more time zones entered, the more significant and drastic the symptoms, as found, for example, in those traveling from the United States to Asia.

Sunlight has a direct impact on our internal clock by regulating melatonin, a hormone that regulates sleep and wake cycles in the body. Travel through different time zones can affect the amount and duration of sunlight and therefore, impact the regulation of these cycles. The inability to regulate the cycles results in many symptoms.

SYMPTOMS OF JET LAG

PREVENTION OF JET LAG

EXERCISES FOR JET LAG

Posture Exercises

Posture exercises are designed to keep your body more upright and prevent rounded shoulders and forward head/neck.

Arm Exercises

Leg Exercises

Breathing Exercises

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

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

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

Covid-19 has certainly redefined the workplace as many employees continue to work from home. Prolonged hours sitting at a workstation that may not be optimal has also changed the way we define workplace health and safety. It may be more important than ever to pay close attention to designing an ergonomic workstation, changing position, and stretching regularly to prevent injury.

Since 1894 Labor Day has been designated as the national holiday that pays tribute to the contributions and achievements of American workers. Research supports the notion that healthier employees are happier and more productive. When employers encourage healthy behavior and safety at work, they benefit in many ways. For example, in addition to improving job satisfaction and productivity, healthy employees save money by using less sick time, worker’s compensation benefits and health benefits. For example, according to the Centers for Disease Control and Prevention, approximately 75 percent of employers” health care costs are related to chronic medical problems such as obesity, diabetes, high blood pressure, and high cholesterol. Deconditioned, overweight employees are more likely to suffer from these preventable conditions and are at greater risk for injury. Employers, please consider using this holiday as an opportunity to start a health promotion program at your workplace…have a health fair, offer healthy snacks, encourage walking, smoking cessation, exercising at lunch, and offer fitness club stipends.   

Lower back pain, one of the costliest illnesses to employers, is one example of a problem which can be prevented with a good health and safety program. It is widely accepted in the medical community that the best treatment for lower back pain (LBP) is prevention. Keeping fit, (flexible and strong), practicing good posture, and using proper body mechanics are essential in the prevention of LBP. At our clinic, significant time and effort is spent emphasizing the importance of these concepts to our patients, employees, and the businesses we work with through industrial medicine programs. A comprehensive approach can produce significant reductions in LBP injuries through an onsite safety program which promotes education, wellness, body mechanics, lifting techniques, postural and stretching exercises and ergonomics. 

Prevention of Lower Back Pain

When bending to lift an object think about safety:

Visit your doctor regularly and listen to your body.     

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

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

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

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

PART III OF III

This is the third of three columns dedicated to healthcare for college students. Please find these “10 Tips to Keep Yourself Healthy in College” helpful. However, no discussion regarding the health and wellness of college students would be complete and thorough without addressing what health care and university experts consider the two most dangerous behaviors on college campuses across the nation: binge drinking and unprotected sexual activity. While it is not my intent to offend the religious and moral values of any reader, it is my purpose to provoke direct and meaningful conversation between parents, religious leaders and students. To prevent serious health problems in college, parents must share their experience and discuss their values regarding sexual activity and alcohol consumption with children before they leave home to live independently in college. If you are unable to have a direct conversation about these issues, consider doing what several readers have done; mail a copy of this column to your child!

10 Tips to Keep Yourself Healthy in College

  1. Sleep – somehow, despite a busy academic and social schedule, you MUST get enough rest. Lack of sleep may be the single unhealthiest habit of a college student. It can lead to many negative consequences such as lack of concentration, poor emotional stability, and vulnerability to germs and disease. While one may get by on 3-4 hours sleep for short periods of time, eventually, your body will take control and shut down. Do your best to develop a regular sleep pattern and factor in short naps to catch up on needed rest if necessary.
  2. Diet – the “freshman fifteen” is no joke, it is the real thing. Skipping breakfast, “pigging out” on junk food, late night eating, and drinking high calorie soda and beer all factor into weight gain and poor dietary habits. Make time to eat breakfast, snack on yogurt, fruit and nuts. Fill up on a healthy salad. Avoid a constant diet of fried foods and sweets.
  3. Water – even adults forget to drink plenty of water throughout the day. Carry a water bottle and skip the soda.
  4. Get regular check-ups – see your doctor when home on semester break for an annual check-up or more often if needed. Many college health centers offer this service. Many serious problems can be avoided with early detection.
  5. Get a flu shot, vaccines and mask up – remember, college campuses breed germs and most schools offer inexpensive flu shots and Covid vaccines. 
  6. Exercise – make time to exercise regularly (30-45 minutes 3-5 days per week). Walk, run, bike, lift weights, play tennis, racquetball or swim. Colleges have the best facilities for sports and exercise. Just DO SOMETHING! It will help you sleep, relax and feel better.
  7. Relax – make time to relax. Read a book, go for a run, meditate, do yoga, or walk and have good conversation with a friend. Mental health is important on a stressful college campus.
  1. Emotional Health – is a vital component of a healthy person. College life can be very stressful. Depression, anxiety, addiction, eating disorders, and homesickness are some examples of emotional problems common among college students. If you feel emotionally unhealthy, get professional help. All colleges have trained counselors equipped to assist you. 
  2. Drink Sensibly – binge drinking might be one of the most dangerous behaviors on a college campus. Studies show 44% of U.S. College students engage in binge drinking uniformly among freshman through seniors. Of these, 50% binged 3-4 times in a two week period. Binge drinking is defined as 5 drinks in a row for men and 4 for women. Binge drinkers are more likely to be victims of poor academic performance, addiction, trauma, auto accidents, assault, unprotected sex, sexual assault, and death. Some of the most common reasons reported for binging are: to get drunk, status, campus culture, peer pressure, academic stress. TALK TO YOUR CHILDREN!
  1. Safe Sex – promiscuous sex is physically and emotionally unhealthy. Unprotected sex can be LIFE ALTERING! Studies by the Center for Disease Control found that almost 80% of college students 18 to 24 years old had sexual intercourse at least one time during college. 73% reported having unprotected sex and 68% of this group did not believe that they were at risk of contracting a sexually transmitted disease. TALK TO YOUR CHILDREN! GET THE HPV VACCINE!
SOURCES: American Academy of Pediatrics

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

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

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

For all of Dr. Mackarey's articles visit our Health Care Forum!

PART II OF III

This is the second of three columns dedicated to healthcare for college students. As part of the preparation, think about a first aid kit, health care history, and insurance file. For parents without other children at home, once you finish with these preparations and your child departs for college away from home, plan to take dance, art history and conversational Italian classes to occupy your time without children. Resist the temptation to be a helicopter parent…life goes on!

Remember, in living a large community and sharing close quarters makes the development and spread of disease a natural progression. College life can be very unhealthy for many reasons: lack of sleep, poor eating habits, poor hygiene and stress.

10 Symptoms College Students Should Not Ignore

Last week we discussed common illnesses among college students, how to manage and when to seek professional help. Below you will find a list of symptoms that should never be ignored. The college health services department should be contacted if you have any of the following symptoms:

  1. Fever – 102 degrees F or higher
  2. Headache – if accompanied by a stiff neck
  3. Pain with urination
  4. Unusual discharge from penis or vagina
  5. Change in menstrual cycle
  6. Abdominal pain – that will not go away
  7. Persistent cough
  8. Persistent chest pain
  9. Persistent difficulty breathing
  10. Persistent pain or any other symptoms that last longer than you think it should

10 Must-Have Health Care Items For College

Get a small/medium plastic storage box and use it to keep all of the following health care items together in one place.

  1. Health Care Record – keep a copy of the required health care record required by the school in your health box. You may need it for the health services department or for an unexpected visit to the hospital.
  2. Medication List – with names and dosages
  3. Allergy List – with medication used for each allergy. For example, bee sting kit.
  4. Past Medical History List – write down previous surgeries (appendectomy), diseases (Mono) and dates
  5. Special Needs List – for example breathing inhaler for sudden asthma
  6. Mental Health Problem List – problem and dates
  7. Immunization Record – list shots/vaccines you have had and dates. For example, meningococcal disease vaccine.
  8. Health Insurance Card – keep a photo copy of your health insurance card in your wallet and another in this college health care box
  9. Hand Sanitizer
  10. First Aid Kit
    • Bandages to dress wounds
    • Gauze and adhesive tape to dress wounds
    • Elastic bandage to support and compress sprains
    • Antibacterial towel packets
    • Antibacterial/antibiotic ointment
    • Digital thermometer
    • Chemical ice pack/Microwave heating pack for sprains/strains
    • Acetaminophen and ibuprofen for aches/pains/fever
    • Other prescribed medications
    • Vitamins
SOURCES: American Academy of Pediatrics

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”   Next Week: “Health Tips for College Students – Part 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

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: www.mackareyphysicaltherapy.com/forum

It is hard to believe it is that time of year when parents and students are preparing to return to school. Many will leave home for the first time as college freshmen. Over the past month I have received several requests for a copy of my three part series of columns on health tips for college students. In view of this, I thought other parents preparing to send a child off to college this fall might also find this information valuable.

To fully appreciate the importance of this topic, one must keep in mind that living in a large community and sharing close quarters is the first ingredient in the development and spread of disease. College life can be very unhealthy for many reasons. Lack of sleep, poor eating habits and stress add spice to the recipe for disease. Lastly, poor hygiene added to the equation, will really get the Petri dish cooking up some nasty germs.

5 Common Health Problems for College Students

1. Colds, Flu, Covid-19

These are caused by viruses. While both are similar flu symptoms are typically more severe.

Cold Symptoms: coughing, sneezing, watery eyes, mild fevers

Flu Symptoms: high fever (above 102 degrees), body aches, dry cough, upset stomach or vomiting

Covid-19 Symptoms: can appear 2-14 days after exposure and can vary from mild to severe; fever, chills, cough, shortness of breath, fatigue, muscle or body aches, headache, loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, diarrhea

Cold & Flu Treatment: rest, plenty of fluids, and treat symptoms. Consult your physician or college health services for the best medicines to control your symptoms. Caution should be used when taking excessive flu meds containing aspirin because an increase in complications (Reye Syndrome) are associated with the flu in college students.

Covid-19 Treatment: get tested and isolate if positive. Contact the college health services to discuss isolation and treatment protocols. If you have mild to moderate symptoms an antiviral may be recommended. Otherwise, over-the-counter nonsteroidal anti-inflammatory drugs may be adequate with rest and fluids

Prevention: While it is not possible to prevent getting a cold or flu, you can take precautions, such as washing your hands and getting a flu shot. Get full vaccinated for Covid-19. And, depending on school protocols and infection rates, MASK UP!

2. Bacteria Caused Strep Throat, Sinus Infections, Ear Infections

Symptoms: very sore throat, pain in the ears or sinuses, persistent fever

Treatment: These symptoms require a visit to the college health services department. You may need to take antibiotics. If so, take as directed and take all of them or you may have a relapse.

Prevention:  Avoid close contact with infected people – no kissing, sharing drinks or eating utensils. Wash your hands, get plenty of rest.

3. Meningococcal Disease

Meningitis is a common form of this disease that can infect the brain, spinal cord and/or blood

Symptoms: high fever, stiff neck, severe headache, a flat, pink or purple rash, nausea and vomiting, as well as sensitivity to light

Treatment: Immediate medical treatment is required. This disease is serious it can be fatal or cause permanent brain damage.

Prevention:  It is strongly recommended that all teens, especially incoming freshman college students, receive a vaccine to prevent the infection of most, but not all, strains of bacteria that cause this disease.

4. Mononucleosis (Mono)

Mono is caused by a virus and is also known as the “kissing disease.” It is very common among college students.

Symptoms:  fever, sore throat, headache, swollen lymph nodes (glands) in the neck, extreme fatigue.

Treatment: If a sore throat or flu symptoms do not resolve in 7- 10 days, see your doctor for a blood test called the “monospot.” While there is nonspecific treatment, plenty of rest and a healthy diet are essential. Medication to control symptoms can also be used.

Prevention:  Plenty of rest, healthy diet, good hygiene

5. Bruises, Sprains and Strains

These are very common in healthy, active college students and are rarely serious.

Symptoms:  Bruises: a bump or bruise can cause the skin to turn purple, brown or red in color. Strains: are injuries to muscles or tendons from overuse or sudden overstretching. Sprains: are injuries to the ligaments which connect the bones. It can be caused by a twist or fall or awkward sudden movement.

Treatment: RICE: Rest, Ice, Compression, Elevation

If the pain or swelling is not improved in 1-2 days, or if you cannot bear weight on the extremity, visit the college health services dept.

Prevention:  While it is important to be physically active, one must do so intelligently:

SOURCES: American Academy of Pediatrics
Visit your doctor regularly and listen to your body.     
Keep moving, eat healthy foods, and exercise regularly

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”   Next Week: “Health Tips for College Students – Part II”

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

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

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

PREVENTION OF RUNNING INJURIES

It is two months away from the 25th Steamtown Marathon. This column is dedicated to those dedicated runners preparing for the big day, Sunday, October 9, 2022.

Congratulations and thank you to Bill King, founder and race director, and his band of brothers, for their tireless efforts organizing and sustaining a great race that instills pride for all people of NEPA. It has inspired many people, including me, to transfer the discipline and determination required to complete a marathon by overcoming challenges one mile at a time.

Now, a little marathon history: In 490 B.C. Phedippides, ran 25 miles from Marathon to Athens to deliver an important military message and died immediately. Ironically, the first marathon of the modern Olympic Games in 1896 in Athens was won by Spiridon Louis, a humble Greek peasant, who stopped along the way for a glass of wine and told the owner of the tavern that he would win the race. He was determined to pace himself properly, as he knew the dusty, hilly path better than anyone in the field. He was greeted with jubilation and become a hero and legend.

HOW TO PREVENT RUNNING INJURIES

Avoid the “terrible too’s”

Only run miles needed to meet your goals

Avoid inconsistent training

Avoid repeating hard workouts without any easy workouts in between

Consider cross training to avoid overtraining without compromising fitness level

Treat your feet right

Visit your doctor regularly and listen to your body. 

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

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

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

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

It is August and summer is rapidly passing! So, get outdoors and have fun in the sun. However, please be mindful of how your body reacts to high humidity and heat and take appropriate precautions. Athletes are particularly vulnerable this time of year due to daytime practice sessions. (August 8, 2022, first day of acclimatization and August 15, 2022, first day of practice for fall sports according to PIAA), Keep in mind, you don’t have to be running a marathon or playing football in full uniform to suffer from heat stroke.

Heat Stroke

Heat stroke, one of the most serious heat-related illnesses, is the result of long term exposure to the sun to the point which a person cannot sweat enough to lower the body temperature. The elderly and infants are most susceptible and it can be fatal if not managed properly and immediately. Believe it or not, the exact cause of heatstroke is unclear. Prevention is the best treatment because it can strike suddenly and without warning. It can also occur in non athletes at outdoor concerts, outdoor carnivals, or backyard activities.

Hot Temps and Exercise

Some “old school” folks think that wearing extra clothing and “breaking a good sweat” is an optimal goal for exercise. However, it may be potentially very dangerous in hot and humid conditions. When exercising in hot weather, the body is under additional stress.  As the activity and the hot air increases your core temperature your body will to deliver more blood to your skin to cool it down. In doing so, your heart rate is increased and less blood is available for your muscles, which leads to cramping and other more serious problems. In humid conditions, problems are magnified as sweat cannot be evaporated from the skin to assist in cooling the body.

The American Academy of Pediatrics and The American College of Sports Medicine has the following recommendations which are appropriate for both the competitive athlete and weekend warrior:

Signs of Heatstroke:

Treatment of Heatstroke:

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

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

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

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

Part 2 of 2

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

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

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

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

Memory Loss

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

Weight Gain

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

Sexual Performance Challenges

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

Urinary Frequency

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

Boredom

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

Loneliness and Isolation

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

Take Care of Your Health

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

SOURCES: National Institutes of Health; Mayo Clinic, WebMD

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

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

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

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

Part 1 of 2

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

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

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

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

Joint Aches and Pains

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

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

Wrinkles

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

Dry Skin

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

Loss of Muscle Mass and Bone Density

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

Loss of Balance

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

Sleep Problems

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

SOURCES: National Institutes of Health; Mayo Clinic, WebMD

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”   Next Week: Part 2 of 2 on Slowing the Aging Process. This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician.

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

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

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