The number one resolution each year is to lose weight. The internet is flooded with endless recommendations for diet and exercise. While not guaranteed, the recommendations below are safe, simple and easily implemented. And, it is a good way to start your day…give it a try!
Source: WebMD, Mayo Clinic
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.
For all of Dr. Mackarey's articles visit: mackareyphysicaltherapy
Special Feature “ Health & Exercise Forum” with GCSOM: Steven Scheinman, MD, GCSOM President and Dean
Steven Scheinman, MD, Geisinger Commonwealth School of Medicine President and Dean, retired at the end of 2021, leaving behind a legacy that will continue in perpetuity. It is often said that success can be measured by the degree to which one makes the world a better place. By that measure, my friend and mentor, Dr. Steven Scheinman, is a very successful man! His numerous contributions to our community will have a long-lasting positive impact, not only on health and wellness, but also on the spirit and pride of its humble citizens.
Dr. Scheinman has demonstrated many of the attributes associated with great leaders and philosophers; openness, with a curiosity and tolerance for diverse cultural and intellectual experiences; conscientiousness, with a gift for dutifulness, diligence, and orderliness; and extraversion, with a tendency to experience positive emotions and being active and sociable.
In 2010, the Robert Graham Center, a think tank focused on primary care, analyzed the physician shortage in Pennsylvania. The researchers concluded, “Pressures from a growing, aging, increasingly insured population call on Pennsylvania to address current and growing demand for primary care providers to adequately meet health care needs. Policymakers in Pennsylvania should consider strategies to bolster the primary care pipeline . . .”
Northeastern Pennsylvania was certainly not immune to the problem. In fact, our need for increased access to primary care, which includes mental and behavioral health, reached a boiling point in September of 2012 when our community was shocked by a tragic rash of teen suicides.
That same year, Dr. Steve Scheinman arrived in Scranton to assume leadership of what was then The Commonwealth Medical College (TCMC). Our community was justifiably proud of the school…almost singlehandedly and completely single-mindedly, the people of northeastern Pennsylvania built the school without a major hospital or university partner – something no other community has done. Its purpose, of course, was not just to be a point of pride. It was to ensure the health and wellbeing of our entire region.
When Dr. Scheinman took the reins, TCMC intended to re-populate the region’s physician workforce but had few ways beyond admissions policies favorable to local students to incentivize its talented young graduates to remain. Dr. Scheinman took the school’s mission as his own and went to work. He guided our medical school to full accreditation – with six commendations, including one for community engagement. He convened a consortium of mental and behavioral health providers, patients and caregivers and founded the Behavioral Health Initiative (BHI), which has gone on to help found the Autism Collaborative and create opportunities for additional graduate medical education in psychiatry in our region.
Undeniably, however, Dr. Scheinman’s most important achievement was in presiding over TCMC’s integration with Geisinger. Geisinger was the perfect partner for this community’s medical college. Both the school and the system are focused on the health of the people in our region. Both focus on serving community and solving the problems that affect our overall wellbeing. Importantly, integration with Geisinger secured the future of medical education in northeastern Pennsylvania. The crowning achievement, however, of becoming Geisinger Commonwealth School of Medicine (GCSOM) is its turbocharged ability to meet the founding goal of the school – to create a physician pipeline right here in our neighborhoods. Together with leaders from Geisinger, in 2018 Dr. Scheinman announced the launch of the Abigail Geisinger Scholars Program.
Dr. Scheinman tells me that area students have always expressed to him a deep desire to come home – and since 2016 more than 30 have done so -- but financial considerations too often derail these plans. Thanks to the Abigail Geisinger Scholars Program, financial considerations are now an incentive, not an obstacle. And because GCSOM maintains admissions policies that favor local students, a great number of Abigail Geisinger Scholars grew up right here in northeastern Pennsylvania.
The program offers tuition-free medical education to GCSOM students in exchange for a promise to return to our region and work as a Geisinger physician. Today, up to 45 students per class are enrolled in the program and are dedicated to specializing in family medicine, internal medicine, medicine/pediatrics, and psychiatry – all areas of primary care devoted to keeping people healthy and out of the hospital. In 2021, the first five students in the program graduated from GCSOM and are now in residency training. In the coming years, we will see hundreds added to that number with each and every one ultimately “coming home.”
All of this happened under the leadership of Dr. Steve Scheinman, who earlier this year announced his retirement. On Jan. 3, Dr. Julie Byerley will succeed Dr. Scheinman as the third president and dean of Geisinger Commonwealth School of Medicine. As he leaves us to enjoy a well-deserved retirement, I think the entire community owes him a sincere thank you not only for securing the future of our school, but also for helping our community realize the vision of what having our own medical school would mean -- a guaranteed pipeline of excellently trained physicians to care for us. His legacy will be the wonderful young GCSOM graduates practicing in our region. Here are a few who are already doing so:
· Pat Connors, MD, who practices internal medicine with Prime Med in Scranton.
· Rachel Brutico Gianotti, MD, a Geisinger pediatrician, and her husband, Vince Gianotti, MD, an emergency medicine doctor in Wilkes-Barre.
· Matthew Mullen, MD, a Geisinger cardiac surgeon in Scranton.
· Angela DiBileo Kalinowski, MD, a family medicine doctor with Prime Med in Clarks Summit.
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 orthopedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
Read all of Dr. Mackarey's articles at: mackareyphysicaltherapy.com/forum
A routine visit to your primary care physician can be overwhelming. In addition to countless forms about insurance and privacy, endless questions about your medical history can be exhausting. A plethora of questions about your medical history is followed up by the health conditions of your closest relatives. While it may seem intrusive and laborious, the health conditions of your parents, grandparents, siblings, aunts and uncles can help them know what to be on the lookout for with you. For example, if your mother has high blood pressure, they might want to keep a closer eye on yours. Both nature (your genes) and nurture (your family’s lifestyle) can have an effect on your health -- and you get both from your parents.
It is important to disclose any ongoing conditions (like diabetes or asthma) or serious illnesses (like cancer or a stroke) your parents, grandparents, and siblings have or had and how old they were when the health problem started. If any of them have passed away, let your doctor know their cause of death and how old they were when they died. They also may ask about things like your family’s lifestyle or diet, because relatives tend to have these in common.
Just because a close relative had a certain condition or illness, that doesn’t necessarily mean you will have it. However, your chances are slightly higher than other people’s. Some health issues that can be passed down include:
Ethnicity refers to the cultures, customs and lifestyle choices of certain groups more than in the general population. Your doctor may ask about your race because people who have roots in certain parts of the world are more likely to have some conditions. For example, African-Americans have a higher chance of having sickle cell anemia and high blood pressure, Caucasians have a higher incidence of cystic fibrosis and Jewish people from Eastern Europe are more likely to carry the BRCA gene mutation and be born with Tay-Sachs disease.
Many people do not know much about their family medical history for a variety of reasons. If possible, ask your closest relatives about their health and the health of other family members such as; aunts, uncles, or cousins. If you’re lucky someone may have kept a family tree, baby books, or other keepsakes that could be of value. If that doesn’t work, there are other options in an internet age;
The U.S. Surgeon General’s office has an easy way for you to collect this kind of information. It’s called My Family Health Portrait. It helps you make a kind of family medical tree that you can share with relatives and download to take to your doctor.
Information about your relatives can often be found in death certificates or medical records such as age at death, cause of death, and ethnic background. The rules are different for each state, but close family members are often allowed to order copies of these. Obituaries, which are often posted online, may also have some information.
For those who don’t know much about your relatives and don’t have time to research it on your own, there are companies that can help fill out your family tree. Once you know the names of your relatives, you can try to contact them or find obituaries or death certificates.
For some, it may be helpful or necessary to have genetic or DNA testing performed. A conversation with your primary care physician will help make an informed decision.
Not everyone will be able to provide a thorough and comprehensive medical history for their physician. For example, adopted children or those who lost parents at an early age often lack access to a strong family history. Do your best to talk to your doctor about the information you do have or tell them that you don’t know much about your family health history. They can help you sort through it and maybe even tell you where else to look. Even if you’re missing some facts, any information you have can be useful.
SOURCES: WebMD; National Institutes of Health
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: https://mackareyphysicaltherapy.com/forum/
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM
October is National Physical Therapy Month. The American Physical Therapy Association (APTA) would like the nation to recognize the positive role physical therapy plays in your health and wellness. We are passionate about what we do! No, we don’t save lives, but we do save lifestyles and quality of life! PT’s are great people. We have a special gift to provide healthcare unique to our field. For example, while many different health care professionals treat back pain, PT’s are some of the very few working to rehabilitate stroke and head injury victims, amputees, children with cerebral palsy and other serious neurological and orthopedic disorders.
In honor of physical therapy month and the thousands of dedicated physical therapists working hard to keep you healthy and mobile, I would like to share some health and wellness pearls of wisdom.
Remember, we cannot control our gene pool or what happens to our bodies, however, we can control our lifestyles. Research suggests that lifestyle may play the biggest role on how healthy you are and how long you live. The food you eat, what you drink, if you smoke, how active you are and how you handle stress are critical factors that determine your longevity. Research also tells us that smoking, physical inactivity, and poor eating habits are the leading causes of death, in that order.
One, to be truly healthy, one must have a health mind, body and spirit. A healthy mind requires education and intellectual stimulation. The body requires a good diet and physical activity while the spirit thrives on faith and hope. Strive to find balance and address all three elements of health and wellness.
Two, keep it simple. Should I walk, run, swim, or ride? Do I use free weights, barbells, rubber tubing or lifting machines at a gym? The answer is KEEP IT SIMPLE! You don’t need to join an expensive gym with a personal trainer to get in shape. Bands, light dumbbells, walking at the mall, and biking will all get you in shape. It must be convenient and consistent. Physical activity is one of the most important factors in improving a lifestyle in a positive way. But, it does not have to be complicated. A minimum of 30-45 minutes of physical activity, 3-5 days per week will have many positive effects on your body. But, the studies also show that engaging in 10-15 minutes of activity 2-3 times per day, is also valuable to your health…even at work!
Three, be realistic. Expect that exercise will take time to have a noticeable benefit. Don’t get overly ambitious and set yourself up for failure.
Four, be religious. Be religious about exercise and diet but don’t get too compulsive. Studies show if you are too compulsive, you will probably not keep it up for life.
Five, ask a professional. There are a million misconceptions about health and fitness. For example, some people still think you can spot reduce! Ask a professional, (medical doctor, physical therapist, nutritionist, exercise physiologist), if you have a question about beginning a diet or exercise program. If you have health issues or concerns, see your primary care physician first.
Six, there is no secret to a long and healthy life. According to the National Institutes of Health (NIH), while genes play an important role, lifestyle plays the biggest role on how healthy you are and how long you live. The food you eat, what you drink, if you smoke, how active you are and how you handle stress are critical factors that determine your longevity. The NIH research has found that smoking, physical inactivity, and poor eating habits are the leading causes of death, in that order.
Seven, find a fitness mentor or role model. I have the good fortune of meeting many patients over the years that serve as my health & fitness role models. I continue to be inspired by those who overcome their disabilities and injuries through hard work and determination to regain health, wellness and function. Find someone who inspires you!
Eight, find a spiritual mentor or role model. Learn a lesson from “the greatest generation.” The WWII generation rarely complained, worked hard and placed great emphasis on God and responsibility to family. Try to associate with people whose “glass of water is always half full.”
Nine, do the right thing. When it comes to exercise, do the right thing. Get good advice, wear the appropriate clothing and shoes and eat and drink appropriately for the activity. Walk and run in running shoes, eat plenty of whole grains, fruits and vegetables with a good balance of protein and carbohydrates. Drink plenty of water before and during endurance activities. Make proper adjustments for different temperatures.
Ten, have FUN! A healthy lifestyle doesn’t have to be drudgery. There are plenty of good and flavorful healthy food choices. An occasional cheat is good. Also, there are plenty of fun activities and exercise options. Run, walk, swim, bike, hike a canyon, cross-country ski, downhill ski. Use the elliptical, recumbent bike, or stairmaster, recumbent stepper. Alternate routines, cross-train, or play a sport like tennis, golf (walk the course), racquetball or squash. Mix it up. IF YOU WANT TO EXERCISE FOR LIFE - YOU MUST HAVE FUN!
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
For all of Dr. Mackarey's articles visit: https://mackareyphysicaltherapy.com/forum/
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.
There are many reasons why losing weight, the number one health goal, is the most elusive goal of all. Not the least of these reasons is the psychology of eating…because in the land of plenty, we eat mindlessly! Consider the facts; First, we thought the food was bad…but when we chemically modify the food such as removing or altering the fat or sugar and removing the calories, it failed to reduce our weight. In fact, it has been discovered that “fake sugar,” even thought it does not have calories, can still increase blood glucose levels. Next, we decided fat cells were the enemy but we failed to control our weight when we removed fat cells from our body through liposuction. Then, we decided the problem was our digestive system so we placed bands or staples in the stomach or by-passed the small intestine. While these efforts helped many in the short run, long term, without a change in behavior, it failed as a long-term solution. Many medical professionals have concluded that the problems people have with weight are not exclusively due to the food, fat cells, stomach or intestines, but rather, THE MIND!
Mindful eating, also referred to as intuitive eating, is based on Buddhist teachings in which focus is placed on the experience of eating, AND ENJOYING, our food. The concept was presented in a feature column in The New York Times written by Jeff Gordinier based on his time spent in a Buddhist monastery. He discovered that mindful eating practitioners ate in silence and chew small pieces of food very slowly and deliberately to experience its taste, texture and smell. It requires full attention to the experience of eating and drinking on the body and mind. It is often referred to as “the opposite of diets” because with mindful eating there is not right or wrong way to eat but rather varying degrees of awareness about WHAT WE EAT AND WHY. Furthermore, the goal of this exercise is to teach our mind and body to connect and communicate while eating so one can learn important cues such as: what are my hunger signals? What does my stomach feel like when it is half, three-fourths and completely full?
One study of 1,400 mindful eaters found that they enjoyed lower body weights, greater sense of well-being and suffered from fewer eating disorders. However, many feel the concept, while valuable, is very difficult to put in practice in the busy American family. Research shows that, even when not perfectly relaxed, the simple act of the family meal can have a powerful impact on mindfulness, health and wellness.
In a country that thrives on a fast pace with over-book schedules, families struggle to balance work and school and after school sports and activities. Consequently, fast food, eat-and-go habits have become the norm. According to some studies, most find it difficult find time to sit and relax for a family meal even once a week. Additionally, when families do pull off a family meal, it is often overwrought with school drama, sibling rivalry, and parental discipline about school, homework or social activities, making the situation stressful. Despite the family conflict, studies strongly support the health values of the family meal.
A recent study from Columbia University that received national attention found that children who participated in a family meal regularly were less likely to have problems with drugs or alcohol and more likely to excel in school. Moreover, those children eating with their families at least 5 times per week benefited most. Other studies have found that the there is a significantly lower incidence of teens who smoke, use alcohol, have sex at a young age, fight, get suspended from school or commit suicide among those who have meals with their family on a regular basis.
| Mindless Eating | Mindful Eating |
| 1. Eating past full and ignoring body signals | 1. Listening to your body and stopping when full |
| 2. Eating when emotions tell us to eat | 2. Eating when our bodies tell us eat |
| 3. Eating alone, at random times and places | 3. Eating with others, set times and places |
| 4. Eating emotionally comfort foods | 4. Eating nutritious and healthy foods |
| 5. Eating and multitasking | 5. When eating, just eat |
| 6. Considering a meal an end product | 6. Considering where food comes from |
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Read all of Dr. Mackarey's Articles at: https://mackareyphysicaltherapy.com/forum/
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.
After a long, cold and snowy winter, complicated by COVID 19, we look to spring as a time of renewal. It is a time for great hope and optimism; trees are budding, flowers blooming and more people are doing their civic duty and receiving vaccinations…all contributing to a sense of promise for a fresh start!
Spring can also be a time of personal renewal…a time to reestablish goals for health and wellness. However, to be completely healthy, one must have a healthy mind, body and spirit. A healthy mind requires intellectual stimulation, a healthy body requires eating well and engaging in physical activity and a healthy spirit, requires faith, hope and prayer and meditation. This spring, consider the following tips to promote a healthy mind, body and spirit throughout the year.
Begin your meal with healthy vegetables and salads will fill you up and reduce the temptation to over-indulge in high-fat, high-calorie foods. Drinking plenty of water throughout the day is also very important for good health.
Physical activity is one of the most important factors in improving a lifestyle in a positive way. But, it does not have to be complicated. A minimum of 30 minutes of physical activity, 3-5 days per week will have many positive effects on your body.
One cannot be completely healthy without a healthy mind. Like your body, you must continue to challenge your mind in order for it to remain strong, learn, expand, and grow. Read a good book, do crossword puzzles or try something new...piano lessons! Emulate my mentor, Dr. Gino Mori, who has been taking classes (and takes the exams) in art, science and history since his retirement more than 20 years ago!
Prayer, meditation, or chanting has been known to reduce your heart rate, blood pressure and stress level. These activities can lead to a sense of peace, serenity, joy, and faith. Remember, those who are spiritual and faithful live longer.
Those who love themselves are more likely to take care of their bodies. People who are not comfortable in their own skin are never satisfied with their appearance and often attempt to change their body. For example, men use steroids to appear “bigger and better” or women have cosmetic surgery to appear “younger and better.” It is impossible to love others if you don’t love yourself. You must learn to accept and embrace change in your body and life in order to have a healthy mind, body and spirit.
Get the appropriate amount of uninterrupted sleep. A good sleep promotes healing and refueling for your body. When needed, sit, rest, or take a short nap to recharge.
Countless hours are wasted on feelings of anxiety, regret or worry about a past or upcoming event. This can be a waste of precious life time and adds stress to the body, which makes you more susceptible to disease. Stay focused on the beauty of the present moment!
When you associate with healthy people, you take on their healthy habits. You will drink less, eat healthier and exercise more if you are hanging around with those who engage in these habits...they will have a positive influence on you! Bob Knowles, local insurance broker, is my health and wellness role model. He has tremendous discipline; exercises every morning before work, eats and drinks in moderation and makes time to reflect for self-improvement.
The camaraderie of good friends is essential for a healthy mind, body and spirit. Make it a priority to associate with people who “celebrate life!” The health benefits from these positive-minded, healthy people who appreciate you for who you are will provide you with the support, love, and respect necessary to survive any challenge. Find people who know how they celebrate life! My role model for optimism is Steven Scheinman, MD, President and Dean of Geisinger Commonwealth School of Medicine. He demonstrates a keen instinct to find good in others and maintain a positive and optimistic attitude in challenging situations.
Studies show that laughter has health benefits and assist the body in healing. Laughter is contagious, so hanging around with people who are fun and funny, will bring fun and laughter into your life. Try to look for humor in every situation and keep laughing. Spend more time with people that spread joy and laughter. Silly sisters, Rosemary Quinn Malloy, Melissa Quinn LeStrange and Rebecca Quinn Walsh bring a smile to my face whenever I see them or hear their names!
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
See all of Dr. Mackarey's articles at: https://mackareyphysicaltherapy.com/forum/
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
American Heart Month is not just for lovers. Long after the Valentine’s roses wilt, our hearts will require special attention for a long healthy life. It is the goal of The National Heart, Lung, and Blood Institute to motivate Americans to adopt healthy lifestyles to prevent heart disease. And, in 2021, a healthy heart may be more important than ever to reduce the risk of severe illness from COVID-19.
A recent study by the Center for Disease Control (CDC) found that while many Americans believe that they are “young at heart”, it turns out that many have hearts older than their actual age. For example, the study found that the average American male heart is eight years older and the average American female heart is five years older than their chronological age.
The CDC’s findings may offer some explanation for the fact that many Americans die from heart attacks, strokes, and heart failure when compared to other people around the globe. Furthermore, while more Americans use heart medications more than other people in the world, heart attack and stroke continue to be the leading cause of death in the US, killing more than 80,000 each year.
The CDC has developed a new test to determine “Heart Age,” which has been found to be a much more reliable indicator of a person’s risk for heart disease. The heart age test will determine if your heart is older, younger or average for your age, which can be much more important for longevity than chronological age.
The CDC is encouraging people to take matters into their own hands …be proactive. In addition to calculating your Body Mass Index ((BMI), the CDC is asking people to use an online calculator to determine their heart age. The calculator will give a person a more accurate percentage of risk for heart attack or stroke. Based on the outcome, one must see their family physician or cardiologist to discuss the results and implement a plan.
Heart Age is very easy to use: You just need to enter your age, sex, blood pressure, whether you are treated for high blood pressure, whether you smoke or have diabetes, and your body mass index (BMI), with a handy calculator if you don’t know it. The tool gives you your risk for heart disease in the next ten years, compared with normal.
Visit: www.framinghamheartstudy.org
Enter: sex, blood pressure, (list if controlled), diabetes (list if controlled), smoking history, and body mass index (BMI), a simple height/weight calculation found on-line at www.bmicalculator.cc
Example: A 53 year old women with an acceptable BMI, may actually find that she is at great risk for suffering a heart attack or stroke because she smokes cigarettes and has uncontrolled high blood pressure. The calculator includes all the significant factors proven by science to affect a person’s risk of heart attack or stroke. These include: blood pressure, weight, BMI, blood sugar, cholesterol, age, sex and smoking history.
Example: 50 year old male smoker has uncontrolled high blood pressure of 140/96, no history of diabetes, and a BMI of 30 has a predicted heart age of 72 years. A female with a similar profile would have a heart age of 74 years.
The Solution
To some, the solution may be obvious and for others it may be impossible. In the previous example of the 50 year old smoker, if he quit smoking for one year, he would halve reduced his heart age by 14 years (15 years for a woman). If he would reduce his blood pressure to 120, he would reduce his heart age by 6 years (10 years for a woman). And, if both risk factors were removed, he would reduce his heart age by 19 years (23 for a woman).
In the above examples, the 53 year old man does not have to take his 72 year old heart age as a death sentence.
What Individuals can do…
Require health plans to cover, with limited co pays or deductibles, preventative services such as blood pressure screening nutritional counseling, prescription exercise and tobacco cessation products.
Promote health, wellness through diet and exercise by sponsoring health fairs and establishing bike lanes and walking trails in the community.
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
See all of Dr. Mackarey's content at: https://mackareyphysicaltherapy.com/forum/
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
Part I of II
Difficulty sleeping during the COVID-19 quarantine has become a common problem and can be manifested in a variety of ways; insomnia, fragmented sleep and nightmares. National prescription providers have reported a 21% increase in anti-insomnia, anti-anxiety and antidepressant medications since March of 2020. The next two weeks in Health & Exercise Forum” will be dedicated to sleep wellness.
We do it every night, hopefully. Children are doing it. Our grandparents are doing it. Teenagers do it all the time. We sleep of course. These hours in which we slumber are vital to our ability to function during the day and to our health overall. It does not appear evolutionarily advantageous for us to be unconscious for extended periods of time. Modern science tells us that much of our body’s restoration, strengthening, and processing occurs while we sleep. Our brains consolidate the information they have learned throughout the day and enhance our memory. Additionally, sleep restores sugar storage in our brains and improves the functioning of our immune system. But science does not illuminate why we need such a prolonged period other than the fact that we just seem to get sleepy after a long day.
Sleep is crucial to us as a species, but it is not always easily attained. For many individuals across the globe, this author included, sleeping properly can be a challenge. The trial and tribulations of the human experience can lead to restless nights and early morning risings without adequate sleep. But what is considered “adequate” sleep? The answer depends on your age. As we grow older, our sleeping requirements change drastically from infancy to elderdom. Infants are learning and processing so much information of this new world they now inhabit. Thus, their brains need enough time to analyze and consolidate the data, necessitating 12 to 15 hours of sleep. As we advance into adulthood, our sleep requirements drop to approximately 7 to 9 hours with some variability from person to person. Good indications of a restful night’s sleep include waking up feeling refreshed, functioning with enough energy for your daily tasks, and having continuous sleep- meaning there are not extended periods of time of wakefulness when we are supposed to be sleeping.
This seems easy enough to say, but significantly more difficult to do. Current reports demonstrate that roughly 100 million people suffer from insomnia at some point each year, with 25% progressing to long-term chronic sleep insufficiency. Insomnia is described as difficulty falling asleep or staying asleep for three nights per week for at least two consecutive weeks in a three-month period. There are a lot of unhealthy sleeping habits permeating the country. We measure the quality of sleep in two different dimensions duration (quantity) and depth (quality). The duration is straightforward enough. Do you sleep for the recommended 7 to 9 hours per night? The quality is a little more difficult to quantitate. Some individuals may sleep for the proper duration of time, but the depth is not adequate. Sleep quality is determined by the number of arousals or awakenings in a given night. As few as 5 arousals in a night can result in daytime sleepiness and performance deficits. In addition, how long we remain in certain phases of sleep also determines the quality of our sleep. There are four stages of sleep: N1, N2, N3, and REM with N3 being the most restful of the stages. When we fall asleep, we go through a predictable descent into sleep. We repeat the cycle of N1 to N2 to N3 to REM sleep every 60 to 90 minutes. The more time we remain in the restful stages, N3 and REM, the better our sleep is. As we age, we inevitably spend less and less time in restful sleep.
There are many factors that influence how we sleep. Everything from what we drink to the type of curtains we have can impact those crucial hours of sleep. Some of the more common culprits that disrupt our sleep are:
For More Informations:
-http://healthysleep.med.harvard.edu/healthy/
-https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2110998
-https://www.sciencedirect.com/topics/medicine-and-dentistry/insomnia
Read Dr. Mackarey’s Health & Exercise Forum – every Monday. Next Week Read, Sleep and Wellness 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 Geisinger Commonwealth School of Medicine.
Read all of Dr. Mackarey's articles in our health and exercise forum: https://mackareyphysicaltherapy.com/forum/
Guest Columnist: Timothy Farrell, MD3
Tim Farrell is a third year medical student at Geisinger Commonwealth School of Medicine. Originally from Clarks Summit, Pennsylvania, Tim received his bachelor’s degree from Loyola University Maryland in Baltimore, MD. Currently a 2nd Lieutenant in the US Army, he enjoys listening to music, running, and spending time with his two dogs. He volunteers with the Cody Barrasse Foundation in the Organ Transplant Assistance Program, where he helps patients receive grant funding as they await their transplant surgery. He hopes to pursue a career in General Surgery.
