This column is repeated every year at this time with the intent of raising the level of awareness to prevent death or serious illness from heat stroke in athletes and other active people in hot, humid weather.

It is the end of July and we have managed to survive two “heat waves” in NEPA. While it is important to have fun in the sun, 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 5 & 6, 2024, first day of acclimatization and August 12, 2024, first day of practice for fall sports according to PIAA). Visit www.piaa.org for more information. 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, 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:

• Heat Exhaustion – can be a precursor to heat stroke
• Signs: cramps, weakness, fatigue, nausa
• Treatment: rest in shade, cool down with cool (not cold) towels, and drink plenty of fluids.
• Core Body Temperature above 105 degrees Fahrenheit
• Hot, dry skin – flushed but not sweaty
• Lack of sweating *
  • *NOTE: athletes often have external heatstroke and they can sweat even with an increase core temperature
• Very rapid pulse
• Mental confusion, disorientation or hallucinations
• Physical clumsiness, sluggishness or fatigue
• Seizure
• Dizziness

Treatment of Heatstroke:

• CALL 911 – Remember this may be life-threatening
• Relocate  – to a cool shady place or air-conditioned indoors and lie down with slight elevation of feet
• Undress – Remove outer garments and roll onto side to expose as much skin as possible to the air
• Cool Down – spray or sponge with cool water (not cold) and fan the skin
• Ice – place ice packs to the groin, neck and armpits to cool down large blood vessels. No ice bath.
• Core Temperature – is the only accurate measurement so medical personnel may take rectal temp if necessary. Must get core temp to 102 degrees Fahrenheit ASAP.
• Begin CPR – if breathing stops
• No Aspirin or Acetaminophen – to decrease temp
• Administer Fluids – if person is alert enough to swallow give 32 to 64 oz over 1-2 hours

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 orthopaedic 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 27^th Steamtown Marathon is three months away and, despite the warm weather, many local runners are deep into training. With serious heat waves of summer, any prolonged endurance activity in minimal to moderate heat can be dangerous if not prepared. Adequate hydration is critically important, not only to those training for a marathon but also for other outdoor endurance activities such as cycling, hiking, long distance power walking, etc

Next to oxygen, water is the nutrient most needed for life. A person can live without food for a month, but most can survive only three to four days without water. Even though proper hydration is essential for health, water gets overlooked as one of the six basic nutrients. Dehydration occurs when the amount of water taken into the body is less than the amount that is being lost. Dehydration can happen very rapidly (i.e. in less than eight hours); the consequences can be life threatening and the symptoms can be alarmingly swift.

In the body, water is needed to regulate body temperature, carry nutrients, remove toxins and waste materials, and provide the medium in which all cellular chemical reactions take place. Fluid balance is vital for body functions. A significant decrease in the total amount of body fluids leads to dehydration. Fluids can be lost through the urine, skin, or lungs. Along with fluids, essential electrolytes, such as sodium and potassium, are also perilously depleted in a dehydrated individual.

The risk of dehydration is not limited to endurance athletes and outdoor enthusiasts. Dehydration is the most common fluid and electrolyte disorder of frail elders, both in long term care facilities and in the community! Elders aged 85 to 99 years are six times more likely to be hospitalized for dehydration than those aged 65 to 69 years.

Is water adequate to prevent dehydration? Will a sports drink improve my performance? While some answers to these questions apply generally to all, others vary according to the temperature, humidity, length of time and intensity of the activity and condition of the athlete. 

Proper hydration is essential for the comfort and safety of the recreational and serious athlete. Hydration is critical to maintain cardiovascular function, body temperature and muscle performance. As temperature, humidity, intensity, and duration of exercise increase, so too does the importance of proper hydration. Excessive sweating can lead to a loss of blood volume which requires the heart to work much harder to circulate you blood through your body.

Dehydration is a major cause of fatigue, loss of coordination, and muscle cramping leading to poor performance. Prehydration, (drinking before exercise) is the first step in preventing dehydration. Marathon runners, other long-distance runners, and cyclists often prehydrate1-2 days before a big event. Rehydration, (drinking during or after exercise) is the second step in preventing dehydration. While athletes may be more vulnerable to dehydration, all persons engaging in exercise would benefit from increased performance, delayed muscle fatigue and pain by maintaining adequate hydration. Proper prehydration would include drinking 12-16 ounces of water 1-2 hours before exercise.  Athletes with other health issues should consult their family physician before engaging in long distance endurance sports.

American College of Sports Medicine Hydration Recommendations:

• Eat foods high in carbohydrates and low in fat. Drink plenty of fluids between exercise sessions. The best fluids are plain water or fluids without sugar, caffeine or alcohol.
• Drink 17 oz or 2+ cups of fluid 2 hours before exercise
• Drink every 15 minutes during exercise.
• Keep drinks cooler than the air temperature. Drinks should be readily available.
• If you exercise more than 60 minutes, you may benefit from a sports drink containing a carbohydrate. The carbohydrate drink should not exceed 8% solution
• If you exercise more than 60 minutes, take 30-60 grams of carbohydrate per hour to delay fatigue and fuel muscle contractions.
• If you exercise more than 60 minutes, include (.5-.7 g per gallon) sodium in your drink of choice. This will also encourage additional drinking.
• Drink 24 ounces of water for every 2 pounds you lose after your workout. This is based on pre and post exercise weight.
• If you exercise more than 90 minutes, sports drinks may be helpful. 60 to 100 calories per 8 ounces of drink will help supply the needed calories for performance.
• Avoid caffeine. While the energy is good, it acts as a diuretic to rid the body of fluid. This is counterproductive for the high-level athlete.

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 orthopaedic 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!

JUNE IS GREAT OUTDOORS MONTH! AS WE KICK OFF SUMMER AND CELEBRATE THE FOUR OF JULY, MAKE TIME TO GET THE HECK OUTSIDE! Research shows that spending time outdoors has many positive effects on your health. While there are many year-round activity options, in Northeastern Pennsylvania our short-lived summer is the inspiration to “suck the marrow out of a sunny day!”  Summer in NEPA is enjoyed in many ways such as walking, running, hiking, biking, horseback riding, boating, kayaking, and swimming. Studies show that even less vigorous activities such as fishing, picnicking camping, barbequing, or reading a good book on the porch are healthier than being indoors.

It is reported that Americans spend 90% of their lives indoors and that number increases with age. Worse yet, for some, venturing outdoors is considered risky behavior with fear of the sun, ticks, wind, mosquitoes, and other creatures of God. Well, the truth of the matter is the risk of being one with nature is far less than the ill effects of a life stuck indoors. Please consider the following benefits of spending time outdoors.

Benefits of being Outdoors:

• Nature’s Vitamin D – Current research suggests that Vitamin D (The Sunshine Vitamin), may offer significant disease prevention and healing powers for osteoporosis, some forms of cancer and heart disease. Of all the methods of getting an adequate amount of Vitamin D, none is more fun than spending time outdoors in the sunlight. It seems that the health concerns of ultraviolet light, sun burn, and skin cancer have created an overreaction to the point of Vitamin D deficiency in many. Balance and common sense go a long way. One can attain normal levels of Vitamin D by being outdoors in the sun and exposing their arms and legs for 10 -15 minutes a few times per week. Additional time in the sun warrants sunscreen and Vitamin D supplements can be used if necessary.

• Increase Activity Level – While exercising indoors in a gym is valuable, research shows that time spent indoors is associated with being sedentary and being sedentary is associated with obesity, especially in children. Some studies show that children in the United States spend an average of 6 ½ hours per day with electronic devices such as computers, video games and television. It is also reported that a child’s activity level more than doubles when they are outdoors. So, get out of the office, house, and gym as often as possible. Consider weight training at the gym and doing cardio by walking, biking, or running outdoors.    

• Improved Mental Health – It is well documented that light affects mood. So, unless you live in a glass house or a light box, getting outdoors is important to your mental health. Furthermore, studies show that exercising outdoors in the presence of nature, even for as little as 5- 10 minutes has additional mental health benefits. For those less active, read or listen to music in a hammock or lying in the grass.

• Improved Concentration – Richard Louv, author of the book, “Last Child in the Woods,” coined the term, nature-deficit disorder.” This term is supported by research that found children with ADHD focus better when outdoors. Furthermore, it was discovered that these children scored higher on concentration tests following a walk in the park than they did after a walk in their residential neighborhoods or downtown areas, showing the benefit of the “green outdoors.”

• Improved Health and Healing – Researchers at the University of Pittsburgh found that patients recovering from surgery recovered faster with less pain and shorter hospital stays when they were exposed to natural light. Next time you’re recovering from an illness, discuss this with your physician.

• Improved Breathing – In general, breathing fresh air is good for you. Some exceptions might be those with severe allergy problems when the pollen count is high. Despite this, it may be better to take allergy medicine and enjoy the benefits of being outdoors than to be stuck inside. Many pulmonologists believe people with pulmonary problems would benefit from outdoor activities such as a 10–15-minute walk because they are prone to osteoporosis and Vitamin D deficiency.  Local pulmonologist, Dr. Gregory Cali, DO, agrees, and also adds that studies do not show that high humidity is dangerous for respiratory patients, but it may be uncomfortable. In cold temperatures, those with pulmonary problems must avoid directly breathing cold air by covering up their mouths when walking outdoors. Overall, the benefits far outweigh the risks.

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 orthopaedic 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!

Spring is here! So, too, is allergy season and spring sports! It seems this every year at this time a young little league baseball player wheezes as they cross home plate and desperately tries to catch their breath. Players, coaches, umpires, parents watch in dismay, deciding whether they need to call an ambulance. Minutes later the player recovers from this scary situation…until the next time. Could this be an example of exercised-induced asthma (EIA)?

What is EIA?

Dr. Gregory Cali, a local pulmonologist, (lung doctor) was gracious enough to participate in an interview about this problem…exercise-induced asthma (EIA). The topic was chosen in response to an email question from a concerned mother of an athlete with asthma.  Dr. Cali informed me that the first thing to know about exercise induced asthma (EIA) is that EIA is not a distinct disease in itself-but is one manifestation or presentation of asthma. Putting it simply, EIA occurs in patients who have develop narrowing of the bronchial tubes ( bronchoconstriction) when they exercise.  Some experts would rather we use the phrase exercise induced bronchoconstriction which is what happens when someone has an asthma attack.  This bronchoconstriction occurs because of spasm of the tiny muscles of the airways, plugging of the airways with thick mucous, and swelling or edema of the cells lining the airways. 

In fact, it is inflammation of the airways, mostly due to allergies, that is at the root of most cases of asthma. This inflammation causes the bronchial tubes to become over-reactive-and predisposed to narrowing- when exposed to certain triggers.  Exercise is one of those triggers in susceptible people. The patient with EIA complains of chest tightness, wheezing, and shortness of breath when exercising.  Some patients only experience coughing with exercise.  Symptoms are usually worse in cold, dry air. This is believed to be due to the drying and cooling of the airways, which occurs with exercise, especially if the patient opens his or her mouth while exercising.  Nasal breathing is much better at warming and humidifying air and may help to reduce EIA.  

Diagnosing EIA

Dr. Cali feels that the most important point about EIA is to make sure a specific diagnosis is made.  It is difficult at times to differentiate asthma from the normal breathlessness, which occurs with exercise.  The feature of EIA that distinguishes it from normal breathing, or being "out of shape" is the fact that EIA is ALWAYS associated with a decrease in airflow.  This can be measured with either a peak flow meter or a spirometer.  It is also important that a specific diagnosis be made so that a person will not be labeled as asthmatic when they may be "normal" or have other conditions such as heart problems or anemia. 

Dr. Cali also recommends before a person is labeled asthmatic, they have spirometric testing.  An improvement in airflow after inhaling. A bronchodilator is an important indicator of asthma.  Sometimes a bronchial challenge test is needed to diagnose asthma.  In this test, the subject breathes in a known bronchoconstrictor in small quantities and the response is noted.  Patients with asthma almost always respond to the inhaled agent by a reduction in airflow. 

PREVENTION AND MANAGEMENT OF EIA

Inform Coaches – If coaches are made aware, than they can be prepared for the onset of EIA. Provide emergency contacts and medications with instructions, such as inhalers, should be available.

Warm and Moisten Air - Whatever the patient can do to warm and moisten the inhaled air can help prevent EIA.  Nose breathing during exercise or wearing a loose covering over the mouth in cold weather may help.  Sometimes, in severe cases, switching to an indoor sport like swimming may be necessary.

Start Out Slowly - It is important to start out slowly and warm up first before exercising at full tilt. Slowly jog around the track or field before practice or a game to prepare your lungs for full-speed.

Medications – are often necessary.  Quick- acting bronchodilators like Albuterol, used 15-20 minutes before planned exercise, is recommended.  This can be repeated once more during the exercise, but if tightness or wheezing occurs, the exercise should be stopped. Many patients with asthma require preventative treatment with anti-inflammatory medications.  Inhaled steroids and/or leukotriene inhibitors may have to be added if the asthma is not controlled with Albuterol alone.  In fact, some patients with asthma who are overly reliant on quick acting bronchodilator medications can get into serious trouble if they do not use inhaled steroids. Be sure to communicate your needs with your coaches.

Play Smart - In conclusion, people with asthma should not shy away from exercise.  With proper precautions, people with asthma should be able to participate in all kinds of sports activities: baseball, football, soccer, swimming, tennis and running (even a marathon)! The key point is that the asthma needs to be under control and monitored by the patient, parents, coaches and doctor as a team. 

Visit your doctor regularly and listen to your body.     

Medical Contributor: Gregory Cali, DO, pulmonary specialist, Dunmore, PA

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 orthopaedic 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!

This column is repeated every year at this time with the intent of raising the level of awareness to prevent death or serious illness from heat stroke in athletes and other active people in hot, humid weather.

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 7, 2023, first day of acclimatization and August 14, 2023, first day of practice for fall sports according to PIAA). Visit www.piaa.org for more information. 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, 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 heat stroke 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:

Treatment of Heat Stroke:

• Heat Exhaustion – can be a precursor to heat stroke
  • Signs: cramps, weakness, fatigue, nausea
  • Treatment: rest in shade, cool down with cool (not cold) towels, and drink plenty of fluids.
• Core Body Temperature above 105 degrees Fahrenheit
• Hot, dry skin – flushed but not sweaty
• Lack of sweating *
  • *NOTE: athletes often have external heat stroke and they can sweat even with an increase core temperature
• Very rapid pulse
• Mental confusion, disorientation or hallucinations
• Physical clumsiness, sluggishness or fatigue
• Seizure
• Dizziness

Treatment of Heat Stroke:

• CALL 911 – Remember this may be life-threatening
• Relocate  – to a cool shady place or air-conditioned indoors and lie down with slight elevation of feet
• Undress – Remove outer garments and roll onto side to expose as much skin as possible to the air
• Cool Down – spray or sponge with cool water (not cold) and fan the skin
• Ice – place ice packs to the groin, neck and armpits to cool down large blood vessels. No ice bath.
• Core Temperature – is the only accurate measurement so medical personnel may take rectal temp if necessary. Must get core temp to 102 degrees Fahrenheit ASAP.
• Begin CPR – if breathing stops
• No Aspirin or Acetaminophen – to decrease temp
• Administer Fluids – if person is alert enough to swallow give 32 to 64 oz over 1-2 hours

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 in downtown Scranton and is an associate professor of clinical medicine Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, check out our exercise forum!

STAY ACTIVE & HAVE FUN IN THE SUN!

Can you believe that the 4^th of July holiday was more than one month ago? Do not despair! There is still plenty of time to be outdoors in NEPA and experience so many activities such as: biking, hiking, running, walking, swimming, boating, golfing, and playing tennis to name a few. Late summer and early fall tend to be beautiful and is also a wonderful opportunity to discover your inner child, mix it up and try something new! Below are some new and exciting ways to stay active and have fun in the sun:

Spending time on any of the beautiful lakes in NEPA is time well spent. From an exercise standpoint, rowing, canoeing and kayaking offer a very special experience. Most kayaks are light weight, easy to use and maneuverable on a lake. Sitting low on the water offers a unique perspective as you feel yourself gliding across the lake. The Countryside Conservancy, in partnership with Lackawanna State Park, sponsors moonlight kayak events on the lake at the park. With a bright full moon, you can begin at 8 pm and return at 10 pm. Bring bug spray and headlights to enjoy the sunset and moon rise on the lake. You will feel like a kid breaking the rules of the park by being on the water after dark!

NOTE: Try kayaking in the daytime first and then advance to sunset trips before staying on the water for the moonlight. Rentals are available at the park.

Gear:

• Clothing – a DryTec type material for shirt and pants…bring along a light long sleeve in case the wind picks up or the bugs are out.
• Shoes – Aqua shoes are best…old sneakers will work
• Water – handheld water bottle or a water proof bag for money, keys, ID, and a granola bar.
• Insect Repellent - a must
• Headlamp – to see and be seen on the water and packing up.
• Change of Clothes – towel and change of clothes in your car…just in case

Website: www.countrysideconservancy.org; www.dcnr.state.pa.us/stateparks.org  

Stand up paddle boarding (SUP) is becoming a fast-growing sport among water enthusiasts. It is a fun way to exercise your core, improve balance, and tone your upper body. It requires minimal equipment; a board that is essentially a long and wide surfboard and a long paddle to use while standing on the board. It can be done in the ocean surf, bay, lakes, or rivers; however, beginners would be wise to stay in calm water. Rentals are available at most beaches.

Check out the video for more information: REI paddleboard basics

Elliptical Peddle Boarding

What is it? Imagine a standup paddle board with a handlebar and pedals like a exercise stepper machine. Instead of using a paddle, you step up and down on the pedals and fins under the board propel you through the water.  Check it out…Hobie Mirage Eclipse Stand Up Peddle Board; Dick’s Sporting Goods

Aqua Zumba

Zumba is a very popular form of dance aerobics spiced up with Latin music. When adding water and sun to this already cool activity, you are assured to have fun while exercising. As with any aquatic exercise, the added resistance from the water gives arm rows and leg kicks more challenge. Female participants report an additional benefit; they are uninhibited to “shake that thing” to the music under the cover of the water. So, beat the heat, let loose and get some fun in the sun while you exercise.

NOTE: Consider trying regular Zumba first to get the hang of it. Amy Sekol is a local certified Zumba instructor and also offers Aqua Zumba. (amys.zumba.com)

Website: www.zumba.com

Elliptical Biking

I love this idea…why didn’t I think of it first! In the gym I enjoy the elliptical machine because it simulates running without the impact on my joints but of course, I would rather be outdoors. Well, this is the answer to my prayers…an elliptical machine that is attached to a bike with handle bars and brakes included. I think it will probably be difficult on steep hills but it is something I MUST TRY!

Website: www.elliptigo.com;  www.mywingflyer.com

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, check out our exercise forum!

 

It is time to celebrate the 4^TH of July with some fun in the sun…but don’t forget to protect your skin! A little awareness and some precautions can go a long way to make this holiday weekend safer!

Despite the fact that we have limited exposure to sunny days in NEPA (50%), skin cancer still exists in large numbers. Skin cancer is the most common cause of cancer in the United States. While there are several types of skin cancer and not necessarily all are deadly, procedures to remove these skin cancers are both costly and frequently result in unsightly scars. The most dangerous type of skin cancer, called melanoma, results in an estimated 10,000 deaths per year. The good news? Nearly all skin cancers are preventable!

UV rays and Skin Cancer

The majority of skin cancers are caused by harmful ultraviolet (UV) rays from the sun. Two major types are UVA and UVB:

• UVA rays account for the majority of UV rays in sunlight (about 95%) and penetrate deep into the skin causing continual damage throughout our lives – a process called ‘photo-aging’ that results in wrinkles, sunspots, and uneven texture. UVA can also damage skin at a microscopic level, which may contribute to the development of skin cancers.
• UVB rays, while they do not penetrate as deeply, are what cause sunburns when we spend too much time under the sun. UVB rays are primarily responsible for the development of skin cancers.

Aging

In the field of anti-aging, advertisers make lofty promises for many products that claim to contain or boost collagen. Whether or not these work is a whole other discussion, but what is collagen and what does it have to do with wrinkles?

Collagen is the most abundant protein in the human body. It is found in nearly all tissues and organs, and plays a crucial role in maintaining structural integrity. Unfortunately, collagen production naturally decreases with age. This causes many of the findings we associate with older age, such as sagging skin and wrinkles, as well as joint pain. Collagen also works together with another important protein called elastin, which helps to maintain elasticity – a feature commonly associated with youthful skin.

When exposed to UV rays, these proteins can become damaged. For instance, studies have shown that skin exposed to UV rays increases the expression of proteins called matrix metalloproteinases, or MMPs. You can think of these MMPs as collagen’s enemy, as they cause their degradation. This results in a decrease in collagen’s structural function leading to loose and wrinkled skin. UV rays can also stimulate the production of reactive oxygen species. These are substances such as hydrogen peroxide and bleach, which further cause destruction of skin’s microscopic structure.

Sunscreen Tips & Tricks

So, you’re convinced and have decided to keep your skin healthy and youthful – what next? With so many different products on the market, choosing a daily sunscreen can become a difficult task. Here are a few pointers:

• Look for the words “broad spectrum” or “UVA/UVB” on the label – this will ensure you are protecting yourself from all of the sun’s damaging effects
• Chose a product that is water-resistant if you anticipate sweating or swimming.
• Don’t stress over SPF. SPF stands for “sun protection” factor. An SPF 15 sunscreen blocks over 90% of UV rays. What’s more important is re-applying periodically throughout the day.
• Don’t let the cold weather fool you – while they may not feel warm, the suns rays are still penetrating the layers of your skin.
• Wear sunscreen even when it’s cloudy – harmful UV rays are invisible and are able to pass through.
• Don’t forget your ears and lips! Some skin cancers are especially common in these areas.

Sunscreen – Chemical vs. Physical Blockers

Another consideration when choosing a sunscreen is chemical versus physical blockers:

• Chemical sunscreens typically contain a combination of the following ingredients: oxybenzone, avobenzone, octisalate, octpcrylene, homosalate, and octinoxate. These work by absorbing the UV rays and preventing their damaging effects. Make sure to apply at least 30 minutes before heading outside, as these take some time before they begin working effectively.
• Physical, or mineral, sunscreens contain zinc oxide and/or titanium dioxide. These works by creating a layer over the skin that deflects or blocks the UV rays from penetrating. These are a great choice especially if you have sensitive skin.

If preventing skin cancer isn’t incentive enough to wear sunscreen daily and avoid excessive sun exposure (and indoor tanning booths!), then consider the rapid effects on aging the sun’s rays can have. While a tan may look good for a week, avoiding exposure to UV rays will both delay and prevent aging for years.

For more information on skin cancer and prevention, please visit the Center for Disease Control’s website (https://www.cdc.gov/cancer/skin/) and contact your physician for specific concerns regarding spots on your skin.

Guest Contributor: Eduardo Ortiz, MD, Geisinger Commonwealth School of Medicine 2018

NEXT WEEK! 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 Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's Articles. check out our exercise forum!

Like many of you, I have always enjoyed the outdoors...walking, running, biking, hiking etc. However, recently, I have been more concerned about my safety, (getting older and more cautious) when doing these activities on the side of the road.

Almost 15 percent of all motor vehicle injuries to people happened to those not in cars but while walking, running or hiking. In fact, over 4,000 walkers or runners were fatally hit by a motor vehicle according to the Centers for Disease Control (CDC). These statistics continue to increase as the number of distractions to drivers increases (phone calls, texts, etc). Consequently, walkers, runners and cyclists must be more aware than ever to prevent injury from motor vehicles.

Five high risk factors for walkers, runners and cyclists:

• After dark
• At rush hour in high traffic
• Walk or run “with” instead of “into” traffic flow
• More than one other person with you
• Headphones

“Runner’s World” offers the following recommendations:

• Leave word. Tell somebody or leave a note at home about where you plan to go and how long you plan to be out. That way your loved ones will know to come look for you if needed.
• Protect yourself: If your route is in a high crime area, avoid dawn and dusk, carry self-defense spray, exercise with a partner, leave jewelry at home and vary your route and routine.
• Identify yourself. Run with proper ID, and carry a cell phone with emergency contacts taped to its back.
• Pretend you're invisible. Don’t assume a driver sees you. In fact, imagine that a driver can’t see you, and behave accordingly.
• Face traffic. Except for cyclists, walking and running “into” oncoming traffic is best. It’s easier to see, and react to, oncoming cars. And cars will see you more clearly too.
• Make room. If traffic gets heavy, or the road narrows, be prepared to move onto the sidewalk or shoulder of the road. When walking or running into traffic, stay as far left as possible. When biking, favor the far right side of the road.
• Be seen. Wear high-visibility, brightly colored clothing. When out near or after sunset, reflective materials are a must. (If you don't own reflective clothing, a lightweight reflective vest is a great option.) And use a headlamp or handheld light so you can see where you're going, and drivers can see you. The light should have a bright LED (drivers see blinking red as a hazard).
• Unplug your ears. Avoid using iPods or wearing headphones—you need to be able to hear approaching vehicles. If you do use headphones, do so with the volume low and just one earbud in.
• Watch the hills. When they crest hills, drivers' vision can suddenly be impaired by factors like sun glare or backdrops.
• Beware of high-risk drivers. Steer clear of potential problem areas like entrances to parking lots, bars, and restaurants, where there may be heavy traffic.
• Watch for early birds and night owls. At odd hours be extra careful. Early in the morning and very late at night, people may be overtired and not as attentive.
• Mind your manners. At a stop sign or light, wait for the driver to wave you through—then acknowledge with your own polite wave. That acknowledgement will make the driver feel more inclined to do it again for the next walker or runner. Use hand signals (as you would on a bicycle) to show which way you plan to turn.

Cyclists

• Stay on the right and obey traffic rules
• Wear a helmet
• Use hand signals when turning
• Wear visible clothing and have reflectors on your bike
• Carry a tire patch and first aid kit
• Maintain your bike
• Watch for pedestrians, parked cars, loose gravel and cracks and potholes.

Source: http://www.runnersworld.com

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: http://mackareyphysicaltherapy.com/form

This week IS MEMORIAL DAY 2021…THE UNOFFICIAL FIRST DAY OF SUMMER! IT IS TIME TO GET THE HECK OUTSIDE! Research shows that spending time outdoors has many positive effects on your health. While there are many year-round activity options, in Northeastern Pennsylvania our short-lived summer is the inspiration to “suck the marrow out of a sunny day!”  Summer in NEPA is enjoyed in many ways such as walking, running, hiking, biking, horseback riding, boating, kayaking, and swimming. Studies show that even less vigorous activities such as fishing, picnicking camping, barbequing, or reading a good book on the porch are healthier than being indoors.

It is reported that Americans spend 90% of their lives indoors and that number increases with age. Worse yet, for some, venturing outdoors is considered risky behavior with fear of the sun, ticks, wind, mosquitoes, and other creatures of God. Well, the truth of the matter is the risk of being one with nature is far less than the ill effects of a life stuck indoors.

Consider the following benefits of spending time outdoors.

Nature’s Vitamin D

Current research suggests that Vitamin D (The Sunshine Vitamin), may offer significant disease prevention and healing powers for osteoporosis, some forms of cancer and heart disease. Of all the methods of getting an adequate amount of Vitamin D, none is more fun than spending time outdoors in the sunlight. It seems that the health concerns of ultraviolet light, sun burn, and skin cancer have created an overreaction to the point of Vitamin D deficiency in many. Balance and common sense go a long way. One can attain normal levels of Vitamin D by being outdoors in the sun and exposing their arms and legs for 10 -15 minutes a few times per week. Additional time in the sun warrants sunscreen and Vitamin D supplements can be used if necessary.

Increase Activity Level

While exercising indoors in a gym is valuable, research shows that time spent indoors is associated with being sedentary and being sedentary is associated with obesity, especially in children. Some studies show that children in the United States spend an average of 6 ½ hours per day with electronic devices such as computers, video games and television. It is also reported that a child’s activity level more than doubles when they are outdoors. So, get out of the office, house, and gym as often as possible. Consider weight training at the gym and doing cardio by walking, biking, or running outdoors.    

Improved Mental Health

It is well documented that light affects mood. So, unless you live in a glass house or a light box, getting outdoors is important to your mental health. Furthermore, studies show that exercising outdoors in the presence of nature, even for as little as 5- 10 minutes has additional mental health benefits. For those less active, read or listen to music in a hammock or lying in the grass.

Improved Concentration

Richard Louv, author of the book, “Last Child in the Woods,” coined the term, nature-deficit disorder.” This term is supported by research that found children with ADHD focus better when outdoors. Furthermore, it was discovered that these children scored higher on concentration tests following a walk in the park than they did after a walk in their residential neighborhoods or downtown areas, showing the benefit of the “green outdoors.”

Improved Health and Healing

Researchers at the University of Pittsburgh found that patients recovering from surgery recovered faster with less pain and shorter hospital stays when they were exposed to natural light. Next time you’re recovering from an illness, discuss this with your physician.

Improved Breathing

In general, breathing fresh air is good for you. Some exceptions might be those with severe allergy problems when the pollen count is high. Despite this, it may be better to take allergy medicine and enjoy the benefits of being outdoors than to be stuck inside. Many pulmonologists believe people with pulmonary problems would benefit from outdoor activities such as a 10–15-minute walk because they are prone to osteoporosis and Vitamin D deficiency.  Local pulmonologist, Dr. Gregory Cali, DO, agrees, and also adds that studies do not show that high humidity is dangerous for respiratory patients, but it may be uncomfortable. In cold temperatures, those with pulmonary problems must avoid directly breathing cold air by covering up their mouths when walking outdoors. Overall, the benefits far outweigh the risks.

Read “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: mackareyphysicaltherapy.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.

November is also Native American Heritage Month!

Happy Thanksgiving! Like most of you, I am most thankful for the love and support of my family and friends. I am also very thankful for health and wellness. But this year, the year of the global pandemic which has limited my access to the warm hugs and smiles of those I love, I am more grateful than ever for simple things…the beauty of nature and the great outdoors in NEPA!

With this in mind, I am also grateful to the first environmentalists in the Americas…Native Americans! Long before John Muir and the Sierra Club, Native Americans were stewards of the planet. Native Americans feel that everything in nature has a soul… living creatures, trees, mountains, rocks and even water! Therefore, they believe that all of nature must be treated with respect and honor.  Today, when being outdoors in nature is more important than ever, we are the beneficiaries of their stewardship. Now it is our turn to enjoy, respect and protect nature for future generations!

GET THE HECK OUTSIDE!

Research shows that spending time outdoors has many positive effects on your health. With a little imagination, one can find many year round activity options in Northeastern Pennsylvania. While swimming, boating, kayaking, biking and golfing may be winding down, consider other options this winter. With proper equipment and clothing, walking, running, hiking, fat-tire biking, snowshoeing, cross-country and downhill skiing can be enjoyed. Studies show that even less vigorous activities such as barbequing or reading a good book on the porch are healthier than being indoors... so bundle up next to a good fire pit or outdoor propane heater and get outdoors!

Even before the pandemic, it was reported that Americans spend 90% of their lives indoors and that number increases with age. Worse yet, for some, venturing outdoors is considered risky behavior with fear of the sun, heat, ticks, wind, cold, mosquitoes and other creatures of God. Well, the truth of the matter is the risk of being one with nature is far less than the ill effects of a life stuck indoors. Please consider the following benefits of spending time outdoors.

• Nature’s Vitamin D – Current research suggests that Vitamin D (The Sunshine Vitamin), may offer significant disease prevention and healing powers for osteoporosis, some forms of cancer and heart disease. Of all the methods of getting an adequate amount of Vitamin D, none is more fun than spending time outdoors in the sunlight. It seems that health concerns of ultraviolet light, sun burn and skin cancer have created an overreaction to the point of Vitamin D deficiency in many. Balance and common sense go a long way. One can attain normal levels of Vitamin D by being outdoors in the sun and exposing their arms and legs for 10 -15 minutes a few times per week. Additional time in the sun warrants sunscreen and Vitamin D supplements can be used if necessary.

• Increase Activity Level – While exercising indoors in a gym is valuable, research shows that time spent indoors is associated with being sedentary and being sedentary is associated with obesity, especially in children. Some studies show that children in the United States spend an average of 6 ½ hours per day with electronic devices such as computers, video games and television. It is also reported that a child’s activity level more than doubles when they are outdoors. So, get out of the office, house and gym as often as possible. Consider weight training at the gym and doing cardio by walking, biking or running outdoors.    

• Improved Mental Health – It is well documented that light affects mood. So, unless you live in a glass house or a light box, getting outdoors is important to your mental health. Furthermore, studies show that exercising outdoors in the presence of nature, even for as little as 5- 10 minutes has additional mental health benefits. For those less active, read or listen to music outdoors next to a fire.

• Improved Concentration – Richard Louv, author of the book, “Last Child in the Woods,” coined the term, nature-deficit disorder.” This term is supported by research that found children with ADHD focus better when outdoors. Furthermore, it was discovered that these children scored higher on concentration tests following a walk in the park than they did after a walk in their residential neighborhoods or downtown areas, showing the benefit of the “green outdoors.”

• Improved Health and Healing – Researchers at the University of Pittsburgh found that patients recovering from surgery recovered faster with less pain and shorter hospital stays when they were exposed to natural light. Next time you’re recovering from an illness, discuss this with your physician.
• Improved Breathing – In general, breathing fresh air is good for you. Some exceptions might be those with severe allergy problems when the pollen count is high. In spite of this, it may be better to take allergy medicine and enjoy the benefits of being outdoors than to be stuck inside. Many pulmonologists believe people with pulmonary problems would benefit from outdoor activities such as a 10-15 minute walk because they are prone to osteoporosis and Vitamin D deficiency.  Local pulmonologist, Dr. Gregory Cali, DO, agrees and also adds that studies do not show that high humidity is dangerous for respiratory patients but it may be uncomfortable. In cold temperatures, those with pulmonary problems must avoid directly breathing cold air by covering up their mouths when walking outdoors. Overall, the benefits far outweigh the risks.

Read “Health & Exercise Forum” – Every Monday.  

OR access ALL of Dr. Mackarey's content at https://mackareyphysicaltherapy.com/forum/

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

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