According to the United States Environmental Protection Agency, NEPA and all of Pennsylvania is experiencing a change in climate as indicated by a half a degree (F) in temperature, more frequent and heavy rainstorms and the tidal portion of the Delaware River is rising one inch every eight years. Last summer was one of our hottest on record and this summer has produced several heat waves with more expected. For those without air conditioning or access to a lake or pool, it will also be remembered as record setting warm temperatures. A local reader who cares for her elderly mother wrote to express her concern about dehydration in the elderly. Age, diet, illness and medications are some of the many reasons why elders suffer from dehydration not only in the summer heat, but year-round.
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.
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. More than 18% of those hospitalized for dehydration will die within 30 days, and associated mortality increases with age. Men appear to dehydrate more often than women and dehydration is often masked by other conditions.
Elderly individuals are at heightened risk for dehydration for several reasons. Compared to younger individuals, their regulatory system (i.e. kidneys and hormones) does not work as well and their bodies have lower water contents. Older adults often have a depressed thirst drive due to a decrease in a particular hormone. They do not feel thirsty when they are dehydrated. This is especially true in hot, humid weather, when they have a fever, are taking medications, or have vomiting or diarrhea. They have decreased taste, smell, and appetite which contribute to the muted perception of thirst. Because of dementia, depression, visual deficits, or motor impairments, elderly people may have difficulty getting fluids for themselves. Many elderly individuals limit their fluid intake in the belief that they will prevent incontinence and decrease the number of trips to the bathroom. The medications that they are taking (e.g. diuretics, laxatives, hypnotics) contribute to dehydration.
Elders may suffer headaches, fainting, disorientation, nausea, seizure, a stroke, or a heart attack as a result of dehydration. The minimum daily requirement to avoid dehydration is between 1,500 (6.34 cups) and 2,000 ml of fluid intake per day. Six to eight good-sized glasses of water a day should provide this amount. Better hydration improves well-being and medications work more effectively when an individual is properly hydrated.
Those who care for the elderly whether at home or in a health care facility need to be alert to the following symptoms:
By the way, plain old tap water is a good way to replenish fluid loss. Keep in mind that some energy drinks not only have excess and unneeded calories but also contain sugar that slows down the rate at which water can be absorbed from the stomach. Consuming alcoholic and caffeinated beverages actually have an opposite, diuretic effect!
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
It is the middle of summer in NEPA with plenty of time to have 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 golfing, swimming, kayaking, biking, hiking, water skiing and other outdoor activities 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!
The majority of skin cancers are caused by harmful ultraviolet (UV) rays from the sun. Two major types are UVA and UVB:
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.
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:
Another consideration when choosing a sunscreen is chemical versus physical blockers:
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
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
Despite recent challenges for air travel due to increased volume, severe weather and a nationwide shortage of air traffic controllers, Americans report high levels of enthusiasm for air travel this summer, including travel abroad.
Confession; I recently was on a long trip that required sitting on an airplane for more than six hours…and I wore compression stockings … guess I’m getting older (and wiser)!
Have you noticed that being in a car or on an airplane for more than three hours leads to neck and back pain? Soreness, stiffness and swelling in your legs? With a little planning, preventing or limiting these problems on long trips is possible. Also, as people age and/or develop other health problems, they are more vulnerable to developing a more serious problem associated with long trips; deep vein thrombosis (DVT) or blood clots. But problems with long-distance travel can be avoided. The following tips, based on research and personal experience, can prevent neck, back and leg pain and stiffness and DVT.
A DVT is a blood clot that forms in a deep vein. The deep veins pass through the muscles and cannot be seen like the veins just under your skin. While it may occur in your arms, it is much more common in the legs, especially the calf muscle when traveling. When a blood clot forms in a leg vein it usually sticks to the vein wall. Often, pain and swelling lead you to the doctor and treatment is rendered before serious complications develop. However, there are two possible complications. One, a pulmonary embolus, occurs when a part of the clot logged in your deep vein of the calf breaks off and gets lodged in the lung. This is a very serious problem that can be fatal. Two, post-thrombotic syndrome, occurs when you have pain and swelling in your calf after a DVT.
The following risk factors for DVT significantly increase the potential for problems when traveling on long trips by air, more than 5 hours. Trains, cars and buses also create a risk, but air travel creates a greater risk for the following reasons: reduced cabin pressure, reduced cabin oxygen levels, dehydration and alcoholic drinks, which may increase dehydration and immobility.
Airplane seats are “C” shaped and force you to round your neck and back forwards. These exercises are designed to stretch and extend your back in the opposite direction. Please perform slowly, hold for 3-5 seconds and repeat 10 times each hour.
Sitting:
When sitting in an airplane seat, take the neck pillow in the overhead compartment and place it in the small of your lower back. While sitting or standing up, perform postural exercises every 30-45 minutes.
Visit your doctor regularly and listen to your body.
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
I wish I could tell you that after turning 50, there are health issues associated with age I plan to be mindful of and address proactively. Unfortunately, that ship has sailed for me well more than a decade ago. So, I share this medical information, not only as a health professional but also as an experienced senior.
Entering the fifth decade is not all dome and gloom. Often, this decade is associated with an established family, gratifying career, good health and acquired self-confidence…realizing that life does not have to be perfect to be wonderful!
However, research tells us that as the body ages, even small changes at the cellular level can be manifested into big changes and problems over time. Nine of ten older adults have some type of chronic disease and eight of ten have more than one. But the good news is that, with a modicum of effort, most of these illnesses can be controlled or prevented, including regular doctor visits, health screening and testing, and lifestyle changes.
While it is normal to experience some weight gain is expected with age. However, uncontrolled, the average person will gain 1-2 pounds per year, leading to 11 pounds per decade, according to the National Institutes of Health. Consequently, almost 45% of Americans between 40 to 60 are obese. Obesity is associated with at least 20 chronic illnesses such as high blood pressure, heart disease, diabetes, cancer, and arthritis.
SCREEN: Body Mass Index (BMI)
TREATMENT: Diet, Exercise, Lifestyle, Medications, Surgery
With age, the flexibility of blood vessels loses elasticity and, unchecked, two out of three adults over 60 have high blood pressure. While genetics is a factor, there are a few things that you can control such as diet (salt, calories), exercise, weight, stress, and smoking.
SCREEN: Blood Pressure Test, Lab Tests, Electrocardiogram (ECG/EKG)
TREATMENT: Diet, Exercise, Lifestyle, Medications
Plaque buildup in the arteries of the heart begins in childhood and advances rapidly with age. 6-7 percent of US adults between the ages of 40 and 60. 20% of men and almost 10% of women between the ages of 60 and 80 have heart disease.
SCREEN: Blood Pressure, Cholesterol testing, Blood Sugar Testing, Imaging (ECG/MRI)
TREATMENT: Diet, Exercise, Lifestyle, Medications, Surgery
10 % of Americans have diabetes and the percent only increases with age. Diabetes is associated with many serious chronic illnesses such as heart disease, blindness, kidney disease and others.
SCREEN: Blood Test for blood sugar levels such as A1C, fasting plasma glucose test and random plasma glucose test
TREATMENT: Diet, Exercise, Lifestyle, Medications
In many cases osteoarthritis (wear and tear of joints) is often associated with age. However, lifestyle, joint injuries, inactivity, obesity and diabetes play a significant role.
SCREEN: Physical Exam, Functional Scores, Xrays, MRI, CT, US
TREATMENT: Diet, Exercise, Physical Therapy, Lifestyle, Medications (NSAID’s, Steroids, Viscosupplementation), Bracing, Surgery
Loss of bone density and strength is associated with age and certain metabolic conditions such as early menopause, thyroid disease, prolonged use of blood thinners and steroids. However, a diet rich in vitamin D, regular weight bearing exercises such as walking, jogging, dancing etc can go a long way.
SCREEN: Fracture Risk Assessment Tool (FRAX), Dual-Energy X-Ray Absorptiometry (DEXA) TREATMENT: Diet, Exercise, Physical Therapy, Lifestyle, Medications (Oral and Injection)
Losing balance with age is a common problem due to changes in the vestibular system (balance system in the brain), loss of muscle strength and joint flexibility, and compromised vision and hearing. This can often lead to falls, head injuries and fractures.
SCREEN: Timed Up and Go (TUG) Test, Morse Fall Scale
TREATMENT: Physical Therapy – Falls Prevention Program/Balance Training , Diet, Exercise, Lifestyle, Environmental Modification, Vision/Hearing Testing
Almost 10% of adults between the ages of 55 and 65 have some form of vision and/or hearing loss. This can lead to many problems such as balance and falls as well as isolation and depression.
SCREEN: Regular Hearing Tests/Vision Testing
TREATMENT: Corrective Devices
Both men and women suffer from bladder problems with age... especially frequency and control. It can impact lifestyles in many ways. Often adults fail to hydrate properly, especially when traveling, to control urgency. This can lead to other health problems.
SCREEN: Urine Analysis, PSA, Imaging, CT Urogram, Urine Cystoscopy, Ultrasound,
TREATMENT: Diet, Exercise, Lifestyle, Avoid Caffeine and heavy lifting, Medications, Surgery
As the body ages, so too do the cells that make it up. Often these cells change into cancer different parts of the body. Skin, colon, breast, prostate, lung, throat, etc. Today, however, much progress has been made for early detection and treatment.
SCREEN: Physical Exam (Skin Exams), Lab Tests (blood work, PSA), Imaging (CT, Mammography, MRI), Genetic Testing, Pap Smears, HPV Tests, Colonoscopies/Stool Tests, Multi-Cancer Early Detection (MCED)
TREATMENT: Diet, Exercise, Physical Therapy, Lifestyle, Medications, Chemotherapy, Radiation, Immunotherapy and Targeted Therapy Surgery specific to the cancer type.
Age related mental health issues are vastly unreported and diagnosed. Medical problems can contribute to mental health such as high blood sugar levels and some infections. Overall, lifestyle, environmental factors and family structure and support are particularly important.
SCREEN: No Single Test – Combination of Tools including - Neurological and Cognitive Tests, Brain Scans (CT/MRI), Blood tests, Genetic Testing
TREATMENT: Diet, Exercise, Physical Therapy, Lifestyle, (avoid excessive toxins like alcohol and nicotine), Medications, Environmental Modifications.
SOURCES: WebMD, NIH, Mayo Clinic, Alzheimer’s Association, American Cancer Society, American Heart Association, American Diabetes Association
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
Happy Father’s Day! It is my hope that this information will be helpful to all the fathers who enjoy working in the yard! It is not too late to buy dad a new cart or kneeling pads for the yard. Last week, Health & Fitness Forum presented tips for gardeners for preventing hand and arm injuries such as carpal tunnel syndrome. This week’s column is dedicated to prevention of lower back and lower body injuries when working in the yard and for gardeners with disabilities.
A relaxing and enjoyable activity for many, gardening can turn dangerous without proper precaution as repetitive stress injuries, back pain, muscle pulls, can stem from raking, weeding, digging and pruning, can turn into serious problems if not treated appropriately. Since prevention is the best approach, the US Dept of Agriculture promotes warm-up exercises and injury prevention tips to help all levels of gardeners avoid serious and long-term injuries while enjoying this popular outdoor activity.
People with various disabilities enjoy gardening at different levels. For example, those suffering from neurological diseases with muscle weakness, paralysis and poor balance as well as those with musculoskeletal problems such as neck and LBP or hip and knee arthritis can safely enjoy gardening at some level. This outdoor labor of love is very therapeutic.
Warm up and stretching is important. Don’t garden first thing in the morning before you have a chance to warm up. Get up, go for a short walk, have breakfast and maybe warm up with a hot shower before working in the garden. Some stretches include;
Note: These exercises should never be painful when completing them. You should only feel a gentle stretch. Hold the stretch10 seconds and repeat 5 times before you garden and every 2-3 hours while working. Should you experience pain, please consult your family physician or physical therapist.
The following guidelines to prevent injury and foster healthy gardening for those with and without disability:
Source: Karen Funkenbusch, MA; Willard Downs, PhD.: U. S. Department of Agriculture - Agricultural Engineering Extension
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
Farmers and gardeners in NEPA always say that Memorial Day, the “kick off” day for planting without the fear of frost, however, this year we have had an unusually cold and wet spring… but it is not too late to start…not only for the beds but your body! While gardeners are anxious to work in their gardens and enjoy the fruits of their labor, a relaxing and enjoyable activity can turn dangerous quickly. Precautions are necessary as repetitive stress injuries such as shoulder and elbow tendonitis and carpal tunnel syndrome can stem from raking, weeding, digging and pruning. Additionally, simple scrapes, blisters, and bites can turn into serious problems if not treated appropriately. Since prevention is the best approach, the American Society of Hand Therapists (ASHT) promotes warm-up exercises and injury prevention tips to help all levels of gardeners avoid serious and long-term injuries while enjoying this popular outdoor activity.
ASHT recommends following these upper extremity warm-up exercises prior to gardening:
Note: These exercises should never be painful when completing them. You should only feel a gentle stretch. Hold 10 seconds and repeat 5 times. Should you experience pain, please consult a physician or hand therapist.
ASHT recommends the following guidelines to prevent injury and foster healthy gardening practices:
Professional Contributor: Nancy Naughton, OTD, CHT, is an occupational therapist and certified hand therapist practicing in NEPA.
Next Week: “Prevention of Gardening Injuries” Part II of II.
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
As most sports enthusiasts know, in 2021 Tiger Woods ruptured his Achilles tendon while training at home and in 2023 Aaron Rodgers, a former Green Bay Packer quarterback, did the same in the first game of the 2023/24 NFL season with the New York Jets. As with many sports injuries, it is painful and devastating and best managed by PREVENTION!
Spring is here and as the days continue to get longer and temperatures begin a slow steady rise, athletes and weekend warriors are eager to get outdoors to play and exercise. However, be mindful of the weather (damp and rainy), temperature (cool mornings and evenings) and winter “dust” on your muscles and tendons. Many overjealous fitness enthusiasts will rush to pound the pavement and barely “fit in” a warm-up before participating. But, no matter how limited time is, skipping the warm-up is risky.
This time of year, one can expect to feel a little cold and stiff, especially if you are over 40, and therefore a little caution and preparation are in order to avoid muscle/tendon strain, or worse yet, muscle/tendon tears. The Achilles tendon is one of the more common tendons torn. Prevention of muscle tears, including the Achilles tendon includes; gradual introduction to new activities, good overall conditioning, sport specific training, pre-stretch warm-up, stretch, strengthening, proper shoes, clothing, and equipment for the sport and conditions.
A muscle contracts to move bones and joints in the body. The tendon is the fibrous tissue that attaches muscle to bone. Great force is transmitted across a tendon which, in the lower body, can be more than 5 times your body weight. Often, a tendon can become inflamed, irritated, strained or partially torn from improper mechanics or overuse. Although infrequent, occasionally tendons can also snap or rupture. A tendon is more vulnerable to a rupture for several reasons such as a history of repeated injections of steroids into a tendon and use of medications such as corticosteroids and some antibiotics. Certain diseases such as gout, arthritis, diabetes or hyperparathyroidism can contribute to tendon tears. Also, age, obesity and gender are significant risk factors as middle-aged, overweight males are more susceptible to tendon tears. Poor conditioning, improper warm-up and cold temperatures may also contribute to the problem.
Tendon rupture is very painful and debilitating and must not be left untreated. While conservative management is preferred, surgical management is usually required for complete tears. The purpose of this column is to present the signs, symptoms and management of Achilles tendon ruptures.
The Achilles tendon (also called the calcaneal tendon), is a large, strong cordlike band of fibrous tissue in the back of the ankle. The tendon (also called the heel cord) connects the powerful calf muscle to the heel bone (also called the calcaneus). When the calf muscle contracts, (as when you walk on the ball of your foot), the Achilles tendon is tightened, tension is created at the heel and the foot points down like pushing a gas pedal or walking on tip of your toes. This motion is essential for activities such as walking, running, and jumping. A partial tear of the tendon would make these activities weak and painful, while a full tear through the tendon would render these activities impossible.
With age, the Achilles tendon (and other tendons) gets weak, thin, and dehydrated, thus making it prone to inflammation, degeneration, partial tear or rupture. The middle-aged weekend warrior is at greatest risk. A full or complete tear (Achilles tendon rupture) usually occurs about 2 inches above the heel bone and is associated with a sudden burst of activity followed by a quick stop or a quick start or change in direction, as in tennis, racquet ball, and basketball.
In some instances, the tendon can be injured by a violent contraction of calf when you push off forcefully at the same time the knee is locked straight as in a sudden sprint. Other times, the tendon is injured when a sudden and unexpected force occurs as in a trip off a curb or sudden step into a hole or a quick attempt to break a fall.
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
Next Week: Achilles tendon Part II of 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 orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
The World Health Organization has classified obesity as a chronic disease and determined that it is reaching epidemic proportions, not only in the United States, but globally. Moreover, closer to home, the Pennsylvania Department of Health has determined that PA ranks 17th among all states in the country for percentage of obese residents. Childhood obesity is defined as having a body mass index (BMI) at or above the 95th percentile for age and sex in children aged 2 and older.
People have theorized for many years that obesity must be genetic. Scientific research has validated this theory and more importantly, a recent study has shown that while there is an obesity gene that may predispose one to obesity, one can control the outcome with exercise. The fat mass and obesity gene (FTO) is linked to a high body mass index according to a new study in the Archives of Internal Medicine. More importantly, this study found that exercise can offset a genetic predisposition for obesity. Aerobic exercise 30-45 minutes 3-5 times per week coupled with mild weight training and other physical activities can overcome the FTO. With new knowledge, it becomes apparent that it is critical to promote a healthy lifestyle with exercise and physical activity at an early age to prevent childhood obesity.
Obesity increases with age and its prevalence among obese children will continue to be obese with age. Childhood obesity is the leading cause or is associated with: hypertension, Type II diabetes mellitus, coronary heart disease, lower extremity joint stress and pain, lower self-esteem and other psychological problems.
As with adult obesity, childhood obesity is most often caused by multiple problems including: nutritional, psychological, familial, and physiological.
Weight loss is not the primary role of a good childhood obesity program. The goal is to limit or stop weight gain so the child will eventually grow into their body weight over a period of many months or years. One study suggests that it requires 1 ½ years of body weight maintenance for every 20 percent excess in ideal body weight for a child to ultimately attain ideal body weight.
In conclusion, childhood obesity is a serious epidemic. It is physically and emotionally stressful for the child/adolescent and family. This problem requires a comprehensive team approach including: family, physician, educator, dietitian, psychologist, physical therapist and other health and exercise specialists. Lastly, to be successful, it must involve the entire family and be a lifetime lifestyle change 7 days a week regarding diet and exercise, not a 3-to-6-month fad. It must be a long-term program with a long-term goal!
Sources: World Health Organization (WHO), Archives of Physical Medicine, 2008, Vol 168, 1791 – 1797
Visit your doctor regularly and listen to your body.
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
At least once a week, a patient jokingly asks if they can get a “lube job” to loosen up their stiff knee joint. I respond by providing them with information about osteoarthritis and viscosupplementation, a conservative treatment administered by injection and approved by the FDA for the treatment of osteoarthritis of the knee.
Osteoarthritis (OA) is also known as degenerative arthritis. It is the most common form of arthritis in the knee. OA is usually a gradual, slow and progressive process of “wear and tear” to the cartilage in the knee joint which eventually wears down to the bony joint surface. It is most often found in middle-aged and older people and in weight bearing joints such as the hip, knee and ankle. Symptoms include: pain, swelling, stiffness, weakness and loss of function.
Your family physician will examine your knee to determine if you have arthritis. In more advanced cases you may be referred to an orthopedic surgeon or rheumatologist for further examination and treatment. It will then be determined if you are a candidate for viscosupplementation. While this procedure is the most commonly used in the knee, it has also been used for osteoarthritis in the hip, shoulder and ankle.
Viscosupplementation is a procedure, usually performed by an orthopedic surgeon or rheumatologist, in which medication injected into the knee joint acts like a lubricant.
The medication is hyaluronic acid is a natural substance that normally lubricates the knee. This natural lubricant allows the knee to move smoothly and absorbs shock. People with osteoarthritis have less hyaluronic acid in their knee joints. Injections of hyaluronic acid substances into the joint have been found to decrease pain, improve range of motion and function in people with osteoarthritis of the knee.
When conservative measures, such as anti-inflammatory drugs, physical therapy, steroid injections fail to provide long lasting relief, viscosupplementation may be a viable option. Often, physical therapy and exercise are more effective following this injection to provide additional long-term benefit. Unfortunately, if conservative measures, including viscosupplementation fails, surgery, including a joint replacement may be the next alternative.
In 1997 the FDA approved viscosupplementation for osteoarthritis of the knee. Presently, there are several products on the market. One type is a natural product made from the comb of a rooster. However, if you are allergic to eggs or poultry products or feathers, you should not use the natural product. The other medication is best used for patients with allergies because it is manufactured as a synthetic product.
The long-term effects of viscosupplementation is much greater when other conservative measures are employed:
SOURCES: Genzyme Co, Sanofi-Synthelabo Inc, Seikagaku Co. and American Academy of Orthopaedic Surgeons
Visit your doctor regularly and listen to your body.
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
As discussed last week in Part I of Cervical Pillows, studies on cervical or neck pillows have shown that those using a cervical pillow demonstrated a significant reduction in chronic neck pain and headaches. However, researchers cautioned that there are many different types of pillows and that, depending on the individual; some may be more effective than others. This week, I offer tips on choosing the best pillow for you.
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
