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STAY ACTIVE & HAVE FUN IN THE SUN!

Can you believe that the 4th 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:

Sunset or Moonlight Kayaking

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:

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

Stand Up Paddle Boarding

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!

 

Summer heat and humidity are here and the risk of heat related illnesses are particularly high for those over 65, especially dehydration. 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. Furthermore, age related changes in 50-60 year olds can also make one vulnerable to dehydration if they are active and exercise in the heat. Not long ago, a local medical professional and good friend of mine was hospitalized for several days due to dehydration and associated illness. He is an active, fit, healthy 59 year old who continued his daily running for exercise during the June/July heat wave.

It is often forgotten that, 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. The elderly 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 persons 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, a 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 (but these symptoms apply to both young and old):

Plain old tap water is a good way to replenish fluid loss. 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 form the stomach. Consuming alcoholic and caffeinated beverages actually has an opposite, diuretic effect!

Visit your doctor regularly and listen to your body.     

 Keep moving, eat healthy foods, exercise regularly, and live long and well!

Contibutor: Janet M. Caputo, DPT, OCS

NEXT MONDAY! – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next week: Part II - Dehydration Prevention”

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 4TH 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:

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:

Sunscreen – Chemical vs. Physical Blockers

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

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!

Have Fun and Get in Shape!

Happy Independence Day! This summer try to think of your pleasure puddle in different light…a health spa! It may very well be the exercise of choice for many people. Many have discovered the benefits of moving their limbs in the warm water of a home pool following knee or shoulder surgery. Also, long distance runners who often look for cross training methods without joint compression and arthritis sufferers who are often limited in exercise choices by joint pain from compressive forces when bearing weight, can enjoy the buoyancy effects of  water. These are good examples of the benefits or water exercise…aerobic and resistive exercise without joint compression.  

Exercise and Arthritis

Most doctors recommend some form of exercise with arthritis. Pain and fatigue are the most limiting factors for the person with arthritis. Pool exercise may be the answer. With proper technique, adequate rest periods, appropriate resistance and repetitions, water exercise can be very effective.

Benefits of Water Exercise:

Getting Started

  1. Start Slowly – Don’t Overdo it
    • 5-10 minutes and repetitions first time and add 2-3 minutes/repetitions each week
    • Long Term Goal: 20 – 40 minutes per session / 3-4 times per week
  2. Submerge The Body Part
    • That you want to exercise into the water and move it slowly
  3. Complete The Range of Motion
    • Initially 5 times, then 10-15-20-30 times
  4. Assess
    • Determine if you have pain 3-4 hours after you exercise or into the next day. If so, you overdid it and make adjustments next time by decreasing repetitions, speed, amount and intensity of exercise.
  5. Warm-Up
    • Make sure you warm up slowly before the exercise with slow and easy movements
  6. Advance Slowly
    • By adding webbed gloves, weighted boots, and buoyant barbells to increase the resistance.
  7. Exercises – standing in shallow end of pool
    • Heel Raises – push toes down and heel up
    • Toe Raises – lift toes up and heel down
    • Leg Kicks – extend leg up and down
    • Hip Hike – raise knee up 4-6 inches and down
    • Leg Squeeze – squeeze knees together and apart
    • Leg Curl – bend knee
    • Torso Twist – slowly turn arms/torso to right, then to left
    • Shoulder Forward and Backward – like paddling a boat
    • Shoulder Out and In – like a bird flying
    • Bend Elbow Up and Down

Visit your doctor regularly and listen to your body.     

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

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

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

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

Tomorrow is the first day of summer! The days are longer and sun stronger! Local dermatologist, Dr. Ted Stampien, Jr. can be seen driving his convertible with so much protection from the sun; he may as well have the top UP (bucket hat, sun block 50, long sleeves)! He joked that even the most vigilant dermatologists allow for a little fun in the sun. However, he emphasizes that there is no such thing as a HEALTHY tan.

While protection from the sun is very important, Dr. Stampien feels that too much time indoors playing computer games and watching television, can lead to potential problems from lack of exposure to the sun. One must use good judgment and have balance as the potential exists for Vitamin D deficiency due to lack of sun exposure. This problem may be true for individuals who use too much protection or spend most of their day indoors due to occupation or poor health. Therefore, it will be the purpose of this column to discuss the importance of Vitamin D for health and wellness.

What is Vitamin D

Vitamin D, a fat soluble vitamin, is found in food and can be made by your body after exposure to ultraviolet (UV) rays from the sun. The liver and kidney help convert Vitamin D to its active form. Vitamin D assists calcium absorption, which is essential for normal development and in forming and maintaining strong bones and teeth. Without Vitamin D, bones can become thin, brittle and soft. The classic Vitamin D deficiency diseases are rickets in children and osteomalacia in adults. Rickets results in skeletal deformities. Osteomalacia is the softening of bones. Vitamin D is essential for normal bone health and may diminish or prevent the onset of osteoporosis in the elderly.

The requirement for Vitamin D is dependent on age, sex, degree of sun exposure and the amount of pigmentation in the skin. Since Vitamin D can be produced by the body and retained for long periods of time by the body’s tissues, the precise daily requirement has been difficult to determine. Instead, an Adequate Intake (AI) level has been established. AI is a level of intake sufficient to maintain healthy blood levels of an active form of Vitamin D. The AIs are similar for males and females but increase with age:

Sources of Vitamin D:

Vitamin D Deficiency

Vitamin D deficiency can occur when dietary intake of Vitamin D is inadequate, when there is limited sunlight exposure, when the kidney cannot convert Vitamin D to its active form or when Vitamin D is inadequately absorbed from the gastrointestinal tract. Season, geographic location, time of day, cloud cover, air pollution, sunscreens, living indoors and living in cities where tall buildings block adequate sunlight from reaching the ground affect UV ray exposure. Individuals with limited sun exposure are at risk of Vitamin D deficiency. Homebound individuals, people living in northern latitudes (e.g. New England, Alaska), individuals who cover their bodies for religious reasons and people whose occupations prevent exposure to sunlight may need to supplement with Vitamin D.

Sunscreens with a sun protection factor of 8 or greater will block UV rays that produce Vitamin D. Older adults have a higher risk for Vitamin D deficiency because the skin’s ability to convert Vitamin D to its active form decreases with age and the kidneys, which help convert Vitamin D to its active form, do not work as well when people age. Individuals with pancreatic enzyme deficiency, Chron’s disease, cystic fibrosis, sprue, liver disease, surgical removal of part or all of the stomach or small bowel disease may need extra Vitamin D because Vitamin D is a fat soluble vitamin and they have reduced ability to absorb dietary fat. Vitamin D supplements are often recommended for exclusively breast-fed infants because human milk may not contain adequate Vitamin D. Consult with your pediatrician on this issue.

Read “Health & Exercise Forum” – Every Monday in the Scranton Times-Tribune

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: mackaryphysicaltherapy.com/forum

Part I of II

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 9, 2021, first day of acclimatization and August 16, 2021, first day of practice for fall sports according to PIAA), However, 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:

Treatment of Heatstroke:

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Next Week: “Heat Stroke 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 in downtown Scranton and is an associate professor of clinical medicine Geisinger Commonwealth School of Medicine.

For all of Dr. Mackarey's Articles visit: https://mackareyphysicaltherapy.com/forum/

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.