Age-related changes to your body are normal and expected. For example, loss of muscle tone, stiffness in joints, and loss of balance. With effort, some of these changes can be retarded and managed with stretching, strengthening and balance exercises. The brain is no different…it can slow down and lead to memory lapses. However, for most of us, it too can be managed and with a little effort, be kept sharp and clear.

• 1. Exercise Your Body

Many experts feel that exercise is the best method to maintain not only physical health but mental health. Regular exercise can prevent the things that contribute to memory loss with age such as; diabetes, high blood pressure, high cholesterol, obesity and stroke.

Specifically, aerobic exercise may be most beneficial. Aerobic exercise is any type of sustained exercise that strengthens the heart and lungs to improve the body’s use of oxygen. This may include running/jogging, brisk walking, cycling, swimming, rowing, and the use of a treadmill, elliptical, stepper or similar device, at light to moderate intensity which requires the use of oxygen to adequately meet the oxygen demands of the body for an extended period of time. The generally accepted time and frequency is at least 30 minute sessions performed three or more times per week. Two 15 minute or three 10 minute sessions are also valuable. For those with back, hip, knee and other lower body pain, consider low-impact or partial weight-bearing activities such as a recumbent bike or stepper or upright bike instead of a treadmill.  

• 2. Healthy Diet

The benefits of a healthy diet are well-documented. Specifically, a Mediterranean-style diet comes highly recommended. It focuses on plenty of fruits and vegetables with fish instead of red meat and olive oil instead of butter.  Researchers found people who closely adhered to a Mediterranean diet were nearly 20% less likely to have thinking and memory problems.

• 3. Exercise Your Brain

Exercise your brain just as you do your body. Make time each day to challenge your brain. Learn something new to keep your mind sharp. Play cards, read a book, do crossword puzzles or other word games, take a class or learn play a musical instrument.

• 4. Maintain Social Activities

Human beings are social animals and in the right setting, we stimulate and challenge each other. Join a book club, fitness center, or a community center. Consider volunteering, taking an art or photography class. Social interaction can prevent isolation which can lead to depression and depression is associated with dementia.

• 5. Sleep Better

Without adequate sleep, attention and concentration is compromised. Studies show that those who have normal restful sleep outperform those who are restless and sleep deprived. Some tips for better sleep are: avoid big meals before bed, keep a consistent sleep and wake up time, avoid nicotine, caffeine and alcohol close to bedtime. “

Consider an afternoon “power nap!” Recent studies show that an afternoon nap was rejuvenating to the mind and body. Participants improved on mental skills such as memory, calculation, orientation and attention.

• 6. Stress Less

Cortisol is the hormone associated with stress. Recent studies have found that elevated cortisol levels were associated with poorer overall cognitive functioning, including memory, language, and processing speed.

Try yoga, massage, breathing techniques to relax. Progressive muscle relaxation (PMR) techniques can be very effective…try it on YouTube!

• 7. Don’t Smoke

Smoking is clearly one of the worst things you can do to your body AND MIND! Smoking can lead to early memory lose in part due to small strokes in the brain. Do whatever it takes to quit; nicotine replacement, medication, or counseling.

• 8. Regular Medical Check-ups

There are many medical conditions and medications associated with memory loss. Regular medical check-ups can prevent, diagnose and treat some of these conditions such as; depression, diabetes, thyroid disease, vitamin deficiencies, and drug interactions or side effects. For example, sleep aid and anxiety drugs associate with memory loss.

• 9. Use Technology

In addition to common tricks such as word association, sticky notes, use your smart phone for appointments and reminders. If you don’t know how to use a smart phone, it is time to learn something new…and that is a healthy brain activity!

SOURCES: WebMD; Harvard Health

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

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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!

Provisional Bag/First Aide Kit

It is one week away from the 27^th Steamtown Marathon. This column is dedicated to all the runners preparing for the big day. One small piece of advice; start slowly, avoid the first mile adrenaline sprint downhill, and enjoy the journey! Remember, only one Olympic marathon winner (Juan Zabala, Argentina, 1932) was in the lead at the 5 mile mark. Lesson: The last miles matter more than the first!

Today, I hope to address some common questions for the novice marathon runner or for those coming from other locations to run in the race. What should you pack? How should I dress? What supplies will I need?

Elite runners are so experienced that they know exactly what to pack in preparation for the big marathon day. However, those, running in marathon for the first or second time usually have lots of questions. First, what you need and what you can bring will depend on your support team. If you are running alone and will not have family or friends meeting you along the way, then you are limited to a fanny pack and a few supplies. If you have a support team, then they can carry a bag with supplies, meet you along the course and you can have a sense of security.

Remember; do not do anything different on race day. Try out special clothing, water with supplements and snacks on a practice run. Also, experiment with your best pre-race meal. You will be getting up at 5-6:00am to catch the bus from Scranton to Forest City. You may want to pack breakfast to eat in the high school gym such as; bagel, peanut butter, jelly, banana and coffee or Gatorade. Moving your bowels before the race is a must.

Dress: Columbus Day Weekend in NEPA could bring 30 to 40 degree temperatures when you catch the bus in Scranton and at the 8:00 am race starting time in Forest City.

Clothing:

• Hat and Gloves: Wearing a hat, light gloves can be a good idea. DryTech materials are best to prevent retention of sweat.
• Long Sleeve Shirt and Light Jacket may be necessary. Wearing old items are best so they can be discarded along the way once you are warmed up.
• Remember, any extra items can be placed in a labeled bag at the starting line and will be transported to the finish line for your convenience. So, if it’s a cold morning, wear a jacket and warm up pants on the bus to the starting line and “bag it!”

Accessories:

• Sunglasses and Sunscreen: If sun and warm temps are forecasted, sunglasses are best placed on top of your hat until needed and sunscreen applied before the race.
• Skin Lubrication: Lubricate your skin with petroleum jelly in areas of potential friction such as arm pits, nipples, thighs and feet.
• Dry Tech Clothing: Wear dry tech protects, including shirt, underwear and socks, to prevent excessive moisture and friction.
• Favorite Water Source and Snack: Water and light snacks will be provided every 2 miles but sometimes it is good to have your own favorites, especially in the high school gym before the race.

MARATHON FANNY PACK – Especially for those running without a support team

If you don’t mind the little pack on your butt, a fanny pack can be valuable. In it, you will want supplies such as: small bandages, small roll of medical tape, ibuprofen, antacid tablets, small tube of lubricant, favorite running snack, and extra shoe laces. One might also consider packing a little money, credit card, ID, emergency contact numbers and medical insurance cards. A cell phone is optional.

MARATHON SUPPLY BAG – For those with support team

your supply bag. In the bag, you might consider all of the above fanny pack items and: A change of clothes such as: extra running shoes, socks, shorts, shirt, water proof wind breaker, according to the weather, especially if rain is predicted.  Towels, ace bandages, gauze pads and wrap, antibiotic cream, mole skin, sunscreen, petroleum jelly, safety pins, extra water and favorite sport drink, favorite sport snacks, extra ibuprofen, antacid, anti diarrhea medicine, chemical ice pack, mobile phone, money, credit cards, ID, medical insurance cards.

For those with allergic reactions, remember to pack: epinephrine, antihistamine, and other important medications.

Don’t Forget:

Map and directions to the bus or starting line, course map, race number, and get your timing chip.

Enjoy! Enjoy! Smell the roses, take in the fall foliage and chat with a fellow racer. Savor the moment enjoy the day…you are doing something very special!

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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!

There is plenty of summer remaining … so make time to get to the water! Research shows that spending time outdoors has many positive effects on your health. Moreover, new research has found that being near a body of water makes us calmer and healthier. You know that special feeling you get when you drive to the lake or the beach and jump out of the car and smell the fresh air and hear the sound of splashing in the lake or the waves of the ocean? Well, it is not just because you’re on vacation…the water makes your muscles relax and breath deeper. Your brainwaves slow down to simulate the gentle roll of the water…lake or ocean! These “blue environments,” not to be confused with “blue zones” are the subject of extensive research at the University of Exeter Medical School in the UK.

Time spent near water promotes physical activity, general fitness and well-being. In addition, noted for reducing the incidence of diabetes and other diseases associated with obesity. Additionally, time near the water slows down our heart rate, reduces stress hormones and improves mental health. In fact, the study also found that subconsciously, people consistently preferred pictures of natural environments (rivers, lakes, oceans) even when compared to attractive urban landscapes. In fact, urban landscapes with water (rivers, fountains etc) were far more popular than those without. Also, health disparities between coastal and inland communities are more noticeable for low-income individuals who do not have the means to venture to the coast. This may be one of the reasons that four out of the five “Blue Zones” discovered by Dan Buettner are islands.

WHY BEING IN, ON, OR AROUND THE WATER IS HEALTHY

• WATER STIMULATES ALL 5 SENSES -Water provides a totally immersive experience.  We feel the coolness trickling on our skin, we taste the salt, smell the seaweed, hear the waves and splash of the water, and see the sun glistening on the water.
• WATER STIMULATES OUR NERVOUS SYSTEM -Water impacts our physiology in that it triggers our parasympathetic nervous system to lower heart rate and blood pressure which promotes relaxation. Even the act of drinking a glass of water can promote relaxation and wellness.
• WATER IS BLUE…BLUE IS THERAPEUTIC -If the rolling blue waves in the lake and ocean aren’t enough, the blue light waves will work to promote further relaxation. Additionally, the beautiful backdrop of a blue sky is the icing on the cake to make you chill out! Similar to “white noise” used by millions of parents to promote sleep for infants and toddlers, “pink noise” (the noise associated with natural sounds) is more smooth, soothing, ongoing and natural as it reduces brain wave activity…have you ever experienced a “beach nap?”
• WATER STIMULATES OUR INNATE BIOPHILIA - The biologist and naturalist Edward Wilson coined the term “biophilia” to describe the theory that humans have an instinctive bond with nature. As a species, our origins have begun on open savannahs and endless shorelines. These natural environments instinctively return us to a simpler time and place.
• WATER IMMERSION BALANCES OUR HORMONES -Did you ever notice the inner harmony of swimming underwater or total floating? When you are doing these activities, your body sends signals to balance stress hormones similar to the bodies response to meditation or relaxing.
• WATER ACTIVITIES STIMULATE ENDORPHINS -Whether you are swimming, surfing, kayaking, paddle boarding, fishing, clamming, walking the shoreline, digging a water hole or making a sand castle, these activities will stimulate endorphins. These natural chemicals associate with increased levels of with happiness, pain management and overall well-being.

In addition to the benefits of being by a body of water, just being outdoors promotes better health and wellness:

• 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.
• 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
• Improved Mental Health – Documentation reveals that light affects mood. So, unless you live in a glass house or a light box, getting outdoors is important to your mental health.
• Improved Concentration – Richard Louv, author of the book, “Last Child in the Woods,” coined the term, nature-deficit disorder.” This term, supported by research, found children with ADHD focus better when 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.
• 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.

Sources: NIH, Global News, Plume, L, University of Exeter Medical School in the UK.

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

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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!

We’ve all heard it before – encouragement to exercise to trim our waistline or to speed up our metabolism.  However, there may be more benefit to lacing up those sneakers than you’d think.  Recent studies have established a link between exercise and cognition, making physical activity even more important.

The Benefits:

Exercise has been shown to improve sleep and mood, decrease stress, and even increase libido.  It also can bolster our self-esteem and ability to problem-solve and to remember details.  In fact, strength training has even been shown to reverse cognitive decline to a degree in aging adults with mild impairment. Though the medical community is still trying to elucidate exactly how exercise boosts our brains physiologically, increased circulation to the brain and modulation of the hypothalamus-pituitary-adrenal axis that regulates the body’s response to stress have been implicated as the bearers of benefit. While exercise can be advantageous for everyone, it perhaps is even more valuable to those struggling with mood disorders.  Exercise can help combat anxiety and depression and quell the symptoms of Attention Deficit Hyperactivity Disorder and Post Traumatic Stress Disorder as it helps the brain to pump out neurotransmitters and pain-fighting endorphins. Exercise makes addiction management easier, as well, and has recently been shown to help alcoholics lessen consumption.

How Much is Enough?

So, how much exercise exactly is enough to illicit tangible cognitive benefit, you ask?  Any amount of weight lifting, running, walking, or yoga helps, but habitual activity helps the most.  Studies cite that a few consecutive weeks of participation in a fitness regimen yielded notable, positive results in subjects.  Try to make exercise part of your daily routine to encourage good fitness habits.  If you find the idea of adopting a strenuous new fitness program intimidating or off-putting, have no fear.  Moderate exercise is enough to do the trick.  The Mayo Clinic cites both brisk walking and mowing the lawn as examples of moderate activity, so an average fitness level is adequate for yielding positive mental results. 

How To Begin:

If you’re thinking about beginning an exercise program for the first time, start gradually.  Begin with walking for 10 to 15 minutes twice daily, and add 1 or 2 minutes to your session every time you walk until you can walk continuously for 45 to 60 minutes.  The same principle can be used when beginning other fitness routines involving biking, swimming, running, etc.  Begin a weight training program to strengthen bones and tendons using 3 to 5 pound dumbbells, and increase the weight you use by a pound once you can easily perform 30 consecutive repetitions.  Be careful to pay close attention to posture and form. Contact your physical therapist or a personal trainer for assistance with designing an appropriate exercise program.  Don’t hesitate to contact your physician, either, if you have questions about whether a particular exercise program is safe and suitable for your age group or current fitness level. Consider these tips to make the most of your workout:

• Don’t let the idea of fitting exercise into your busy schedule stress you out.  If you can only find time to exercise on the weekends, do that.  Every workout, no matter how frequent, can help to recharge your brain.
• Understand that beneficial exercise doesn’t have to be particularly laborious or formal.  Walks around your block or playtime with the kids count as physical activity, too.
• Consider using a fitness app to track your progress – some even have barcode scanners and calorie counters to help you track food intake in addition to exercise.
• Unless you’re performing brisk aerobic exercise for over 60 minutes, opt for water when you work out rather than sports drinks.
• Exercise outdoors to gain an additional boost in creativity – a recent study showed that hikers performed better on cognitive tasks after spending time outside.
• Use your exercise sessions to let your mind wander.  Instead of using your time on the treadmill to plan your itinerary for the week, use it to focus on yourself, your breathing, and your movement.

Guest Contributor: Leanne Woiewodski, MD, graduate, GCSOM

Sources:

US National Library of Medicine, National Institutes of Health, Helpguide.org, IDEA Health & Fitness Association, Mayo Clinic, Public Library of Science

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

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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

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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!

What is a myth?

A myth is a traditional story, idea, or belief, especially one concerning early history of a people or explaining a natural or social phenomenon. It is a widely held but false belief or idea. In medicine, health myths are also widely held beliefs about health issues such as medicines, herbs, treatments, cures, antidotes, etc. which are partially or totally false and unsubstantiated in the scientific literature. This is a partial list of the most common health myths:

1. 8 GLASSES OF WATER IS ESSENTIAL FOR GOOD HEALTH
   • You don’t need to search very long to find copious information purporting the value of water to maintain good health. Sources suggest between 8 and 15 cups of water per day! Despite the plethora of contradictory information, there is no research to support an exact amount. In fact, most scientifically validated research suggests that healthy adults do not need to count cups and those who drink water when thirsty receive adequate hydration for good health. Remember, there are many water-rich foods to provide hydration; soup, fruit, vegetables, juice, coffee, and tea. However, be aware that if your urine is dark yellow you need more hydration. And, if you are very physically active or live in a warm climate, you may require more water.
2. EATING EGGS WILL LEAD TO HEART DISEASE
   • In the late 70’s, eggs received a bad reputation when high cholesterol in the blood could increase the risk of heart disease. The love-hate relationship with eggs and egg products has continued to grow since. However, recent findings suggest that eating an egg or two a day will not raise the risk of heart disease in healthy adults. While egg yolks do contain cholesterol, the amount is relatively small and is offset by the fact that eggs also have many nutrients such as omega-3’s, which are associated with lowering the risk of heart disease.
3. ANTIPERSPIRANTS CAN LEAD TO BREAST CANCER
   • Some research attempted to link the preservatives (parabens) used in some deodorants and antiperspirants with the activity of estrogen in the body’s cells because these parabens are found in breast tumors. However, there is no scientific evidence that parabens cause breast cancer. So, don’t sweat it!
4. SPENDING TOO MUCH TIME IN THE COLD AIR WILL LEAD TO A COLD
   • Sometimes “old wives tales” are true…but not this one! Grandparents and parents have been telling their grandchildren and children to button up and don’t spend too much time in the cold. In fact, one study found that healthy men who spent several hours a day in cold temperatures (just above freezing) had an increase in virus-fighting activity in their immune systems. Moreover, documentation supports that spending too much time indoors, especially during winter flu season, puts you at risk for getting the flu…so circulate fresh air or get outdoors!
5. EVERYONE NEEDS A MULTIVITAMIN TO BE HEALTHY
   • Research does not support this theory that everyone needs a multivitamin to supplement for nutrients not in your diet. In fact, most medical experts agree that healthy adults receive all necessary nutrients and vitamins from a well-balanced diet including; fruits, vegetables, whole grains, nuts and healthy oils. However, if your physician recommends a vitamin, do so. It may be that you are insufficient or at risk due to other medical conditions. If you are pregnant, for example, you will need to take folic acid to lower the risk of birth defects. 
6. EATING A GOOD BREAKFAST IS NECESSARY TO LOSE WEIGHT
   • Some diets purport that eating breakfast is necessary to stimulate your metabolism in order to lose weight. This theory is not confirmed, and for those who enjoy breakfast, it may limit hunger sensation and prevent unhealthy snacking. However, a study from Cornell University found that those who did not eat breakfast did not overeat at lunch and dinner and consumed approximately 400 fewer calories per day. So, for some healthy adults, eliminating breakfast can help lose weight…the premise of “intermittent fasting.”
7. GREEN MUCUS IS A SURE SIGN OF INFECTION
   • Most would agree, the slimy green mucus in your tissue is disgusting. However, without a lab test, it is not a sure sign of an infection or need for antibiotics. Often, clear mucus indicates a sinus infection, while green mucus represents a common cold.
8. TOO MUCH SUGAR MAKES KIDS HYPERACTIVE
   • Sugar making your kids hyper? Maybe it’s just kids being kids! It is widely accepted that sugar is not good for kids (unhealthy calories leading to obesity, etc). However, Research shows that it is not the cause of hyperactivity (caffeine or chocolate may). It may be that parents are so focused on their behavior after sugar intake that they expect their kids to be wired when it may just be attributed to the normal behavior of kids just being kids!
9. A TOILET SEAT IS A COMMON AREA TO SPREAD DISEASE
   • Believe it or not, toilet seats are not the most unsanitary item in the bathroom. So, if you can’t cover it, don’t sweat it. Bugs such as E. coli, norovirus, and other flu viruses cover bathroom doors, door handles, and floors. Thorough hand washing is essential and use a paper towel for door handles.
10. CRACKING YOUR KNUCKLES OR OTHER JOINTS WILL LEAD TO ARTHRITIS
    • One thing is certain…cracking your knuckles is annoying to everyone around you! But studies show that it is not harmful to your joints or causes arthritis. The popping noise is not because the bones are grinding together; it is due to movement of gas bubbles in the joint capsule.  
11. ELIMINATING FAT FROM YOUR DIET WILL MAKE YOU HEALTHIER AND HELP YOU LOOSE WEIGHT
    • Total elimination of fat from your diet is not only unnecessary to be healthy and lose weight, but is unhealthy and harmful. Fat provides essential nutrients and is an important component of a healthy diet. Due to the fact that fats have more calories per gram than protein or carbohydrates, limiting fat intake is necessary to avoid extra calories. Instead, chose low fat dairy products (milk, yogurt, cheese) and consider eating small amounts of food with healthy fats, such as avocados, olives, or nuts. 
12. CHILDHOOD VACCINES LEAD TO AUTISM
    • Vaccines do not cause autism. Despite much controversy, there is no scientific evidence that supports a connection between autism and childhood vaccines. In fact, the original study that started the debate years ago has been disproven and retracted. Fact: childhood vaccines protect children from a variety of serious or potentially fatal diseases.

SOURCES: WebMd; National Institutes of Health, Mayo Clinic

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 does not intend 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!

February is National Cancer Prevention Month and March is Colorectal Cancer Awareness Month. Unfortunately, according to a study conducted by Northeast Regional Cancer Institute (NRCI), our area has a higher rate of cancer compared to the rest of the United States. Residents of NEPA must be vigilant! While there is no fool-proof method for cancer prevention, scientific research does support the fact that healthy lifestyle choices are essential.

Important Tips to Reduce Your Risk of Cancer:

1. AVOID SMOKE AND SMOKING! - Perhaps the most important thing one can do to prevent cancer is to avoid smoking…first hand or second hand. It has been directly linked to cancer of the lung, head and neck, bladder and pancreas and others. Smoking increases the risk of lung cancer by 20 to 30 times.
2. Exercise, Exercise, Exercise - 30 -45 Minutes of moderate exercise or physical activity 4-5 days per week is recommended to reduce the risk of cancer. Walk, ride a bike, swim, or join a gym, just do something! However, individuals exercising for longer durations at higher intensities were shown to experience the greatest reduction in their risk cancer.
   • Why Exercise Works - Various biological mechanisms including hormonal changes have been suggested as possible reasons for the reduction in cancer through exercise. However, current research has demonstrated a strong link between cancer and stress. Stress, which reduces our body’s natural defense mechanisms, such as adrenal cortical or stress hormones, increases our susceptibility to disease including cancer. Exercise and physical activity has been shown to not only reduce stress, anxiety, and depression but also to elevate mood. These psychological improvements may be the reason why exercise and physical activity are effective in preventing cancer.
     • Obesity as a risk factor for cancer has been demonstrated in the scientific literature for years. Individuals that are more physically active are usually not overweight. Exercise increases basal metabolic rate, expends calories, and burns fat to help control your weight and to help maintain a more normal lean body mass. Physical activity and exercise prevent obesity.
   • Colorectal Cancer - Physical activity and exercise has been shown to have the greatest prevention against colorectal cancer. Colorectal cancer is the second leading cause of cancer death among American men and women combined. Physical activity reduced the risk of colorectal cancer up to 70% for both men and women.
   • Breast Cancer - Research has been able to establish a similar relationship between physical activity and breast cancer. Approximately one out of every eight women in the United States can develop breast cancer at some point in their lifetime. Exercise has been shown to reduce the risk of breast cancer up to 40%.
   • Prostate Cancer - Prostate cancer, the second most common cause of male death, will affect one in every five American males. However, the risk of prostate cancer can be reduced up to 30% through physical activity and exercise. Researchers hypothesize that exercise may have its greatest protective effect against prostate cancer when initiated early in a man’s life.
   • Cancer of the Lung/Uterus/Cervix - Lung cancer is the leading cause of cancer death in the United States. Cancers of the uterus and cervix will accounts for 7,400 deaths annually in the United States. Exercise and physical activity can reduce the risk of lung and uterine/cervical cancer up to 40% and 90%, respectively.
3. Avoid Obesity and Stress - Both obesity and stress, as mentioned above, have been linked with cancer of various types. A healthy low-fat diet, limited in red meat, with moderate amounts of fish, rich in fruits, vegetables and nuts along with and regular exercise are essential components for prevention , especially for colorectal and prostate cancer.
4. Use a Water Filter - The use of a good home water filter has many healthy benefits. It may reduce your exposure to carcinogens and other harmful chemicals. Also, using a steel or glass container to store drinking water is important to avoid chemicals such as BPA found in plastic bottles.
5. Drink Plenty of Water - The American Cancer Society recommends drinking more than 8 cups of water per day to prevent bladder cancer by diluting the concentration of urine in the bladder. 
6. Limit Consumption of Meat - Processed, charred, blackened, and well-done meats are associated with heterocyclic amines, which are cancer causing and formed when charcoal broiling meat. Marinating meat for an extended time prior to grilling has been recommended to improve safety according to some studies.
7. Eat Green Vegetables - Some studies suggest that the really dark greens such as spinach, kale, collards and broccoli are valuable in cancer preventions. Endive, arugula, and romaine must be added to this list.
8. Eat Nuts - Some studies show that snacking on Brazil nuts and other nuts high in antioxidants, lowers the risk of some cancers such as bladder, lung and colorectal.
9. Limit Sun Exposure - Take time to use adequate sun block and proper clothing to protect your skin from the sun to prevent skin cancer, especially if you are light skinned. At all costs, avoid sunburn!
10. Eat Organic and Natural Foods - When possible, buy fresh foods and meats free of antibiotic and hormones. Choose organic produce grown free of pesticides. Eat farm-raised fish and limit consumption of fish from waters high in mercury concentration
11.  Visit Your Physician Regularly - Regular check-ups by your physician is essential to stay healthy and have early detection of disease. Many tests and vaccinations offer life saving information such as: PAP tests, mammograms, colonoscopies, PSA blood tests and others. Ask your physician about new vaccinations such as HPV, Human Papillomavirus. These are important for the prevention of cervical cancer in women and head and neck cancer in men.

Source: American Cancer Society

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!

Last week we discussed the healthiest New Year’s Resolutions, however, given the fact that 80% of those who made resolutions will have failed by January 19^th, this week I will recommend the use of technology to improve the odds…there is an App for that!

While some apps can be a waste of time, when you find the right app for you most polls show that it can be extremely helpful. They can be used for learning, socializing, calculating, writing, graphing, news, weather, music, school, money AND HELPING YOU KEEP YOUR NEW YEAR’S RESOLUTIONS!

According to “Per Statista,” the most common resolutions are as follows: save money (59%), exercise more (50%), more time with family and friends (40%), lose weight (35%), spend less money (26%), less time on social media (19%), and less job stress.

Apps for Saving Money

Goodbudget, YNAB (You Need A Budget), PocketGuard, and Quapital are some of the better budget Apps. Some of these Apps are free, while others require a nominal fee. In addition to tracking spending and saving, most allow you to set you own parameters and goals. Some helpful features are: moving money from checking into savings every time you buy a coffee.

Apps for Tracking Exercise

In addition to wrist trackers like Fitbit and Smart Watches, there are exercise equipment options with programs and tracking like Peleton, Norditrack and exercise mirrors like Tonal. However,  there are also specific Apps that help you set goals and see your progress. Some of these include: Fitness22, FitNotes, MyFitbnessPal and Strong. Some of these allow you to input your exercises and create graphs showing progress in body weight, fat percentage and more.  These Apps are especially useful for those who dislike going to the gym.

Apps for Prioritizing Time with Family and Friends

While distance-base technology such as Skype, WhatsApp, and Zoom worked well to keep connected during the pandemic and after, there are other Apps that offer more personal ways. Cozi is one of the best as it offers a simple organizer that displays the schedule of the entire family to assist you in planning a get together. Cozi is a great option as a simple organizer that offers a clear visual representation of the entire family’s schedule. It not only shows when people are free but also tracks the amount of time you spend (or don’t spend) with these special people.   

Apps for Losing Weight

There are so many weight loss apps available that it is easy to get confused or overwhelmed. Some of the most popular with the best reviews are: Noom, Reverse Health, Perfect Body, WeightWatchers and MyFitnessPal. MyFitnessPal has the added benefit of tracking exercise and activity with a calorie expenditure report. Simply set a goal, enter food intake and exercise/activity output and the app calculates the rest. A bar-code scanner makes it even easier!

App for Bill-Tracking

Keeping a better eye on finances and expenses is a common resolution, especially as the holiday bills come in. Stax Bill, NetSuite, Paystand and Rocket Money are highly rated. These apps help you budget, save, provide an income analysis and credit scores, and disclose recurring fees.

App for Reducing Stress at Work and Home

Reducing stress is another common resolution and learning stress management techniques and incorporating them into our daily lives is vital. Some of the highly rated apps are: Personal Zen, Sanvello, The Mindfulness App, Headspace and Moodfit. These apps not only give you the tools for managing stress but also provide insights into your mood patterns and stressors. In addition to a “blue mood” you can also track gratitude and other feelings. Also, nutrition, sleep, and medications, which can affect your mood, can also be tracked. Once a pattern is established, tools can be applied to reduce and manage stress.

App for Reducing Time on Social Media

While at first glance it may seem odd that one might use an app to stop using another app but…don’t rule it out! OneSec is an app that creates a 10 second delay after you open an app to allow you time to pause and take a deep breath before you indulge. It will also tell you how many times you have opened the app in the last 24 hours…you might be shocked!

SOURCE: LIFEHACKER

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

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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: mmptc@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 Scranton and Clarks Summit and is an associate professor of clinical medicine at GCSOM. For all of Dr. Mackarey's articles, visit our exercise forum!

3^rd of 3 Columns on Balance Disorders and Falls Prevention

Preventing a fall can not only save your independence but also your life! Preventing injuries from falls reduces the need for nursing home placement. Injuries from falls are the seventh leading cause of death in people over the age of sixty-five.

The following suggestions will assist you in minimizing your risk of a fall:

• Diet & Hydration: Proper nutrition and hydration provides adequate amounts of vitamins and minerals to maintain energy levels and prevent drowsiness. Adequate hydration is also important. Treat dehydration from fever, diarrhea and vomiting by drinking plenty of fluids. You may need IV fluids administered in hospital.
• Exercise: Exercise and activity improves strength, flexibility and balance.
• Medication: Consult a pharmacist or physician regarding medications that can cause: drowsiness, dizziness, lightheadedness, faintness, fatigue, tiredness, unsteadiness, blurred vision, double vision, confusion, or otherwise affect alertness, balance or coordination.
• Positional Changes: Avoid sudden drops in blood pressure by avoid sudden changes in posture and position, standing up slowly, sitting for a few minutes and tapping your toes before getting out of bed and raise head of bed with a wedge pillow.
• Alcohol: Be cautious with alcohol since it interferes with alertness, balance, coordination and reflexes.
• Illness: Treat respiratory infections such as ear infections, colds, flu, sinus congestion to prevent labyrinthitis and Meniere’s disease.
• Frequent Urination: Be cautious with urgency, especially at night.  Consider bedside commode and a grab bar by toilet. Turn lights on and put on eyeglasses to supplement vision. Night lights are recommended. A pendant alarm may be beneficial.
• Vision: Check eyesight and hearing regularly. Poor eyesight makes it difficult to see potential hazards. Update old eyeglasses. Inner ear problems can affect balance. Adequate lighting is paramount. Light switches should be within reach without getting out of bed and on both ends of hallway. Nightlights in bedroom, bathroom and hallway are recommended. Keep a flashlight handy. Turn lights on when entering house and at night.  Use light paint and wallpaper to reflect more light. Use 100 watt bulbs for an adequate amount of light.
• Assistance Devices: Use assistive devices when negotiating uneven terrain or when you feel weak or tired. To avoid falls in the bathroom install grab bars in the shower, tub, and toilet areas. Use bathmats with suction cups or nonslip adhesive strips in tub/shower. Consider a shower stool or bench and an elevated toilet seat.
• Good Footing: Proper footwear with a flat sole, wide base and nonslip grips are important. Footwear should be tied securely and fit snugly. Do not walk in stocking feet
• Remove Hazards: Inspect your floors for hazards! Remove rugs and runners that slip or attach nonslip backing. Tack loose rugs. Glue vinyl flooring. Keep pathways free of electrical/telephone cords. Remove wax from floors. Mops up spills promptly.
• Safety on Stairs: Install secure handrails on both sides. Improve lighting. Ensure carpeting on stairs is firmly attached. Highlight with tape or paint edges of steps especially if narrow or higher/lower than the rest. Paint outdoor steps with a mixture of paint and sand for better traction. If carrying item up or down steps, use handrail.
• Walkways: Sidewalks and walkways should be clear, well lit and free of snow and ice. Salt or sand if slippery. Repair uneven paving.
• Eliminate clutter: Do not store items on steps. Rearrange furniture to move around easier. Watch out for pets. Avoid stepping over pets.
• Store Items Within Reach: Limit reaching by storing frequently used items where they can be reached easily. If reaching is required, use a stepstool with high, sturdy handrails. Repair or discard wobbly stools. Do not use a chair to reach for items.

Following these helpful hints will keep you safe by preventing a loss of balance and a potential fall!

Contributor: Janet M. Caputo, PT, DPT, OCS

Medical Reviewer: Mark Frattali, MD, ENT: Otolaryngology /Head Neck Surgery at Lehigh Valley Health Network

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. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.

For all of Dr. Mackarey's articles, visit our exercise forum!

2^nd of 3 Columns on Balance Disorders and Falls Prevention

Last week we discussed the causes of balance loss. Today, we will discuss treatment for this problem. Two primary treatments are medication and vestibular rehabilitation.

1. Medication

Medication for dizziness and loss of balance requires a visit to your family doctor. In a more involved case, your family physician may refer you to a specialist such as an ear, nose and throat physician or neurologist. There are many medications available for loss of balance. While this can be complicated, the specialist will determine the most appropriate one for your balance disorder.

2. Vestibular Rehabilitation

Vestibular rehabilitation for dizziness and loss of balance is a great adjunct to medication to manage your balance disorder. It is a comprehensive program that addresses a wide range of problems that may cause imbalance such as: addressing the inability to tolerate motion, visual changes, providing balance rehabilitation, instruction in repositioning techniques for BPPV (benign paroxysmal positional vertigo), correcting postural dysfunctions, muscle weakness, joint stiffness, offering education for prevention, maintenance and self care after discharge. Through experience and motion, vestibular rehabilitation allows: formation of internal models (one learns what to expect from ones actions), learning of limits (learning what is safe and what is not) and sensory weighting (one sense, either vision, vestibular or somatosensory is selected in favor of another in maintaining balance).

In some minor cases, vestibular rehabilitation may be performed at home. However, more serious cases may require an evaluation by a physician specializing in the dizzy patient such as an ear, nose and throat physician or neurologist. These specialists will determine the nature of your problem and may enroll you in a more structured program under the direction of a physical therapist. ­Vestibular rehabilitation addresses not only vertigo (i.e. dizziness) but also balance problems.   

Benign Paroxysmal Positional Vertigo (BBPV)

Benign paroxysmal positional vertigo (BPPV) and vestibular hypofunction (e.g. unilateral and bilateral vestibular loss) are two causes of vertigo that can be addressed by a vestibular rehabilitation. Your physical therapist will tailor a program designed to address your specific vestibular disorder (i.e. BPPV or hypofunction).

If you have been diagnosed with BPPV, your therapist may take you through an Epley maneuver. In BPPV, particles in the inner ear become displaced and get lodged in an area that produces vertigo. Vertigo is experienced with tilting head, looking up/down and rolling over in bed. The causes include: infection, head trauma and degeneration. During the Epley maneuver the patient is guided through positional changes which clear these particles from the symptomatic part of the ear.

If you have been diagnosed with either unilateral or bilateral vestibular hypofunction, your therapist will most likely design a program to “retrain” your vestibular system with special exercises, including:

• Gaze Stability Exercises for unilateral hypofunction involve staring with eyes fixated on a stationary object held at eye level. The head is rotated from left to right or up and down while gaze is maintained. Once mastered, your therapist will increase the challenge by either changing your position (e.g. from sitting to standing).
• Habituation Exercises are designed to “desensitize” your brain to the sensation of vertigo. Our sensory system is designed to protect our bodies from harmful stimuli. Many harmful stimuli produce painful sensations. However, vertigo (i.e. dizziness) is not painful. Therefore, if we expose ourselves to movements that produce dizziness, our bodies will eventually “get used to the sensation” and start tuning it out until the movement no longer produces “dizziness”.  

If you have a vestibular problem that primarily manifests as loss of balance, exercises to stimulate your balance responses, strengthen your legs, and enhance your joint position sense may be helpful. These exercises encourage reliance on vestibular and/or visual input. The exercises are performed on unstable surfaces (i.e. tilt boards, balance beams, and foam) and include a variety of tasks from simple standing to more complex arm and leg movements requiring coordination.

Other Vestibular Treatment Options:

In addition to the above mentioned treatments, Posturography and Virtual Reality Training are computerized programs that may be used by your therapist to address your vestibular and/or balance problem. Also, Recreational Activities that involve using your eyes while head and body is in motion (i.e. dancing, golfing, tennis, walking while looking from side to side) are shown to be helpful in stimulating balance and vestibular responses. Furthermore, you may consider Alternative Balance Activities (i.e. Yoga, Tai Chi, Pilates) which incorporate slow gentle movements to improve strength, balance and posture as well as relaxation techniques for the anxiety that accompanies dizziness/off-balance.

Whatever you do, just DO NOT give into your dizziness. People that just “give up” become sedentary. A sedentary lifestyle further denies your body the necessary stimuli to challenge your vestibular system and make it stronger. Eventually, these people end up in a vicious cycle because the more they sit the dizzier and more off balance they get which only makes them sit more! 

Remember, one fall increases your risk of another fall. It is imperative to determine what caused your fall and take action! Ask your physician or physical therapist to assess your fall risk.                                                                                             

Contributor: Janet M. Caputo, PT, DPT, OCS

Medical Reviewer: Mark Frattali, MD, ENT: Otolaryngology /Head Neck Surgery at Lehigh Valley Health Network

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog: Next Monday Part III on Balance Disorders and Falls Prevention

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. Dr. Mackarey is in private practice and is an associate clinical professor of medicine at GCSOM.

For all of Dr. Mackarey's articles, check out our exercise forum!