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The “first Thanksgiving” was in 1621 between the Pilgrims of Plymouth Colony and the Wampanoag tribe in present day Massachusetts to celebrate the harvest and other blessings of the previous year. In 1789, President George Washington, at the request of Congress, proclaimed Thursday, November 26, as a day of national thanksgiving. In 1863, Abraham Lincoln proclaimed the national holiday of Thanksgiving to be the last Thursday of November.

Americans and Canadians continue to celebrate this holiday as a time for family and friends to gather, feast, and reflect upon their many blessings. Like most, I am very grateful for the simple things; family, good friends, food, shelter, and health. This year, I am also thankful for the dedicated scientists who developed the COVID 19 vaccination so we can safely enjoy Thanksgiving with our families. It turns out that being grateful is, not only reflective and cleansing; it is also good for your health!

Grateful people are more likely to behave in a prosocial manner, even when it is not reciprocated. A study by the University of Kentucky found those ranking higher on gratitude scales were less likely to retaliate against others, even when others were less kind. Emmons and McCullough conducted one of the most detailed studies on thankfulness. They monitored the happiness of a group of people after they performed the following exercise:

There are many things in our lives, both large and small, that we might be grateful about. Think back over the past week and write down on the lines below up to five things in your life that you are grateful or thankful for.” The study showed that people who are encouraged to think of things they’re grateful for are approximately 10% happier than those who are not.

7 Proven Health Benefits of Being Grateful     

  1. Being Grateful is Contagious: Studies show that something as simple as saying “thank you” to a stranger holding a door open for you or sending a co-worker a thank you note for helping you with a project makes them more likely to continue the relationship. Showing gratitude can improve your life by fostering solid friendships.
  2. Being Grateful Improves Physical Health: Research has found that those who are grateful experience fewer aches and pains and tend to report that they feel healthier than most people. Moreover, grateful people are more likely to be health conscious and live healthier lifestyles.
  3. Being Grateful Improves Psychological Health: Multiple studies have demonstrated that gratitude reduces many negative emotions. Grateful people have less anger, envy, resentment, frustration or regret. Gratitude increases happiness and reduces depression.
  4. Being Grateful Fosters Empathy and Reduces Aggression: Participants in a study by the University of Kentucky found that those who scored higher on gratitude scales were less likely to retaliate against others and were more sensitive and empathetic when compared to low gratitude scorers.
  5. Being Grateful Promotes Better Sleep: A study published in Applied Psychology, found that 15 minutes of writing down a gratitude list before bed led to better and longer sleep.
  6. Being Grateful Improves Self-Esteem: When studying athletes, it was determined that those who scored high on gratitude scales demonstrated improved self-esteem which led to optimal performance. Conversely, those athletes who were not grateful and resented contemporaries making more money, for example, had lower self-esteem and negative performance outcomes.
  7. Being Grateful Improves Mental Strength: Research has repeatedly shown that gratitude not only reduces stress, but also improves one’s ability to overcome trauma. For example, Vietnam veterans who scored higher on gratitude scales experienced lower incidences of post-traumatic stress disorder. Recognizing all you have to be thankful for, even during the worst times of your life, fosters resilience.

Conclusion: Amy Morin, psychotherapist, mental health trainer and bestselling author offers this advice: “Developing an “attitude of gratitude” is one of the simplest ways to improve your satisfaction with life. We all have the ability and opportunity to cultivate gratitude. Simply take a few moments to focus on all that you have, rather than complain about all the things you think you deserve.” So…be grateful and have a happy Thanksgiving!

Source: NIH, Forbes, Amy Morin “13 Things Mentally Strong People Don’t Do.”

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

Part II of II

November is National Chronic Obstructive Pulmonary Disease (COPD) month. COPD is the fourth leading cause of death in the United States, according to the Centers for Disease Control and Prevention. This problem refers to a group of lung diseases that causes damage to the airways and air sacs in the lungs.  People with COPD suffer from diminished airflow and difficulty breathing. Emphysema and chronic bronchitis are two of the most common types of COPD. The damage can't be reversed, so treatment includes medications and lifestyle changes designed to control symptoms and minimize further damage, according to the Mayo Clinic.

Exercise is an important part of life for those with COPD because it improves the overall strength and endurance of respiratory muscles. When you exercise, muscles adapt and use oxygen more efficiently so your lungs don't have to work so hard. Also, in addition to improvement in breathing, exercise boosts mental health, helps maintain a healthy weight and blood pressure, and improves circulation. Most importantly, exercise will improve your quality of life with COPD. Before you begin an exercise program, see your family physician or pulmonologist for approval. Then, see a physical therapist to design a program specific to you needs. Always begin slowly and rest if you get short of breath, have chest pain, feel dizzy or sick to your stomach.

TOP EXERCISES FOR THOSE WITH LUNG DISEASE

1. Endurance Exercises

While not all of these endurance exercises may be appropriate for you, one or two of these may offer a good starting point.

Walk Around the House – Start walking around the house for 1-2 minutes nonstop. Every 1-2 hours. Then, add 1-2 minutes every week.

Static Marching – hold onto the countertop or back of chair and march in place for 30 seconds. Rest 1-2 minutes and repeat. Do 5 cycles. Add 5-10 seconds every week.

Climb the Steps – If you can do so safely, use the steps for exercise 1-2 times per day. Then, add 1-2 times per day.

Walk the Mall/Treadmill – If you are able to get out of the house and can tolerate more extensive endurance exercises, get out and walk the malls or use a treadmill.

Recumbent Bike – If balance is a problem, but you can tolerate more extensive. Endurance exercise, use a recumbent bike (a bike with a backrest)

Walking is free exercise and can be done in some form by almost everyone…even with an assistive device such as a cane or walker. For those with COPD who are active and fit – walk 4-5 days per week for 30 to 45 minutes. Less fit individuals can walk for 15 to 20 minutes. For those with COPD who are in poor condition and have significant SOB – walk for 2-3 minutes (to the bathroom or around the house) every 30 to 45 minutes. Try not to sit for 60 minutes without getting up and walking around.

2. Posture Exercises

Posture exercises are designed to keep your body more upright and prevent rounded shoulders and forward head/neck. More erect posture promotes better breathing. Perform 5 repetitions each 3 -5 times per day

Row-The-Boat - Pinch shoulder blades together as if you are rowing a boat.

I-Don’t-Know – Shrug shoulders up toward the ears as you do when you say “I don’t know.”

Chin Tucks – Bring your head back over your shoulders and tuck your chin in

3. Arm Exercises

Bicep Curls – sit in chair and bend your elbows up and down with a can of peas in your hands

Wrist Curls – as above but bend your wrists up and down

Chair Push-ups – Push up with your arms to get out of a chair

Saw Wood – pull a light resistance band (yellow) back from a door knob as if you were sawing wood.

4. Leg Exercises

Hip Hikes – Sit in chair and march by hiking your hip and lifting up your heel 4-6 inches off the floor

Leg Kicks – Sit in chair and kick your knee out straight – then bend it down to the floor

Hips Out and In – Sit in chair and bring your knees in and out against a resistance band

Toe Raise/Heel Raise – Sit in chair and raise your toes up – then raise your heels up

5. Breathing Exercises

Diaphragmatic Breathing - The diaphragm muscle is essential for breathing. While sitting or lying down, put one hand on your abdomen and the other on your chest. Slowly inhale through your nose and try to separate the hand your stomach from the hand on your chest. Then, slowly exhale through pursed lips.

Pursed Lipped Breathing - breathe in through your nose slowly for 3- 5 seconds. Then, purse your lips as though you're going to whistle. Lastly, exhale slowing through the pursed lips over 5 to 10 seconds.

More Info

“Better Breathers Club,” in conjunction with the American Lung Association, offers a free local support group to help patients and their families suffering from COPD and chronic lung disease. For more information contact the American Lung Association at www.lung.org

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

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

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

Part I of II

World COPD Day 2022 is Wednesday November 16th! The purpose of this two part series on lung disease is to raise the level of awareness for the prevention and treatment of this disease.

Chronic obstructive pulmonary disease (COPD)

Chronic obstructive pulmonary disease (COPD) has become the fourth leading cause of death and is one of the only major chronic diseases which has seen an increase in mortality rates.  COPD includes emphysema, chronic bronchitis and asthma.

Patients with COPD suffer from progressive shortness of breath, cough, wheeze, and sputum production.  Most patients with emphysema have been cigarette smokers. 

Patients with emphysema develop obstruction to airflow as a result of narrowing of bronchial tubes due to excess mucous, smooth muscle constriction, and destruction of lung tissue.  Eventually, the lungs become over distended, which leads to overexpansion of the chest itself.  This process leads to the so-called ''barrel chest'' appearance of patients with advanced COPD. 

The most common symptom of COPD is shortness of breath.  Initially the patient complains of shortness of breath only with exertion, but symptoms progress over time to include difficulty breathing, even at rest.  Eventually the disease worsens to the point that oxygen is required and the patient may become severely disabled.  

Treatment of COPD starts with smoking cessation, and, when symptomatic, patients are started on inhaled bronchodilator medications.  Some of these medications include albuterol, ipratropium, titotropium, and inhaled steroids. Long-acting bronchodilators such as formoterol or salmeterol and theophylline medications may be added.  Oxygen is added when the patient's own oxygen level falls to a certain point.  In fact, oxygen is the only therapy that has been shown to prolong the life of patients with COPD. 

Over time, patients with COPD decrease their level of activity due to the sensation of shortness of breath.  This downhill slide eventually leads to a very sedentary existence.  Recent studies have shown that COPD not only affects the lungs, but is a condition which affects the diaphragm and the peripheral muscles. Patients with COPD have been shown to have abnormal limb muscles as a result of deconditioning and systemic inflammation. 

Exercise and Lung Disease

Pulmonary rehabilitation has been shown in numerous studies to decrease the shortness of breath associated with COPD.  Exercises to strengthen the arms are helpful to assist patients in performing activities of daily living such as combing hair, cooking, and reaching objects above their heads.  Walking and riding a stationary bike are helpful to exercise the leg muscles, especially the large thigh muscles. Despite the fact that exercise programs may not improve lung function, the patients overall level of function are almost always improved.  

Patients who participate in rehab programs have less shortness of breath, are less likely to be hospitalized, and have improved functional capacity.  These patients have lower rates of healthcare utilization, and improved overall health status and quality of life scores. The ideal pulmonary rehabilitation program includes smoking cessation training, breathing and relaxation exercises, nutritional information, and training in proper use of medications.  The most important feature of a pulmonary rehab program, however, is aerobic exercise involving the arms and legs. 

Pulmonary rehabilitation is an integral part of the treatment of a patient with

COPD, and should be considered in any patient who can tolerate exercise.  A cardiac stress test should be done to ensure that there are no occult coronary artery blockages or cardiac rhythm abnormalities. 

In summary, COPD is a growing cause of disability, morbidity, and mortality.  Medications, oxygen, and pulmonary rehabilitation can help to improve symptoms and quality of life.  The combination of bronchodilator medications with pulmonary rehabilitation is the most effective approach when treating patients with COPD.  Next week, in Lung Disease - Part II, learn more about pulmonary rehab for patients with COPD to improve their functional status.  

Guest Columnist: Dr. Gregory Cali, DO – is a pulmonologist (lung doctor) in Dunmore, PA.

Visit your doctor regularly and listen to your body.     

Keep moving, eat healthy foods, and exercise regularly

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

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, PA and is an associate professor of clinical medicine at GCSOM.

See all of Dr. Mackarey's articles at www.mackareyphysicaltherapy.com/forum

According to the World Health Organization about half of the world’s adult population has had a headache at least once in the past year. Prolonged use of electronic devices has greatly contributed to this problem. For many people, these headaches are infrequent and do not often affect daily life.  But what about when your headache occurs frequently or is so severe it prevents you from going about your day to day activities? Some types of headaches are more easily treated and managed than others.

There are two types of headaches: primary and secondary. Primary headaches occur without an underlying disease and include migraines and tension-type headaches.  Secondary headaches can be associated with serious disease, requiring emergency care, or can be referred from other structures of the body such as the cervical spine (neck). 

Headaches symptoms that may constitute a medical emergency are: vomiting, seizures, fever, muscle pain, night sweat, weight loss, and neurologic symptoms such as blurred vision.  If you are experiencing any of these symptoms, if your headache worsens, or your symptoms change it is recommended that you seek medical attention. Any headache that is unusual for you and does not resolve itself in a reasonable time should be brought to your primary care physician’s attention.

Primary Headaches:

Migraines: Migraines are a primary form of headache that typically lasts from four to seventy two hours, can range from moderate to severe pain, and typically are located on only one side of the head.  Often they can be accompanied by an aura, nausea or vomiting, sensitivity to sound, or light sensitivity.  Migraines can be aggravated by routine physical activity such as going up stairs. This type of headache is thought to occur in the central nervous system and is related to blood vessels.

Tension-type: Tension-type headaches are the most common primary headache disorder and can last anywhere from thirty minutes to seven days.  These can often have a pressing or tightening quality that occurs on both sides of the head.  Here there is no nausea, vomiting, light sensitivity, or aggravation with physical activity. This type of headache is thought to occur in the central nervous system but can have a hereditary component and is usually associated with muscle tender points. Tension – type headaches can be treated with relaxation techniques such as Progressive Muscle Relaxation (PMR), medications, and physical therapy.

Secondary Headaches:

The most common secondary headache that is not related to a serious medical condition is a cervicogenic headache (originating from the neck).

Cervicogenic Headache: The length of time a cervicogenic headache can last varies.  Here the pain is on one side and usually starts in the neck.  This type of headache is aggravated or preceded by head postures or movements of the neck.  Due to the nerves of the neck and face sharing common connections, pain signals sent from one region can lead to discomfort in the other.  Physical therapy can be an effective treatment to help relieve symptoms. For example: posture, exercise, ergonomics, massage, manual techniques, traction, trigger point, and acupressure.

A cervicogenic headache can be caused by an accident or trauma or can stem from neck movement or sustained postures.  Sustained postures could mean sitting in front of a computer at work or looking down at your phone.  Changing these postures throughout the day could help reduce symptoms.  Changing postures could mean bringing your phone closer to you using pillows or another supportive surface when reading or checking social media.  If you are someone who works at a desk, it could involve taking breaks or getting a standing desk.  However your life requires you to move, there are some simple and effective exercises you can perform throughout the day to help cervicogenic headache symptoms.

5 TIPS FOR TENSION HEADACHES

Progressive Muscle Relaxation: PMR is an effective method for reducing tension throughout the body.  With this method you first tense a muscle group, such as at the neck or shoulder, and then relax the muscles noting the difference between the two.  This helps reduce both stress and tension. For more information or to learn how to do PMR, refer to podcast at: https://www.psychologies.co.uk/try-progressive-muscle-relaxation

Manage your stress level: While stressors vary from person to person, one method for managing stress is with exercise.  Any form of exercise can help reduce stress, but a cost free method is aerobic exercise such as walking or running.  A less time consuming method could be to perform deep breathing exercises throughout the day.

Heat or cold: When feeling sore or stiff, applying a hot or cold pack or taking a hot shower can help ease a tension headache. 

Posture: Some tips for posture are to make sure your head is over your shoulders rather than sitting forward and making sure you are sitting or standing up straight with your shoulders back. 

Over the counter medications: Talk to your doctor or pharmacist for additional information.

5 TIPS FOR CERVICAL HEADACHES

Posture: See tips listed under tension headaches.

Ergonomics: If your job or hobbies require you to sit for extended periods it may be beneficial to change positions throughout the day or consider getting a standing desk. Also, limit time on electronic devices. When sitting make sure the monitor is at eye level, your legs are able to fit under your desk, and you are close to the keyboard and monitor.  If you are working with a laptop or phone, avoid putting it on your lap. Instead, bring your laptop closer to you by putting pillows on your lap.

Exercise: Some exercises to help relieve symptoms are chin tucks, shoulder blade pinches, and back extension.  These exercises can be performed multiple times throughout the day in sitting or standing.

Physical Therapy: Physical therapy may include massage, manual techniques, stretching, traction/ decompression and exercise.  A physical therapist can assess your posture and provide strategies specific to you.

Over the counter medications: While medication may not cure cervicogenic headaches, they may help relieve pain. Talk to your doctor or pharmacist for additional information.

Contibutor: Alexa Rzucidlo, PT, DPT

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 Geisinger Commonwealth School of Medicine (formerly The Commonwealth Medical College).

Part I of II

Introduction

As the days continue to get shorter and temperatures begin a slow steady decline, athletes and exercise enthusiasts will work harder to “fit in” a warm-up before running or other activities during the winter months. 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.

How the Achilles Works

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

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.

Achilles Tendon

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.    

Achilles and Age

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.

Achilles Tendon Rupture Symptoms

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

As more of us become more comfortable living with COVID 19, travel plans have exploded. For 2 ½ years many have put air travel for family vacations on hold and we are eager to get back to air travel. As you may have gathered from my previous columns, travel is one of my passions. My family and I have been fortunate to have visited many spiritual places of natural wonder and beauty that we call our National Parks. Many of the parks are on the west coast and require some preparation to endure the many hours of travel by airplane through different time zones. Moreover, travel to other countries and continents, often requiring 8, 10, 16 or more non-stop hours on a plane can really take a toll on your mind and body and gave new meaning to the term “jet lag.”  

WHAT IS JET LAG?

According to the Mayo Clinic, jet lag, also known as jet lag disorder, is a sleep disorder that can occur in people who travel through different time zones in a short period of time, such as a flight from New York City to Los Angeles. Obviously, the further the distance traveled and the more time zones entered, the more significant and drastic the symptoms, as found, for example, in those traveling from the United States to Asia.

Sunlight has a direct impact on our internal clock by regulating melatonin, a hormone that regulates sleep and wake cycles in the body. Travel through different time zones can affect the amount and duration of sunlight and therefore, impact the regulation of these cycles. The inability to regulate the cycles results in many symptoms.

SYMPTOMS OF JET LAG

PREVENTION OF JET LAG

EXERCISES FOR JET LAG

Posture Exercises

Posture exercises are designed to keep your body more upright and prevent rounded shoulders and forward head/neck.

Arm Exercises

Leg Exercises

Breathing Exercises

Read Dr. Mackarey’s Health & Exercise Forum – every Monday

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

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

REMEMBER TO HYDRATE

The 25th Steamtown Marathon is one month away! While the serious heat waves of summer may be behind us, any prolonged endurance activity in minimal to moderate heat can be dangerous if not prepared. Adequate hydration is critically important, not only to those training for a marathon but also for other outdoor endurance activities such as cycling, hiking, long distance power walking, etc

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

In Our Body...

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.

This Risks

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

Is water enough?

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

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

Dehydration

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

American College of Sports Medicine Hydration Recommendations:

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.

A NEW APPROACH TO WEIGHT LOSS

There are many reasons why losing weight, the number one health goal in America, is the most elusive. Not the least of these reasons is the psychology of eating…because in the land of plenty, we eat mindlessly! Consider the facts; first, we blamed it on the fact that the food was unhealthy…but when we chemically modify the food such as removing or altering the fat or sugar and removing the calories, it failed to reduce our weight. In fact, it has been discovered that “fake sugar,” even thought it does not have calories, can still increase blood glucose levels. Next, we decided fat cells were the enemy but we failed to control our weight when we removed fat cells from our body through liposuction. Then, we decided the problem was our digestive system so we placed bands or staples in the stomach or by-passed the small intestine. While these efforts helped many in the short run, long term, without a change in behavior, it failed as a long-term solution. Many medical professionals have concluded that the problems people have with weight are not exclusively due to the food, fat cells, stomach or intestines, but rather, THE MIND! 

WHAT IS MINDFUL EATING?

Mindful eating, also referred to as intuitive eating, is based on Buddhist teachings in which focus is placed on the experience of eating, AND ENJOYING, our food. The concept was presented in a feature column in The New York Times written by Jeff Gordinier based on his time spent in a Buddhist monastery. He discovered that mindful eating practitioners ate in silence and chew small pieces of food very slowly and deliberately to experience its taste, texture and smell. It requires full attention to the experience of eating and drinking on the body and mind. It is often referred to as “the opposite of diets” because with mindful eating there is not right or wrong way to eat but rather varying degrees of awareness about WHAT WE EAT AND WHY. Furthermore, the goal of this exercise is to teach our mind and body to connect and communicate while eating so one can learn important cues such as: what are my hunger signals? What does my stomach feel like when it is half, three-fourths and completely full?

THE RESEARCH

One study of 1,400 mindful eaters found that they enjoyed lower body weights, greater sense of well-being and suffered from fewer eating disorders. However, many feel the concept, while valuable, is very difficult to put in practice in the busy American family. Research shows that, even when not perfectly relaxed, the simple act of the family meal can have a powerful impact on mindfulness, health and wellness.   

In a country that thrives on a fast pace with over-book schedules, families struggle to balance work and school and after school sports and activities. Consequently, fast food, eat-and-go habits have become the norm. According to some studies, most find it difficult find time to sit and relax for a family meal even once a week. Additionally, when families do pull off a family meal, it is often overwrought with school drama, sibling rivalry, and parental discipline about school, homework or social activities, making the situation stressful. Despite the family conflict, studies strongly support the health values of the family meal.

A recent study from Columbia University that received national attention found that children who participated in a family meal regularly were less likely to have problems with drugs or alcohol and more likely to excel in school. Moreover, those children eating with their families at least 5 times per week benefited most. Other studies have found that the there is a significantly lower incidence of teens who smoke, use alcohol, have sex at a young age, fight, get suspended from school or commit suicide among those who have meals with their family on a regular basis. 

TIPS FOR MINDFUL EATING

6 Ways to Practice Mindful Eating

Mindless EatingMindful Eating
1. Eating past full and ignoring body signals1. Listening to your body and stopping when full
2. Eating when emotions tell us to eat2. Eating when our bodies tell us eat
3. Eating alone, at random times and places3. Eating with others, set times and places
4. Eating emotionally comfort foods4. Eating nutritious and healthy foods
5. Eating and multitasking5. When eating, just eat
6. Considering a meal an end product6. Considering where food comes from

– by Christopher Willard PsyD

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

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

Read all of Dr. Mackarey's Articles at: https://mackareyphysicaltherapy.com/forum/

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

Covid-19 has certainly redefined the workplace as many employees continue to work from home. Prolonged hours sitting at a workstation that may not be optimal has also changed the way we define workplace health and safety. It may be more important than ever to pay close attention to designing an ergonomic workstation, changing position, and stretching regularly to prevent injury.

Since 1894 Labor Day has been designated as the national holiday that pays tribute to the contributions and achievements of American workers. Research supports the notion that healthier employees are happier and more productive. When employers encourage healthy behavior and safety at work, they benefit in many ways. For example, in addition to improving job satisfaction and productivity, healthy employees save money by using less sick time, worker’s compensation benefits and health benefits. For example, according to the Centers for Disease Control and Prevention, approximately 75 percent of employers” health care costs are related to chronic medical problems such as obesity, diabetes, high blood pressure, and high cholesterol. Deconditioned, overweight employees are more likely to suffer from these preventable conditions and are at greater risk for injury. Employers, please consider using this holiday as an opportunity to start a health promotion program at your workplace…have a health fair, offer healthy snacks, encourage walking, smoking cessation, exercising at lunch, and offer fitness club stipends.   

Lower back pain, one of the costliest illnesses to employers, is one example of a problem which can be prevented with a good health and safety program. It is widely accepted in the medical community that the best treatment for lower back pain (LBP) is prevention. Keeping fit, (flexible and strong), practicing good posture, and using proper body mechanics are essential in the prevention of LBP. At our clinic, significant time and effort is spent emphasizing the importance of these concepts to our patients, employees, and the businesses we work with through industrial medicine programs. A comprehensive approach can produce significant reductions in LBP injuries through an onsite safety program which promotes education, wellness, body mechanics, lifting techniques, postural and stretching exercises and ergonomics. 

Prevention of Lower Back Pain

When bending to lift an object think about safety:

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: mackareyphysicaltherapy.com

PART III OF III

This is the third of three columns dedicated to healthcare for college students. Please find these “10 Tips to Keep Yourself Healthy in College” helpful. However, no discussion regarding the health and wellness of college students would be complete and thorough without addressing what health care and university experts consider the two most dangerous behaviors on college campuses across the nation: binge drinking and unprotected sexual activity. While it is not my intent to offend the religious and moral values of any reader, it is my purpose to provoke direct and meaningful conversation between parents, religious leaders and students. To prevent serious health problems in college, parents must share their experience and discuss their values regarding sexual activity and alcohol consumption with children before they leave home to live independently in college. If you are unable to have a direct conversation about these issues, consider doing what several readers have done; mail a copy of this column to your child!

10 Tips to Keep Yourself Healthy in College

  1. Sleep – somehow, despite a busy academic and social schedule, you MUST get enough rest. Lack of sleep may be the single unhealthiest habit of a college student. It can lead to many negative consequences such as lack of concentration, poor emotional stability, and vulnerability to germs and disease. While one may get by on 3-4 hours sleep for short periods of time, eventually, your body will take control and shut down. Do your best to develop a regular sleep pattern and factor in short naps to catch up on needed rest if necessary.
  2. Diet – the “freshman fifteen” is no joke, it is the real thing. Skipping breakfast, “pigging out” on junk food, late night eating, and drinking high calorie soda and beer all factor into weight gain and poor dietary habits. Make time to eat breakfast, snack on yogurt, fruit and nuts. Fill up on a healthy salad. Avoid a constant diet of fried foods and sweets.
  3. Water – even adults forget to drink plenty of water throughout the day. Carry a water bottle and skip the soda.
  4. Get regular check-ups – see your doctor when home on semester break for an annual check-up or more often if needed. Many college health centers offer this service. Many serious problems can be avoided with early detection.
  5. Get a flu shot, vaccines and mask up – remember, college campuses breed germs and most schools offer inexpensive flu shots and Covid vaccines. 
  6. Exercise – make time to exercise regularly (30-45 minutes 3-5 days per week). Walk, run, bike, lift weights, play tennis, racquetball or swim. Colleges have the best facilities for sports and exercise. Just DO SOMETHING! It will help you sleep, relax and feel better.
  7. Relax – make time to relax. Read a book, go for a run, meditate, do yoga, or walk and have good conversation with a friend. Mental health is important on a stressful college campus.
  1. Emotional Health – is a vital component of a healthy person. College life can be very stressful. Depression, anxiety, addiction, eating disorders, and homesickness are some examples of emotional problems common among college students. If you feel emotionally unhealthy, get professional help. All colleges have trained counselors equipped to assist you. 
  2. Drink Sensibly – binge drinking might be one of the most dangerous behaviors on a college campus. Studies show 44% of U.S. College students engage in binge drinking uniformly among freshman through seniors. Of these, 50% binged 3-4 times in a two week period. Binge drinking is defined as 5 drinks in a row for men and 4 for women. Binge drinkers are more likely to be victims of poor academic performance, addiction, trauma, auto accidents, assault, unprotected sex, sexual assault, and death. Some of the most common reasons reported for binging are: to get drunk, status, campus culture, peer pressure, academic stress. TALK TO YOUR CHILDREN!
  1. Safe Sex – promiscuous sex is physically and emotionally unhealthy. Unprotected sex can be LIFE ALTERING! Studies by the Center for Disease Control found that almost 80% of college students 18 to 24 years old had sexual intercourse at least one time during college. 73% reported having unprotected sex and 68% of this group did not believe that they were at risk of contracting a sexually transmitted disease. TALK TO YOUR CHILDREN! GET THE HPV VACCINE!
SOURCES: American Academy of Pediatrics

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 our Health Care Forum!