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Special Feature “ Health & Exercise Forum” with GCSOM: Steven Scheinman, MD, GCSOM President and Dean

Steven Scheinman, MD, Geisinger Commonwealth School of Medicine President and Dean, retired at the end of 2021, leaving behind a legacy that will continue in perpetuity. It is often said that success can be measured by the degree to which one makes the world a better place. By that measure, my friend and mentor, Dr. Steven Scheinman, is a very successful man! His numerous contributions to our community will have a long-lasting positive impact, not only on health and wellness, but also on the spirit and pride of its humble citizens.

Dr. Scheinman has demonstrated many of the attributes associated with great leaders and philosophers; openness, with a curiosity and tolerance for diverse cultural and intellectual experiences; conscientiousness, with a gift for dutifulness, diligence, and orderliness; and extraversion, with a tendency to experience positive emotions and being active and sociable.  

A summary of some his most impactful accomplishments:

In 2010, the Robert Graham Center, a think tank focused on primary care, analyzed the physician shortage in Pennsylvania. The researchers concluded, “Pressures from a growing, aging, increasingly insured population call on Pennsylvania to address current and growing demand for primary care providers to adequately meet health care needs. Policymakers in Pennsylvania should consider strategies to bolster the primary care pipeline . . .”

Northeastern Pennsylvania was certainly not immune to the problem. In fact, our need for increased access to primary care, which includes mental and behavioral health, reached a boiling point in September of 2012 when our community was shocked by a tragic rash of teen suicides.

That same year, Dr. Steve Scheinman arrived in Scranton to assume leadership of what was then The Commonwealth Medical College (TCMC). Our community was justifiably proud of the school…almost singlehandedly and completely single-mindedly, the people of northeastern Pennsylvania built the school without a major hospital or university partner – something no other community has done. Its purpose, of course, was not just to be a point of pride. It was to ensure the health and wellbeing of our entire region.

When Dr. Scheinman took the reins, TCMC intended to re-populate the region’s physician workforce but had few ways beyond admissions policies favorable to local students to incentivize its talented young graduates to remain. Dr. Scheinman took the school’s mission as his own and went to work. He guided our medical school to full accreditation – with six commendations, including one for community engagement. He convened a consortium of mental and behavioral health providers, patients and caregivers and founded the Behavioral Health Initiative (BHI), which has gone on to help found the Autism Collaborative and create opportunities for additional graduate medical education in psychiatry in our region.

Undeniably, however, Dr. Scheinman’s most important achievement was in presiding over TCMC’s integration with Geisinger. Geisinger was the perfect partner for this community’s medical college. Both the school and the system are focused on the health of the people in our region. Both focus on serving community and solving the problems that affect our overall wellbeing. Importantly, integration with Geisinger secured the future of medical education in northeastern Pennsylvania. The crowning achievement, however, of becoming Geisinger Commonwealth School of Medicine (GCSOM) is its turbocharged ability to meet the founding goal of the school – to create a physician pipeline right here in our neighborhoods. Together with leaders from Geisinger, in 2018 Dr. Scheinman announced the launch of the Abigail Geisinger Scholars Program.

Dr. Scheinman tells me that area students have always expressed to him a deep desire to come home – and since 2016 more than 30 have done so -- but financial considerations too often derail these plans. Thanks to the Abigail Geisinger Scholars Program, financial considerations are now an incentive, not an obstacle. And because GCSOM maintains admissions policies that favor local students, a great number of Abigail Geisinger Scholars grew up right here in northeastern Pennsylvania.

The program offers tuition-free medical education to GCSOM students in exchange for a promise to return to our region and work as a Geisinger physician. Today, up to 45 students per class are enrolled in the program and are dedicated to specializing in family medicine, internal medicine, medicine/pediatrics, and psychiatry – all areas of primary care devoted to keeping people healthy and out of the hospital. In 2021, the first five students in the program graduated from GCSOM and are now in residency training. In the coming years, we will see hundreds added to that number with each and every one ultimately “coming home.”

All of this happened under the leadership of Dr. Steve Scheinman, who earlier this year announced his retirement. On Jan. 3, Dr. Julie Byerley will succeed Dr. Scheinman as the third president and dean of Geisinger Commonwealth School of Medicine. As he leaves us to enjoy a well-deserved retirement, I think the entire community owes him a sincere thank you not only for securing the future of our school, but also for helping our community realize the vision of what having our own medical school would mean --  a guaranteed pipeline of excellently trained physicians to care for us. His legacy will be the wonderful young GCSOM graduates practicing in our region. Here are a few who are already doing so:

· Pat Connors, MD, who practices internal medicine with Prime Med in Scranton.

· Rachel Brutico Gianotti, MD, a Geisinger pediatrician, and her husband, Vince Gianotti, MD, an emergency medicine doctor in Wilkes-Barre.

· Matthew Mullen, MD, a Geisinger cardiac surgeon in Scranton.

· Angela DiBileo Kalinowski, MD, a family medicine doctor with Prime Med in Clarks Summit.

Thank you, Dr. Scheinman!

Read Dr. Mackarey’s Health & Exercise Forum – every Monday. This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

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

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

October is National Physical Therapy Month

October is National Physical Therapy Month. The American Physical Therapy Association (APTA) would like the nation to recognize the positive role physical therapy plays in your health and wellness. We are passionate about what we do! No, we don’t save lives, but we do save lifestyles and quality of life! PT’s are great people. We have a special gift to provide healthcare unique to our field. For example, while many different health care professionals treat back pain, PT’s are some of the very few working to rehabilitate stroke and head injury victims, amputees, children with cerebral palsy and other serious neurological and orthopedic disorders.

In honor of physical therapy month and the thousands of dedicated physical therapists working hard to keep you healthy and mobile, I would like to share some health and wellness pearls of wisdom.

Remember, we cannot control our gene pool or what happens to our bodies, however, we can control our lifestyles. Research suggests that lifestyle may play the biggest role on how healthy you are and how long you live. The food you eat, what you drink, if you smoke, how active you are and how you handle stress are critical factors that determine your longevity. Research also tells us that smoking, physical inactivity, and poor eating habits are the leading causes of death, in that order.

The following health and wellness tips can also serve you well…

One, to be truly healthy, one must have a health mind, body and spirit. A healthy mind requires education and intellectual stimulation. The body requires a good diet and physical activity while the spirit thrives on faith and hope. Strive to find balance and address all three elements of health and wellness.

Two, keep it simple. Should I walk, run, swim, or ride? Do I use free weights, barbells, rubber tubing or lifting machines at a gym? The answer is KEEP IT SIMPLE! You don’t need to join an expensive gym with a personal trainer to get in shape. Bands, light dumbbells, walking at the mall, and biking will all get you in shape. It must be convenient and consistent. Physical activity is one of the most important factors in improving a lifestyle in a positive way. But, it does not have to be complicated. A minimum of 30-45 minutes of physical activity, 3-5 days per week will have many positive effects on your body. But, the studies also show that engaging in 10-15 minutes of activity 2-3 times per day, is also valuable to your health…even at work!

Three, be realistic. Expect that exercise will take time to have a noticeable benefit. Don’t get overly ambitious and set yourself up for failure.

Four, be religious. Be religious about exercise and diet but don’t get too compulsive. Studies show if you are too compulsive, you will probably not keep it up for life.

Five, ask a professional. There are a million misconceptions about health and fitness. For example, some people still think you can spot reduce! Ask a professional, (medical doctor, physical therapist, nutritionist, exercise physiologist), if you have a question about beginning a diet or exercise program. If you have health issues or concerns, see your primary care physician first.

Six, there is no secret to a long and healthy life. According to the National Institutes of Health (NIH), while genes play an important role, lifestyle plays the biggest role on how healthy you are and how long you live. The food you eat, what you drink, if you smoke, how active you are and how you handle stress are critical factors that determine your longevity. The NIH research has found that smoking, physical inactivity, and poor eating habits are the leading causes of death, in that order.

Seven, find a fitness mentor or role model. I have the good fortune of meeting many patients over the years that serve as my health & fitness role models. I continue to be inspired by those who overcome their disabilities and injuries through hard work and determination to regain health, wellness and function. Find someone who inspires you!

Eight, find a spiritual mentor or role model. Learn a lesson from “the greatest generation.” The WWII generation rarely complained, worked hard and placed great emphasis on God and responsibility to family. Try to associate with people whose “glass of water is always half full.”

Nine, do the right thing. When it comes to exercise, do the right thing. Get good advice, wear the appropriate clothing and shoes and eat and drink appropriately for the activity. Walk and run in running shoes, eat plenty of whole grains, fruits and vegetables with a good balance of protein and carbohydrates. Drink plenty of water before and during endurance activities. Make proper adjustments for different temperatures.

Ten, have FUN! A healthy lifestyle doesn’t have to be drudgery. There are plenty of good and flavorful healthy food choices. An occasional cheat is good. Also, there are plenty of fun activities and exercise options. Run, walk, swim, bike, hike a canyon, cross-country ski, downhill ski. Use the elliptical, recumbent bike, or stairmaster, recumbent stepper. Alternate routines, cross-train, or play a sport like tennis, golf (walk the course), racquetball or squash. Mix it up. IF YOU WANT TO EXERCISE FOR LIFE - YOU MUST HAVE FUN!

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

For all of Dr. Mackarey's articles visit: 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.

Part II of II

Difficulty sleeping during the COVID-19 quarantine has become a common problem and can be manifested in a variety of ways; insomnia, fragmented sleep and nightmares. National prescription providers have reported a 21% increase in anti-insomnia, anti-anxiety and antidepressant medications since March of 2020. The past two weeks in Health & Exercise Forum” have been dedicated to sleep wellness.

Last Week in 'Health and Exercise Forum'

We discussed the importance of sleep for health and wellness. Sleep is crucial to us as a species, but it is not always easily attained. For many individuals across the globe, sleeping properly can be a challenge. The trial and tribulations of the human experience can lead to restless nights and early morning risings without adequate sleep. This week, we will discuss how lack of quality or quantity of sleep can impact our lives in many ways and make suggestions to improve your sleep hygiene.

Cognitive Performance

Although it may be tempting to sleep in on weekends after a long week of classes, some studies report that this habit results in a smaller volume of the gray matter of the brain in adolescents. Also, in this report, students who altered their sleep pattern on weekends had a lower grade average than those who did not. Therefore, it seems that it is not only important to maintain an average healthy average amount of sleep each night, but also to stay consistent with the hours that you are asleep.

Physical Fitness

There are many studies that have linked unhealthy sleep patterns to obesity. Inadequate sleep causes irregular levels of the hormones that are responsible for telling our brains when we need to eat. Therefore, this hormone imbalance can lead to obesity and thus make us vulnerable to the dangerous effects dramatically increased body fat.

Longevity

A healthy sleep schedule has been shown to reduce the risk of heart disease and stroke, which are two of the leading causes of death in the United States. For example, interruptions in sleep due to disorders like sleep apnea have been shown to be a risk factor for stroke and that persistent tiredness often preceded heart disease.

Physical performance

Whether you are a high school or collegiate athlete, or simply enjoy some daily exercise, a healthy sleep schedule can help maximize performance. It is worth noting that it is possible that athletes require different sleep patterns than the general population to reach peak performance. Moreover, it has been shown that sleep loss is linked to a decreased ability in athletes to store sugar in the muscle to use as energy during a workout.

Needless to say, there are a plethora of things that can negatively impact our sleep. Even one night of poor sleep can drastically impact our performance and ability to concentrate the following day. So how do we combat this? There are several simple habits that can improve sleep hygiene and increase the likelihood of getting a good night’s sleep.

TIPS TO IMPROVE SLEEP HYGIENE:

  • Set a routine- Going to bed and waking at the same time every day, even on weekends, strengthens our circadian rhythms. Our brains become accustomed to the routine and allow us to fall asleep quicker, reach more restful sleep faster, and wake up feeling refreshed rather than startled by the blaring of our alarms.
  • Limit screen time before bed- As stated earlier, the light from our devices tricks our eyes into believing it is day rather than night. Try to stop using your devices an hour before you head to bed to allow your brain to naturally power-down for the day. This means limiting falling asleep to Netflix as best we can. An even better idea would be to remove TVs from the bedroom all together.
  • Exercise earlier in the day- While frequent exercise is essential to our health and helps us fall asleep, working out right before bed can result in poorer sleep. Avoid strenuous exercise at least one hour before bed.
  • Meditation- Alright, I can hear the groans already, but it works- especially in individuals who have difficulty quieting their minds after a hectic day. An article released by the Journal of the American Medical Association (JAMA) demonstrated significant improvements in the quality of sleep in those who practiced mindfulness meditation and compared to those who did not.
  • Moving when you have difficulty falling asleep- If you find yourself unable to fall asleep within 30 minutes of lying down, get out of bed. Go to another room and read in dim lighting or listen to music until you feel tired and try again. 

There are thousands of other resources that can help us achieve a great night’s sleep. Apps like “Calm” and “Headspace” have guided meditations and relaxation techniques to help us unwind before bed. More useful information about healthy sleep and why it is important can be found on Harvard Medical School’s Healthy Sleep website. And there are hundreds of thousands of YouTube videos with relaxation techniques and informative healthy sleep videos to be discovered. If these interventions do not improve your sleep, talk to your primary care doctor and see which next steps are right for you.

 Sleeping well is not always easy and there will undoubtedly be nights on which rest eludes us despite our best efforts. But with consistent healthy sleep habits, we will be on our way to a healthier and better tomorrow.

For More Informations:

-http://healthysleep.med.harvard.edu/healthy/

-https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2110998

-https://www.sciencedirect.com/topics/medicine-and-dentistry/insomnia

Timothy Farrell, MD3

Tim Farrell is a third year medical student at Geisinger Commonwealth School of Medicine. Originally from Clarks Summit, Pennsylvania, Tim received his bachelor’s degree from Loyola University Maryland in Baltimore, MD. Currently a 2nd Lieutenant in the US Army, he enjoys listening to music, running, and spending time with his two dogs. He volunteers with the Cody Barrasse Foundation in the Organ Transplant Assistance Program, where he helps patients receive grant funding as they await their transplant surgery. He hopes to pursue a career in General Surgery.

Read Dr. Mackarey’s Health & Exercise Forum – every Monday or at https://mackareyphysicaltherapy.com/forum/

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

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

Part I of II

Difficulty sleeping during the COVID-19 quarantine has become a common problem and can be manifested in a variety of ways; insomnia, fragmented sleep and nightmares. National prescription providers have reported a 21% increase in anti-insomnia, anti-anxiety and antidepressant medications since March of 2020. The next two weeks in Health & Exercise Forum” will be dedicated to sleep wellness.

Everyone Needs Sleep!

We do it every night, hopefully. Children are doing it. Our grandparents are doing it. Teenagers do it all the time. We sleep of course. These hours in which we slumber are vital to our ability to function during the day and to our health overall. It does not appear evolutionarily advantageous for us to be unconscious for extended periods of time. Modern science tells us that much of our body’s restoration, strengthening, and processing occurs while we sleep. Our brains consolidate the information they have learned throughout the day and enhance our memory. Additionally, sleep restores sugar storage in our brains and improves the functioning of our immune system. But science does not illuminate why we need such a prolonged period other than the fact that we just seem to get sleepy after a long day.

How much Sleep Do I Need?

Sleep is crucial to us as a species, but it is not always easily attained. For many individuals across the globe, this author included, sleeping properly can be a challenge. The trial and tribulations of the human experience can lead to restless nights and early morning risings without adequate sleep. But what is considered “adequate” sleep? The answer depends on your age. As we grow older, our sleeping requirements change drastically from infancy to elderdom. Infants are learning and processing so much information of this new world they now inhabit. Thus, their brains need enough time to analyze and consolidate the data, necessitating 12 to 15 hours of sleep. As we advance into adulthood, our sleep requirements drop to approximately 7 to 9 hours with some variability from person to person. Good indications of a restful night’s sleep include waking up feeling refreshed, functioning with enough energy for your daily tasks, and having continuous sleep- meaning there are not extended periods of time of wakefulness when we are supposed to be sleeping.

You are not alone, roughly 100 million people suffer from insomnia at some point each year!

This seems easy enough to say, but significantly more difficult to do. Current reports demonstrate that roughly 100 million people suffer from insomnia at some point each year, with 25% progressing to long-term chronic sleep insufficiency. Insomnia is described as difficulty falling asleep or staying asleep for three nights per week for at least two consecutive weeks in a three-month period. There are a lot of unhealthy sleeping habits permeating the country. We measure the quality of sleep in two different dimensions duration (quantity) and depth (quality). The duration is straightforward enough. Do you sleep for the recommended 7 to 9 hours per night? The quality is a little more difficult to quantitate. Some individuals may sleep for the proper duration of time, but the depth is not adequate. Sleep quality is determined by the number of arousals or awakenings in a given night.  As few as 5 arousals in a night can result in daytime sleepiness and performance deficits. In addition, how long we remain in certain phases of sleep also determines the quality of our sleep. There are four stages of sleep: N1, N2, N3, and REM with N3 being the most restful of the stages. When we fall asleep, we go through a predictable descent into sleep. We repeat the cycle of N1 to N2 to N3 to REM sleep every 60 to 90 minutes. The more time we remain in the restful stages, N3 and REM, the better our sleep is. As we age, we inevitably spend less and less time in restful sleep.

What causes poor sleep and why are so many Americans suffering from insomnia?

There are many factors that influence how we sleep. Everything from what we drink to the type of curtains we have can impact those crucial hours of sleep. Some of the more common culprits that disrupt our sleep are:

For More Informations:

-http://healthysleep.med.harvard.edu/healthy/

-https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2110998

-https://www.sciencedirect.com/topics/medicine-and-dentistry/insomnia

Read Dr. Mackarey’s Health & Exercise Forum – every Monday. Next Week Read, Sleep and Wellness Part II.

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

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

Read all of Dr. Mackarey's articles in our health and exercise forum: https://mackareyphysicaltherapy.com/forum/

Guest Columnist: Timothy Farrell, MD3

Tim Farrell is a third year medical student at Geisinger Commonwealth School of Medicine. Originally from Clarks Summit, Pennsylvania, Tim received his bachelor’s degree from Loyola University Maryland in Baltimore, MD. Currently a 2nd Lieutenant in the US Army, he enjoys listening to music, running, and spending time with his two dogs. He volunteers with the Cody Barrasse Foundation in the Organ Transplant Assistance Program, where he helps patients receive grant funding as they await their transplant surgery. He hopes to pursue a career in General Surgery.

Guest Columnist: Catherine Udomsak, DPT

Dr. Catherine Heimrich, PT, DPT
Dr. Catherine Heimrich, PT, DPT

Read Part 1 here...

Patients frequently ask me about the merits of yoga, from relaxation to flexibility. Many say, they are too busy or they don’t know enough about it. Well, in light of the fact that everyone has been forced to spend more time indoors, slow down and try new things, now may be a good time to try yoga.

It is hard to believe that yoga, which is now a cultural mainstay, was once considered a foreign practice.  An ancient discipline that totes numerous health benefits, yoga is meant to cultivate inner peace, enlightenment, and a strong relaxed body. In the past, only major cities housed yoga studios but over time yoga has spread into small towns across the country.  Studios offer a variety of classes and each promotes their own unique philosophy. Whether you are looking for a new workout regime, compliment to your current program or simply to quiet your mind in a hectic world, yoga may be an option for you. 

What is yoga?

Yoga is a discipline that developed over 5,000 years ago and is generally recognized as an ancient system for wellbeing. The word yoga, from the Sanskrit word “yuj”, literally means to yoke or to bind together.  The primary focus of yoga is to harmonize or unite the mind, body, and spirit through a combination of poses, breathing techniques, and meditation. 

Where did it come from?

The specific origin of yoga is a topic of debate.  However, it is said to have originated in India and was brought to the Western world by yoga gurus in the late 19th and early 20th centuries. The basis for most current yoga practices is The Yoga Sutras of Patanjali.  In The Yoga Sutras, eight limbs of yoga are specified. The three most common limbs are meditation, pranayama or breathing exercises, and asana which are the physical poses.  Yoga classes can vary greatly, however, most classes include a combination of meditation, breathing exercises, and physical postures. 

Types of Yoga

There are numerous styles of yoga.  If you are a newcomer, deciding on a yoga class may be difficult.  It is always a smart idea to call a studio before attending a class to gain information and have any questions answered.  Furthermore, if you have any health concerns you may want to consult your doctor prior to trying a new form of exercise.  Some common forms of yoga include but are not limited to: 

Hatha - Hatha yoga is a general broad-based term referring to any type of yoga that teaches physical postures. Typically, one will find Hatha classes to be slow and gentle and a great option for beginners. 

Vinyasa - This type of yoga focuses on the coordination of breath with movement. In Vinyassa yoga classes you can expect a continuous flow of movement from one posture to the next.  Classes can be fast paced and are often appealing to those looking for a more strenuous workout.

Iyengar - Unlike Vinyassa, this type of yoga focuses on holding postures for a period of time to bring the body into it’s best alignment.  If you attend this type of yoga class you can expect to use props including yoga blocks, blankets, and straps. 

Ashtanga -  This type of yoga follows a specific sequencing of postures. This rigorous form of yoga always performs the same postures, in the same order at each class and is typically fast paced. 

Bikram - Typically performed in rooms heated to 105 degrees Fahrenheit and 40% humidity, the heat warms muscles and allows a deeper stretch. The difference between Bikram and Hot yoga is that Bikram follows a specific sequence of 26 poses from which hot yoga often deviates. 

Yin Yoga - This meditative practice is perfect for those who want to calm their mind. In this type of yoga, poses are held for 5 minutes or longer.  The purpose is to apply a deep stretch to the connective tissue (the tendons, fascia and ligaments) to improve flexibility. 

Restorative - Best for those who want to focus on relaxing and taking some time to slow down. Most restorative yoga classes will be slow moving with longer hold times to allow deep relaxation.   

Basic Yoga Poses

Below you can find a few common yoga poses or asanas that can be found in beginner classes.  These poses promote flexibility and strength and can be incorporated into your everyday workout routine. Remember, before you attempt the poses, begin by walking, biking or running to warm up. Don’t overstretch, perform slowly, and hold the position. You should feel  mild discomfort NOT pain.

Choosing a Yoga Studio

There are a lot of options when it comes to where to start to practice yoga. It is important that the studio you choose employs certified yoga instructors who have completed comprehensive training.  A good instructor can make all the difference in your yoga experience. The studio should provide a clean environment and offer a variety of classes including beginner level if you are a newcomer.  The best way to get a feel for a studio is to stop in for more information.  You may want to ask about pricing as there are often discount introductory rates.  Ask about rentals if you do not own a yoga mat and request to see the space.  Some yoga studios have a strong sense of community while others are more like a gym. Try out a few different places until you find a fit for you.

Guest Columnist: Catherine Heimrich, DPT is a doctor of physical therapy and is an associate at Mackarey & Mackarey Physical Therapy Consultants, LLC in downtown Scranton, where she works with outpatient orthopedic and neurological patients. She has a special interest in vestibular and balance problems. 

Model: Sarah Singer, PTA

Read Dr. Mackarey’s "Health & Exercise Forum" every Monday in the Scranton Times-Tribune.

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

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

Dr. Catherine Heimrich, PT, DPT
Dr. Catherine Heimrich, PT, DPT

Yoga for a Healthy Mind, Body, and Spirit, Part 1 of 2

Guest Columnist: Catherine Heimrich, DPT

Patients frequently ask me about the merits of yoga, from relaxation to flexibility. Many say, they are too busy or they don’t know enough about it. Well, in light of the fact that everyone has been forced to spend more time indoors, slow down and try new things, now may be a good time to try yoga.

It is hard to believe that yoga, which is now a cultural mainstay, was once considered a foreign practice.  An ancient discipline that totes numerous health benefits, yoga is meant to cultivate inner peace, enlightenment, and a strong relaxed body. In the past, only major cities housed yoga studios but over time yoga has spread into small towns across the country.  Studios offer a variety of classes and each promotes their own unique philosophy. Whether you are looking for a new workout regime, compliment to your current program or simply to quiet your mind in a hectic world, yoga may be an option for you. 

What is yoga?

Yoga is a discipline that developed over 5,000 years ago and is generally recognized as an ancient system for wellbeing. The word yoga, from the Sanskrit word “yuj”, literally means to yoke or to bind together.  The primary focus of yoga is to harmonize or unite the mind, body, and spirit through a combination of poses, breathing techniques, and meditation. 

Where did it come from?

The specific origin of yoga is a topic of debate.  However, it is said to have originated in India and was brought to the Western world by yoga gurus in the late 19th and early 20th centuries. The basis for most current yoga practices is The Yoga Sutras of Patanjali.  In The Yoga Sutras, eight limbs of yoga are specified. The three most common limbs are meditation, pranayama or breathing exercises, and asana which are the physical poses.  Yoga classes can vary greatly, however, most classes include a combination of meditation, breathing exercises, and physical postures. 

Benefits of Yoga

So what is with all the hype?  Why has yoga become so popular?  Many would say it is due to its numerous mental and physical health benefits.  Research has shown that yoga, when practiced regularly, can reduces stress levels and even boost one’s immune system. Regular stretching releases tension in the body and the controlled breathing and mediation decrease anxiety. Studies show that those who practice yoga habitually can have decreased blood pressure and cholesterol making them less prone to heart disease. Other ailments which are shown to be positively impacted by yoga include insomnia, depression, and chronic pain including low back pain and headaches. Yoga is an excellent way to combat the negative effects of stress on the body and cope with anxiety and angst. 

In addition to stress reduction, yoga has many physical benefits.  These include increased flexibility, strength, and balance. Those who practice yoga regularly are often less prone to injury, such as a muscle strain or tear, due to their increased flexibility. Furthermore, yoga can be an effective way to strengthen one’s core which is crucial to maintaining ideal posture and protecting the back.  For athletes, yoga can be a great way to challenge one’s balance and improve stability.  In the elderly, it is a safe way to improve overall body awareness and decrease the risk of falling.  Yoga has also been shown to improve respiration and many report an overall increase in energy when incorporating yoga into their lives. 

With all of the positive impacts yoga has on the body it is easy to see why it has become such a popular form of exercise.  There are classes to meet almost all needs and most poses can be modified based on ability. Yoga can be practiced by those of all ages and all fitness levels. Whether you’re looking for a way to loosen up tight muscles or you simply wish to quiet your mind for an hour, yoga is a tool to improve and maintain health. The only thing you need is a mat and an open mind.  

Is yoga right for me? 

Yoga can be practiced by anyone. From children to adults to the elderly, there are classes for all ages and abilities.  It can be a form of cross training for athletes, especially runners who tend to have tight musculature.  It also promotes balance and core stability which may be beneficial to sportspersons including football players, soccer players, boxers, etc.  Furthermore, there are classes for the elderly which focus on balance and maintaining mobility. There are even prenatal yoga classes for pregnant women to promote deep breathing, flexibility and muscle tone.  

Next Week: Types of Yoga and Basic Poses

Guest Columnist: Catherine Heimrich, DPT is a doctor of physical therapy and is an associate at Mackarey & Mackarey Physical Therapy Consultants, LLC in downtown Scranton, where she works with outpatient orthopedic and neurological patients. She has a special interest in vestibular and balance problems. 

Read Dr. Mackarey’s "Health & Exercise Forum" in the Scranton Times-Tribune every Monday. Next Week: Yoga - Part 2

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. 

(Read Part 1 Here)

Special Feature “ Health & Exercise Forum” with Geisinger Commonwealth School of Medicine-- the third Monday of every month! 

Guest Columnist: Kathryn Schmidt, MD

Dr. Kathryn Schimdt
Dr. Kathryn Schimdt

Personal Bio: Kathryn received her medical degree from Geisinger Commonwealth School of Medicine in 2019 and is now an Internal Medicine resident at University of Utah Health in Salt Lake City. She loves her program and her new city, both of which allow her to optimize her wellness, with easy access to skiing, hiking, and other outdoor activities. Prior to medical school, she attended the University of Wisconsin-Madison for her undergraduate studies and Northwestern University where she completed a post-baccalaureate pre-medical and health program. Throughout school, she worked as a research assistant, first with stem cell transplant recipients and women affected by gynecological cancers, and then with solid organ transplant patients. During medical school, she served as a volunteer at the Care and Concern Clinic, as well as at an organization called Pathstone, acting as a mentor to men and women who were transitioning back into the community after having spent time in prison. During her last year of medical school, she received a global health scholarship that allowed her to teach English in Thailand, with an emphasis on preventative health care topics. She has joined the global heath track within her residency program and hopes to continue to stay engaged in global healthcare throughout her career. When not working, she likes to kick-box, ski, hike, write, and be in the company of good friends or family, whether that be taking a weekend camping trip to a new place or just having a board game night. Something that makes her really happy is traveling… she has been to all 7 continents and is always ready for the next adventure!

My name is Kathryn, and I am a resident physician in Salt Lake City, far away from family, who reside in various locations on the East Coast. It’s always tough to be so far from family, but especially now. I know everyone is experiencing their own version of disappointment or grieving for a lost sense of normalcy, but my hope is that the more effectively we deal with this now, the sooner we can get back out there - where everything should be waiting for us, just as we left it. I’m finding it harder and harder to complain, given that I have patients who can’t see their families due to strict, but necessary rules, yet still happily greet me each morning when I wake them up before it’s light outside. In the meantime, I am grateful for and energized by all the people around me doing good. I am in awe of everyone in SLC (from my residency program director, the hospital administrators who have come to personally check in, the people working tirelessly to find creative solutions to obtain additional masks and ventilators, and all of the hospital staff who help in both medical and non-medical ways to the restaurant/grocery store workers and other essential community workers etc etc ETC), and on a larger scale - Utah, the US, and the entire world - who are coming together to figure this mess out.

Most of us are going through a roller coaster of emotional states as this storm –called COVID-19 – continues to gain momentum, with global impact. Millions of people are experiencing major life changes. If this resonates with you, you are not alone. People have been self-quarantining or socially isolating for various amounts of time. With the cancellation of planned trips and weddings, the closing of schools and colleges, and mandated work-from-home arrangements, it is easy to be discouraged, especially given that we aren’t yet seeing the light at the end of the tunnel. While each person will respond differently to the challenges we are facing, fear and anxiety seem to be two feelings commonly cited during this difficult time. 

While there is no perfect solution, there may be some helpful things you can do to feel more in control of your day-to-day emotions and general well-being. Different things work for different people, and there isn’t any single, correct way of doing things, so I would recommend getting rid of “should do’s” and expectations. Collectively, we need to cut ourselves some slack and realize that this is a process of trial and error. My hope is that we can feel a sense of togetherness and global solidarity despite physical isolation, understand how to continue living in this very unusual and weird time, and ultimately, find some peace among the chaos. 

10 Tips for Being Happy & Healthy During COVID-19 Crisis

1. Social distancing and self-quarantine can be isolating and lonely, but social distancing does not mean we must socially isolate. Take this opportunity to use face time or the phone to catch up with friends and family. Set up virtual happy hours or dinner dates via Face Time or Zoom or try having a game night through Jack Box Games. 

2. Focus on general wellness. There are many free apps right now for meditation, yoga, stretching, online exercise classes, and breathing techniques. Additionally, be sure to stay hydrated, get a good night’s rest, and get some fresh air. In many areas, walking outside in areas where you can be 6 feet from other people is okay to do. Make a sound track of your favorite relaxing or pump-up music to go along with your stretching or work out routines. 

3. Do those things you have been meaning to do for the last month, but always seem to put off. This is the perfect time to try out a new recipe, read a new book, catch up on your favorite tv show, organize your closet, teach yourself a new language (a little bit each day goes a long way), try out a new hobby or craft (there are apps for learning to draw, scrap-booking, etc.), play a new board game or do a new puzzle, or come up with something else fun and unexpected. Get creative!! 

4. Be present. As someone who likes to plan ahead of time, living day to day has helped me to be more present in the now rather than worrying about the future. It has also helped me to focus on the enjoyable activities of day-to-day life rather than worrying about always being in some spectacular place or taking some awe-inspiring picture. This is a time to reset and find our way back to what is most important in our individual lives. 

5. Reach out to others. It is easy to feel alone, but sending a text or card can make someone else’s day. You could also consider making cards for people in nursing homes who can’t currently see their families, donate blood if you’re healthy and meet all requirements, foster an animal from a local shelter, or buy groceries for elderly neighbors. Additionally, having a sense of purpose can increase your happiness and help you to feel more fulfilled. 

6. Recognize that the emotions you are feeling are valid & normal.  AND talk about them. It is okay to grieve the loss of normalcy. It is also okay to not be okay, but please reach out and allow others to assist you while you’re feeling this way. While it is certainly okay to feel this way, it can be helpful to list a few things each day that you are grateful for. Committing to the daily practice of writing down just a few things that we are grateful for helps to re-wire connections in the brain making it easier to choose happiness in times of distress. 

7. Be productive. Regarding working from home, find a place at home you can work away from the spaces where you sleep or play. Try to find a spot with good lighting. De-clutter your space (and your mind). Eliminate distractions. Set a time during which you will focus on your work and stick to it. During this time, try to avoid checking news about COVID-19 and save all the social media and meme hunting as a reward for after you have finished your work for the day. It may be helpful to outline your goals and priorities for the day. An organized to-do list will keep you focused on the specific tasks at hand and checking items off provides a sense of accomplishment. If you have children, try incorporating their structure they may need. 

8. Exercise. We all know this is easier said than done though. So choose to do things that fulfill your daily exercise needs. Use an indoor exercise bike, treadmill or elliptical, climb the stairs for 10-15 minutes, lift soup cans or use exercise bands.

9. Spend more time outdoors. Fresh air, scenic views, and a little vitamin D from the sun can make all the difference…but practice social distancing!

10. Fake it until you make it. It sounds silly, but the more you smile, even if it’s fake, positively affects how you feel because it triggers something in the brain that makes you happier…AND LAUGH. Only second to loving, laughing is the easiest way to feel like everything is going to be okay.

Read Dr. Mackarey’s "Health & Exercise Forum" every Monday in the Scranton Times-Tribune.

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

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

Paul J. Mackarey, PT, DHSc, OCS

The human body is designed to defend against foreign bodies such as germs, bacteria, and viruses, including COVID-19. A healthy immune system may foster a speedier recovery from illness. While you may not be able to improve an otherwise healthy immune system, you can take steps to maintain its health and integrity.

A healthy immune system protects us by creating a barrier that stops invaders or antigens, from entering the body. When an unwelcome invader slips through the barricade, the immune system responds by producing white blood cells and other chemicals and proteins that attack the foreign substances.

10 Tips to Maintain a Healthy Immune System

  1. Don’t Smoke – it is obvious why this tip is critically important 
  2. Eat a Mediterranean Diet – high in fruits and vegetables, fish/seafood, nuts, seeds, legumes, extra virgin olive oil and minimal amounts of red meat.
  3. Maintain a Healthy Body Weight – body mass index (BMI) between 18.5 and 24.9 is healthy. To calculate your BMI: www.nhlbi.nih.gov
  4. Drink Plenty of Water … and Drink Alcohol in Moderation 
  5. Get Adequate Sleep – 8 hours is a good goal but if not possible, supplement with a daytime nap
  6. Practice Good Hygiene – Avoid infection by washing hands often and thoroughly. Flossing and brushing your teeth is also important
  7. Prepare Foods Properly - clean meat/fish cutting surfaces and cook food thoroughly
  8. Limit stress and Be Positive - make time to reflect and meditate and, when possible, avoid people who “suck the oxygen out of the room!” YouTube “Progressive Muscle Relaxation” for easy to use relaxation techniques
  9. Be Active – physically and mentally – keep your body and mind moving and when possible spend time outdoors and enjoy the natural beauty of NEPA
  10. Exercise – BUT DO NOT OVER EXERCISE! While exercise is an essential part of a healthy immune system, over exercise can weaken your immune system. In fact, many marathoners report a mild fever and flu-like symptoms after running the 26.2 mile race.  

Prevent Cabin Fever While Confined to Your Home 

Is there a secret to a long and healthy life? Do genes control our destiny? How does lifestyle impact our health? According to the National Institutes of Health (NIH), while genes play an important role, lifestyle plays the biggest role on how healthy you are and how long you live. The food you eat, what you drink, if you smoke, how active you are and how you handle stress are critical factors that determine your longevity. The NIH research has found that smoking, physical inactivity, and poor eating habits are the leading causes of death, in that order.

To maintain a healthy immune system, physical activity is one of the most important factors in improving a lifestyle in a positive way. A minimum of 30 minutes of physical activity, 5 days per week can greatly contribute to longevity. Most experts agree that moderation is important. If you overindulge with exercise you will be at greater risk for musculoskeletal injuries. This is especially true for those who are newcomers. The goal is to gradually work into a fitness program and maintain it for life…now, during home confinement; it may be a good time to begin.  

Researchers have found that the benefits of regular physical activity are numerous. Some of the more important benefits are:

    Simple suggestions for beginning an exercise program at home

Sources: WebMD.

     Visit your doctor regularly and listen to your body.      

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

Next Week: Learn some simple home exercises using Resistance Bands.

Read Dr. Mackarey’s "Health & Exercise Forum" every Monday in the Scranton Times-Tribune.

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

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