Seniors and Baby boomers, think again about your Thanksgiving day menu. That belly around your middle is deadly!

With turkey day fast approaching, and senior and their baby boomer kids, gen-X grandchildren and little ones preparing to gather for traditional feast.  A review of the meal plan may involve more than pinching some pennies this year.  Reach down and pinch your belly as well.

A study by the New England Journal of Medicine in Nov. 13th, 2008 issue, see link http://tinyurl.com/6xhp8,

indicated that belly fat, ie adipose tissue, can be an indicator of increased risk of death.  An addition of an extra 2″ around the waist raises the chance of an early death by 13%-17%.  The average waist in American males has increased from 35 to 39 inches. Yet I would have to say that 36″ should be the norm.  SO, if you are a 40″ waist you have a 26-34% higher risk of early death than your buddy that has a 36″ waist.  Damn, that is scary.

For the ladies the average waist size of an American female has expanded from 30″ to 37″ in the last 40 years.  I am scared to say what a good average should be, but I am sure it is safe to say 33-34″.  SO, the same numbers do apply.   So normal ladies out there, your friend that is overweight, if she has a waist of 40″ she has a 39-51% higher chance of dying earlier than you.  OMG!  Its time that all of us that have friends and family that are fighting obesity, speak up and help.  It is not about fashion or beauty, it is really a matter of life and death.

In an extreme example,  men out there that have waists that exceed 47″,  their risk for early death is double that of someone who has a 31.5″ waist.  Did you read that, double. Yikes.

The National Institutes of Health recommends that men with waists measuring 37 inches or greater and women with waists larger than 31.5 inches modify their lifestyles to reduce their waists and resulting health risks. Nearly 39 percent of men and 60 percent of women are carrying too much belly fat. Straight from the government folks.  See full article. http://tinyurl.com/48btx8

An interesting note from the study, is that those who are tall, and yet have a low body weight, were also at a higher risk than normal for early death.  It is hypothesized that this is related to not enough muscle mass. Take note super models!

So,  look around at your family members.  And plan smartly, low carb side-dishes for that turkey day.  Plan an early meal, and then do a family walk.
Start a new tradition with a family walk before dessert. Start now with the grand kids and teach them about proper diet and exercise.

Have a great Thanksgiving!

It is thought that adipose tissue, particularly tissue from visceral-fat deposits, secretes potential mediators in the development of chronic diseases^..

Understanding Ice Therapy, a key to Total Joint Surgery Success.

         Whether you are preparing to have a new knee or hip surgery, or you just had surgery, one of your key allies in a successful recover is ice.  The use of ice, in a pack or bag, is a natural way to drastically improve healing, reduce edema, inflammation, and pain. 

Since ice is a natural substance, the only side-effects you have to worry about are:

1. You need to make sure your ice pack is wrapped in a pillowcase or towel. Do not place an ice pack directly on your skin.  It can burn, or blister you.

2. Discomfort. Icing in general is not a pleasurable experience.

3. Condensation or wetness. In which having a small towel under your limb to catch the water will aid with that.

To achieve amazing results, one must understand some key principles.

Successful Icing is based on three key factors:

1)    Size of area covered with the cold pack.

2)    Significance of the cold obtained be the ice pack.  Rather the difference between the temperature of the ice pack and your tissue.  The colder the better. (CAUTION) please use a towel or pillow case between the ice pack and your skin.

3)    Time or duration you have applied the ice pack.

First: Large enough ice-pack to do the job.

The size of the ice pack is critical.  The larger the surface area covered by the cold, the better the physiological response/adaptation to the cold effects. 

Suggested Ice Packs:

        Rehabilitation grade ice packs called ColPac.  Lots of Physical Therapy Centers use them.

asc by Chattanooga are the best.  Try here. http://www.painreliever.com/Colpac%20Products.html?gclid=COuz0vbdlZYCFQQCagodl0GdEQ

        Longs Drugs also carries a really affordable

 ice pack. look for the 15”  x 10” size.

   

 

 

 

 

 

 

      You can also make your own.  I have listed the recipe for home-made ice packs under the                 category.

 

Second:  Ice pack is cold enough to achieve effect.

         It is important to use one of the above, or similar ice pack systems to achieve great results.  Using frozen vegetables, and ice cubes is not cold enough. 

         What do I mean “ not cold enough”.  The ice pack must stay consistently cold for at least 20 minutes.  Ice, and or frozen vegetables absorb your body heat and warm up to room temperature too fast.  

Third:   Time required to achieve optimal results.

         For icing to be effective, the first 10-15  minutes are required to initiate the bio-chemical/physiological response that will benefit your healing. Then icing requires a second 10 minutes minimum to reach full effectiveness.  That is why it is important to have adequate cold and keep the ice pack applied for 25-30 minutes. 

“It is to your benefit to find a very high quality ice pack and get used to using it after your exercise routine.” 

“Be consistent with your icing.  It is as important as pain meds, and exercises.”

                                                                Mark A. Smith P.T.

P.S. Ice is your friend!!!

X-Stop surgery for spinal stenosis.

Within the last 6 months I have had several clients who have underwent the X-Stop procedure to treat their spinal stenosis.    

It is a fascinating procedure, one that offers a lower level of invasiveness, as spinal surgeries go.  A rather quick recovery, and if it works, the reduction of pain is rather substantial. 

     Below is a picture of the titanium device.                                                          

                                                                     

It is placed between two vertebrae, and is not screwed into the vertebral bodies or any bone structure. It is placed between two of your spinous process and away from your nerves and spinal cord.

the procedure is called IPD: Interspinous Process Decompression. 

In layman’s terms it acts as a sophisticated wedge that keeps your vertebrae from compressing your nerves when you are standing upright. 

The rehabilitation and recovery after this procedure is pretty straight forward.  

Your goals immediately after surgery are to:  1) get your pain in control, 2) decrease post op inflammation.3) begin to strengthen your legs, trunk and back.  See my next post about exercises for after the X-Stop surgery, and/or consult a physical therapist. 

   Here is a great website for further or more detailed information.

 http://www.back-pain-online.com/treatments/xstop.htm

Symptoms for spinal stenosis are:  

• dull or aching back pain spreading to your legs
• numbness and “pins and needles” in your legs, calves or buttocks
• weakness, or a loss of balance, and
• a decreased endurance for physical activities 

 The symptoms can increase when walking or standing for a length of time.  

If you have the about symptoms, you can decrease or  improve your symptoms if you sit, lean forward stretching your low back, lie down, and/or put your feet up. 

   Make sure you have a qualified MD assess you before you think you have spinal stenosis. There are other spinal conditions that have similar conditions.

Improve your physical performance by listening to Music!!

Brunel University’s School of Sport and Education has reveals that, according to Dr Costas Karageorghis’s latest research, listening to music with a beat can improve endurance by 15%!!! 

The study, due to be published in the U.S. periodical Journal of Sport & Exercise Psychology, is the latest from a 20-year programme of work into the motivational qualities of music in sport and exercise. The findings illustrate the considerable benefits associated with exercising in time to music: something that some elite athletes, such as marathon world record holder Haile Gebrselassie, have been doing for years.

Not only does it improve or enhance endurance by 15% but improved the “feeling states of exercisers”, which helped them derive greater pleasure from their activities.

As a former weight trainer ( bodybuilder), I have used music often to focus my concentration or to motivate.  I have often wondered if it actually improved my abilities or enhanced my performance.  

Now the researchers have proven it.  This also bodes well for rehabilitation, such as Physical Therapy.  

When I first started in Physical Therapy, 13+ years ago, music was common in the rehab rooms.  Since the increase in paperwork, music has lost its place.  Now its time to bring it back for the benefit of our clients. 

link to the article: http://www.sciencedaily.com/releases/2008/10/081001093753.htm

Latest Alzheimer / Dementia study reports significanf benefit from combination therapy.

For those of you who work with, live with, or care for someone with Alzheimer’s / Dementia the results of this recent study are amazing.  A lot of us have begun to wonder if these drugs were effective, and what can be done to help our patients/clients keep their abilities as long as possible.  Well here is an answer.

Enjoy!  and Contact your MD as soon as you can! 

The results from a long-term study of Alzheimer’s drugs published by Massachusetts General Hospital in the July/September issue of Alzheimer Disease and Associated Disorders,  demonstrated that the Alzheimer’s disease drugs significantly slow the rate of advancement of the disease.  

They also determined that  treatment using a combination of two different classes of drugs resulted in the patients  maintaining their ability to perform daily activities at a better rate than previously thought.  

“There has been the impression that these drugs only work for some patients and for a limited amount of time,” says Alireza Atri, MD, PhD, of the MGH Department of Neurology, lead author of the current study. “One of the problems in judging these drugs has been that patients naturally continue to decline, which can make them think the drugs have stopped working. But our study, which has some unique strengths, indicates that treatment does have long-term benefit.”

“What we can say now is that providers should help patients understand that the benefits of these drugs are long term and may not be apparent in the first months of treatment. Even if a patient’s symptoms get worse, that doesn’t mean the drug isn’t working, since the decline probably would have been much greater without therapy.” Atri is an instructor in Neurology at Harvard Medical School (HMS) and associate director of the Center for Translational Cognitive Neuroscience at the Veterans Administration Hospital in Bedford, Mass.

Two types of medications have received FDA approval for Alzheimer’s treatment.

Cholinesterase inhibitors have been available since the mid-1990s and act by inhibiting the breakdown of the neurotransmitter acetylcholine.

The drug memantine, which received FDA approval in 2003, is the first of a second class of agents that modulate the actions of the amino acid glutamate and is often used in combination with cholinesterase inhibitors (CIs).

The researchers were able to conduct such a study by analyzing data on patients treated at the MGH Memory Disorders Unit since 1990, including 144 who did not receive any pharmaceutical treatment, 122 treated with a CI alone and 116 who received both a CI and memantine. As part of their regular treatment, every six months patients received standardized assessments of both cognitive abilities and how well they carried out daily activities.

The results showed significant differences in the rate of symptom progression among all three groups – with the smallest level of decline in those receiving combination therapy. While there was an average of two and a half years’ worth of data on the study participants, the researchers analyzed the information with a statistical model that predicted probable outcomes for up to four years.

Although the model’s projection of future benefits is conservative, it predicted that the longer patients kept receiving combination therapy, the smaller their rate of decline would become, suggesting that treatment might even protect brain cells from further damage, a possibility needing further investigation.

 

Here is a list of Common Treatment Options.

There is no definitive cure for dementia since the exact causes of the disorder is unknown. However, it is possible to minimize some common symptoms of early stage of Alzheimer’s Disease with medications currently available. They include:

• Tacrine (Cognex): The drug is seldom prescribed due to many side effects, potential liver damage and disappointing memory results.

• Newer drugs such as Donepezil (Aricept), Rivastigmine (Exelon) and Galantamine (Reminyl) with fewer side effects are stated to be beneficial for memory improvement but effective only in early and middle stages of Alzheimer’s Disease (12).

• Donepezil is expected to delay the onset of AD for about one year in people suffering from mild cognitive impairment (MCI) (13).

• Memantine HCl (Namenda): was actually prescribed for moderate to severe stage AD but now is being prescribed even in earlier stages (12).

• Cholinesterase inhibitor. The common side effects include dizziness, agitation and delusional behavior (13).   Cholinesterase inhibitors are used to treat cognitive functions and behavioral symptoms in Lewy body disease.

• ARICEPT® is indicated for the treatment of dementia of the Alzheimer’s type. Efficacy has been demonstrated in patients with mild to moderate Alzheimer’s Disease, as well as in patients with severe Alzheimer’s Disease.Administration of Vitamin E has proved to show positive effects without side effects (12).

• Opiate drugs are often used to relieve pain.  However, they can cause strong cognitive impairments which is not recommended for people with Alzheimer’s / Dementia.  Ask your doctor to try Aspirin, Tylenol, Tylenol for arthritis, Tylenol 3, Ibuprophen, or Aleve. 

• Clonazepam and Sodium valproate are used to relieve myoclonus (4).