Physical activity can be divided into two types: aerobic and anaerobic.

Aerobic exercise involves large muscle movements over a sustained period of time and includes activities like:

• Running
• Fast walking
• Aerobic exercise class

When you make aerobic activity a part of your regular routine, your heart and cardiovascular system become much healthier.  In addition, your mood improves because exercise relieves stress and tension.

Anaerobic exercise builds new muscle and includes activities like:

• Lifting weights
• Resistance training

Only 20 minutes of anaerobic exercise per day can make a dramatic change in your body’s shape and condition. Muscle mass helps protect bone mass, which is especially important for women.

Tips for Daily Routine

• Do housework yourself instead of hiring someone else to do it.
• Work in the garden or mow the grass. Using a riding mower doesn’t count! Rake leaves, prune, dig and pick up trash.
• Go out for a short walk before breakfast or after dinner. Start with 5-10 minutes and work up to 30 minutes.
• Walk or bike to the corner store instead of driving.
• When walking, pick up the pace from leisurely to brisk. Choose a hilly route.
• When watching TV, sit up instead of lying on the sofa. Better yet, spend a few minutes pedaling on your stationary bicycle while watching TV. Throw away your video remote control. Instead of asking someone to bring you a drink, get up off the couch and get it yourself.
• Stand up while talking on the telephone.
• Walk the dog…

Starting a Program

Check with your doctor before beginning an exercise program.  Once you get the go ahead, start slowly and gradually work up to longer and more strenuous workouts.  Over training, especially when you’re just starting out, can lead to strains and injuries.

If daily exercise isn’t practical for you, set a goal of exercising four times a week in 30 minute sessions.  You can count minutes of activity that are already part of your day, such as time spent gardening, to achieve a goal of  30 minutes of exercise accumulated throughout the day.

Try parking farther away from your workplace to get a brief walk into daily routine. Take stairs instead of elevators.

Find the exercise that works best for your lifestyle, whether it’s a  gym, on a hiking path or on a playing field.  If you are going to exercise outside, make sure to protect your face and exposed parts of your body from sun damage.

The Power of Muscle

Exercise builds muscle mass and as your muscle mass increases you burn more calories even when you are not exercising.
Each pound of lean body mass burns about 14 calories per day. Each pound of fat tissue only burns about 2 calories per day.

The rate at which your body burns calories when at rest (not exercising) is known as your resting metabolic rate. It’s also referred to simply  as “metabolism”. By increasing your metabolism through exercise, you make the process of losing or maintaining your weight easier.

Building lean muscle mass through exercise can help you reshape your body in the way you desire. Consuming low-fat protein daily can help you build lean muscle mass. Without adequate protein intake, your body will steal protein from your muscles and organs.

Low Back Pain Exercises

Exercise is an important adjunct to your treatment.  However, be sure to follow your doctor’s instructions carefully.  Do not overdo exercise, particularly when beginning.  Start by trying the movement’s slowly and carefully.

If the exercise causes some mild discomfort, which lasts a few minutes, do not be alarmed.  This will disappear as your muscles becomes stronger.  But if pain is more than mild and continues for more than 15-20 minutes, discontinue exercising and speak to your doctor.

Some specific exercises can help your back.  One is to gently stretch your back muscles.  Lay on your back with your knees bent and slowly raise your left knee to your chest.  Press your lower back on the floor.  Hold for 5 seconds.  Relax and repeat the exercise with your right knee.  Do ten (10) of these exercises for each leg, switching legs.

While some exercises are specific for your back, it’s also important to stay active in general.  Swimming and walking are exercises for overall fitness.

Diabetic Leg Exercises (9 of 9 picture displays).
People with diabetes are more likely to develop problems in the legs and feet.  Daily exercise and not smoking can help prevent serious damage.

Walking:  Take a brisk daily walk of ½ -1 hour.  Try to increase the distance every day.

Staircase exercise:  Walk briskly up a flight of stairs using only the balls of the feet.

Stretching the calf muscles:  Lean with the palms of your hands against a wall.  Keep your feet some distance away with the heels firmly on the floor.  Bend your arms 10 times, keeping your back and legs straight.

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1. Fever is a normal body response to infection and a symptom of an illness, not an illness itself.
2. Temperatures of 100-103 degrees are usual with childhood infections and help combat disease.
3. Temperatures of 104 degrees and above may cause convulsions in infants and chills in older children and adults.
4. Sudden changes in temperature can precipitate convulsions in infants (up to 2 years of age).
5. Temperatures of 105 degrees and above if prolonged can cause brain damage.

Facts:

1. A normal temperature is about 98.6° Fahrenheit when taken orally (by mouth).
2. Temperatures taken rectally (by rectum) usually run 1° higher.
3. A normal axillary (under shoulder, in armpit) is between 96.6° (35.9° C) and 98° F (36.7° C). The normal axillary temperature is usually a degree lower than the oral (by mouth) temperature. The auxillary temperature may be as much as two degrees lower than the rectal temperature.
4. Temperatures will register lower after sleeping, becoming chilled, or drinking cold liquids.
5. Temperatures will register higher after exercising, exposure to higher environmental temperatures, and drinking hot liquids.

Treatment:

For high fevers that are difficult to bring down with Aspirin or Tylenol alone, try the following: Alternate Aspirin and Tylenol in the appropriate doses for child’s weight and age every 2 hours.

1. For a child having an elevated temperature (100° or above orally or above 101° rectally), give Aspirin or Tylenol every 3-4 hours. You should take their temperature at least every 2 – 4 hours.
2. Place the child in a tub of lukewarm water and sponge briskly for 15 minutes. If the child’s temperature is still elevated, continue sponging for an additional 15 minutes. Sponge the child no more frequently than every two (2) hours and no longer than 30 minutes at a time. Remember not to chill the child as this will prohibit the fever from going down and may even cause it to rise.
3. A fever does not necessarily indicate a dangerous infection. The child’s temperature regulating mechanism is not well developed and a fever is often higher than one would expect with a relatively minor infection.
4. Follow the doctor’s orders with regard to antibiotics and other medications.
5. Call your family doctor immediately if the child twitches, convulses, or if spots or rash appear.
6. With viral infections it is recommended to use Tylenol instead of Aspirin because of the association of Reeve’s Syndrome with Aspirin.

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Research shows that most ulcers of the stomach and the duodenum develop because of infection with Helicobacter pylori. Bacteria weakens the protective mucous layer of the stomach. This allows acid to seep in and injure the underlying stomach cells.

Historically, the bland diet has been used in peptic ulcer disease (PUD). With the introduction of H2 inhibitors for the treatment of PUD, the use of diet has been questioned. In addition, there is growing evidence that most ulcers are associated with the microorganism called Helicobacter pylori, which is usually treated with bismuth-subsalicylate, tetracycline or ampicillin and metronidaxole.

Gastric irritants include: caffeine, alcohol, aspirin, non-steroid anti-inflammatory drugs, smoking.

GERD is Gastroesophageal Reflux Disease – It occurs when gastric contents reflux into the esophagus (swallowing tube to the stomach.) The most common symptoms are heartburn, regurgitation, dysphagia (difficulty swallowing or the feeling that food is “sticking” in your throat or chest) and chest pain. GERD is a chronic disorder whose management requires lifestyle and dietary changes often combined with drug therapy.

Modifications include: Weight loss if overweight, avoid tight clothing in the abdominal area, meal consistency, maintain upright posture while eating, stop smoking if applicable. Avoid fatty foods, chocolate, alcohol, tomato products, citrus juices, coffee*, spearmint and peppermint.

Elevate the head of the bed 6 inches and avoid eating at least three (3) hours before reclining or going to bed.

Alcohol, citrus fruits, tomato products and mint irritate the already sensitive esophageal mucosa. High fat foods decrease the lower esophageal sphincter (LES) pressure and delay gastric (stomach) emptying. Both are ideal situations for reflux of gastric contents. Chocolate also relaxes the LES and delays gastric emptying.

*Controversy exists over the effect of coffee on reflux since caffeine itself has no effect on LES pressure. Some studies have shown that coffee after a meal affects LES pressure. GERD is most likely a result of the meal and not the presence of coffee.

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Fun Food Tips … Did you know?

Choosing pretzels out of a vending machine instead of potato chips can save 9 grams of fat.

Starting a meal with a glass of water will curb your appetite.

A root beer float made with 1/2 cup of low fat ice cream and 8 oz. of root beer has only 3g of fat!

Fortune cookies are usually fat free!

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Start with clear  liquids:  Sodas, Gatorade, Jell-O, Clear Soups (like chicken or beef broth) and Popsicles.

Try small amounts of the above about every 20 minutes rather than a lot at one time. Your stomach will tolerate small amounts. Also try eating (drinking) the liquids at room temperature (not hot or cold) at first. This too will help your stomach tolerate the liquids.

Next, try a few crackers or toast with clear liquids. DO NOT TRY ANY OTHER SOLID FOOD AT THIS TIME.  Try saltines or plain graham crackers or plain, dry toast.

Next, try full liquids. This includes cream soups, ice cream, pudding etc.  You may still have clear liquids, saltine crackers, plain graham crackers and plain dry toast.

Next, try soft foods:  This includes baked or mashed potatoes, pasta, cooked cereals, bananas, etc.

If you tolerate all of the above, you may now, slowly start back on your regular diet.

REMEMBER:  Your stomach is still sensitive – a little at a time.

In a 1972 episode of All In The Family, the theme was menopause:

Archie: Edith, if you’re gonna have a change in life, you gotta do it right now. I’m gonna give you just 3o seconds!

Edith: Can I finish my soup first?

Unfortunately, this what many people, both men and women, still think they know about menopause. Menopause is perhaps the least understood stage of life and arguably the most feared. No other stage of a woman’s life has as much potential for understanding herself both physically and spiritually and thus tapping into significant control and empowerment.

But it’s important to understand the basics. Menopause refers to the cessation of menses or periodic menstruation. It is often referred to as “the change of life” or simply, “the change.” the average age of menopause is currently about fifty-two with a range from forty-five but may be experienced as early as age thirty-nine.

Many women experience menopause at the same age as their mothers.. An important point to remember is that menopause is a gradual biological change. Perimenopause refers to a period of six to thirteen years during which menstrual cycles may stop for several months and then return or may increase or decrease in duration and blood flow.

While some women simply stop having periods and have no symptoms whatsoever, others experience hot flashes, vaginal dryness and decreased libido or sex drive. A blood test is often done at this time to “diagnose” menopause. This consists of measuring the levels of the pituitary gonadotropins FSH and LH hormones produced by the pituitary gland to stimulate the ovary to produce eggs.

During the years of menstruation, FSH and LH peak with ovulation at mid-cycle each month. During the Perimenopause the pituitary gland and the ovaries undergo a gradual change during which ovulations decrease and PSH and LH levels gradually increase. When FSH and LH reach a certain level in the blood, they are said to be in the menopausal range.

These hormonal shifts are frequently the cause of many symptoms associated with menopause. Hot flashes or vasomotor flushes are characterized by a feeling of heat and sweating, particularly around the head and neck. They affect anywhere from 50-85% of women sometime during their menopause of which 10-15% experience hourly waves of heat with drenching sweats causing considerable sleep disturbance and depression.

The actual cause of hot flashes is poorly understood and they usually subside in a year or so.

After menopause some women complain of vaginal dryness and irritation caused by thinning of vaginal tissue associated with decreased estrogen levels. This may be accompanied by an increase in the alkalinity of the vagina resulting in vaginal infections. This symptom is also associated with frequent urination, incontinence and urinary tract infections.

Postmenopausal osteoporosis is one of the most common and disabling diseases affecting women in the US today. It has been shown that 2-5% loss in bone mass per year in women occur over a five year period during perimenopause. However, almost 50% of a woman’s bone loss in her life span occurs before the onset of menopause.

Thus, progressive bone loss in women is due to factors more complex than simply estrogen or calcium deficiency, though these remain important factors. Many other symptoms that have become associated with menopause include but are not limited to heart disease, depression and Alzheimer’s disease. However these illnesses are largely multi-factorial and their influence on menopause remains poorly understood.

Regarding the treatment of menopause, many physicians argue whether menopause deserves a treatment and thereby be regarded as an illness as opposed to a natural state of health.

Many strategies are available for better tolerating the symptoms of menopause. Many women find that hot flashes can be tolerated by avoiding potential triggers such as caffeine, alcohol and stress or increasing your daily exercise, taking Vitamin E and eating foods rich in soy.

Vaginal symptoms can be controlled with water-based lubricants and various vaginal creams containing estrogen. Urinary problems can be avoided with Kegel exercises and biofeedback.

Osteoporosis can be minimized with exercise and calcium supplementation long before the onset of menopause. Some women will make a clear and firm decision to opt for hormone replacement therapy, while others are less certain and others fear it. Hormone replacement therapy must come with an understanding of the risks and benefits.

Hormone replacement therapy has been shown to effectively reduce hot flashes along with sleep disturbance and night sweats. In addition, hormone replacement therapy minimizes changes that occur in the bladder and vagina irritation, avoiding frequent infection and subsequently improving sexual performance and pleasure.. Significantly, hormone replacement therapy helps stabilize bone mass and decreases the risk of fractures and osteoporosis.

However, Hormone replacement therapy is not for everyone. Women with a history of breast cancer, liver or gallbladder disease, thrombophlebitis, stroke and heart disease should avoid hormone replacement therapy. Small and controversial studies have linked oral hormone replacement with and increased risk of endometrial and breast cancers. Whatever your choices may be, it is important to talk with your doctor and maintain routine health evaluations and screening.

With or without the help of hormones, every woman will benefit if she enters menopause consciously knowing there is much more to be gained than lost and the possibility of understanding and empowerment lies within reach of this new stage of life.

—Frank Sharp, M. D.

Hypertension cannot be cured in most cases. It can be successfully managed with lifestyle changes and/or medication. With proper food selection, a diet for high blood pressure can be varied and adequate in all nutrients, including vitamins and minerals.

Modifications include:

Reducing the amount of sodium in the diet. Sodium is essential for good health. While American adults average 4,000 to 6,000 milligrams daily, the recommended daily limit for the general public is only 2,4000. Someone with high blood pressure should consult a doctor to see how much sodium should be consumed daily. As a guide, however, 2,000 to 3,000 milligrams (2 to 3 grams) is enough.

A common dietary source of sodium is salt. Sodium is one of two minerals that make up salt (the other is chloride). One teaspoon of salt contains a whopping 2,300 milligrams of sodium, an entire day’s supply. But, Sodium is also “hidden” in the diet in other foods, mainly processed and packaged foods.

Maintain a health body weight and exercise regularly. Maintaining a healthy body weight and exercising are very important in controlling blood pressure. If you are overweight, just a modest weight loss can significantly improve high blood pressure. Regular exercise (with a physician’s approval) is important in helping you lose weight and maintain weight loss. This helps keep blood pressure down. Normal blood pressure is 120/80 with variations ranging from 110/70 up to 140/90 depending on body build and a variety of physical exercises performed by individuals.

Limit consumption of alcohol. In many people, drinking excessive alcohol raises blood pressure. It is recommended people with high blood pressure limit alcohol consumption to no more than one ounce per day. That’s about the amount in two ounces of 100-proof whiskey, one eight-ounce glass of wine, or two 12-ounce cans of beer.

Eat adequate amounts of potassium-rich foods. Potassium, another mineral essential to good health, works in concert with sodium to regulate blood pressure. Studies have shown that people who consume more potassium have lower blood pressures than people who consume less. Rich sources of potassium include many fruits, such as cantaloupe, bananas, watermelon, oranges and orange juice, as well as, potatoes, spinach and zucchini. (Important note: If taking medication for high blood pressure, such as diuretics, consult a doctor before using salt substitutes that contain high amounts of potassium.)

Head injury, regardless of the type, including surgical operations to the head, is followed by a group of symptoms that may be regarded as common to all forms of cranial trauma.

All of the symptoms may not be found in every patient, but most are present in the majority of instances.

MOST IMPORTANT

1.  First is the presence of possible injury to the brain.
2.  Second is injury to the scalp and skull.
3. If any of the following signs and symptoms of brain injury listed below are observed in the patient, notify your doctor immediately:

• Sleepiness:  This is the main symptom to watch for  –  any decrease in alertness is important!
• Eye pupil changes are very important!  The pupil of the eyes are the black center circles.
  • Normal pupils are equal in size and contract and dilate in response to light
  • Abnormal pupils are unequal in size to indicate brain injury.
  • Unequal pupil size that fail to change size when light is directed at the eyes is a sign of brain injury.
  • Fixed pupils: Remain the same size regardless of the amount of light.
• • Dilated pupils: Pupils remain enlarged regardless of decrease in amount of light.
  • Personality changes: Irritability and confusion.
  • Headache:  It is expected.  If it is long lasting or increases in severity, medical advice is needed.
  • Nausea and Vomiting:  This is often due to the headache.  It can be a sign of increased pressure in the head.
  • Dizziness
  • Ringing in the ears.
  • Elevated temperature above 100 degrees F.
  • Convulsions.
  •  Careful observations of the patient during the first two days after a head injury is  extremely important recognizing complications.

Gout may also involve the elbow, knee, hand, foot, ankle and/or shoulder.  It affects adults of both sexes but is 20 times more frequent in men than women.

Frequent Signs and Symptoms include:  Sudden onset of severe pain in the inflamed joint, usually at the base of the big toe or larger joints.  Involved joints are red, hot, swollen and very tender.  Skin over joint is red and shiny. Fever, sometimes.

Causes include:  A high level of uric acid in the blood due to increased production of uric acid or decreased elimination of uric acid by the kidneys.

Risk increases with:

1. Use of diuretic drugs (water pills) such as furosemide and hydrochlorothiazide
2. Use of some antibiotics
3. Some blood diseases such as polycythemia and leukemia
4. Men over 60
5. Family history of gout
6. Obesity
7. Many disorders including thyroid problems, kidney disease, anemia, hyperlipidemia, high blood pressure, diabetes and vascular disease.
8. Trauma, surgery, and radiation treatment
9. Eating large amounts of anchovies, sardines, sweetbreads, kidney or liver
10. Chemotherapy may raise uric acid levels

Preventive Measures:

Avoid and/or lessen risk factors when and where possible.

Outcomes:

1. The first attack of Gout may last a few days.
2. Recurrent attacks are common without treatment to reduce the uric acid level in the blood.
3. Symptoms can be eliminated with treatment.

Possible Complications.  If untreated, Gout may cause:

1. Inflammation of bones, ligaments and tendons.
2. Crippled deformed joints.
3. Kidney stones.

Avoid greasy foods, milk, orange juice or liquids that contain caffeine.

As the vomiting and diarrhea improve, continue to add foods more firm in consistency. Let your appetite be the guide.

Be sure to drink plenty of liquids to avoid dehydration.  Signs and symptoms of dehydration are dry mouth, no tears when crying, sunken eyes, loose wrinkly skin, failure to urinate 4 times in 24 hours, inability to keep balance when walking.

If diarrhea has not cleared up within 3 days, or if you notice blood when you vomit or in your stool, follow up with your physician.