Boomers: Tips on How to Exercise Safely

As the weather gets warmer, people often get motivated to spend more time outdoors. Whether it’s working on projects around the house, playing with the grandkids at the park or out exercising, the American Academy of Orthopaedic Surgeons (AAOS) stresses important that baby boomers remember their bodies are not as young as they used to be and not overdo it.

In 2008, more than 166,000 people between the ages of 45 and 64 were treated in emergency rooms, clinics and doctors’ offices for injuries related to exercise and exercise equipment, according to the U.S. Consumer Products Safety Commission.

“Baby boomers have become increasingly active as they age and orthopaedic surgeons think this trend will continue,” says Ray Monto, MD, spokesperson for the AAOS. “One thing to keep in mind is that when you are 50, you may injure your body more easily than when you were 20. Joints, tissues and muscles may not be as flexible as they used to be. So as boomers age, they should take extra steps to protect themselves from injuries when exercising.” Dr. Monto adds, “a little extra stretching before and after exercise, for example, goes a long way.”

The AAOS offers the following tips to help boomers prevent exercise-related injuries:

• Check with your doctor before beginning any exercise program. A physician will make sure your heart is in good condition and can make recommendations based on your current fitness level. This is especially important if you have had a previous injury.

• Always warm up and stretch before exercising. Cold muscles are more likely to get injured, so warm up with some light exercise for at least three to five minutes.

• Avoid being a “weekend warrior.” Moderate exercise every day is healthier and less likely to result in injury than heavy activity only on weekends.

• Do not be afraid to take lessons. An instructor can help ensure you are using the proper form, which can prevent overuse injuries such as tendonitis and stress fractures.

• Develop a balanced fitness program. Incorporate cardio, strength training and flexibility training to get a total body workout and prevent overuse injuries. Also, make sure to introduce new exercises gradually, so you do not take on too much at once.

• Take calcium and Vitamin D supplements daily.

• Listen to your body. As you age, you may not be able to do some of the activities that you did years ago. Pay attention to your body’s needs and abilities, and modify your workout accordingly.

• Remember to rest and schedule regular days off from exercise and rest when tired.

Baby boomers who exercise regularly are less likely to experience depression, weight gain, diabetes, high blood pressure and sleep disturbances, so it’s important to incorporate physical activity into your routine at any age.

Physical Activity May Strengthen Children's Ability to Pay Attention

As school districts across the nation revamped curricula to meet requirements of the federal “No Child Left Behind” Act, opportunities for children to be physically active during the school day diminished significantly.

Future mandates, however, might be better served by taking into account findings from a University of Illinois study suggesting the academic benefits of physical education classes, recess periods and after-school exercise programs. The research, led by Charles Hillman, a professor of kinesiology and community health and the director of the Neurocognitive Kinesiology Laboratory at Illinois, suggests that physical activity may increase students’ cognitive control – or ability to pay attention – and also result in better performance on academic achievement tests.

“The goal of the study was to see if a single acute bout of moderate
exercise – walking – was beneficial for cognitive function in a period of time afterward,” Hillman said. “This question has been asked before by our lab and others, in young adults and older adults, but it’s never been asked in children. That’s why it’s an important question.”

For each of three testing criteria, researchers noted a positive outcome linking physical activity, attention and academic achievement.

Study participants were 9-year-olds (eight girls, 12 boys) who performed a series of stimulus-discrimination tests known as flanker tasks, to assess their inhibitory control.

On one day, students were tested following a 20-minute resting period; on another day, after a 20-minute session walking on a treadmill. Students were shown congruent and incongruent stimuli on a screen and asked to push a button to respond to incongruencies. During the testing, students were outfitted with an electrode cap to measure electroencephalographic (EEG) activity.

“What we found is that following the acute bout of walking, children performed better on the flanker task,” Hillman said. “They had a higher rate of accuracy, especially when the task was more difficult. Along with that behavioral effect, we also found that there were changes in their event-related brain potentials (ERPs) – in these neuroelectric signals that are a covert measure of attentional resource allocation.”

One aspect of the neuroelectric activity of particular interest to researchers is a measure referred to as the P3 potential. Hillman said the amplitude of the potential relates to the allocation of attentional resources.

“What we found in this particular study is, following acute bouts of walking, children had a larger P3 amplitude, suggesting that they are better able to allocate attentional resources, and this effect is greater in the more difficult conditions of the flanker test, suggesting that when the environment is more noisy – visual noise in this case – kids are better able to gate out that noise and selectively attend to the correct stimulus and act upon it.”

In an effort to see how performance on such tests relates to actual classroom learning, researchers next administered an academic achievement test. The test measured performance in three areas: reading, spelling and math.

Again, the researchers noted better test results following exercise.

“And when we assessed it, the effect was largest in reading comprehension,” Hillman said. In fact, he said, “If you go by the guidelines set forth by the Wide Range Achievement Test, the increase in reading comprehension following exercise equated to approximately a full grade level.

“Thus, the exercise effect on achievement is not statistically significant, but a meaningful difference.”

Hillman said he’s not sure why the students’ performance on the spelling and math portions of the test didn’t show as much of an improvement as did reading comprehension, but suspects it may be related to design of the experiment. Students were tested on reading comprehension first, leading him to speculate that too much time may have elapsed between the physical activity and the testing period for those subjects.

“Future attempts will definitely look at the timing,” he said. Subsequent testing also will introduce other forms of physical-activity testing.

“Treadmills are great,” Hillman said. “But kids don’t walk on treadmills, so it’s not an externally valid form of exercise for most children. We currently have an ongoing project that is looking at treadmill walking at the same intensity relative to a Wii Fit game – which is a way in which kids really do exercise.”

Still, given the preliminary study’s positive outcomes on the flanker task, ERP data and academic testing, study co-author Darla Castelli believes these early findings could be used to inform useful curricular changes.

“Modifications are very easy to integrate,” Castelli said. For example, she recommends that schools make outside playground facilities accessible before and after school.

“If this is not feasible because of safety issues, then a school-wide assembly containing a brief bout of physical activity is a possible way to begin each day,” she said. “Some schools are using the Intranet or internal TV channels to broadcast physical activity sessions that can be completed in each classroom.”

Among Castelli’s other recommendations for school personnel interested in integrating physical activity into the curriculum:

• scheduling outdoor recess as a part of each school day;

• offering formal physical education 150 minutes per week at the elementary level, 225 minutes at the secondary level;

• encouraging classroom teachers to integrate physical activity into learning.

An example of how physical movement could be introduced into an actual lesson would be “when reading poetry (about nature or the change of seasons), students could act like falling leaves,” she said.

The U. of I. study appears in the current issue of the journal Neuroscience. Along with Castelli and Hillman, co-authors are U. of I. psychology professor Art Kramer and kinesiology and community health graduate student Mathew Pontifex and undergraduate Lauren Raine.

Operation Patient Access: Quality Surgical Care for All

WASHINGTON - Surgical groups, led by the American College of Surgeons (ACS), along with other key health care stakeholders, today announced the formation of Operation Patient Access: Quality Surgical Care for All, an effort to bring into focus the urgent issues facing access to quality surgical care in the United States. With nearly 400 surgeons from around the country meeting with their elected representatives today, they will call attention to urgently needed policy changes to address gaps in the availability of quality surgical patient care.


"As policymakers examine how to reform this country's health care system in the midst of the current economic crisis, there is a growing concern that the focus on cost controls will dominate discussions and decisions to the extent that access to quality surgical care will be further compromised," said L.D. Britt, MD, FACS, Chair, ACS Board of Regents. "Operation Patient Access is designed to help policymakers understand that patient access to quality surgical care is at risk and that we want to work with them to craft workable solutions that address access problems while preserving and improving high-quality surgical care."


The shortage of general surgeons in the US has been well-documented and continues to be a major concern because these surgeons are mainstays in rural parts of the country and also staff trauma centers in urban areas. Operation Patient Access released new information today that shows that the shortage and the resulting gaps in access to care are actually getting worse:


-- The American College of Surgeons Health Policy Institute issued trend
information in a new unpublished report that highlights research
indicating the shortage of general surgeons has raised concerns about
the access to care for underserved and rapidly aging populations in
pockets of both rural and urban areas of the United States.
-- New research published in the March issue of the Journal of the
American College of Surgeons reveals shortages of qualified surgeons
in many regions of Maryland, especially in rural areas. The study
states that excessive administrative demands and an aging physician
and general population could push these shortages to critical levels
over the next 10 years.


"One of the goals of Operation Patient Access is to spur dialogue and build consensus among stakeholders on how best to tackle and solve this problem because this is about making sure patients get the right care at the right time in the right place," said Thomas Russell, MD, FACS, Executive Director, American College of Surgeons.


Among the solutions being discussed by Operation Patient Access participants are: increase the number of residency programs; expand the National Health Services Corps; establish student loan forgiveness programs; provide more funding for graduate surgical education; reduce liability cost; and implement alternative payment methods for health care.


A key reason that patient groups are coming out in support of Operation Patient Access is to make sure that there are enough well-trained surgeons available to provide quality surgical care to those who need it when they need it.


"Susan G. Komen for the Cure supports the American College of Surgeons and its Operation Patient Access program," said Diana Rowden, VP, Health Sciences, Susan G. Komen for the Cure. "Highly trained, experienced surgeons provide the treatment that is the foundation of breast cancer care, resulting in overall quality outcomes for women with breast cancer. These experts can and do provide women with the range of surgical options that are part of a comprehensive individualized treatment plan. A rigorous training program and extensive continuing education ensures that surgeons are qualified and current in their approaches to breast surgery."


Other areas of surgery in which shortages are developing include orthopaedic surgery, neurosurgery, urology, obstetrics-gynecology, and cardiothoracic surgery.


"We're facing a situation where 50 percent of the practicing cardiothoracic surgeons in this country are planning on retiring within 10 years, with more than 70 percent following within 13 years," said John Mayer, MD, FACS, past president of The Society of Thoracic Surgeons and current chair of the Council on Health Policy and Relationships for the Society. "This issue is compounded by the fact that we aren't getting enough trainees into our cardiothoracic surgery fellowship programs. Between 2002 and 2007, thoracic surgery has seen a drop of 24 percent in the number of first year trainees. This is a forbidding harbinger of things to come."


About Operation Patient Access


Operation Patient Access is a collaboration of America's surgical community, including patients, surgeons, hospitals, public health and other providers - with the ultimate goal of bringing into focus the urgent issues facing access to quality surgical care. Operation Patient Access partners include: The American College of Surgeons, American Academy of Ophthalmology, American Academy of Otolaryngology - Head and Neck Surgery, American Association of Neurological Surgeons, American Association of Orthopaedic Surgeons, American College of Osteopathic Surgeons, American Osteopathic Academy of Orthopedics, American Society of Plastic Surgeons, American Urological Association, Congress of Neurological Surgeons, New England Rural Health Round Table, The Society of Thoracic Surgeons, Society for Vascular Surgery, Texas Rural Health Association, Utah Department of Health, and the Wyoming Health Resources Network.

Web site: http://operationpatientaccess.facs.org/

10 Ways to Spend Less on Health Care in a Recession

After many months of wondering, we finally have confirmation that we’re in a recession. Unfortunately, that means spending less on necessities and eliminating what we now consider to be luxuries. But during these tough economic times, the Institute for Good Medicine and the physician members of the Pennsylvania Medical Society urge you to protect your greatest asset – your health.

“Taking care of yourself or your family should never be viewed as a luxury, particularly if you have a chronic illness, or if you are unemployed or uninsured. We want to help our patients stay healthy or get healthy, regardless of their personal circumstances,” notes Daniel Glunk, MD, internal medicine physician and president of the Pennsylvania Medical Society.

The society offers these 10 ways to spend less on health care and stay (or get) healthy:

Don’t stop doing the right things
Take good care of yourself to avoid additional costs.

1. Take your medications as prescribed. If you take medications for a chronic condition such as high blood pressure, asthma, arthritis or diabetes, it can be extremely dangerous and ultimately more costly to stop taking them or alter your dose without consulting your doctor. Ask your doctor if a generic drug would be appropriate – the quality, strength and purity are the same as brand-name drugs, but they’re cheaper because the manufacturer didn’t invest millions to develop the drug. Also ask your doctor about prescription drug assistance, or visit www.RxAssist.org to see if you qualify for free and low cost medications.

2. Pay attention to early warning signs of health problems, particularly if it’s a symptom you haven’t experienced before. The longer you wait, the more costly it can be to treat. Visit your nearest clinic or doctor’s office before you head to the emergency room.

3. Keep important medical appointments. If you have a chronic illness or if your child is due for required immunizations, please keep those appointments. Worried about the cost? Visit http://findahealthcenter.hrsa.gov/ for a listing of clinics and federally qualified health centers that provide services free-of-charge or at reduced cost for those who qualify.

4. Continue self-exams and annual screenings. Take advantage of free health screenings at local clinics, hospitals, or health fairs. Sign up for periodic screening reminders from the American Cancer Society here: http://acsremindme.com/register.php?CID=206. The Pennsylvania Department of Health offers free pelvic and breast exams, pap tests, mammograms to women who qualify. Call 1-800-215-7494 for more information.

5. Fill out the online health assessments offered by the Pennsylvania Medical Society. In just a few minutes, you can find out what steps to take to improve your overall health. Visit www.myfamilywellness.org and click on “How’s Your Health?” The assessment’s personalized reports offer valuable suggestions for making positive lifestyle changes.

Do something
Continue or begin healthy habits.

6. If you smoke, quit. Nearly one quarter (23%) of Pennsylvania’s adults smoke and about 20,000 die each year from the effects of smoking. Smokers pay approximately $16,000 to $18,000 more in health care costs over their lifetime than non-smokers. If you smoke, kicking the habit will save you big bucks PLUS, it will dramatically improve your health. Contact your local American Cancer Society, American Lung Association about smoking cessation classes.
Beginning in February, the PA Department of Health is giving away a four-week supply of nicotine patches. Call 1-800-QUIT-NOW for more information.

7. Get moving. Regular exercise reduces your risk of heart disease, diabetes, stroke, high blood pressure and osteoporosis. First, if you haven’t exercised regularly in a long time, consult your doctor. Exercise also helps to control weight; contributes to healthy bones, muscles, and joints; reduces falls among older adults; helps to relieve the pain of arthritis; reduces symptoms of anxiety and depression; and is associated with fewer hospitalizations, physician visits, and medications. So, whether you take a brisk walk, climb stairs, ride a bike or lift weights, just get moving. You’ll feel better and hopefully need to visit the doctor less. Contact your local hospital about free or low cost exercise and weight-control classes.

8. Eat healthy. Try to make more meals at home. While fast-food value meals may seem like a good deal, they’re not always the healthiest choice. Instead, try cooking at home, including more fruits and vegetables in each meal. For great recipes, cooking tips and shopping lists, visit the American Caner Society’s Great American Eat Right Challenge (http://www.cancer.org/docroot/subsite/greatamericans/eat_right.asp).

9. Be more careful. The riskier your lifestyle, the more likely you are to have health problems. Take simple precautions in daily life: lift with your knees, buckle-up, and don’t take unnecessary risks. If you’re a do-it-yourselfer, make sure you know what you’re doing, or enlist the help of someone who does. Maybe now isn’t the best time to try putting on the new roof or re-wiring the house.

10. Be resourceful. If you have health care benefits, check to see if your plan includes lifestyle programs and preventive services. Take advantage of workplace wellness programs or check with your local hospital about free healthy lifestyle classes.

Avoiding Surgery for Low Back Pain

The simplest method for treating low back pain may actually be the best method. A literature study published in the February 2009 issue of The Journal of the American Academy of Orthopaedic Surgeons finds that in most cases of symptomatic lumbar degenerative disk disease, a common cause of low back pain, the most effective treatment is simply a combination of physical therapy and anti-inflammatory medication.

Symptomatic lumbar degenerative disc disease occurs when a disc weakens, often due to the effects of aging, repetitive strain or injury to the disc space. The result is that the disc cannot hold the vertebrae as well as it used to, and that lack of stability can cause low back pain. In some cases, the pain is great enough that the patient may seek treatment from an orthopaedic surgeon. These treatments can include a range of noninvasive and invasive/surgical options.

According to the review findings:
1 90 percent of patients with low back pain will see their symptoms fade on their own within three months
2 Most of those patients will recover within six weeks.

Therefore, the researchers determined that, barring an emergency, the initial treatment of all patients with low back pain should be noninvasive.

“Recently, disc replacement surgery has been proposed as a cure or treatment for symptomatic lumbar disc disease,” says Luke Madigan, M.D., an attending physician at Knoxville Orthopaedic Clinic, Knoxville, TN, and the lead author of the review. “But the FDA studies on lumbar disc replacement have only so far shown equivalence to fusion for discogenic disease. Long-term outcomes are still to be published and caution should be exercised with their use.” Madigan also notes that in the past, surgical fusion was used to treat this condition, and the success rate was 50-60 percent.

Meanwhile, noninvasive treatments have brought about greater success by helping patients strengthen the injured area and prevent further strain:

1 Physical therapy that focuses on strengthening core muscle groups in the abdominal area and the lower back has demonstrated positive effects in patients with disc-related pain.
2 Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen have been found effective for short-term relief of low back pain, and no NSAID was found to be any more effective than the others.
3 Educating patients on better body mechanics—for example, lifting with the legs instead of the back—is found to lessen the strain that is placed on the lumbar region.
4 Another recent literature review advocated mobilization or activity in the treatment of low back pain as opposed to bed rest, and exercise has been shown to improve function and decrease pain in adult patients with chronic low back pain.
5 Braces have not been found to be effective in treating low back pain, although whether patients actually wear the brace in the prescribed manner may be a factor.

Invasive treatment should only be explored if these and other noninvasive treatments have not been effective.

“Surgery should be the last option, but too often patients think of surgery as a cure all and are eager to embark on it,” Madigan says. “Also, surgeons should pay close attention to the list of contraindications, and recommend surgery only for those patients who are truly likely to benefit from it.”

HeartSaving Solutions Offers Free CPR Course for Parents

The economic meltdown has taken its toll; family budgets are being slashed as belts tighten. But Seattle-based CPR training firm HeartSaving Solutions (http://www.onlinebabycpr.com) believes all parents should have the right to learn how to save their children’s lives in the event of an emergency. To that end, the company has made its online infant and child CPR course completely free of charge.

Available to parents, grandparents, older siblings and anyone else who would like to learn infant and child CPR from the comfort of their own homes, Online Baby CPR used to cost $13.95 per person. HeartSaving Solutions founder Keith Weaver, however, decided to provide the infant and child CPR training for free when he realized that in spite of its importance, many parents just can’t afford to take any CPR course right now.

“I’m a dad myself. I know parents have limited time and, these days, even more limited money. But at the same time, we at HeartSaving Solutions are alarmed that thousands of babies and children die each year as a result of choking, suffocation and drowning — three situations in which CPR can literally be a lifesaver,” Weaver explained. “So Online Baby CPR is dedicated to giving parents and parents-to-be a way to learn those vital skills at home, at their pace, for free. In this one area, we’re able to remove the barrier the recession had presented to parents.”

The Online Baby CPR course is designed for parents and is a complete CPR training class. Proceeding through the course on their own time, participants will learn child and infant CPR, choking and drowning prevention, automated external defibrillator (AED) use, and how to help a child or baby who is already choking. There is no software required and nothing to download. Although parents will thoroughly learn the basics of CPR, the free course does not offer a CPR certification, making it for personal use only.

Those wondering whether they can really learn CPR online needn’t worry. Online Baby CPR uses industry best practices to teach the lifesaving concepts of CPR through video, images, audio, text and quizzes; students can ask questions at the OnlineBabyCPR.com forums, where certified CPR trainers are on hand to provide answers.

“We hope parents, grandparents and primary caregivers will take this free, convenient opportunity to learn how to save their children’s lives through CPR,” Weaver said. “With Online Baby CPR, it’s easier than ever before to make your home a safer place.”

About HeartSaving Solutions

HeartSaving Solutions is a certified CPR, AED and First Aid training provider. The company provides outstanding on-site training to businesses and has been chosen by one of the largest AED manufacturers to provide training to many of its customers in the Northwest. To learn more about HeartSaving Solutions, visit the company at http://www.heartsaving.net; more information about the Online Baby CPR course is available at http://www.onlinebabycpr.com.

No More Dry Eyes -- Tips to Get the Grit Out

Dry eyes can be a nuisance. But when severe cases are not treated, the condition becomes more than an irritation. The surface of the eye is susceptible to infection and scarring. The January issue of Mayo Clinic Health Letter covers the causes of dry eyes and treatment options.

Healthy eyes are continuously covered by layers of fluids. The outermost layer includes fatty acids that smooth the tear surface and slow evaporation of the thicker, middle layer, which is mostly water. Mucus makes up the innermost layer, which allows tears to be evenly spread over the eye surface. Dry eyes happen when any of these three components is out of balance.

For example, dry eyes occur when tear glands don’t produce enough fluids or when problems with blinking hamper tear distribution. Also, several commonly used medications, including diuretics, pain relievers, sleep medications and antidepressants, can cause dry eyes.

Most people with dry eyes don’t develop long-term complications, but they can happen. Treatments are designed to both increase comfort and reduce the possibility of complications. The best treatment depends on what is causing dry eyes.

If the irritant is lack of tears, using nonprescription artificial tears is the mainstay treatment. Generally, it’s best to avoid drops such as Clear Eyes and Visine, which reduce redness but may aggravate dry eyes. Some products have a thicker consistency, and their effects last longer, but they can blur vision. Others such as Refresh Dry Eye Therapy use an oil-based component to help prevent evaporation. Another option, Optive, lubricates the eye surface and keeps the eye healthy.

For severe dry eyes, a physician may recommend tear conservation methods such as blocking tear drainage with tiny silicone plugs or cauterizing the tissues of the tear drainage area so scarring closes the tear ducts.

Other options are prescription cyclosporine (Restasis) drops and corticosteroid drops or contact lenses that cover the white of the eye to help retain moisture. For impaired blinking, surgery may be needed.

At home, using eyedrops before eyes become irritated is helpful. Protecting eyes from blowing air, for example with wraparound sunglasses, can reduce eye irritation. So can avoiding smoke and not rubbing the eyes. A humidifier can help when the air inside the home is dry.