Arthritis and Exercise: What to Do and What Not to Do

There are many different types of arthritis. According to the Arthritis Foundation, common forms include rheumatoid, osteoarthritis, gout, fibromyalgia and psoriatic arthritis. While many medications can improve pain and quality of life for people with any type of arthritis, exercising is one of the most important ways to manage the condition. Exercise cannot cure arthritis, but it can preserve joints and improve quality of life.  Read more

A National Goal: Improving Cardiovascular Health and Quality of Life

Chronic diseases, such as heart disease, cancer and diabetes, are responsible for seven out of every 10 deaths among Americans each year, and many of the risk factors that contribute to the development of these diseases are preventable. Healthy People 2020, an initiative of the U.S. Department of Health and Human Services (HHS), aims to improve the health of all Americans by providing science-based, 10-year national objectives. Read more

Why Should I Get a Flu Shot?

According to the New York State Department of Health (DOH), achieving and sustaining high influenza vaccination coverage among health care personnel will protect staff and their patients, and reduce disease burden and health-care costs. That’s why New York is one of the many states enacting a mandatory influenza immunization (or formal refusal) for health care workers. Yet despite the benefits and availability of the vaccine, many health care personnel have concerns and misconceptions about it, just as many other people do.

Whether you are a health care worker or not, debunking the myths about influenza vaccine will enable you to make an educated decision: Read more

How Can I Ease Anxiety Over Medical Tests and Procedures?

According to the Centers for Disease Control and Prevention, preventive health guidelines advocate routine testing by age range to maintain good health. These tests include childhood immunizations, well child visits, annual physicals for adults, flu shots, cholesterol screening, screening mammograms, prostate exams, colonoscopy and more! Many people get frightened or nervous about going for medical tests or procedures, and waiting for results may create even more stress. Read more

Dehydration — Not Just a Warm Weather Problem

Dehydration is often a concern of marathon runners and other athletes, especially during warm weather. Unfortunately, it can be a problem for the very young and the very old, as well. What many people may not know is that dehydration can be a problem for anyone. Clinical dehydration can occur in people who are vomiting or have diarrhea and do not know how to replace the salt and water that is exiting the body. Read more

So, You’ve Been Bitten by a Tick

Ticks are parasitic arachnids that live in grassy or wooded areas. People can unknowingly pick up ticks as they walk past bushes, plants and grass. Ticks can also be carried on a pet and then transferred to a human. According to the National Institutes of Health: “Ticks can be fairly large—about the size of a pencil eraser—or so small that they are almost impossible to see. Ticks can cause a variety of health conditions ranging from harmless to serious.” Read more

Protect Your Head! Brain Injury Awareness

Phineas Gage was an American railroad construction foreman in the 1800s who is remembered for his survival of an accident in which a large iron rod was driven completely through his head, destroying much of his brain’s frontal lobe. After that, his personality and behavior were so profoundly affected that friends saw him as “no longer Gage.”

Types of Brain Injury

Gage had suffered a traumatic brain injury, or TBI—the same type of injury experienced lately by several well-known individuals, including Sen. Gabby Gifford and Junior Seau. While there are two types of brain injury—TBI and acquired brain injury—what we hear about in the media mostly involves TBI, an often-puzzling condition. The Brain Injury Association of America defines it as an alteration in brain function, or other evidence of brain pathology, caused by an external force. According to the Centers for Disease Control and Prevention, the causes of brain injury are falls (35.2%), motor vehicle crashes (17.3%), struck by/against events (16.5%), assault (10%) and unknown (21%).

There are many different types of TBI: diffuse axonal injury, concussion, contusion, coup-contracoup and penetrating injury, to name a few. Depending on the type of injury and its location on the brain, the outcome—including the behavior of the injured individual—varies. Brain injury can affect people of any age or gender.

Rehabilitation Takes a Team

Individuals who suffer brain injuries will begin acute rehabilitation as early as possible. In acute rehabilitation, a team of health professionals with experience and training in brain injury work with the patient to regain as many activities of daily living as possible. The team includes a physiatrist (doctor who specializes in physical medicine and rehabilitation), rehabilitation nurse, physical therapist, occupational therapist, speech therapist, social worker and nutritionist. Activities of daily living include dressing, eating, toileting, walking, speaking and more.

Prevention Tips

Preventing TBI has become a public health priority. The American Association of Neurological Surgeons offers the following guidelines:

* Buy and use helmets or protective head gear for such sports as baseball, cycling, skiing and more;

* Wear a seatbelt when you drive or ride in a car;

* Do not drink alcohol and drive;

* Do not dive in water less than 12 feet deep or in an above-ground pool;

* Remove hazards at home that can contribute to falls, like scatter rugs, electrical cords, etc.; and

* Maintain safety in the bathroom for the elderly.

Finally, if you or your loved one suffers a TBI, community support is available through your local hospital, Brain Injury Association of America and even in online communities.

References

Brain Injury Association of America (2012).

American Association of Neurological Surgeons (2012).

To find a great doctor who is right for you, please call the Physician Referral Service at 1 (866) 804-1007 Monday through Friday, 9 am to 5 pm.

 

Winter Safety — A Top Priority!

Every winter, unfortunately, the hospital sees patients that have had a weather-related accident. Here are some winter safety tips, taking it from the top down:

Hats

According to the Center for Health Policy at Indiana University, the myth that we lose most of our body heat through our heads is just not true. If that were the case, going without a hat would be the equivalent of going without pants. This is good news for those who dread “hat hair.” That being said, a hat will help you stay warmer. A long walk in the cold, snow or rain requires a hat for greater comfort.

Layers

The American Academy of Pediatrics recommends that we dress infants and children in thin layers, which will help keep them warm and dry. People of all ages should follow this advice as well. Elderly individuals who are less mobile at home may be colder; getting up and walking about, even in the house, can improve circulation and increase body heat.

Footwear

Proper footwear is a must during winter. In the event of snow or ice, women, especially, need to proceed with caution. Stilettos or very high-heeled shoes can be a hazard. In fact, falling off high heels is a common problem, resulting in sprains, strains and fractures. Using common sense about footwear—especially in the snow or ice—is essential. Wearing snow boots when going out and then putting heels on at your destination is a better option than wearing heels in snow or ice.

Boots with rubber soles or those that grip or create traction are good if you have to go outdoors. Black (transparent) ice, in particular, is something that everyone needs to be very careful about. Shoe chains that are worn over the shoe can be particularly helpful in the snow. (Caveat: Do not wear them in the house!) Designed in the early 1900’s, they work along the same premise as tire chains, wrapping around the shoe and providing traction in the snow and ice.

Accident Prevention

Finally, proceed with caution. Stay indoors in the snow, ice or heavy wind. We see a number of seniors who are blown down and fall due to high winds, and ultimately fracture a bone. Food can always be ordered in to your home. Better yet, follow the weather channel and be prepared in advance for inclement weather by having enough food, water and warm clothing on hand. Having a neighbor or buddy whom you check on or who checks on you is also a great idea!

When in doubt, stay in and stay warm!

 

References:

American Academy of Pediatrics (2012). Winter Safety Tips. http://www.aap.org/en-us/about-the-aap/aap-press-room/news-features-and-safety-tips/pages/Winter-Safety-Tips.aspx

Sample, I. (2008). The Guardian News. http://www.guardian.co.uk/science/2008/dec/17/medicalresearch-humanbehaviour

Shoe Chains (2012). http://suite101.com/article/shoe-chains-may-prevent-falls-in-snow-and-ice–tips-for-seniors-a309201

 

Arthritis: Myths and Facts

Myth: Everyone will get arthritis because we are living longer.

Fact: According to the Campaign for Aging Research, “The key risk factors for the development of arthritis are age, excess weight, injury and complications from other conditions, heredity and lack of physical activity. Arthritis can develop because of previous joint injuries or joint inflammation, hereditary joint conditions, or diseases that affect the joints (such as diabetes). Joint injury can also occur when joints are put under repetitive, high impact stress for long periods of time. Some very specific types of arthritis can result from hereditary factors. Arthritis symptoms such as pain, stiffness, fatigue and fear of harming oneself often lead people with arthritis to avoid exercise. Ironically, inactivity can worsen arthritis problems.”

Bottom line: Not everyone gets arthritis as they age, but it is common. 

 

Myth: It is too painful to exercise with arthritis and will increase disability.

Fact:  While it is true that people with arthritis often feel stiff upon wakening or if they have been inactive, exercise ultimately strengthens muscles and ligaments and reduces pain. Of course, it is essential to check with your primary care doctor, orthopedist or physiatrist (a medical doctor who specializes in physical medicine and rehabilitation) for advise on a specific exercise program. Additionally, physical therapy is often overlooked for people with arthritis. Sessions with a physical therapist can strengthen muscles and joints and give relief. Physical therapy can teach prescribed exercises that would be beneficial for your specific arthritis-related problems.

Bottom line: If you have arthritis and have not had physical therapy, it is a MUST DO to make it easier to exercise safely and productively.

 

Myth: Avoiding foods with nightshades will reduce inflammation related to arthritis.

Fact: Most of the studies of foods that cause inflammation are not available in peer-reviewed journals.

Bottom line: Anecdotal stories and books related to arthritis cure diets abound, but many of these recommendations have not been properly researched. Use caution when modifying your diet and consult with your physician.

 

Myth: There are no complementary remedies to help arthritis.

Fact: According to the 2007 National Health Interview Survey, which includes a comprehensive survey on the use of complementary health approaches by Americans, 5.2% of American adults used complementary health approaches for joint pain or stiffness, and 3.5% used them for arthritis. The National Center for Complementary and Alternative Medicine has studied glucosamine and chondroitin extensively. These two substances are forms of chemicals found naturally in cartilage. Studies using large numbers of arthritis sufferers found no real improvement in pain or improvement of narrowing of joint space. However, there was a modest but inconclusive finding that the two taken together could improve those with moderate to severe pain.

Bottom line: If you are interested in trying complementary remedies, discuss your thoughts with your physician.

 

Myth: I cannot exercise if I have had a joint replacement

Fact: Yes, many people can, but you should do so safely.

Bottom line: Check with your orthopedic surgeon or physiatrist about how much exercise, what type of exercise and when you can resume exercise post-surgery.

 

Myth: There’s not much I can I do if I have arthritis.

Fact: According to the Arthritis Foundation, maintaining a normal body weight can relieve joint pain. This means losing weight if you are overweight. Work closely with your orthopedist or physiatrist. A physiatrist may prescribe a physical therapy plan for you that can help strengthen your muscles and joints and keep you mobile! Finally, keep abreast of breakthroughs from reliable sources such as the National Arthritis Foundation, Centers for Disease Control and Prevention or National Institutes of Health.

Bottom line: With some initiative and a good working partnership with your doctors, you can live better with arthritis.

Susan Brindisi, MS Ed, MA, CHES, CRRN, is a Registered Nurse in the Department of Rehabilitation Medicine