Septrowan2015

Celebrating 16 Years

I keep seeing stories about hepatitis C. Should I be worried?

How can I fit fitness into my hectic schedule?

Should I even bother to get a flu vaccine after the ineffectiveness of last year’s vaccine?

September 2015

Intestinal bacteria may affect body fat, ‘good’ cholesterol levels

By Amy Norton, HealthDay The size of your waistline may depend to some degree on the specific bacteria dwelling within your gut, new research suggests.

The study, of nearly 900 Dutch adults, found that certain gut bacteria might help determine not only body fat levels, but also blood concentrations of HDL cholesterol and triglycerides.

HDL is the “good” cholesterol that helps maintain a healthy heart; triglycerides are another type of blood fat that, in excess, can contribute to heart disease.

This is the first study to offer “solid evidence” that gut bacteria are linked to cholesterol and triglyceride levels, said lead researcher Jingyuan Fu. But it does not prove that the bacteria directly alter people’s blood fats, stressed Fu, an associate professor of genetics at University Medical Center Groningen, in the Netherlands.

So it’s too early to recommend probiotic supplements for heart disease prevention, experts said.

However, the findings add to growing evidence that the intestinal microbiome plays an important role in human health.

The term “microbiome” refers to the trillions of bacteria and other microbes that naturally dwell in the gut.

As recent research has revealed, those bugs do much more than support good digestion: They aid in everything from immune function, to metabolizing drugs to producing vitamins, anti-inflammatory compounds and even chemicals that relay messages among brain cells.

Studies have also suggested that when the microbiome lacks diversity, that may contribute to health conditions such as obesity, asthma and type 1 diabetes.

This latest study “contributes important information to our understanding of the gut microbiome and health risks, in particular cardiovascular disease,” said Dr. Lea Chen, a gastroenterologist and microbiome researcher at NYU Langone Medical Center, in New York City.

September is Fruit and Veggies More Matters Month

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The findings, published online this month in the journal Circulation Research, are based on 893 adults ranging in age from 18 to 80. Fu’s team analyzed fecal samples to get a snapshot of each person’s intestinal microbiome.

Overall, the researchers found 34 types of bacteria that were associated with people’s triglycerides and HDL levels, and with body mass index (BMI) — a measure of weight in relation to height.

The investigators estimated that the gut microbiome explained 4 percent to 6 percent of the variance in BMI, triglycerides and HDL across the study group. That’s a “modest” impact, Chen pointed out. Plus, it’s not clear that the microbiome is the cause at all.

“The identified gut bacteria could be driving changes in BMI or cholesterol, or they could merely be the byproduct of these factors,” said Chen, who was not involved in the study.

A few of the bacteria highlighted in the study are known to be involved in metabolizing bile acids that affect cholesterol levels. But Chen and Fu both said much more research is needed to understand how different gut bacteria function in relation to cholesterol and other risk factors for heart disease.

The American Society for Microbiology has an overview of the human microbiome at asm.org.

“At the current stage, this field is still in its infancy,” Fu said.

Researchers do not yet know how to define a “healthy” microbiome. But studies have suggested that modern living may be decreasing the diversity of the typical American’s gut microbiome — and that lack of diversity may be related to higher disease risks.

What makes a microbiome less diverse? Experts suspect that C-sections and lack of breast-feeding are two factors: C-sections deprive newborns of beneficial bacteria from the birth canal, while breast milk feeds gut bacteria.

Diets filled with processed foods are also thought to be at fault.

What’s key, Fu said, is that the gut microbiome can be changed through diet — unlike age, genes and certain other heart disease risk factors. But it’s not clear exactly what changes might support a healthy heart.

For now, Chen suggested that people stick with proven ways —which include eating a diet rich in fruits, vegetables, fish, fiber-rich grains and other “whole” foods.

Heath Tip:

EAT WELL The American Academy of Family Physicians suggests these nutrient-rich choices:

• • • •

Whole grains, such as rolled oats, whole-wheat pasta, brown rice and whole-grain crackers.

A colorful variety of fruits and vegetables, specifically, dark and leafy greens and orange veggies.

Lean proteins, including fish, skinless poultry, lean cuts of beef and pork, and beans.

Low-fat dairy products, including milk and cheese.

Source: HealthDay

Rowan Medicine MedicaLink Ask Rowan Medicine

I keep seeing stories about hepatitis C. Should I be worried?

Dr. Drew Chiesa, a gastroenterologist with Rowan Medicine, responds:

If you were born between 1945 and the virus without knowing it. The U.S. Centers for Disease Control and Prevention (CDC) estimates that, 1964, you may be surprised when in this country, 2.7 million people have chronic hepatitis C infection and, in 2013 (the most recent year for your physician recommends a blood which results are available), more than 19,000 people died from hepatitis C. test for the virus that causes hepatitis Even those individuals with chronic hepatitis C may not exhibit any unusual symptoms. Instead, their C infection. You may even be more first indication of disease will be detected through a routine liver function blood test. surprised to hear that the risk factors Narrowing the diagnosis to hepatitis C usually requires multiple blood tests. The first looks for the for hepatitis C infection presence of antibodies that indicate exposure to “But, physicians who recommend this test include intravenous drug the virus. If that test detects the virus, a second test use, having a hepatitiswill then measure the amount of the virus present are following the most recent U.S. Preventive infected birth mother, receiving a blood Service Task Force guidelines that resulted from in the blood. Depending on those test results, your transfusion prior to 1992, having multiple physician could recommend treatment with antiresearch showing 75 percent of people infected sex partners or getting a tattoo with an viral medications that target hepatitis C or regular with the hepatitis C virus were born during the monitoring to watch for signs of liver damage or that unsterilized needle. ‘baby boom’ years.”

But, physicians who recommend this test the dormant virus has become active. are following the most recent U.S. Preventive Unlike hepatitis A and hepatitis B, there is Service Task Force guidelines that resulted from research currently no vaccine that can prevent hepatitis C, but a cure is possible. showing 75 percent of people infected with the hepatitis For years, physicians have relied on a number of antiviral medications that could clear the body of the C virus were born during the ‘baby boom’ years. hepatitis C virus. Often taken as combinations, these medications caused significant side effects and Hepatitis C is a chronic infection of the liver, caused needed to be taken for up to six months to rid the body of the virus. by person-to-person Some relatively new drugs on the market – including transmission through Sovaldi, Harvoni, Viekira Pak and the recently approved infected blood. Hepatitis Dalinza – have been been shown to be even more effective, C generally causes few, if with a daily dose able to clear the hepatitis C virus in as any, symptoms with the little as 12 weeks. initial infection. Symptoms The downside of these medications is their expense, that do occur can include ranging from $600 to $1,000 per dose. While that is mild muscle aches, nausea, certainly a lot of money, it may represent significant fatigue and tenderness in the savings over the cost of treating the complications of area of the liver, but these hepatitis C infection that could ultimately require a symptoms may not occur liver transplant. until several months after If you are diagnosed with hepatitis C, your physician can the initial infection. After help you determine the course of treatment that best helps a dormant period that can you to defeat this disease. last decades, approximately But the first step in that battle is to get tested. During 80 percent of those infected your next visit with your physician, ask if you should be with the virus will develop a screened for the hepatitis C virus. chronic hepatitis C infection Dr. Drew Chiesa is a Rowan Medicine which can then progress into gastroenterologist and a faculty member at the Rowan serious complications like University School of Osteopathic Medicine. To schedule liver cancer, liver failure an appointment, please call (856) 566-7070. or cirrhosis.

The time gap between infection and the appearance of disease means millions of people may be infected with

Rowan Medicine MedicaLink Ask Rowan Medicine

How can I fit fitness into my hectic schedule?

Katie Horch, director of Rowan Medicine’s University Wellness Center, responds: September is never an easy month for staying fit, especially if you are the parent of children who are still in school.

Coming hard on the heels of the final hazy days of August, September bursts upon us with a full schedule of changes, traveling at warp speed. We go from relaxing in the sun at the beach, backyard or pool to a

mad dash of school supply shopping, moving older kids into college dormitories and finalizing after-school care details for younger children.

September is deceptive, too. It begins with a holiday weekend, but the next day the alarm sounds signaling the beginning of chaotic mornings of breakfast, book bags and bagged lunches. And don’t forget that we are also just a little more than two months away from the beginning of the end-of-the-year holiday season!

With all that upheaval, it’s no wonder that so many people get off the exercise path in September, both literally and figuratively.

So, how do you get back to – or begin – a fitness routine when it seems every waking hour is already double-booked with work, back-to-school activities and household chores that have been pushed to the only available time on the weekends?

As with many things in life, when it comes to If you are asking this question, congratulations! It means you have already acknowledged the need starting and staying on a fitness routine, failing to get and be healthy. As with many things in life, when it comes to starting and staying on a fitness to plan is planning to fail. routine, failing to plan is planning to fail. Adding or continuing with a fitness plan is a lifestyle choice. You can choose to work out, choose to take a nap or choose to sleep in that extra hour.

Here are a few tips that will help you select a fitness path that will take you through the hectic fall months.

• Consider that a one-hour workout is only four Our memberships are open percent of your day. Not having time to work out to the community! goes back to the choices you make about using your time.

• $99 for 3 months • Once you have decided on a time of the day • $180 for 6 months to work out, try to keep that time of the day as consistent as possible so it always fits into your • $360 for 1 year schedule. A helpful technique: add your workout Tour our facility today and time to your daily schedule on your computer or learn about the unique smartphone as a reminder. services available to our • Don’t feel shy or embarrassed to ask for help members, including or additional information from the staff where you exercise. Your workout and progress shouldn’t suffer due to a • Indoor track lack of information.

• Stretching and • Find a plan that works for you. If a friend or colleague has a certain abdominal area routine that works, it doesn’t mean that same routine is the best • Cardio room and one for you. Finding the best routine may take a little time, but weight room once you do, you will find that routine is the best path to your optimal health and fitness.

The University Wellness Center

NeuroMusculoskeletal Institute (NMI) One Medical Center Drive, Academic Center, 2nd floor Stratford, NJ 08084 • 856.566.6746

Katie Horch, M.Ed, CPT, is the program director of the University Wellness Center at the Rowan University School of Osteopathic Medicine in Stratford.

The University Wellness Center is a convenient and comprehensive fitness center, with individual and group programs available to all area residents.

Membership information is available by calling 856-566-6746.

Rowan Medicine MedicaLink

Tired of carrying a ‘spare tire?’

Meet our physicians!

Visit our booth for free health screenings and information and more!

Saturday, October 3 – 10 am to 4 pm (rain date October 4) Yellin School, Warwick Road

Our specialists are in tune with the latest diagnostic treatments and medical advancements for patients needing orthopedic and rehabilitation services and pain management.

NeuroMusculoskeletal Institute Call for an appointment 856-566-7010 42 East Laurel Road Suite 1700 Stratford, NJ 08084

• Games • Crafts • Food • Plenty of other surprises!

“Like” Stratfordfallfestival on Facebook for more information!

rowanmedicine.com

Would you like to participate in a research study?

COMMIT TO FIT 5K

Rowan University EPA Intramural Field Glassboro, NJ October 10, 2015

Our research is a team-based approach with a focus on a good clinical practice, subject safety, and protocol compliance. Call our office to inquire if we have a clinical trial for you!

Current and Future Clinical Studies • Alzheimer's Disease • Diabetes • Endometriosis • Fibromyalgia • Multiple Sclerosis • Obesity • Stroke

For more information please visit www.committofit5k.org or email rowanfitdocs@gmail.com

Office of Clinical Trials Management, 42 East Laurel Road Stratford, NJ 08084, 856-566-6003

Rowan Medicine MedicaLink

Should I even bother to get a flu vaccine after the ineffectiveness of last year’s vaccine?

Dr. Jennifer Caudle, a Rowan Medicine family physician, responds:

It’s true that the vaccine through the skin in effectiveness of last just one-tenth of a second. year’s seasonal influenza You’re allergic to the (flu) vaccine was the vaccine? In the past, people lowest it’s been in about with egg allergies often a decade. Usually, the avoided the vaccine because vaccine is between 50 to it is usually grown in chicken 70 percent effective in eggs. Now, however, an preventing the flu, but egg-less variety of the vaccine last year’s vaccine fell to less than half that. is available.

Why was last year’s vaccine so ineffective?

You say you never get sick?

Part of the reason stems from the nature of That’s lucky. But, as with the the flu virus. weather, it isn’t always easy to The influenza virus is constantly changing predict when your luck will and new strains appear each year. At the end change. Getting vaccinated of every flu season, the U.S. Food and Drug also protects those around Administration (FDA) works with the World you. Because the flu virus can Health Organization and other agencies spread from one person to to determine which virus strains are most another as easily as touching and then slowly fade with the likely to circulate in a door handle or ATM machine, you may come in “Why was last year’s vaccine so beginning of spring. the United States in contact with the virus several times throughout the ineffective? Part of the reason stems People have lots of reasons for not the next flu season. winter months. getting a flu shot, and believe me, The flu vaccine is If you are not vaccinated and you become from the nature of the flu virus.”

I’ve heard most of them. Patients then developed to infected with the flu virus, you can spread the have told me they are afraid of needles, or that the protect against those virus strains, and pharmaceutical infection to others before you even begin to have vaccine doesn’t work, or that they know someone companies begin the months of work needed to symptoms. And some of the people you infect may who got the vaccine and then got sick with the flu. produce more than 150 million doses of the vaccine. not be as healthy as you.

I understand the concerns, I really do. But the Unfortunately, flu viruses can mutate quickly and People with chronic flu vaccine is safe and essential to nipping this easily. That happened last year, and the dominant virus medical conditions, such as seasonal bug in became one that wasn’t specifically covered by the asthma, chronic “Because the flu virus can spread obstructive the bud. And this vaccine. That meant more people got sick and we had year’s vaccine an exceptionally long flu season that lingered into the pulmonary from one person to another as is available in a early part of May. disease, cancer, variety of forms, easily as touching a door handle or So, if you know the vaccine isn’t 100 percent diabetes and ATM machine, you may come in including one effective and you’ve never had the headache, scratchy kidney or liver that protects throat and the feels-like-you’ve-been-hit-by-a-train contact with the virus several times disease, are much against four muscle aches that come with a bout of seasonal flu, do more susceptible throughout the winter months.” virus strains you need to get vaccinated this year? to serious (quadrivalent) as Yes, you absolutely do. And the sooner you do, complications well as three strains (trivalent).Don’t like needles? the better. caused by the flu. Because The flu vaccine comes in a nasal spray. It can also be No one can predict exactly when flu season will they often have multiple delivered through extremely small ‘microinjection’ start or how severe it will become. Years of tracking, chronic health conditions, needles that are just 6/100ths of an inch, or through however, indicate that flu season will start around midpeople over the age of 65 years account for 80 a system that uses a stream of fluid to inject the October, reach its peak from December thru February to 90 percent of deaths and 50-70 percent of Rowan Medicine MedicaLink is an Advertorial Supplement published by Rowan University School of Osteopathic Medicine (RowanSOM). RowanSOM staff: Mary Louise Bianco-Smith (editor), Julia Swope, Gerald Carey, Lynne Yarnell, Lucy McGorry, Bernardine Jones. Please send inquiries via email to: sominfo@rowan.edu or RowanSOM Marketing Department, Suite 1600, 42 East Laurel Road, Stratford, NJ 08084, 856-566-6191.

Rowan Medicine MedicaLink hospitalizations caused by the flu, according to government estimates.

Even a ‘mild’ flu season can still cause 3,000 flu-related deaths in this country alone, while an ‘average’ season will send 200,000 people to the hospital and a severe outbreak could cause as many as 49,000 deaths.

Finally, the flu vaccine won't make you sick. Most flu vaccines are made with dead viruses that can’t possibly cause an infection. Some, including the nasal mist, have live but extremely weakened viruses that cannot lead to the flu. Once you are vaccinated, it takes about two weeks for your body to develop the antibodies needed for maximum protection. So, if you become infected with the flu virus shortly before or after you are vaccinated, you could become sick despite your vaccination.

For seasonal flu, prevention is the best protection for you and the people around you. So, take a few minutes; roll up your sleeve and give your health a real shot in the arm.

Dr. Jennifer Caudle is a Rowan Medicine family physician and a faculty member at the Rowan University School of Osteopathic Medicine. She is also an on-air health expert who can be seen on CBS3 Philly News, CNN, Fox News and others. To schedule an appointment at her Sewell office, please call 856-218-0300.

You are invited!

Rowan Family Medicine Open House Friday, October 9, 2:00 - 3:30 p.m.

100 Century Parkway, Suite 140 Mount Laurel, NJ 08054

Care for the entire family

• Adult and Pediatric Medicine • Medical Weight Management • Osteopathic Manipulative Medicine (OMM) • Gastroenterology • Onsite LabCorp Substation

Come and meet the physicians and staff; tour the office and learn about our services.

RSVP: 856-566-6207 or sominfo@rowan.edu

Need a family physician?

As your primary care office, we will manage and coordinate all of your medical care, including: • Routine preventive care • Annual wellness physicals • Acute care • Chronic disease management • Specialist referrals • Follow-up vists Stratford 856-566-7020

Mount Laurel 856-380-2400

Most insurances accepted

Hammonton 609-704-0185

Sewell 856-218-0300

Sniff, sniff, sneeze, sneeze: It’s time for fall allergies Come fall, while others are thinking about pumpkins, football, and raking leaves, you’re thinking about your ragweed misery. Get help to control your fall allergies.

Seasonal allergies, including fall allergies, affect more than 35 million Americans and cost the U.S. economy more than $7 billion in lost productivity.

Understanding Allergens

“Inhalant allergens are substances that can trigger allergy symptoms when inhaled by sensitive people,” explains Bruce Gordon, MD, an ear, nose, and throat allergy specialist at Cape Cod Hospital in Hyannis, Mass., and an instructor at Harvard University in Cambridge, Mass.

“Inhalant allergens are divided into two types on the basis of their persistence: perennial and seasonal,” Dr. Gordon says. “Perennial allergens are present throughout the year, with little variation. Seasonal allergens have distinct periods of time in which they are present in the environment in large quantities.”

Gordon says that plants typically pollinate in three seasons: “These seasons vary in length as a function of the growing season. In the spring, trees pollinate.

In the summer months, especially in early summer, grasses pollinate. Finally, in late summer and into fall, weeds pollinate.”

Ragweed - One of the main contributors to fall allergies

is the ragweed plant. A single plant can produce one billion pollen grains per season. Ragweed grows abundantly throughout the South, North, and Midwest, and its lightweight pollen grains can travel up to 400 miles in the wind.

“Ragweed pollen has a very distinct season from late summer to mid-fall,” says Gordon. “East of the Rocky Mountains, ragweed is the predominant cause of outdoor fall allergy symptoms.” Ragweed can be found growing in vacant lots, along the road, and in open fields. “In areas with colder temperatures, the first frost usually occurs at about the time ragweed pollination ends. In Southern regions, ragweed may pollinate through the winter,” notes Gordon.

Other Weeds - In various parts of the country,

goldenrod, curly dock, lamb’s quarters, pigweed, sheep sorrel, and sagebrush can all cause fall allergies. “Goldenrod blooms at the same time that ragweed does, but it is insect-pollinated [as opposed to wind-pollinated] and is not a significant allergen for most individuals,” Gordon says. “The bright goldenrod flower, however, does alert everyone that the more inconspicuous ragweed is also blooming.”

Here are some other precautions you can take: • • •

Use a face mask when you are outside, especially between 5 and 10 a.m. and on windy days.

Remove pollen from your skin and hair by showering frequently.

Keep your windows closed and turn on the air conditioner.

MORE INFORMATION

Molds - Outdoor molds are another cause of fall allergies.

They first appear in early spring, but thrive until the first frost.

They are common in soil, compost piles, and in the leaves that cover the ground during the fall. “In temperate climates, mold spores form a distinct fall season in mid to late fall, after ragweed season is over. Mold spores are common airborne allergens. They are light, very small, and easily inhaled into the lungs. Spores rise high in the atmosphere during the warming of the day, falling back to the ground with the cool of evening,” says Gordon.

Protecting Yourself If you have fall allergies, you should be extra cautious on windy days and in the morning. “Wind-pollinated plants such as ragweed have specialized male flowers that produce huge amounts of buoyant pollen, easily released into the wind.

Pollen is most often released in the mornings,” Gordon says, cautioning that people who are allergic to pollen have strong sensitivities in the morning.

• Dry your clothes inside in the dryer • • •

instead of hanging clothes outside.

Have decaying leaves removed from your yard and gutters.

If you rake leaves in the fall, wear a face mask.

When you first turn on your car air conditioner, leave your windows open and avoid breathing the air for several minutes until mold spores can disperse.

Use a quality vacuum that has a highefficiency filter weekly to keep indoor allergens to a minimum.

•

Change the air filter in your furnace regularly. Filters can trap lots of dust and allergens, so replace them every 30-90 days. Look for Certified asthma & allergy friendly filters, like Lysol brand air filters.

Don’t Suffer in Silence If your symptoms of sneezing, runny nose, or itchy and watery eyes get worse in the fall, you probably have an outdoor fall allergy. Eighty percent of people

The Asthma and Allergy Foundation of America has more information at, aafa.org.

Allergies Defined: Allergy is characterized by an overreaction of the human immune system to a foreign protein substance (“allergen”) that is eaten, breathed into the lungs, injected or touched. This immune overreaction can results in symptoms such as coughing, sneezing, itchy eyes, runny nose and scratchy throat. In severe cases it can also result in rashes, hives, lower blood pressure, difficulty breathing, asthma attacks, and even death. with seasonal allergies complain about these symptoms as well as problems with sleeping, being tired, having poor concentration, and decreased productivity at school or work.

But treatment is available. “Many [people] can be helped with modern medical treatments, if they would only complain to their doctors and get tested to detect possible allergies,” urges Gordon.

Source: The Asthma and Allergy Foundation of America and Everydayhealth.com.

When to Ice, When to Heat Athletes aren’t always sure whether to use heat or ice on injuries and aches and pains, so here is some advice from experts.

If you suffer a sudden sports injury, you should follow a recovery program known as RICE: rest, ice, compression, elevation.

“Elevation is probably the most important thing because it limits the amount of blood flow to the area and the amount of swelling,” Dr. Scott Lynch, director of sports medicine at Penn State Hershey Medical Center, said in a center news release.

Applying cold is important because it helps narrow blood vessels, preventing blood from accumulating at the injury site and causing too much inflammation and swelling that can delay healing.

Icing an injury for the first 48 to 72 hours reduces the amount of secondary tissue damage and can also ease pain, said Dr. Cayce Onks, a family and sports medicine doctor at the medical center.

Apply ice for 20 minutes, once an hour, Onks recommended. This gives the skin a chance to recover from each application of ice and prevents frostbite or damage to the skin.

Special freezer packs are available, but an ice bag is better, he said.

“You can mold it around the injury and get more coverage,” Onks said.

“You also have to keep in mind that because of the chemicals in freezer packs, they can get much colder than ice and you could cause temperaturerelated skin problems.”

Heat is the best way to treat ongoing muscle aches and pains, or to loosen tense and sore areas before physical activity, he explained.

Source: Healthday

MORE INFORMATION

How to prevent sports injuries this fall School is back in session and that means fall sports are being played on fields and in gyms all around the South Jersey area.

And anyone who plays sports or exercises is potentially at risk for a sports injury and should follow the injury prevention tips.

Here are some things different groups can do to reduce or prevent injury risk.

Parents and Coaches: • Try to group youngsters according to

skill level and size, not by chronological age, particularly during contact sports. If this is not practical, modify the sport to accommodate the needs of children with varying skill levels.

• Match the child to the sport, and don’t push the child too hard into an activity that she or he may not like or be physically capable of doing.

• Try to find sports programs where certified athletic trainers are present. These people, in addition to health care professionals, are trained to prevent, recognize, and give immediate care to sports injuries.

• See that all children get a preseason physical exam.

• Don’t let (or insist that) a child play when injured. No child (or adult) should ever be allowed to work through the pain.

• Get the child medical attention if needed.

A child who develops any symptom that persists or that affects athletic performance should be examined by a health care professional. Other clues that a child needs to see a health professional include inability to play following a sudden injury, visible abnormality of the arms and legs, and severe pain that prevents the use of an arm or leg.

• Provide a safe environment for sports. A poor playing field, unsafe gym sets, unsecured soccer goals, etc., can cause serious injury to children.

Student Athletes: • Be in proper condition to play the sport.

• • • • •

Get a preseason physical exam.

Follow the rules of the game.

Wear appropriate protective gear.

Know how to use athletic equipment.

Avoid playing when very tired or in pain.

Make warm-ups and cool-downs part of your routine. Warm-up exercises, such as stretching or light jogging, can help minimize the chances of muscle strain or other soft tissue injury. They also make the body’s tissues warmer and more flexible.

Cool-down exercises loosen the muscles that have tightened during exercise.

Source: The National Institute of Arthritis and Musculoskeletal and Skin Diseases

Tips for Preventing Injury Whether you’ve never had a sports injury and you’re trying to keep it that way or you’ve had an injury and don’t want another, the following tips can help.

• • • • • • •

• •

Avoid bending knees past 90 degrees when doing half knee bends.

Avoid twisting knees by keeping feet as flat as possible during stretches.

When jumping, land with your knees bent.

Do warm-up exercises not just before vigorous activities like running, but also before less vigorous ones such as golf.

Don’t overdo.

Do warm-up stretches before activity.

Stretch the Achilles tendon, hamstring, and quadriceps areas and hold the positions. Don’t bounce.

Cool down following vigorous sports.

For example, after a race, walk or walk/ jog for 5 minutes so your pulse comes down gradually.

Wear properly fitting shoes that provide shock absorption and stability.

Use the softest exercise surface available, and avoid running on hard surfaces like asphalt and concrete.

Run on flat surfaces. Running uphill may increase the stress on the Achilles tendon and the leg itself.

Source: Healthday

The National Institute of Arthritis and Musculoskeletal and Skin Diseases has more about preventing injuries at niams.nih.gov.

Listen to the warning signs of stress Stress in Children Warning Signs Your boss dumps a last-minute presentation on you. You feel annoyed, but confident that you can handle it.

An hour later the phone rings — it’s day care. Your daughter is sick and you need to pick her up. The day continues as more bad news continues to interrupt your day, one that you thought would be problem-free. That crankiness you feel, that headache, that tension in your neck and that desire to devour a box of chocolates — that’s you feeling stressed. It’s also your body sending out a call for help.

Stress is your body’s natural reaction to any kind of demand that disrupts life as usual. In small doses, stress is good — such as when it helps you conquer a fear or gives extra endurance and motivation to get something done. But there’s also bad stress, which is often caused by worries such as our money, jobs, relationships or health, whether it be sudden and short or long-lasting.

Feeling stress for too long, whether for several hours, days or months, sets off your body’s warning system of physical and emotional alarms.

Your body’s stress warning signs tell you that that something isn’t right.

Much like the glowing orange, 'check engine' light on your car’s dashboard, if you neglect the alerts sent out by your body, you could have a major engine malfunction. Stress that is left unchecked or poorly managed is known to contribute to high blood pressure, heart disease, obesity, diabetes and suicide.

So when things aren’t going your way, or you feel like you are losing control or are overwhelmed, pay attention to the warning signs.

They are just some of the ways that your body is telling you it needs maintenance and extra care.

Everyone reacts to stress differently, and each body sends out its different set of red flags. Some people may not even feel the physical or emotional warning signs until hours or days of stressful activities. But when you do notice a stiff back or that you are snapping at your friends, pay attention to the signs and listen to what your body is telling you. While the adrenaline rush after acing that presentation to the board is something to enjoy, the warning signs of stress are not anything to take lightly or ignore. By noticing how you respond to stress, you can manage it better and in healthy ways, which will help your body correct itself, reducing the high cost and care of chronic, long-term health problems.

• Headaches, muscle tension, neck or back pain

• Upset stomach • Dry mouth • Chest pains, rapid heartbeat • Difficulty falling or staying asleep

• Fatigue • Loss of appetite or

overeating 'comfort foods'

• Increased frequency of colds

Source: American Psychological Association

• Lack of concentration or focus

Health Tip: Choose a healthier way to cope

• Memory problems or forgetfulness

• Jitters • Irritability • Short temper • Anxiety • • • •

Your heart may pay a price when you’re stressed or depressed. But there are things you can do to help lighten the burden.

The American Heart Association recommends: Identify the source of your stress or depression, and find ways to cope with it. This may mean psychological therapy.

Practice healthy habits, such as by taking a daily walk, but don’t push yourself too hard, too fast.

Devise a healthier meal plan. Don’t reach for junk food when you get stressed.

Make healthy lifestyle changes one at a time, rather than trying to change too much at once.

Source: HealthDay

Many young children in the United States exhibit signs of stress, but parents often overlook those symptoms, according to a new survey.

The WebMD nationwide survey of parents of children ages five-13 found that 72 percent of the children displayed stress-related negative behaviors more frequently over the previous 12 months.

Forty-three percent of parents said their children were arguing more, 7 percent reported increased crying/ whining among their children, and 34 percent said their children seemed to be worried and anxious.

The survey also found that stressrelated physical symptoms were more common among children, WebMD said. Forty-four percent of parents said their children had headaches, 44 percent reported stomachaches, 38 percent said their children had nightmares or sleeping problems; and 20 percent reported decreased appetite or other changes in children’s eating habits.

About 20 percent of parents said their child had received behavioral counseling or therapy.

Many parents said they had high levels of stress, but many fail to recognize signs of stress in their children. Sixty percent of parents rated their youngsters’ stress at four or below on a scale of 10, according to WebMD. “Parents seem to be recognizing their own stress, but they are not necessarily recognizing the link between what’s happening in the family and how it’s affecting their children,” Dr. Sandra Hassink, president of the American Academy of Pediatrics, said.

“A child’s stress increases along with family stress,” she noted.

“Younger children don’t talk about being ‘stressed’ in those terms. So parents might not be hearing their children articulate that they’re under stress, but I wonder if some of it might be coming out in physical and behavioral issues,” Hassink said.

Source: WebMD.com

More Americans getting knees replaced, and at younger ages

By E.J. Mundell, HealthDay

The data, from the National Hospital Discharge Survey, shows that between 2000 and 2010, more than 5.2 million total knee replacements were performed in the United States. By 2010, the operation had become the leading inpatient surgery performed on adults aged 45 and over.

The rate at which middle-aged and older Americans got their

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knees replaced almost doubled over the years covered by the study, for men and women, the researchers found.

People aren’t putting off the procedure for as long, either.

In 2000, the average knee replacement patient was about 69 years old, but by 2010 that age had dropped to just over 66, the findings showed.

One expert said there’s been a change in doctors’ and patients’ attitudes toward the timing of knee replacement.

“In the past, the trend amongst orthopedic surgeons was to delay performing a joint replacement on a patient until a person was so hindered by their joint pain that they were nearly incapacitated in their activities of daily living,” said Dr. Neil Roth, an orthopedic surgeon at Lenox Hill Hospital in New York City.

However, “that philosophy has evolved,” he said, so that nowadays surgeons “perform joint replacements sooner, to prevent physical deterioration and deconditioning, and to try to maintain activity levels.”

The new study was led by Sonja Williams of the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS) and published in the September issue of the NCHS Data Brief.

Looking over the data, her team also noted a gender gap in knee replacement rates, with women significantly more likely to get a new knee compared to men. In 2010, about 65 of every 10,000

women aged 45 or older got a knee replacement, the research showed, compared to about 45 of every 10,000 men of similar age.

AGING BABY BOOMERS ARE GETTING BUM KNEES REPLACED AT A GREATER RATE, AND AT A YOUNGER AGE, THAN EVER BEFORE, A NEW U.S. STUDY CONFIRMS. Why is the operation becoming more popular for both genders?

According to Roth, aging boomers are demanding more mobility as they age.

“People want to remain active longer, well into their 8th and 9th decades of life, and painful joints are not conducive to remaining active,” he said.

Joint replacements are getting better, too, he added.

“Technologically, the longevity of knee and hip implants has also improved, lasting sometimes up to 15 years or longer,” Roth said.

“While that still may necessitate revision surgery for those patients in the younger age groups, 45 to 64, it may not require two revision surgeries.”

Also, “the surgeries are more sophisticated now,” Roth said, “especially with the use of [surgical] navigational systems, as well as custom-made knee and hip replacements.”

The bottom line, he said, is that

Find out more about knee replacement at the American Academy of Orthopaedic Surgeons at aaos.org.

“all of these factors have led to an increased utilization of joint replacements for those needing them at an earlier age and has put aside the mantra of ‘waiting until, you can’t take it any longer.”

Roth stressed that these procedures remain invasive and complex, are not without risk, and shouldn’t be taken lightly. “Joint replacement surgery is still a major surgical procedure with significant risks, such as blood clots, infection and loss of motion,” he said.

Dr. Eric Grossman is co-director of joint replacement surgery at Northern Westchester Hospital in Mount Kisco, N.Y. He agreed that the rise in joint replacement has largely been based on patient demand.

“Patients today are unyielding in their desire to continue to be active and maintain a physically vivacious life,” Grossman said. “For patients with severe, debilitating arthritis, a total knee replacement can reliably achieve significant improvements in a patient’s pain and functional level, including returning to walking, cycling, tennis, golf, and skiing among other activities.”

And there’s been one other improvement boosting uptake of the operation, he added.

“Hospital lengths of stay continue to decline as refinement of the rehabilitation is also improved,” Grossman said. “Patients used to be hospitalized for weeks.

In some cases today, the surgery is being done on an ambulatory basis, but most commonly patients stay in the hospital for just one to three nights.”

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