Exercise Archives

Treatment Options for Knee Arthritis

Last month I attended a lecture titled, “State-of-the-art Treatment Options for Knee Arthritis” given by orthopedic surgeon, M. Mike Malek, MD at the Inova Fairfax Hospital. If you suffer from chronic knee pain or osteoarthritis of the knee, then this lecture provided pertinent information.

Dr. Malek first explained that this did not include rheumatoid arthritis which is a systemic disease. Osteoarthritis is a joint problem and a wear and tear problem. It is a degenerative problem that becomes arthritis. Part of osteoarthritis could be genetic and part of it is acquired. The knee is the least protected joint in the body and the most commonly injured.

As a wear and tear problem, the surfaces of the knee become pitted, eroded, uneven, and painful. This has to go on for 18 to 24 months before showing any changes on an x-ray.

Osteoarthritis symptoms include:

  • Pain
  • Loss of range of movement
    • Going up and down stairs
    • Unable to get off the toilet seat or couch
    • Night pain and stiffness
    • All day and night pain and stiffness

Causes include the following:

  • Excessive wear — weight is a major problem
  • Sport injury
  • Age
  • Obesity
  • Deformity — bow leggedness makes it worse
  • Work-related injury
  • Major trauma
  • Weak quadriceps
  • Lack of vitamin D

There is no laboratory test for osteoarthritis. There are 208 joints in the body and any joint can be affected, but the knee is the most common.

What are your treatment options?

  • Activity modification (One person said he’s a runner and he has knee problems. Dr. Malek said to find something else).
  • Physical therapy
  • Anti-inflammatories (NSAID) (Everything has side effects).
  • Cortisone injections
  • Visco supplementation (Joint fluid therapy — hyaluronic acid — something your knee produces).
    • There are five companies in the US that use rooster combs
    • Euflexxa is the only one that’s synthetic
  • PRP (protein-rich plasma)
    • Your own blood is taken and the Growth Factor is injected back
    • Athletes get on a regular basis
    • Makes healing faster
  • Bracing — customized about $1,200
  • Arthroscopy with or without HTO (High Tibial Osteotomy)
  • Arthroplasty — open surgery

With a knee replacement you will never have the full range of motion. Unicondylar knee replacement is a possibility for bowed legs. Only a part of the knee joint is replaced through a smaller incision than would normally be used for a total knee replacement.

The bottom line is your age, activity, use, and abuse of your knee will determine the length of how long your knee will last. However, you have a variety of treatment options for knee arthritis. Remember that nothing will last forever, not even knee replacement surgery. For more information, check out Dr. Malek’s Web site: http://kneesurgeryfairfax.com or http://kneeman.com.

See also a post I wrote last month about arthroscopic knee surgery.

Enhanced by Zemanta

Arthroscopic Knee Surgery

A couple of weeks ago, I had arthroscopic knee surgery because of a fall more than a dozen years ago. It was partially exploratory to determine the next step as well as to “clean it up.” The next two weeks will determine my options, but total knee replacement is not necessary.

In order to go through this surgery, I had to get a second opinion and while the second doctor determined that surgery is necessary, it was his opinion that a total knee replacement should be considered “just in case” I might need one down the road. On the other hand, my world-renowned knee specialist said you never replace anything that’s in good condition and basically, other than my knee cap, my knee is in very good condition. But the most important lesson in this is to prevent falls in the first place and to prevent arthritis from creeping in.

Fitness expert Sonia Gow, in a previous post, shared her expertise about why people fall. She mentioned that falls are not a normal part of aging.

Did you know that falls are a leading cause of hospital admissions for people over 65? For those over 65, one in three will experience a fall each year. According to the Centers for Disease Control and Prevention, 20 to 30 percent of the falls result in injuries such as lacerations, hip fractures, and head traumas with hospital bills averaging nearly $18,000 per patient.

According to Mary Tinetti, M.D., professor of internal medicine at the Yale School of Medicine, the more chronic health conditions you have, the more likely you are to suffer a fall.

  • Diabetes can worsen vision and desensitize nerves in the feet.
  • Depression can increase risk of falling.
  • Many medications cause dizziness and affect balance, especially sleep aids.

Other diseases causing a higher rate of falls include:

  • Circulatory disease
  • Chronic obstructive pulmonary disease
  • Arthritis

Yoga and tai chi which has slow, rhythmic movements can help you with your balance. Don’t forget to strengthen your arms too since you can use them to steady yourself. Find a personal trainer or borrow/buy a DVD to help you.

The Relaxation Response

As we all know, high blood pressure is a problem for many seniors. Along with our age, high blood pressure creeps up as well. A younger senior might be diagnosed as “pre-hypertensive” and because it’s easier for doctors to simply prescribe an anti-hypertensive medication rather than to encourage lifestyle changes, they find themselves on a pill or two. It is possible, however, that the drug could do more harm than good and could cause unnecessary anxiety. Herbert Benson, MD, author of bestseller, The Relaxation Response, offers an alternative.

Benson believes that by practicing the Relaxation Response, you will be better able to cope with difficult situations by allowing your body to achieve a more balanced state through the physiologic effects of the Relaxation Response. However, stopping the practice will stop the benefits within several days. There are no side effects when practiced once or twice daily for 10 to 20 minutes.

On page 35 of his book, he gives a case study of a woman with moderate hypertension with a family history of high blood pressure. After 14 months of practice she says:

The Relaxation Response has contributed to many changes in my life. Not only has it made me more relaxed physically and mentally, but also it has contributed to changes in my personality and way of life. I seem to have become calmer, more open and receptive especially to ideas which either have been unknown to me or very different from my past way of life. I like the way I am becoming; more patient, overcoming some fears especially around my physical health and stamina. I feel stronger physically and mentally. I take better care of myself. I am more committed to my daily exercise and see it as an integral part of my life. I really enjoy it, too! I drink less alcohol, take less medicine. The positive feedback which I experience as a result of the Relaxation Response and the lowered blood pressure readings make me feel I am attempting to transcend a family history replete with hypertensive heart disease.

There are two essential ingredients to the Relaxation Response:

  1. Repetition of a word, sound, phrase, prayer, or muscular activity.
  2. Passively disregarding everyday thoughts that inevitably come to mind and returning to your repetition.

Here are the simple steps to elicit the Relaxation Response:

  1. Pick a focus word, short phrase, or prayer that is firmly rooted in your belief system.
  2. Sit quietly in a comfortable position.
  3. Close your eyes.
  4. Relax your muscles, progressing from your feet to your calves, thighs, abdomen, shoulders, head, and neck.
  5. Breathe slowly and naturally, and as you do, say your focus word, sound, phrase, or prayer silently to yourself as you exhale.
  6. Assume a passive attitude. Don’t worry about how well you’re doing. When other thoughts come to mind, simply say to yourself, “Oh well,” and gently return to your repetition.
  7. Continue for 10 to 20 minutes.
  8. Do not stand immediately. Continue sitting quietly for a minute or so, allowing other thoughts to return. Then open your eyes and sit for another minute before rising.
  9. Practice the technique once or twice daily. Good times to do so are before breakfast and before dinner.

According to Benson, you can even elicit the Relaxation Response while exercising. If you are jogging or walking, pay attention to the cadence of your feet on the ground — left, right, left, right, left right — and if other thoughts come into your mind say — oh well — and return to — left, right, left, right. He reminds you to keep your eyes open! Swimmers can pay attention to the tempo of their strokes, cyclists to the whir of the wheels, and dancers to the beat of the music. So find a creative way to incorporate the Relaxation Response into your life.

Virginia Tech and Cascades Recreation Area

It was time for an out-of-town adventure and time to check off Virginia Tech from my bucket list. But a 4+ hour overnight trip would not be filled with just a visit to a university campus. In researching things to do in Blacksburg, Va, the Cascades Recreation Area in the Jefferson National Forest seemed like a worthwhile and fun place to visit. What seemed enticing was not only the hike, but the reward of seeing a magnificent 69 foot waterfall. (Seniors, you can get in free with your National Park Pass).

To get to the falls required a round trip four-mile hike which I thought would be a piece of cake considering I had done an 8.15 mile walk in the Great Aloha Run. Studying the map at the beginning of the hike, it appeared that the lower trail would be more scenic and “easier” because the upper trail was described as being more challenging because of the hill. Hence, we chose the lower trail and began our hike along the lovely Little Stoney Creek.

“Easier” is a relative term — easier if you’re younger and “grueling” in my book with having to step over all shapes and heights of rocks, twisted roots, numerous steps, and narrow pathways. Knowing what was at the end of the trail, I could not give up. Truthfully, I could not have done it without my husband. Well, maybe I could’ve, but it would’ve taken all day and there were dark clouds above and a thunderstorm looming. As we passed people coming down, they kept saying we were almost there and it was worth it.

There comes a point where the lower trail and upper trail meet and it becomes just one path to the falls. I asked a group if they had taken the upper trail (the one we had not chosen) and they said yes and a gentleman explained that it was a road that the park uses for maintenance. Therefore, it was wide and smooth. What a relief that we had an easier way back, but it was raining so the mud road was a little slippery. But, we could still walk much faster and get back to our car.

It took about 1.5 hours to get to the top and it was definitely worthwhile. I was drenched in perspiration on a cool day, but what an awesome view and an exhilarating feeling of accomplishment. I had an apple for nourishment which my body really needed. Unfortunately, it started to rain so we did not have much time to enjoy the view and had to start our descent on some slippery rocks and steps. However, once we got to the maintenance road, it felt as though we were home free.

It was a wonderful trip in every way — one of the best front desk people I’ve ever encountered (Ritz Carlton quality at a Hampton Inn), excellent service and food at Sal’s Italian Restaurant, and on the way home we stopped at the Woodrow Wilson Presidential Library and Museum in Staunton, Va where we had an excellent tour guide. That was the icing on the cake. Oh, and yes, the visit to Virginia Tech and their hokie stone buildings was also awesome. Now I know why they’re called Hokies.

Enhanced by Zemanta

The President’s Challenge: Adult Fitness Test

About three years ago,the President’s Council on Physical Fitness and Sports introduced an adult fitness test. If you did not get the Presidential Physical Fitness Award while you were in school, here’s your chance to prove your fitness or to just get started moving your body. Actually, the awards did not even exist when we seniors were in school. In 1966, President Lyndon Johnson established the Presidential Physical Fitness Award for exceptional achievement by boys and girls ages 10 to 17. Now, here’s your chance to keep up with our children and grandchildren. Our starting point is The President’s Challenge: Adult Fitness Test.

However, if exercise is not part of your routine, be sure to seek the advice of your medical practitioner first. The test is for people 18 and older who are in good health. Although the Web site has a “senior” link, the link is not working. That’s unfortunate because certainly most of our senior bodies are no longer like the younger generation. However, the test was inspired by the many baby boomers who asked council members if there was a fitness test available that was similar to the ones used in schools. The test has four basic parts:

  • Aerobic fitness—the ability of your heart and lungs to deliver blood to muscles
  • Muscular strength and endurance—whether you are strong enough to do normal activities easily and protect your lower back
  • Flexibility—the ability to move your joints through their proper range of motion
  • Body composition—whether you have too much body fat, especially around the waist

To get the details go to: http://www.presidentschallenge.org/challenge/adult.shtml. If you’re not in the best of shape, getting started is probably one of the most difficult steps and staying motivated can be even more difficult. As I mentioned in my last blog post, making a decision is critical. To stay motivated, the program offers awards that you can sign up for on the same Web site. Having an accountability partner has proven to be one of the best ways to move ahead in many areas of life. Find out about my new Gracefully Age Program by contacting me — gracefullyageprogram@gmail.com or by calling 703.825.8384. I encourage you to accept the President’s Challenge and take the Adult Fitness Test.

Enhanced by Zemanta

Whole Grains and Blood Pressure

Wheat

For many seniors, as we age, our blood pressure seems to creep up as well. Here’s one solution to lower blood pressure naturally. Refrain from reaching for any white grain such as white rice or white bread. Instead, replace it with brown rice and whole grain bread. In a study of overweight adults in their 50’s, those that replaced refined grains (rice, cereal, bread) with whole grains lost weight as well as a drop in their systolic blood pressure (top number) of five to six points.

High blood pressure can raise your risk for a heart attack, congestive heart failure, kidney disease and blindness among the many problems. Other diseases such as diabetes can raise your risk even further.

The study suggested that lowering blood pressure by eating three servings of whole-grain foods daily could reduce the risk of coronary artery disease by at least 15 percent and stroke by 25 percent or more.  Generally, refined or processed foods have more sodium which is known to contribute to high blood pressure. However, the study did not define exactly how whole grains might contribute to the lowering of blood pressure.

Check this Web site of the Harvard School of Public Health for more information on the benefits of whole grains.

With all of the known side effects of blood pressure medication which even includes heart failure, taking prescription medication should be your last option.  Pre-hypertension or even hypertension can often be controlled with diet and exercise.

February is American Heart Month. On the Web site of the American Heart Association, you will see some staggering figures: 2,200 Americans die of cardiovascular disease each day, it is the number one cause of death of women 20 and older, more women die of heart disease than the next four causes of death combined, including cancer. It is the number one killer in America, also known as the “silent killer.”Enhanced by Zemanta

How Long Will You Live?

Here’s an eye-opener if you want to know how long you’ll live: find out how fast you walk. I want to share an article from the January 2011 issue of Consumer Reports on Health.

Your walking speed and ability to rise from a chair are surprisingly effective at predicting your longevity. In a study of more than 3,000 healthy retirees, for example, those with the slowest gait were about 50 percent more likely to die within seven years. Take these tests to see how you compare.

Walking Speed: In a hallway, mark start and finish lines six meters (19 feet, 8 inches) apart. Have a partner time you. Walk briskly but don’t run, and stride past the finish line without slowing. Divide the time in seconds by six to get meters per second. Average: 0.9 meters per second for people over 50.

One-Leg Balance: With bare feet, stand with your arms folded across your chest. Raise one foot slightly off the ground and have someone start a stopwatch, stopping when you uncross your arms, move the leg you’re standing on, or touch the raised foot to the floor. (Stand next to a counter or piece of furniture). Average: 43 seconds for 18- to 39-year olds; 40 seconds for 40- to 49-year olds; 37 seconds for 50- to 59-year olds; and 27 seconds for 60- to 69-year olds. (With eyes closed: 9 seconds for 18- to 39-year olds; 7 seconds for 40- to 49-year olds; 5 seconds for 50- to 59 -year olds; and less than 3 seconds for those older than 60).

Chair Stands (for people 70 and older): Stand up from a chair five times in a row as quickly as possible without stopping. Keep your arms folded across your chest, come to a full standing position each time, and sit all the way down each time. The clock should be stopped when your bottom hits the seat the fifth time. Average: 14.28 seconds for women and men.

Sit-ups (for people younger than 70): Lie on your back with your knees bent at a right angle and your feet flat on the floor. Place your hands palms down on the ground next to your body, and with your lower back kept flat on the ground, curl up your shoulders so your fingers slide forward about 3.5 inches, then return your shoulders to the floor. Count the number you can complete in one minute. Averages for women: 25 for women 40 to 49; 31 for those 50 to 59; and 12 for those 60 to 69. Averages for men: 33 for men 40 to 49; 39 for those 50 to 59; and 18 for those 60 to 69.

Practice makes perfect so if these exercises can determine how long you will live and you want to live a long life, it’s time to get moving! A long life to all of you.

Happy New Year 2011!

It’s been just over two years since I started this blog and what an enlightening journey it’s been. When I started it, I was writing two times a week and then cut down to once a week when I started aboutalz.com. Now, as the new year begins, I am in the process of developing a new program, Gracefully Age Program  (GAP), where I work with seniors and baby boomers who struggle to find enough time to take care of their aging bodies, but would like to feel like they are in their 20’s again … except with better judgment.

My clients and I work together on the goals to be accomplished. Currently, we are in a three-month pilot program, but the actual program starts this spring and will run for six months. I am developing resources for the program as well as joint ventures. My program will be unique in that as a Cellular Response energy healer, I will incorporate energy exercises which I find totally intriguing.

As my blog has pointed out for the past couple of years, we seniors need to take care of our bodies if we want to have a good quality of life ahead of us. As I observe seniors around me, so many of them have let their bodies deteriorate. They have no energy. They have no sparkle in their faces. They are in pain. Diseases are rampant. I felt a program like GAP could help people even more than what I am doing in my Cellular Response practice. But only people who are committed to do anything to have optimal health will succeed in such a program. We all know people who could benefit from such a program, but they are going to have to want it for themselves. I will be the link that will help them achieve their goals.

So, I need more time to spend on the next chapter of my retirement career of helping more people and therefore, I will be adding to my blog every other Wednesday instead of weekly. I’ll be back in two weeks.

I appreciate your friendship. Make 2011 the best year ever!

Second Anniversary — noranagatani.com

This week I celebrate my second anniversary with noranagatani.com. It’s been an awesome experience and mind-boggling when I think about people who have connected with me via comments, phone calls, and e-mails. I’m also grateful for the wonderful contributing authors.

Using the tagline, “Helping Seniors Live Happily Ever After,” has enabled me to cover a variety of topics, but what I’ve cared most about is the health of my generation. If you still haven’t caught on to exercising, it’s important that you do.

Granddaughter

I’ve mentioned being retired — it’s been almost five years now — and what fun to experience so many new things. Topping the list is becoming a grandma. What a delight! I’ve also been a “Cellular Response” practitioner for almost a year and how gratifying to see people feeling good.

Now I’m taking it a step further and I’ve developed a program to have seniors and baby boomers take charge of their own health. So I’m working with seniors and baby boomers who are struggling to find enough time to care for their aging bodies and would like to feel as though they are in their twenties again, except with better judgment. Know any senior who would do anything and pay anything to feel more energetic? Give me a call to find out more and get in on my no-cost pilot program. I’m looking for volunteers from anywhere in the United States. Call any time — 703.825.8384. I’d love to help!

Brain Rules: Part I

Brain Rules by John J. Medina, PhD, is an intriguing and interesting book published in 2008. Dr. Medina is a developmental molecular biologist and research consultant. He is the director of the Brain Center for Applied Learning Research at Seattle Pacific University. He also teaches at the University of Washington School of Medicine, in it Department of Bioengineering. In Brain Rules he talks about 12 principles of surviving and thriving at work, home, and school.

  1. Exercise: Exercise boots brain power.
  2. Survival: The human brain evolved, too.
  3. Wiring: Every brain is wired differently.
  4. Attention: We don’t pay attention to boring things.
  5. Short-term Memory: Repeat to remember.
  6. Long-term memory: Remember to repeat.
  7. Sleep: Sleep well, think well.
  8. Stress: Stressed brains don’t learn the same way.
  9. Sensory Integration: Stimulate more of the senses.
  10. Vision: Vision trumps all other senses.
  11. Gender: Male and female brains are different.
  12. Exploration: We are powerful and natural explorers.

Chapter 1 immediately caught my attention with exercise boosts brain power. So all of my writing about “moving” and all of the hours I spend in various forms of exercise should pay off. He answers the question: Is there one factor that predicts how well you will age? Before answering the question, he profiles two people he met on television — Jim and Frank.

Jim is in a nursing home — picture him in a nursing home, in a wheelchair, his eyes vacant, lonely, friendless staring into space. Most people would not want to spend their last years of life in this way. On another channel, the author meets Frank … Frank Lloyd Wright, that is. He was amazed at his use of language and the clarity of his mind. Wright completed the designs for the Guggenheim Museum (his last work) when he was 90 years old in 1957.

Jim or Frank — which lifestyle are you headed for? Medina says:

Put simply, if  you are a couch potato, you are more likely to age like Jim, if you make it to your 80s at all. If you have an active lifestyle, you are more likely to age like Frank Lloyd Wright and much more likely to make it to your 90s.The chief reason for the difference seemed to be that exercise imporved cardiovascular fitness, which in turn reduced the risk for diseases such as heart attacks and stroke.

He goes on to say that a lifetime of exercises can also do amazing things for cognitive performance in areas like long-term memory, reasoning, and problem-solving, but the area that’s not improved by exercise is short-term memory and certain types of reaction times. Also, over-exertion and exhaustion can also hurt cognition. So, folks, we continue with our “senior moments.”

Medina says, “Your lifetime risk for general dementia is literally cut in half if you participate in leisure-time physical activity. Aerobic exercise seems to be the key. With Alzheimer’s, the effect is even greater: Such exercise lowers your odds of getting the disease by more than 60 percent.” Now this is amazing — “… a 20-minute walk each day, and you can cut your risk of having a stroke — one of the leading causes of mental disability in the elderly — by 57 percent.”

Exercise opens up your blood vessels so it can feed your brain. In addition as the blood flows more freely, the body makes new blood vessels, which penetrate deeper into the tissues of the body.

He concludes the chapter by saying, “Our brains were built for walking — 12 miles a day! To improve your thinking skills, move.”

In order to have enough energy to exercise, we must get enough sleep. In Brain Rules: Part II, I talk about sleep.