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Are You Hydrating Enough?

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Are You Hydrating Enough?

August is fully upon us and with it the blistering hot, dog days of summer are here. With rising temperatures and intense humidity we also see an increase in issues related to dehydration. The dangerous thing about dehydration is it has a way of sneaking up on you and you will feel its effects before you realize it. Generally people are thoughtful and remember to hydrate if they are going to play a sport or mow the lawn but most are not nearly as diligent in their day-to-day hydration practices.

More often than not people rely on thirst as their indication that they are dehydrated and as a result do not consume an adequate amount of water. The problem is that thirst is a poor indicator for the body’s need for water because by the time you are thirsty you are already significantly dehydrated.

Obviously dry mouth and increased thirst are signs that you are dehydrated but so is fatigue, dry eyes or blurred vision, lack of sweating, dizziness, cramping, dark urine and light headedness. In severe cases rapid heartbeat, rapid breathing, fainting, confusion and anger can all be indicative of dehydration.

So how much water do you need? The amount depends on your weight, heat exposure and medications you may take. There is considerable debate as to whether you should drink approximately ½ your body weight or by multiplying your body weight by 2/3. Personally I think that if you are somewhere in between and add a dose of common sense you’ll be fine. In addition add 12 ounces for every 30 minutes of a work out. If you take a dehydrating medication add an additional 12 ounces. Equally important is to not over hydrate. When you drink too much water you will dilute the sodium and electrolytes in your body, which can create a whole of other problems.

Everyone needs to be concerned with dehydration but children, older adults and people with chronic illnesses are especially vulnerable. Older adults naturally have a lower volume of water in their bodies and are more likely to take medications and have conditions that result in dehydration. Young children become dehydrated very easily especially with vomiting and diarrhea.

So, if you are on the dry side of hydrating I encourage you to take a look at where you can do better to wet your whistle. It is a simple critical component of self-care that is easily remedied and immediately effective.

Drink up!

With Gratitude,
Pat

What’s The Matter with Me?

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What’s The Matter with Me?

Check out the list of the following symptoms to asses if any apply to you. While all of the symptoms are related to many disorders they are also associated with low levels of vitamin B12. In order to accurately discern whether your B12 levels are low or you are suffer from some other issue a simple blood test is in order and your doctor can easily do this for you.

Low levels of B12 can lead to:

  1. Weakness, tired, lightheaded
  2. Heart palpitations/shortness of breath
  3. Constipation/diarrhea/loss of appetite/excessive gas
  4. Tingling in hands and feet/difficulty walking with ease
  5. Vision Loss
  6. Pale skin/smooth tongue
  7. Depression/ memory loss or behavioral changes

Low levels of B12 can be cause by a variety of issues but it is often the inability of our body to absorb the vitamin that is generally the root cause. Those individuals who are susceptible to any gastrointestinal disorders or have had gastrointestinal surgery are at a higher risk, as are older individuals, vegetarians, pregnant and lactating woman as well as those who suffer from pernicious anemia. Pernicious anemia is an autoimmune disease that affects the gastric mucosa resulting in atrophy, which in turn through a series of steps inhibits normal B12 absorption. Tingling in the hands and feet is a hallmark symptom of Pernicious anemia.

From a dietary standpoint the best sources of B12 include eggs, cheese, milk and milk products, meat, fish, fortified breakfast cereals, shellfish, poultry and some soy based products. B12 is a water-soluble vitamin so it is hard to overdose on it because what ever is not needed is generally excreted in your urine. Some of the side effects from taking B12 can include headaches, itching, anxiety or nervousness and in severe case uncontrolled movements.

I’m often asked if it is better to use the injectable form or take the oral supplements. This is entirely dependent on the state of your gastrointestinal system. In the case of pernicious anemia taking an oral supplement would be of little value because the atrophy of the stomach wall does not allow it to be absorbed therefore an injection is the best option. If you are able to digest and absorb properly then an oral supplement is fine. If you have assessed a need for B12 it’s important that you let your physician know before you begin to take it to ensure there are no issues with any other medication you are taking.

As with any medication, vitamin or supplement be certain that you have a need for it before beginning and if you do so taking it regularly will give you the best results.

With Gratitude,
Pat

Spring: Glorious and Problematic

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Spring: Glorious and Problematic

Starting in mid to late March with the arrival of the daffodils, Bartlett Pears, forsythia and crocuses and carrying onward to the Tulips, roses and dogwoods Atlanta is a panacea of color and scent that delights all of our senses. Not many places on the planet rival the beauty that arrives in Atlanta each spring, however this beauty comes at a price. Pollen, the unwelcome yet necessary culprit that produces this cornucopia of color coats our noses, throats and eyes.

Pollen counts measure the amount of pollen grains in a cubic meter of air. Pollen counts that reach above a thousand are considered to be extremely high. With pollen counts that can regularly hang out at 2-3 thousand and have reached over 9000 you can understand why we have more than our fair share of coughing, runny noses, congestion, scratchy throat and itchy eyes during these beautiful spring days. Believe it or not even with our tremendously high pollen count we haven’t even reached the top ten pollen counts in the country. Internationally Islamabad has the highest counts reaching the 40,000’s! No matter what the pollen count is where you are there are things that you can do to help minimize your symptoms.

Consider the following to assist in ameliorating symptoms and/or preventing them before they get started:

  1. Monitor the local pollen count. Weather.com publishes the daily pollen count, delineating the specific pollens in question and whether it is mild moderate or severe. Know what you are sensitive to and avoid your exposure as much as possible on heavy pollen days.
  2. Rinse your hair before going to bed. During the day your hair is exposed to the environment leaving your hair laden with the grains of pollen. Rinsing your hair helps you prevent inhaling the pollen that would otherwise fall on your pillow.
  3. Keep your car and windows closed during heavy pollen days. Despite the fact that the temperature is usually perfect and the breeze feel delicious avoid the temptation.
  4. Wash your clothes, curtains and linens and vacuum couch and chairs.
  5. Animals that are exposed should be rinsed regularly during high pollen count days. This will avoid them tracking the pollen through the home or getting it on your hand while petting.
  6. If your allergies are severe consider wearing a mask to filter pollen when you are outside.

Treating your allergies

If you have the misfortune of developing an allergic response consider a Neti pot with a salt solution to flush your nasal passages. It can be quite effective in reducing the inflammation in you nasal passages. Acupuncture and local bee pollen can also be of great assistance in reducing your symptoms. Orally quercitin is a natural antihistamine that can be taken in a tablet form (most effective) and occurs naturally in garlic, citrus fruits broccoli, berries, wine, apples, parsley, legumes and lettuce. For those with severe reactivity immunotherapy shots may limit your reactivity and reduce allergic triggers. No matter what approach you take make sure to keep yourself hydrated. Whatever your level of sensitivity I hope you are able to enjoy the beauty that graces us throughout the spring season.

With Gratitude,
Pat

Pickleball? Seriously?

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Pickleball? Seriously?

Yes despite it’s ridiculous name it is sweeping the country and the fastest growing sport in the world. I play and as a result people frequently ask me about my experience of playing. This prompted me to use the opportunity in this month’s newsletter to expose those of you who are curious about the game and want to know more. Pickle ball is the fastest growing sport in the world for many reasons but the biggest is it is just flat out fun. Many of you may have heard of this new craze but have no idea what it is and many of you are already avid devotees. For those of you who are curious this will remove some of the mystery.

Pickleball is a combination of three sports-tennis, badminton and ping-pong. It is played indoors or outside on a court similar to a tennis court that is about two feet shorter on the ends but the same width. The paddle is flat and approximately the same size as a racquetball racquet. The ball is the size of a whiffle ball on steroids or about the size of a baseball. Tennis serving boxes are in the front while the pickball serving boxes are in the back close to the server. It can be played with two, three or four players.

Some additional information that makes pickleball an attractive exercise option include:

  1. It won’t break the bank. Most places available for play are either free or have a nominal fee of $3-$5. Paddles can be purchased from $28 to $198 at pickleballcentral.com and amazon (of course). Some facilities have extra paddles available for your use.
  2. You don’t have to coordinate everyone’s busy schedules. You simply show up any time during the predetermined time and play for as little or as long as you want.
  3. Most everyone can play. If you have a previous history of playing any of the sports involved you will pick it up in just a few minutes. For those of you with little to no racquet experience you can also learn very quickly however may take a little more practice to become proficient.
  4. You can play virtually anywhere. Whenever I travel I usually do an Internet search for local pickleball locations and simply show up at the appointed time. People are always welcoming to outsiders. For example if I travel to St. Simons Island I will do an Internet search for pickleball St. Simons and it let’s me know the details of where and when games will be played.
  5. It’s a very social game. Everybody is generally welcoming and gracious. Over time you get to know an entire new group of friends and competition can range from very competitive to social but either way you will get a good workout and get your body moving. The limited size of the court is also a big advantage for those with knee or foot issues.
  6. Games generally don’t last a long time. You play to 11 however if there are a number of people waiting games are often shortened to 7 to allow more playing time for everyone.
  7. It’s great exercise and you can get a good workout but you generally are just having fun so you don’t notice the effort it takes.

For more information check out this video on how to play. What is Pickleball? – USAPA Pickleball

If you are interested in seeing some high level play watch the championship from last year by clicking this link. Pickleball Channel – YouTube

No matter what part of the country you live in consider checking out your local pickle ball centers and give it a try. I think you’ll have fun and be glad you did.

With Gratitude,
Pat

A Gift To Yourself

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A Gift To Yourself

So here we are once again at the beginning of a new year with all the promise it holds for the upcoming year. Whether you write down goals with specific intentions, unconsciously think them through, or ignore them all together the truth is statistically 92% of us won’t win our battle.

When most of us set goals or intentions for the year they are often unrealistic and lack self-compassion. This lends itself to a fairly high probability of limited success. I am sure it comes as no surprise when you hear some one say “It’s the same every year. I want to loose weight, exercise more and sleep better. I just never seem to quite get there”. There is a reason it’s the same thing every year.

We have all made mistakes, tried and failed, done and said things that we weren’t proud of and at the end of the day usually don’t let ourselves off the hook easily. When we make a mistake or things don’t go the way we planned or in the time we allotted we often give ourselves negative messages such as I’ll never be able to do it, I don’t know why I bother, I have no will power, I’m such a looser and soon you just stop trying.

When we continually come up short in our endeavors we are usually left feeling defeated. Creating unrealistic goals such as working out 5 days a week, changing your diet and committing to sleeping at least 8 hours a night is an overwhelming amount of change. While the enthusiasm is to be admired, a total revamp of your life all at once is the perfect recipe for failure. Consider take incremental steps at whatever level of comfort seems right for you. Stretch yourself but with considerate mindfulness. It is equally important to acknowledge yourself for whatever steps you do take no matter how large or small.

Make friends with self-compassion as a companion in your desire to create something new in this year. Whether you want to loose weight, start a relationship, getting a new job, being a better parent or partner or whatever else you may want to change recognize that inherent in that will be opportunity for growth and inevitably some amount of discomfort and struggle. However, it doesn’t need to be a battle.

Supporting ourselves by reminding and equally acknowledging what we did well instead of tearing ourselves down with what we didn’t do is what self -compassion looks like. In all likelihood most of us will not make changes perfectly but that doesn’t mean we stop doing it. Assess what is working and give yourself a hand and carry on. For the things that aren’t going quite as planned have some patience and compassion for yourself and start again. You are much more likely to have success in whatever changes you are trying to make.

As you journey on the path to the newer year I ask you to consciously consider acknowledging as many things as you can that you are doing well. Consider grace and self-compassion as a gift to yourself.

With Gratitude,
Pat

Exercise and Your Brain

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Exercise and Your Brain

It turns out that exercise is good for more than just looking good in a bathing suit and fighting off heart disease. Research shows it is significantly important for our brain health. In an era where Alzheimer’s is growing at an alarming rate any thing that we can do to help our brain health is not only advisable but also essential.

According to the Alzheimer’s Association findings for 2017 more than 5.5 million people are living with Alzheimer’s and that number is growing rapidly. It is the 6th leading cause of death in the United States and 1in 3 seniors will die with Alzheimer’s or another dementia. Since 2000 deaths from heart disease have decreased by 14 % while deaths from Alzheimer’s have increased 89%! In addition it kills more than breast cancer and prostrate cancer combined.

So how does exercise help your brain? Initially we believed that our brains were static with little ability to change but now we know that the brain has neuroplasticity, which means that the brain has the ability to create new neurological patterns. It creates these new neurons and patterns through a process called neurogenesis. Dr. Gage at the Salk institute for Biological Studies along with a multitude of other studies has shown that through increased blood flow to the brain through exercise triggers biomechanical changes that spur neuroplasticity and generates new brain cells even in the aging brain.

The significance of this is that we have the ability to consciously and purposely have an effect on our brains ability to create these new neurons. Thus far the research has primarily been proven with aerobic exercises and to date it has been unclear whether anaerobic resistance training has the same effect. It turns out that as little as three hours of brisk walking a week has been shown to halt and even reverse the brain atrophy that starts somewhere in our forties. Aerobic exercise is especially helpful in the regions of the brain responsible for memory and higher cognition.

We all know that exercise is helpful in many other ways aside from creating neurogenesis in our brain. Exercise lowers blood pressure, maintains cardiovascular health, increases muscle mass and has been helpful in addressing depression as well as many other issues. My hope for each of us is to age gracefully and enjoy all of life we can. To that end I encourage you to get up, get moving and stay smart.

With Gratitude,
Pat

A Breath of Fresh Air

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A Breath of Fresh Air

There is nothing more relaxing than a good deep breath. It is one of the most highly utilized techniques employed in any setting to assist you to calm down, relax and get focused. So why write a newsletter about your breath? I am sure you have been successfully breathing for as long as you can remember. Interestingly, however, you may be surprised to find that a large number of people don’t breath correctly and this can actually create more stress than relaxation. Justifiably most people rarely pay attention to their breath but with a slight modification you can optimize your breathing to significantly produce increased relaxation for your mind and body.

Take a second and take a good deep breath. Did you find that as you inhaled deeply your chest and shoulders lifted filling your lungs with air? This actually creates what I refer to as an “anxiety breath”. It makes sense if you think about it. When you get startled or taken by surprise you breath in the same way by inhaling a large amount of air as your chest rises.

Creating a calming breath still involves inhaling through your nose and mouth, however instead of filling your lungs by lifting your shoulders and ribcage as you breath in push out your lower abdomen with as little movement in the upper body as possible. Try practicing this by placing a hand on your stomach and as you inhale attempt to push on your hand as you fill the lower abdomen. As you exhale passively allow your belly to relax. Although it may feel awkward at first with just a few practice breaths it becomes more natural.

Breath is one of the only conscious connections between the mind and the body and can be valuable not only to relieve stress but also to calm and center you before a test, a big meeting, working on a project or to be in the moment and enjoy the day. If you have children I encourage you to share this techniques with them. We often overlook the stress they are under and teaching them techniques such as this at an early age will serve them for years to come.

Practicing proper breaths will assist you to stay calm especially in more stressful moments. When you are calm you think better and make clearer decisions. As trivial as it may sound consider evaluating your breathing and measure how effectively it is working for you. You won’t be disappointed.

With Gratitude,
Pat

Balance

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Balance

Aging is going to happen whether we rebel against it or not but we do have some control over aging well. Unfortunately, it is well documented that the likelihood of developing balance issues as you age is significantly high. This is because as we age we lose full balance function through a decreased or loss of sensory processing, the ability to integrate the information and issue motor commands and because we are generally weaker. Increased incidences of falls are one of those realities but with a little effort you can minimize it being your reality.

Ideally we want to begin to address these issues long before we need them however you can start at whatever level you are capable of and progress from there. Safety when performing these exercises is critical so I always insist that some one else is present especially when you first start. What we do know is that repeating specific movements will create a new neurological pattern in your brain. In addition by performing these repetitions you will strengthen the muscle utilized in balance. The more repetitive the movement the stronger the neurological connection and the easier you can access the movement.

I frequently discuss this with most of my more senior patients at some point and with a minimal amount of effort they find significant improvement and minimize the chance of injury while feeling stronger and more stable.

Consider trying the following simple exercises as recommended by the National Institute on Aging:

  1. Standing up from a seated position without pushing up with your arms. This will activate your gluteus muscles, which often don’t fire optimally as you age.
  2. Try standing in front of your kitchen counter or behind a sturdy chair. Gently place your hands out in front of you on the surface to steady yourself. Creating a slight space between your hands and the counter then lift one leg off the floor with a bent knee, look straight ahead and hold for ten seconds. Repeat with the other leg. Try to do five times each side morning and night. When you feel comfortable lift you hands up higher but keep them outstretched in case you need to catch yourself. When you are proficient try doing this with your eyes shut. (Continue to keep your hands out in front.)
  3. Placing one foot behind the heel of your front foot and perform Heel/Toe walk. (walking in a straight line) Choose a spot in front of you and keep your eyes focused on it as you take a step moving the back foot in front of the lead foot. Keep your arms out to the side to assist in your balance and repeat for twenty steps morning and evening
  4. When you have become fairly proficient with the above exercises try doing some of your regular exercises such as bicep curls or stretching on a large exercises ball. Performing exercises on the ball initiates a muscle in your abdomen called the transverse abdominus, which is a critical muscle recruited in balance.

If you are someone who likes to participate in a class experience I highly recommend Thai Chi as a safe effective gentle way to incorporate balance exercises into your life. Thai Chi can best be described as continuous flowing movement. It incorporates your whole body, is very gentle and almost anyone can participate. There are many places around town that specialize in groups specifically for the aging. Cate Morrill in Little Five Points has a company called Shoulders Down Inc., 404-525-6466 or try Jude at Decatur Healing Arts 404-378-6288.

I encourage you to try a number of these options and decided what works best for you. The sooner you begin the less likely you are to develop problems in the future so please get busy now!

Got Water?

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Got Water?

Summer is upon us and with that an increased need for hydration. It may surprise you that many people drink virtually no water at all and believe they get a sufficient amount in their coffee or tea. Aside from water, coffee and tea each contain caffeine which actually contributes to dehydration instead of resolving it.

This occurs simply by loosing more water than you take in. Each day we diminish our water by evaporating it through our skin, breathing as we exhale, urinating and through fecal material in our stool.

This loss of water can be caused by many things such as:

  1. Heat exposure especially during exercise
  2. Diarrhea and/or vomiting
  3. Burns
  4. Urinary tract infections
  5. Limited water and/or drinking dehydrating beverages such as coffee, tea etc
  6. Fever

Dehydration leads to a variety of symptoms ranging from mild to severe. Being thirsty or having a dry mouth is obvious but some symptoms are not so apparent and often go unrecognized. Headache, rapid heart rate, dizziness, rapid breathing, irritabilty and/or confusion, listlessness, muscle cramping, delerium and in a severe state loss of consciousness can all be caused by dehydration. Urine color is also a tell tale sign. Urine color should be pale yellow to clear. Darker urine is indicative of dehydration, but be aware that taking Vitamin B can also create a darker urine color even when you are well hydrated.

While prevention is obviously the best choice, remedying dehydration is fairly simple. Drink plenty of water or drinks with electolytes. Stay away from soda, caffeine and sugar laden energy or sport drinks. While Gatorade is a good hydration source its cousin, G2 contains half the carbs and calories but has the same electolytes for hydration making it a much better choice.

The amount of water we need depends on our weight and the eight glasses/day that you may have heard is not true for everyone. Larger people need more water. Sixty Four to 100 ounces a day is a good rule of thumb for most average weights with increasing amounts during times of exessive perspration, workouts, sickness or burns. If you allow yourself to get dehydrated know that it can take a day or so of consistent hydrating to get back to a proper level of hydration. Alcohol will also dehydrate you. If you are drinking alcohol make sure you drink additonal water. Not only will it keep you hydrated you will drink less alcohol and consume fewer empty calories.

Lastly, let’s not forget our pets. They get dehydrated just as easily so keep their bowls full of fresh water especially if they spend time outside. Fortunately they aren’t nearly as resistant as some of us are and will drink when they are thirsty. As long as the water is available they will generally self regulate well.

If I haven’t convinced you yet that drinking water is critical to virtually every aspect of maintaining a healthy body consider that drinking the proper amount of water water will keep your skin moist, plumped and younger looking. So, please be mindful, good to yourself, drink enough water and stay healthy.

Low Vitamin D Levels?

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Low Vitamin D Levels

During your most recent physical you may have been told that your vitamins D levels were too low. If you happened to mention it to you friend there is a good chance they may have had a similar experience. So why all of a sudden do we have a nation of Vitamin D deficient people? In truth what has actually happened is that physicians have begun to test for it as a normal screening process and finding that indeed many people do have lower than acceptable levels.

These lower levels are a result of gallons of sunscreen, limited exposure to the sun, dark skin and/or limiting your consumption of the foods that contain Vitamin D. We have consistently been warned about the negative effects of the sun and have dutifully slathered our children and ourselves with sunscreen to prevent skin cancer. Despite its effectiveness it has also had some negative drawbacks. Vitamin D is one of the fat-soluble vitamins, which means that it is stored in our fat cells and released when it is needed. The sun is unfortunately one of our best sources for this vitamin, which is integral to many bodily processes.

Normal Levels of Vitamin D contribute to:

  • Decreased risk of fracture due to osteopenia or osteoporosis
  • Decreased dental cavities
  • Reduced incidence of heart disease and diabetes
  • Decreased levels of C-reactive protein, which is a marker for inflammation in our body. High levels of C-reactive protein increase the chance that we will develop a disease.
  • Prevention and treatment of depression
  • Reduced risk of allergies especially in adolescents and children
  • Regulating cholesterol levels in the blood

Foods such as salmon, sardines, mackerel, tuna, shitake mushrooms, egg yolk, milk, cheese and yogurt contain vitamin D but studies show that in general you’d have to eat an uncomfortable amount to fulfill all of your daily Vitamin D requirements. Since Vitamin D is a fat-soluble vitamin in order to achieve maximal absorption I recommend that you take it with whatever meal contains the largest amount of fat.

The amount of Vitamin D you need daily is dependent on how deficient you are. In general a minimum of a 1000 IU/day for children and 1,500 to 2000 IU/day for adults if your blood levels are normal. If you are deficient you doctor may put you on a prescription of 50,000 for eight weeks prior to putting you on a maintenance dose. Having a blood test and talking with your physician is the best way to determine your specific needs. On your next physical make sure to have you Vitamin D levels assessed so that can ensure you are taking the proper amount.