Body

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

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

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!