The more your body weighs, the more wear and tear on your joints. Exercise can help you lose weight, but it can also help in other ways.
Stretching and strengthening exercises -- if done carefully -- can improve joint mobility and lower pain intensity.
Here's how to get started.
As billions of dollars are budgeted to reform health care, legislators in Washington are frantically looking for ways in which the money can truly change the broken health care system without too much of an upset to its key constituents: payers, providers, employers and patients. As in most industries, modernization by the (government-sponsored) introduction of technology sounds like the safe choice. Surprisingly, forcing physicians to implement electronic medical records and to share these records via statewide exchanges is facing a daunting practice to practice "docfight." With the unpleasant possibility of an unrealized promise for change, some suggest we turn the light on the other sleeping elephant in the room -- telemedicine. Brush the dust off this misunderstood (and often misused) technology and health care reform may just live up to its promise, in our lifetimes.
Simply defined, telemedicine refers to the delivery of medical care using telecommunications including: phone, email, Internet and other channels. Over the years, the application of telemedicine was interpreted narrowly to mean the use of technology to overcome physical distance. Specifically, it became synonymous with the use of video conferencing to bring the expertise of specialized physicians (who typically reside in urban America and work in large medical centers) into rural areas where such specialties were scarce or absent. While the supporting technologies have evolved, from ISDN lines to dedicated fiber optics, the principal promise (prejudice) of telemedicine remained frozen in time.
Then came the Internet, introducing the liberating notion that any two places, any two devices, indeed any two people, can connect, reliably and instantly. Armed with the Internet, telemedicine has quickly dropped the expensive dedicated conferencing lines, and swapped them with inexpensive cable modems. Telemedicine could now accomplish the same result for fewer dollars -- an excellent incentive for growth. But, (author is now pointing to an elephant in the room H.P.) looking at the Internet as a cheaper way to do the same thing is perhaps as naïve as thinking of email as a mere replacement to paper mail and a good way to save on stamps. Yes, the Internet can save some cash in connecting two points (e.g. our two physicians), but its promise lies in that it can connect any two points.
So what can we expect if we wake our dormant telemedicine by allowing it to take advantage of the true networked capability of the Internet? By reaching patient's homes, access to medical care will start equalizing across geographies. The variations in its quality will diminish. Primary care physicians could summon specialists to help care for the patients sitting in front of them in their exam room. Physician offices can expand services by tapping allied providers they could otherwise not afford to keep on staff (e.g. nutritional services, sleeping disorders, etc.). The stigma of entering the office of a mental health provider will not keep patients away, as they can engage the therapist routinely, from the intimacy of their homes. Patients can be discharged home earlier after surgery and still be followed during their surgeon morning rounds from the hospital. Live health care can be available in pharmacies, workplaces, airports and handhelds. It can bring additional physicians into crowded emergency rooms to help with triage; it can allow the military to project broader health care to where the troops go. It can allow us physicians to care for patients in Haiti during our lunch break in the office. Fundamentally, we can expect the paradigm to change. Health care goes to where the patient is.
This vision is far from pie in the sky. In fact, it's starting to become a reality in communities across the country. For example, the U.S. Department of Veterans Affairs (the VA) has been enlisting a growing number of telemedicine technologies to help Americans discharged from the armed forces to manage diabetes, high blood pressure and other physical and mental health issues from their homes. Health companies, too, are making networks of providers available to their consumers online, extending care into homes and workplaces. These span from Hawaii (HMSA) to Minnesota (Blue Cross and Blue Shield of Minnesota and OptumHealth), Pennsylvania (Rite Aid) and New York (HealthNow New York), among others.
As with any change, there are real risks involved. Even with its increasingly high-definition audiovisual capabilities, telemedicine does not allow for a hands-on exam. It thus requires physicians to exercise different clinical judgment on the care they render. Patients may abuse telemedicine to scout for physicians who more readily issue prescriptions (for regular or even controlled medications). Indeed, patients may abuse telemedicine as a whole by simply overusing it. After all, it is available at home right after dinner when there are no good shows on cable. Medical boards are rightfully concerned that state lines (which define physician licensure), or even national borders will perforate as patients look far and wide for their doctors. Lastly, since the Internet is open for all, it can become a goldmine for imposters, swindlers and downright poor-quality providers, to disseminate their wares.
But the challenges, real as they are, have been seen and conquered before. Amazon was blasted for taking the joy out of in-store book buying. Expedia eliminated the friendly agent from the travel agency down the street. Online banking and retail were feared to be leaky and insecure. Online grocery shopping did not allow the buyer to physically examine the produce and e-books turned the page on turning pages altogether. And yet they all prevailed somehow, and reached a point where they became an accepted part of our lives. This was done not by the persistence of the entrepreneurs, but by their adaptation. Not every product is sold on Amazon. Not every gourmet dinner is available to order in. Complex travel plans still end up with an agent and few people buy real estate entirely over the Internet.
Telemedicine is no different. It is right for a defined scope of medical care, but is not a replacement for the relationship between a patient and her doctor. Telemedicine needs to be portrayed clearly as such to remove ambiguity and unrealistic expectations. It needs the capability to validate that the people who use it are who they claim to be and that the providers in it are licensed, audited and held accountable to the quality of care they deliver by their state medical boards, as they are in their practices today. Prescriptions could be limited to known safe lists and, as with any other modern computer-based system, measures should be in place to constantly look for abusers, intruders and other forms of mayhem. All of the above is doable. We have done it before.
Telecommunication has changed almost every dimension of our lives within one generation. Telemedicine is its application in health care. It's big, it's powerful and it's mostly asleep. With the current state of health care, isn't it time we wake this elephant up?
Steve Jobs has been granted a medical leave of absence by Apple's board of directors.
According to the Wall Street Journal, COO Tim Cook will run day to day operations for the company.
Jobs wrote the following note to Apple employees:
Team,At my request, the board of directors has granted me a medical leave of absence so I can focus on my health. I will continue as CEO and be involved in major strategic decisions for the company.
I have asked Tim Cook to be responsible for all of Apple's day to day operations. I have great confidence that Tim and the rest of the executive management team will do a terrific job executing the exciting plans we have in place for 2011.
I love Apple so much and hope to be back as soon as I can. In the meantime, my family and I would deeply appreciate respect for our privacy.
Steve
Steve Jobs Taking Medical Leave Of Absence
Read More: Apple, Apple's Steve Jobs Granted Medical Leave Of Absence, Steve Jobs, Steve Jobs Cancer, Steve Jobs Health, Steve Jobs Leave, Steve Jobs Leave Of Absence, Steve Jobs Medical, Steve Jobs Medical Leave, Steve Jobs Medical Leave Of Absence, Health NewsSteve Jobs has been granted a medical leave of absence by Apple's board of directors.
According to the Wall Street Journal, COO Tim Cook will run day to day operations for the company.
Jobs wrote the following note to Apple employees:
Team,At my request, the board of directors has granted me a medical leave of absence so I can focus on my health. I will continue as CEO and be involved in major strategic decisions for the company.
I have asked Tim Cook to be responsible for all of Apple's day to day operations. I have great confidence that Tim and the rest of the executive management team will do a terrific job executing the exciting plans we have in place for 2011.
I love Apple so much and hope to be back as soon as I can. In the meantime, my family and I would deeply appreciate respect for our privacy.
Steve
Story continues belowAdvertisementJobs has struggled with health issues in recent years and the news that he will be taking a leave of absence comes a year and a half after the chief executive received a liver transplant.
In 2004, Jobs announced he had been diagnosed with pancreatic cancer and, that same year, underwent surgery to remove the cancer. He took a medical leave of absence between January and June 2009, with Cook taking over responsibilities for day to day operations. He received a liver transplant in 2009.
When asked about his health at an Apple press conference in July, Jobs replied he was "doing fine" and "feeling great." Yet others have expressed concerns about the CEO's health. The New York Times writes, "In recent months, Mr. Jobs has looked increasingly frail, according to people know have seen him." The lack of a precise end date on Jobs' leave of absence is troubling to some, suggesting the CEO's health issues could be complex and more long term.
Cook, not Jobs, took the stage at a recent press conference in New York at which Verizon announced that it would begin carrying Apple's iPhone. Jobs is expected to appear with News Corp CEO Rupert Murdoch to unveil the media mogul's new iPad newspaper, The Daily.
Read more about Tim Cook here.
"I'm incredibly stressed out, and this Arizona thing has really put me over the top," complained my patient, just this week, a woman in her mid fifties. "I just can't seem to let it go. It's like I'm always on edge," she lamented. Looking at her intake paperwork, I noted that her stated reason for the appointment with me was "trouble with memory." Right at that moment, I wondered if she had any idea how deeply connected were her verbal and written complaints.
Bad things happen. And the human brain is especially adept at making sure that we keep track of these events. This is an adaptive mechanism important for survival. When we are exposed to a real or perceived threatening situation, powerful things happen in the brain to memorialize aspects of the event, including all manner of associated circumstances like where, when and how it occurred. This package is stored in the brain under the direction of a structure located deep in the temporal lobe called the hippocampus. While the hippocampus itself doesn't store memories, it serves to triage our experiences based upon their survival significance.
Dangerous events are stress producers, and as such, they are associated with activation of the "fight or flight" response in which the adrenal glands increase their production of the hormone cortisol. And it is cortisol that alerts the brain as to the importance of an experience, priming the hippocampus to store the event in a "high priority file." This is the mechanism by which the traumas of our lives or the traumatic events in the lives of others are more securely stored in our brains and explains why events like the recent violence in Arizona don't readily fade from memory. These memories, while stressful, permit us to consciously modify our behavior to avoid dangerous circumstances.
Cortisol can have other more sinister effects upon the hippocampus however. When this stress hormone is persistently elevated it actually proves toxic to the very brain cells it would normally nurture -- the neurons of the hippocampus. This is why persistent stress is associated with damage and shrinkage of the hippocampus and a resultant decline in memory function.
We shouldn't forget about events like the tragic shootings in Arizona, but we should endeavor to remember the event with association to more positive feelings. Holding the victims and their families in our thoughts and prayers is an important part of healing as it begins to associate the event with our senses of compassion and empathy. But constantly revisiting the tragedy itself creates persistent stress leading to persistent cortisol activation, ultimately damaging the hippocampus, one of our most fundamentally important brain structures.
Professor Santiago Ramon Y. Cajal, Spanish neuroscientist and winner of the 1906 Nobel Prize in medicine stated, "Every man can, if he so desires, become the sculptor of his own brain." What we choose to focus on changes our brains in a very real physical and functional sense, and this has profound implications for how our lives will play out. As Gandhi counseled, "Keep your thoughts positive because your thoughts become your words. Keep your words positive because your words become your behaviors. Keep your behaviors positive because your behaviors become your habits. Keep your habits positive because your habits become your values. Keep your values positive because your values become your destiny."
Mental fitness is served by consciously redirecting our attention away from the constant bombardment from the media whose reason to be seems to be focused on keeping us in a state of constant alert. Living our lives locked in the situation room creates brain pathways that nurture a persistent sense of fear and foreboding, ultimately fostering the likelihood that our actions will reflect this perception, culminating in choices reduced to "flight or fight."
President Obama called upon the nation to observe a moment of silence following the Arizona tragedy. Hundreds of people gathered in prayer outside the hospital where Representative Giffords was fighting for her life. We are drawn to the calmness offered by prayer and mediation in times of anguish, and during those brief moments in which we embrace the stillness, we are redirected away from the imposition of fear and mistrust, and instead behold the goodness. In the end, this is powerfully therapeutic for us as individuals, and as a species.
The gym can be a rather sanctimonious place. It's often filled largely with people who eschew eating anything bad for their bodies, put health first, and embody everything that's wholesome and good in life. Well, except for one little matter: Many of them drink like fish! Yes, some of the same people who make some of us feel guilty with their seemingly pure lives have a guilty secret of their own that seems about as contradictory as a pro-choice Catholic.
Two recent studies highlighted in The New York Times found a correlation between people who drink alcohol a lot and people who exercise a lot. In the first study, rats who had an "inbred taste for alcohol" were given an unlimited supply of alcohol. Those who had exercised on running wheels drank significantly more than the rats who didn't exercise, surprising even researchers.
The second study was based on actual people -- hundreds of thousands who were interviewed via telephone. It found drinking alcohol "is associated with a 10.1 percentage point increase in the probability of exercising vigorously." It also stated that "heavy drinkers exercise about 10 more minutes per week than current moderate drinkers and about 20 more minutes per week than current abstainers."
So why would people who make one healthy choice for their bodies make such an unhealthy one when it comes to booze? Some think it could have do with being a thrill seeker with a work-hard-play-hard mentality, or that some forms of group exercise spark social events, or perhaps people exercise more so they can drink and burn off the calories.
But for whatever reason, it seems to be true given conversations heard around the gym and from my friends who drink as hard as they run (and my friend list is heavy with marathoners and endurance athletes). In fact, in several of the cities I've lived in, my gym has had its own bar.
The good news is that exercising may protect people from some of the negative effects of drinking too much. A third study showed that when binge drinking, exercise seemed to protect some brain cells from being lost. So there's something to raise a glass to, and if you need someone with whom to clink your glass, then hit your gym -- it may be the best place to find a drinking buddy.
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
First Posted: 01/17/11 08:52 AM Updated: 01/17/11 11:18 AM