About Me

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My practice motto has been "we help you live a longer, healthier life..." I’ve been in private practice 35 years, and in the last 25 years have placed great, and ever increasing, emphasis on prevention. I practice preventive care by first identifying health risk factors (the factors which predispose you to disease) and then developing the best strategy to minimize or eliminate these risks. Special diagnosis and treatment tracks in my office include asthma, COPD, high cholesterol and obesity, and diabetes.I now place special emphasis on the provision of truly affordable health care to all, including patients with HSA's, high co-pays, and high deductibles.

Monday, December 27, 2010

New Year's Resolutions... Will You Keep Them?

As 2011 approaches, many of us will be making New Year’s resolutions. Some of the most popular resolutions will follow the usual tradition: to make a commitment to fitness, stop smoking, and lose weight. But times are changing, and so do the resolutions. Now, with economic stress and job pressure, many people may choose to "shoot" for a less stressful life.

In reality, 50% of those who start an exercise program drop out within less than 6 months and their treadmills become dust collectors; too many lost pounds are rapidly regained, and cigarettes continue to be a big seller. And soon after you enjoy a few days of rest, daily stresses resurface. So how do you succeed?

Don’t try to make too many changes. Identify the issues most important to you, and concentrate on the top two. For most people, this translates into increasing exercise, and managing stress.

Exercise: For beginners, it's extremely important to make realistic goals. Trying for a six minute mile on the first day is not realistic, and potentially dangerous. Cardiovascular exercise is the most important, with stretching and moderate muscle strengthening next.
Start exercising slowly. Gradually increase the intensity and duration in small increments until a relatively high level of exercise can be tolerated. Even if you are a regular exerciser and took a “holiday break,” restart at a lower level, and progressively return to your usual level. If you’re sedentary or over 35 years old, or are not known to be in excellent health, see your health care provider before strenuous exercise.

Stress: What is stressful to one person may not be stressful to another. Stress is best defined as a situation which requires a behavioral adjustment (Dr. Herbert Benson, Mind/Body Medical Institute). Stress increases the body's adrenalin production, and with it physiologic changes occur, including a rise in heart rate and blood pressure. This was the flight-or-fight response of the cave man, frequently unsuitable for dealing with “modern” stress. Some stress is important as a motivator for daily function and long-term achievement, but excess stress takes away from life’s enjoyment and productivity, and can make hypertension and other medical conditions permanent.
The Relaxation Response is an effective antidote to stress, which can be learned and practiced by almost anyone. It can be elicited by many techniques, including meditation, diaphragmatic breathing, imagery, yoga, and progressive muscle relaxation. All techniques involve a brief, intense focusing of attention, and the passive disregard of everyday thoughts. Many books have been written on the subject, and a copy of a progressive muscle relaxation routine can be obtained from our office (just give us a call or request it on your next visit).

There is a wonderful synergism between exercise and stress management. With regular exercise, the body produces its “relaxation hormones,” endorphins; and with relaxation management, the likelihood to succeed in exercise increases remarkably.

People who exercise regularly and practice stress management say that, to them, these habits have become an addiction. What a great “addiction” to have…

Sunday, December 5, 2010

I Can't Exercise - Just Do It!

 
I am not here to convince you to exercise; you already know the reasons why you should. Yet, more than 60% of Americans under-exercise, and of these, more than 25% are simply sedentary. The remainder of this writing is taken from my previously published  EzineArticles and other articles.

Common reasons given for failure to exercise include: I don't have the time...I'm too tired...I don't know what type of exercise to do...I have a medical condition (usually a "bad heart," back pain or knee pain)...I'm too heavy... I become short of breath...I can't afford the gym...It's boring...I'm too old.

And there are more innovative excuses: my uncle lived to 106 and he never exercised (we should all be blessed with such good genes)...It's too cold outdoors in the winter...I'm always away... I do enough at work...

You get the idea.

Almost any form of physical activity is helpful, but a good exercise program should include at least 30 minutes of moderate, aerobic physical exercise most days of the week. Examples of aerobic exercise are brisk walking, jogging, bicycling, swimming and aerobic dance. An effective exercise program should include:
  • Warm-up, 3 to 5 minutes. A warm-up gradually increases your heart rate and the blood flow to the heart and muscles preparing them for exercise. To warm-up, do the activity you have chosen to do (for example walking or biking), but at a slower pace during the warm-up period.
  • Aerobic activity, at least 30 minutes (build up gradually from 15 minutes over several weeks). With aerobic exercise you use more oxygen to burn calories for the extra energy you spend. Exercise within your target heart rate zone (target charts are available in gyms, on the net, and at your doctor's office).
  • Cool-down 3 to 5 minutes. Cooling down allows your heart rate, breathing and blood pressure to return to normal, and allows you to stretch better.
  • Stretching, 5 to 10 minutes. Stretching will improve your flexibility, decrease muscle soreness and help you relax. It's important to stretch those muscles you were using during exercise. Hold each stretch for 15-20 seconds, but don't stretch to the point of pain.
  • Strength training, which is a very important component of a good exercise program.
Before you start an exercise program, check with your doctor if you are over 40 or have a history of medical problems. If you truly have special needs, a reasonable exercise program can usually still be designed for you.

Start before it's time for New Year's resolutions

Are you interested in checking your degree of conditioning and your general exercise capacity? We have a unique testing facility where we measure your maximum oxygen capacity (known as vO2max) and tell you how fit you are. The test is done as part of a cardiopulmonary exercise evaluation, under medical supervision. We are the only free standing medical facility in our area performing this type of evaluation.