Local Lululemon Community Sweat Challenge

It's Lululemon's 20th birthday.  The local Lululemon decided to put together a "sweat challenge."  They gave out "passports" to individual participants along with cards from 20 local gyms/clubs for a free class.  The business "stamps" the passport when the participant takes a class.  The challenge started at the end of August and last until September 23rd.  My regular exercise routine consists of Pilates at IM=X (once or twice a week, paid), yoga classes on Sunday mornings at said local Lululemon (free) and sometime Sunday afternoon at Fleet Feet (in store yoga for runners, $5 donation), treadmill (45 mins walk or walk/run mix), and walking my small dog (more of a stroll).  Initially I was reluctant to participate but decided to shake up my routine and try some new classes.  It has been fun.  I have enjoyed all of them, some more than others (they fit me better). 

Here's a summary of the classes I attended (date, business name (instructor name if remembered/known), class type (time) along with my other non-challenge workout activities.  I only numbered the activities that earned a passport stamp.

1. Friday, 8/24/18.  The Floating Lotus -- Happy Hour Yoga (5: 30 pm class).  Enjoyed. 
2. Saturday, 8/25/18.  IM=X (Emily)-- Pilates Reformer (8 am) -- this is part of my normal routine.
3. Saturday, 8/25/18.   Little Rock Athletic Club (Heather)-- Hot Yoga (4 pm).  Enjoyed.
Sunday, 8/26/18.  Walk with Lizzie (my dog) at Two Rivers Park  (~7-8 am) -- this is Lizzie's big walk of the week, the rest are short walks once or twice daily.
4. Sunday, 8/26/18.  Orange Theory (Quen) -- OT60 (9 am).  Enjoyed.
5. Sunday, 8/26/18.  Lululemon (Catherine from Big Rock Yoga) -- yoga (11 am). Enjoyed.

Monday, 8/27/18 --  treadmill at home
 6. Tuesday, 8/28/18.  Omnis Crossfit -- crossfit (4:30 pm).  Enjoyed, made me feel out of shape.
7.  Wednesday, 8/29/18.  Clique Cycle (Annie) -- yoga rather than spin class (6:30 pm)
8.  Thursday, 8/30/18.  Clubhaus Fitness (David) -- hot pilates (5 pm). Great class, great instructor.
9.  Friday, 8/31/18.  Zen Studio (Kelly) -- Barre Bounce (noon, took off work early for Labor Day weekend)
10. Friday, 8/31/18.  Arkansas Yoga Collective (Wesley) -- all levels Yoga (5 pm).  Enjoyed.
11.  Saturday, 9/01/18.  Barefoot Yoga (David) -- Hot Yoga (10 am).  Love this class.
Sunday, 9/02/18.  Walk with Lizzie (my dog) at Two Rivers Park  (~7-8 am).
12.  Sunday, 9/02/18.  Big Rock Yoga (Sandra) -- all levels Yoga (10:30 am).  Enjoyed.

Monday, 9/03/18.  Cammack Village 5K (hills, heat, humidity) -- finished in 36:37.02, won 3rd place in female Senior division
Tuesday, 9/04/18.  IM/X (Emily) -- pilates/Abs (4:30 pm)
13. Wednesday, 9/05/18.  Straightright Boxing (Anthony) -- adult fitness class (6:30 pm).  Love!
14. Thursday, 9/06/18.  D1 Fitness -- Adult Training (5:30 pm) -- Great workout even if it reminded me of line drills from my old basketball days in Jr/Sr high
15. Friday, 9/07/18.  Blue Yoga Nyla -- Happy Hour Yoga (5 pm).  Enjoyed.
16. Saturday, 9/08/18.  Full Out Barre   -- Barre w/ cardio (9 am).  Great workout, tough.
Sunday, 9/09/18.  Walk with Lizzie at Two Rivers Park  (~7-8 am)
Sunday, 9/09/18.  Lululemon (Kelly from Zen) -- all levels yoga (11 am)
Sunday, 9/09/18.  Fleet Feet  -- in store yoga for runners (4:30 pm, $5 class) -- great stretching

Monday, 9/10/18.  Treadmill at home
17. Tuesday, 9/11/18.  Pure Barre  -- Pure Empower (5 pm) -- Great workout, tough.

I learned that I need to put more cardio into my routine.  Either I need to run more on my treadmill or add in something like Orange Theory, Straightright, crossfit, or cardio barre.  I would be willing to do that especially if I could get my husband to do those with me (he won't go to pilates or yoga with me, I've tried; doubt he'd do barre with me either).  I think he might like those workouts.  Will work on him. 

I found it harder to eat health with so many out of my house workouts during the week.  I have not mastered the cooking healthy meals ahead of time on the weekend for the upcoming week.  My husband was working out of town during this time period.  He isn't much of a cook but might have helped with meals if he had been home however I'm not sure he would have liked me not sitting down for meals with him. 

I had to give up some of my quilting/sewing time to do the challenge.  Not an issue in the short run but I know my "soul" needs the sewing time like I need sunshine.  I will somehow have to find some balance between exercise, sewing/quilting, and home cooked meals (rather than salads, soup, sandwiches).  Life is journey and this challenge has been a nice adventure.

My thanks to Lululemon for putting this together and to all the businesses that participated.  There were some I was not able to try -- R.E.P.S., Unleased (Roland), McClure Fitness (Benton), and Crossfit Maumelle.  Either hours didn't fit my schedule or distance (drive time to/from was greater than workout time).   You know what would be lovely -- a city/county pass that would allow you to buy 10-20 passes to be used in say a 2-3 month period but could be used at several places rather than just one. 

Meet my rescue dog Lizzie.  This is where she insist on sitting when I sew.

This one was taken out at Two Rivers Park.  She allowed me to place her on the tree branch and then stayed put while I took the photo.

Bag for My Yoga Mat

Our local Lululemon hosts free yoga classes on Sunday morning.  I have been going to them since the beginning of this year (learning about them around Christmas).  I had been using a cheap (thin) mat I bought at Wal-Mart.  A couple of the girls who work there gave me one of theirs (new, 5 mm thick).  It is wonderful.  As it is heavier and nicer than my old one I felt I needed a bag to protect and carry it (although a carrying strap might have worked and I may yet make one).  I found a pattern at Annie's Bags (here's the link: http://www.byannie.com/yoga-bag).  Here's how it turned out.

 This side has three pockets, two with zippers.  The other side only has the middle pocket without a zipper.

 Both ends have non-zippered pockets.

As support for the store I have since purchased the same mat (different color) for one of my sisters.

Sitting All Day is Damaging

I take this type of information even more seriously than I used to given my new job which is very sedentary.  Thanks DoctorMama for the link to this LifeHacker article:  How Sitting All Day Is Damaging Your Body and How You Can Counteract It

Related posts:

Pedometers and Physical Activity  (November 30, 2007)

Getting Back Into Shape  (November 13, 2008)

Exercise Only Good if Done (March 18, 2009)

Finger and Wrist Exercises (April 19, 2010)

Get Up and Move (January 28, 2010)

Motivation

Updated 3/2017-- photos and all links removed (except to my own posts) removed as many no longer active. 

I have meet several amazing people at my new job.  Here is one of them:  Richard Vaughn.  The poster isn’t accurate any longer, the 12 should read 20.

Richard is the IT guy at my work place.  He broke his back at age 17.  This hasn’t kept him from having a full life. 

……Shortly after graduation as a 17 year old, a severe accident - a fall of roughly 85 feet from a scaffolding - left me paralyzed and in a wheelchair. This was in the early 1970s. It was suggested that I enter one of several “special schools” for the handicapped. There, I was told, I might learn a vocation and become a “contributing member of society.”

I did go to a “special school” – college! Within 5 years, I was a Systems Programmer in the largest data center in the State of Arkansas. Though probably hired because of my handicapped status, I worked my way from Computer Operator to Programmer, then Systems Programmer and, finally, established a firm career as a Network Administrator. I am now in my 35th year as a computer professional……

He stumbled upon the idea for the motivational poster a few years ago at the gym (lifting weights) when another gym user stated “What’s my excuse?”  He now uses the sale of the poster to raise money for the Leukemia/Lymphoma Society.   Help spread the word on his poster and inspiration.

If he can be so active, then indeed “what’s your excuse?”  Remember too much sitting is bad for you, so get up and move.

Shout Outs

Updated 3/2017-- photos and all links (except to my own posts) removed as many no longer active. 

Doctor Fizzy is the host for this week’s Grand Rounds. You can read this week’s edition here (photo credit).

I attended my very first grand rounds as a third year med student. The talk was given by my former pathology professor to a large auditorium packed with students, residents, fellows, and attendings. I don't remember the topic of the lecture, but I do remember this:
Midway through the lecture, the professor called on me. In an hour-long lecture, he called on one person out of 200 in the audience, and somehow that person was me. I almost choked on my cinnamon-raisin bagel.   ……..

All in all, not my favorite grand rounds.

But this week's grand rounds are going to be awesome. I'm dedicating it to all the medical trainees that got humilated during lectures, pimped during rounds, or tried to answer three beeping pagers at once.  ……….

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H/T to @medrants who twitted  “Practicing Medicine Can Be Grimm Work - http://nyti.ms/kveFkD -  a beautiful op-ed from one of our med students”  

The NY Times Op-Ed piece is by Valerie Gribben:  Practicing Medicine Can Be Grimm Work

TODAY, after four arduous years of examinations, graduating medical doctors will report to their residency programs. Armed with stethoscopes and scalpels, they’re preparing to lead the charge against disease in its ravaging, chimerical forms. They carry with them the classic tomes: Harrison’s Principles of Internal Medicine and Gray’s Anatomy. But I have an unlikely addition for their mental rucksacks: “Grimm’s Fairy Tales.”………….

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Robin Young, Here and Now/NPR, interviewed Francesco Pia last Wednesday: What You Don’t Know About Drowning

……Lifeguarding consultant Francesco Pia has some advice for the summer about drowning. He worked as a lifeguard in New York’s Orchard Beach, and he made a documentary called “The Reasons People Drown,” that challenged a lot of misconceptions about drowning. He found that:

1.) Drowning is often silent: …..

2.) Drowning happens very quickly: ….

3.) Drowning often happens when people are around others: ….

Remember Drowning Doesn’t Look Like Drowning

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Check out this great advice from the Better Health post:  The Right And Wrong Ways To Strengthen Your Core Muscles

What do slouching, back pain, and a middling forehand or weak shot off the tee have in common? Often it’s a weak core—the girdle of muscles, bones, and joints that links your upper and lower body. Your core gives you stability and helps power the moves you make every day……..

Core Exercises: 6 workouts to tighten your abs, strengthen your back, and improve balance is available from Harvard Health Publications. You can read an excerpt here from the report with tips on checking and improving your posture. ……..

Core Exerise #1: Plank

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I’ve always been concerned about the number of drugs some patients have to take. The risk of side effects and bad interactions increases with each addition. H/T to Dr. Elaine Schattner (@medicallessons) to the link to this Scientic America article by Laura Newman: Overprescribing the Healthy Elderly: Why Funding Research and Drug Safety is Paramount

My frail, 92-year-old mother was prescribed 80 mgs of the cholesterol-lowering drug, or statin, simvastatin for years. She fell four times in the last four years of her life: the last fall was the least forgiving. Doctors diagnosed her with rhabdomyolysis, a life-threatening condition, and acute kidney failure; she was dead within 8 weeks. …..

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Dr. Sanjay Gupta speaks with Paul Stanley (KISS) about microtia and how he has dealt with it himself.

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Sarah McFarland, Threads Magazine, has a piece announcing: “Show Your Support" and Embellish a Bra (photo credit)

The 2011 American Sewing Expo is coming right up - September 23-25 at the Suburban Collection Showplace in Novi, Michigan…..

A staple exhibit at ASE is the annual entries in the "Show Your Support Bra Challenge." Sponsored by Coats & Clark and BurdaStyle, the contest showcases some amazing lingerie decorated by the skills of sewers across the country…..

You can find the Show Your Support Bra Challenge full rules and the entry form online at the ASE site. Good luck, and good for you if you enter!

MyPlate – Size Matters

Updated 3/2017-- photos and all links (except to my own posts) removed as many no longer active. 

The new food “pyramid” was unveiled this past Thursday.  It is now in a much simpler form – a plate.  What I didn’t find defined at the ChooseMyPlate website is the plate size. 
So I googled “standard dinner plate size.”  Here is the answer:

It can be helpful to know the manufacturers intended use for an item, but it is important to remember that you can use the item in whatever way that works for you!

Dinner plate 10 to 10 3/4"
Luncheon plate 9 to 9 1/2"
Salad plate 8 to 8 3/4"
Bread and butter plate 5 to 7 3/4" (usually about 6")

When found, dessert plates are generally somewhere between salad plates and bread and butter plates in size. Dessert plates are not common, so the salad plate doubles as a dessert plate in most patterns.

Another size that you might see in a pattern is one that is larger than a dinner plate. These are frequently call buffet plates, service plates or chargers and are usually 11" to 12" in diameter.

Chris Maddera makes this point in his essay:  The Psychology of Dinner Plates  (bold emphasis is mine)

….the size of our dinner plates was a major contributing factor of Americans becoming overweight.

Here’s the way it works: the diameter of a typical American dinner plate is 11 inches; the diameter of a typical European dinner plate is 9 inches. r² shows that the 2-inch difference amounts to the 11-inch plate having 50% more surface area than the 9-inch plate. If, like most people, you fill your plate, you’re putting 50% more food on it than a person with the 9-inch plate.

This means we’re eating 50% more food, since we usually eat whatever is on our plates. Or, to look at it differently, we feel full when our plate is empty.

By the way, some restaurants use 13-inch plates, which means it’s twice as big as the 9-inch plate.

Size of the plate matters as does the choice of food we put on it.  Don’t use the larger plates for your children or if you are a petite female.  Consider not covering up the entire surface area.

And don’t forget to get up and move – walk, swim, dance, bowl, etc. 

Walking a Dog

 Updated 3/2017-- photos and all links (except those to my own posts) removed as many are no longer active and it was easier than checking each one.

Earlier this week there was an article in the NY Times by Tara Parker-Pope  --Forget the Treadmill. Get a Dog.  -- which states in a more elegant way what I have been saying for years now. 

……Several studies now show that dogs can be powerful motivators to get people moving. …..

Just last week, researchers from Michigan State University reported that among dog owners who took their pets for regular walks, 60 percent met federal criteria for regular moderate or vigorous exercise. …….

A study of 41,500 California residents also looked at walking among dog and cat owners as well as those who didn’t have pets. Dog owners were about 60 percent more likely to walk for leisure than people who owned a cat or no pet at all. ……..

I have called my dog Rusty my personal trainer.  He never lets me off the hook.  We walk daily regardless of the weather (hot, cold, rain, snow).

I also use a pedometer to remind me to get up and move more.  It it a nice device to motivate me to not sit (& blog, read, knit, quilt) too much.

Here’s a replay of my tribute to Rusty, My Personal Trainer (January 2010)

“Five more minutes,” I tell him as he nimbly places his paws on my knees, brown eyes imploring.
“Okay, you win.” 
Orange ball cap on my head, gloved hands grab the leash.
We exit the gate, the January sun cold as we jog toward the neighbors woods. 
Will there be ducks on the pond today?

Weight Lifting, Breast Cancer, and Lymphedema

Updated 3/2017-- photos and all links (except to my own posts) removed as many are no longer active and it was easier than checking each one.

Last August, Kathryn Schmitz, PhD, MPH and colleagues published the results of their study Weight Lifting in Women with Breast-Cancer–Related Lymphedema in the New England Journal of Medicine.  They have now published a similar study in the Archives of Internal Medicine (see full reference below).

While the NEJM article focused on breast cancer survivors with lymphedema, the Archives article focuses on breast cancer survivors without lymphedema.

The new study adds weight for the need to change historic dogma which cautions breast cancer patients to avoid weight training after a mastectomy and or axillary dissection.

As noted by Schmitz, etc (bold emphasis is mine):

Breast cancer survivors at risk for lymphedema alter activity, limit activity, or both from fear and uncertainty about their personal risk level, and upon guidance advising them to avoid lifting children, heavy bags, or other objects with the at-risk arm.

Such guidance is often interpreted in a manner that deconditions the arm, increasing the potential for injury, overuse, and, ironically, lymphedema onset.

Adherence to these precautions may limit physical …. Furthermore, activity avoidance may deter survivors from performing regular exercise, which may prevent cancer recurrence and improve survival.

The randomized controlled equivalence trial (Physical Activity and Lymphedema trial) enrolled 154 breast cancer survivors (only 134 completed the study)  1 to 5 years post-unilateral breast cancer with at least 2 lymph nodes removed and without clinical signs of lymphedema.  Recruitment took place between October 1, 2005, and February 2007, with data collection ending in August 2008.

Participants in the weight lifting intervention group (n = 72)received a 1-year membership to a community fitness center near their homes. For the first 13 weeks, women were instructed twice weekly during 90 minute sessions on safe performance of exercises in groups of 2 to 6 survivors.

Upper body exercises (seated row, supine dumbbell press, lateral or front raises, bicep curls, and triceps pushdowns) were performed with dumbbells or variable resistance machines. Lower body exercises (leg press, back extension, leg extension, and leg curl) were performed with variable resistance machines. Three sets of each exercise were performed at each session, 10 repetitions per set.

After 13 weeks, participants continued twice weekly unsupervised exercise to 1 year. Weight was increased for each exercise by the smallest possible increment after 2 sessions of completing 3 sets of 10 repetitions with no change in arm symptoms.

Participants in the control group (n = 75) were asked to not change baseline level of exercise during study participation and were offered a 1-year fitness center membership with 13 weeks of supervised instruction following study completion.

Fewer women experienced incident BCRL onset in the weight lifting intervention group (11%, 8 of 72) compared to the control group (17%, 13 of 75).

The difference was even greater among women with 5 or more lymph nodes removed:  7% (3 of 45) in the weight lifting intervention group and 22% (11 of 49) in the control group.

Once again, this is a small group, but I lean more and more towards allowing motivated patients to begin weight-lifting with a slow, progressive program.   They should learn proper technique.  They should wear their custom-fit compression garment during all exercise sessions.

Weight-lifting has been shown to decrease bone loss which is important in these women as in all women.  Having more strength can also aid in everyday activities like carrying bags of groceries or carrying children/grandchildren.

 

 

REFERENCE

Weight Lifting for Women at Risk for Breast Cancer–Related Lymphedema: A Randomized Trial; Kathryn H. Schmitz, Rehana L. Ahmed, Andrea B. Troxel, Andrea Cheville, Lorita Lewis-Grant, Rebecca Smith, Cathy J. Bryan, Catherine T. Williams-Smith, Jesse Chittams; JAMA. Published online December 8, 2010. doi:10.1001/jama.2010.1837

Weight Lifting in Women with Breast-Cancer–Related Lymphedema; New England Journal Medicine, Vol 361 (7):664-673, August 13, 2009; Kathryn H. Schmitz, Ph.D., M.P.H., Rehana L. Ahmed, M.D., Ph.D., Andrea Troxel, Sc.D., Andrea Cheville, M.D., Rebecca Smith, M.D., Lorita Lewis-Grant, M.P.H., M.S.W., Cathy J. Bryan, M.Ed., Catherine T. Williams-Smith, B.S., and Quincy P. Greene

…….

Related Posts

Lymphedema (December 5, 2007)

ARM Technique (October 15, 2008)

Weight Lifting Good for Breast Cancer Patients  (August 19, 2009)

Some Resources for Fit in 10

Updated 3/2017-- photos and all links (except to my own posts) removed as many are no longer active and it was easier than checking each one.

The University of Arkansas Division of Agriculture Cooperative Extension Service has produced a series of workout DVD’s, handouts, and postures. LaVona S. Traywick, professor of gerontology, is largely responsible for the information. Even though these are aimed at those of us over 50, I feel they include good information for all ages.

It is important to continue your normal exercise program during the holiday season. It will not only help keep your from gaining weight during this time, it will help with the stress that often comes with the season.

….

Increasing Physical Activity as We Age: Exercise Recommendations (FSFCS30 pdf)

The hardest part of exercising for many is getting started, but when you think about fitness goals in 10-minute segments, it doesn’t seem as daunting.

Increasing Physical Activity as We Age: Fit in Ten (volunteer leader training guide, pdf)
Fact Sheets Handouts (many with diagrams of the exercises):
Increasing Physical Activity as We Age: Balance (FSFCS31 pdf)
Increasing Physical Activity as We Age: Endurance (FSFCS32 pdf)
Increasing Physical Activity as We Age: Strength Training (FSFCS33 pdf)
Increasing Physical Activity as We Age: Stretching (FSFCS34 pdf)

Increasing Physical Activity as We Age: Strength Training with Stretch Tubes (FSFCS36 pdf)

Poster Stretch it Out: Strength Training with Stretch Tubes (pdf)

Theses must be ordered, not available for free:

Hit the Floor: Strength Training on an Exercise Mat (poster, MP493, $3)

Get on the Ball: Strength Training with a Stability Ball (poster MP494, $3)

Fit in 10 DVD Video (DVDFCS10, $10)

Shout Outs

Updated 3/2017-- photos and all links (except to my own posts) removed as many are no longer active and it was easier than checking each one.

John Mandrola, M.D., Dr John M, is the host for this week’s Grand Rounds! You can read this week’s edition here.

Hey all.
Welcome to another edition of Grand Rounds, a collection of writings from medical bloggers, the world-wide.
Here are this week's posts, collated into four chapters, with just a little commentary and a few selected images. ……….

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A really nice piece at EP Monthly by Dr. Greg Henry:  The ED as Political Safe Zone 

………..Now if you believe that the ED is that bastion of neutrality, free of all political bias, I have a bridge in lower Manhattan that heads to Brooklyn that I’d like to sell you. The reality is that politics are everywhere. The question is, how do we rein them in so that we can give out reasonably competent care without letting our innate prejudices control us? ………….

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As Movin Meat said in his post: An Anticipated Relaunch

One of my favorite writers has returned to the blogosphere!  Intueri has relaunched as In White Ink -- The Unwritten Details!  The early posts are promising, as one would expect of a long-time medblogger, and the site design is lovely, as one would expect from the beautiful, minimalist design of the old site.

…….I've added it to my feed reader, and I'd recommend you do as well.

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Kim, Emergiblog, is the host of the latest edition of Change of Shift (Vol 5, No 12)! You can find the schedule and the COS archives at Emergiblog. (photo credit)

Welcome to Change of Shift!

…….Now, let’s get started!

Editors Pick of the Week and Dedicated to Raise Blood Pressure Post: A story of a frequent flyer who needs the flights, presented by NPs Save Lives at The Nurse Practitioner’s Place: He’s Gotta Ticket To Ride and The NP Says It’s Okay posted at The Nurse Practitioner’s Place.

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From twitter comes a link to a very nice article

@Mtnmd RT @apjonas Sedentary Physiology Part 1 – Not Just The Lack of Physical Activity http://bit.ly/hlZrxq VERY interesting

The article is written by Travis Saunders who is a PhD student researching the relationship between sedentary time and chronic disease risk in children and youth.  It begins:

Welcome to our 5-part series delving into the fascinating research being performed in the emerging field of sedentary physiology.  Today, we’ll start with an introduction.  For Part 2 in our series, click here.

……., I’d like to give a bit of background.

What is sedentary behaviour?
Sedentary behaviours are those characterized by very low energy expenditure – typically those requiring 1.5 METs or less.

Here are links to all 5 parts:
Sedentary Physiology Part 1 – Not Just The Lack of Physical Activity
Sedentary Physiology Part 2 – Can Sitting Too Much Kill You?
Sedentary Physiology Part 3 – The Importance of Interruptions in Sedentary Time
Sedentary Physiology Part 4 – How Does Sitting Increase Health Risk?
Sedentary Physiology Part 5 – Future Directions

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Medical advances can be amazing!  This NPR story by Richard Knox is exemplary of just such an advance in the field of congenital heart malformations:   Stitch In Time: Fixing A Heart Defect Before Birth

…….

About 17,000 U.S. babies are born every year with a serious heart defect. Nobody knows how many might benefit from the kind of fetal surgery Wells had. ……

The root cause of HLHS, much of the time, is a partially blocked valve that regulates blood flow from the heart's main pumping chamber, the left ventricle, to the aorta, which carries blood to the entire body. …

The goal of fetal heart surgery is "to open the aortic valve at a point when the left ventricle is not quite beyond irreparable damage," says Dr. Wayne Tworetzky, a cardiologist at Children's Hospital in Boston.  ….

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NPR story by Susan Stamberg: In Paris, A Display From Hockney's Pixelated Period.   All the drawings are done on either an iPhone or iPad.  Beautiful!  (photo source)

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Joan Benoit Samuelson and Me

I was once told that I looked like Joan Benoit. I’m not sure the person was serious, but I took it as a huge compliment. The thought that I could favor in any way (real or imagined) Joan Benoit was amazing to me. After all, this woman was a marathon runner!!! Not just any marathon runner, but the first woman to win the gold in the Olympics woman’s marathon when the event was introduced in 1984 in Los Angeles!!!

My running is more jogging or plodding but I have always enjoyed it. I don’t have speed, but when I train I can build up endurance. Over the past few years it has become more walking my dogs than running.

Joan Benoit Samuelson is the famous runner brought in this year to compete in the 34th Firecracker 5k held on the July 4th weekend.   The 5K takes  place today, July 3rd, at 7:30 am.

I got to meet her yesterday when I picked up my husband’s and my race packets at Easy Runner, the race host.  I was star-struck but managed to ask for a photo.  Was at a loss of where to take the conversation when she noticed the pedometer on my skirt’s waistband.  “How many steps do you do each day?”

“I try to get at least 10,000 steps each day.  When you work in an office, it’s easy to fool yourself into thinking you’re more active than you are.”

“Good for you,” she replied.  “If everyone in American did the same we wouldn’t have nearly the obesity problem we have.”

Finger and Wrist Exercises

Updated 3/2017 -- photos and all links (except to my own posts) removed as many no longer active. and it was easier than checking each one.

A few weeks ago I received an email from a reader who appreciated my past post on posture.  She then requested information on exercises and prevention of finger/hand issues from computer/keyboard use.  I replied that I would work on it.

Thanks to TBTAM who reminded me of this with this tweet last week.

Duration of EMR use and upper extremity musculoskeletal symptoms correlated. And I was blaming the blog.... http://bit.ly/bVbOvU

One of my earliest post (June 3, 2007) was  “Good Posture for Sewing (or Blogging)”.  Posture makes a huge difference in body mechanics, be it at the computer, sewing machine, or in the operating room.  Poor body mechanics lead to or contribute to many chronic use issues (ie back pain, carpal tunnel, cubital tunnel).

You and I should consider taking breaks every 30-60 minutes from our computer/desk/sewing machine work and do some stretching exercises for our wrists and hands and body. 

Most involve simply putting all the joints through as full range of motion as possible.

Flex (bend) and extend (straighten) each finger.  Spread your fingers as wide apart as possible and hold for a count of 5.

Flex and extend the wrist.  Move the wrist in a circular fashion with the fingers both relaxed and in a gentle fist. 

Straighten the elbow.  Rotate the forearm so the hand is palm up and then palm down.

Don’t forget the shoulders.  Shrug your shoulders and down, roll then in gentle circles.  Raise your arms above your head with your palms meeting.  Move your arm/shoulder as if you were swimming so as to move the joint through its full range.

Neck Rolls – relax your shoulders and let your head roll forward. Slowly rotate your head in a circle. Repeat five times.

E-Hand.com has some nice photos (including this one) with instructions on some exercises intended to help prevent carpal tunnel syndrome.

Extend and stretch both wrists and fingers acutely as if they are in a hand-stand position. Hold for a count of 5.

Here are some sites with more exercises:
Typing Games to improve dexterity
Slide show: Hand exercises for people with arthritis by Mayo Clinic Staff
Finger Exercises for Arthritis By Kate McQuade, eHow
How to do Wrist Exercises to Help Arthritis in the Hand By LivingWellYoga, eHow
Finger injuries - causes, treatments and recovery exercises

Get Up and Move

Updated 3/2017-- photos and all links (except to my own posts) removed as many no longer active. and it was easier than checking each one.

Last week, researchers  at the Swedish School of Sport and Health Sciences published an editorial online in the British Journal of Sports Medicine, warning us of the dangers of prolonged sitting.

Dr. Elin Ekblom-Bak and colleagues note the benefits of regular physical activity for several major health diseases is clear and unanimous, but warn that recent studies suggest that prolonged bouts of sitting time and lack of whole-body muscular movement can undo some of the benefits even for someone who is considered “in shape.”

The editorial mentions a study published last year that tracked more than 17,000 Canadians for about a dozen years. Peter Katzmarzyk  and colleagues found people who sat more had a higher death risk, independently of whether or not they exercised.

Our bodies are designed to be active.  I, like many of you, sit too much.  It’s a hazard of our jobs and our hobbies.  It is important to do as Dr. Ekblom-Bak says: "It is important to have a five minute break from desk work every 45 minutes.”

I don’t have to give up my computer time or my sewing/knitting or my reading or my TV.  What I have to do (and what you should do) is make a conscious effort to remember to stand up and move for a few minutes ever 30-45 minutes of prolonged sitting.

When  watching TV, use the commercials as reminders.  It’s a great time to get up and stretch or do a few lunges or maybe a jumping jack or two.

In my sewing room, I have to get up when I need to press seams.  This breaks up the sitting time.  I don’t always have automatic “breaks” when knitting, reading, or using the computer.  I have to remind myself to do so. 

Last week, Dr Anonymous posted Warning: Sitting Can Kill You.   How about David Bowie’s Let’s Dance?  Anyone want to join me?

REFERENCES

“Are we facing a new paradigm of inactivity physiology?"; British Journal of Sports Medicine Online First 2010; doi 10.1136/bjsm.2009.067702; Elin Ekblom-Bak, Mai-Lis Hellénius, Björn Ekblom

Sitting time and mortality from all causes, cardiovascular disease,
and cancer;  Med Sci Sports Exerc 2009;41:998–1005; Katzmarzyk PT, Church TS, Craig CL, et al.

My Personal Trainer

“Five more minutes,” I tell him as he nimbly places his paws on my knees, brown eyes imploring.
“Okay, you win.” 
Orange ball cap on my head, gloved hands grab the leash.
We exit the gate, the January sun cold as we jog toward the neighbors woods. 
Will there be ducks on the pond today?

Weight Lifting Good for Breast Cancer Patients

Updated 3/2017-- all links (except to my own posts) removed as many no longer active. and it was easier than checking each one. 

Historically, we healthcare providers have cautioned breast cancer patients to avoid weight training after a mastectomy and or axillary dissection.  We often use 15 lbs as a guideline for a save weight to lift using the arm on the mastectomy side.  A new study suggests this advice turns out to be misguided.

The study has been published in the August 13 issue of the New England Journal of Medicine.  It is a small study, but the results do challenge our current reluctance to allow lymphedema patients to weight-lift.

Kathryn Schmitz, PhD, MPH and colleagues enrolled 141  breast cancer survivors with lymphedema.   The enrollees were then placed into two groups.  One was assigned to a weight-lifting group who lifted twice-weekly for 13 weeks.  The other group was used as a control group and did no weight-lifting.

The weight-lifting women (71) wore a custom-fitted compression garment on their affected arm during their workouts.  Their arms were measured monthly to ensure any changes were noted as soon as they occurred.  Each week were asked about changes in symptoms.

Both groups had the same proportion of women who experienced an increase of 5% or more in their limb swelling.  However, the weight-lifting group had fewer exacerbations of their condition which required treatment from a physical therapist; 9 compared to the 19 women in the control group.   The weight-lifting group also had a reduction in symptoms such as pain.

Further studies need to be done to verify their results, but I would allow motivated patients to begin weight-lifting with a slow, progressive program.   They should learn proper technique.  They should wear their custom-fit compression garment during all exercise sessions.

Weight-lifting has been shown to decrease bone loss which is important in these women as in all women.  Having more strength can also aid in everyday activities like carrying bags of groceries or carrying children/grandchildren.

REFERENCE

Weight Lifting in Women with Breast-Cancer–Related Lymphedema; New England Journal Medicine, Vol 361 (7):664-673, August 13, 2009; Kathryn H. Schmitz, Ph.D., M.P.H., Rehana L. Ahmed, M.D., Ph.D., Andrea Troxel, Sc.D., Andrea Cheville, M.D., Rebecca Smith, M.D., Lorita Lewis-Grant, M.P.H., M.S.W., Cathy J. Bryan, M.Ed., Catherine T. Williams-Smith, B.S., and Quincy P. Greene

Related Posts

Lymphedema (December 5, 2007)

ARM Technique (October 15, 2008)

Walking

I call my dog Rusty my personal trainer.  We walk every day regardless of the weather.  He was preceded by other dogs (Columbo, Girlfriend, and Ladybug) who got me into this walking habit.  It has kept my weight down over the years without having to go to the gym.

I was reminded of this earlier this week by an article in my local paper.  This link needs a subscription, this one does not.  I especially love this part of the article as it highlights a community in Arkansas where “volunteer” dog walking has become a weekly club event.  Kudos to them!

And there's another way to dabble in dog time. In many communities, volunteers for local Humane Society shelters gather to give the friskiest residents a workout. In Arkansas, the Humane Society of Independence County has a weekly Dog Walk Club. Its volunteers walk dogs at 8:30 a.m. every Wednesday at the North Complex on 3451 E. Main St. in Batesville. Anyone can volunteer by calling (870) 251-4145 or (870) 307-5305A similar group meets in the nation's capital. Kevin Simpson, director of animal training and behavior for the Washington Humane Society, has dubbed the year-old group the People & Animal Cardio Klub, or PACK. (Because pack animals run together.)

"People love it because they're helping out and getting exercise," he says. The cooped-up canines get an even better deal: They're socializing and blowing off steam, which means they'll be better behaved and, thus, more adoptable.

 

As I have said before in previous posts, walking is a great exercise.  It is good for both you and your pets (or the ones in the humane society).  I would encourage you to take it up.

If you are just beginning a walking program, remember as summer begins here in the United States that heat becomes an issue quickly.  Walk in the early morning or evening, or consider going to the mall to walk inside in the air conditioning. 

 

 

My past related posts include:

Heat Related Illnesses (August 2007)

Pedometers and Physical Activity (November 2007)

50-Minute Strength Workout (December 2007)

Getting Back Into Shape (November 2008)

 

 

Exercise Only Good if Done

Updated 3/2017-- all links (except to my own posts) removed as many are no longer active and it's easier than checking each one. 

This isn’t really plastic surgery related, but considering that I am always trying to get patients to get more active or to remain active, then maybe it is.  I like to tell my patients that I have the easy part, they have the hard part of maintaining the results.  This is especially true for the liposuction or abdominoplasty patients where keeping their weight in line is an issue to outcome in years to come.

There is a new article published in  Circulation: Journal of the American Heart Association earlier this week which looked at different types of exercise after a myocardial infarction (MI). 

The authors,  Dr Margherita Vona et al, did a controlled trial using 209 patients who were referred to cardiac rehabilitation after having an MI.  These patients were then randomly assigned to one of four groups:  aerobic training, resistance training, both combined, or no exercise.  

The researchers looked at flow-mediated dilation (improve blood vessel function) at baseline after 4 weeks of exercise, and then again one month after stopping training.  The flow-mediated dilation more than doubled with exercise, from about 4% to about 10% in all three exercise groups.  Those in the no exercise group had a small increase from the baseline 4% to about 5%.

The benefits of physical activity did not last when the activity ended.  Within a month of no exercise, the flow-mediated  function returned to baseline levels.

The important finding of this study is as Dr Vona said, "Long-term adherence to training programs is necessary to maintain vascular benefits on endothelial function." 

Exercise / physical activity has to be like “brushing your teeth”.  It needs to be something that you do regularly and not just once or this week, but for life.

It is not important which physical activity you choose to do, it is important that you do it.  It is important that you continue to be physically active on a regular basis.

Source

"Effects of different types of exercise training followed by detraining on endothelium-dependent dilation in patients with recent myocardial infarction"; Circulation 2009; DOI: 10.1161/CIRCULATIONAHA.108.821736; Vona M, et al

Other Blog Posts

50-Minute Strength Workout

Pedometers and Physical Activity

Getting Back Into Shape

Getting Back Into Shape

 Updated 3/2017 -- all links (except to my own posts) removed as many no longer active and it was easier than checking each one.

I am a strong advocate for physical activity.  Any physical activity.  I encourage my patients, friends, family to find something they like to do and DO IT.   For one sister that means running 5K’s, half-marathons, full marathons.  For my mother, it’s the senior citizen dances.  For my husband, it’s running on the treadmill.  For me, it’s walking (walk/jog) my dog and shooting baskets in the back yard.  (Okay—it also includes dancing to the radio and commercials.)

If you haven’t been active in a long time and are seriously de-conditioned, start slow.  There is a program called “The Couch-to-5K Running Plan” which offers some good advice and an easy to follow plan. 

Or you can follow the plan at Shape Up America! 10,000 Step Program which uses a pedometer to keep track of how much (or little) you move each day.

With Halloween just past (all that candy) and Thanksgiving and Christmas coming up, now is a good time to get moving or keep moving.   Here is the post I wrote last November on using a pedometer. 

I use a pedometer as a reality check. I often go home tired after a day in surgery or in the office. I'm tired so I must have expended a lot of energy and therefore used a lot of calories/done a lot of moving right? Wrong! In the course of a "normal" day most adults take anywhere from 900 to 3000 steps in a day and not much more. That means to truly get "enough" physical activity in daily, I (and you) need to go for that daily walk. Fortunately, I enjoy walking. Most days (barring horrible weather) I enjoy my walks with my dog. Other days--I just do it--rain or cold or heat. This is a picture of my pedometer with my step count on a surgery day. It includes the time from getting dressed to just finishing in the operating room. Notice how few steps have been taken.

JAMA recently had an article (referenced below) that showed "The results suggest that the use of a pedometer is associated with significant increases in physical activity and significant decreases in body mass index and blood pressure." Overall, the pedometer users increased their physical activity by 26.9% over baseline. The person who gets the most out of the use of a pedometer is the who has a step goal (ie 10,000 steps per day).

The JAMA article also found "Pedometer users also significantly decreased their systolic blood pressure by almost 4 mm Hg from baseline. Reducing systolic blood pressure by 2mmHg is associated with a 10% reduction in stroke mortality and a 7% reduction in mortality from vascular causes in middle-aged populations; thus, it is critical that the effects of pedometer use on blood pressure be examined closely in future studies."

Perhaps you might think about getting a pedometer for someone for Christmas or even one for yourself. It does not need to be an expensive one. I use the Sportline 340 (having lost a few, they cost less to replace). I never bothered to program in my step length. I simply use it to count the steps and aim for that 10,000 mark. Most days I go past it, but there are days I have to "work" at it. Simple adjustments will add up--park the car farther away from the store, take the stairs down two flights or up one rather than using the elevator, walk one extra block, etc.

Some suggestions on getting started with your new pedometer...

• Start out by wearing the pedometer each day for two weeks and don't do anything to change your normal routine. Keep an exercise log of the daily step count. At the end of the second week, take a look at how many steps you are taking each day in the course of living your life.
• If you feel comfortable doing so, take the highest number of steps you have walked on any given day during that 2 week period. Use that number of steps (ie 2500 steps) as your first daily step goal. To avoid injury, do not select a higher number. Continue to keep your step log.
• At the end of that two week period, review all the steps you took each day. If you are ready, add another 500 steps to your daily goal. Your new step goal is now 3000 steps a day for the next two week period.
• Continue in that manner, working up until you finally reach the goal of 10,000 steps a day.
• The goal is to keep you active for the rest of your life. So don't go overboard and injury yourself. Take it slow. Take it easy.
  
• It takes about six months to "lock in" a new behavior. Aim to do what is necessary to change your exercise behavior permanently. Be prepared to dedicate yourself to your daily goal each day for a minimum of six months. If you do that, you are much more likely to maintain this goal permanently.
• If you skip a few days due to illness, work or other obligations, the sooner you get back into the exercise groove, the more likely you will be able to get back into your routine.
• Reaching that walking activity goal of 10,000 steps does not mean that you can increase your food intake. Continue to try to eat a healthy and reasonable portion diet.
• So the weather's yucky, walk laps at the mall, go to a museum, or walk laps inside your home. Get up and move!
  

Here's my total at the end of the day.

References
Using Pedometers to Increase Physical Activity and Improve Health: A Systematic Review; Dena M Bravata, MD and others; JAMA, Nov 21, 2007, Vol 298, No 19, pp2296-2304
Shape Up America! 10,000 Step Program

Callipygian

Updated 3/2017-- photos/video and all links removed as many are no longer active and it was easier than checking each one.

I learned a new word recently.
callipygian

PRONUNCIATION:
(kal-uh-PIJ-ee-uhn)
MEANING:
adjective: Having well-shaped buttocks.
ETYMOLOGY:
From Greek calli- (beautiful) + pyge (buttocks). Two related words are dasypygal and steatopygia.
USAGE:

"And it hasn't been lost on modern film directors that a nice set of tights can showcase the callipygian assets of a well-formed leading man."

Heroes in Hosiery; South China Morning Post (Hong Kong); Jul 20, 2006

I am being asked by more and more patients about buttock shaping, lifting, and even implants. The entire idea of defining a nice buttock is interesting to me. Difficult to put into words, but something "you know when you see" one. And yes, I do check out men's butts. The girls in the OR and I have been know to whisper about how nice Dr ___'s butt looks in his scrubs.

Okay, back to the topic. What defines a well-shaped buttock?
Characteristics
The features that are common to attractive youthful, female buttocks in all ethnic groups include:

• A smooth inward sweep of the lumbosacral area and waist.
• A very feminine cleavage as the buttocks separate superiorly and inferiorly.
• Maximum prominence in the mid to upper buttocks.
• There should be minimal infragluteal crease, with no droop above this line.

Sacral dimples or depressions may be present or absent in attractive youthful buttocks, but are not considered a determinant of their beauty.
Even with the difference in cultural ideas of the "ideal" buttock, the above features hold. Some ethnic differences include (some good photos can be found here):
Caucasian patients

• will generally want buttocks that are full but not really large.
• fullness of the lateral thigh is considered objectionable.
• Some prefer a full rounded lateral buttocks.
• Others prefer a flat or hollow lateral buttock (considered a more "trim" or athletic look).

Hispanic or of recent Hispanic descent

• prefer buttocks that are very full.
• lateral buttocks that are very full
• a slight fullness in the lateral thigh.

Asian patients

• prefer buttocks that are shapely but small to moderate in size
• little or no fullness in the lateral buttocks or lateral thigh.

African-Americans and Caribbean's of African descent

• have a strong and consistent cultural ideal of very large buttocks
• often will request a "shelf" (extreme prominence of the upper buttocks)
• prefer very full lateral buttocks
• a very full, prominent trochanteric area of the lateral thighs is considered attractive by both men and women in this culture

There are multiple procedures that can be used to get to or closer to the "ideal" (must in keep in mind the patient's ideal) buttock. These include:
Micro-fat grafting
Buttock Reduction/Contouring
Gluteal Implants
Buttock Lifts
Combination of the Above
And don't forget these exercises that help tone and bulk up the glutes. You can find them here or a video here or this youtube video (the one below) or this one,

REFERENCES
Dr Thomas L Roberts, III, MD, FACS Website: BetterButtocks.com (nice photos and patient information)
Body Contouring, Buttocks Surgery; eMedicine Article, Dec 19, 2006; Robert F Centeno MD and Neal R Reisman MD, JD
Body Contouring, Flankoplasty, and Thigh Lift; eMedicine Article, Feb 25, 2008; Keith M Robertson MD and Bruce G Freeman MD
Beautiful Buttocks: Characteristics and Surgical Techniques. Clin Plast Surg, July 2006;33(3):321-32; Cuenca-Guerra R, Lugo-Beltran I (abstract available here)
Buttocks Lifting: How and When to Use Medial, Lateral, Lower, and Upper Lifting Techniques; Clin Plast Surg. July 2006;33(3):467-78; Gonzalez R. (abstract available here)
Gluteoplasty; Aesthetic Surgery Journal, Vol 23, No 6, pp 441-455; Constantio G Mendieta MD (abstract available here)
Gluteal Aesthetic Unit Classification: A tool to Improve Outcomes in Body Contouring; Aesthetic Surgery Journal, Vol 26, No 2, pp 200-208; Robert F. Centeno MD (abstract available here)
Gluteal Reshaping; Aesthetic Surgery Journal, Vol 27, No 6, pp 641-655; Constantino G Mendieta MD (abstract available here)

Update on Marathon Death

Updated 3/2017-- photos and all links (except to my own posts) removed as many no longer active.

The Little Rock Marathon took place on March 2nd. We had a runner, Adam Nickel, collapse after finishing the race in 3:02:26. He was not known to have any medical problems. He finished 18th overall in the marathon.

Autopsy Provides Answers, but little solace

Autopsy results from the Arkansas Crime Lab, released Monday, indicate that Nickel had a vascular disease known as “multifocal small coronary artery fibromuscular dysplasia,” which means he had small heart arteries that restricted the flow of blood. The small arteries were near a critical part of the heart that regulates electrical impulses.

That, combined with abnormal electrolyte percentage levels that many distance runners experience, including raised potassium percentage levels, led to a significant heart arrhythmia that proved fatal.

Dr. Charles Kokes, the crime lab’s chief medical examiner, said an electrocardiogram could have detected Nickel’s condition, but a physical alone would not.

Many runners might have Nickel’s condition, not know it and still feel fine, Kokes said. In Nickel’s case, the fact that the affected arteries were so near nodes in the heart that control electrical impulses led to the fatal event.