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In my last post I told you that I would reveal the one thing you can do to have a significant, positive and lasting effect on your brain health as you get older. See if you can spot it in the following list:
a) Learn to dance Gangnam style
b) Join a choir
c) Catch a wave
d) Pump some iron
Ok, that was a trick question. All of these answers are somewhat correct, but I was looking for the “most” correct answer (flashbacks to undergrad, anyone?): Pump some iron.
I realize I sound like a broken record – I’ve already written about how aerobic exercise can promote healthy aging here and here, and I’ve even already written about resistance training, or lifting weights, here.
So why am I at it again? Because it’s important!
I’m fresh out of the 2012 Aging and Society Conference, where researchers came together to discuss what works and what doesn’t when it comes to healthy aging. It turns out everyone pretty much agrees that exercise is hands down the most effective intervention to keep your brain cells happy into old(er) age. All sorts of different types of exercise, ranging from simply walking to attending resistance training classes, are associated with different types of improvements in cognition, memory, and even brain size.
Of course, there are different levels of effort involved with different types of exercise, or even when talking about a single form of exercise. When my friend Jess asks me to go for a walk, she means a power walk: it usually involves going up hills, sweating like a pig (even though pigs, ironically, don’t sweat much), and barely having enough breath for girl talk (though somehow we always seem to find it). When my friend Al and I go for a walk, what he means is a “mosey”: we stop to look at the view, pet the dog, chit chat with strangers, and have more than enough breath for lengthy discussions about life, work, and the possibility of alien lifeforms. When it comes to brain health, whether you’re walking or pumping iron, a little sweating and effort can go a long way. For example, resistance training has been proven to be most effective when the load, or how much weight you are working with, increases over time. So kick the intensity up a notch: there will still be plenty of time for chit chat around a post-exercise, antioxidant-rich mug of matcha (my new obsession – stay tuned).
Now that the obvious has been (re)stated, I want to take this opportunity to discuss the idea that perhaps lifestyle interventions such as exercise could be prescribed by your doctor. We know that exercise can improve cognition in aging but also conditions like depression. Should physicians prescribe lifestyle changes? Or are diet, exercise, and other lifestyle activities choices we should make ourselves? How would you feel if your doctor prescribed you exercise instead of pills? Would you be more motivated to exercise if the prescription came from your doctor instead of from your friendly Internet science blogger? Your thoughts in the comments!
Dr. Julie Robillard is a neuroscientist, neuroethicist and science writer. You can find her blog at scientificchick.com.
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Does my butt look fast in these pants?
Since I started running (in earnest) a couple of years ago, I’ve been doing what I can to stay motivated. Running is a great sport because 1) it’s cheap 2) you can do it anywhere 3) it’s hard. So, because of #3 I welcome all opportunities to make running fun – and wearing amusing shirts during races seems like as good a strategy as any.
The idea for the “Does my butt look fast in these pants?” shirt came from a sign I saw at a recent marathon. A guy was cheering on the ladies with a homemade sign that read: “Your butt looks fast in those pants!” I laughed so hard it took me a quarter mile to recover. So I shamelessly stole his idea and made a Better Health women’s running shirt out of it. If you think it’s cool and want one too – I’d be happy to print you one. The larger the batch we order, the less expensive it will be.
So if you’re looking for a funny Christmas gift… or if you just want to thwart the race competition by making it impossible for them to pass you without sputtering out a laugh, let me know. Email me if you’d like to order a shirt and we’ll discuss details. My email is: firstname.lastname@example.org (They are made of Nike dry-fit fabric, come in the colors shown only, and are available in Ladies S, M, L – if guys show interest I suppose we could order a run of men’s shirts too?). Let’s prepare to GET BETTER HEALTH this season… and run our way to victory in the battle of the bulge.
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If you live in a small town or rural area of the United States, you may have noticed that family doctors are becoming an endangered species. Private and public health insurance reimbursement rates are so low that survival as a solo practitioner (without the economies of scale of a large group practice or hospital system) is next to impossible. Some primary care physicians are staying afloat by refusing to accept insurance – this allows them the freedom to practice medicine that is in the patient’s best interest, rather than tied to reimbursement requirements.
I joined such a practice a few years ago. We make house calls, answer our own phones, solve at least a third of our patients’ problems via phone (we don’t have to make our patients come into the office so that we can bill their insurer for the work we do), and have low overhead because we don’t need to hire a coding and billing team to get our invoices paid. Our patients love the convenience of same day office visits, electronic prescription refills, and us coming to their house or place of business as needed.
Using health insurance to pay for primary care is like buying car insurance for your windshield wipers. The bureaucracy involved raises costs to a ridiculously unreasonable level. I wish that more Americans would decide to pay cash for primary care and buy a high deductible health plan to cover catastrophic events. But until they do, economic pressures will force primary care physicians into hospital systems and large group practices. My friend and fellow blogger Dr. Doug Farrago likens this process to being “assimilated by the Borg.”
Doug offered a challenge to his readers – to customize the definition of Star Trek’s Borg species to today’s healthcare players. I gave it my best shot. Do you have a better version?
Who are the Borg:
The Borg are a collection of alien species that have turned into cybernetic organisms functioning as drones of the collective or the hive. A pseudo-race, dwelling in the Star Trek universe, the Borg take other species by force into the collective and connect them to “the hive mind”; the act is called assimilation and entails violence, abductions, and injections of cybernetic implants. The Borg’s ultimate goal is “achieving perfection”.
My attempt to customize the definition:
Hospitalists are a collection of primary care physicians that have turned into cybernetic organisms functioning as drones of the collective or hive. Hive collective administrators (HCAs), in association with partnered alien species drawn from the insurance industry and government, take other primary care physicians by economic force and connect them to “the hive mind”; the act is called assimilation and entails crippling reimbursement cuts, massive increases in documentation requirements, oppressive professional liability insurance rates, punitive bureaucratic legislation, and threat of imprisonment for failure to adhere to laws that HCA- partnered species interpret however they wish. The HCAs’ ultimate goal is “achieving perfect dependency” first for the drones, then for their patients, so that HCAs and their alien partners will become all powerful – dictating how neighboring species live, breathe, and conduct their affairs. Resistance is futile.
To learn more about my insurance-free medical practice, please click here. We can unplug you from the Borg ship!
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"Muffin Top" Excision
At ten months of age I had a life-threatening condition that required risky abdominal surgery. The pediatric surgeon had to open my belly from end to end, right above my umbilicus. I lost most of my colon in the process, but the only apparent long term effect was an impressive seven-inch scar. After forty years of living, the scar had become “stuck,” resulting in a preponderance of skin slowly increasing its droop over the old gash. Basically, I had a non-clothing-induced “muffin top” and no amount of diet and exercise would improve it.
So off I went to the plastic surgeon, knowing that he couldn’t erase the scar but could improve the contours of my abdomen. In effect, I could retain my current appearance (that of a woman who had a permanent belly indentation caused by a lifelong history of wearing high-waisted pants that were two sizes too small) or I could opt for surgery and embody the look of an athlete who had picked a fight with Zorro. The choice was clear. I would settle for the long slice on a thin belly.
The problem with being a doctor under the knife is that you know exactly what the other guy is doing. This procedure was completed under local anesthesia, and so I was chattering away with my surgeon the entire time. Although it took us at least half an hour to numb the area, I could still feel every tug and pull, hear the click of forceps, and the crunch of clamps. It was a little unnerving to have one’s abdominal flesh wide open to the world – something I’d only expected of my patients previously. So my surgeon snapped a photo for my blog (see above) though I opted out of looking at the image in the middle of the procedure. I have my limits.
So why am I sharing this with you, dear readers? Well, I do have a few tidbits of advice for anyone who is planning to undergo a substantial cosmetic surgery under local anesthesia. I hope these are helpful:
1. Wear a comfortable pair of undies. The unisex/unisize disposable options available at the surgical suite do provide comic relief – if you think you’ll be needing that. The pair that I received were the color and texture of surgical booties and about the right size for a guy in the WWE.
2. Try not to kick the surgical assistant(s) during the numbing portion of the procedure (or during any other portion come to think of it). Let’s face it, lidocaine hurts. Each injection feels like a bee sting, and if you’ve got a lot of surface area to cover, you’re going to be spending the first half hour (or more) squeezing something with great vigor. Which leads me to my next tip:
3. Find something firm to grip during the procedure. I found the surgical table arms to be nicely padded and an adequate thickness for death grips. I did wonder if I should have brought one of those “stress balls” with me, or perhaps a pair of hand grip strengtheners from a local gym (see image to the left).
4. Be prepared to make small talk with your surgeon for an hour or more. Preparing some “talking points” in advance could have made my patter more amusing, I suppose. But the art of distraction is a valuable asset in wide-awake surgeries. Your nervousness may actually make you a little extra charming, so don’t worry about what you say. Just do what it takes to keep your mind off the situation.
5. Don’t put your hands in the sterile surgical field. At certain times during the procedure your surgeon is likely to happen upon a spot that isn’t fully numb. You will probably respond with a squeal (or kick) and a loud “Ow!” The surgeon will then ask you what you are feeling and you must resist the urge to show him/her by pointing at it. Many an abdominal wound has been accidentally poked by well meaning patient fingers. Be careful! Just say you feel something sharp and the surgeon will know where it hurts… because he/she just did something to cause the reaction!
6. Get detailed post-op wound care instructions. You’ll probably exit the surgical suite with a lot of gauze and tape all over you, and it will occur to you later on that you haven’t the faintest idea when it’s safe to remove it. Can it get wet? Should you remove the steri strips? When do the stitches come out? When should you begin to use silicon scar gel? Do you need neosporin? Make sure you ask these questions before you’re released back into the wild.
7. Ask about movement restrictions and exercise precautions. You may be surprised by how restricted your movement should be in the first two weeks after surgery. I guessed that back flips would be counter-productive in my case, but didn’t realize that I couldn’t “walk fast” or twist at the waist. Make sure you understand what you can and can’t do to optimize your healing.
8. Take some pain medicine at least an hour before the local anesthetics are due to wear off. This was my biggest mistake. I asked if the wound would be painful later on and my surgeon denied any knowledge of potential post-op pain. So, six hours later when I felt as if someone had attacked my belly with a blow torch, I found some comfort in a maximum dose of ibuprofen and a vodka martini (and for those who know me well – yeah, I couldn’t finish the martini because it tasted gross).
9. Keep the scar protected and moist. Healing skin loves to be moist, especially early on. Ask your surgeon how best to accomplish that.
10. Get the stitches out on time. Don’t leave them in too long or you will be at risk for a larger or thicker scar. Disolvable stitches are convenient, but they do cause more inflammation which can lead to larger or more robust scar formation.
11. Tell your surgeon that you love the results (if they’re good!!) He/she will really appreciate the feedback.
I’m very pleased to report that my abdominal recontouring was a success, and I hope you’ll learn from my mistakes if you’ve got one coming up. Now I must strive to keep a new muffin top from growing by eating a healthy, calorie controlled diet (excluding real muffins!?) and exercising regularly.