I had a conversation with Jesus and we have decided to add a verse to the new testament–“thou shall not sleep in chairs”. This verse is especially aimed at seniors who find themselves sitting in their favorite recliner nodding off. I know that you may think that your chair is so very comfortable, but I am sure that your body doesn’t agree when it is time to get up from that chair.
Neck and back pains are two of the most common complaints I get from seniors. In most cases seniors ask me what they should take for the pain, while those who have embraced a more active role in their care will usually ask me what exercises they can do to help their condition. There are many exercises that I can prescribe and God knows there are tons of medications that will mask your pain for a few hours, but often times the answer is literally right under their nose. Just take a look at the chair you are sitting in and many of the answers for neck and back complaints will start here.
The American furniture industry has followed suit with the food industry and has decided to make everything oversized and subsequently less healthy. I guess this makes sense to accommodate the people who are consuming the triple bacon cheeseburgers with large recliners to lay out in after their meals. Despite the fact that we are one of the fattest nations in the world, the furniture has even outgrown our waist lines. Most sofas and recliners are large enough to accommodate a 6 foot 4 inch, 300 pound person, while the average person is often shorter than 5 foot 8 inches and less than 200 pounds . This combination leads to little people in big chairs.
The phenomenon of little people in big chairs is great for the back pain industry and even for people like me who make a living on helping people with their pain. Although I could just ride this career as a Physical Therapist out and just keep prescribing back exercises and calling physicians to prescribe more pain medicine, I decided to go straight to the top and talk to the man himself–Jesus Christ.
Jesus and I decided that taking on the furniture industry might not be the best use of our time, so our new sub-commandment starts a little smaller and focuses on you. If you are tired and know that you are about to nod off, do yourself a favor and go lay down. The stress that is put on your neck and back once gravity starts to pull your head down during sleep is enough to give anyone pain. If you are a senior, this act not only causes pain but actually contributes to the hunch-backed posture that all of you should be trying to avoid. The simple act of laying down removes gravity from your equation and now your neck and back can actually rest at the same time you do.
There is a bunch more science behind this issue, but Jesus and I thought that the science would bore you too much. Just consider this your 11th commandment and do it. You, your neck, and your back will thank us later.
Most of us have tried a diet at least one time in our lives. Today many will choose to sound more sophisticated and call their diet “a lifestyle change” rather than a diet, but it is what it is. Regardless of what you want to call it, the “5W diet” is about to change your life, IF you choose to embrace it.
I still have a way to go but I am a living example of what the “5W diet” can do. As a former personal trainer and someone who has consistently worked out since I was about 14 years old, it pains me when people ask me “do you work out?”. Knowing that you spend hours in the gym consistently and having people not automatically assume you work out is a smack in the face. Regardless of how I feel about the question, I have been getting it for the last decade or so as I adopted a body that straddled the line between husky and fat. I am proud that with the “5W diet”, the question has reverted back to what I was used to hearing most of my life–“where do you work out?” or as one of my patients who is about my age asked me the other day “how much do you bench press?” I am not saying that these are the reasons why I am eating healthy, but it sure does feel good when it is obvious that you work out and take a serious interest in your health. I have tried a few diets over the years, but this is by far the most natural and easiest diet I have ever experienced and you don’t need money or any type of membership to get started with the “5W diet”. All you need is your brain and a little time to invest. Lets get started.
To get started on the “5W diet”, read and answer these questions about yourself:
To start the diet, you have to figure out who you are. Who you are makes a big difference as to what you eat. Without getting too scientific, you need to simply answer whether you are a hyper-metabolic or hypo-metabolic person. In other words to you have a fast metabolism that allows you to burn food quickly or do you have a slow metabolism that burns food slowly. Many of us know this from a young age. If you can eat what you want and never see your figure change, you are likely hyper-metabolic, while if you have always had to watch what you eat and exercise just to maintain your weight, you are like hypo-metabolic. Regardless of whether your metabolism is fast or slow, you need to embrace “Who” you are and eat accordingly. Those with slow metabolism need to train their metabolism with small and more frequent meals, while those with faster metabolism must understand that just because your metabolism manages your weight well, the same may not go for your health. Metabolism can be a gift or a curse depending on what you do with it, so make sure you know where you fall on this issue. Also be sure to understand that no matter where you start with metabolism, it will slow down as you age, if you do nothing to train it. With this being said, if you are older there is a good chance that your metabolism is slower unless you are training it with your eating habits. As a general rule of thumb, eat five to six small meals per day to help your metabolism work for you best.
This may be the most important W of the 5W’s to me. What you eat is of vast importance. If you eat the traditional Western diet, there is a good chance that what you eat is not right for your body. “Forks over Knives” can explain the pitfalls of the Western diet better than I can and I don’t want to make a blanket claim about what people eat, as many will have different responses to the same foods. What I will say is that the data and evidence is very clear amongst the masses of people who eat a Western diet as compared to almost any other culture. The Western diet which is meat-centric and clearly regards bacon and cheese as the King and Queen has birthed a nation of heart disease, while the peddling of the most addictive drug known to man a.k.a. sugar has made diabetes a hallmark of our communities. I don’t want to lose you here with my rhetoric, but you need to understand what you eat. You need to have a basic understanding of what meat and cheese does to your body, and then decide how much of it you should ingest.
Beyond meat and cheese, you need to read the ingredients of what you eat and have an idea of what it is before simply trusting that the FDA has your best interest at heart. Many of these ingredient labels list things that you would never ingest if offered by name, but when they are on the label of your favorite food, you ingest them in bliss. We all know that bliss is a close cousin to ignorance, but both are related to early death and poor quality of life, so you may want to steer clear of them. Remember that this Western culture is founded on capitalism and the very initiative of capitalism is never to lift you up, but rather to put you down. There is no better way to push you to the bottom of the capitalism triangle, than to do it through the foods that you eat every day. If you don’t take anything else from the 5W diet, please make sure you understand this–Knowing “What” you eat and “What” it does to your body in both the short-term and long-term future is a baseline level of responsibility that you should hold yourself to for the rest of your life.
“When?” is a bit underrated as to its difficulty in this diet system. I know this because I have the “Who?” and the “What?” figured out really well but the “When?” still gets me at least once or twice a week when I lose the battle to my cravings for a late night snack. The timing of when we eat and more importantly when we don’t eat is of extreme importance for our health, fitness, and energy levels. As we discussed above in “Who?”, you need to eat at a certain frequency to train your metabolism. Beyond this you need to eat at certain times like upon arising in the morning to break your fast a.k.a. breakfast. You also need to understand when you should not eat, like 2-3 hours before bed time when there is no need to be fueling your body. Depending on the what, there is a good chance that every time you eat, you spike your glycemic levels and cause your body to preserve fat. The wrong “when?” can transform hours during which your body could be burning fat reserves to hours of fat preservation. Learn about the when a little more on your own as it is a little more complicated than what I can put in this paragraph, but it is also more important than most people think.
As a start to your 5W experience I advise that you make a habit of eating breakfast; make a habit of eating at least 5 small meals per day, stop eating about three hours before bed time, and try not to eat much if you know you are not going to move much. Remember that food is ultimately fuel, but if you don’t plan to use it as such, it can quickly turn into fat.
Where you eat is a topic that may go a little deeper than many want to go, so I will keep this on the surface. The point of the “Where” in the 5W’s is based around how present you are while you eat. Being mentally present when you eat can have an effect on how much you eat and how often you eat. If you are like me and in the car a lot, you will find that when you eat, there are many other things going on; so much so that the eating is in the background. In these cases, the brain will sometimes not even acknowledge the meal and therefore when more food is available, the brain will allow you to keep on eating. This goes for people who eat while working, while socializing, or doing anything else that may put the act of eating in the background. I know that this isn’t the easiest thing to accomplish, but do your best to eat at home or eat in a setting in which eating can be one of your top areas of focus. The brain is the CEO of your body and it is important that your brain take in the fact that you are eating, as many times our stomachs will allow us to go to far. The sophistication of your brain can realize when you have eaten enough far before discomfort and pain occur in your stomach or elsewhere, but where you choose to eat and your brain’s ability to focus on the meal in that setting may play a role in determining which organ will queue you first. My advice is to respect each meal as much as you can and stay mentally present while you’re eating to avoid the trap of over eating or constantly seeking satisfaction from food that only your brain will be able to realize.
Those who follow my writing, know how long I can talk about “Why?” The piece that I wrote on PRVRB.com titled “Why?” was a little on the long side, but as I said then, “why?” is one of the most important words known to man. It is no different when it comes to eating and nutrition. Most people know the cliché line of living to eat vs. eating to live, but when you watch most people eat, it is clear which objective is guiding them. The truth for many is that they live to eat. If this were not the case, I doubt that the premiere burger at every fast food joint would have bacon and cheese. If anyone can explain to me how bacon and cheese helps us live, I welcome that genius commentary. We should all ask ourselves why we are eating our choice of food before each meal. This may seem a little monotonous, but my guess is that there would be a lot of change of hearts right before a meal if we picked up this habit. I am not saying that we shouldn’t find some level of joy in food, but if the answer to the “why?” for every meal is “because it taste good” then you are the poster child for living to eat. That is not to put anyone down, but to highlight the fact that with all of Gods great creations, you have decided to devote your life to food. I know that living to eat does not have to be a mutually exclusive practice that cuts you off from all of Gods other creations, but as a veteran in the healthcare industry, I can promise you that living to eat will catch up to you and it will eventually consume your life.
Eventually the “live to eat” attitude leads to excess weight, painful movement, reliance on medications, increased time spent in healthcare, and decreased energy to fulfill your real purpose. Hold your self accountable to the “Why’s” for each meal that you ingest and at least set a goal to have your “eat to live” decisions outnumber your “live to eat” decisions as a start.
That’s it! I know many of you may expect more from a diet, as historically diets are about giving you the answers. I don’t value answers as much as I do questions, as questions breed active intellect, while answers given without questions breed lazy stupidity. If you don’t find this helpful and want a diet plan that tells you when, where, and what to eat without said diet knowing who you are, or you knowing why you are doing things a certain way; I am sure you can find hundreds at the tip of your fingers. I hope you choose the way that will ultimately empower you while improving your health, fitness, and beyond. Although I am sure you can see that this was more an exercise in trying to educate and enlighten, I truly stand behind these principles in being a catalyst for a healthier lifestyle. If you want to get on a “diet” or a “lifestyle change” that will truly work, the “5W diet” is the way to go. I put my name on it as well as my intellectual inspiration-back guarantee.
In the words of my son’s godmother–Cat Wilson, during a commercial that I can’t forget, once you start the 5W diet you may hear people saying this as YOU walk by “You go healthy!”
Medicare has become a part of the American dream for the middle class. Those who work most of their lives feel like they can take a step back and breathe when they hit 65 years old and Medicare kicks in. Unfortunately this is simply not the case. If you read the fine print, there are a few things that you or your loved ones need to be very aware of when it comes to Medicare.
While it is true that Medicare is a hallmark for the middle class worker, while Medicaid is often considered as insurance for the poor and disabled; as life progresses, many wish they had the latter. With statistics showing very clearly that about half of us will encounter chronic disease before we die, those 50% who head to battle with chronic disease with Medicare as their partner may find that this part of the American dream is flawed in many ways.
A chronic disease process typically means that you will eventually need some level of caregiver presence. This will vary based on the chronic disease that you encounter, but in most cases disease is progressive in nature and the need for in home assistance or transition to a living setting that provides assistance is inevitable. What many of my Medicare patients are shocked to find out is that when it comes to paying for this assistance, Medicare is nowhere to be found.
On the other hand, Medicaid will pay for Assisted Living or pay for personal care service aides to come to your home. So to be clear, I am telling you that the person who worked their entire life to get to Medicare will now be ineligible for a benefit that the person who possibly chose not to work or was hindered by a disability will be eligible for.
“Essentially, to survive the American healthcare system in your senior years, you need to either appear to be poor, or actually be rich.”
This scenario is very frustrating for many, but unfortunately once you reach this reality, there is little you can do to change it. The only advice I can offer is to plan for these possibilities far ahead of time. Essentially, to survive the American healthcare system in your senior years, you need to either appear to be poor, or actually be rich. Unfortunately our healthcare system and our culture does not cater to the middle class in this situation, and day after day I see this first hand. The common theme is that middle class individuals can not afford the help that they desire and the federal government won’t help them until they are broke.
I do not claim to be a social worker or a lawyer for the aging population, therefore take the remainder of this as a general outline to pursue with either of the individuals I just mentioned. Without giving specific details, I can tell you that your plan should be to go broke! I don’t mean to just spend your money on random items until there is no more, although aimlessly spending all your money is a better plan than dying with lots of money or spending your entire life savings on healthcare in your last years of life. I believe that the most effective way to navigate this system that is designed to burn you in the end is to push your assets through to the next generation.
By pushing your money to the next generation, I mean to literally put everything in someone else’s name–a son, a daughter, a grandchild, whoever; just don’t have the money in your name when the healthcare needs start to build. You will have to do the leg work to execute the plan in a manner that you are most comfortable with, but the goal is to have money without having money. I believe this plan requires someone who you can trust with your money and assets regardless of whether your health fails or thrives. Chronic disease may or may not give you a heads up that it’s coming for you, so your plans need to made regardless of what you think your health outlook is. In most cases, Medicaid and other lines of assistance will look back five years into your assets and cash flow, therefore I typically recommend your process begin no later than your late 50’s or early 60’s.
Many patients report to me that they simply don’t trust anyone with their money, some will cite the tax difficulties with transferring property and assets to their loved ones, and there are other issues that will make this process less than smooth. No matter how difficult the process of getting broke may be, I can nearly guarantee it won’t be as difficult as figuring out how to pay $5,000 per month for assisted living or $20-24 per hour for a personal care service aide to work in your home for the needed amount of hours.
To be fair, Medicare will pay for your doctors visits and will pay for skilled services like Physical Therapy, but when living life becomes an assisted task after conditions like strokes, Alzheimer’s disease, and congestive heart failure hit you, the benefits that are offered by Medicare are simply not enough.
Invest in relationships while you can, so that one day you can trust a loved one to take your assets and use them appropriately on your end of life needs. Understand that while Medicare is a big pot of money that you contributed to all of your career, the fact is your money comes with regulations and rules that are not always in your favor. To me the ideal situation is to be poor enough to get Medicaid benefits and to have your trusted beneficiary top off those Medicaid benefits with the gifts that you have given them over the years.
“Some may walk away from reading this and think that I am encouraging you and your loved ones to dupe the system, and your’e right, I am!”
Some may walk away from reading this and think that I am encouraging you and your loved ones to dupe the system, and your’e right, I am! The system is designed to dupe you, and frankly I love my patients and have grown tired of seeing so many of them struggle. I have come to the conclusion that the system is designed to simply allow you to hold their money for about 65-70 years with plans to take it all back when the time is right. One thing is for certain, we will take none of the money or things with us when we leave; the question is where will the money and things go as we leave this earth? If you choose not to follow this plan, it is very likely that your life savings will get inserted right back into the system as planned, and from a generational finances point of view, it will be as if you never existed. If you execute the plan I have described here, there is a great chance that your children, grandchildren and various loved ones who are left behind will have the assets to show that you made sound end of life decisions. Historically, many of us get this wrong and generationally our families suffer and continue to try to catch up in a game that is somewhat rigged. This is your chance to change your family’s trajectory by having a game plan to beat the system.
Share this with your friends and loved ones so that the fine print on Medicare won’t be missed.
Joint pain has become a near fact of life for those who are lucky enough to age into your 50’s, 60’s, and beyond. Cortisone injections have basically piggy backed onto joint pain to become one of the most common interventions in joint related healthcare today. I would estimate that I see at least one patient per day who has had a cortisone injection. In most cases my patients are having these injections to help with knee pain, but cortisone can be injected to any joint as a powerful anti-inflammatory that may or may not help with pain and dysfunction. Beyond the help that this powerful steroid may provide in various painful joints, patients and loved ones need to be aware of the other things that come with this treatment approach.
“Cortisone injections are like a blind hero with a gun”
Cortisone injections are like a blind hero with a gun. Imagine a hero with good intent entering a crime scene with plans to save the day by shooting the bad guys; but now imagine that he is blind. Would you want to be an innocent bystander in this situation? In the case of cortisone injections, the cortisone is the blind hero and your ligaments, cartilage, and other tissues around the joint are the innocent bystanders.
Cortisone may very well take care of the nasty inflammation in the joint which in this analogy is the bad guy, but at the same time it will land a few shots on the good guys which leads to weak or dysfunctional tendons, ligaments, and cartilage. In many ways cortisone potentially sacrifices three good guys to kill one bad guy. Does this make sense to you?
I am in no way saying that you should never consider a cortisone injection, but I am saying that you should understand the fine print that will not likely be highlighted during your consideration of the intervention. In the most common area that I see cortisone injections being used–the knee-joint; I have found that my patients who wait out surgery in favor of multiple cortisone injection tend to struggle more with rehabilitation and recovery after a total knee replacement. This makes sense when you consider that the surgery replaces the joint, but the structures around the joint are unchanged. In the case of those who endure multiple cortisone injection, these structures are likely to be weaker and therefore less efficient during the rehabilitation process due to the abuse they have taken from repeated cortisone injections.
In most cases I see patients get days, weeks, or even months of relief from cortisone injections, but ultimately most of them still end up having surgery, if they are an appropriate candidate. So why beat your joint down to end up with the same conclusion–a joint replacement? I do not have the answer to that question as I am not the one giving or getting the injections.
My goal is never to answer the questions for you, but rather to make sure you know the questions. Many of the patients that I discuss this topic with walk away adamantly being against cortisone injections all together, while some just become more conservative with their willingness to have repeated injections. There is no wrong answer here, as this is about what is good for you and your painful joint. I have become very aware that for most people surgery is the very last resort and for some it isn’t even an option. I don’t have any judgement on this thought process, as surgical intervention always carries a risk, which many could argue far exceed the risk of cortisone injections. In many cases I wish I could have met these people when they were a bit younger, because inevitably they have made their beds already, and they will have to sleep in the bed they made, no matter how they choose to execute that sleep.
“the dysfunctional joint formula is simple: increased body weight + weak or poorly functioning muscles = joint degeneration, arthritis, and considerations of cortisone injections vs. surgery vs. a painful existence. “
My advice is that if you are under 50 years old, consider your weight, your diet, and your activity level; as negligence in these areas is almost guaranteed to lead you to this conundrum one day. If you are over 50 years old, remember that the more cortisone injections that you receive, the worse your overall joint health is likely to be. Know that joint degeneration is generally a one way street–this means that as you lose cartilage and damage your joint, your only real recourse is to slow down the process. Unlike muscular issues, you can’t simply re-grow cartilage in your joints, and while inflammation and arthritis can improve, the only way to control this type of condition is to get to the root of the problem. In many cases, especially in America, the dysfunctional joint formula is simple: increased body weight + weak or poorly functioning muscles = joint degeneration, arthritis, and considerations of cortisone injections vs. surgery vs. a painful existence.
So if you are staring a joint replacement in the face or simply having joint pain that has prompted your physician to suggest cortisone injection consideration, remember what you learned here and consider taking an approach that involves weight reduction and muscle-training instead. Rely on natural anti-inflammatory aids such as cold packs or various foods that fight inflammation. Make the smart decision to bypass or at least take a conservative approach with your exposure to cortisone injections and I promise that your painful joint and your Physical Therapist will thank you in the future.
As a Doctor of Physical Therapy I often have to explain to people the difference between a PhD and a clinical doctorate degree. I often explain how a PhD is generally more research based, while a clinical doctorate degree is more hands on. I am definitely not the research type, but if there is one topic I would like to research, it would be the word “why”. Keep in mind that I am specifically talking about “why?” in the question form as I believe this represents the word’s most valuable usage.
For about the last 12 years I have grown to appreciate “why?” as one of the most valuable uses of the English language. The word “why” may not quite match up to words like “Love” and “God”, but pound for pound the word can hold its own with just about any other word, especially when you add the question mark.
This is especially true when it comes to learning and decision making. If I were to research this word, I would study the brain activity and psychology that occurs when “why?” is in action. I would look for a way to somehow quantify the value of “why?” in regard to feeding intellect and critical thinking. My appreciation for “why?” has progressed into daily usage with my children, my decision-making as a man, as well as my professional opinion and associated actions as a Physical Therapist. I think if used properly, “why?” will take you to the next level in every area of your life.
USE “WHY?” TO MASTER YOUR CRAFT
As with many things…Read the rest at PRVRB.com to see how Halle Berry, Denzel Washington play a role in a “Why?” that you may have never thought of….
I write this as a 37-year-old fatherless black man. I have been corrected by many when I say that I don’t have a father, as many flock to the biological meaning of this word; but I’m sticking with my presentation. Not that being fatherless should be a contest, but if it was I would definitely be in the running to win. Many state that they grew up without a father but then describe a father who simply wasn’t around much or didn’t do a good job. Some describe a situation in which their father left at an early age, or in some unfortunate cases, the father was taken from this earth. My story is very clear; this man did not exist in my life until about 3 years ago when I met him for the first time.
I’m using the word “met” loosely because this meeting consisted of my mother giving me a photo of a man who for most of my life was just a name on my birth certificate. Read the rest at Prvrb.com
Furniture walking is not quite a mainstream term. In fact many of you are probably thinking of how infants progress to independent walking when you hear this term. Some may even think I am speaking of actually walking on furniture. In my world “furniture walking” means one thing. It refers to the act of using furniture, walls, and anything else to help balance while walking. I have not done structured research on this topic, but this issue is at best a growing problem and at worst, an epidemic.
Many of you have likely seen or actually participated in furniture walking at some point in your life. If its dark, we hold on to things as we walk. If you are sick or hurt, it is likely that you reach out for support. The problem with furniture walking is when it becomes and every day thing.
Many furniture walkers will hold to the wall for one step and then reach out for a chair on the next step. Sometimes the piece of furniture is four-foot high, while sometimes its three-foot high. Sometimes the furniture is sturdy, while sometimes its unstable. Sometimes the furniture is within reach and sometimes its a stretch to get to. The key with furniture walking is that there is usually no consistency with the surfaces that are being depended on for balance. The nature of furniture walking is generally a dynamic one; as the reaching, bending, leaning, and stepping that is required to get to the furniture is often more risky than walking itself.
In theory a person who is furniture walking has decreased confidence in their balance. If you consider yourself to have poor balance, do you really want to constantly bend forward or side ways and depend on an item that was not made for what you are using it to for?
I asked one of my patients if he had to define what a table is for a three-year old, how would he describe it; he said “its something you eat on or sit things on”. I asked the same of a chair; and he said its something you sit on. I asked the same about walls; and we agreed that they were to support and frame a home. I then asked him to describe a cane or a walker; and he said its something to help you walk and balance. We went on to discuss why we don’t use basketballs to sit on at our kitchen table, as well as a number of other items that could be used for something, but were not designed for that purpose. In the end, I convinced him to avoid furniture walking and to use a cane to help with his walking and balance; by bringing light to the fact that he was using items to help his balance and walking that were designed to do something totally different rather than using a device that was designed to precisely address his need.
For those of you who do not furniture walk, it may seem like over kill with all of the examples, but when you encounter a furniture walker you will soon find that it is tough to convince them to trade in their furniture for a cane or a walker. Many consider assistive devices such as canes and walkers to be for “old people” or as one of my patients put it “for the handicapped”, but I would contend that these devices are mostly for “smart people”. These “smart people” may also have some level of balance or gait dysfunction, but the good news is that they will not allow pride to knock them down to the ground.
I strongly advise that all the furniture walkers trade in that dining room chair, that sofa, that rickety table, or those walls for a Physical Therapy Evaluation and possibly a cane or walker to go with it.
The good news is that the furniture walking or even walking with a device does not have to be long-term. Balance and walking quality can be improved with training! If you don’t want to use a cane or a walker, furniture walking is the wrong answer. The correct answer would be to consult your local Physical Therapist and start working on your balance and gait.
I hope that everyone takes this seriously, although my experience tells me that many won’t. Just remember that the bible says that “ones pride will bring him low”. In this case, being brought low could very well refer to the falls that occur with people who furniture walk rather than using the assistive device that they NEED. I hope you will listen to my words or “THE WORD”, but if not, you will likely being seeing a Physical Therapist pretty soon, although out of necessity rather than choice. When falls occur and bones break, Physical Therapy becomes a must. During the furniture walking phase, Physical Therapy is a choice. The decision is all yours.
One of the most common conditions I see on a daily basis is swelling. When we are younger, swelling is simply a response to a body part that has suffered trauma or injury. As we age, swelling can mean something totally different, and represent some really serious issues.
The most common area for swelling amongst my favorite group of 65-years old and up is the lower legs and feet. I literally see swollen feet on a daily basis, to the point that explaining the remedies for this issue has become as easy for me as reciting the alphabet.
The routine nature in which I deal with swollen feet can sometimes desensitize me to the fact that many who suffer from this condition do not know what to do to get rid of it. I sometimes find myself moving too quickly through this education with my patients and have to slow down and realize that many of the people who are experiencing swelling in their feet have never been given any instructions on how to conservatively manage the condition. Many of these people know what the drug Lasix is, as many times this water pill is a first resort of physicians for people who retain fluid.
Unfortunately not many of my patients can tell me the conservative ways to manage this condition, and this is something I hope to change.
Before I get into the ways to get rid of the swelling I need to stress why it is so important. Some may want to get rid of the swelling because it looks bad or they can’t fit the shoes they want to wear, which are not bad reasons; but the consequences of swollen feet can be far greater than the cosmetics.
In many cases swelling in the lower legs and feet signifies that there may be a circulatory issue. Our arteries are responsible for pushing the blood from our heart out to the rest of our body and our veins are responsible for taking the blood and other fluids back toward our heart. Just like any other body part, veins tend to struggle a little more as we age. When the veins can’t keep up anymore, many of us will see and accumulation of swelling in the lower legs and feet. The consequences of this occurrence can range from a trip and fall due to difficulty picking up your feet while you walk, all the way up to forming a blood clot in your calf that transitions to a pulmonary emboli. For those who don’t know what this means; a pulmonary emboli can kill you. For that matter a fall can kill you, although not usually immediately. There are a bunch of other outcomes to go with those two, but the point is that the stakes are high and swelling in the feet is something that needs to be managed as soon as possible.
Here are four things you can do without much assistance that can have a significant effect on swelling in the feet:
Use gravity to your advantage – Gravity is seriously underrated by most people. The role that gravity plays in our risk for falls, our posture, and even our circulation is usually not considered. The fact is that arteries in the legs usually are being helped by gravity, while veins are usually fighting against gravity. While your veins will eventually age and get tired, gravity is always working at full power. When you are sitting or standing, your veins are working in direct opposition to gravity. This is a big deal for many seniors, as much of your time is likely spent in a seated or standing position. The only time of day when your veins are not engaging in this fight is when you are laying down. When you are laying down, gravity is essentially turned off in regard to its influence on arteries or veins. Your veins can simply do their job without any resistance when you take gravity out of the picture. The issue I find with many is that you sleep 8 hours, but sit up or stand up the other 16 hours. You can see how the veins are constantly under the pressure to fight gravity with this time share. My recommendation is to take short bouts of laying down during the day. Lay down for approximately 15 minutes, two to three times per day. To make this even more effective, prop some pillows under your feet so that not only do your veins not have to fight gravity, but if you can get your feet higher than your heart, gravity is now actually helping your veins do their job.
Keep it moving – Aside from gravity, fluid moves more when you are moving. The squeeze that a muscle creates when it is working is called muscle pump-action. This muscle pump-action does just what it sounds like it would do; it pumps or pushes the fluid and blood through the veins back towards the heart. In many ways the heart is just a pump which pumps blood throughout our body. Unfortunately we do not have a matching pump in our feet to move the fluid back. For many of my patients, we create this pump with ankle pump exercises during which you simply move your ankles back and forth as if tapping your toes or pressing and releasing a gas pedal. This movement allows the muscles in the feet and the calves to contract and squeeze that fluid back. Beyond this specific exercise, any muscle pump-action helps the veins do their job and should help some swelling leave those feet. Walking utilizes multiple muscle groups that will generate a comprehensive pumping action that should improve your swelling.
Watch your salt intake – Salt may be the most underestimated food ingredient there is these days. I often have to clarify to my patients that I am not just talking about table salt or seasonings that you get from your pantry, but this includes the sodium that is naturally or unnaturally in the food before you even think about seasoning it. I think this issue is compounded by the changes in the foot industry that has loaded our foods with sodium, as compared to decades ago when people actually needed to put salt on their food. The “low-fat” movement caused many food manufactures to load up on sugar and salt to replace the flavor that you lose when you get rid of fat, and many who have used salt all of your lives were never given the memo. Meats such as pork chops, bacon, steak, and others are naturally high in sodium; and many of patients add seasoning that further increases the sodium count on these foods. The nature of sodium causes us to retain more fluids. Many cardiac patients will be on a sodium restriction for this reason, but in many cases the natural sodium count keeps their daily intake high even if they don’t put a dash of salt on their food. If you can keep your sodium and table salt intake low, there is a good chance you will see a reduction in your swelling.
Use compression garments – Once your veins show that they simply can not keep up no matter how many conservative measures you try, it may be time to simply give them some manual help. Compression garments basically squeeze the veins with enough force that it somewhat does their job for them. Veins are like straws in some ways, if you squeeze a straw, the fluid will push out of the straw. The role of a compression stocking or a compression boot is to create that pressure that will push that fluid through the vein. Compression stocking are the most common option and they are relatively cheap. Ask your Physician or Physical Therapist about to get a pair that you can wear some of the time or maybe nearly all the time to give your veins the help they need.
Hopefully you can execute all four of these conservative recommendation simultaneously to get the best outcome. The beauty of these remedies is that there are no side effects. You won’t have to worry about running to the bathroom every 5 minutes or having your blood pressure drop because your fluid pill is draining too much fluid out of you; you won’t have to worry about adding another man-made pill to processed by your body; and finally you won’t have to worry about being self-conscious about how your legs look or wearing flip-flops as your every day footwear because you can’t fit any of your shoes.
As always you should talk to you Physical Therapist or Physician about your specific situation. Swollen feet could be a sign of a condition that needs medical treatment, so if your feet are swollen, make sure you know why before you start yourself with any conservative management. Don’t let swollen feet stay in your life any longer than they have to. If you know your legs and feet are always swollen, address this issue today.
Back in the eighties Whitney Houston sang a song titled “The Greatest Love of All” and the line “I believe the children are our future” eventually transitioned from a song lyric, to a belief that guides much of our culture. I don’t know if this was the case every where, but I sure remember hearing that song at graduations and other ceremonies more than a few times. Similar to many pop culture acceptances, I don’t think people really stopped and thought about how little sense the lyric makes.
“Children” and “future” is generally an oxymoron. If you really think about it literally, the only being that has childhood in its future is an unborn child. Adults planning to have children may have an argument to speak in these terms, but I don’t think that the songwriter was coming from either of these perspectives.
Now that I have given it some thought, I believe the line would most accurately read “ I believe the seniors are our future”. The truth is that all of our futures involve aging and hopefully becoming seniors, if we are lucky. Even the children who the songwriter was referring to, can only look ahead to getting older. I wonder if changing the word “children” to “seniors” in this song could have shifted our culture to treating our seniors as well as we treat our children?
I have three children of my own and I love them dearly, so don’t get me wrong as I get into this. The group that we identify as “seniors” are as important, if not more important than the 17 and under group that we consider “children”. Not many will agree with this at first glance; maybe not even the seniors themselves; but give me a few minutes to explain and see if I can sway you.
Ask a young child “What do you want to be when you grow up?” and they will usually give you answers like a doctor, a police officer, an engineer or other well-respected careers. Ask a young child about the house they will have or the car they will drive and many will have it all planned out. Children decide pretty early what types of things they want when they grow up. Now ask a young child or even a young adult about aging. You might be surprised that not many will embrace the idea of growing older than 60 or 70 years old, and some will not even be able to imagine life beyond their 50’s. Why is this?
Children strive to achieve things that look good from the outside looking in, but things that look unattractive they shun away. Many of them don’t really take the time to process what it means when they say “I’m not trying to get that old”. I frequently respond to my patients who comment “I’m getting old”, that “it’s better than the alternative”. Surprisingly to me, I have now been around enough seniors to know that my opinion on this subject is not unanimous. Like some of their younger counterparts, many of the seniors I have met along my journey are ready for life to conclude. I can’t yet say that I can relate to that thought process, but I try my best to put myself in their shoes.
The fact of the matter is that there is a common thread between both the young child who does not want to make it past 70 years old and the senior who doesn’t want to push through another day. Our society has allowed aging to look really bad, and for some, to feel really bad too!
The structure of our society and the mindset that permeates our culture causes us to put arbitrary guidelines on aging that limit us as we age. Children don’t want to get old, simply because as a society we generally treat our seniors like second class citizens or handicapped individuals.
I often tell my patients about my mother as a motivating tool. When I get a patient who is my mother’s age who uses age as an excuse, I will talk about my mother doing pull ups or sit ups in efforts to teach them that age does not dictate your status, but rather your mindset and circumstances define what you can do. Many will ignore my examples as if my mother is an anomaly, but the fact is there are many seniors who are thriving into their 90s and 100s with a better quality of life than those in their 60’s.
This may seem like a shame for these individual person’s but as we move our focus back to the children, who are always watching; what do you think the image of a sixty year old who can no longer walk and needs to take 20 pills a day will do to an observant child’s mind? The idea is that children who we hope will age to become seniors one day, may never push toward their full potential, as they fear that the game is rigged in the end. The examples of seniors living in beat down nursing homes with substandard care; seniors taking countless pills per day and still feeling awful; and seniors being cared for by people we would not dare let take care of our children, contribute to the vision of what a child may believe their future will be if they grow old.
If we think about almost every thing we do in life, we usually consider the ending or conclusion of something to be as important or more important than the beginning. From things as simple as watching a movie; who will consider a movie good if it starts off good, but has an awful ending? What parent focuses heavily on Kindergarten through 8th grade, but as their child enters high school and college decides to take a hands off approach? What runner focuses on starting a race really fast but jogs to the finish line when they are behind? I could go on but the point is that the ending of nearly everything is generally as important or more important than the beginning, and Life is no different!
As a community, a country, a world we need to focus on our seniors more than we do currently. Now that the baby boomers are becoming the bulk of our seniors, people are starting to pay attention more. This attention is more due to the cost associated with not paying attention, but I will take it however it comes.
Senior citizenship can look really good if you play your cards right, as in many ways the age sixty-five is the beginning of life rather than the end. A successful senior doesn’t have to go to work, has the wisdom and maturity to enjoy all that life has to offer, and can likely enjoy the family they have helped to nurture along the way. At no other point in life do you have so much freedom. Childhood is ruled by parenting and lack of maturity; Teen years are ruled by parents, peers, and society; and adulthood is ruled by career, bosses, children, and the struggle of the climb. The initiation of senior life welcomes a life with no boss, no job, no kids, limited responsibility, and hopefully lots of time. I will enjoy my adult years, but I often tell my wife that I will be ready to move into a senior living facility or Assisted living facility at 50 years old, as I truly desire to have the life that I see some of my patients living.
On the other hand there are many of my patients who would make me absolutely fear getting older. I partially blame the individuals and I partially blame myself and the rest of our society. I know for a fact that if some of the lives I have witnessed cause me to cringe, that the young eyes that observe these lives on a daily basis want no parts of getting old.
I really do wish that these children who see the bad, could see what I have been able to witness. Some people really enjoy seeing landmarks and scenery that the world has to offer, but I like to see the people who the world has to offer. I am talking about 67-year-old woman living a life of leisure with custom workouts and long vacations; the 75-year-old man putting on a clean suit and going out looking for a new girlfriend; the 85-year-old woman going to New Orleans for the first time and asking me where to get the best Hurricane (alcoholic drink); the 98-year-old women who post the sharpest church pictures on Facebook while she plans her 100th birthday; and the 100-year-old woman who can out walk me while she explains why I should have olive oil every day. The privacy of healthcare doesn’t allow me to share the identity of these people, but I am talking about real people who make aging look really fun.
I pray that the type of people I have mentioned will multiply and allow themselves to be seen by the masses, but most importantly the children. I strongly believe that a child who believes the end of this game called life will be awesome, will work harder and smarter as they navigate through the game. Those who believe that the game can’t be won, will play the game recklessly and never reach their full potential.
I would like for all of the seniors reading this to send me a photo of you aging gracefully. Send your “Aging Graceful” images to Eric@DoctorPetty.com so that I can have a little more ammunition beyond my mother’s story to convince the children and your peers that aging can be a beautiful thing.
Before I start I will admit up front that this is a subject that I have been obsessive about for years. If it was not for my wife telling me she would un-follow me, this post would have been called doo-doo hands! I think this is the most accurate way to describe what about 95% of the population has based on our bathroom practices.
CBS news estimated that 95% of people wash their hands improperlyand I couldn’t agree more. I have been doing my own non-scientific experiment for years as I watch people routinely call themselves washing their hands by taking a 5 second rinse with water only. Sometimes I want to give people the benefit of the doubt considering that a man can urinate with little to no contact with germs if being very careful. On the other hand those who have obviously just stunk it up and proceed to the sink for a two second plunge have converted me to a “pound only” type of guy. This means that unless we are doing business, I am not shaking your hand–you can get a fist bump or pound only.
Years and years of locker rooms, gyms, and public settings had convinced me that people are just nasty; but as I have matured and met more people I have come to hope that ignorance is the root of this problem. Even those of you who try to wash your hands effectively sometimes fall short to common pitfalls that not only leave your hands dirty, but leave you with other people’s doo-doo on your hands!
If you lay eyes on this information, I hope you will convert over to the 5% who prefer to keep their business in the toilet rather than on their hands, on sinks, on faucet handles, on door handles, and everywhere else.
Washing your hands is simple but complicated. I know if my 4-year-old can do it, that everyone else can, but the fact is that people only take time for things that they deem important. Now I am not going to go on and on about the science of how washing your hands can save you from being sick, or save your family from being sick, or even saving your life and many others; but the Center for Disease Control (CDC) outlines this very well.
Hopefully health and life makes this an important enough issue to pay attention. I understand for those of you who still don’t think it’s that big of a deal. If this is you, I suggest you stop reading now, but be sure to go all the way with it and cancel all future vaccines and shots from your physician. While you’re at it just cancel your health insurance and never see a physician again, because not washing your hands properly but claiming to care about your health is like refusing to teach your children their ABC’s, but claiming you want to send them to college.
If you are still reading, here is all you need to do:
Have your paper towel ready first-this is very important in public bathrooms. If you do all of the following steps perfectly but then have to go touch the paper towel dispenser that Mr. Doo-Doo hands just touched before you, then you have just negated your entire process.
Use warm water-always use warm water when washing your hands to effectively clean them as temperature plays a part in killing bacteria.
Use soap-I don’t know who came up with the tap water wash, but depending on where you are the water may be dirtier than your hands. You need to use soap to wash your hands every time and make sure the soap lathers. The harder and dirtier the water is, the longer it will take to get a lather.
Take your time-I have heard a number of things to sing while you are washing your hands to reach the minimum time to kill bacteria and clean your hands properly–pick one and do it! Washing your hands for a few seconds is like not washing them at all.
THE FINISH IS THE MOST IMPORTANT PART!-Even the best hand washers can get caught up at the end of the process. Some fast food places have gone next level and have the attachment that allows you to open the door with your foot; some doors allow you to simply push with your body to get out. Whatever you do; DO NOT TOUCH THE FAUCET, THE PAPER TOWEL DISPENSER, OR THE DOOR HANDLE! If you followed step 1, you should have your paper towels ready and be using this to turn off the water and open the door if there is a handle. Remember that the 95% who are not washing their hands at all or not washing them properly are many times still touching those paper towel dispensers, faucet handles and door handles, so I consider touching these fixtures like putting my hand in a public toilet before the person has flushed.
The good news is that technology is helping us avoid many of these pitfalls with automatic soap and water dispensers, motion detected towel dispensers, doors that can be open without using your hands, and a number of other advancements. Many of us have no excuse to not complete the entire hand washing process properly.
Just like anything else in America, when it starts to cost us money we start to take notice. The CDC and health insurers understand the importance of hand washing with keeping our world healthy and keeping health cost down; and slowly but surely they will make sure that the public does as well. Why wait for them to give you a kick in the butt, when you have the information right here.
Wash your hands PLEASE! Help keep us all healthy, especially our children and our seniors who are most susceptible to the diseases that dirty hands spread.