Fitness - What Is Fitness?

Aristotle helped define the standards of fitness 2,500 years ago when he taught that a thing that suits its purpose well is fit. Fortunately for us, the cardiovascular system, lungs, skeleton, muscles, endocrine system and all the other amazing components of the body function for our purpose: to live well.

Exercising aids fitness in numerous ways, each involving one or more of those systems.

Increased physical activity causes the heart to work harder than at rest. That increases blood flow, floods tissues with fresh oxygen and removes cellular waste products.

Exercise causes the lungs to draw in extra oxygen to bathe the tissues and help power the heart. Exhalation removes carbon dioxide, a waste product of certain biochemical reactions.

Regular, moderate exercise helps raise HDL (High-Density Lipoprotein) cholesterol (the 'good' type). It helps regulate blood sugar levels and converts stored fat into sugars that are used to provide energy. That process also prevents obesity.

The other benefits of a regular fitness program are more obvious and usually among the more direct goals of most people who make the effort: increased muscle mass, toned legs, buttocks, arms, stomach and healthier looking skin. Along the way, the individual receives the added value of greater strength, improved balance, higher endurance and (often) a better frame of mind.

Different types of routines will emphasize one area more than another. Aerobic routines help the cardiovascular and pulmonary systems, weight lifting focuses on building muscle tone and mass, yoga and pilates helps balance, flexibility and muscular control. But each of these, and several more, help more than just the intended focus group. The body is an integrated system and improving one area almost always has beneficial consequences for others.

All those benefits, at least to a moderate degree, can be had for minimal daily effort. Moderate intensity activity for 30 minutes per day, at least five days per week, will go a long way toward optimizing fitness.

A brisk walk, taking the stairs up one or two flights, a short daily jog, jumping rope and many other simple activities can be carried out with no special equipment or training.

More intense activity, done properly, can raise that level even further. A vigorous tennis game, a few laps in the swimming pool, an hour on the treadmill or exercise bike, or any of a dozen others, can raise your fitness to a peak with only a moderate investment of time and money.

For the truly committed there are, of course, a thousand and one classes at the gym, and every conceivable kind of home fitness equipment to fit a variety of budgets. A daily routine using free weights, followed by a good jog around the park will keep all systems functioning well.

And, as Aristotle taught all those centuries ago, to function well is to live well.

Abdominal Ultrasound

Abdominal ultrasound uses high-frequency sound waves to acquire images of the abdominal organs. Unlike x-ray, ultrasound is non-ionizing radiation, so it has no known negative effects on the patient. It is often used in conjunction with other imaging modalities. Ultrasound, x-ray, and magnetic resonance imaging (MRI) image the body using different technologies, so each may be helpful in determining different properties of a mass for a more complete diagnosis.

Preparation

Bowel gas hinders the visualization of the abdominal organs. When a loop of gas-filled bowel lies between the transducer and the organ being examined, an artifact called shadowing is seen on the image and obstructs the view of the organ. Patients who are scheduled for an abdominal ultrasound are asked to fast during the eight hours prior to the examination. This allows bowel gas to subside for optimal imaging.

Most likely, the patient will not need to undress for this examination. The patient's shirt will be pulled up around the chest and towels will be used to protect the clothing from the ultrasound gel. Ultrasound gel is water-based and will not damage clothing. Upon drying, it may look like a white splotch that can be easily removed.

abdominal ultrasound

Protocol

Several organs are imaged during an abdominal ultrasound. The pancreas is located in the upper, middle region of the abdomen. The liver is a larger organ that lies in the right upper quadrant of the abdomen. The size of the liver is measured. The patient usually lies on his or her back during the imaging of the liver and pancreas.

The gallbladder lies underneath the liver and must be imaged with the patient lying in two positions: on his or back, and on the left side. This allows the sonographer to differentiate between gallstones and polyps as gallstones will move within the gallbladder with the change in position. Lying on the left side also moves bowel loops toward the left side of the abdomen to create a larger sonographic window. The gallbladder wall and common bile duct are measured.

Bowel becomes more of an issue when imaging the spleen on the left side. The patient will most likely be asked to roll up on his or her right side to move bowel toward the right side of the abdomen. The size of the spleen is measured. It is usually enlarged in cases with mononucleosis. The kidneys may or may not be measured in images with the liver and spleen. A renal ultrasound is ordered if full examination of the kidneys is necessary.

Abdominal ultrasound is often used in children when radiation exposure is highly undesirable. It is often used to follow-up computed tomography (CT) or magnetic resonance imaging (MRI) examinations to better visualize liver ducts, to determine if a mass is cystic or solid, or to assess blood flow using Doppler.

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Acetaminophen for Low Back Pain

Acetaminophen, or Tylenol, may be a good alternative treatment for back pain. The main ingredient in Tylenol is acetaminophen. Classified as an painkiller, Tylenol is an nonprescription drug used to alleviate pain and decrease fever.

acetaminophen

Getting Acetaminophen

Acetaminophen is purchased in the form of certain pain medications, like Excedrin, Vanquish and Aspirin-Free Anacin. Tylenol is procurable in generic form, and in combination with other medications.

Acetaminophen is consumed for short-term pain relief for moderate to mild pain, and to temporarily relieve high fever. One may take acetaminophen for neck and back pain if one has muscle pain and/or chronic rheumatoid arthritis.

Acetaminophen impacts the brain. It acts by reducing the level of the central nervous system chemical that activates pain signals. It also wields a cooling effect by suppressing the prostaglandins (lipids derived from fatty acids) that play a role in the brain’s temperature control center.
Acetaminophen and Tylenol are found in tablet, extended release capsule, pill, liquid, or drop form. You may take acetaminophen with or without meals. It also comes in suppository pill form.

Precautions of Acetaminophen

The acetaminophen label discourages consuming alcoholic beverages and acetaminophen at the same time. An overdose of acetaminophen in combination with alcohol could cause liver problems, and possibly death. It's possible that liver problems could occur even after taking the amount recommended on the boxes.

Studies are being conducted to determine the circumstances in which this might happen. Patients with liver illness, and/or alcoholics should visit with their physician prior to taking acetaminophen, and should read the directions on the box. One should never consume more than the recommended quantity.

Allergic reaction to Tylenol or other components of the drug is possible. If you experienced allergic reactions to any of the ingredients listed on the package, don’t use it. Also, refer to your physician if you have an allergy after consuming a dose.

If your son or daughter is under two years old and has a cold, cough, or other respiratory issue, speak with your physician before administering him any drug with acetaminophen in it. Inappropriate use of Tylenol can bring about serious side effects, and can even cause death in younger patients.

References:
Chou R, et al. (2007). "Diagnosis and treatment of low back pain: A joint clinical practice guideline from the American College of Physicians and the American Pain Society." Annals of Internal Medicine. 147 (7): 478–491.
Chou R, and Huffman, LH. (2007). "Medications for acute and chronic low back pain: A review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline." Annals of Internal Medicine. 147 (7): 505–514.

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Aciphex (Rabeprazole)

Aciphex (rabeprazole) is a proton pump inhibitor used to treat GERD (gastroesophageal reflux disease) and duodenal ulcers.

aciphex

GERD (gastroesophageal reflux disease) occurs when stomach acid leaks out of the stomach and into the esophagus, resulting in heartburn and damage to the inner lining of the esophagus (erosive esophagitis). Aciphex (rabeprazole) is a proton pump inhibitor often used to prevent GERD symptoms.

How Aciphex Works

The active compound in Aciphex is rabeprazole sodium, which limits the stomach lining’s ability to produce gastric acid (hydrochloric acid). Reducing stomach acid alleviates GERD symptoms and gives the esophagus time to heal. When taken with antibiotics, Aciphex is used to treat duodenal ulcers.

Aciphex Doses

Aciphex is generally taken for four to eight weeks to relieve GERD symptoms and heal damage caused by erosive esophagitis. If this time frame is insufficient a further four to eight weeks is warranted.

Aciphex is also taken over long periods of time to treat chronic GERD and other conditions caused by excessive stomach acid. The medication is usually taken once a day, and can be taken with or without food. Aciphex pills should not be crushed, chewed or split as the pill is designed to release rabeprazole sodium slowly.

If you miss a dose of Aciphex, take the dose as soon as you remember. An exception to this rule occurs if you are close to your next dose, in which case skip the missed dose.

Rabeprazole Drug Interactions

Before taking Aciphex inform your doctor of any other medication, vitamins, or herbal supplements you take. You should not take rabeprazole sodium if you are allergic to proton pump inhibitor medications including:
  • Aciphex (rabeprazole)
  • Nexium (esomeprazole)
  • Prevacid (lansoprazole)
  • Prilosec (omeprazole)
  • Protonix (pantoprazole)
  • Zegerid (omeprazole).
Patients with liver disease should inform doctors of their condition before taking Aciphex.

Aciphex may interact with other medications, so be sure to provide your doctor with a complete list of current medications. Be sure to inform your doctor if you take blood thinners such as Coumadin (warfarin), Nizoral (ketoconazole) or medication containing cyclosporine such as Sandimmune or Neoral.

Pregnancy and Aciphex

Aciphex is not considered harmful to an unborn child, but expectant mothers should inform their doctors they take Aciphex. It is not known if rabeprazole sodium can be transferred by breast milk, and doctors may recommend stopping Aciphex treatment while breastfeeding.

Aciphex Side-Effects

As a rule, Aciphex is a well tolerated medication. Like any drug, however, the possibility of unwanted side effects exists. Side effects of Aciphex can include insomnia, headaches, diarrhea, upset stomachs, nervousness, rashes and itching. Seek immediate medical attention if Aciphex use triggers hives, facial swelling (including the lips, tongue and / or throat) or difficulty breathing.

Aciphex and Osteoporosis

While Aciphex is considered safe for long term use, a study published in 2008 suggests a link between long-term use of Aciphex and bone fractures.
Disclaimer: The information contained within this article is for informational purposes only, and is not intended to be a substitute in any way for care and treatment by a qualified health professional.

Resources

Drugs.com (updated 24 July, 2008).
RxList. (n.d.). Aciphex.

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Using Oxygen Safely While Traveling

oxygen safely while traveling

Get copies of oxygen prescriptions from the health care provider who diagnosed the need to use oxygen, and make sure there is not any other needed paperwork. Depending on the means of travel, make prior arrangements for oxygen at the end of the destination. With some forms of transportation oxygen may travel with you. Before traveling, call a local company to find out the requirements for traveling with oxygen. Leave plenty of time to make those needed arrangements.

Traveling By Auto with Oxygen

Just as if there is a pet in the car, it is necessary to keep windows cracked open for the air to circulate. When using liquid oxygen, place the canister upright on the floor or on the seat. Secure it with a seat belt or tie it securely to the back of the seat. Store any extra oxygen canisters behind the seat: do not put them in the trunk as temperatures there can rise too high. Do not smoke or let anyone else smoke in a car with oxygen.

Traveling By Bus or Train with Oxygen

Call the bus or train depot in advance and report the need for oxygen. Most likely, the oxygen tank can go along. Some transportation companies require a copy of the prescription prior to entry onto the train or bus. Being without oxygen, even for a short time, can be dangerous, so preparation ahead of time is crucial.

Traveling By Plane with Oxygen

Call the airline in advance to make arrangements: oxygen tanks may not be allowed on the airplane. However, airlines may supply oxygen for a fee. Be aware that the airline's oxygen will only be available on the plane; oxygen is required for the airport. Call the local medical equipment company to arrange to have oxygen delivered at the airport, as well as for any layovers during the flight.

Traveling By Ship with Oxygen

Most cruise ships will allow personal oxygen to come along. It is advisable to call the cruise ship prior to boarding, and make arrangements. The shipping line will need a letter from a health care provider including a medical history, and a copy of the oxygen prescription. Arrange to have oxygen delivered at the ship, as well as to any layovers during the cruise.

Traveling Dos and Don'ts

Always keep open flames at least five feet away from stored oxygen or oxygen in use. This includes cigarettes, pipes, matches, candles, or fireplaces. Keep oxygen at least five feet away from any other source of heat like space heaters, furnaces, and radiators. When not in use keep the oxygen canister completely turned off. It is advisable to keep a fire extinguisher at hand, and know how to use it.

Never smoking near oxygen. Post a "no smoking" sign near oxygen tanks. Never use oxygen while cooking with gas. Do not spray air freshener or hairspray near oxygen: aerosols are highly flammable. Using vapor rub, petroleum jelly near oxygen is dangerous as oil-based products are flammable as well.

A good place to start making plans to travel with oxygen is with a local supplier. Chain suppliers usually can help by communicating with their offices in other towns to make arrangements. Many are part of a network that can make a trip comfortable and safe.

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Lyme Disease and Humans

Lyme

Lyme disease is probably the most common vectored disease in the world. Its causative agent is a spirochete: Borrelia burgdorferi. Borrelia normally requires both a tick host of the Ixodes genus and a warm-blooded host to complete its infectious cycle, but insects may occasionally also be vectors, transmitting Borrelia from one host to another.

Spirochetes undergo multiple changes as the ticks are biting their warm-blooded host. But these pale in comparison with the changes that occur inside a human.

Inside the Human

If left alone once inside a warm-blooded host, spirochetes move through the blood stream, reproduce slowly, produce blebs, change shape, and move into the host's organs and tissues where they give off toxins that often reduce host mobility. Reduced host mobility increases the probability that new ticks will find and bite the infected host and transfer the spirochetes to more vertebrates.

Spirochetes Release “Cluster Bombs”

Each active bacterium releases into the body thousands of infectious packages, called blebs. Although the bacteria reproduce only about once every two weeks, these blebs are produced almost continuously, are hyper infective and appear to cause most of the symptoms of LD. Blebs are a sort of smoke screen against the immune system. As immune cells and antibodies are attacking the blebs, the bacteria (hidden inside other cells) can continue to release more blebs without injury. Since blebs are not true cells, they may be destroyed without eliminating the actual bacteria.

Borrelia Attacks our Immune System
Our immune response is slowed down and even rendered ineffective by bacteria that can rapidly change their surface characteristics. Borrelia's ability to swiftly generate new combinations of surface proteins while the tick is feeding makes it important to remove I. scapularis ticks early in the feeding bout. But it is even more important to be treated as soon after infection begins as possible. If Borrelia are given time to change their surface proteins and develop other defenses against our immune systems and antibiotics, Borrelia may become able to escape our most concerted efforts to eradicate them.

Spirochetes are Shape Shifters

As if the arsenal of attack by ticks and spirochetes does not perplex the host's immune system enough, the bacteria will change their characteristics when the host marshalls defenses against the spirochetes. They seem to have programs that instruct them to:
  • Produce new forms of both surface protein groups (vlsE and Osp).
  • Change shape and discard surface proteins.
  • Move from the blood stream into body fluids.
  • Enter cells and become invisible to antibodies and killer T-cells.
  • Destroy immune system cells.
  • Hide behind the blood-brain barrier where many antibiotics cannot penetrate.
There are no fewer than three shapes of Borrelia, two of which are highly infective:
  • the spirochetal form,
  • an L-form that discards its cell wall and integrated surface proteins, and
  • a cystic form that enters cells and becomes inactive.
The infective shapes of Borrelia disrupt cell function, destroy connections between them, and eventually kill the cells. Being inactive, the cystic form is resistant to antibiotics, does not present antigens to the immune system, and escapes destruction from most medications. The few medications that are active against the cystic forms are dangerous.

Neurological Damage

Most neurological damage in the body is caused by the L-form of Borrelia. This form easily enters cells, can break into small round cells (cocci), and in the nervous system, disrupts connections (synapses), destroys neurons and their supporting tissues, and produce holes (lesions) in the brain that cannot be repaired. These changes become manifest as:
  • altered sensory perception,
  • forgetfulness,
  • muscle weakness,
  • slow or rapid heartbeat,
  • low or high blood pressure,
  • personality changes,
  • dementia – sometimes extreme,
  • “Lyme rage,”
  • and many others.
A full blown disease with these characteristics needs a multi-pronged attack to be eliminated.

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Lyme Disease and Ticks

Lyme

Most people have been or know someone affected by Lyme Disease. The ticks that transmit this disease are found in all of the US, Canada, Mexico, European and most Asian countries. When they bite, they can inject the bacteria that cause Lyme disease and other diseases.

Early Symptoms of Lyme Disease

Lyme disease begins after a tick bite. This is sometimes followed by a bulls-eye rash, becoming exhausted in the middle of the day – totally incapable of continuing without collapsing in bed, flu-like symptoms that may or may not go away, or suddenly developing arthritis. Since any of these symptoms could be something else, diagnosing LD is difficult.

Diagnosis Difficulties

The bulls-eye rash is diagnostic for Lyme disease and treatment often begins with no further testing, but almost 50% of people affected have no or atypical rashes. When Lyme disease is suspected, doctors send blood samples for testing. This test looks for antibodies in response to the bacterium. If the test is positive, the standard treatment is two weeks of antibiotics. If it provides a false negative diagnosis (which it does about 40% of the time), the patient may be sent away and not properly treated for some time and require extensive treatments to cure the disease. Which antibiotics, the duration and mode of administration, and the bacterium's response to treatment vary widely.

Borrelia burgdorferi and its Effects
Borrelia burgdorferi, is a spirochete transmitted by the black-legged tick, Ixodes scapularis (previously called I. dammini). Once infected, spirochetes travel through the blood stream and affect many organs, often burrowing into the cells, and wreaking havoc wherever they settle: They trigger arthritis; cause heart arrhythmias, (rarely) heart attack, weaken cardiac muscle; alter sensory input, motor control, disrupt thought processes, may cause paralysis of facial muscles (Bell's palsy) and other muscle groups; trigger muscle pain (myalgia), weakness, and sometimes tetany; produce rashes – often with a bullseye appearance; and can cross the placenta, causing fetal abnormalities.

The Ticks

The tick's role in transmitting Lyme Disease was noted shortly after the identification and naming of Lyme Disease in 1977. Ticks usually hatch without internal parasites, obtaining them over a period of several days as they feed from previously infected hosts.

About 50% of black-legged ticks carry B. burgdorferi. Almost 20% carry the agent for Babesiosis or Ehrlichiosis, and half of this second group carries two of the three agents. As treatments are different, doctors often test for all three agents when a patient presents an infection after a tick bite.
Tick development includes four stages: egg, larva, nymph, and adult. As sit and wait predators, they feed only once during each stage after the egg. They climb vegetation and hold on until something knocks them off or they are carried away by an animal.

Tick Development: Three Stages

Larvae, the size of the dot in the letter “i,” usually hatch in the spring, wait low in the vegetation, and feed on small mammals or birds. Larvae molt about three months after feeding, and the nymphs climb about a foot off the ground to feed on medium or large mammals and birds that walk by. At the end of the summer, the nymph molts to the adult stage.

Most feeding adult ticks are females. Males attempt to mate shortly after molting, may not feed again, and die soon after mating. A female must feed so her eggs can develop, and can live up to a year without feeding. She only becomes sexually receptive after engorging while feeding for at least a day. After mating, she swells to ten times her already swollen size, all the time transferring bacteria to the host. See the article “Lyme Disease: Warding Off The Disease” to find out how to reduce your chances of obtaining Lyme disease.

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