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Run Your Way To A Longer Life 

Running healthResearch published in the Journal of the American College of Cardiology found that running, even in very small amounts, provides similar health benefits to those who run regularly throughout the week.

For their study, researchers examined more than 50,000 participants between the ages of 18 and 100 over a period of 15 years. Each individual was asked about his or her exercise habits, and 24 percent said running was oftentimes part of their routine. Participants were asked to report their average weekly running duration, but instead of tracking health benefits by how much running a person did, researchers simply compared runners to non-runners.

They found that regardless of whether a person ran 30 minutes a week of 4 hours a week, their risk of death was about 30 percent lower than non-runners. Additionally, runners were 45 percent less likely to suffer death from heart disease. Runners also lived an average of three years longer than their non-running counterparts.

“This study tells us that doing some exercise is clearly better than doing none at all,” said Clyde Yancy, a cardiologist with the American Health Association.

In addition to lowered death risk, running can help combat other health issues, like:

  • Obesity
  • High Blood Pressure
  • Diabetes

“Fitness largely negates adverse effects of other cardiological risk factors,” said Carl Lavie, co-author of the study. “Fitness may be the strongest predictor of survival.”

Lavie said ideally individuals would exercise for 30-45 minutes a day, but even a 5-minute run will reduce mortality risk.

“(The study gives) comforting information for people whose frequent excuse for not running is they don’t have enough time,” Lavie said.

Dr. Silverman comments

This article brings to mind some health advice I read from Chris Pratt, best known for his role as Andy Dwyer in Parks and Recreation. When promoting his new movie Guardians of the Galaxy, Pratt was asked how he was so successful in sliming down for some of movie roles. He said:

“6 months seems like a long time unless you’re looking backwards. What were you doing in February? Seems like yesterday. That was six months ago. So if you’re someone who was been struggling with their weight their whole life, all you have to do is just a few things everyday and remain consistent, and time will fly just as fast as it flies whether you’re working hard or not. So if you just cut the crap out of your diet and spend an hour a day doing something physical that will make you sweat, six months will pass by, you will feel better mentally, physical, spirituality; It’s all tied together.”

Pratt summed up in one paragraph what I’ve been saying on this blog for over two years. Just get moving. Once you start working out you’ll be like a rock rolling down a hill. You’ll be looking for that exercise high or that next compliment from a friend. That’s what this study says, too. Exercise, even in small amounts, can have a huge impact on your overall health and wellness.

Related source: Yahoo, USA Today

Permanent Surgical Screws: The Aaron Dobson Case 

Aaron DobsonLast Sunday was the final football-less Sunday of the year, and as teams make their way through training camp some players are still trying to recover from last year’s injuries. New England Patriots wide receiver Aaron Dobson is one such player.

Dobson suffered a stress fracture in his left foot at the tail end of the 2013 season, and he underwent an operation to have a “permanent” screw inserted into his foot. I put the word permanent in quotations because there seems to be some misconception about the functionality of the hardware. Fantasy football sites continue to hypothesize that the injury is very severe because doctors had to insert a “permanent” screw.

Sure, inserting hardware into a foot can be considered a major surgery, but in theory, there is no such thing as a permanent screw. The purpose of a screw is to permit the body to heal correctly. Once the bones heal and the foot is stabilized, the screws no longer serve a purpose.

This doesn’t mean that they should be removed; it just means that they can be. Calling it a permanent screw gives the impression that they will hold the bones in piece forever, and their removal would again leave the foot in shambles. This is not the case.

It’s similar to learning to ride a bike. Your parents put training wheels on your bike at first to facilitate learning to ride (and to cut down on falling). After a while you mastered it to the point where you didn’t need the training wheels anymore. The screws in Dobson’s foot facilitate healing, but after a while, they wouldn’t serve a purpose. The only difference is that it’s much easier to remove training wheels from a bike than screws from a foot.

Back to Dobson

Dobson has yet to be cleared for practice, despite being given an initial two-to-three month recovery window.

According to a source at the Boston Herald, Dobson didn’t begin running until July, meaning he likely won’t be up to full speed for some time. The doctors who are evaluating him on a regular basis have a better idea of how quickly he can amp up his workload, but in true Patriot form they are playing it close to the belt. He is currently on the Physically Unable to Preform list, and if he isn’t activated before the season begins, he’ll have to sit out the first six games of the season per league rules.

We Are The Medicine – Maggie O’Connor, MD

Dr. Maggie O'ConnorThe following piece was written by Maggie O’Connor, MD, a lead physician at Abbott Northwestern Palliative Care Team. Dr. O’Connor is retiring on August 5th, and as part of her departure she decided to share some words that touched many in the medical community. I found the piece so moving that I asked if I could share it on my blog. Below is what she wrote in a weekly newsletter to staff and colleagues.

I have written at least five draft versions of this and finally settled on three things I want to say:

  • Dying is not giving up, quitting or a failure.
  • We are the medicine.
  • Thank you.

A few weeks ago I said goodbye to a man I had known for a couple of months who I knew would either die or be discharged to a residential hospice before I could see him again. Diagnosed with cancer this spring, he had gone through a grueling course of chemo and radiation in hopes of shrinking his cancer, having surgery and being cured. A few days before I saw him in the hospital, he had learned that the cancer had spread and he was dying. He came into the hospital frighteningly short of breath. During my first visit, he said he couldn’t bear to go on living. He felt like he was only a burden on his family and of no value to anyone.

I gave him meds to ease his breathing, and we talked about the number of people I see who share his feeling of wanting to get dying over with, but often this is because they either feel so bad physically or have no sense of meaning or purpose. And yet, when they realize there are things they still want to say to their family or share with them, they feel that sense of purpose returning.

His eyes lit up. I knew he got it, and I left him with that. Over the next few days, his shortness of breath eased. My visits were not long. He was busy talking with family, passing on his wisdom. Sometimes I offered thoughts on the choices he was considering, but mostly I just popped in every day as he did his work preparing his family. He could barely get out of bed, but his manner was filled with grace and dignity. Dying is as heroic as battling the disease.

We are the medicine.

All the tests we know about, procedures we can do, diagnoses we make, physical care we provide and collaborative team-working we have are important and are part of what I love here at Abbott Northwestern. But there is another part of what we do that I see every day, even in the rush and distraction. I have seen it in the transport person who appeared to step back a little and wait without a care as an elderly woman—who didn’t want help, mind you—slowly walked up to the cart and stepped up on the stool that he provided. Once she was on board, he adjusted the covers and settled her in.  Or the rapid response nurse who paused before launching into the protocol to ask the patient and family about their hopes and goals for treatment, which happened to be just beginning to shift toward comfort. Or the doctor who, when I asked him what he saw ahead for a patient I was meeting, told me, “Nothing but tears.”

Whether we are racing or going easy, whether we can spend time or have only two minutes, whether our hearts are light or weighted down, the attention we give to the patient in the moment makes a mighty difference. The look in the eye, the anticipation of a need, the belief that we can help the situation – that presence is healing. We are the medicine.

So, time to say goodbye. Thank you for the jokes—good and bad, the camaraderie, and all the conversations about biking and dancing and kids and living life and, and, and…. I’ll miss you. You have been like the best of a small town community. I’m not leaving because I want to get away from here. I’m leaving because all sorts of riffs have been playing in my mind, and I want to see which ones are ready to become a melody. Thank you many times over.


Vitamin D – The Key to Successful Surgery

Vitamin DA recent study published in the Southern Medical Journal found that an increasing amount of Americans are suffering from Vitamin D deficiency. The problem with any deficiency is that most people are unaware that they aren’t receiving the proper amount until it’s too late.

With Vitamin D deficiency, a person is likely to develop some bone density issues. There are two main bone density problems I deal with on a daily basis:

Weak Bones Leading to Fractures – As bone density shrinks, the likelihood that someone will suffer a fracture increases. Eventually, tasks that were once routine could lead to fractures. Oftentimes I’m tasked with fixing and stabilizing these breaks, which leads me to the other issue.

Weak Bones Unable to Stabilize – When I’m preforming an operation, especially when I’m inserting screws or other hardware, it’s imperative I attach the piece to a strong and stable bone. Without a good, strong bone it’s very difficult to obtain fixation. Vitamin D deficient patients will have noticeable diminished strength in their foot and they’ll heal slower.

I have many examples of patients who have been referred to me who failed to heal after a primary fusion operation who were able to heal without surgery with a simple addition of Vitamin D. When discussing surgery with a patient I always stress the importance of adding Vitamin D to their diet in the days and weeks leading up to an operation. As an orthopedic surgeon who routinely identifies vitamin D deficiency, I can tell you right now that a short period of sufficiency makes my life a lot easier.

The study in the Southern Medical Journal suggests adding routine Vitamin D screenings to reduce the number of deficient patients, but that will likely be too costly an option to seriously consider. Instead, older adults and anyone who suffers an injury should make it a point to consume the daily recommended amount of Vitamin D. It doesn’t matter whether your daily Vitamin D comes from a big glass of milk or a supplement. What matters is that you are building strong and healthy bones.

Bigger Feet, Smaller Shoes Don’t Mix

Shoe ProblemA study by researchers at the College of Podiatry in the United Kingdom found that the average foot size continues to grow, but more and more people are forgoing professional help when purchasing a new pair of shoes.

Researchers say their findings show that the average shoe size has increased two sizes since the 1970’s, but many adults aren’t buying the right size shoe. In a study of more than 2,000 adults in the U.K., more than a third of men and nearly half of women admitted to buying shoes that didn’t fit properly.

Many men and women who buy ill-fitting shoes opt for a style with too narrow a toe box. Steve L. Haddad, president of the American Orthopedic Foot and Ankle Society, said these individuals may be doing permanent damage to their feet.

“It’s like when your mom said, ‘Don’t make that face, it will stay that way,’” he says. “It does actually stay that way when you put so much pressure on the toe over a long period of time.”

Online Ordeal

Many podiatrists say there are two main reasons so many individuals suffer from shoe-related foot pain. The first reason, which we’ve documented on the blog on numerous occasions, is that many people sacrifice comfort for fashion. Shoes like high heels and narrow-toed shoes may look great, but you’re doing severe damage to your feet.

The second issue is quite interesting. Many in the footcare industry say the rise in online shopping has led to an increasing number of foot issues. Driven by the need to find the best deal or search several stores in a short amount of time, many shoppers are turning to online stores for their shoe needs. The issue is that not all Size 8 shoes are the exact same size. Some brands run small, while others run wide. Shoppers justify this by saying they’ll return anything that doesn’t fit, but oftentimes they’ll ignore the discomfort because they really like their new pair of shoes and don’t want to go through the hassle of returning them and finding another pair.

Dr. Silverman comments

Ease continues to trump sensibility in today’s society. Sure it may be easier to buy shoes or visit a doctor via a videochat, but you’re much more likely to get the best advice by visiting a professional in person.

I understand all the benefits of buying shoes online, but your feet are too important to damage simply because you don’t want to take a trip to the store. If you’re truly determined to buy shoes online, I strongly recommend visiting a store first. Have a professional measure your feet, and try on some brands you think you’ll look for online. Note which brands are tighter and which ones run small so you can purchase the best fitting pair online.

Oh, and please send the shoes back if they don’t fit!

Related source: Wall Street Journal

Defending Champs Manchester City Lose Negredo to Foot Fracture

Alvaro NegredoDefending Barclays Premier League Champions Manchester City will be without Alvaro Negredo for up to three months after the striker broke the fifth metatarsal in his foot during Friday’s friendly against Edinburgh.

Manager Manuel Pellegrini said Negredo underwent a successful operation to address the damaged bone on Tuesday.

“Alvaro had surgery today [Tuesday] on his broken foot and he will probably be out for two or three months,” said Pellegrini. “It is a blow for us because Alvaro is a very important member of our squad, so obviously we will miss him.”

Negredo spoke about the injury to fans through his Instagram account.

“I want to let you know that it’s going to be hard for the next few months. I fractured my 5th metatarsal and will be out a few months,” said Negredo. “I will be back stronger than ever. I will return with a vengeance.”

Negredo had a solid debut season with City, tallying 23 goals in 48 games in all competitions. If the timetable is correct, a three month absence would rule him out for the first nine Premier League matches as well as three group-phase games in the Champions League.

The Premier League doesn’t begin until August 16, but that doesn’t mean Manchester City is taking it easy. The team is currently on a US tour, and if you’re looking to get your soccer fix now that the World Cup is over, Manchester City will make a visit to the Twin Cities in the near future. They square off against Olympiacos in the Guinness International Champions Cup at TCF Bank Stadium on August 2.

Dr. Silverman comments

There are two main types of fractures Negredo may have sustained. Since I’m not privy to the X-rays, I’ll explain both.

The first and most common type of fifth metatarsal fracture is known as an avulsion fracture. A fifth metatarsal avulsion fracture occurs when tension in the ligament and pressure on the foot causes a part of the bone to break. Oftentimes the fracture is non-displaced and doesn’t require surgery. That said, it can take 8 to 10 weeks to heal without an operation. If it’s displaced, an athlete can have screws inserted into the foot to speed up recovery time. This process usually allows the fracture to heal properly in about four weeks.

The other main fifth metatarsal fracture is the well-documented Jones Fracture. Simply put, non-surgical treatment of a Jones fracture is not ideal. The bone simply will not heal perfectly, even if the patient stays off their feet for a few weeks. The bone will heal in an unstable position, making it prone to aggravation and sometimes reducing blood supply to the area.

I typically address these injuries with an operation that inserts a screw down the center of the bone. This ensures the bone heals in a stabilized state, which speeds up the healing process. Surgical success rates approach 95 percent with this type of operation. Surgically stabilizing the foot will give Negredo the best chance to, as he put it, return “stronger than ever.” I wish him well on his road to recovery.

Related source:

Custom Mouthguards Help Reduce Football Concussions

Mouthguard concussionsA new study by researchers at the Academy of General Dentistry found that athletes who used custom-fitted mouthguards suffered fewer concussions and traumatic brain injuries (TBI) than athletes who wore over-the-counter mouthguards.

For their study, authors Winters and DeMont separated 412 male high school athletes from six area high schools into two groups. The first group of 220 players wore custom-fitted mouthguards, while the second group of 192 players wore an OTC mouthguard. All players wore the same type of football helmet, and every player and coach was given the same set of instructions about reporting and management of head injuries.

Researchers recorded data any time a mild or severe head injury occurred during practice or in a game. One of the main data points researchers focused on was the thickness of the mouthguard at the time of injury. After collecting all the data, researchers uncovered:

  • The average thickness of custom-fitted mouthguards at the beginning of the season was 3.5 mm.
  • The average thickness of OTC mouthguards was 1.65 mm at the start of the season.
  • There were 24 documented head injuries throughout the season.
  • 16 players who suffered a head injury were wearing an OTC mouthguard. The other eight were wearing custom-fitted mouthguards.
  • 3.6% of players with a custom-fitted mouthguard suffered a concussion/TBI, while 8.3% of players with an OTC suffered a similar injury.

Mouthguard Conclusions

The authors note that previous studies have already shown that wearing a mouthguard during athletic activity can reduce the likelihood of suffering a head injury, but they add that there’s been little research into which mouthguards are best. The authors believe their study shows conclusively that parents and athletic directors should recommend their athletes seek out custom-fitted mouthguards if they want to reduce the incidence of head trauma.

“The results of the current study appear to support previous findings that wearing a custom-fitted mouthguard may reduce the incidence of mild TBI/concussion in high school football athletes,” the authors conclude. ”The current study also suggests that custom mouthguards should have at least a 3 mm thickness in the posterior occlusal area to statistically reduce the incidence of mild TBI/concussion in high school football athletes.”

Dr. Silverman comments

This is a great study, but the results are not earth shattering. It’s logical that a more padded mouthguard will offer more protection than less padded counterparts.

The results make it clear that it’s worth it to wear a mouthguard. Spending a little more on a custom-fitted mouthguard is a small price to pay to significantly reduce your child’s likelihood of suffering a traumatic brain injury or concussion.

Cam Newton Still Recovering From Ankle Surgery

Cam Newton AnkleThe Carolina Panthers are hoping to make another run at the playoffs in 2014, but much of their success depends on whether or not Pro Bowl quarterback Cam Newton can fully recover from an ankle operation he underwent nearly four months ago.

The Panthers report to training camp on Thursday, but don’t be surprised if Newton is limited in the early stages of camp. He’s less than four month removed from surgery to repair a damaged ligament in his left ankle. All signs point to Newton being under center when Carolina opens their season September 7, but many pundits wonder if he’ll retain the mobility he flashed during the first three years of his career.

Newton led all quarterbacks in rushing yards in 2013, and he’s tallied more rushing touchdowns over the past two seasons than any other quarterback. Coupled with the fact that he no longer has veteran Steve Smith hauling in his passes, Newton may have a tough time living up to expectations after a breakout 2013 campaign.

We’ll keep an eye on Newton once training camp gets underway at the end of the week, but it’s likely that the team will take it slow with Newton out of the gate. Carolina’s first preseason game is August 8, and although most teams trot their starters out for at least one series, we wouldn’t be shocked if Newton didn’t see his first preseason action until August 17 when the Panthers take on the Kansas City Chiefs.

Dr. Silverman comments

According to one source, the operation Newton underwent was to tighten the ligaments in his left ankle. I expect Newton to have increased confidence in his foot once his stabilized ankle is fully healed.

I’m happy to hear that Newton went under the knife. Some people may say that it’s never a good sign when a young athlete undergoes a major surgery, but I don’t view it that way. Instead of risking even more damage by playing with unstable ankle ligaments, Newton made the proactive choice to correct the issue. Too many times it seems that I’m writing about athletes who decide not to stabilize their ligaments or have their ankle instability addressed. If he has to miss a preseason game or two, so be it. This will give him the best chance to stay healthy for the games that matter.

I wish him the best of luck this season.

Related source: ESPN, CBS

War on Obesity: Mexico Bans Soda & Junk Food Commercials

Mexico Soda banMexico announced that it has banned all high-calorie food and soft drink commercials from terrestrial and cable TV in an attempt to combat the growing obesity trend.

According to the press release, the restrictions will be into effect immediately but it will not be a round-the-clock ban. Government officials say the junk food and soda commercial ban will be in effect from 2:30 pm to 7:30 pm on weekdays and from 7:30 am to 7:30 pm on weekends. Similar restrictions will also be imposed on advertisements shown at movie theaters.

The health ministry said the new ban would affect about 40 percent of commercials for soft drinks and sugar-laced goods. Only food and drink products that “meet nutritional standards,” will air during the restricted airtime.

Proponents of the restrictions say the obesity epidemic in Mexico is getting out of hand. According to official figures, 70 percent of adults and 30 percent of children in Mexico are obese or overweight.

Not The First, Won’t Be The Last

Mexico is taking great strides to combat childhood obesity, but they are hardly the first nation to ban unhealthy commercials from television. The United Kingdom, Norway and some provinces in Canada have banned junk food advertising from children’s television programming.

While they’re not the first to ban junk food commercials, Mexico’s restrictions may do more good than most. Instead of simply banning junk food and soda commercials from programming aimed at children, Mexico is banning all unhealthy ads during the time periods when most children watch TV, including a 12-hour ban on the weekends. This means advertisers won’t simply be able to move their ads from SpongeBob Squarepants to a more family orientated show like Modern Family unless it runs later in the evening.

Dr. Silverman comments

This is a wonderful move by Mexico. The country has one of the highest incidence rates of diabetes, which is brought on by a poor diet. They need to make healthy changes.

I can’t say that it will completely reverse Mexico’s obesity epidemic, but it certainly has to move the needle in the right direction. The whole world will be watching, and if the program is a success, I would be shocked if other countries didn’t institute similar regulations.

Related source: BBC

Interrupted Sleep May Increase Dementia Risk 

Sleep DementiaStruggling to get a good night’s sleep? You may be putting yourself at a greater risk for developing dementia, according to research presented at the Alzheimer’s Association International Conference 2014.

For their study, researchers tracked a large cohort of mostly male individuals to see if interrupted sleep led to an increased likelihood of developing dementia. After examining the data, researchers concluded that participants with a sleep disturbance had a 30 percent increased risk of developing dementia, and that risk jumped to about 80 percent if the patient also suffered from posttraumatic stress disorder (PTSD).

“Our results further the very interesting body of data that sleep problems do seem to be a risk factor for developing dementia,” said lead investigator Kristine Yaffe, MD. “This is a very robust finding; it is not a huge finding, but it is robust.”

Sleep Issues

Researchers noted that a large number of Americans are afflicted with some type of sleep disorder, with some of the more common conditions being:

  • Sleep Apnea
  • Insomnia
  • Poor Sleep Quality
  • Inability to Stay Asleep or Fall Back Asleep

As we’ve noted in other sleep-focused blogs, sleep is a restorative process where your brain essentially cleanses itself after a hard day’s work. Throughout your day, toxins and other molecular deteris make their way into our brain cells. Sleeps acts as a “time out” for your brain where it can flush the toxins out of its system. As one previous study put it, when you are asleep your brain is functioning just like a washing machine. It’s full of dirty particles that need to be cleansed. If you don’t sleep long enough for your brain to complete this cycle, toxic particles can build up in your brain, which can eventually lead to dementia or Alzheimer’s disease.

Dr. Yaffe added that individuals who have a family history of mental health issues should take steps to ensure they are getting the necessary amount of sleep.

“I think it is very important because of course if one could prevent dementia by treating sleep problems by, say, using CPAP [continuous positive airway pressure] for sleep-disordered breathing or by treating insomnia, this would be a really wonderful intervention to maybe prevent dementia,” concluded Dr. Yaffe. “There’s a lot of interest in this as a possible area for intervention.”

Related source Medscape