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October 20, 2016 By Dr Anand Kulkarni 3 Comments

OSTEOPOROSIS

osteoporosis

How often have you come across your parents, grandparents or an elderly relative who has had a minor fall in the bathroom, slipped on the floor or had a terrible jerk while travelling on a bumpy road and sustained fractures of bones with a lot of pain, suffering and disability.

It has been noticed that the culprit for such incidents is OSTEOPOROSIS.

Osteoporosis is one of the most common disabilities encountered in the elderly. It literally means POROUS BONE. The condition results in reduced density and increased fragility of bones resulting in higher risk of fracture with minor falls, cough, sneeze, or minor bumps.

osteo1

The condition is observed worldwide. There are more than 10 million cases per year in India. In the USA about 55% of its population aged 50 years and older have Osteoporosis. One third have disabilities and one third regain their pre-fracture status. The health costs from fractures are tremendous amounting to billions of dollars annually.

It is very important to learn about osteoporosis because it is a ‘SILENT DISEASE’ except occasional bone pains. You may not know that you have osteoporosis until your thin weakened bones fracture in a bump or fall. The more common sites are Hip, Spinal Vertebrae and Wrist.

Clinical studies suggest that approximately 1 in 2 women and 1 in 4 men aged 50 years and older will break a bone due to osteoporosis. Such people in this age group usually present with chronic vague backache, loss of height, or stooping (Kyphosis) and should consult doctor immediately.

osteo2

THE RISK FACTORS ARE,

  • Advanced age
  • Family history of osteoporosis
  • Early menopause
  • Short Stature
  • Lack of Exercise
  • Poor nutrition with lack of Calcium
  • Lack of Vitamin D
  • Chronic Cigarette Smoking and Excessive Alcohol Consumption
  • Medical Illnesses- like hyperthyroidism, surgical removal of ovaries, long term steroid therapy and rare inherited bone disorders like Osteogenesis Imperfecta.

SCREENING is advised for all elderly above 65 years of age and Men and Women less than 65 years of age who have increased risk of fracture or already suffered from fracture.

DIAGNOSIS – is by bone scan which measures-Bone Mineral Density (BMD). The test called DEXA (Dual Energy X ray Absorptimetry) gives indication of likelihood of fracture due to osteoporosis.

It is also used to monitor response to treatment.

Result.— T score a)   ( -1) and above ——- normal

  1. b)   (-1) to ( -2.5) ——- mild bone loss or osteopenia
  2. c)     ( -2.5) and below —- osteoporosis

Our aim should be to prevent bone less or slow down the occurrence of Osteoporosis and encourage healthy bone mineralization.

Following measures are recommended:

  1. Healthy Nutritional Diet – To be incorporated during childhood and adolescent period itself with adequate calcium and magnesium intake. Calcium intake should be 1000 to 1200 mg per day. Common calcium rich foods are dairy products, cheese, ragi, broccoli, spinach, cabbage, green beans, soy beans, okra, dates, egg, salt water fish and fruits like orange, figs.
  2. Vitamin D intake of 800 IU per day is a must. We encourage exposure to SunLight and supplementation as Vitamin D requirement cannot be fulfilled through nutrition alone.
  3. EXERCISE plays a major role. Weight bearing exercises like walking, playing golf, Dancing, Hiking, Racket sports like Tennis, Squash promote mineralization of bones and make them healthy. Muscle strengthening exercises like weight lifting benefit by increasing muscle strength and Non- Impact activities like YOGA help in balancing, posture, agility of joints and benefit people with osteoporosis by decreasing the risk of falls and fractures.

Studies have also reported an increase in BMD in the spine of those who do YOGA regularly. Exercise should be tailored to the individual person based on BMD report and medical condition in consultation with health care professional.

osteo3

osteo    

  1. Other Lifestyle Changes – Have a Positive Attitude towards Life, avoid the use of tobacco and Cigarette Smoking, moderate alcohol intake if any, and measures to avoid falls like having railings, avoid slippery floors, having a mat or carpet on the floor helps etc.

Medications—You may also require osteoporosis medications to either build or maintain bone density. People have been treated with medications like Bisphosphonates, Hormone Therapy in Women, Calcitonin, Parathyroid Hormone. Stem Cell Therapy is also being tried out in severe cases.

But, any of these modalities of treatment should be undertaken in consultation with your Doctor. The doctor is the only one who will be able to decide the right treatment for you weighing the benefits and risks of the therapy.

Cultivate healthy living and enjoy life!

October 17, 2016 By Leah Burkhart 3 Comments

What is Coaching, Anyway?

fitness-trainer-north-hollywood

GOQii’s mission is to provide global access to health professionals who can help you to reach your best health potential. To do that, GOQii has cultivated a community of health coaches to help you on your journey towards better health habits and (by extension) a better quality of life.

Just one thing, though….

What is a health coach?

Is it, like…a guy who is going to blow a whistle at me and tell me what to do throughout the day?

Nope.

Oh…so it’s someone who is just going to tell me what to eat and when?

Not….exactly…no.

Well – what the heck is a health coach, then?

Coaching is a relatively new vocation so far as vocations go. A purist working in an organization like the International Coaching Federation would say that coaching is:“A professional who will partner with clients in a thought-provoking and creative process that inspires them to maximize their personal and professional potential.”

Huh?

Basically…using this definition – a coach is intended to facilitate a relationship whereby YOU make the decisions about what goals YOU want to commit to. The coach is there to help ask the right questions to help you land on the appropriate goal. The coach is there to provide insights about the patterns he/she notices about what you are doing now. Finally, the coach is there to provide accountability for you by checking in on you regularly and asking about the goals you set in motion.

They use skills like Motivational Interviewing (an evidence based approach that helps people navigate confusion and ambivalence about changes they want to make in life) as well as visualization exercises and Socratic questioning.

So..then…what is a health coach?

A Health Coach is someone who integrates the skills and techniques of coaching (motivational interviewing, socratic questioning, etc.) alongside health education (giving you information that you may not know in order to help you make habit changes that are appropriate for the kinds of results you want to have).

Your GOQii coach is a health coach. They are trained health professionals who are qualified to give you information if you need it. BUT -the philosophy we follow, here, at GOQii is as follows:

  • Most people actually already know what to do – the challenge is in implementing it. They really just need accountability
  • Health isn’t about revamping your entire nutrition plan or following complex exercise routines all at once. It’s about making sustainable changes over time that turn into life-long habits and evolve into robust health in the long-term.
  • YOU know what you need better than anyone. Our job as your coach isn’t so much to tell you what to do as it is to help you unlock your own potential.
  • Yes – occasionally, you really do need some information. You might have read an article about health that confused you. You might not be sure about the next best step. If that is the case – we can and will help you by providing options for first steps – but at the end of the day, YOU are in charge. YOU decide.

So What Will Your First Coaching Call Look Like? 

  1. First, your coach will ask you what your long-term BIG PICTURE goal looks like.
    • What do you want to see change in the next year?
    • What kinds of people do you envision spending your time with?
    • What kinds of actions do you want to be doing?
    • EXAMPLE: “I want to be able to run a marathon by the end of the year.” or “I want to lose 40 pounds by the end of the year.”
  2. Second, your coach will ask you your
    • What will that change get you that you don’t have now?
    • What is motivating you to make that change?
    • EXAMPLE: “I used to love  I felt empowered by it. And lately, I haven’t felt very empowered. I want to feel that way again.” Or “I want to lose some weight so that my knees don’t hurt as much. I am struggling to keep up with my little 3-year old. I want to be able to play and run and hide and seek right along with her. I feel like my current weight is making that challenging for me because exercise is causing me physical pain.”
  3. Third, your coach will get you to identify a check-point to try and commit to in the next month.
    • In the next month, what would indicate to you that you were moving in the right direction?
    • How far do you want to try and be toward that long term goal by the end of the month?
    • EXAMPLE: “I want to be able to run at least 2 miles without stopping.” Or – “I would really like to have lost at least a couple of pounds by the end of the month.”
  4. Fourth, your coach will help you to take that goal and frame it into actions. It’s one thing to say you want to run a marathon. But that takes practice. Sure you might want to lose weight. But both of those things are Now you need to figure out which actions you want to take to get you there!
    • What is a specific action that you can take between now and next week that will move you toward your monthly check-point?
    • How will you monitor your progress on that?
    • How might you arrange your environment to optimize your success?
    • Who will you recruit as your support for that goal?
    • How will you reward yourself every time you engage in this behavior?
    • EXAMPLE: “I will make a commitment to run 20 minutes per day at least twice this week. I’m not sure, yet, how long I can go without stopping. But I will run/walk both times and push myself as far as I am comfortable. To monitor my progress, I’ll check in with the GOQii app and check it off on the list when I have completed my task. In order to assure that I run….I will put my running clothes out the night before so that I do it first thing in the morning. I’ll keep my GOQii coach for support, and I will reward myself after my run by allowing myself a download of a song on my music device or will download a new audiobook every time I complete the weekly goal.
  5. Fifth – your coach will wind up the conversation by summarizing what you have committed to. He or she will ask if you have any questions or are in need of any resources. Perhaps you are looking for some workout videos that are free. Or maybe you are looking for a quick and easy breakfast recipe that you might look at after your run. Whatever the case, your coach can help point you in the right direction and hold you accountable. And after wrapping up, your coach will set a follow-up appointment with you for the following month.
  6. Finally – your coach will follow up with you every day during the week via text to make sure you have all that you need. If you have questions along the way, you can reach out. If you feel like you’re struggling to find the motivation, your coach can help you identify what will get you back in the game.

Make no mistake – You are always the one in the driver’s seat. But your coach is there to be your copilot along the way. Your coach will help guide you along your journey and hold you accountable to the habits you want to put in place in order to get to the destination you ultimately want to get to.

Good luck – and Be The Force!

October 4, 2016 By Dr Manali Rao 1 Comment

What is contraception?? Birth control or fertility control

csphonqik1

Why or how does it play such a major role in the betterment of a society? I have a little story to share. Like all women, my friend was also super excited about her wedding. It was the perfect match, the man was perfect with a well-paying job, loving family and most importantly he was a man with a heart of gold. Are you wondering how our discussion on contraception fits into the scheme of this here?

Let me explain. Here’s what happened! Couple of days before their big day, my friend’s to be husband made it very clear to her that he does not want to use any contraceptive. But, he did not want a child for a year at least. And, that he also did not want her to use a barrier method of contraception (female condoms) either! The other conditions laid down by her to be partner was also that she had to lose weight and remain slim for the rest of her life. This is kind of a heard story right? It does not come as a surprise.

Now, my friend was in atotal fix. There were so many terms and conditions and unfortunately she had no say in the matter. It was told to her and she had to follow it. She was not very keen on OCPs (Oral Contraceptive Pills) given their side effects like weight gain, nausea, sore or swollen breasts, lighter or heavy periods, mood changes, abdominal pain and headaches. So what other option was she left with?

IUCD (Intrauterine Contraceptive Device)-It is a small contraceptive device, often ‘T’-shaped, containing either copper or levonorgestrel, which is inserted into the uterus. They are one form of long-acting reversible contraception which are the most effective types of reversible birth control.

Was my friend aware that it is not advisable to use IUCDs unless you have conceived at least once? Nope! She wasn’t aware nor did she take any medical advice. So just to keep her husband happy, she opted for IUCD.

What happened next?!!

She started having adverse effects like excessive bleeding during menses, abdominal pain, and loss of weight and before we knew it, she looked under nourished.

What led to all this? Who was to be blamed? Was it the girl’s fault?  Or was it her husband, who had the notion that using a barrier method reduces the pleasure or the basic psyche that the girl must to do all that pleases her husband irrespective of what the consequences could be. I would say all three and most importantly it’s the lack of knowledge about contraception.

I am saddened by the thought that some people still think contraception is unnecessary as it decreases libido and that it’s a taboo. Well, trust me folks it is not so. When one uses contraception, they can avoid unwanted pregnancies and space planned pregnancies to promote optimal birth outcomes.

When a pregnancy is planned, one can start prenatal care, including increasing their intake of folic acid; work with the gynecologists to address relevant medical conditions, as well as substance abuse; and take other steps that lead to healthier outcomes for both the mother and the infant.

Pregnancies that are unplanned are more likely to be affected by delayed prenatal care, maternal depression, low birth weight, poorer childhood physical and mental health, and other complications. Breastfeeding rates are also lower after unintended pregnancies. We should also remember that most of the unintended pregnancies end in abortion, which affects both the parents psychologically and affects the mother physically.

When you look at the facts, contraception is a smart public health policy.

Of course, for some women, birth control is essential for other health reasons, including acne, fibroids, and endometriosis and to reduce problems associated with irregular or very heavy periods.

There are several methods of contraception:

Natural Family Planning (NFP): Couples can use NFP techniques like the rhythm method, basal body temperature, or the cervical mucus method to try to pinpoint when a woman is ovulating (fertile). To prevent pregnancy, sexual intercourse is to be avoided around the time of ovulation.

Other methods include barrier method (condoms), OCPs, IUCDs.

Remember, contraception plays an important role in the well-being of the family and the society as a whole.

Finally, don’t forget to consult your gynecologist for advice on the right Contraceptive method for you.

September 27, 2016 By Leah Burkhart 1 Comment

The Foods all Nutritionists agree are ‘Good For You’.

344361-vegetables

We all love reading about the latest trending super food. Whether its Acai berry, Maca powder, or cacao nibs…we wanna know what’s going to up our metabolism or give us that boost of energy we are absolutely itching to have again.

Well folks…let the drum roll begin. Because the REAL super food category of the hour is not some fancy-named upgraded coffee bean or a concoction of some super vitamin made in a lab somewhere.

It is…..

Plants. Specifically fruits and vegetables (Background applause!!!)

Wait….how come you’re leaving? Wait! No…seriously! they are SUPER good for you!

I know, I know. It’s WAY snazzier to imagine that the secret ingredient is some hidden oil or seed or fruit buried at the bottom of Indiana Jones’ cavern. We want the food to be a singular holy grail. But, that is just not the way of it.

No – I’m afraid your mother, and her mother before her and HER mother before HER knew what they were talking about when they said simply “eat your vegetables.”

We have the evidence to prove it. Here are just a FEW examples of the tangible benefits researchers have uncovered about eating more vegetables.

  1. Those who eat more fruits and vegetables (at least 8 servings per day) are 30 percent less likely to have heart disease. (https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/vegetables-and-fruits/)
  2. Those who eat more fruits and vegetables (specifically 8 servings or more) report greater levels of happiness and emotional satisfaction. http://sciencenewsjournal.com/eat-fruit-veggies-happy/
  3. Eating fruits and vegetables is associated with better weight loss and management outcomes:https://www.cdc.gov/nccdphp/dnpa/nutrition/pdf/rtp_practitioner_10_07.pdf
  4. Eating a high concentration of fruits and vegetables are associated with a reduced risk of cancer:http://www.cancerresearchuk.org/about-cancer/causes-of-cancer/diet-and-cancer/how-healthy-eating-prevents-cancer
  5. Those who eat as few as five servings of fruits and vegetables every day tend to live longer. http://nutritionfacts.org/2015/09/17/how-much-longer-do-fruit-and-vegetable-eaters-live/
  6. Eating fruits and vegetables can even improve your sex life:http://www.huffingtonpost.com/knowmore-tv/8-ways-eating-fruit-juice_b_9872488.html

So if you’re looking for the newest, latest and greatest super-food, you really need no look toward the dark corners of the Bermuda triangle. It’s right in front of you at your local farmer’s market.

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