Ahad, 1 September 2013

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The Star Online: Lifestyle: Health


Busting fitness myths

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There are many fitness myths, and they are as persistent as mosquitoes on a warm, humid night. We take a look at some of the most common myths among dieters and gym-goers.

MUSCLE can turn into fat; lifting weights can transform a woman into a she-Hulk; and a thousand sit-ups everyday will give you Superman's abs.

Yes, fitness myths are many, and they are as persistent as mosquitoes on a warm, humid night.

People are always looking for shortcuts to cut the fat and get in shape with minimal effort. Such endeavours often involve "quick-fix" exercises, lotions and potions, and diets that promise to give you a sexy, sculpted look in a matter of weeks.

Most of these claims, however, have little or no merit. So let's take a moment to clear up some of the most common fitness myths.

You can spot-reduce fat

Let's start off with the king of fitness myths – you can reduce fat in one area by doing specific and targeted exercises. The misconception that sit-ups can help carve a set of six-pack abs, in particular, continues to be popular among gym-goers.

epa03674682 US Actress, Jessica Biel attends the Time 100 Gala, a celebration of 'TIME' magazine's 100 most influential people in the world in New York, New York, USA, 23 April 2013.  EPA/PETER FOLEY

Do lifting weights make women bulky? Think again. Ladies who lift weights at the gym, but do not train specifically to bulk up, will end up with that firm and fit body you see on movie stars like Jessica Biel. –  EPA

I actually know of someone who did 100 sit-ups every day, for want of a sexy midsection. Not only did it not work, he ended up with a slipped disc.

Here's the thing – you cannot spot-reduce your problem areas unless you go for liposuction. Without the aid of such surgeries, when you exercise, your body will draw fat from different regions, at different rates, depending on your genetic make-up.

Think about it, if spot reduction was possible, we would all be walking around with six-pack abs!

A better way to actually get them would be to perform compound exercises on a regular basis. These exercises utilise multiple muscles and joints simultaneously, and help improve overall muscular strength and tone.

Push-ups, pull-ups and squats are simple, but effective exercises that target the entire body, including the all-important rectus abdominis.

Cardio burns the most calories

First, just let me say that cardio is overrated as a fat-loss plan. Ironically, when it comes to losing weight, the first thing that most people do is head out for a run.

Sure, cardio has its benefits, and doing some amount of exercise is better than no exercise at all. But not only is cardio NOT the most effective way to lose weight, doing lots and lots of it can actually be counterproductive in your pursuit of "hotness".

The reason for this is because doing too much cardio can eat up your muscles. Your metabolic rate is determined mainly by the amount of muscle mass that you have, so losing muscle will result in your body needing fewer calories. This is an obvious cue for weight gain.

A more feasible weight-loss solution would be to start on strength training, and combine it with moderate cardio and proper nutritional intake.

While cardio exercises burn more calories than strength training during your workout, lifting weights actually torches more fat overall.

In a study published in The Journal of Strength and Conditioning Research, women who completed an hour-long strength-training workout burned an average 100 more calories in the 24 hours afterward than those who skipped the weights.

This means that their bodies continued to burn fat, even while they were at rest. The more muscles you have, the more fat your body will burn.

Lifting weights makes women bulky

False! Eating cupcakes make women bulky. Mention lifting weights, and the image that often comes with it is that of a professional female bodybuilder.

To begin with, no one ends up looking like a bodybuilder by accident. Also, women do not have enough testosterone (one of the main hormones responsible for muscle growth) to gain extraordinary amounts of muscle mass anyway.

The reason why these professional female bodybuilders are able to achieve a high degree of muscularity is due mainly to a rigorous work ethic that involves lifting very heavy weights regularly, good genetics, and a specific diet and/or supplementation to facilitate muscular hypertrophy.

Women who lift weights at the gym, but do not train specifically to bulk up, will end up with that firm and fit body you see on folks like Jessica Biel.

It's not all about appearances. According to the Mayo Clinic, strength-training exercises are important because they help counteract muscle loss that occurs with ageing.

Research shows that lifting heavy weights helps to maintain bone mass, especially in the high-risk group of post-menopausal women.

Muscles will turn into fat

This is like saying that cow doo-doo can turn into Wagyu beef. Muscle and fat are two different types of tissue, so it is physiologically impossible for one to turn into the other.

When you stop working out, you will lose muscle mass. The longer you take a break from exercising, the smaller your muscles will become. This causes a dip in your metabolism, and can result in a flabby appearance over time.

However, the change in appearance has nothing to do with one type of tissue turning into the other.

Obviously, the reverse can't happen either. Fat can't turn into muscle, it can only be reduced.

It all boils down to simple science; if the amount of calories expended in a day exceeds the amount of calories consumed, you will lose weight.

Although lifting weights can induce fat loss and facilitate muscle growth, it does not turn fat into muscles.

You can out-exercise a bad diet

Now, this is one myth that I wish were true! After all, all those hours at the gym SHOULD entitle me to eat whatever I want, and whenever I want to, right?

Reality could not be sadder. In fact, some of the top nutritional mistakes active people make include believing that exercise gives them the license to eat whatever they want, says the American Council on Exercise.

"Though active people typically pay close attention to their fitness regimen – proper cardiovascular workout, strength training and stretching – they may be making crucial mistakes in their diet," the council points out. This could ultimately affect the overall fitness benefits of an active lifestyle.

Sure, working out regularly means that you're burning off more calories than you would if you were just bumming around and watching TV. However, maintaining an active lifestyle doesn't change the fact that you still need to follow a healthy, balanced diet for optimum health and performance.

So, if you were to shave off some 500 calories from running for an hour, then proceed to gorge on half-a-dozen doughnuts (one contains roughly 500 calories), then you've basically negated your entire workout. Worse, you are refuelling your body with refined carbs, and you will likely feel hungry and want to eat more in the next hour or so.

You need to cut out carbs completely to lose weight

Ever since the low-carb, high-protein and high-fat Atkins diet took the world by storm in the early 2000s, carbohydrates have come away with a nasty reputation among dieters.

Many go as far as eliminating all forms of carbs – bread, rice, pasta, and even fruits and vegetables, believing that a carb-free diet is the golden ticket to weight loss.

While consuming too many carbs will obviously lead to tighter jeans, they are a necessary nutrient that your body needs to function normally.

In fact, 55-65% of your total daily calories should come from carbs, as recommended by the US Department of Agriculture (USDA).

Completely neglecting carbs will leave you tired, sluggish and hamper your performance. Plus, a diet low in fibre will also give you bad breath and constipation – not the ideal combination to the hot bod that you want to have now, is it?

Stick to good carbs that are also rich in fibre, such as oatmeal and whole-grain bread, to maintain a healthy and consistent weight.

Fiona Ho is a certified personal trainer and a fitness enthusiast who has a love-hate relationship with gourmet burgers.

Let's work together on skin health

Posted:

In conjunction with World Skin Health Day 2013, the Malaysian Dermatological Society urges us to join in as partners with healthcare providers in promoting patient safety.

PATIENTS and their family members can improve health outcomes by learning to recognise skin reactions caused by medications and alerting their healthcare providers promptly. This can play an important role in preventing medical errors and adverse events.

Recognising adverse skin drug reactions

While medications have relieved and cured many a symptom, it can rarely cause unwanted skin reactions and suffering. Although most of these skin side-effects resolve upon stopping the offending medication, severe forms of drug reaction can cause temporary disfigurement and even death, especially in those who present late and have other medical illnesses.

Patients and their family members should learn to recognise the different forms of adverse drug reactions and seek medical assistance as soon as possible. They also have a social obligation to inform and educate their family members and friends about these adverse drug reactions.

Hives is characterised by a rash with raised, itchy, red wheals on the surface of the skin.

Inform your doctor if you were started on any medication days or weeks before the occurrence of itchy red spots. It may be medication for infection or pain, or traditional complementary medication and health supplements taken for general well being.

Measles-like rash

Inform your doctor if you were started on any medication days or weeks prior to the occurrence of itchy red spots. It may be medication for infection or pain, or traditional complementary medication and health supplements taken for general well-being.

The rash usually starts on the face and gradually extends to the trunk and limbs. After stopping the medication, the rash usually settles by turning brown, with superficial peeling of the skin. This is the most common and least dangerous form of adverse skin drug reaction.

Red eyes with either mouth or/and genital ulcers, associated with painful skin rash

This is a severe form of drug reaction which necessitates inpatient care in a hospital. If the patient has not taken any medication prior to the illness, this condition may be associated with a herpes viral infection.

Swollen eyelids or lips

This usually occurs within minutes or one to two days after taking medication. Itchy skin wheals may be present. Danger signs include difficulty in swallowing, breathing or fainting.

Although these symptoms can rapidly improve with treatment, they may recur between four and 16 hours later. Other signs of drug reaction include measles-like rash with pustules, generalised red itchy swollen skin or generalised dry scaly skin, and painful reddish-blue round patches that heal with a blue-black stain.

The patient's role

Inform the doctor if you have:

> A history of rashes after taking medication – itchy or painful red rashes, swelling of eyelids and lips, painful red eyes with oral and/or genital ulcers, or round painful reddish-blue patches that heal with a blue–black stain.

> Itchy and red skin on the face and forearms after being exposed to the sun (photosensitivity/photodermatitis).

> Rashes after using gloves, costume jewellery, skincare products, etc (contact dermatitis).

> Family members with allergy to penicillin, sulphur drugs or anti-epileptic medications (familial drug reactions).

Inform the nurse before any injections or transfusion if:

> Your doctor has not indicated that you are going to receive this therapy.

> You are given a medication you are allergic to.

> You suspect that the medication may cross-react with the drug you are allergic to.

> The blood group stated on the blood pack is different from your own blood group.

Inform the pharmacist if:

> You are given medication you are allergic to.

> You suspect that the medication may cross-react with the drug you are allergic to.

> You are given more than the usual dose of your regular medication, but you were not informed of the change by your doctor.

> You are given medication the doctor did not ask you to take.

Know your medications and their possible side effects. Return to the clinic and inform the doctor if any side effects occur.

If you are given an ointment to apply on your lesions, ask the pharmacist about:

> The correct sites to apply it to.

> The correct way to apply it.

> When to stop applying it.

The role of family members and care providers

Accompany the patient if they have:

> Difficulty communicating with the healthcare provider.

> Difficulty hearing or seeing.

If patient has difficulty applying topical medication, learn from the healthcare provider:

> How to apply the medication properly, especially shampoos and solutions that require dilution.

> The correct site for each cream/ointment/solution.

> When to stop the treatment as prolonged use of certain medications may cause adverse effects.

> Ask the doctor about possible side effects that can occur and what you should do in the event of such an occurrence.

Avoiding problems

There are several steps you can take to minimise your risk of side effects. These include:

> Avoiding fragrant or scented skin care products if the patient has eczema or psoriasis.

> Protecting a patient from direct sunlight if the drug can cause photosensitivity, eg isotretinoin, neotigason, doxycycline.

> Protect the patient from direct sunlight and apply sunblock if they have a skin disease that is aggravated by sunlight, eg lupus erythematosus, photodermatitis.

> Do not allow the patient to drive if they are taking a sedating antihistamine.

> Have a stool and anti-slip mat in the bathroom if the patient is using a moisturising soap or ointment.

> Inform the doctor if the patient or their first-degree relative has a history of allergies.

> Alert the nurse if the patient's name tag/medication slip/appointment card does not belong to him/her.

A little effort made by the patient and family may prevent costly medication errors, and improve patient safety and health while on medical treatment. Let's work together for a better and safer healthcare environment.

This article is courtesy of the Dermatological Society of Malaysia, in conjunction with the 38th Annual Dermatology Conference to be held in Kuantan, Pahang, from Sept 12-15.

A bond that doesn't paralyse

Posted:

A young man with locked-in syndrome copes with the help of a wisecracking, no-nonsense nurse.

THERE wouldn't seem to be anything funny about Patrick Stein's situation.

The 20-year-old from Northfield, Illinois, former captain of the Loyola Academy swim and water polo teams, suffered a brain aneurysm in 2010 that ruptured during surgery to repair it. The bleeding caused a massive stroke at his brain stem, and left him with locked-in syndrome – a near-total paralysis.

He needs full-time nursing care, and had to fight to keep state payments to cover it.

He can't speak or swallow. All he can move are his eyeballs and eyelids, and to a small extent, one finger and one side of his face. He communicates by spelling out words with his eyes, moving them up to confirm letters read out loud from a specially designed alphabet board.

His mental faculties and his sardonic sense of humour, however, are intact. Which gives him one thing in common with Mary Jo Harte.

Harte became Patrick's nurse three years ago. They make an unlikely pair. He is a college-age North Shore jock, albeit a sidelined one; she is a middle-aged nurse, a gay woman with a brash manner who struggles with her weight.

But they both like a good laugh. And they have become wise-cracking buddies, joking in person and by texts, his dictated using the spell board.

Mary Jo Harte, right, talks to Patrick Stein, 20, in his home in Northfield, Illinois, July 23, 2013.  Patrick is a former water polo player at Loyola Academy who is now immobilized by Locked In Syndrome. He and Mary Jo use a spell board, where one reads off colors and letters, to speak and joke with each other. (Carolyn Van Houten/Chicago Tribune/MCT)

Harte talks to Patrick in his home in Northfield, Illinois. The paralysed 20-year-old and the no-nonsense nurse have developed a close bond.

The gay woman often plays the straight man. Like the time Harte was repeating some advice about rehabilitation that Patrick had been refusing to take. She thought she was finally making headway. To her delight, he started blinking, indicating that he wanted to talk.

She took out the spell board and starting reading out letters, with Patrick looking up every time she got to the one he wanted.

F. U.

By the time he got to "C", she got the picture. She laughed, even though "like an idiot, I'm writing it all down".

And all the times she has accidentally bumped her chest into Patrick's face? That has become one of their running jokes and comedic material for Harte, who performed stand-up comedy when she lived in California. She used her adventures caring for Patrick in a performance at a Glenview comedy club last year before a crowd that included Patrick and his friends and family.

She told of one of his joking emails asking her to send him a photo of her cleavage, and ended her act by taking out a cell phone and pointing it at her chest.

"There you go, precious," she told him as the audience cheered.

But even with a really funny nurse, and though Patrick is fiercely positive and brooks no pity, there is no avoiding the reality of his situation.

With his mother Colleen reading out letters from the board, he spelled it out.

IT SUX.

"That's not how you spell 'sucks'," his mother objected.

Ignoring her, he continued.

BUT I PUT UP WITH IT.

He is the same person inside his head, he said, but being paralysed is like being trapped inside a freezer.

Last December, the Steins were told that because Patrick's tracheotomy tube had been removed in October, he was no longer considered technology-dependent enough to be eligible for the Medicaid waiver programme that covers in-home nursing care for medically-fragile children, regardless of their parents' income.

The Steins filed suit challenging the decision, arguing that although the tube had been removed, Patrick still had the tracheotomy – the hole into his trachea – and so should still be eligible.

Harte, who segued from nurse to friend and advocate in September because she was no longer able to manage the physical demands of his care, started an online petition drive at change.org that garnered more than 105,000 signatures.

Patrick's plight prompted Governor Pat Quinn, who learned about it from a TV news report, to reverse the decision in July.

"Clearly it was a unique situation, and the governor directed his staff immediately to get to work reviewing the facts of the case and seeing what could be done to help him," said Quinn spokeswoman Brooke Anderson. The reversal ensured that the state will continue to pay for Patrick's nursing even after he turns 21 in December. A class action suit settled last month established that the state can no longer reduce funding to medically-fragile children when they turn 21 and age out of the children's waiver programme. Payments are to be based on medical necessity, not age.

The family withdrew its lawsuit.

Patrick's relationship with Harte is special. When they're together, "he laughs harder than you can imagine," said Colleen, a real estate broker.

"They laugh together; they cry together; they tease each other," said Patrick's doctor, Dr Philip Sheridan, a pulmonary and critical care specialist with NorthShore University HealthSystem. "It's beyond a nurse/patient relationship. It's a friendship, a bond of trust and honesty that's developed between the two of them."

Through two years of intensive therapy and great effort, Dr Sheridan said Patrick's condition has improved a little. "He is able to do some gestures; he can partially smile."

Still, "the prognosis for total neurologic recovery is not good. And the further you go out with any neurological injury and not make a recovery, the more difficult it becomes.

"I don't have a crystal ball," Dr Sheridan said. "That's why he, his family, everyone that supports him, and especially Patrick himself, wants to do anything and everything they can. He's not one to give up."

"There are people who come out of this," said Colleen. "We still have hope."

And Patrick and Harte have their friendship, and their schtick. – Chicago Tribune/McClatchy-Tribune Information Services

Kredit: www.thestar.com.my

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