Jumaat, 22 November 2013

The Star Online: Lifestyle: Health

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The Star Online: Lifestyle: Health

For your joint future


Want to avoid surgery? Take care of your joints.

AS much as Dr Sean Haslam loves performing surgery, he certainly wouldn't object if people would take good enough care of themselves to avoid – or at least postpone – it.

"Anytime we can get something to help patients without surgery," says the orthopaedic surgeon, "it's good for everybody."

But people don't seem to be paying attention. In the US, the number of knee replacements is up 165% in the last two decades and, according to the Journal Of The American Medical Association, could exceed 3.5 million by 2030.

Why pay attention to your knees, hips, shoulders and other joints?

Randi Schwartz swims under the watch of trainer Bryan Mineo in Dallas on Oct. 24, 2013. Schwartz has taken up swimming to help rehabilitate after hip replacement. (Brandon Wade/Dallas Morning News/MCT)

Staying pain free:Schwartz swims under the watch of trainer Bryan Mineo.

First, doing so could keep you out of the operating room. Second, when your joints don't hurt, you're going to feel better physically and mentally. Plus, you're better able to stand up, sit down, move around and do any number of ordinary tasks with the most minimal of groans and bodily creaks.

"The main reason for total knee replacement is for pain," Dr Haslam says. "If we can get rid of the pain, we can get rid of the real need to have surgery."

The keys to joint health for most people are, no surprise, losing weight and exercising. Some dramatic cases in point:

In a Canadian study, none of 125 obese knee-replacement candidates who lost 10% of their body weight went on to have the surgery, says Dr Haslam, who was part of the research team.

About half who dropped out of the study, which he stresses isn't yet published, lost "a significant amount" of weight and also opted not to have their knees replaced.

Because six to eight times your body weight is experienced through the knee, every 10 pounds lost means 60 to 80 pounds less pressure, he says. Plus, additional weight can lead to a greater risk in developing arthritis and a likelihood that mild osteoarthritis you might already have will worsen.

At the T. Boone Pickens YMCA in Dallas, trainer Shane McLean has clients who have "not great knees" and "not great shoulders", he says. "They're usually overweight."

The obvious solution to joint health is to lose weight. But, says Dr Haslam, "it's a vicious cycle. The formula is simple; the execution is difficult."

Patients tell him they can't lose weight because they can't work out, and they can't work out because it hurts. The less you move, though, the stiffer you get. And the stiffer you get, the more you'll hurt when you start moving.

But inactivity leads to loss in cartilage, which "allows some slide", between your bones, Dr Haslam says. Without cartilage, you have scraping of bone on bone, which is as painful as it sounds.

Losing weight won't replace cartilage; what's done is done. But it will make for less stress on joints.

Exercise also helps because it stimulates the release of synovial fluid. Think of the Tin Man and how a few squirts of oil helped loosen his joints and get him moving.

The more you move your joints, the more a release of synovial fluid you have, Dr Haslam says. "It bathes the cartilage."

That's important because cartilage doesn't have a blood supply. Instead, it depends on the fluid to provide nutrients.

Proper exercise technique is essential for healthy joints, successful workouts and weight loss, says McLean.

He has three herniated discs in his own back, so he empathizes with the many people who have pain.

"There are various things I do to work around the problem," McLean says. "Just because you have a bad back or bad knees, I believe there's something you can do."

Poor posture causes many of the joint issues he sees.

"People are hunched over," he says. "Shoulder problems usually stem from posture issues and incorrect weightlifting technique. When you have a hunched back and your upper body isn't underneath your hips, chronic conditions start to happen. It won't hurt today or tomorrow, but somewhere down the line it will."

Randi Schwartz, 52, says during the years she was running regularly, she ignored signs that something was amiss in her body. Not until her hip started roaring did she pay attention.

"I had whispers, and I kept running right through it," says Schwartz. "Big-time yoga – right on through it."

Several years of discomfort eventually led to hip replacement surgery recently. She no longer runs but walks for exercise. She's also built up her technique and stamina to swim – an excellent exercise for joints – for more than 3km without stopping. But the journey has been tough.

"This I did to myself," says Schwartz, who works in retail couture. "All those years of running and pounding and not listening."

Running isn't inherently bad for joints. A recent study published by the US National Center for Biotechnology Information found that running "significantly reduced" the incidence of osteoarthritis and risk of hip replacements. One reason seems to be that runners have a lower body mass index.

In general, though, Dr Haslam cautions that running and other higher-impact sports such as basketball and tennis are better started when a person is young. As you age and lose bone mass, your body calls upon the bone mass you've already banked, he says. Starting it later can cause more pain.

"My rule of thumb is that if you're not having pain, go ahead," Haslam says. "But if you start to develop arthritis and have pain every time you're 300 yards out and it gets worse, you may want to switch exercise."

He and McLean emphasize low-impact workouts such as specific classes, the elliptical trainer, a recumbent bicycle, walking and swimming – anything that maintains cardiovascular benefits without loading the joints.

"If you can only walk five minutes a day, walk five minutes a day," McLean says.

Dr Haslam likens having stiff joints to wearing a coat that's too tight. You feel increased pressure and can't move well. Simple motions are difficult and painful. He offers these tips for easing or eliminating that discomfort.

Think range of motion – The more range of motion you have, he says, "the more limber and less stiff you are." So stretch daily. Reach behind your head like you're fixing your hair, and behind your back like you're zipping a dress. Fully extend and fully bend your knees regularly.

Sit on an exercise ball – Moving around or standing is preferable to sitting, but not always feasible. So sit on an exercise ball while you watch TV or at your desk. "You're working your core, and that's great for your back," he says.

Consider supplements – Gluco-samine and chondroitin have beneficial effects on osteoarthritis, which is often due to loss of cartilage between bones. Plus, if you take calcium, make sure it has vitamin D. Without that, "calcium won't get into the bone", he says. – The Dallas Morning News/McClatchy-Tribune Information Services

Using stand-up comedy to raise ED awareness


Comedy is being used as a platform to deliver messages about erectile dysfunction among Malaysian men.

CAN'T get it up? It wilts within seconds?

Men laugh about it, but most are afraid or feel awkward to seek treatment when their wiener malfunctions.

Erectile dysfunction (ED, or impotence) is no longer an old man's disorder as an increasing number of young men in their 30s are having problems with optimal erection (also known as Grade 4 hardness).

ED occurs when a man can no longer get or keep an erection firm enough for sexual intercourse. Having erection trouble from time to time isn't necessarily a cause for concern. But, if ED is an ongoing problem, it may cause stress, relationship problems and affect self-confidence.

"Traditionally, Asian men are often shy to approach a sensitive topic like ED, but strangely, we find people often joke about it.

"So, I figured if we approach ED in a light-hearted manner, it would be better received by men and their partners. Most importantly, the comedy is a novel approach to a serious topics," shares Dr Jason Leong, a medical doctor and part-time comedian.

Hence, he is producing Get H4rd, Stand Up!, a first-of-its-kind comedy show that utilises humour as a platform to overcome the challenges of social and cultural sensitivities in discussing sexual health problems. The show brings together some of Asia's leading comedians.

The line-up, besides Dr Leong, who will be the host, comprises Vivek Mahbubani (pic, Hong Kong), Rishi
Budhrani (Singapore) and GB Labrador. – Filepic

The line-up, aside from host Dr Leong, comprises Rishi Budhrani (Singapore), GB Labrador (Philippines) and Vivek Mahbubani (Hong Kong).

The Get H4rd! campaign kicked off earlier this year as part of Pfizer Malaysia's educational efforts to create awareness that ED is a health condition that can affect men of all ages, especially those aged 25 to 45.

Dr Leong says that the show is "clean", as the jokes will be based on social observations.

"It won't be crude or distasteful," he reassures. "It's going to be a straight-up, intelligent, soft-sell comedy show, but only for those above 18. I try to be a family-friendly comedian and the ED topic never crossed my mind until Pfizer approached me to do this show. When you joke about something, it becomes easier to talk about it."

While Dr Leong, the winner of the 7th Hong Kong International English Comedy Competition, has not worked with the other comedians, he has seen them perform and is convinced the audience will react favourably.

"We're all men, so we'll have our different takes on it! And we tend to relate to Asian comedians better. ED is a global phenomenon as well as a lifestyle problem. It can be a subtle indicator of underlying problems such as not eating right, diabetes, hypertension, heart disease, etc. ED makes a man feel less like a man and there is a stigma attached to the disease," he explains, adding that some of his material came from his patients.

The tendency is for older men to seek medical advice to overcome the problem, but younger men keep quiet about it or seek help elsewhere. ED can lead to depression, anxiety or other mental health conditions.

Dr Leong, 28, has been a comedian for the past three years, and if he had the choice, he would give up his profession to make people laugh all the time.

"My doctor friends are always telling me to quit being a doctor and go after my dream, not the other folks. But, if there is a catastrophe, I'm a doctor first!"

The show will be in English and the doctor is busy preparing new material. Yes, he admits to bombing in a few shows, being in tears and picking up the pieces, but being a stand-up remains his passion.

He runs his jokes by his wife, his first line of defence, before honing it further.

"We're not here to sell any product during Get H4rd, Stand Up! It's purely an awareness show. ED is still very much a boy's club topic and not many females know about it. But, I can tell you the urologists will definitely be happy after the show!" he concludes.

* The 90-minute Get H4rd, Stand Up! show takes place from Nov 28-30 at PJ Live Arts Main Theatre, Jaya 1, Petaling Jaya, Selangor. Showtime is at 8.30pm and tickets are priced at RM40. Strictly for 18 years and above. For tickets, go to www.tix.my or call 017-228 9849 or 03-7960 0439.

Kredit: www.thestar.com.my

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