A Heart-to-Heart on Cardiac Health

February is overrun with the hearts and flowers fanfare of Valentine’s Day. But long after bouquets have wilted and chocolate boxes have been picked over, our hearts should continue a steady beat.

The statistics about heart disease are staggering – it causes more deaths each year than all forms of cancer combined, even though it’s preventable for some people.  Doctors use American Heart Month to remind us to be good to our hearts, so we’ve asked cardiologist Dr. Jeffrey Alexis for some tips.

Scripts:  What’s the best ways we can help prevent problems with our heart?

Alexis:  We can all work to keep our hearts healthy by avoiding tobacco, eating right and getting more exercise.  Smoking damages so many parts of our body; if you’re addicted to tobacco, do whatever it takes to quit.  Miraculously, your body can reverse the damage caused by smoking.   Check out New York State Smokers Quitline for tips and access to resources.

Obesity also contributes to a variety of diseases that can hinder heart functioning. Stay trim, eat a nutritious, plant-based diet – with low-salt and low-calorie foods. Don’t drink too much alcohol.  Make sure you get enough exercise – 30 to 60 minutes per day. This protects against heart disease by:

• helping the heart work more efficiently;
• reducing blood pressure;
• decreasing the tendency of blood to form life-threatening clots;
• moderating stress;
• helping your body use insulin; and,
• helping you maintain a healthy weight.

Scripts:  How do we know if cardiovascular problems are beginning? Are there warning signs?

Alexis:  Pay attention to your blood pressure and cholesterol levels; it’s really important that you know these numbers. 

Regular blood pressure screenings start in childhood. Adults should have their blood pressure checked at least every two years. You may need more-frequent checks if your numbers aren’t ideal, or if you have other risk factors for heart disease. Optimal blood pressure is less than 120/80 millimeters of mercury. There are many inexpensive medications that doctors prescribe to help manage blood pressure or hypertension, and stave off heart disease, if your numbers are high.

Adults should have their cholesterol measured every five years. You may need more frequent testing if your levels are off, or if you have other risk factors for heart disease.  Doctors sometimes even check children’s cholesterol levels if there’s a strong family history of heart disease.  An ounce of prevention goes a long way.

Dr. Jeffrey Alexis is a member of the URMC Program in Heart Failure and Transplantation team, which cares for people with advanced heart disease. 

For more information about heart care, visit URMC’s Heart and Vascular Center or call 275-2877.

Cancer Survivors Look to Exercise for Better Life

A morning jog, fast walking, weightlifting and other forms of exercise were off-limits for most cancer patients as recently as 15 years ago.

Fast forward to today, and the latest research suggests that exercise is not only safe for many people with cancer, but might relieve the side effects of cancer treatments—and might even improve survival.

Researcher Karen Mustian, a University of Rochester Medical Center exercise psychologist and physiologist specializing in cancer, designs and studies exercise programs specifically for patients and survivors.

We spoke with her about the evolving story of exercise and cancer.

Scripts: How has the view of exercise for cancer patients changed?

Mustian: It was not that long ago that we were very hesitant to promote exercise for people with cancer, particularly those receiving treatments. We worried they were too sick to work out, and that exercise somehow would make them worse and compromise their ability to complete their treatments and recover.

By 1999, however, almost a dozen small studies suggested exercise might be safe and helpful for cancer patients. Since then, there’s been a dramatic increase in scientific evidence supporting exercise, ranging from simple walking, weightlifting, Tai Chi, yoga and even activities as vigorous as team paddling or dragon boat racing.

Scripts: So, given the changes in thinking, how much exercise do you recommend?

Mustian: Studies have shown exercise to be helpful for a wide variety of debilitating problems. It can improve cancer-related fatigue, sleep problems, depression, anxiety, physical function, immune function and overall quality of life. Experts now suggest that cancer patients and survivors should strive to reach the recommended public health guidelines for physical activity – either moderate-intensity aerobic activity for a minimum of 30 minutes, five days a week, or vigorous-intensity aerobic activity for a minimum of 20 minutes, three days a week.

But the story is not completely done. Some people treated for cancer will need exercise programs that are modified to ensure safety and effectiveness without making cancer-related side effects or other health conditions worse. At this point, scientific evidence does not provide the detailed knowledge to allow us to write explicit exercise “prescriptions” with precise doses, modified for specific cancer-related side effects. Still, we can make broad recommendations.

Scripts: What do you advise for your patients?

Mustian: First, I ask them what they like to do. Do they prefer to be inside or outside? If they like the outdoors, I encourage them to find a physical activity they can do in each season. In Rochester, even in the winter, this might mean cross-country skiing or simply getting outside and playing in the snow. It’s really important to find something you like to do.

I also suggest they work with an exercise professional who has additional training in the unique needs of people treated for cancer. I also encourage them to speak with their oncologist and ask if there are special limitations that they need to consider.

Some cancer patients come through my lab, asking about the amount of exercise they have to do to get rid of their fatigue. Unfortunately, there is no “dose” of exercise specifically designed to reduce fatigue. So, my staff tailors the exercise prescription to each individual, taking into account the baseline level of physical fitness, unique limitations and preferences, along with their goals and whether they’re interested in achieving improvements in mental health, physical health, or some combination.

It’s important to give people a range of options. Cancer patients and survivors have a lot of obligations to manage — jobs, family, and treatments. Asking them simply to add 30 minutes of exercise a day is not always practical or even necessary to achieve significant reductions in cancer-related side effects. For instance, if one person’s main goal is to lift depression or anxiety or fatigue, and they might be able to achieve that with as little as 10 minutes of exercise a day.

Scripts: Do we know exactly how exercise helps cancer patients?

Mustian: It is difficult to say.  To begin with, we don’t know precisely what causes the many side effects of cancer in the first place. We know cancer-related fatigue, neuropathies and cognitive impairments are real, but we can’t articulate a specific cause. We think they are linked to the disease and treatments. We also can’t describe exactly how exercise — either through biological or psychological mechanisms — alleviates these side effects.

It is likely exercise works because it’s what we call a “multi-targeted, multi- system” intervention. Just think: When you do something simple, like standing up from your chair and walking across the room, you activate your entire body from the cellular to the whole organ level, triggering multiple systems, including your muscles, heart, lungs, brain, immune system and more.

Scripts: Your research has shown that yoga can improve sleep and quality of life for cancer survivors. Is that the best exercise?

Mustian: Yoga is a wonderful exercise, but it’s not for everyone. Some people simply don’t enjoy it. For those who do, it helps to reduce several side effects associated with cancer and its treatments. Remember, while some yoga is “gentle,” that does not mean it is easy.

My study and others have shown that yoga works best for cancer patients when it integrates breathing exercises, mindfulness and meditative exercises, and imagery components with yoga postures. Collectively, those components seem to make yoga enjoyable. They’re also what probably make yoga successful.

Again, the people I see in my research studies are interested in living longer, but they also emphasize they want their quality of life to be high. They are not so much looking to exercise to gain extra years, even though they suspect it may help with this, but they are interested in using it to help them maintain their functional independence so they can participate fully in all they want to do. I think that is what most of us, even those of us lucky enough not to have experienced cancer, want for ourselves.

Karen Mustian directs the Physical Exercise Activity Kinesiology Clinical Research Core Laboratory, or PEAK Lab, at the Medical Center. For more information or to contact her, call 585-273-1796 or visit: http://www.urmc.rochester.edu/physiology-exercise-lab/index.cfm

 

Pregnancy: The 9-Month Marathon

Nursery décor.  Daycare. The just-right designer stroller.

When you’re pregnant, there’s no shortage of decisions.

But what about  the myriad of other health choices pregnant women make, almost unconsciously? Whether to reach for that second slice of pizza, or try an apple instead? If  they should take a post-dinner walk around the neighborhood, or camp out on the couch (with a book of baby names)? Late night TV, or a solid eight hours of sleep?

And of course, we’ve all heard the phrase “eating for two,” but what does that really mean? Is pregnancy really cart blanche to pound your way through a nightly pint of Haagan-Daz? Or does it, perhaps, suggest something more powerful – that expecting women have a unique responsibility to make health choices for not only themselves, but, by default, for their babies?

Sure, noshing on a nutrient-rich diet when you’re nauseated – or when you’re only craving french fries and pickles – isn’t easy. Neither is working out when you’re exhausted from growing a human.

Still, these healthy habits are incredibly important. In the clip below, we asked maternal fetal medicine expert Dr. Loralei Thornburg to explain why.

Craving Social Support for Your Pregnancy?

Researchers from the University of Rochester and Cornell University have teamed up to launch a major study, “eMoms Rochester,” that will assess how effectively electronic and web-based strategies can promote healthy behaviors in women both during pregnancy and immediately after their babies are born.

This innovative research effort is the first of its kind and part of a broader federal initiative to evaluate how technologies, such as cell phones, can be employed to improve health.  Women who participate will not only receive information on how to be healthy during and after their pregnancies, but could also receive up to $140 in gift cards as a small “thank you.”

Want more information about the “eMoms Rochester” study? Just visit www.emomsroc.org or call (585) 273-3090.

Shoveling: Tips to Help You Fight the Fluffy Stuff

With Thanksgiving festivities around the corner, it’s time to face the cold, hard facts: Mr. Snow Miser could start fiddling with the thermostat at any moment.

Luckily, those wee-morning driveway shoveling duties don’t have to be back-breaking – so long as we pace ourselves, practice smart body mechanics, and know when to call it quits.

To learn more about how we can shovel safely — and how we can avoid a trip to a back-pain specialist — we spoke with senior physical therapist Joe Griseta, who shares this sage advice:

• Don’t buy a shovel just because it’s on sale. Shovels aren’t one-size-fits-all; you have to consider the construction. Is it made of plastic or metal? (Metal, while durable, lends extra weight to the chore.) Is the blade right-sized for you? (Too big, and you won’t be able to easily hoist the load.) Is the shaft short enough for you to comfortably grip both the handle on one end, and close by the blade on the other? If not, look for something shorter.

• Don’t wait for the storm to pass. We know the cliché (“it’s like shoveling in a snowstorm!”), but it’s actually worthwhile to work in a few spurts as the snow falls. Don’t hold off until there’s too much to manage, or you’ll risk staining your heart and your back.

• Don’t “warm up” with a cup of coffee. Shoveling is a vigorous activity, and caffeine is a stimulant – so don’t mix the two. You don’t want your heart beating any harder than it has to, so stick with a glass of water.

• Treat shoveling as a sport. This may sound funny, but take a few minutes to warm up by walking in place and doing some stretches. Focus on breathing deeply. Hydrate. Dress in layers (so that you can peel them off easily if you start to overheat). And just like running, here’s a quick test to know if you’re working too hard: see if you can carry a conversation at the same time. If you can’t talk and shovel simultaneously, slow your pace.

Want more tips? Just watch the clip below. Want to learn more about our Physical Medicine and Rehabilitation programs? Click here.

Are Extreme Feats Good for the Heart?

On Sunday, the world’s biggest race – New York City’s ING Marathon – attracted two million sideline spectators and 315 million television viewers worldwide.

After watching gazelle-like runners cross the finish line, many of us might be inspired to try a bit more intense exercise ourselves…but we have niggling doubts. Are such vigorous feats even safe? Didn’t a recent study show that, in the midst of a marathon, runners can actually suffer temporary cardiac damage, upping their risk for sudden death as much as seven-fold?

We sat down with cardiologist Dr. Imran Chaudhary to learn what the average heart can handle. In the clip below, he gives some great tips; he also reminds us that “intense” exercise is relative. While a marathon might be intense for a professional athlete, a mundane winter chore like snow shoveling might qualify as “intense” for a couch potato.

Of course, don’t just take our word for it – Dr. Chaudhary encourages viewers, especially if they’re 35 or older, to talk with their own doctors before beginning any exercise program.

Dog Walking, Housework, the Tango: Ingredients for Healthy Aging?

It’s no state secret that frequent exercise is an essential part of healthy aging — but what counts as exercise might surprise you, according to geriatrician Dr. Bill Hall.

Hall, who directs the Center for Healthy Aging at URMC’s Highland Hospital, says that walking with a furry friend,  even learning an exotic dance like the tango are great options for older adults who are looking for ways to make regular physical activity more enticing.

Dr. Hall gives more insight in the clip below.

Want to learn more about living longer from Dr. Hall? He’ll present the morning plenary session at our annual Men’s Health Day event, a day of information and education geared at men 35 and older. Set for Friday, Sept. 10, at the Hyatt Regency Hotel downtown, the day packs discussions on aging, back pain, cardiovascular health and male menopause, plus health screenings, hands-on demonstrations, giveaways, healthy snacks, breakfast and lunch, and deluxe raffle prizes.

Legendary Chicago Bear running back and pro football Hall of Famer Gale Sayers will deliver the keynote address. Now retired from sports and in his 60’s, Sayers – a business owner, internet technology entrepreneur, motivational speaker and philanthropist – is a prime example of successful aging.

Tickets for the event are $15 and include free parking at the Hyatt Regency Hotel and all meals. Reservations are required. To make yours, call (585) 275-2838.