Nancy Alexander

By Nancy Alexander

Doesn’t that sound awesome?!  Independence Day… now this is a day worth celebrating.  Is there anything more empowering?  Is there anything more meaningful?  Is there anything more important than this?  No, I don’t think so.

Today is July 4th, otherwise known as Independence Day.  Independence Day is a federal holiday in the United States commemorating the adoption of the Declaration of Independence on July 4, 1776.  It represents the birth of the United States of America as an independent nation. Thank you to all in our armed forces who fought and are fighting for our freedom.  I do not take your efforts lightly.

 

 

 

 

 

On a personal note, I am grateful for my independence.

I am grateful to have a choice as to how I live my life.

I am grateful for being an American.

I am grateful for being a woman.

I am grateful for Title IX.

I am grateful for making it into my 50’s.

I am grateful for my family.

I am grateful for my friends.

I am grateful for my health.

I am grateful for my ability to dream.

I am grateful for my dreams for the future.

I recently left a salaried position at an awesome organization to make my living in my own business.  I recently wrote a book and I am about to publish it to share my story with the world.  With my story, I hope it helps others who are going through some challenging times to see that their path is worth it.  I am thankful beyond measure.

I hope you can see the value of living with a grateful heart.  Even if it’s just a small part of your life.  See it, feel it, focus on it.  It will grow if you do.

I hope you can see the value of dreaming.  Go ahead, dream!  There are no limits – only the limits we place on ourselves.  Free yourself and dream.

We all have these choices, every day.  Every day is Independence Day, if you let it be.

Happy Independence Day!

About

by Nancy Alexander, PT

I was reminded of Bob recently when I saw one of those inspiring quotes on social media.  It read, “Life is all about how you handle Plan B.”  We’re all dealt with change in life, aren’t we?  Some things just don’t go as planned.  Sometimes we get some news that has the potential to rock us to the core.  Truth is, we have a choice as to how we respond.

Bob is 69 years young and retired five years ago.  His wife retired about a year ago.  About two years ago, Bob started noticing some changes to his body.  He self-diagnosed it as restless leg syndrome.  He and others also noticed his walking changed.  His feet were wider apart and his arms were up in the air beside him.  His facial expression changed.  Actually, it didn’t change — that was the problem.  It was flat with little expression at all.  He had bouts of constipation that could not be explained.  He is a frequent swimmer and he began to notice that he couldn’t flutter kick like he used to.  “I sunk,” Bob said.  “I just didn’t have the strength or coordination to do it.”

His symptoms were explained about one year later when he was diagnosed with Parkinson’s Disease.  “That is not how I planned to spend my retirement,” Bob noted.  I asked Bob what his initial reaction was.  “I wasn’t surprised,” he said.  As a pharmacist, he had known something wasn’t right and had an idea what it might be.  Bob revealed he has an uncle with Parkinson’s.  His younger brother has Parkinson’s, too.

Bob is a doer.  He is very active and currently swims at the Canandaigua Family YMCA three days per week.  He performs cardio exercise two days per week.  He walks about five miles per day.  He is active on the weekends, too.  Bob has always been active physically and professionally.  He retired from UR Medicine’s Thompson Health after 30 years of service.  He was Director of Pharmacy and Cardiopulmonary Services.  He has also served as Executive Director of Therapeutic Services at Thompson Health.  He contributed to St. John Fisher’s Pharmacy program for many years including serving on the Pharmacy Assessment Committee and multiple search committees.  He was awarded a Preceptor of the Year there.  “I really enjoyed being at St. John Fisher,” said Bob.  “That was fun and I was appreciated.” 

Bob served on the Board of Directors for the Canandaigua Family YMCA for approximately 20 years.  He served as President of the Board for three years, and Vice President for three years.  He is currently President of the Thompson Health Guild and has served there about five years.  He currently works at the Habitat for Humanity’s Re-Store in Canandaigua.  He enjoys woodworking and has a shop at his home. 

He and his wife started travelling more after they retired.  They visit family across the United States and have been on many cruises.  They’ve been to Hawaii twice and plan to go again.  It is easy to see that Bob has contributed greatly to the health of his community.  His accomplishments are many.  His achievements are extensive.  His attitude, however, is arguably his greatest asset.

“When I received this diagnosis, I decided I could feel sorry for myself or move on,” said Bob.  “I’m not going to change it.  It is what it is.  Sitting and stewing is not going to help.”  He remembered telling his younger brother when he was diagnosed with Parkinson’s Disease that it wasn’t a death sentence.  “Now,” Bob said, “I have to remind myself to take that same advice.”   Bob added, “Other people have it a lot worse than I do.  To me, it’s an easy choice.  I really don’t feel any different.  I can still do all the things I enjoy – I just get tired a little more quickly.  I’m so thankful I’m turning 70.”   

Soon after being diagnosed with Parkinson’s Disease, Bob took action.  He enrolled in treatments called LSVT-LOUD and LSVT-BIG.  Bob said both helped him greatly.  (For more information, visit https://lsvtglobal.com/patient-resource)  Bob attended a local support group but hasn’t been able to go much as it conflicts with his hours at the Re-Store.  “I walked in and was surprised there were three other guys I knew there.”  He started journaling about having Parkinson’s Disease and notes observations he’s made and writes about how he feels about what is happening.  He is staying active and takes his medications.  “It is so important for me to continue exercising and to just keep moving.  I feel better when I do.”

Bob is making this adjustment look easy.  I’m sure it’s not.  He could have become angry.  He could have complained.  He could be bitter.  He is none of those things.  He is the same kind and caring man he has always been.  He made a choice to keep on living.  I’m sharing this story because Bob wanted to share it.  He hopes that others who are dealt a challenging diagnosis can learn to live with their condition, and, more importantly, live a good life at that.  “As long as you can keep doing what you’re doing, do it!” said Bob.  “Know your limits – but do what you can.” 

As for Bob, he continues to exercise five days per week and looks forward to spending time with his wife, traveling, seeing his grandkids.  “I’m going to keep going.” 

Plan B is looking pretty good to Bob.  Well played, Bob.  Well played.

http://www.agingwellnow.com/about/

by Nancy Alexander, PT

When researching osteoarthritis recently online, I was blown away by all the ads and articles touting the next miracle cure for arthritis.  “Heal your joints now!”  “Made with safe, patented nutrients!”  It went on and on.  I had to scroll down to get to the information I really needed.  Please know there is no magic cure for osteoarthritis (OA).  What’s important to know is that there are ways to manage this condition to help reduce pain and enjoy activities better.  Furthermore, these strategies will help you lead a healthier lifestyle for the long term.

 

Sometimes called degenerative joint disease or degenerative arthritis, osteoarthritis (OA) is the most common chronic condition of the joints, affecting approximately 27 million Americans.  OA can affect any joint, but it occurs most often in knees, hips, lower back and neck.  Common risk factors include increasing age, obesity, previous joint injury, overuse of the joint, weak thigh muscles, and genes.  The good news is we can control our weight and fitness level right now.  We have choices we can make every day!  Let’s make the right choices.

 

According to Oxford Dictionaries, arthritis is defined as painful inflammation and stiffness of the joints.  It occurs when the protective cartilage on the ends of your bones wears down over time.  Think of our upstate New York roads in the spring.  We have a bumpy ride, right?  There are cracks in the pavement and potholes.  The cartilage of our joints with OA are just like the road surface.  What was once smooth is now rough.  Cartilage breaks down and causes fissures at the surface (these are your potholes).  It’s important to know that this joint damage cannot be reversed – unless you’re considering surgery for a joint replacement.  Sure, there are arthroscopic procedures for major tears in the cartilage that suddenly limit your range of motion and function.  But degenerative changes at a joint that occur over time cannot be reversed.  Watch out for the so-called “cures” out there – we can’t cure arthritis.

 

OA affects our lives in a number of ways:

Pain –  our joints hurt.  This is typically achy but can also be sharp with certain movements.

Stiffness – movement is slower, feels boggy.  You may even have limited range of motion.  For example, you might not be able to bend your knee all the way or you may not be able to straighten it out completely.

Decreased mobility – it hurts to move, so we avoid it.  For example, we park close to stores, and maybe limit how often we leave our home.

Fall risk – the less we move, the weaker we get.  Weakness and decreased range of motion leads to increased fall risk.

 

How can we manage these conditions?   OA is typically treated in the following ways:

Medications:  These typically begin with over the counter NSAIDS (Eg., Advil).  For something stronger, your physician might progress to prescription narcotics, and later steroids, and/or injections.

Modalities:  Ice or heat – which is better?  Ice is ideal for acute inflammation.  That is, when you have a recent injury or sudden pain with movement.  Ice helps control inflammation and pain.  Heat is very soothing for an arthritic joint – absent of any acute inflammation.  For example, I have arthritis at my low back and sitting in a heated seat feels wonderful.  However, I have tried this and sometimes it makes the pain worse.  That to me is diagnostic as I now know there is some kind of acute inflammation going on.  Time for ice.  If you’re ever not sure which one to use and you try heat and it makes your pain worse, you have your answer.

Posture education:  We want to preserve the natural curves in our spine and joints.  Using a lumbar roll and sitting on a surface where are hips are slightly higher than our knees is ideal for a normal spine.

Movement:  Engage in general movement throughout your day.  This can include but is not limited to household activities, home maintenance, gardening, hobbies, walking.

Exercise:  When we’re in pain and feeling stiff, we actually need to move sometimes.  We often do the opposite and the cycle of disability begins.  This can be counter-intuitive.  Listening to your body can help you understand this and you can learn to use movement to your advantage.

 

Exercise relates to function.  It needs to.  Movement and exercise help us make our lives better.  Exercise can also decrease your reliance on pain medications, too.  This can be a big advantage.  For your safety, always consult with your physician prior to starting any exercise program.

 

There are common conditions that we may experience as we get older.  Osteoarthritis is one of the most common.  OA is not reversible.  There is no cure.  We can better manage OA through various methods including movement and exercise – this is the preferred long-term approach.  Exercise can be targeted to stretch muscles and strengthen key muscle groups including the core.  Keep Moving!!

 

For more information, please contact Nancy at nancy@agingwellnow.com.

http://www.agingwellnow.com/about/

 

 

 

Just a few days ago we celebrated the first day of fall here in the Finger Lakes region of NY…  with summer-like temperatures.  While we can’t prevent fall from coming (eventually), we can take action to help prevent falls.  You know, the serious kind.  Fall prevention is a very broad topic.  I want to focus your thoughts today on one very important aspect of fall prevention:  the injury you cannot see.

Are falls preventable?  Yes!

Falls can have a profound impact on you, your family and society.  Every 13 seconds an adult over age 65 is rushed to the emergency room due to a fall.  If by discussing fall prevention here leads to one less fall, we have done a great thing.

 

 

 

Photo courtesy of National Council on Aging

WHAT IS A FALL?

A fall is defined as landing on the ground or some other lower surface when you didn’t intend to be there.  This may include slips, trips, etc.  Have you had a fall in the past year? Past 6 months, past 3 months?  Were you hurt?  Do you feel unsteady when standing or walking?  Do you worry about falling?  Do you limit your activity because you fear falling?  Fear of Falling is a lasting concern that may cause someone to stop doing activities that they remain able to do.

Fact:  The fear of falling is in itself a risk factor for falls.

Here’s why:  Legs weaken with inactivity. When we sit, we lose muscle strength that we need to use to stand and walk and move. Inactivity leads to falls due to the change in strength, balance and coordination.  Also, it may make someone feel alone.  Over time, if they avoid activities with others, this can lead to depression or anxiety.

}  Fear of falling is the injury you cannot see.

}  You may not even see it yourself, but your loved ones might.  I usually hear from someone’s daughter that their mother needs help.  And I will add that the one who fears falling is almost always receptive to information and help.

}  Falling, and the subsequent fear of falling, shakes your confidence.

}  There is an evidenced-based questionnaire called the ABC Scale that I often use to help assess someone’s confidence and fall risk when it comes to their mobility.  Please let me know if you would like a copy of it by emailing me at nancyalexander@achievemorept.com.

 

Here is a list of factors that are also known to help predict fall risk.  A score of 4 or more implies someone is at risk for falls.

◦      Age 65 or older

◦      Three or more documented medical diagnoses

◦      Prior history of falls within 3 months.

◦      Incontinence

◦      Visual impairment

◦      Impaired functional mobility (eg fear of falling)

◦      Environmental hazards

◦      Poly-pharmacy (4 or more prescription meds)

◦      Pain affecting level of function

◦      Cognitive impairment

How did you score?

(Source:  MAHC-10 – Fall risk assessment tool)

 

 

What can I do about it?

TAKE CONTROL

}  Fall prevention sometimes requires a multi-dimensional approach.  That is, consulting with your physician and other allied health professionals can put you on a path to a healthier lifestyle.

}  Take control of your fitness level.  By becoming stronger, we are better able to handle the varied environments and surprises that come our way.

}  According to WJ Evans, chief of physiology lab at Tufts University said, “Most falls are due to profound muscle weakness from not doing anything.”  Great news!!  We can change this!

}  Think positively… believe you can make a change

}  Exercise

}  Eat right

}  See your physician regularly

}  KEEP MOVING!

}  Your mindset is critical.  If you believe you can improve your health and fitness, you can!

}  If you believe you can’t, you most definitely won’t.

}  BELIEVE!

 

ALWAYS talk with your doctor or healthcare practitioner before starting an exercise program.

Begin with physical therapy or fall prevention classes. Be sure the classes you sign up for are designed for your age group or ability level and have an experienced instructor. Let the instructor know you are new to the class when you first arrive.  Observe a class if you’re not sure.

When you find something that works for you, stick with it.

Some types of exercise known to be effective to reduce falls include:

}  Fall prevention classes

}  Core training

}  Pilates – Buff Bones® (visit www.Buff-Bones.com for more information)

}  Tai Chi

}  Walking program

}  Aquatic exercise (good for fall prevention – limited effectiveness to help with bone strengthening)

 

In summary:

}  Fall risk increases as we age.  Falls have a profound effect on our lives.

}  Falls are largely preventable.

}  There are many causes of falls and thus many solutions.

}  Our fitness level has a major bearing on fall risk.

}  We can decrease our fall risk by getting stronger… at any age!

}  Beware the fear of falling… the injury you cannot see.

}  Contact your physician and fall prevention expert like a physical therapist or experienced trainer to discuss options that are safe for you.

 

About

By Nancy Alexander, PT, CSCS

 

Fact:  You can increase your bone strength and improve your balance at any age… it’s true – at ANY age.

Did you know that bone remodels throughout our life?  … It is a continuous process.  After the active skeletal growth phase in youth, and after menopause in women (a bit later in men), the remodeling process becomes unbalanced and we begin to lose more bone than we replace. This results in a net decrease in the total amount of bone.

Conditions that exhibit decreased bone density like osteoporosis and osteopenia don’t have to happen if we have enough bone mass.  If we have enough reserve it’s not an issue.  And, we can increase it with exercise.

In addition, we can improve our balance at any age.  Balance is neurological in nature and this system does break down some as we age.  But research shows us again and again that with targeted exercise, this can be reversed.

Ten million Americans have osteoporosis – 9 million of these are over the age of 50;  another 34 million Americans have low bone density.  Your bone density is so important as you age.  One half of women and two in five men will develop osteoporosis during their lifetime.  Osteoporosis is the underlying cause of approximately 2 million fractures every year.  Back pain, caused by changes in the vertebrae, may be the first sign that something is wrong.  (Source:  National Osteoporosis Foundation)

 

 

 

 

 

 

 

Do you know which bones are more likely to fracture when you have osteoporosis?

There are two types of bone tissue:  cortical and trabecular.  Areas with more trabecular bone tissue are at greatest risk for fracture when you have osteoporosis.  These include the ends of long bones (eg femur or hip); radius (wrist); and the vertebra (spine).

With osteoporosis, you can see bone loss and architectural changes when imaged.  This is not the case with osteopenia.  Osteopenia is sometimes called “early stage” osteoporosis.  I think this is a bit of a misnomer.  Low bone mass (osteopenia) does not always mean you will get osteoporosis, but it is a risk.

Approximately 48 million Americans over the age of 50 years have low bone mass.   Genetics play a role and so does race and ethnicity.  It can be affected by poor diet, lack of exercise, smoking and drinking alcohol too much.

I once worked with a patient who had fractured his shoulder blade when he fell while skiing.  He was in his 50’s at the time.  As a skier myself, the more I thought about his fall it just didn’t make sense to me.  That fall should not have caused his shoulder blade to break.  I shared my concerns with him at his next visit and he was thinking the same thing.  I suggested he have his bone density checked and sure enough, he had osteopenia.  The good news was now he could put in place strategies to help increase his bone strength.

Bone density is assessed by something called a Dexa Scan.  This is considered the gold standard for measuring bone density.  The World Health Organization (WHO) uses a classification known as the T-Score.  Here are the scores and what they mean:

-1 to (+) = healthy bone

-1 to -2.5 = osteopenia

<-2.5 = osteoporosis

It is important to know your numbers.  So many people I ask have been scanned but are not able to tell me their T scores.  Knowledge is power.  By knowing your score, you can see where you lay on this scale and investigate what strategies you need to put in place now.

All women over the age of 65 should get a scan, according to the National Osteoporosis Foundation and the U.S. Preventive Services Task Force.  Experts differ in their recommendations for bone scans for men. The National Osteoporosis Foundation recommends that all men over the age of 70 should get a bone scan.  With certain co-morbidities and family history, scanning is recommended at a younger age.

Consider the importance of fall prevention strategies for those with decreased bone density.  Fall prevention is especially critical for those with osteoporosis.  People with low bone density are more likely to break a bone compared to people with normal bone density.  Remember you can build bones at any age.  Take action now to improve your fitness level and safety.

Just like building a bank account

Structured exercises help build stronger bones.  Regardless of age, we can always still strengthen our bones and remember, we can always improve our balance too.  Think of your bones as a savings account.  There is only as much bone density in your account as you deposit.  Keep depositing!

Bones builds in relation to impact, speed, direction, and force.  Site specific exercise helps:  hip, spine, wrist.  Beware to avoid spinal flexion, especially loaded flexion.  Avoid combining spinal flexion, lateral flexion and rotation all at the same time.

Weight bearing and strength training exercises are ideal to help you build strong bones.  A new program called Buff Bones® is one of the few programs safe for those with osteoporosis and can be easily modified for other chronic conditions commonly seen in the adult population.

Buff Bones® is a medically-endorsed, full body workout for bone strengthening and balance.  It helps strengthen your muscles too.  It integrates Pilates, strength training, functional movement and rehabilitative exercise to improve the health and longevity of your bones and joints.

Only licensed instructors can teach this class.  As a licensed instructor I offer this at two locations:  Oasis Rochester in Rochester, NY and at the Canandaigua YMCA in Canandaigua, NY.  Current classes are sold out but more will be offered soon.  I also bring my physical therapy experience with me to focus on proper form and to help to provide education to all.

Each class is one hour long and performed with bare feet for optimal benefit.  We use a mat and light hand weights are encouraged if desired.  Participants need to be able to get up and down from the floor without assistance.  Always consult with your physician before starting any new exercise program.

Each class follows a sequence starting in standing, then we lay on our backs.  We then transition to side-lying, hands and knees, and on our stomach before rising back to standing.  The class ends with light stretching and “centering.”  Class participants describe the class as gentle, yet effective.

In summary, remember that movement and exercise on a regular basis are critical for long term health, fitness and quality of life.  We need to keep moving!  For those with osteoporosis or osteopenia, seek out safe bone strengthening strategies that integrate alignment and balance techniques.  Even if you don’t have osteoporosis or osteopenia, strengthening your bones is important and can and should be done at any age.

http://www.agingwellnow.com/about/