Category: Personal Fitness

Staying Fit as the Seasons Change

Seattle had a beautiful summer this year that stretched out through most of September. It was easy to stay inspired for outdoor sports. As the leaves are turning and daylight is shorter don’t let weather hold you back from training. Here are a few suggestions:

  1. Train with friends. Having a buddy helps to keep you accountable. It is too easy to let yourself off the hook when you are tired, and besides you can accomplish your social goals at the same time as your fitness goals. Consider it multi-tasking.
  2. Work on your core. The stronger your trunk muscles are, the better your balance and stability.  It enhances any other sporting activity. Yoga and Pilates classes are popular ways to strengthen your abdomen and back.
  3. Increase aerobic endurance. Thirty minutes three times a week is an important baseline for aerobic fitness. Make that 30 minutes increasingly difficult to improve stamina after your routine becomes habit.
  4. Return to the gym. Spinning classes, swimming pools and treadmills are easier to use when there are others around. The energy from other people is contagious. Sports equipment at home is a great idea, but it seems to collect dust before it ends up in garage sales.

What ever you do, be adventurous, creative and open-minded. Staying fit is good for your mood, good for your brain, good for generating energy, and good for your health. Don’t let it lapse when it is unseasonable!

Anti-aging, Beauty, Breast health, Breast Reduction, Doctor-Patient Relationship, Personal Fitness

The Beautiful Upper Arm

During the 2008 presidential campaign period Michelle Obama reintroduced the sleeveless sheath dress (a la Jackie Kennedy) as a new fashion statement. So the cut of the upper arm became important for style. This worked well with her “let’s move” campaign for diet and exercise.

So how does one get Michelle Obama arms?

Well, upper body workouts are a good start. Women are not as likely to develop their arm muscles as men, but it is an important part of feeling good, staying strong, and looking fit.  

However, lots of women may have good muscle tone with other factors the interfere with the shape of their upper arms.

Some carry fat selectively in their upper arms. This is common for an overly enthusiastic fat collection in the triceps region, leaving a hanging weight of extra tissue. LIPOSUCTION can be a valuable way to contour the upper arms with minimal scarring. Its success is somewhat dependent on the elasticity of the skin. The best results occur when the skin retracts to its former shape after the fat is removed. This may take three to six months to occur.

If you have too much skin, or skin that has been irreversibly stretched out, the extra skin needs to be removed with an ARM LIFT. There is a large array of variations on an arm lift (known as a BRACHIOPLASTY). A minimal scar armlift can confine the scar to the armpit. If there is more excess skin the scar may need to extend down the inner arm or over the triceps region to achieve a better contour. As in most areas of plastic surgery, the choice needs to be individualized for the best outcome.  

If your upper arm is one that you hate to show in sleeveless dresses, a consultation may help define a good solution for you.



Body Contouring, Doctor-Patient Relationship, Personal Fitness, Uncategorized, Weight loss

Herbal Supplements Can Increase Bleeding Risk at Surgery

Sixty percent of Americans choose homeopathic drugs, food supplements, or herbal products as an alternative to traditional medications to enhance their health. These products are pharmacologically active and naturally occurring plant extracts. Because their source is “natural” and they are sold without a prescription, they have increased in popularity for those seeking a wholesome life style. Despite their natural source, supplements can contribute to prolonged and excessive bleeding at surgery. Here is a list of some of the commonly used complementary/alternative medical products that can be harmful when combined with surgery. The following should be tapered and then discontinued two to three weeks before surgery.

BAICAL SKULLCAP (Chinese Skullcap)- This herb has been used by the Chinese for irritability and dysentery. It interferes with coagulation and can cause bleeding.

BROMELIN. This extract of pineapple is used to treat arthritis. It interferes with platelet function and can cause bleeding.

CHINESE AGRIMONY- This remedy is used for cough and colds, pain relief, and infections. It markedly increases the risk of bleeding.

CHINESE PEONY- Used for gastric upset, this flowering plant interferes with coagulation.

FEVERFEW- Used to reduce fever, treat arthritis and prevent migraines, feverfew can result in withdrawal symptoms as it is discontinued.

FRITILLARIA- This bulb is cooked and eaten to treat hypertension, lung problems and opium toxicity. DAN S HEN- This Chinese product is used for stroke, angina, arthritis, insomnia, and menstrual disorders. It has a powerful antiplatelet effect that leads to bleeding.

DEVIL’S CLAW- Used for centuries in South America for pain, fever, and digestion, Devil’s Claw interferes with normal coagulation.

GARLIC- Garlic has been used as a medicine for centuries. It has been advocated for high blood pressure, fungal infections, heart attack and cancer. There is good evidence of garlic in high doses resulting in bleeding, nausea and vomiting as well as low blood sugar.

GINGER- Ginger is for gastric, distress, migraines and headaches. It is known to interfere with platelet function.

GINSENG- Conditions treated with ginger include colic, infections, aging, and stress. It can increase bleeding, and have side effects of nausea, headaches, and blood pressure changes.

GINKO- Used to treat Alzheimer’s and other memory disorders, ginkgo has been associated with excess perioperative bleeding.

LICORICE- Used for peptic ulcers, cancer, and adrenal insufficiency, licorice can increase bleeding, result in hypertension and lower potassium levels.

CAPSAICIN (red chili pepper)- Capsaicin has been recommended for pain relief, itching and psoriasis. It interferes with platelet function.

SAW PALMETTO- this is a treatment for an enlarged prostate and urinary tract infections. It interferes with normal coagulation.

OIL of WINTERGREEN- Prescribed for inflammation, joint pain, and hypertension, this food flavoring agent has been associated with prolonged surgical bleeding. GEUM JAPONICUM- This diuretic can cause prolongation of clotting time.

JAPANESE HONEYSUCKLE- Homeopathic remedy for fever, ore throat, headache, and infection, Japanese honeysuckle interferes with platelet function.

DAN SHEN- Conditions treated with dan shen include atherosclerosis, insomnia, menstrual disorders, HIV, stroke, angina, and prostatitis. It blocks platelet function and can lead to prolonged bleeding.

VITAMIN E- Popular as an anti-cancer anti-oxidant there is increase in bleeding risk with high does.

FISH OIL- Fish oils are popular for their anti-cardiovascular disease benefits. It is also used to treat dry eyes. Prolonged bleeding times occur and is dependent on the dose.

ARNICA MONTANA- Used in Europe to treat arthritis and muscle aches, it has been popular to reduce postoperative bleeding and swelling. It is associated with bleeding as it interferes with platelets.

CHONDROITAN and GLUCOSAMINE – These two are often taken together to enhance cartilage repair. They increase bleeding potential. Supplements and old-fashioned remedies are not generally thought of as medicines and thus many do not mention them to their doctors. These substances may have been in use for centuries, but they can have harmful effects at the time of surgery. They are classified as a food rather than a drug, so they escape FDA regulation. This can make them variable in quality or dosage.

Make sure your surgeon knows what non-prescription items you are taking so as to avoid any unsafe interactions at the time of your procedure.

Doctor-Patient Relationship, Nutrition, Personal Fitness

What Prompts Successful LIFESTYLE CHANGES for Weight Loss?

In the United States one third of adults are Obese (BMI >30). OBESITY brings a burden of increased medical problems and risk of premature death. Excess body mass significantly decreases energy, activity and sense of well being, not to mention body image. Many resources, public and private are being devoted to combating this epidemic. MICHELLE OBAMA has made anti-obesity her signature issue in the “Let’s Move” campaign.

The Nov 24, 2011 NEW ENGLAND JOURNAL of MEDICINE published a randomized controlled study in 415 obese people to compare two different approaches to supporting WEIGHT LOSS. All patients were followed by their doctors for a two year period. One group of subjects had weight loss coaches that provided in-person support with both group and individual sessions. A second group had its counseling provided remotely by e-mail, phone or web site. The third group was entirely self directed without supplemental advise or support.  

The self directed (non-supported) control group had a mean weight loss of .8 kg, not much change at two years. The two groups that received support both were able to maintain a 5% weight reduction. This modest weight loss is a good start on decreasing cardiovascular and diabetic risk even if it is still a far distance from being at ideal body weight. The group with face-to face coaching did slightly better than those who received their support on line, but support was critical.

The take home lesson is that lifestyle changes are hard to maintain especially when attempted all by yourself.  Education and encouragement make a difference in being able to sustain change in habits. You may lack both time and money for one on one coaching, but taking advantage of on line support systems may be a very good method to reinforce behavioral modifications. Most health clubs offer a supervised program to track diet and exercise. There are multiple web sites for monitoring calorie intake and exercise to track progress in those key behaviors. Here are a few you might find helpful: – Weight Watcher’s Support Network – Weight-Control Information Network – Web site with resources for surgical weight loss – Successful group based on the 12 Steps model

Don’t forget to keep moving!

Nutrition, Personal Fitness, Weight loss

The New England journal of Medicine Explains: Why It Is So Hard to Maintain Weight Loss?

Yo-yo dieters know the disappointment of working hard to achieve a weight loss goal and having the progress fade away as soon as the discipline is relaxed. What makes it so difficult to stay at a stable weight once the pounds have been shed? The October 27,2011 edition of the New England Journal of Medicine (vol.365. No.17 p1597) provided a valuable study that provided some clues to the metabolic explanation.  Researchers from the University of Melbourne in Australia published their study of 50 overweight men and women that were enrolled in a 10 week calorie restriction weight loss program. Hormones were measured before the diet, at 10 weeks, and one year later. The hormones they examined were those known to be responsible for appetite control. These substances are released from the gastrointestinal tract, the pancreas, and fat stores. The hormones circulate to the hypothalamus in the brain where they regulate food intake and energy expenditure. When caloric restriction begins the body increases the output of hormones that create hunger and decrease energy expenditure. In other words these hormones fight to keep the weight on as you struggle to keep it off. If we lived in an area of famine this would be adaptive. In our culture with an overabundance of food, it is difficult to turn off the system that is counter productive in the modern world.

The researchers found that at 10 weeks the dieters had lost an average of 13.5 kg or 14% body weight. One year later they had regained an average of 5.5 kg so that their weight loss from the beginning was only 8.2%. The hormones of starvation were all increased at week 10 and one year contributing to the creep up in weight. These hormones had not returned to normal levels even as weight gain was occurring. A strong physiologic basis appeared to be the cause of regaining weight rather than voluntary resumption of old habits.

These studies will allow researchers to focus on ways to alter the appetite controlling hormones.

Nutrition, Personal Fitness, Weight loss

Summer sports

Summer seems to be an ideal time for setting  personal fitness goals. When the days are long and the sun is out Seattelites seem to have lots of energy and see that much is possible. I have long been a fan of triathlons, especially the Danskin. The terrific thing about the Danskin is that there are women of all ages and sizes who have just decided to get more fit. The idea of the race seems to be for the many participants to have a goal to work towards and have fun accomplishing that goal. It’s a helpful supportive environment that is about enjoying fitness, not competition.  

Having a summer sporting goal such as a triathlon can be a good way to schedule exercise on a regular basis to maintain a healthy lifestyle.  It’s helpful for weight loss, body toning, aerobic fitness and of course, fun.  

Many of my patients are athletic and recognize that regular workouts are a critical part of feeling good about your body.  Plastic surgery works best on those who maintain their fitness. For some, body contouring procedures can be a confidence lifting step that helps to motivate them for healthy choices.

I’ll be doing the Seafair and the Danskin triathlons this summer.  Hope to see you there.

Breast health, Nutrition, Personal Fitness

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