Tag Archives: health

How our supervisor keeps moving strong into her seventies

Linda Guerin is our supervisor here at the surgery clinic at UMass Memorial. Outside of work she is active with her grandchildren.   I have known her for many years and her energy level has not wavered.  Her secret?  Healthy eating and exercise!  Read below about what she does for exercise and how she keeps moving strong in her seventies!

Team blog series (5)

What do you currently do for exercise? I currently work out 4 nights a week and have been for over a year- I take a variety of classes including Zumba, P90x, and HIIT class.

What has been your biggest challenge with exercise in recent years?- I need to have both my knees replaced but it does not prevent me from attending classes

How did you overcome that challenge to keep moving?  I just keep moving, I was doing a fitness program with weights for over five years and decided it was no longer working for me and my knees and joined FIT Friendzy Studios over a year ago and I just over the variety of classes they offer and I love to challenge myself.

Why is exercise important to you right now in your life? I’m determined to stay healthy and fit especially the older I get it’s even more important to me. I will be 71 in January. I  work full time and I eat healthy.  Over a year ago I gave up junk food and sweets (sugar) and don’t miss it at all. It’s so important to me to be healthy, you never know what tomorrow brings but it will not be because I didn’t work on my health.  I have also lost 90 lbs since I changed my lifestyle.

I love spending time with my grandchildren and family and friends. I also love to tent camp for a couple of weeks in the summer when I’m visiting my son and family in Michigan. I need to be healthy to do that. I also found a way to exercise while camping. I truly enjoy being active, it’s a big part of my life.  I stay late at work just not to miss my classes. I truly love my life!

Thank you Linda!

Janet

 

 

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by | November 25, 2019 · 4:19 pm

Why a busy surgeon makes time for exercise

Team blog series (3)

Dr. Perugini is our director of bariatric surgery here at the UMass Memorial Weight Center and an avid exerciser.  In this post, he shares why he makes time for exercise, what he does for exercise, and why it is an important part of his health and enjoyment of life. 

What do you currently do for exercise? 

Usually, I alternate between strength training and running.  I have free weights at home.  I do P90x routines.  I like the different routines.  I like the fact that they work different muscle groups.  They rotate between free weights, body weight exercises.  For me, I feel like I get a nice routine that works on big muscle groups, balance, core strength and flexibility.

I also love running.  I am presently training for a long race; for the last month or so, I focused on running.  This has been all on roads.  I love trail running. Finally,  I go to a great yoga center for classes.

What has been your biggest challenge with exercise in recent years?

Some small injuries.  I have some tendinitis that makes running on roads interesting.   Also, I ran a lot with my daughter.  She has left home to start college.  I felt a little sadness in losing my running partner.

How did you overcome that challenge to keep moving?

I found some directed stretching and strengthening programs that made the pain much more tolerable (Summit Medical Group has some great rehabilitation exercises available on line).  Also, I pay attention to the bevel at the side of the road.  If I run with my right leg on the outside towards the curb, the pain worsens.  If I run with the right leg inside, my ankle feels okay.   Also, if I need to lay off running, I switch to the strength training routines.  Similarly, if an injury keeps we from strength training, I switch to running.  I think it’s good to exercise in cycles anyway.

Why is exercise important to you right now in your life?

For me, it is a great way to relieve stress.  I don’t like to listen to anything when I run, so the run becomes a time for meditation.  I think it is good for me to let my mind wander.  Its great for creativity, too.  A lot of people describe getting their best ideas when they let their minds wander during exercise.

What advice do you give patients who are struggling with exercise motivation?

If we are struggling for motivation, I don’t think we are doing it right.  Exercise should be a time to feel good.  It helps to relieve stress.  There is a good buzz that happens during and afterwards. It should feel like play, and we all need play.  Be playful, and courageous.  Try something new.  Find the thing you love.

Thank you Dr. Perugini!

Keep Moving, Be Well

Janet

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by | November 18, 2019 · 3:59 pm

The exercise mindset shift of a new mom

Inspired by Dr. Gitkind’s story last week, about how he used his fitness to help others, I decided to do a blog series about the real life exercise challenges and successes of UMass Memorial Weight Center Staff. This week I interviewed Anna Grotevant, one of our amazing dietitians.  As many of you know, she had a baby last year.  I asked her about how being a new mom has shifted her mindset about exercise.


Team blog series (2)

What was your mindset about exercise before pregnancy?

Before starting a family I exercised to stay fit and as a social activity. I wasn’t very consistent. I had more time to myself and tended to procrastinate. I didn’t really use exercise as a form of self-care because I had other forms of self-care that were more relaxing. Exercise felt more like something I had to check off on my to-do list. I would go weeks or months without exercising even though it is important to me.

What do you do now for exercise as a new mom?

After giving birth to my daughter a year ago, I spent time recuperating. I stopped exercising completely as I didn’t have the physical or mental energy to think about it. I also felt like I was so “out of shape” that my typical forms of exercise (running /yoga) were out of the question. Once I hit six months postpartum, I started with some walking. I built up from there, and now I’m walking, running, strength training and doing some yoga – usually something every day. I exercise on my own in the evening and with my sister on the weekends (we have “run dates”, which I really enjoy). I also walk on my lunch at work when it’s nice out.

How has your mindset about exercise shifted since having a baby?

My mindset about exercise has shifted. Since I have less time to myself, I tend not to procrastinate. If I’m going to do anything it has to be while my daughter is sleeping, so I get right on it as soon as my daughter goes down. I also have to multitask – I look at exercise not only as a way to stay fit but as a form of self-care and relaxation. I appreciate the time I have to myself a lot more. I’m a lot more gentle and forgiving in my workouts because it’s not about burning calories or running faster, but just about being able to move my body and have some time alone.

What is the biggest challenge about exercising as a new mom?

The biggest challenge about exercising as a new mom is the time that it takes. There’s always something I “should” be doing. Exercising during my daughter’s nap time means I’m not doing any of my household tasks. Having exercise dates with my sister on weekends means I’m not spending time with my daughter and husband.  That can actually make my life feel more stressful, especially if I’m falling behind in my responsibilities or it’s a particularly busy time of life. I try to manage this by prioritizing. I say no to some activities and requests from others so that I can preserve time for the people who are most important to me. I try to incorporate exercise into family activities on the weekends. Most importantly, I try to remember that no one is perfect. I can’t be the perfect mom, wife, sister, daughter, employee or exerciser. I can just do my best with what I’ve got and keep moving forward.

Thank you Anna!

Keep moving, be well,

Janet

 

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by | September 30, 2019 · 8:17 pm

Is it your body or your mind holding you back?

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The header at the top of this page is a collection of pictures of people who are on a weight loss journey. They are all at various stages on that journey, most are not at their goal weight yet.  However, each of them are now doing things they could not do before losing weight.  It is quite inspiring to see these smiling faces enjoying life while on the journey. How did they overcome their body and get so fit?  It took changing their mind so their body didn’t get in the way.

 The brain is a reality simulator.  What you imagine can seem very real.  Just think of how you feel when waking up from a dream.  The feelings can stay with you for a while, even though it was all in your head.

When your body is carrying extra weight, it can hold you back from exercising and doing many other activities you once easily enjoyed.  It can seem like you cannot exericse and it would be better to wait until you lost some weight to get started.  What you are feeling in your body is very real.  Just like a dream however, what your brain believes about how much is enough exercise may not be the reality.  Your expectations could be based on your memories of what you used to be able to do and what you want to be able to do now.  They could also be based on recommended amounts, which are really general guidelines.    Just like your dream, your mind can hold beliefs about what your body should be able to do, even when your body is telling you that it cannot do it.

This can feel like your body is getting in the way, holding you back from exercising.  However it is really your ideas about what it means to exercise that is holding you back.  Your body does not know the recommendations.  It only knows what it can do now, in this moment.  Your body does not know how many calories you want it to burn, it only knows what it will burn based upon what will be keep you healthy and well.  Your body does not know the numbers displayed on the weight machine or the treadmill or your activity monitor.  It only knows if it can tolerate what you are asking it to do.

If it cannot tolerate it, your body will let you know through pain and fatigue. Pain and fatigue are a sign of too  much too soon. Contrary to popular beliefs, pain is not a sign of progress (nope, not even muscle soreness). If you body has what it needs to do what you are asking it to do, it will let you know instantly through more energy, greater freedom of movement, more focus and a better mood.  Basically, your body is smarter than your brain when it comes to exercise. Your body and brain work best when they work together, that means your brain observes your body rather than dictates what it should be able to do.

So the next time you start thinking your body is working against you, ask what it is trying to tell you.  The answers may not be clear right away, and usually it is not telling you to stop exercise completely.  It is usually telling you it needs less for a while until it has time to adapt. You will know you have found the just right level and type of exercise by how you feel during and after exercise.  Your body  will tell you if and when it is ready for more. Until then, keep the peace between your brain and your body, by trusting you body to tell your brain how much is enough exercise right now.

Keep Moving Be Well,

Janet

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by | September 18, 2019 · 6:44 pm

The weight loss you don’t want

Why exercise for diabetes_(9)

When you are trying to lose weight, every pound down on the scale is exciting.  It’s an affirmation that what you are doing is working.

Or is it?

If the goal is just to lose weight, regardless of your health or how your body feels or functions at the lower weight, then yes, it is working.

But if your reasons for losing weight are to feel and function better, be healthier, live longer and look better, research is affirming the scale is not the best tool.

Weight loss can be up to 30% muscle loss. This the weight loss you don’t want! It turns out, muscle is more about our health and longevity then we ever thought. Here is some of the recent research backed connections between muscle loss and health:

  • Joint Replacement:  Patients who had less muscle mass had more complications, slower wound healing, increased risk of infections and longer recuperation after  total knee replacement surgery.
  • Cancer: Patients who had lower levels of muscle mass had reduced ability tolerance of treatment. Patients with less muscle mass having surgery for colon cancer had a higher incidence of both blood transfusion and complications after surgery.
  • Gastric Sleeve:  Patients with lower muscle mass were at greater risk of a leak after having a sleeve procedure for weight loss.
  • Osteoporosis:  The loss of bone and muscle have a huge impact on how a person ages.  Researchers now know that there is a strong connection between loss of muscle and loss of bone.  Researchers are asking we think of muscle loss and bone loss one disease because they know that increasing muscle mass has a direct effect on improving bone mass.
  • Others:  Reduced muscle mass has been connected to increased risk of falling, bone fractures, reduced longevity, fatigue, arthritis, as well as emotional health including depression, anxiety, and social isolation.

The medical name for muscle loss is Sarcopenia and it is now considered a disease.  However, this is not the kind of disease a medication can fix.  Muscle, like the rest of your body is a use it to keep it commodity.  The way to keep it, or get it back if you lost it is through strength training exercise.

sarcopenia

How do you know if you are losing muscle?  Well, that is part of the problem.  Measuring muscle mass has not been quite as convenient as getting on the scale.  Fortunately, researchers have found there is an easier way to test muscle loss. Its called a hand grip test.  It is strongly connected with how much muscle mass you have.  No tool is perfect, but this is one of our best ways to know if you are holding on to your muscle mass as you age and as you lose weight.

Soon, we will be incorporating this test as part of our measurements before and after weight loss surgery to give you another number to see how you are doing.  Since the connection between muscle mass and health has the potential for being a reliable measurement of true progress with weight loss for health, these numbers are ones to pay attention to as you lose weight.

Keep Moving, Be Well

Janet

 

Sources:

  1. The impact of sarcopenic obesity on kneeand hip osteoarthritis: a scoping review Godziuket al. BMC Musculoskeletal Disorders (2018)
  2. Preoperative grip strength measurement and duration of hospital stay in patients undergoing total hip and knee arthroplasty A. J. Shyam Kumar. European journal of orthopedic surgery, July 2013
  3. Is sarcopenia a better predictor of complications than body mass index? Sarcopenia and surgical outcomes in patients with rectal cancer Colorectal Disease  SB Jochum, 2019, 
  4. Preoperative Detection of Sarcopenic Obesity Helps to Predict the Occurrence of Gastric Leak After Sleeve Gastrectomy, Martin Gaillard, Obesity Surgery August 2018
  5. Osteoporosis and sarcopenia: two diseases or one?, Jean-Yves Reginster, Current Opinion in Clinical Nutrition and Metabolic Care, Jan. 2016
  6. Interaction of nutrition and and exercise on bone and muscle, Endocrinology 2019
  7. Sarcopenia FDA report, April 2017
  8. Sarcopenia is a disease –  why are we looking for a medication.? The Conversaion

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by | August 27, 2019 · 7:30 pm

Exercise and Osteoarthritis

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What is Osteoarthritis?

In normal joints, a firm, rubbery material called cartilage covers the end of each bone. Cartilage provides a smooth, gliding surface for joint motion and acts as a cushion between the bones. In osteoarthritis or OA, the cartilage breaks down, causing pain, swelling and problems moving the joint. As OA worsens over time, bones may break down and develop growths called spurs. Bits of bone or cartilage may chip off and float around in the joint. In the body, an inflammatory process occurs and cytokines (proteins) and enzymes develop that further damage the cartilage. In the final stages of OA, the cartilage wears away and bone rubs against bone leading to joint damage and more pain.  Arthritis Foundation Website

How does exercise help?

Exercise is considered the most effective non-drug treatment for reducing pain and improving movement in osteoarthritis. Arthrtis.org

Movement in general can reduce inflammation, the cause of pain in arthritis.   Your lymph system relies on movement to keep this fluid part of your blood moving so your body can lower inflammation.  All three types of exercise work well for osteoarthritis:

  • Stretching reduces stiffness that makes movement more difficult.  Simply moving a joint through its full range of motion a few times several times a day can be very beneficial in reducing stiffness and movement limitations from OA
  • Strength training helps your muscles, ligaments and tendons support arthritic joints. Strength training has been shown to reduce arthritis pain.  The key is knowing how to do strength training with proper alignment so your joints work there best and you minimize strain.  In your exercise visit, we practice this to ensure strength training is not painful so your body can gain strength without strain.
  • Cardio can reduce pain, but there are several factors to consider.  If the activity is weight bearing (such as walking), your joints probably won’t tolerate it for as long. However, since walking is a type of activity needed for daily life, it is important to incorporate if at all possible.  Use a cane or walker if it helps you walk with less pain.   Walk in several short bouts for the duration that does not increase pain.  Supplement with a form of cardio that is non-weight bearing and allows you to move for a longer period of time,  such as an exercise bike or seated aerobics. The key is doing the amount and type that decreases, not increases pain and then repeat that more frequently to make up for the lower duration.

The key to each of these  is listening to your body.   When movement decreases pain, it is lowering inflammation.  When pain increases, so does inflammation.  So doing small bouts throughout the day, doing the types of exercise that reduce pain and stiffness is the way to use exercise as the most effective non-drug treatment for reducing pain and improving movement in OA.

One last thing to consider is stress.  If exercise or physical activity is stressful, it will increase inflammation.  Choose types of movement you enjoy, that leaves you feeling good about yourself, and do it in a way that it does not increase your pain, and you will be using exercise in the way that it can make it easier to live with osteoarthritis.

In the next blog, I will address why exercise is important if you are having  joint replacement surgery.

Keep moving, be well,

Janet

Sources:
Exercise in the management of knee and hip osteoarthritis. Elizabeth Wellsandt and Yvonne Golightly. Current Opinion in Rheumatology. 30(2):151–159, MAR 2018
Educating patients about the benefits of physical activity and exercise for their hip and knee osteoarthritis. Systematic literature review. C.Gay, A.Chabaud, E.Guille, E.Coudeyre.  Annals of Physical and Rehabilitation Medicine.  June 2016, Pages 174-183

 


Please share these posts with anyone you know interested in losing weight with or without weight loss surgery.  Click here to learn more about the UMass Memorial Weight Center

These weekly blogs are general guidelines. These guidelines apply to patients who are cleared by a physician for the type of exercise described. Please contact your physician with any concerns or questions. Always report any symptoms associated with exercise, such as pain, irregular heartbeats, and dizziness or fainting, to your physician.

 

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by | July 9, 2019 · 7:30 pm

Exercise and diabetes

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If you have been told your blood sugar (glucose) is too high, you probably have also been told to exercise.  But why?  Knowing how exercise helps lower blood sugar levels is a key for staying motivated to exercise regularly.  Let’s take a look at the inside story of exercise and blood sugars. 

Sticky Blood: When sugar gets wet, it gets sticky.  One of the biggest problems with having high blood sugars is that sugar makes blood “sticky”.   When sugar is at higher levels in your blood for too long, it is concerning because that “sticky” blood is now traveling to every part of your body.   This is why diabetes puts you at risk for so many different medical issues.  Nearly every part of the body is strained when blood sugars are high; your kidneys, your nerves, your eyes, etc.

Natural blood sugar management: Two of the most important ways your body is designed to move sugar out of your blood after you eat is (1) the movement system (2) the insulin system.  The movement system is meant to be the main system for keeping blood sugar from getting too high. The insulin system is designed to be your back up system, for use when you are not moving.

When you move:

  • your body uses the sugar in your blood to help fuel moving muscles
  • your body is able to use its own insulin more efficiently.  After exercise, your body is more sensitive to its own insulin, making this back up system work better for hours after exercise.

When you don’t move often:

  • your main (movement) system for managing blood sugars is not available
  • your body needs to use the back up (insulin) system to bring sugar into cells to be stored as fat
  • over time your back up (insulin) system gets overused and can ‘wear out’

When you have type II diabetes, your body is resistant to insulin, causing sugar and insulin build up in your blood.   When you move your body, you activate the main natural system for lowing your blood sugar.   Exercise then, temporarily reverses the cause of type II diabetes.

Not all movement is created equal.  However, if you move all day for your job or for child care, your movement system could be counteracted by another system – the stress system.  When you are moving but stressed, your body releases more sugar into your blood.  That means the movement system cannot do its job as effectively.  This is what sets exercise apart from your every day physical activities.  Exercise is when you are moving for the purpose of self-care. When movement reduces, rather than increases stress, it is able to do its job of lower blood sugars. 

Plus, exercise has GREAT side effects. The bonus is, exercise also helps you manage diabetes in other ways too:

  • Think clearly:  Moving your body can help your brain function better, giving you a better mood, focus and ability to make healthy choices
  • Health protection:  Regular exercisers have a lower risk of heart disease, cancer and stroke.  When you have diabetes you are at greater risk for health concerns, so the extra protection from exercise comes in very handy.
  • Weight managementExercise (specifically strength training) counteracts the metabolism lowering effect of dieting by keeping your muscles strong and functioning well while losing weight.
  • Improved sleep: When sleep deprived, the stress response in the body is triggered, raising blood sugar and making weight loss more difficult.  Using exercise to improve sleep has a ripple effect to many other parts of your life.
  • Reduce Arthritis pain: stronger muscles around joints can decrease arthritis pain and make moving easier.  Less pain means you can move more and moving more helps keep blood sugar in check.
  • Reduce Back Pain:  The job of the core is to protect the spine from wear and tear. Exercises that teach the core muscles to do their job in a functional way can reduce back pain.  Plus, stretching in a way that helps to improve tolerance of things like bending and lifting and helps the body recover from strains of daily life can reduce back pain flare ups. Again, less pain, more movement, better blood sugar control.
  • Counteracts depression, anxiety, and improves mood and focus:  Exercise, when used properly, has been shown to be very effective as part of a treatment plan for depression, anxiety, ADHD, and other areas of mental health.  Living with a disease like diabetes can be overwhelming at times and can affect mood.  Exercise can help boost your ability to cope with the stress and pressures of having diabetes

Bottom line:  Moving your body, in a way that reduces stress, activates the natural blood sugar management system in your body.  Keep moving to keep this system working for you and your health.

Keep Moving, Be Well,

Janet

 

 

 

 

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by | May 28, 2019 · 8:55 pm