your HEALTH body / mind / fitness
May 13, 2021
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Post-pandemic fitness Get back to your routine sanely and safely
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hile some folks kept up with their fitness routines through zoom sessions and other forms of virtual workouts, even getting outside at times to work out, for many the pandemic meant too much sitting, TV binging and accumulating those dreaded pandemic pounds. Now, with vaccinations happening, and life seemingly on the rebound, the warm weather is an enticement to restart or even finally begin a consistent exercise program for the first time. On one hand: Hooray! It’ll be great to be back in the groove, take a class and see trainers/coaches and classmates I haven’t seen in forever! On the other hand: Yikes! What if I can’t keep up? What if I’ve lost everything I worked so hard to attain? First, know that hope is far from lost. But also realize that unless you’ve diligently kept up your training — perhaps with at-home workouts — you probably will have lost some effects, particularly cardiovascularly. Manage your expectations “Fitness takes longer to gain than it does to lose,” says Laurie P. Whitsel, vice president of policy research and translation for the American Heart Association. But try not to despair, she says. Life has been crazy lately, so you just have to forgive yourself and move forward. “If you’ve taken a break during Covid-19, that’s fine,” Dr. Whitsel says. “This is a stressful time. Maybe we’ve devoted more time to our families, or we’re adjusting to working a different way. So take time off; that’s OK. Then jump back in and do those wonderful things for your heart. You don’t want to give that up.” When workouts do get sporadic or cease completely, that starts the body into what’s known as the detraining effect — “an interesting area of research,” says exercise physiologist Fabio Comana. Some people, studies have shown, may lose training effects in a few days; for others, it may take a month or more. Just how quickly depends on factors like age, general health, the presence of underlying issues such as diabetes, and VO2 max (a measure of how much oxygen the body utilizes during intense workouts). “Let’s say you trained and had an amazing VO2 max in the 60s,” Comana says. “Then you stop. It may drop 10 percent, so you’re down to 54. That’s still high, and in dayto-day living you won’t be winded. But if you’re an older adult with a 25 VO2 max and have a 10 percent drop, it will compromise your activities of daily living.”
What you’ve lost you can get back Cardiovascular fitness tends to be lost more quickly than muscle strength, Comana says. Here’s why: “Muscle adaptations are architectural changes; that is, you’re building bigger muscles,” Comana explains. “But cardiovascular fitness is a mechanism for becoming more efficient, rather than a structure.” Added to that physical mix is what’s going on in our brains. “Any time we’re confronted with a decision” — whether to exercise or not, maybe — “our brains are doing a sort of analysis, weighing the benefits of the decision with the potential costs,”says neuroscientist Shannon Odell. “After falling out of the habit of exercising or of taking time to focus on fitness, that cost may feel extra high,” says Dr. Odell, who admits to slipping out of her own exercise routine. “And research suggests that our brains are wired to follow the path of least resistance, or to make choices that require the least amount of effort.” So, since not doing anything is easier than doing something, no wonder we may be kind of in limbo about how, when and — hearing how quickly we’ve lost fitness — why to start back. That said, please don’t make a U-turn from the door of your recently reopened gym/fitness studio and head back to your car. Ditto for refraining from plopping back down on your favorite sofa with a bag of chips and your favorite beverage. Because while getting back to your pre-pandemic level may seem like a looming mountaintop, you can do it. And once you reach the summit, you’ll see that breathtaking view and feel that sense of accomplishment all over again. Plus, your workout buddies are counting on you — to do it, and to motivate them to do it, too. “We tend to focus on weight,” Dr. Whitsel says,“but we really need to emphasize overall the benefits of physical activity, the mental health and well-being, the positive effect on the cardiovascular system, on your muscles; you’ll feel stronger, have better balance and flexibility, and reduce the risk of falls.” It’s all a matter of feeling safe, of getting started, of planning ahead, of not being hard on yourself if you’re out of breath long before you used to be.
Above photo: Before beginning a fitness routine after a long break from physical activity, experts say it’s best to set realistic expectations and ease into exercise to avoid injuries.
Ease back in
Get (re)started and achieve results without frustration Exercise is a wonder drug, but you can’t feel the effects until you fill your own prescription.“In this time of Covid and stress, exercise can be a great relief for your body and your mind,” Dr. Laurie P. Whitsel says. “It’s more important than ever.” If you’ve been away from exercise, or just lax in consistency, Fabio Comana says the first thing to consider goes beyond physiology. “A lot of times when we’ve detrained, it may not be our choice; it may be circumstances,” he says. “Say you had no ability to work out for a month or two. You’ve not just detrained; you’ve changed your behavior.” Start to re-engage those behaviors that got you in shape; get back to exercising consistently, he says. Surprisingly, motivation doesn’t work as well as believing in yourself to accomplish something. “Where are you most likely to be successful?” he says.“The human brain doesn’t like uncertainty, but that’s what Covid has presented to us — uncertainty. The best way to overcome it is to develop structure.” Try a behavior once and evaluate it, he says. “If it’s something enjoyable and you could do it again, move it to two times and then to three. It’s building tiny habits and creating an automatic process.” Studies show the best way to stay motivated is by setting “small, difficult but still achievable goals,” Dr. Odell says. “So don’t expect yourself to hit that personal best the first week. Remember: Slow and steady.” The silver lining of all this? “We’ll probably recondition faster the second time than the first,” Comana says. Reaching your goal requires mak-
ing your comeback as successful as possible. Plan ahead: When you’ve scheduled a class and put it on your calendar, you’re more likely than not to show up. It’s a matter of holding yourself accountable. You wouldn’t schedule a haircut or a dental appointment and just not show up, would you? Lighten up on yourself: OK, you’ve been doing some neighborhood walking, maybe some crunches and push-ups, maybe some at-home workouts. Now you are ready to really push forward. f you don’t see results from your new workout routine right away, it can get frustrating, and you may be tempted to give up. But remember, it will only get easier with time. Listen to your body: If it’s telling you to slow down or take an option suggested by your instructor, go for it. “You’re feeling appropriate for where you are,” Dr. Whitsel says. “Don’t feel guilty; it’s all part of ramping back up.” Encourage each other: “It’s human nature to be competitive,” Comana says, “but the coach can change the mindshift from competitive to supportive. Pick up your neighbor; it’s fortunate for them and fortunate for you.” Additionally, he says,“Diminish the urge to peek over and see how the person next to you is doing.” And since social distancing keeps us from hugging or high-fiving each other at the end of class, it’s especially important to acknowledge classmates with a two-word call-out:“Great job!” Above photo: The key to returning to exercise safely after a long break is to take small steps and frequently change up your routine, according to fitness experts.
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What you should know about neurostimulation to treat chronic pain What are the treatments for chronic pain? There are many treatments for chronic pain, including, but not limited to: Physical therapy and lifestyle modification, TENS, topical therapies, over the counter and prescription medication, and injections and nerve ablations.
s many as 50 million Americans have chronic pain. It interferes with their work, their activities of daily living, and almost every facet of their lives. Brian J. Snyder, M.D., is a partner and attending neurosurgeon with Neurological Surgery, P.C. (NSPC Brain & Spine Surgery), Rockville Centre, and a fellowship-trained, board certified expert in using neurostimulation to treat chronic pain, surgery for epilepsy, movement disorders, and refractory pain.
What options exist when nothing else works? Neuromodulation, or neurostimulation, is a group of procedures that involve placement of electrodes temporarily (an if successful), permanently in the What causes chronic pain? nervous system. These treatment procedures Chronic pain can have many causes. It can be interfere with the message for pain being sent to caused by prior injury, medical disease, or prior the brain. surgery. Some patients may have chronic pain with These procedures include: spinal cord stimulation Brian J Snyder, M.D. no apparent cause. (SCS), dorsal roots ganglion stimulation (DRG), peripheral nerve stimulation (PNS), occipital nerve What are some of the types of chronic pain? stimulation (ONS), motor cortex stimulation (MCS), and deep brain • Low back pain (caused by arthritis, injury, etc.) – Some patients with stimulation (DBS). chronic low back pain may have had prior surgery and persist with that pain. If a patient had an unsuccessful trial or implant for • Complex Regional Pain Syndrome (CRPS – formerly known as RSD) – neurostimulation in the past, or has a device implanted that Caused by nerve or tissue damage, sometimes very benign in nature doesn’t work very well, are they a candidate for one of these resulting in a severe pain syndrome. procedures? • Migraine and other headache/occipital neuralgia. Yes. The technology has advanced substantially in the last several • Shingles (post-herpetic neuropathy). years and there are new devices and new procedures that are allowing
us to treat many new patients and to better treat patients that have older systems. About Neurological Surgery, P.C. (NSPC Brain & Spine Surgery) Founded in Freeport in 1958, Neurological Surgery, P.C. (NSPC Brain & Spine Surgery) has grown to become one of the largest, private neurosurgical groups in the U.S. with seven conveniently located offices on Long Island, including offices in West Islip, Commack, Port Jefferson Station, and Riverhead. –The practice’s experienced neurosurgeons and interventional neuroradiologists are experts in “Bloodless” brain and spine surgery, including laser spine surgery, endoscopic spine surgery, ultrasonic spine surgery, radiosurgery, and other advanced minimally invasive techniques which are used to treat brain tumors, brain aneurysms, trigeminal neuralgia, herniated disc, spinal stenosis, chronic back pain, and other conditions. Please visit www.nspc.com to learn more. To schedule an appointment for a consultation with Dr. Snyder, please call (516) 255-9031.
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outh Shore Rehabilitation is one of the premiere skilled nursing facilities on Long Island. One of South Shore’s main specialties is their 40-bed Vent Unit. It offers all kinds of Respiratory services, including Vent, Trache, Cpap, and BiPap. High Flow Oxygen was added this year to help aid patients during the pandemic who were having trouble breathing without the assistance of copious amounts of O2 being pumped into their lungs. The team is pleased to welcome a new pulmonologist, Dr Sam Davidoff, who is the Director of Pulmonology at Good Samaritan Hospital and cares for all the various pulmonary patients that are also cared for at South Shore. Under the auspices of Kilita Redmund, the Director of Respiratory Therapy at South Shore, the staff has successfully decannulated over 23 patients, 20 of whom were on vents due to Covid-19. They started doing a goodbye parade for each resident that was decannulated and able to return home. This paved the way for many feel-good moments
between the residents and their families. The team continues to wean patients off of vents and traches and expect many more goodbye parades to come.
275 W. Merrick Rd., Freeport • (516) 623-4000 • https://southshorerehab.net Health memos are supplied by advertisers and are not written by the Herald editorial staff.
Take precautions so that the sun is friend not foe Don’t let sunburn derail your fun
Many people find it impossible to think about summer without conjuring visions of spending endless hours outdoors from morning until evening, whether beachside, on the open water or even floating in a backyard pool. Especially now, as we begin to emerge from the pandemic, outside — making up for 2020’s “lost summer” — is where we want to be. Although a certain measure of sun exposure is required for some natural functions of the body, it’s well documented that too much time in the sun can be hazardous to one’s health. That’s why summer frolickers need to exercise considerable caution each time they step outside. Each year more than three and a half million cases of skin cancer are diagnosed in the United States. So whether you’re planning a trip to the beach, hitting the golf course, or enjoying a backyard cookout, remember to protect yourself from the sun. Banish The Burn Taking sunburn for granted can be a big mistake. Many people wouldn’t risk burns from a hot stove or open fire, but they won’t think twice about being unprotected under the very hot rays of the sun. Depending on the intensity of the sun and the amount of time spent outside, sunburn can be a first- or second-degree burn. In first-degree burns, damage affects the topmost layer of skin. However, sunburn can even affect deeper layers and cause blistering in addition to redness and pain.
Sunburn also can cause some irreparable damage that goes unseen. Medical experts stress that ultraviolet light from the sun can alter DNA, prematurely aging skin or even contributing to skin cancers. It can take years before symptoms become noticeable. Therefore, exercise caution when spending time in the sun — at every age. Always Protect Yourself Sunburn is one of the most easily prevented summertime ailments. It’s also important to note that sunburns are not just limited to the hot weather or when it is sunny outside. Ultraviolet damage can occur at any time of the year, and also from artificial UV sources, such as tanning beds. Preventing sunburn — preventing serious risk to your health — is simple. Seek the shade. The sun’s rays are usually strongest between 10 a.m. and 4 p.m. If you are outside, find shade from a structure, a leafy tree, or a sun umbrella for protection. Also, try to arrange your schedule so that you can take advantage of the early morning and late afternoon for your outdoor activities. Otherwise, limit exposure to the sun and take frequent breaks in the shade. Cover up. Wear protective clothing that covers the arms and legs. Some outdoor gear is designed to offer sun protection. Tightly woven fabrics tend to help the most. Your clothes can be an effective form of protection from the sun’s harmful rays. Some
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outdoor clothing now carries an Ultraviolet Protection Factor (UPF) rating. The UPF rating lets you know how well the fabric shields your skin from ultraviolet (UV) rays. All fabrics block UV rays to some degree, but the most effective have a UPF rating from 15 (good) to more than 50 (excellent). For example, a white cotton t-shirt has a UPF of five. Blue jeans have a UPF of 1,700. In other words, densely woven and bright or dark colored fabrics offer the best defense from the sun’s rays. Light-weight, loose-fitting long sleeves and pants also help. Don’t forget a hat and sunglasses to protect your head and eyes and put sunscreen on exposed skin. Apply — and reapply — sunscreen. Apply sunscreen generously and reapply it regularly. The Sun Protection Factor (SPF) measures how long unprotected skin can be theoretically exposed to the sun’s harmful UV rays before causing damage. UVA rays can prematurely age your skin, causing wrinkles and age spots. UVB rays can burn your skin. Too much exposure to
either can cause skin cancer. Look for products that offer an SPF of 15 or greater. The American Academy of Dermatology actually recommends an SPF of 30 or greater. Make sure the product is broad-spectrum, meaning it protects against UVA and UVB rays. Apply sunscreen thoroughly, paying attention to the tops of feet, hands and other places that tend to go untreated. Reapply every two hours or more frequently, if necessary. Keep in mind that sunscreen is often not applied thoroughly or evenly, and it might wash off while you swim or sweat. That means sunscreen might be less effective than the SPF number might lead you to believe. Dermatologists suggest that along with the sunscreen’s SPF, you should choose a “broad spectrum” sunscreen that offers protection from UVA and UVB rays. It is important to reapply sunscreen frequently. Above photo: Have your time in the sun while sparing your skin from damage and harm to your health.
Celebrate Better Hearing and Speech Month This May With
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Prevent injuries as you return to exercise, sports this summer
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s gyms reopen and summer sports and outdoor activities ramp up following the easing of coronavirus restrictions, Mount Sinai South Nassau experts advise caution before jump-starting a new workout regimen. “It’s important to warm up first followed by stretching before starting exercise, especially if you have been on the couch for months due to the pandemic,” said Stelios Koutsoumbelis, MD, Chief of Orthopedic Surgery at Mount Sinai South Nassau. “We are concerned that people may rush back out without proper preparation, which could lead to a rash of stress fractures, muscle strains, overuse tendon injuries, and soft tissue tears in the knees, shoulders, elbows, hips, and ankles.” To prevent such injuries, Dr. Koutsoumbelis recommends taking these simple steps before exercising: √ Follow a schedule that sticks to the “10 percent rule” of increasing the intensity, volume, distance, and duration of workouts. Make time for rest and recovery after strenuous exercise. √ Warm-up first followed by stretching before practice or training. √ Diversify training by combining or alternating activities like walking, jogging, biking, or weightlifting. Improving your core strength, lower extremity balance, flexibility, and cardiovascular endurance can enhance your fitness. √ Listen to your body; if you feel pain, soreness, or tightness, stop! Early intervention with targeted conditioning and stretching exercises, or even physical therapy, is key to avoiding further injury. √ Eat healthy. Be sure to include fruits and vegetables and adequate portions of protein in your daily diet. If you or your child suffers an injury, don’t live by the rule “no pain, no gain.”
Dr. Koutsoumbelis, left, and orthopedic surgeons at Mount Sinai South Nassau use minimally invasive and arthroscopic surgical techniques that reduce post-operative pain and result in less scarring. Mount Sinai South Nassau’s sports medicine professionals are ready to help by applying their experience and expertise to develop a tailored plan that will lead to a faster recovery and prevent reinjury. If surgery is needed, the hospital’s orthopedic surgeons use minimally invasive arthroscopic and image-guided surgery to repair common and complex orthopedic sports injuries. “The benefits of minimally invasive and arthroscopic surgery include reduced post-operative pain, less scarring, a quicker recovery, and a faster return to normal activities,” said Dr. Koutsoumbelis. “Many of these surgeries can be performed on an outpatient basis.”
Minimally invasive procedures such as the Birmingham Hip resurfacing may eliminate the need for traditional hip replacement surgery, just as the Uni-Knee partial knee replacement and ImageGuided knee replacement procedures may help you avoid open surgery. Knee and shoulder injuries repaired at Mount Sinai South Nassau include torn cartilage and anterior cruciate, posterior cruciate, and medial collateral ligaments in the knee as well as instability, impingement, rotator cuff, or labrum tears and recurrent dislocations in the shoulder. Mount Sinai South Nassau’s orthopedic spine surgeons also use minimally invasive surgical approaches that provide short- and longterm relief from painful back problems, such as herniated discs and stenosis. To ensure you maximize the benefits of the treatment plans prescribed to you, Mount Sinai South Nassau Physical Medicine and Rehabilitation’s multi-disciplinary team of an experienced physiatrist and staff of physical and occupational therapists provides top-notch physical therapy and rehabilitation programs. Get a leg up on recovery and return to action sooner by calling Mount Sinai South Nassau Orthopedics at (866) 32-ORTHO or (866) 326-7846. For more information on orthopedics, go to www.southnassau.org/orthopedics.
One Healthy Way Oceanside, NY 11572 877-SOUTH-NASSAU (877-768-8462) www.mountsinai.org/southnassau
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HEALTH MEMO May is Better Hearing and Speech Month
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n honor of Better Hearing and listening devices and to wear Speech Month, hearing protection in loud situations, Comprehensive Audiology is such as sporting events, concerts, raising awareness about the construction sites, or weddings. importance of hearing health. At Comprehensive Audiology, Hearing loss can affect one’s we prioritize and personalize your communication skills with family, hearing health. We offer friends and coworkers, and is also comprehensive hearing evaluations, correlated with increases in the latest in hearing aid technology, cognitive decline, depression, and a range of custom earplugs and hospitalization, falling, and even hearing protection. Opt for better mortality. Considering that the hearing this May! rate of hearing loss approaches 30 Comprehensive Audiology percent for adults over the age of will be offering complimentary Dr. Esther Fogel 65, a timely hearing evaluation hearing screenings during the entire Owner/Audiologist Comprehensive Audiology can be a literal lifesaver. month of May. Call (516) 387-4000 Some common signs of or text (516) 619-2069 or email hearing loss include straining to hear others speak, info@comprehensiveaudiology.com to schedule asking people to repeat themselves, and turning up your free hearing screening today. Follow us the volume louder than others find comfortable. The on Facebook, Linkedin, Google, or Instagram earlier hearing loss is discovered and treated, the @comprehensive_audiology, or visit us at more likely one is to stay active physically, socially, www.comprehensiveaudiology.com. and cognitively, and for longer. Hear’s to good hearing! Contrary to popular belief, acquired hearing loss can occur at any age, due to chronic ear and other infections, certain medical conditions and medications, or exposure to loud noise. The first step to healthy hearing is hearing loss prevention. We live and work in a loud world and protecting you and your loved ones from noise-induced hearing loss, which can affect adults and children of all ages, is almost always preventable. Remind yourself and 261 Broadway, Lynbrook • (516) 387-4000 your children to turn down the volume on personal www.comprehensiveaudiology.com Health memos are supplied by advertisers and are not written by the Herald editorial staff.
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How women can overcome obstacles to financial security
omen still tend to encounter more obstacles than men in pursuit of financial security. Women are still more likely to leave the workforce, at least temporarily, to raise children, resulting in lower contributions to employer-sponsored retirement plans; also to become fulltime caregivers of aging parents or other relatives. Those caregiving duties can exact a big financial toll: Wages, pensions (including 401(k) and similar plans) and Social Security benefits lost to caregiving can amount to more than $300,000 over a lifetime, according to the National Academy of Sciences. Improve your financial outlook with these steps Take full advantage of retirement plans. If your employer offers a 401k or similar plan, put in as much as you can afford each year and increase your contributions when your salary goes up. Choose the mix of investments that can provide the most growth potential, given your individual risk tolerance. Also even if you contribute to a 401k, you may be eligible to find an IRA, which gives you more investment choices. Evaluate Social Security options. You can typically start taking Social Security benefits at 62. But
monthly checks will be much larger if you wait until “full” retirement age, likely between 66 and 67. Also consider whether you’d be better off by taking spousal benefits, if your spouse earned more money than you. You’re generally eligible for spousal benefits even if divorced as long as you were married at least 10 years and haven’t remarried. Look for unexpected income opportunities. Even after you’ve formally retired, find ways to receive some earned income. Perhaps you can work part-time or do some consulting. If you’re a caregiver, you might be able to receive some compensation for your work. Many local governments pay non-spouse caregivers who act as personal attendants, although the rules vary greatly by state and county.
Marie L. Taylor, CRPC, AAMS Edward Jones Financial Advisor 365 Hempstead Ave., West Hempstead 516-538-4338 • 866-400-4338 www.edwardjones.com marie.taylor@edwardjones.com
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MOUNT SINAI SOUTH NASSAU NAMED TOP 10 PERCENT IN NATION FOR ORTHOPEDIC SURGERY. Mount Sinai South Nassau is among the top 10 percent in the nation for Orthopedic Surgery for the seventh year in a row (2015-2021), as well as a Five-Star Recipient for Total Knee Replacement for four years in a row (2018-2021), and Five-Star Recipient for Hip Fracture Treatment for eight years in a row (2014-2021). Our orthopedic specialists bring the latest advances in care of the bones, muscles, and joints. Our team is experienced in innovative techniques and highly specialized treatments, and works closely with experts in pain management and rehabilitation so you can get back to the activities you want to do.
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Learn more at southnassau.org/orthopedics
Get moving Creative ways to incorporate family fitness into your lifestyle We all know how important an active lifestyle is for long-term health and well-being. And now that the warm weather has arrived, there’s no reason not get outdoors and get moving. While eating a diet that is low in fat and high in whole-grain fiber, vegetables and lean proteins is important to our overall health, exercise remains one of the key factors in maintaining a healthy weight. However, many adults and children simply do not get enough exercise during the day. An active lifestyle is often hampered by the prevalence of digital devices or sedentary jobs that encourage more screen time than fitness time. But there are ways for the entire family to get fit. Exercising together is not just a great way for families to get healthy, but also a great opportunity to spend time together. The following are a handful of ways families can work together to incorporate more exercise into their daily lives. Tackle chores. Yes, tasks around the house can count as exercise. Working together not only gets you moving but also cuts down on the time it takes to tackle tasks around the house. Mowing the lawn, vacuuming the rugs, sweeping the floor -- all of these activities can get the heart pumping. Make it fun by setting chores to music or competing against one another to see who gets their task done first or the best. Compete in the pool. Swimming is a low-impact activity that works many muscles in the body. Taking a dip in the pool can be both relaxing and beneficial to your health. Compete with family members to make the most of the time spent in the water. Host relay swimming races, see how long each member of the family can tread water or create any other competitions that keep everyone in the pool moving. Create an outdoor obstacle course. Set up a series of obstacles in your yard and host your own triathlon. You can jump through tires, climb through tubes and scale trees. Make it fun by having adults try to ride tricycles or pair up an adult with a child for sack races. The opportunities for fun are only hampered by your imagination. Go for family bicycle rides. Traverse your neighborhood or
blaze new trails by riding bikes together. Young children can be strapped into trailers that are pulled behind the bike or ride in seats attached to the bike itself. This gives everyone a chance to enjoy the great outdoors and hone their cycling skills. Go hiking. Hiking is another fun family activity that also happens to make for great exercise. Choose a trail that may not be level and push everyone’s endurance to the test. Stroll the beach. We’re lucky enough to live close to the
beach, so take advantage of our many beaches and incorporate them into your fitness routine. Walking or running on sand offers more resistance than walking on pavement. Take a stroll at the seaside. Break up the walk by collecting shells or stopping by the water to observe marine wildlife. Above photo: Make exercise a family affair. Teach your children to embrace good fitness and nutrition habits while they are young.
Dreaming Up the Ideal Retirement Is Your Job. Helping You Get There Is Ours. To learn more about why Edward Jones makes sense for you, call my office today.
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MEET LONG ISLAND’S TEAM FOR BRAIN & SPINE CARE Nassau Neurosurgeons Michael H. Brisman, M.D. Trigeminal Neuralgia Brain Tumors
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