Back surgery is not something most people want to face. Yet 80 percent of us will have to deal with some kind of back pain in our lives.Advanced Pain Management Services on Thomas Johnson Drive is advocating a new type of procedure to relieve back pain, one that involves no surgery and fewer drugs.

Drs. Sandeep Sherlekar and Atif Malik use a system of high-powered water jets known as Percutaneous HydroDiscectomy to cut into the nucleus of the spinal disc and remove buildup of fluid which is the typical cause of lower back pain.

The procedure involves using a stream of water flowing at 600 miles per hour that is only as thick as a strand of hair.

Sixty percent of lower back procedures are done without surgery in Europe, according to Malik. “A lot of people miss out on minimally invasive methods because they don’t realize these options are available,” he said.

The spine is the backbone of the body. When it hurts, the whole body hurts. Low back pain is common in people for all sorts of reasons, the doctors said.

“Man was not designed to walk on two feet,” Sherlekar said. Malik said he doesn’t necessarily agree with that, but said genetics, poor nutrition, lack of exercise and excess weight, along with desk jobs and lots of sitting in general, contribute to low back pain. The older we get, the worse it gets.

The spine is made up of muscle and bone, and muscles must be used. Muscles that aren’t used atrophy, and then cause pain when subjected to too much stress. Core-strengthening exercises help the back muscles, and help people use their backs without hurting them.

“We want people to be active,” Malik said. “We want to repair the problem they have.”

The two doctors were trained in interventional spine specialty.

“Spine care is evolving,” Sherlekar said. “In the old days, you cut and hacked, and if it didn’t work, you sent people to pain management.” That usually meant drugs to relieve pain. “Surgical intervention is not necessarily the best. The outcome is better with conservative pain management.”

The procedure works best for patients up to about age 60. Sherlekar said the earlier people seek treatment for back pain, the better off they’ll be. After treatment, patients must be serious about exercise, good nutrition, keeping their weight down and not smoking if they expect to prevent future back pain.

How it works

HydroDiscectomy has its roots in laser surgery, which has been used as a minimally invasive way to treat back pain since about 1975.

The spine is composed of a row of discs, interspersed with bone. The discs are soft and spongy, resembling a jelly doughnut, Malik said. The center of the disc, known as the nucleus, has lots of fluid, which is supposed to stay there.

But back strains cause fluids to leak out of the nucleus. Fluids leak into the surrounding annulus, and sometimes, leak beyond the annulus, causing a bulging disc. The leaking fluid, especially when it becomes a bulging disc, is the source of much pain.

In the 35-year-old laser method, Malik said, the laser is inserted into the spine to suck out the fluids that are causing the disc to bulge. The problem with this is heat from the laser can cause nerve damage.

Surgery typically doesn’t get rid of the leaky fluid causing the pain, Sherlekar said. Surgery requires immobilization and months of recovery. Once those immobile muscles start being used again, there’s going to be a lot of pain. Sherlekar likened the pain to that surrounding the muscles when a bone is broken. Once you begin to walk on a broken leg or use a broken arm after weeks in a sling, the pain at first can be intense.

“When you fuse the spine (as is often done in surgery), you cast it, and you lose that range of motion while in the cast,” Malik said. When the cast comes off, that’s when the pain is felt most.

Surgery to fuse the spine usually provides temporary relief, he said. The muscles around the fused section atrophy and eventually become painful. “Muscles are made to move,” he said. That’s why patients that undergo back surgery often feel pain return a year or more after the surgery.

HydroDiscectomy enables doctors to reach a long, slender probe into the spinal disc. It sucks the water out of the annulus surrounding the disc, or to continue the jelly doughnut analogy, the doughnut part of the jelly doughnut. Once the fluid is removed from that “doughnut,” and any bulges removed, pain is decreased, Malik said.

X-rays are used to determine where the probe must go, and an endocsopic probe is used to look at the disc. A needle-like probe is used to suck out the fluid, using a high-pressure water jet. It’s known as the Venturi Effect, Malik said.

The same technology is used to cut steel, he said. Unlike heat, water doesn’t damage the surrounding area.

The procedure to remove the fluid takes about 15 minutes, Malik said. The needle probe is actually inside the spinal disc for about 3 minutes, he said. “People can go back to work within a week.”

It takes a bit longer if there’s a bulging disc. “When you herniate a disc, you create a flap of skin,” Malik said. “You’ve got to remove that; otherwise it won’t heal.” It is removed using an endoscopic probe.

Testimony

Danette Dunn, 36, of Kearneysville, W.Va., had the procedure done six weeks ago. “It was an immediate relief,” she said. “I was to the point where I could barely walk.”

She had two herniated discs, and one was torn. She also had stenosis, or a compressed spinal chord. “I had years of shots and pain medication,” she said. The pain was getting worse in her back, and traveling into her legs and feet.

“I went from a 10 on the pain scale (out of 10) to a one, sometimes a zero,” she said. She was able to walk out of the office after the procedure, which was on a Friday. Two days later, she was back to work.

The doctors have done about a half dozen of these procedures in Frederick . Their practice has offices in Germantown and Waldorf, and Malik also works in New Jersey, where he said insurance companies are more comfortable with the procedure.

“It takes time to adapt to new changes,” Sherlekar said. “Everyone wants 10 years of retrospective data on a new procedure.”

He has been practicing in Frederick since 1997. Sherlekar is an anesthesiologist, and both he and Malik are pain management specialists, not neurosurgeons or orthopedic surgeons. They received their pain management training from a program at Harvard.

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Keishawn Williams is already talking to her baby, although her child isn’t due until November.”What are you doing?” asks Williams, 22. “Are you awake? Are you asleep? Why are you sitting on my bladder?”

Although Williams may not realize it, her body and baby are also conducting a separate, even more important conversation that may influence her child’s health for the rest of its life. Although neither mother nor child is aware of this crucial dialogue, Williams’ body already is telling her baby about what to expect from the world outside, says Mark Hanson, a professor at the University of Southampton in England.

And thanks to those biological signals, the choices that Williams makes today — by getting good prenatal care, eating nutrient-packed vegetables and avoiding alcohol, tobacco and caffeine — may help her baby long after birth, Hanson says. Research into the “developmental origins of adult disease” suggests that Williams’ healthy living may help her child avoid problems such as cancer, heart disease, depression and diabetes not just in childhood, but 50 years from now.

Though adults still need to eat right and exercise, a growing number of studies now suggest the best time to fight the diseases of aging may be before babies are even born, says Peter Gluckman of the University of Auckland in New Zealand.

Williams’ baby is still too young to kick, let alone ponder its future. But its body is already adapting and preparing for its specific environment, Gluckman says, by reading cues sent through Williams’ blood and amniotic fluid.

“Every baby in fetal life is adjusting its pattern of development according to the world it predicts it will live in,” he says.

Reading cues while in utero

During the crucial “window of opportunity” before birth and during infancy, environmental cues help “program” a person’s DNA, says Alexander Jones of Great Ormond Street Hospital in London and the University College of London Institute for Child Health. This happens through a delicate interplay of genes and the environment called epigenetics, which can determine how a baby reacts for the rest of its life, Jones says.

Through epigenetics, chemical groups attach to DNA. Although they don’t change the order of the genes, the chemical groups can switch those genes on or off, Jones says.

Many things, such as chemical contaminants, can cause epigenetic changes. So babies exposed in the womb to synthetic hormones may begin responding abnormally to the natural hormones later made by their own bodies, says Hugh Taylor of Yale University School of Medicine.

That’s why, doctors believe, many babies exposed before birth to a drug called DES, or diethylstilbestrol, later developed rare cancers or fertility problems, Taylor says.

Doctors stopped prescribing DES, which had been used for decades to prevent miscarriages, in 1971. But Taylor and other scientists are concerned that “hormone-disrupting” chemicals, such as those used in pesticides and even common plastics, could cause similar problems.

Babies and children also can develop abnormal reactions to stress, says Jack Shonkoff of Harvard University, co-author of a June paper on early influences in health in The Journal of the American Medical Association.

In the short term, reacting to typical, everyday difficulties can help people develop a healthy response to stress.

But persistent, “toxic” stress — such as neglect or extreme poverty — may program a child’s nervous system to be on perpetual high alert. Over time, this can damage the immune response and lead to chronic ailments, such as heart disease and depression, the study says.

Diet as a predictor

A pregnant woman’s diet tells a fetus a lot about its future environment, including how much food will be available after birth, Jones says.

A baby conceived during a famine, for example, might learn to be “thrifty,” hoarding every calorie and packing on fat rather than muscle, even at the expense of developing vital organs, such as the kidneys, liver and brain. Because of a lack of calories, the baby also may be born small.

In a famine, those early adjustments and predictions about the future could mean the difference between survival and starvation, Jones says.

But babies may run into trouble if the world doesn’t match their predictions, Jones says.

A baby who has learned to hoard calories, for example, may grow up to be fat or diabetic once he or she finally gets enough to eat, Jones says. Doctors believe this occurs not just with babies whose mothers are starving, but with those who are malnourished because of a mother’s medical problems, poor nutrition or exposure to tobacco smoke, which damages the placenta.

It’s well known, Taylor says, that women who smoke are more likely to have low-birth-weight babies, who are in some ways “starved” for nutrients in the womb. Babies born too small are at risk for many immediate problems, such as underdeveloped lungs and bleeding in the brain.

If they survive, these youngsters also face long-term risks.

Studies show that small babies who gain weight rapidly in infancy or childhood — a sign that bodies are already making the most of every calorie — also have higher rates of adult heart disease and diabetes, Jones says.

Specialized X-rays have shown babies of young mothers with poor diets in India, for example, are born with extra belly fat, even though they seem to be a normal weight. Once these babies start getting an adequate diet, they are likely to put on weight, Gluckman says.

“Even by the time of birth, they’re on a different pattern of development,” Gluckman says.

Teaching future mothers

Adversity in early life can increase a child’s risk of disease, but it doesn’t seal his or her fate, Shonkoff says.

Although emotional abuse in childhood increases the risk of adult depression, for example, supportive relationships with adults can help children cope and recover, Shonkoff says.

Communities also can help, Gluckman says. By helping women such as Williams get good prenatal care and nutrition, for example, communities can reduce the number of fetuses who are malnourished and born small, Gluckman says. Babies who are born at normal weight are more likely to maintain that healthy weight.

Because half of pregnancies are unplanned, women need to learn about nutrition — and maintain healthy diets — long before they conceive, Gluckman says.

“We have got to give far greater focus to mothers, the women who are likely to become mothers and to the care of newborn children than we have in the past,” Gluckman says.

Williams, who also has a 1-year-old son and 5-year-old daughter, says she’s trying hard to give her children a bright future. She breast-fed both and now works as a breast-feeding peer counselor at the Family Health and Birth Center in Washington, D.C., where many patients are low-income or minority mothers.

The birth center also aims to help babies by getting their moms good prenatal care.

About 6% of black mothers who delivered at the birth center had low-birth-weight babies, compared with the citywide average of 14.2% for black mothers, says the center’s Ruth Watson Lubic.

“Twentieth-century medicine dealt with child health and adult health separately,” Shonkoff says. “What 21st-century medicine is telling us is that if we want to change adult health, we have to look in babies, even before they’re born.” (c) Copyright 2009 USA TODAY, a division of Gannett Co. Inc.

A Boston doctor says eating peanut butter can be a healthy choice.Dr. Walter Willett of the Harvard School of Public Health in Boston says the presence of some saturated fat doesn’t automatically kick peanut butter into the camp of “unhealthy foods.”

“Olive oil, wheat germ, and even tofu — all considered to be ‘healthy’ foods — have some saturated fat,” Willett says in a statement.

“It’s the whole package of nutrients, not just one or two, that determines how good a particular food is for health.”

Peanut butter has nutrients including fiber and some vitamins and minerals — especially potassium. Unsalted peanut butter has a terrific potassium-to-sodium ratio, which counters the harmful cardiovascular effects of a sodium surplus, Willett says. Even salted peanut butter still has about twice as much potassium as sodium.

Numerous studies have shown that people who regularly include nuts or peanut butter in their diets are less likely to develop heart disease or type 2 diabetes than those who rarely eat nuts, Willett says in the Harvard Heart Letter.

Dining at some restaurants will be a new experience starting today, when California becomes the first state to require that chain restaurants supply calorie counts for virtually everything they serve.”Consumers should be able to make informed decisions about their health and it will raise the consciousness of how much we eat,” said John Rogers, Sacramento County environmental health division chief.

There will be no guessing — or denial — about that double Western Bacon Cheeseburger from Carl’s Jr.: 960 calories. Side of Chili Cheese Fries to go with that? 990 calories. Maybe stick to the fried zucchini at 330 calories?

The new law requires restaurants with at least 20 stores in California — about 17,000 locations statewide — to provide a brochure on site listing calories, sodium, saturated fat and carbohydrates for each menu item. Both sit-down and drive-through restaurants must comply.

Drive-through menus must notify customers that the information is available at the pickup window.

A second phase, effective January 2011, will require restaurants to list calorie counts directly on menus or menu boards.

Alcoholic drinks aren’t included. Also, at restaurants that serve only buffets, such as Hometown Buffet, you’ll be on your own.

Menu labeling was conceived as a way to help customers make choices, said Rogers. His department conducts restaurant inspections, which will include monitoring for proper menu labeling.

Consider this information from Rogers’ department: An estimated one-third of all calories ingested by Americans are from restaurant food, and studies show that diners will shave off as much as 100 calories a meal when presented with calorie counts.

And consider this: Restaurants that fail to comply face a $50 to $500 fine, followed by other charges, such as unfair business practices.

Kim Simon and co-worker Julie Hereth emerged from a midtown Subway at noon Tuesday after splitting a tuna submarine: 530 calories for each.

“I looked to see what the cheapest one was,” said Hereth, explaining her method for choosing lunch.

Carrying a soda and an empty bag of chips, Simon said she welcomed menu-labeling and would put it to good use. She said she switched to a more modest coffee drink after she found out the latte she had been drinking had 500 calories.

“I’ve saved lots of money,” said Simon, 36.

Hereth said she always opts for what she believes are healthier choices, such as grilled chicken, but calorie counts can only help.

“It’s definitely a good idea,” said Hereth, 47.

The state’s restaurants generally endorse menu labeling, said Lara Dunbar, senior vice president of government affairs for the California Restaurant Association.

Statewide standards are preferable to a hodgepodge of cumbersome local ordinances, she said, but there are still gray areas.

For example, Sacramento County’s Rogers is unclear on whether See’s Candy — definitely a chain — qualifies as a restaurant.

Dunbar said extending menu labeling to independent restaurants would cripple that segment, even though there are computer software and online subscription services to formulate nutrition information.

Fine-dining independents, such as Waterboy in Sacramento, face other constraints, she said.

“A chef considers the food more like art and he decides maybe to add a dollop of sour cream here or there. It’s very difficult to standardize a process for a Waterboy,” she said.

Menu labeling began in New York City in 2008 after legal challenges and other controversy, followed by King County in Washington, which started in January.

King County, which includes Seattle, has found that 85 percent to 90 percent of qualifying restaurants are complying, said Dennis Worsham, regional health officer for Seattle-King County.

Restaurants were concerned that menus would rival “War and Peace” with all the new information, but that didn’t happen, Worsham said.

Whether menu labeling changes behavior is still debatable, but some restaurants have changed: One major coffee chain switched from whole milk to 2 percent milk to post a lower calorie count, Worsham said.

New York City and King County are collaborating on studies to determine to what extent behaviors change with menu-labeling.

Subway, with 2,200 restaurants in California and 22,500 nationwide, has been providing nutritional information for more than a decade, said Kevin Kane, a company spokesman.

Subway uses in-house dieticians and researchers for menu development but turns to independent analysis to get nutrition information, he said.

It is useful for some, inconsequential for others, he said.

“If someone is looking for that info, I’m glad it’s up there for them, but for others, they still want the oil, cheese on both sides, it doesn’t matter what you post up there,” he said.

Strings Cafe, a Sacramento-based chain with 29 stores, has worked with suppliers to gather nutritional information on about 40 menu items, said Al DiCaprio, president of the company.

Once they got that information, the company paid about $2,000 for an online service that breaks down Army-sized nutrition information into serving portions, he said.

His fettuccine Alfredo weighs in at 950 calories, he said.

It’s no cottage cheese and fruit, but DiCaprio said that diners generally eat healthy at home and treat themselves at restaurants — like to a plate of fettuccine Alfredo.

“I don’t care how many calories it is, it’s always a big seller,” he said.

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Call The Bee’s M.S. Enkoji, (916) 321-1106.

—–

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Copyright (c) 2009, The Sacramento Bee, Calif.

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Dozens of the nation’s leading organizations in health care, science, medicine and public health are meeting in Washington, D.C., this week with one goal in mind: to develop a national physical activity plan that will make America healthier. Congressional leaders and members of the public both agree that emphasizing disease prevention measures, such as increasing physical activity, is essential to combating chronic diseases, which account for 70 percent of all deaths in the U.S., according to the Centers for Disease Control and Prevention.The preventive power of physical activity has been noted by lawmakers. During mark-up of the Affordable Health Choices Act in the U.S. Senate Committee on Health, Education, Labor, and Pensions, Sen. Tom Harkin (D-IA) said: “The one overarching goal of health care reform is to recreate America as a genuine wellness society - one that emphasizes wellness, fitness, good nutrition, and disease prevention. Consider this: Right now, some 75 percent of health care costs are accounted for by heart disease, diabetes, prostate cancer, breast cancer, and obesity. What these five diseases and conditions have in common is that they are largely preventable and even reversible by changes in nutrition, physical activity and lifestyle.”

Reflecting a growing consensus on the subject, Sen. John McCain (R-AZ) said during the 2008 Presidential campaign, “Parents should provide their children with healthier meals and make exercise a family activity; schools must provide children with nutrition education and should offer more opportunities for physical education; and health-care providers should use yearly checkups as an opportunity to guide their patients through diet and fitness goals.”

The plan will focus on eight key sectors that have heavy influence on physical activity: business and industry, the nonprofit sector, health care, transportation, education, mass media, parks and recreation, and public health.

The American College of Sports Medicine originally called for the development of the plan following a 2006 policy conference. Russell Pate, Ph.D., FACSM, is the scientific lead for the national plan and also served on the advisory committee for the first-ever federal physical activity guidelines. Pate believes the plan will spur necessary change for Americans.

“A comprehensive National Physical Activity Plan will build on the momentum created by release of the 2008 Physical Activity Guidelines for Americans,” he said. “This Plan will be aimed at launching a social movement that shifts the American lifestyle to one characterized by high levels of health-promoting physical activity.”

The public agrees. A national omnibus survey commissioned by ACSM found that:

– 94 percent of Americans feel a national physical activity plan is

important in helping citizens avoid chronic conditions and diseases.

This was especially true in younger generations - nearly 10 percent more

citizens age 49 or younger thought a plan was “extremely

important,” possibly signaling their heightened knowledge about the

importance of disease prevention in the aging process.

– 97 percent of Americans think changes in the health care system that

support disease prevention through physical activity are important.

Minorities especially endorsed these changes, with 83 percent of

African-Americans recognizing them as “extremely important.”

The survey represented a national sample of 1,000 Americans age 18 and over from various geographic regions and demographics. Kelton Research, a leading national public opinion and market research firm, conducted the survey June 19-25. Margin of error is less than 3.1 percent.

During implementation of the plan, the national plan coordinating committee will use the survey information to target specific populations in need of physical activity intervention. The full national plan will be unveiled in the first quarter of 2010. For more information, visit www.physicalactivityplan.org.

The American College of Sports Medicine is the largest sports medicine and exercise science organization in the world. More than 35,000 international, national, and regional members and certified professionals are dedicated to advancing and integrating scientific research to provide educational and practical applications of exercise science and sports medicine.

SOURCE American College of Sports Medicine

Originally published by American College of Sports Medicine.

(c) 2009 PRNewswire. Provided by ProQuest LLC. All rights Reserved.

Ernie Medina Jr. is a preventive care specialist with Beaver Medical Group in Redlands. He specializes in areas of behavior change concerning lifestyle-related diseases, specifically focusing on exercise, nutrition, stress management and smoking cessation. He is also an assistant professor at Loma Linda University and co-founder of a family fitness and wellness center in Loma Linda called Xrtainment Zone. Medina tackles exercise issues.Question: In weight training, is there a minimum amount that’s needed to help build bone density?

Answer: Minimum: usually two or three times a week, two sets of 10-15 reps. If you can do two sets of 15 reps easily, then up the weight. That increase will stimulate bone health and density. In Miriam Nelson’s classic book “Strong Women Stay Young,” she showed a very simple chair-exercise program where they did an eight-week strength program and showed both fat loss and bone density increase.

Q. Should cardio and weight training be mixed in the same day — or the same workout session — and which should be done first?

A. You can do cardio and strength on the same day. If someone is doing five or six days a week of cardio, which is the recommended amount for fat weight loss, then you’ll have to do both on some of the same days. You can do in separate workouts or in the same workout sessions, and as for order, it doesn’t really matter. Some like to do the cardio first so they’re all warmed up for the strength, while

others like to warm up first with a little cardio and then do their strength, followed by the rest of their cardio workout. (Some get too tired in their cardio to do a hard strength workout). So it depends on your goals and how hard you’re working out on cardio and strength, which would dictate which would be first. Bottom line: You can do either one first, as long as you warm up before both.

Q. In weight training, it’s common to add more weights as you progress. What about in cardio? Do you add more time or more intensity or both? Or do you get the same benefit by staying at or near the level you began with?

A. Both. As you get in better shape, that 2-mile walk that took you 30 minutes, will now only take 20 minutes. You went from a 15-minute/mile pace to a 10-minute/mile pace because you’ve gotten in better shape, which is good. If you want to maintain the 50-minute rule, you then will have to walk farther at the faster pace to get 50 minutes in. Or you could wear a weight vest to increase the intensity while you’re walking (though I’m against ankle and wrist/handweights because they’re attached to moving parts and could strain joints, throw you off balance, increase risk of injury, etc.)

One needs to keep one’s heart rate up in the fat burning zone for most of the 50 minutes, so do what you have to to accomplish this. That usually means going faster or wearing extra weight safely.

When someone first starts exercising, they’re huffing and puffing, and could easily be burning 7-12 calories/minute because they’re out of shape. But as they get in better shape, their burn will drop to three to six calories/minute. So they have to increase their burn rate by pushing harder if they want to burn the same number of calories.

So yes, in both strength and cardio, you want to keep challenging your body if you are still trying to reach certain body and health goals.

Q. What gadgets are out there to help stay motivated and help me improve in my fitness quest?

A. There are numerous gadgets on the market to help track your exercise and fitness program. Most of these focus on measuring your exercise and calorie expenditure. The most common and least expensive gadget is a pedometer, which attaches to your body (usually your waist, but they have versions that you can attach to your shoe, put in your pocket, or hang around your neck). Pedometers count the steps you take in a day, and some models will also tell you how far you have walked and how many calories you have burned.

When it comes to pedometers, you usually get what you pay for in terms of accuracy. Focus more on steps because the mileage will usually be way off by the end of the day. A “couch potato” usually walks 3,000 steps per day, while a healthy goal to shoot for is 10,000 steps per day. If you’re trying to lose weight, aim for 13,000-20,000 steps per day.

There are more expensive gadgets that do a similar thing. Nike+ SportKit, which uses a sensor in or on your shoe, sends information to a receiver on your iPod Nano or iTouch. You can then sync your iPod to the Nike+ online community to download your data, track yourself, compete with friends anywhere in the world and complete challenges.

Q. After working out for a couple months, can I take a week off? Won’t that help me recover and get psyched for another couple months?

A. Taking a week off probably won’t hurt anything, unless you’re training for a specific event and it’s an unplanned break in your training schedule. The danger is that week turning into two weeks. Before you know it, it’s been a month and you’re still on break.

What would be better is instead of taking a complete break, change your program to something easier. Try something new that is still fitness-related and maybe you can add it into your regular routine for cross training.

It’s a good idea to change up your workout every six to eight weeks, partly because your body will get used to what you’re doing and partly because you might be getting bored. Most exercisers don’t want to take a break or they start to feel “blah” and not 100 percent. It has become a way of life, so stopping isn’t such a good feeling. To avoid the problems of overtraining, doing a variety of activities keeps it fresh and works out a variety of physical and mental muscle.

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Copyright (c) 2009, San Bernardino County Sun, Calif.

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Why not deal yourself a workout?Phil Black, a San Diego resident who bills himself as a fitness entrepreneur, figured out a fun, simple way to get people moving is to deal them a few cards.

And so FitDeck was born three years ago, primarily catering to the physically fit who wanted more challenges. FitDeck cards demonstrate hundreds of exercises, stretches and movements.

Two weeks ago, Black expanded his repertoire to include a 56-card FitDeck for seniors.

“You just shuffle the cards to create thousands of routines with unexpected combinations, sequences and intensity levels,” he boasts on his Web site, fitdeck.com.

Q. You have some 20 FitDecks _ including exercises to do with a baby stroller. How did you come up with this concept?

A. I was a student at Yale and my roommates and I played poker and also challenged each other to physical games. I challenged them to a push-up contest saying I would deal out 18 cards and guarantee to do as many pushups as the cards told me to do. I flipped the cards over one and a time and did more than 70 pushups.

We found out it was a simple way to get a little workout in.

Q. But how did you get from Yale to this card deck?

A. I was in the finance industry on Wall Street. Followed my dream and became a Navy Seal for five years and learned a huge repertoire of body weight exercises. Then I became a personal trainer and eventually a firefighter. When I was doing personal training, I had to write down exercises on index cards. Then I thought back to my Yale days and that’s how this idea was born.

Q. What do you know about exercise?

A. I have been a personal trainer. I also worked with exercise physiologists, particularly in areas like yoga and pilates.

Q. Is it a good idea to vary exercise so much?

A. There’s a huge body of evidence that repeating exercises for three weeks makes the muscles accommodate to the exercise. By mixing and matching, you change intensities and repetition. Besides, you don’t get bored and in a rut.

Q. This deck for seniors…well, what’s a senior?

A. It can be a 40-year-old deconditioned person. A 60-year-old in fantastic shape might find it too base level. Nothing requires you to get on the ground. You don’t compromise hips and knees. If you achieve all the senior exercises, you can graduate to FitDeck Body Weight. That can be very rigorous.

Q. These exercises look simple but are actually tough if you do them the maximum number of repetitions.

A. The deck has only been out for two weeks and there is high demand.

Q. Then there’s a deck for travel?

A. This is a great workout for travelers _ particularly those sitting in the middle seats. There are neck stretches, calf raises. You literally put the tray table down and do a couple of exercises to feel refreshed at the end of the trip.

Q. Some of your other FitDecks are for prenatal exercises, and postnatal also. There’s office exercises and even baby stroller exercises.

A. Why not use the baby stroller to do some exercises as well as a couple of laps around the park or the neighborhood?

Q. I like the type size and the illustrations on the senior cards. Where are they available?

A. Because we just launched them, they are only available from our Web site (fitdeck.com) and some affiliate Web sites. Eventually we hope to have them in retail stores.

Q. Are there more FitDecks in the offing?

A. Check the Web site for updates.

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(Jane Glenn Haas writes for The Orange County (Calif.) Register. E-mail her at jghaas@cox.net)

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(c) 2009, The Orange County Register (Santa Ana, Calif.).

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Some one million Jordanians suffer from high blood pressure, or vascular hypertension, which is the second leading cause of kidney failure in the country after type II diabetes, according to health experts.Mohammad Ghneimat, director of the Jordan Kidney Patients Association, said 30 per cent of kidney failure cases in the Kingdom are caused by high blood pressure, while diabetes is responsible for 40 per cent of the cases.

He added that if hypertension patients are given suitable medication, it lowers the risk of suffering a stroke, heart attack and kidney failure.

“Unfortunately, 50 per cent of blood pressure patients in Jordan are not diagnosed with the disease, while the other half are not controlling the condition,” Ghneimat explained at a seminar organised by Novartis, a healthcare products company, on Wednesday evening.

According to Osama Braiwish, who heads the Novartis Jordan office, high blood pressure is one of the most common illnesses all around the world, not just in Jordan.

He cited some studies that predicted the number of hypertension sufferers would double during the next 30 years.

“Currently, around a third of the world’s population aged above 35 suffer from high blood pressure,” Gneimat noted.

According to the US Centres for Disease Control, high blood pressure is often called the “silent killer” because it usually has no noticeable warning signs or symptoms until other serious problems arise.

Therefore, many people with high blood pressure do not know they have it.

In addition, high blood pressure can result in damage to the eyes, including blindness. The blood vessels in the eyes can rupture or burst from high blood pressure leading to impairment of sight.

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Copyright (c) 2009, Jordan Times, Amman

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NYSE:NVS,

ch Publication date: 2009-06-20Q: An acquaintance was describing her efforts to lose weight: She goes to a local park after work most days and runs/walks up to 8 miles. Still, she hasn’t lost any weight and pointed to her flabby midsection as evidence. She may be a few pounds overweight but is not obese. Someone joked that she hasn’t changed her eating habits. What might she be doing wrong? Answer: It’s good your friend is attuned to the dangers of abdominal obesity. Experts say extra weight carried around the waist (as opposed to the hips) raises the risk of developing Type 2 diabetes, high blood pressure and high cholesterol.

Generally, for nonpregnant women, if your waist measures more than 35 inches, and for men if more than 40 inches, you may be at greater risk for these chronic conditions. But experts say you can’t spot-reduce specific areas of fat.

Dr. Katherine Dec, medical director of CJW Medical Center Women’s Sports Medicine, offered some advice.

Physiological age, factors related to metabolism and any potential medical issues may affect how successful one is at weight loss, Dec said.

“Her friend is correct. A combination of ‘correct’ eating habits and exercise has the highest rate of success in losing those few pounds,” Dec said. “Another factor could also be in what type of exercise and if she is continuing to challenge herself with the exercise she selects. For example, walking or running at the same pace, same terrain, may not challenge her system enough to utilize the different nutritional sources she is using for fuel.

“In addition to addressing eating habits, she may want to vary her pace with short 30 seconds or one-minute running versus a jog pace during her exercise session. She could change the intervals of time as she finds it is easier to do each session. Also, weight training could be an exercise option.

“Consulting her medical physician could provide assistance in answering the above concerns and assure she has no risks in progressing through different types of exercise or intensity of exercise.”

Contact Tammie Smith at (804) 649-6572 or TLsmith@timesdispatch.com.

ILLUSTRATION: PHOTO

MEMO: HEALTH Q&A

Originally published by SMITH; Times-Dispatch Staff Writer.

(c) 2009 Richmond Times - Dispatch. Provided by ProQuest LLC. All rights Reserved.