Paragon Press – August 2013

Aspirin vs. Warfarin

By definition, a thromboembolism is the formation of a clot (thrombus) in a blood vessel that breaks loose and is carried by the blood stream to plug another vessel. Clots are potentially fatal risks of surgery, with the severity of the problem depending on where the thrombus travels. If you have had total joint surgery in the past 40 years, then you probably know what warfarin is. As the drug surgeons have used to prevent postoperative thromboembolism/clots, warfarin is effective, but has many side effects. The most notable side effect is bleeding, since warfarin interferes with your body’s ability to clot. It can be difficult to determine the proper amount for each patient because dosing is individualized. A recent study following 28,923 patients showed that aspirin may be a more effective prevention for clots than warfarin.

The study showed patients who were treated with aspirin had:

  • A lower incidence of pulmonary embolism (clot to the lungs)
  • A significantly lower DVT rate (clots)
  • Fewer wound-related problems
  • Shorter hospitalization time

The patients who received warfarin were more than six times more likely to develop an embolism to the lungs than one on aspirin. It is also important to note that using aspirin would be less expensive because there is less monitoring of your blood clotting. Regular clinic visits to monitor clotting are necessary while a patient is on warfarin, but not for aspirin. This research shows clear advantages to aspirin, but more study is needed for a definitive answer as to which drug is safest and best. Dr. Van Horne and Dr. Bents keep up with the most recent studies and will review what is best for you and your surgery.


Did you know that because of genetics, some people metabolize caffeine slowly, needing 8 hours to rid half of it from the body, while others need just 2 hours?

Quitting caffeine usually brings withdrawal symptoms that can last 2 to 9 days and doctors recommend you taper off gradually over 2 to 4 weeks to kick the habit.

The following articles were referenced for this newsletter:
http://www.medterms.com/script/main/art.asp?articlekey=25032
http://www.hindawi.com/journals/thromb/2012/837896/
http://www.aahks.org/patients/documentary/inside_look.asp
Wall Street Journal: Tuesday, June 11, 2013, D1

Paragon Press – June 2013

Keeping a balance as you age

No matter what your age

When Brian was in his 20s, he was fit and healthy. He rode his mountain bike and played basketball, although he didn’t think of that as exercise because it was just fun with his friends. Now Brian is in his 40s. He has a family, a full-time job that keeps him late at the office, and after a few spills on his bike, he can’t afford to be aggressive on the trails or the court. He wants to stay active and get exercise, but his outlook has matured.

As life changes, so does your body. Workout routines need to be reassessed throughout our lives, like a 401-k. You take less risk as you age and slow down a bit. Everyone experiences age-related decreases in function. The body decreases the maximal amount of oxygen it can use with age, known as VO2 max. This decreased ability to use oxygen begins in our 20’s and decreases more with age. Muscular strength beings its own descent by the time we reach 30. The majority of this loss in muscle strength occurs after the age of 50 and falls at a rate of 15% per decade. Women also deal with a loss of bone density. It decreases with age, but accelerates after menopause. All of these decreases remind us of our mortality, but we can age gracefully.

And Now For Some Better News

Aging is not for sissies. It’s a battle, but one that will improve your quality of life if you put some effort into it. Experts say the ideal combination of exercise as we get older should include a mix of aerobic, strengthening, and flexibility exercises. Some may find a lot of benefit from high-intensity workouts, but a less-rigorous workout can be just as effective, if done consistently. Dr. Bents suggests trying new exercises as we age to fit our lifestyle and body changes. Simple core exercises should be included in any fitness program, including full or partial squats, sit ups or crunches, planks, and shoulder/rotator cuff exercises.

Try something new: Zumba, yoga, CrossFit, circuit training, or P90X are examples. Tweak your routines as you get older to keep yourself active, interested, and fit. Get up and start moving!

Staying Balanced – Doing only one type of exercise can lead to muscle imbalance, leaving you prone to injury. Here are some suggestions for staying balanced.

Running – If running is something you’ve enjoyed over the years, you don’t need to stop as you age. Your body might need longer to recover. Try alternating the running with another activity, such as swimming or a rowing machine, to allow the joints and muscles to recover without the impact or overuse.

Swimming – Swimming is great for a cardiovascular workout and easy on the joints, but you need to incorporate weight-bearing exercise to prevent bone loss. Walking &/or running are good options. When swimming, try to spend an equal amount of time on your back while in the water to balance overall muscle conditioning and strength.

Cycling – Cycling mainly works the quadriceps. You need to maintain a balance with some other exercise such as an elliptical rider. Overly strong quadriceps can pull the kneecap to the side and create pain. Combining bicycling and running is a good combination to work a variety of muscles and prevent overuse. A stationary rowing machine also is helpful to achieve balance without pressure on the knees, if that is an issue.

Tennis – If you are right-handed, your right side is worked more than the left. Maintain balance with some resistance training, using dumbbells or therapy bands. Free weights force that weaker side to do more of the work, resulting in more balance of the muscles and less chance of injury.

You don’t work out? – No matter what your age, it’s never too late to get up and start moving. Walking doesn’t require a membership. No excuses. As we’ve mentioned in previous newsletters, having a friend join you is more fun and creates some accountability. You’re more likely to stick with any form of exercise when you have a friend join you. Start with something that sounds fun to get your heart pumping, like any of the exercises just described, keeping balance in mind. Incorporate a good core-building activity, such as Pilates or yoga. Exercise DVDs are another great option. They are cheaper than a health club membership, you don’t have to leave home, and you can do them at your own pace. With the incredible variety of DVD’s available today, from P90X to tai chi, everyone can find something they’re willing to try. They really do work and help you reach that goal to MOVE.

Finally, listen to your body. That sore hip or achy knee may be telling you to either slow down or not do as much. Remember how balancing your muscles can improve core strength and keep your body strong.

The following articles were referenced for this newsletter:
Medford Mail Tribune newspaper, April 7th, 2013, Rebalance your workout as you age, Page 1

Paragon Press – May 2013

“I WANT THAT!”

How companies are hooking you on foods and other sneaky things they do to sell them

“Words–so innocent and powerless as they are, as standing in a dictionary, how potent for good and evil they become, in the hands of one who knows how to combine them!”
Nathaniel Hawthorne

Millions of dollars are spent on marketing research about how to sell products, using little to say more. Every word, every image is chosen very carefully to convey exactly what the company desires. Many people in advertising take courses in psychology. Business degree programs offer studies in consumer behavior. They want to know how to get inside your head, sometimes without you realizing it. They are appealing to basic psychological impulses.

Here are a few of the phrases most commonly used:

  • LIMITED TIME-creating a sense of urgency to purchase
  • BY INVITATION ONLY-making the product sound exclusive
  • FREE-creates the a positive feeling, but keep in mind, the seller still has to make money
  • NEW AND IMPROVED-something nobody else has done before now. Our nation loves innovation.
  • MONEY BACK GUARANTEE-studies show people rarely return items, but this promise is reassuring.
  • DOCTOR RECOMMENDED-using an educated, trustworthy figure

Another claim to be wary of is “organic.” People tend to react to this word illogically, thinking it has fewer calories and better nutrition. “Organic” refers to the methods used to produce the foods, not the characteristics of the food.

Recently, General Mills wanted to introduce two new snack bars. They chose the same word to advertise both of them: protein. It’s the new buzz word for many kinds of foods. It’s selling drinks, supplements, bars, and cereals. Marketing has helped you believe protein will help you be healthier, your kid to perform better at sports, or your husband to lose weight.

DID YOU KNOW? – An average adult needs about 50 grams of protein in a day, and about 30 grams of fiber a day.

Do we need all this protein? The Centers for Disease Control and Prevention say that the average American actually eats more protein than needed, which can result in excessive caloric intake.

The U.S. Department of Agriculture recommends the average adult should get 10%-35% of daily calories from protein. Take a look at your diet to see if you actually need that protein bar. You might be spending more on a high protein snack or breakfast food that provides no additional nutritional benefits than what you would normally eat.

Much of the protein being added is from processed soybeans that have had the carbohydrates and fat removed. While this becomes an inexpensive way to add protein, the taste can be chalky. Companies have added other textures to avoid this issue, such as nuts and dried fruit, to produce a chewier texture.

GIVE ME PROTEIN AND FIBER! – When we eat food that promises to be a good source of things we need, such as whole grains or protein, we feel better about ourselves, like we’ve made a smart, intelligent choice that will benefit our bodies. According to the senior vice president of food marketing and innovation for Kellogg’s, over half of consumers are looking for more protein and fiber for breakfast, rather than “low-fat” or “no cholesterol” choices. A food must contain at least 5 grams of protein per serving to be considered a “good source.” For reference, one cup of milk has 8 grams of protein and a 3-oz piece of meat has about 21 grams of protein. A food that claims to be high in fiber must have at least 5 grams of fiber per serving. For reference, a slice of whole wheat bread typically has 1.9 grams of fiber, and 1 cup of cooked green peas has 8 grams of fiber.

What does PROTEIN mean to you? – Packaged food companies have these interpretations of its meanings. These assumptions help them sell their products. Be careful of how they might be targeting you and your family.

The following articles were referenced for this newsletter:
Wall Street Journal, Wednesday, March 27, 2013, “When the Box Says ‘Protein,’ Shoppers Say ‘I’ll Take It’

http://www.mainstreet.com/slideshow/smart-spending/buzzwords-make-you-buy

http://www.ext.colostate.edu/pubs/foodnut/09365.html

http://www.cdc.gov/nutrition/everyone/basics/protein.html

http://www.mayoclinic.com/health/high-fiber-foods/NU00582