Author: Yuliya Shneyderman

Complementary and Alternative medicine

We already know the definition of conventional healthcare. Anything that falls outside the realm of conventional care is considered to be complementary or alternative care. You may also see the term integrative health. Read about the differences here – https://nccih.nih.gov/health/integrative-health.

There are several types of complementary or CAM approaches.

Natural products includes various products like herbs, dietary supplements, probiotics and so on. These tend to be the most common CAM practices that people try.

Mind and body practices include things like yoga, meditation, massage, chiropractic practices and so on.

Some CAM practices can be considered their own medical system. Examples include Traditional Chinese Medicine, Ayurveda, homeopathy and others. These systems have their own philosophies about what causes health and disease, often incorporating a belief in some kind of vital force like qi, and will likely contain a large number of different types of treatments. These systems are often considered holistic, because they think of the person as inextricable linked to a vital force that connects them to the environment, and because the body, mind and spirit are closely connected.

Traditional Chinese Medicine includes practices like acupuncture, massage, herbal remedies, and several other components.

Ayurvedic medicine is one of the oldest systems of medicine still practiced in the world. It came from India and contains several practices like yoga, meditation, herbal and natural products, diet and so on.

Homeopathy is a holistic system which was developed in Germany about 200 years ago. Treatments mainly consist of highly diluted remedies.

Before you decide to use any of these practices, consider whether they are safe for you to use and whether they are effective – https://nccih.nih.gov/health/safety and https://nccih.nih.gov/health/decisions/consideringcam.htm.

Make the most of your healthcare visit

You’ve decided to go see a doctor or other healthcare provider. Maybe it’s just time for a check-up. Maybe you are not feeling well. Whatever the reason, here are some ideas to make the most out of your visit.

Think about your reason for the visit, prepare ahead of time, try to focus on what brought you in – https://www.npr.org/2019/07/03/738497630/how-to-get-the-best-from-your-doctor.

Learn how to ask questions! Sometimes the visits are short, and you forget to ask something you wanted to know about. Try to write down your questions before the visit so that doesn’t happen. Some sample questions are here – https://www.ahrq.gov/patients-consumers/patient-involvement/ask-your-doctor/index.html.

If you are nervous about something, it may be helpful to bring someone with you to the visit. Having two sets of ears can help you to remember some of the important things your doctor may tell you. You can also take notes during your visit, especially if you are getting a prescription, the doctor is sending you for a test or procedure, or they tell you something unfamiliar.

As a patient, you have certain rights. In general, you have the right to get medical care if you need it, and to refuse specific kinds of care. You have the right to an informed decision – that is, your healthcare providers should tell you your diagnosis, the risks and benefits of possible treatments, and the success rate of a treatment if there is a known one. You have the right to privacy of your medical information and the right to view your medical records.

What makes a good doctor?

We all have to seek professional healthcare sometime. But how do we find a healthcare provider we really like and trust?

Think about a good experience you’ve had at the doctor’s office, urgent care, or hospital. What stood out to you as a good quality for your healthcare provider?

Think of a bad experience. What did you find frustrating? What would you change, if you could?

Find some more ideas here – https://www.npr.org/sections/health-shots/2019/07/08/739039046/how-to-pick-a-doctor-or-break-up-with-one

Conventional medical care

Conventional medical and health care are also called allopathic or Western medicine. This is in contrast with complementary, alternative, or integrative health approaches. Most of the healthcare you have probably gotten in the United States is this type of care – the kind where doctors, nurses and other affiliated medical professionals provide the care.

This type of care generally concerns itself with diagnosing, preventing and treating disease. Disease or illness in this system of care is thought to stem from organic changes in the body, like atherosclerosis, or from exposure to pathogens like bacteria and viruses.

The people who provide conventional care are medical doctors who hold MD or DO degrees, nurses (who may have a bachelor’s or master’s degree and who are licensed as RNs or NPs), physical therapists, and various other allied medical professionals. Examples include emergency medical technicians (EMTs), respiratory therapists, dentists, podiatrists, optometrists, and others.

Most medical doctors hold the MD (medical doctor) degree, and some may also have a DO or Doctor of Osteopathy degree. They attend accredited medical schools for several years, then have periods of residency and internship, and some may choose to specialize further. Doctors who provide general every-day medical care are usually those who studied internal medicine or family medicine. They may be known as general practitioners or primary care providers. They can see people for common complaints like respiratory infections, and well-care (check-ups that may include blood laboratories, blood pressure screenings, vaccines, and other prevention and routine care). They can order screening tests, blood work, medical imaging like X-rays or MRIs, and other diagnostic tools, and can prescribe medications. Doctors offices may also have Nurse Practitioners (NP) or Physician Assistants (PA) provide this kind of care under the supervision of the doctor.

Doctors who choose to specialize spend several more years working in a particular area of medicine. This can be based on a particular body system, like cardiology or neurology, a kind of patient, like pediatrics or gynecology/obstetrics, or particular type of disease, like oncology (specializing in cancers). Usually, a primary care provider may refer their patient to a specialist if they require more than routine every-day care.

Conventional care is also found in hospitals, urgent care centers, and rehabilitation centers. Here, many allied health professionals may be present to help doctors provide care.

When should you seek emergency care and when should you go to an urgent care center? Generally, you should go to the emergency room a life-threatening condition (heart attack), sudden serious changes like shortness of breath, numbness or paralysis, or serious/severe conditions like trauma, severe cuts or burns, severe allergic reactions and so on. Urgent care is for times when you need care right away and may not be able to see your primary provider quickly – things like respiratory infections, earaches, etc.

Weight management

You can be active at any size – https://www.niddk.nih.gov/health-information/weight-management/staying-active-at-any-size. You can also find lists of resources and organizations that espouse a Healthy at Every Size philosophy here
https://haescommunity.com/find/ .

Obesity, defined as a Body Mass Index (BMI) of 30 or greater, and overweight, defined as a BMI of 25 to 29.9, have been on the rise in the United States for decades. Obesity is a risk factor for heart disease, some types of cancer, osteoarthritis, sleep apnea and several other health conditions. Overweight when present with other factors like high cholesterol, high blood pressure, family history, or cigarette smoking, is also considered to be a risk.

Image shows a human body and lists medical complications of obesity: sleep apnea, stroke, asthma, pulmonary blood clots, heart disease, diabetes, fatty liver, cancers, arthritis, gout.

Learn more about obesity by watching Part 1 of the documentary Weight of the Nation. All parts are available for free on Youtube.

BMI is one of measures of body composition, previously defined here. Body composition is defined as the relative proportion of fat mass to lean mass in the body. It is usually measured by percent body fat, but that can be hard to do day to day. So one approximate measure is BMI, which is a ratio of mass to height. You can calculate your BMI here – https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm. Another measure is waist circumference, because abdominal fat puts you at higher risk for health complications.

There are more accurate measures of body composition. Calipers can be used by fitness professionals to do a skin-fold measurement to determine body fat percentage with more precision. There are also scales and handheld tools that use bioelectrical impedence to estimate a percent body fat. Less accessible are things like full body tools like air pods, hydrostatic weighing (under water), or special X-rays.

Body fat consists of essential fat (what we need to function), and storage fat. There is a range of normal body fat – https://us.humankinetics.com/blogs/excerpt/normal-ranges-of-body-weight-and-body-fat.

In order to improve your body composition, consider these tips.

Improve your diet, but do it as a change to your habits. Usually when people think of diets, they think of short-term programs meant to lose pounds fast. However, while this can help people lose weight, most will not maintain that weight loss. Read the post titled How can you eat healthier? Take a look at some myths about weight management – https://www.niddk.nih.gov/health-information/weight-management/myths-nutrition-physical-activity.

Practice portion control. Portion sizes have increased in the last several decades. Looks at this Portion Distortion Quiz to see how much. Read about portion control here – https://www.niddk.nih.gov/health-information/weight-management/just-enough-food-portions.

Exercise safely

It is important to prevent injuries when you exercise. There are traumatic injuries that can happen suddenly and overuse injuries that happen from repetitive motions. As a first line of treatment for overuse injuries, you can try RICE – rest, ice, compression and elevation. However, it is important that you see a healthcare professional as well, to make sure nothing serious is going on.

Wear comfortable shoes – https://www.webmd.com/fitness-exercise/features/how-choose-athletic-shoes#1.

Learn how to exercise correctly – https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/weight-training/art-20045842?p=1 .

Wear a helmet or other protective gear when riding a bike, skateboard, roller blades and other activities that can result in injuries. Wear the safety clip attached to treadmills – they will stop the machine if you get too far from the safety bar.

Stay safe when exercising in hot weather – https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/exercise/art-20048167.

Make sure to drink enough water before, during, and after exercise. You probably don’t need to increase your protein intake unless you decide to become a body builder. However, eating or drinking a small amount of protein-rich foods can be helpful with muscle recovery. Make sure you are eating enough carbohydrates for energy.

If you decide to use dietary supplements to enhance performance, first read this https://ods.od.nih.gov/factsheets/ExerciseAndAthleticPerformance-HealthProfessional/. Know that dietary supplements may not always work as you expect, so consider carefully. Using medications like anabolic steroids or human growth hormone to enhance performance is unwise and may lead to health problems.

How to plan an exercise program – be FITT

If you haven’t done much exercising before, or if you’re getting back into it, there are a few things that can help you to plan an exercise program for yourself.

First, make sure to warm up! There are many benefits to warming up – it is a way to slowly increase your body temperature, limber up your muscles and joints, and heart rate. You can do some dynamic stretching or light aerobic activity.

Then, use the FITT principle to focus on either aerobic or strength training, or both. F for frequency – how many times per week will you do it, I for intensity – how hard you need to work, T for time – how long will you do it at one time, and T for type – what kind of activity will you do.

For aerobic or cardio activities, use the guidelines to plan for 150 minutes of moderate or 75 minutes of vigorous activity per week. That can be 5 times of 30 minutes each, or something else that works for you. Intensity can be measured by your heart rate, your breathing rate or METs (Metabolic Equivalents – read more here https://sites.google.com/site/compendiumofphysicalactivities/home). Some examples are here.

For strength training or resistance training, try to exercise all major muscle groups at least twice a week. Try to give your muscles a rest of 24-48 hours between bouts of exercise. Intensity can be measured by the amount of weight you are pushing against. Overload your muscles to the point where it would be hard to do more repetitions. Time is measured not with minutes but with repetitions and sets – a common thing is to repeat the movement 10-15 times, for 2-3 sets, with a rest break of 30 seconds or a minute. Read more here.

Don’t forget to cool down! Now is a good time to do some static stretching of your muscles, especially ones you used during your main exercise. Flexibility exercises can be done every day, but at minimum you should do them 2-3 times per week. Make sure you do not feel pain when stretching, feel the point of tension and stop there – this is the intensity of flexibility exercises.

What is physical fitness?

Can you complete all of your activities of daily life without too much exertion and fatigue? Then you may be physically fit!

We know that exercise and physical activity is important for health. But what kind of physical activity should you do? There are several types of exercise that help with the main components of physical fitness. They are endurance (or aerobic), muscle strengthening, flexibility, and balance. https://medlineplus.gov/exerciseandphysicalfitness.html

Endurance or aerobic exercise helps with cardiorespiratory fitness – this refers to how efficiently your heart pumps blood, how much oxygen your lungs take in, and how well your blood vessels transport oxygen and nutrients to body parts that need them. http://www.shapesense.com/fitness-exercise/articles/cardiorespiratory-fitness.shtml What are some examples of aerobic exercise? Comment below.

Strength or resistance training helps with muscular strength and endurance – this refers to how much weight different muscles group can push or pull. Read more about it here – https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/strength-training/art-20046670?p=1. In particular, one group of muscles that are very important are core muscles – pelvis, lower back, hips and abdomen. Including them in your exercise routine is very important – https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/core-exercises/art-20044751?p=1 .

Stretching, yoga and tai chi can help with flexibility – the ability of joints to reach their full range of motion. Read about the importance of stretching here – https://familydoctor.org/the-importance-of-stretching/?adfree=true. Some of these activities can also help with balance – this is very important for older adults.

Ugandan women and men during the Sukuma dance, a physical fitness exercise to fight cancer by Oketch Michael Eriya

Body composition is another component of physical fitness – read more about it in the post Weight Management. This refers to the relative proportion of fat and lean mass in the body.

How can we move more?

Many people in the United States are not getting the recommended amount of physical activity. Studies show that even small amounts of physical activity can increase people’s health. So why is it so hard to move more?

There are individual reasons and barriers to getting more exercise or physical activity. Schedules tend to be busy, people may not know how to exercise correctly and be intimidated, or your motivation may slack when there are other things to do. What other barriers stand in your way?

There are also structural reasons why exercising may not easy for people – no gyms or affordable places to exercise in the neighborhood, poor infrastructure with no parks or playgrounds, no bike lanes, and other environmental factors can impact our ability to exercise. Read more here – https://newsinhealth.nih.gov/2015/05/opportunities-abound-moving-around.

One way we can overcome our obstacles is by first understanding what they are, and then thinking of ways to overcome them. Comment below with ideas of how to increase your physical activity throughout the day that are realistic to your situation.

Here are some ideas to increasing your physical activity – listen here https://www.npr.org/2018/12/12/676129459/get-started-exercising. And some more ideas to make exercise into a habit, based on research – https://www.npr.org/2018/12/12/676142159/build-an-exercise-habit-that-sticks.

Image of BMCC community at the 5K walk/run event
BMCC 5K walk/run event