Category Archives: General Information

Role of Exercise in Type 2 Diabetes

February 7, 2018 Teresa Stockton - Blog, General Information

Lifestyle changes play an important role in managing type 2 diabetes. Activity decreases blood glucose and regular exercise helps by improving the way your body uses glucose.It can also reduce the risk of diabetes complications like heart disease.

How it Works
Glucose is a type of sugar that is used for energy. It is present in the blood and stored in the muscle and liver. A hormone called insulin helps most of the glucose move from the blood into cells. For those with type 2 diabetes, the body is resistant to insulin and over time the body has trouble making insulin at all. As a result, glucose has trouble getting to the cells, the body doesn’t get enough energy, and glucose builds up in the blood.

During exercise your working muscles have a greater need for energy and therefore glucose. As a result, glucose can enter the muscles and cells with far less insulin. This leads to a drop in blood glucose levels during exercise and for a few hours after while the muscles recover. This causes an immediate though temporary decrease in blood glucose.

Over time, regular activity can make the body less insulin resistant during activity or rest. This can lead to more long term benefits and may lead to a decrease in the need for medication.

In addition to helping control diabetes, exercise can also improve your overall health by decreasing weight, the risk of cardiovascular disease, and blood vessel damage.

Exercise Recommendations
It is important that you talk to a doctor before starting an exercise program. You and your doctor can work together to choose an exercise program that is right for you.

For greatest benefits, you will need to do both aerobic exercises and strength training. Aerobic exercises include things like walking, bicycling, and swimming. Strength training exercises and classes use things like weight machines, free weights, and resistance bands. Adults should aim for:

At least 150 minutes per week of moderate-to-vigorous intensity aerobic exercise
2-3 days of strength training per week
Try not to go more than 2 days without some type of activity

Look for opportunities during the day to add to your overall activity level. Take the stairs instead of the elevator, take a short walk during the day, or walk instead of taking the car. Even 10 minutes of activity can provide some immediate benefits.

Safety Steps
Certain diabetes medication can lead to a dip in blood glucose called hypoglycemia. Talk to your doctor to understand if this may be a problem for you. Be aware of signs of hypoglycemia during exercise such as dizziness, shaking, or confusion. If you have these symptoms, stop exercising and manage hypoglycemia. Let your doctor know about any episodes, since your medication may need to be adjusted.

Diabetes can also affect the nerves and blood flow to the feet. Inspect your feet frequently, since diabetes can sometimes lessen your ability to feel pain from a foot injury.

Keep in mind that exercise is only one piece of an overall diabetes management plan. You will also need to control your blood glucose levels with good nutrition.

by Cynthia M. Johnson, MA

RESOURCES:
American Diabetes Association
http://www.diabetes.org

Centers for Disease Control and Prevention
http://www.cdc.gov

CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca

Public Health Agency of Canada
http://www.phac-aspc.gc.ca

REFERENCES:

Physical activity for type 2 diabetes. EBSCO DynaMed Plus website. Available at: https://www.dynamed.com/topics/dmp~AN~T270048/Physical-activity-for-type-2-diabetes. Accessed February 20, 2017.

Physical activity is important. American Diabetes Association website. Available at: http://www.diabetes.org/food-and-fitness/fitness/physical-activity-is-important.html. Updated December 27, 2016. Accessed February 20, 2017.

What we recommend. American Diabetes Association website. Available at: http://www.diabetes.org/food-and-fitness/fitness/types-of-activity/what-we-recommend.html. Updated May 19, 2015. Accessed February 20, 2017.

How to Manage Your Type 2 Diabetes with Diet. Available at: https://www.jenreviews.com/diabetes/ Accessed November 2018

Last reviewed December 2017 by EBSCO Medical Review Board Michael Woods, MD, FAAP Last Updated: 12/22/2017

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

When Is the Time Right for Physical Therapy?

January 19, 2018 Teresa Stockton - Blog, General Information

Often, we end up in physical therapy based on the referral of our physician after dealing with and injury for a certain period of time. However, physical therapy can be used for many different ailments and can actually help cut down the time off work, off of sports and promote healing much faster.

Physical therapy can be used for many of your minor and major injuries. Following surgeries or traumas (accidents, dislocations, fractures, sprains) it can cause a considerable reduction in swelling and allow things to heal 75-80% faster than if without therapy. It has been shown that following surgery, the quicker someone goes for therapy, the less likely they are to stiffen up or have complications due to loss of range of motion. It also helps to significantly reduce pain and swelling.

Physical therapy is not only used following surgeries or sports injuries, but can be extremely helpful in preventing symptoms from getting worse and developing into more problems. If you’ve been having pain in your shoulder for 3 months or so, your body now has altered the way it moves your shoulder and in turn, you have developed some compensation patterns which could cause things to develop into other areas, such as your neck from your altered movements. This then, can lead to more significant problems which could have been easily avoided if therapy had been started and symptoms had gotten under control.

Remember, the quicker you get into therapy following an injury or persistent pain, the quicker your response time will be to therapy. If you are having some issues, talk to your physician about starting therapy. You don’t have to wait until it has a complete impact on your life or your recreational activities. Stop pain in your life and feel better by visiting one of our PT & Me physical therapists today.

PTandMe and How to Find Physical Therapy Near You

January 12, 2018 Teresa Stockton - Blog, General Information

PTandMe is your online guide to physical therapy. We make it easy for you to look up common conditions, see how physical therapy will benefit you directly, and most importantly, we make it easy for you to find physical therapy. If you are in pain, and need to find a licensed physical therapist in your area – we are the best place to look. To learn more about Physical Therapy click here.

The PTandMe injury center is unique in that it provides information on common conditions that physical therapists treat as well as gives you a glimpse into what physical therapy treatment may look like for your condition. Physical therapists are the musculoskeletal experts, so when it comes injury or musculoskeletal pain – you are in the right place. The injury center covers diagnoses from head to toe. To visit the PTandMe injury center click here.

In addition to the injury center, PTandMe sends out great health and wellness tips each month through the Therapy Connection newsletter & weekly PT & Me blog posts. We partner with over 550 physical therapy clinic nationwide, so the topics covered are relevant and directly from licensed professionals in the field. Featured articles, recipes and fun trivia questions make these resources a great learning tool for everyone.

When it comes to finding physical therapy and scheduling your first appointment, PTandMe makes it easy. We have collected an online database of our partnering clinics throughout the United States so that you can easily access them from your phone or home computer. To find a physical therapist near you visit our “Find a PT” search page by clicking here.

If you are on the fence about going to physical therapy, or simply want more information about it, PTandMe makes it easy for you to find the information you need quickly. The faster you start to treat pain or an injury, the better the long term benefits, so don’t wait to try physical therapy. Get started today and find physical therapy clinics near you!

Direct Access: Physical Therapy Without A Physician Referral

November 2, 2017 Teresa Stockton - Blog, General Information

Did you know that almost all states allow consumers to be treated by a qualified physical therapist without a referral from a physician? It is called direct access and most of our PT&Me partnering locations are able to provide direct access to physical therapy to your community.

EXPERIENCED PHYSICAL THERAPISTS

Quality and consistency of care are the cornerstones of our partnered clinics. Everything the clinics do is directed towards developing and fostering these behaviors. Quality means doing things that work. Licensed physical therapists design programs of care that have been proven to be effective treatment interventions. You can expect individualized, hands-on care.

HONEST AND TRUSTWORTHY

Your well being is our primary concern. Our direct access physical therapy clinics will always do what is best for you. After your initial physical therapy evaluation, your physical therapist will recommend the appropriate plan of care for you. They will not waste your time or money if physical therapy is not your best option for a full and quick recovery.

PHYSICIAN PARTNERS

Our partnered direct access physical therapy clinics have wonderful relationships with numerous physicians in and around your community. If you choose to receive physical therapy via direct access, your therapist will communicate appropriately with your physician at your discretion. If you are new to the area or you do not have a physician and need one, they will be happy to help facilitate a referral to a doctor for you.

* Not applicable to patients in federal or state funded programs, such as Medicare, Medicaid or Tricare

For more information about direct access physical therapy and to see if your state participates, go here:

This article was written by STAR Physical Therapy – with over 65 locations throughout TN. For more information on STAR Physical Therapy, visit them online at www.STARpt.com

Protect Yourself from Tickborne Illnesses

August 15, 2017 Teresa Stockton - Blog, General Information

They may be small, but the bite from just one infected tick can cause symptoms that range from fever and chills to severe infections. However, you can protect yourself from tickborne illnesses, such as Lyme Disease and Rocky Mountain spotted fever, by avoiding areas where ticks are present and preventing ticks from getting on your body.

AVOID TICK HABITATS
Ticks can be found in the northeastern, northwestern, mid-Atlantic, or upper north-central regions of the United States. They are most active in warmer months from April to September. However, they can be active when temperatures are above 40°F (4.4°C).
Tips for reducing your exposure to ticks include:

Avoid moist, shaded, wooded, or grassy areas.
Stay on cleared, well-traveled paths, and walk in the center of trails to avoid overgrown grass and brush.
Avoid sitting on the ground or on stone walls.
You can discourage ticks from your property if you:
Remove leaf litter, brush, and woodpiles from around your home and the edges of your yard.
Mow the grass often.
Discourage animals that carry ticks from coming onto your property.

PREVENT TICKS FROM GETTING ON YOUR BODY
Proper clothing can help protect you from tick bites when you enter areas that may have ticks. When spending time outdoors:

Wear long pants and a long-sleeved shirt. Light-colored clothing will make it easier for you to see any ticks that may get on you.
Tuck your shirt into your pants and tuck your pants into your socks.
Wear a hat. Braid or tie back long hair.
Wear closed toed shoes.

Insect repellant can also prevent tick bites. Repellents containing 20%-30% N,N-diethyl-meta-toluamide (DEET) can be applied to clothes and exposed skin. Repellents that have 0.5% permethrin can be applied to pants, socks, and shoes, but not to skin. Be sure to read product instructions carefully. For example:

Do not apply near your eyes, nose, or mouth.
Do not apply to children’s hands.
Reapply as directed.
Wash your skin when you return indoors.

PERFORM TICK CHECKS
After you spend time outdoors in a high-risk area:

Use a mirror to do a full-body tick check on yourself. You should also check any children who are in your care. Make sure to check for hidden areas, such as the hair, around the ears, under the arms, and in skin folds.
Examine your clothing for ticks that may attach to you after you come home.
Take a shower and wash your hair within 2 hours of coming indoors.
Put clothes worn outdoors in the dryer on high heat for 10 minutes to kill any unseen ticks.
If you have pets that spend time in high-risk areas, perform daily tick checks to prevent them from spreading to humans.

REMOVE TICKS FROM YOUR BODY

If you do find a tick, remove it by doing the following:
Use a pair of fine-pointed tweezers to grasp the tick by the head, as close to the skin as possible.
Pull directly outward. Use gentle but firm force. Do not twist the tick out. Try not to crush the tick’s body or handle it with bare fingers. This can spread the infection.
Wipe the site with an antiseptic to prevent infection.

KNOW THE SIGNS OF TICKBORNE ILLNESSES

Symptoms of a tickborne illness can occur weeks after exposure. Even if you have taken precautions, be sure to contact your doctor right away if you have recently spent time in a high-risk area and have fever and chills, aches and pains, and a distinctive rash.

by Cynthia M. Johnson, MA

RESOURCES:
Centers for Disease Control and Prevention
http://www.cdc.gov

Healthy Children—American Academy of Pediatrics
https://www.healthychildren.org

CANADIAN RESOURCES:
Canadian Paediatric Society
http://www.cps.ca

Health Canada
http://www.hc-sc.gc.ca

REFERENCES:

Preventing ticks on your pets. US Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/ticks/avoid/on_pets.html. Updated June 1, 2015. Accessed March 24, 2017.

Symptoms of tickborne illness. US Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/ticks/symptoms.html. Updated June 1, 2015. Accessed February 20, 2017.

Tick avoidance and removal. EBSCO DynaMed Plus website. Available at: https://www.dynamed.com/topics/dmp~AN~T901539/Tick-avoidance-and-removal. Accessed February 20, 2017.

Michael Woods, MD June 2017

Last reviewed June 2017 by Michael Woods, MD

Healthy Recipes 101: Vanilla Protein Shake – PTandMe

June 27, 2017 Teresa Stockton - Blog, General Information

Healthy Recipes 101 features fit and lean recipes to help you feel great!

VANILLA PROTEIN SHAKE
If you are looking for a healthy meal replacement, this is it! This vanilla protein shake was given to us by a colleague, who we have on good authority, drinks these regularly.

Ingredients
• 1-1/2 1-1/2 cups unsweetened Vanilla Almond Milk
• 1 scoop Vanilla Protein Powder
• 1 tbsp. flaxseed oil or ground flaxseed meal
• ¼ tbsp. of cinnamon
• 1 -2 packets of Stevia to sweeten (optional)

Directions
Put everything into a blender and process until smooth. Enjoy!

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Exercise for Chronic Disease Relief

May 25, 2017 Teresa Stockton - Blog, General Information

For people in need of chronic disease relief, exercise can decrease discomfort, improve daily functioning, and enhance overall quality of life. There are many activity choices. Overall, find something that you enjoy doing and a place that is comfortable for you to do it in. Although being physically active is good for anyone, some exercises provide specific benefits. Here is how different types of exercise can help people with specific chronic diseases.

CHRONIC DISEASE RELIEF : TYPES OF EXERCISE
There are 3 basic categories of exercise:

Aerobic Exercise
These are exercises that raise your heart rate through repetitive movement of large muscles groups. The 2 types of aerobic exercise are:

Weightbearing exercise —Your muscles work against the force of gravity. Examples include jogging, walking, and dancing.
Non-weightbearing exercise —The force of gravity does not play a major role. Examples include biking, swimming, and rowing.

Strength Training Exercise
These are exercises that increase the power, tone, and efficiency of individual muscles by contracting isolated muscles against resistance. An example is lifting weights. The increase in heart rate is short-lived compared to aerobic exercise.

Stretching
These are exercises that improve or maintain the flexibility of your muscles. Good flexibility is important to keeping a full range of motion and decreasing your chances of injury. Ideally, you should stretch after each exercise session.

DISEASE IMPACT
Overall, all 3 types of exercises are important in a chronic disease relief program. However, the list below demonstrates how a certain types of exercise can directly impact your specific health condition.

Heart Disease
Researchers and healthcare professionals have found that regular exercise reduces the risk of having a heart attack, particularly for people with coronary artery disease (CAD).

Specific benefits of exercise for people with heart disease include:

Stronger heart muscle
Reduced cholesterol
Reduced plaque build-up inside the arteries
Better weight and blood pressure control

Type of exercise that can reduce risk of heart disease and heart attack: Aerobic

High Cholesterol
Cholesterol is found in cells throughout your body. Although it tends to get a bad rap, cholesterol is actually essential for life. It only contributes to heart disease when you have too much of certain types of cholesterol or too little of other types.

Exercise can help reduce cholesterol, and even better, it can help raise your HDL (good) cholesterol. Aim for at least 30 minutes of exercise most days of the week. Even short, 10-minute spurts of exercise can help. Exercise also has the added benefit of weight loss, which can also help to lower cholesterol levels.

Type of exercise that has been shown to improve cholesterol levels: Aerobic

Diabetes
Diabetes is a disorder of the body’s insulin production and usage, and it is a major risk factor for coronary artery disease. If there is not enough insulin, glucose (fuel for all cells) cannot get from the blood to the cells. As a result, the body is essentially starved and the glucose builds up in the blood. Exercise can make the cells more sensitive to insulin, and more glucose can move from the blood into cells.

Since exercise changes the way your body reacts to insulin, you may need to check your blood sugar before and after exercising. Talk to your doctor before you begin an exercise program to learn about what your levels should be.

Types of exercise that influence insulin sensitivity and cardiovascular risk factors: Aerobic and strength training

High Blood Pressure
The risk of high blood pressure increases as we age. Exercise can help to lower your risk and even control your blood pressure if it’s already high. Exercise helps with blood pressure by making your heart work more efficiently. This means your heart does not have to work as hard to pump blood, so there is less pressure on your arteries.

A good target for blood pressure is 120/80 mm Hg. Adding moderate physical activities to your normal routines can help you get there. You should aim for at least 30 minutes of aerobic activity on most days of the week. Even several 10-minute spurts throughout the day can help.

Types of exercise that have been shown to lower blood pressure: Aerobic and strength training

Stroke
A stroke occurs when not enough blood is reaching part of the brain. This causes the cells in that area to die. People who have already had a stroke are at increased risk for recurrent stroke or other cardiovascular problems.

A stroke can create some physical impairments. Exercise may improve strength and coordination of the affected muscles. Exercise recommendations may vary depending on the severity of the stroke and the person’s limitations.

Type of exercise for stroke recovery: Aerobic, strength training, and stretching

Cancer
Studies suggest that people with cancer who do not have depression have a better chance of survival than those who do. Exercise is a great way to avoid depression and improve your overall mood. It’s not clear exactly how exercise impacts mood, but it probably works by causing the brain to release chemicals, like endorphins, and increase body temperature, which can have a calming effect.

Types of exercise found to boost energy and mood: Aerobic and strength training

Lung Disease
Chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis, is the most common form of lung disease in adults. Exercise improves activity levels and decreases symptoms.

Types of exercise shown to improve respiratory ability: Aerobic

Arthritis
Continuous motion is essential for the health of your joints, especially arthritic ones. Regular exercise promotes strength and flexibility, and helps preserve the resiliency of joint surfaces.

Types of exercise shown to improve joint health: Nonweightbearing aerobic, strength training, and stretching (water exercises are ideal)

Osteoporosis
Osteoporosis is a bone-thinning disease that can lead to fractures. Weightbearing exercises maintain bone density and strength by tipping the balance in favor of bone formation. Weightbearing activities include walking, jogging, hiking, dancing, stair climbing, tennis, and other activities that you do while on your feet.

Type of exercise shown to improve bone density: Weightbearing aerobic and strength training

In any condition, a well-rounded exercise program will have all 3 types of exercise involved. Aerobic exercise will increase your endurance and ability to get through longer workouts. Strength training will build muscle strength and allow you to tolerate higher intensities as well improve balance and agility. Stretching can decrease stiffness and increase mobility.

Talk to your doctor before beginning any exercise program. You can also consult with an exercise specialist to help you develop a routine.

by Carrie Myers Smith, BS

RESOURCES:
National Institutes of Health
http://www.nih.gov

The American Orthopaedic Society for Sports Medicine
http://www.aossm.org

CANADIAN RESOURCES:
Canadian Society of Exercise Physiology
http://www.csep.ca

Healthy Canadians
http://www.healthycanadians.gc.ca

REFERENCES:
Depression. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 11, 2016. Accessed March 23, 2016.

Exercises for arthritis. Arthritis Foundation website. Available at: http://www.arthritis.org/living-with-arthritis/exercise/. Accessed March 23, 2016.

Fagard RH. Exercise characteristics and the blood pressure response to dynamic physical training. Med Sci Sports Exerc 33. S484-S492; 2001.

Gordon NF, Gulanick M, Costa F, Fletcher G, Franklin BA, Roth EJ, Shephard T. AHA scientific statement: Physical activity and exercise recommendations for stroke survivors. Circulation. 2004;109: 2031-2041. Circulation website. Available at: http://circ.ahajournals.org/content/109/16/2031.full. Accessed March 23, 2016.

Junnila JL, Runkle GP. Coronary artery disease screening, treatment, and follow-up. Primary Care: Clinics in Office Practice. 2006 Dec; 33(4).

Onitilo AA, Nietert PJ, Egede LE. Effect of depression on all-cause mortality in adults with cancer and differential effects by cancer site. Gen Hosp Psychiatry. 2006 Sep; 28(5): 396-402.

Physical activity for cardiovascular disease prevention. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 21, 2015. Accessed March 23, 2016.

Physical activity guidelines for Americans. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 9, 2013. Accessed March 23, 2016.

Weightbearing exercise for women and girls. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00263. Updated October 2007. Accessed March 23, 2016.

Last reviewed March 2016 by Michael Woods, MD Last Updated: 5/8/2014

Want to be a Physical Therapist?

May 9, 2017 Teresa Stockton - Blog, General Information

PHYSICAL THERAPIST
WHAT DO THEY DO?
PTs are health care professionals who provide rehabilitation for musculoskeletal issues.
Rehabilitation includes programs focused on:

Strengthening
Range of motion
Balance training
Functional training
Gait training
Return to work programs
Pain reduction

Physical therapist’s goal is to return patients to a normal life, that is pain free.

HOW TO BECOME A LICENSED PHYSICAL THERAPIST?
1.) Bachelor’s degree, that includes required Prerequisites for PT schools of your choice.
2.) Doctorate degree from credited school which includes a number of hands on clinical experiences.
3.) Apply & sit for licensure exam in state, you choose to work.

PHYSICAL THERAPIST ASSISTANT
WHAT DO THEY DO?
Work as part of the Rehabilitative team to provide physical therapy services under the direction and supervision of the physical therapist.
PTAs implement:

Selected components of patient/client interventions (treatment)
Obtain data related to the interventions provided
Make modifications in selected interventions either to progress the patient/client as directed by the physical therapist

HOW TO BECOME A PTA?
1.) Attend CAPTE – accredited associated program
2.) Apply & sit for licensure exam

JOB SETTINGS: Any setting in which a PTA can work

CERTIFIED ATHLETIC TRAINER
WHAT DO THEY DO?
Certified Athletic Trainers (ATCs) are health care professionals who work alongside physicians to provide:

Preventative services
Emergency care
Clinical diagnosis
Therapeutic intervention
Rehabilitation of injuries and medical conditions

Certified Athletic Trainers can help you avoid unnecessary medical treatment and disruption of normal daily life.

HOW DO I BECOME A CERTIFIED ATHLETIC TRAINER (ATC)?
1.) Graduate from a bachelors or master’s degree program accredited by the Commission on Accreditation of Athletic Training Education (CAATE).
2.) Pass the certification examination conducted by the Board of Certification (BOC).
3.) Once certified, he/she must meet ongoing continuing education requirements in order to remain certified.
4.) Athletic trainers must also work under the direction of a physician and within their state practice act.

JOB SETTINGS

Colleges & Universities
Hospital & Clinical
Occupational Health
Military
Performing Arts
Physician Extender
Professional Sports
Public Safety

This information was written by Advance Rehabilitation Physical Therapy, an outpatient physical therapy practice with locations in Georgia and Florida, that focuses on providing the highest quality rehabilitation services. For more information click here.

Clinic Spotlight: PT & Me Therapists

March 23, 2017 Teresa Stockton - Blog, General Information

This month we are featuring stories from some of our PT & Me therapists. We asked them how they got into the awesome world of physical therapy and what they enjoy about it. These are their stories…

Name:
Kelly Wilson, PT, DPT at University Physical Therapy – 8 locations conveniently located throughout the New River Valley in Virginia

Why did you chose physical therapy as a career?
I took an anatomy class in high school with a teacher who absolutely changed my life. I could not get enough of the curriculum and wanted to learn more about how we work and how we can make ourselves better. I stayed after school one day to ask how I could learn about this topic forever. My teacher suggested that I look into physical therapy. I started shadowing a PT in my hometown and loved it! I was hooked!

What is your favorite thing about going to work each day?
I get to work with the absolute best people on the face of the planet.

Name:
Lea Ann Rumlin, PT, Clinic Owner at DeKalb Comprehensive Physical Therapy – Lithonia, Georgia

Why did you chose physical therapy as a career?
I had an opportunity to observe a PT in high school and found it was very interesting. I thought it was cool to observe a diverse variety of ailments in people.

What is your favorite thing about going to work each day?
I’ve been doing physical therapy for a long time, but it still feels new. I feel blessed to have the opportunity to help people.

Name:
Wendy Richards, MSPT, DPT at Port City Physical Therapy – Portland, Maine

Why did you chose physical therapy as a career?
I wanted to be in a helping profession. Growing up in rural Maine most of the careers were either in healthcare or nursing. That is why I was drawn to physical therapy. I especially liked the stroke patient rehab and spinal rehab aspect of it. Helping people with paralysis was especially fulfilling.

What is your favorite thing about going to work each day?
I enjoy working in a team environment. Working in an outpatient climate and helping patients to get better. Being able to resolve their limitations and improve their lives.

Name:
Jocelyn Zolna-Pitts, PT, Director at Metro Spine & Sports Rehabilitation – Chicago, Illinois

Why did you chose physical therapy as a career?
It combined my interest of medicine with sports. I was always interested in medicine and helping others.

What is your favorite thing about going to work each day?
The daily satisfaction of watching people get better. The challenge and variety of problems patients face and solving their problems through critical thinking with them. I enjoy the fact that you get to play every day at work and it’s a lot of fun!

Weight Loss: What Are Your Options?

February 28, 2017 Teresa Stockton - Blog, General Information

The prevalence of obesity has increased steadily in Western cultures over the past century, particularly during the last several decades. In fact, most health professionals agree that we are in the midst of an obesity epidemic in the United States.

Being overweight is closely linked to many very serious health conditions. It is a significant risk factor for coronary artery disease (CAD), stroke, high blood pressure, high cholesterol, high triglycerides, low levels of HDL (high-density lipoprotein—the “good” cholesterol), and type 2 diabetes. Fortunately, even modest reductions in weight can help reduce the risk or improve these conditions. Plus, practicing the behavioral changes of a healthier diet and regular exercise may actually reduce these risk factors whether weight loss occurs or not.

Energy Balance: The Simple Principle of Weight Loss
Scientists often explain weight loss quite simply in terms of the energy balance equation: energy in versus energy out. To lose weight, you must consume fewer calories than you burn or, in reverse, you must burn more calories than you consume.

This is, of course, easier said than done. But no matter what weight loss methods you may employ—diet, exercise, medications, supplements, surgery, therapy, group support—the principle of energy balance is unavoidable. In fact, experts from both traditional and nontraditional disciplines agree that to achieve and maintain weight loss you must make changes in your diet and activity level to favorably affect the balance of the energy equation.

Using Strategies to Get Started
Getting started is often the most difficult part of losing weight. Any changes you make in your eating and exercising behaviors must become habitual, which takes time. In addition, carrying extra weight, no matter how much, can affect how you feel about yourself psychologically, sometimes making it more difficult to take the necessary steps to begin to change.

The following 5 strategies are crucial to successful weight loss and can help to overcome some of these barriers:

• Set and commit to realistic goals and monitor your progress toward achieving these goals
• Slowly modify your eating and exercise behaviors, as well as habits influencing both
• Examine and restructure unrealistic, negative thoughts, or expectations
• Reduce stress
• Develop a network of social support and information

Looking at Weight Loss Aids
There is a great deal of interest in whether prescription medications or supplements can facilitate weight loss. Some medications suppress appetite by interfering with brain chemicals that affect mood and appetite. Others reduce fat absorption from the gut. Here are examples of medications that may be recommended for weight loss:

• Diethylpropion
• Lorcaserin
• Orlistat
• Phendimetrazine
• Phentermine—can be taken alone or in combination with another medication

Some studies have supported the use of these medications when combined with lifestyle changes. For example, as part of a review of weight loss drugs, researchers analyzed 15 trials involving almost 10,000 people who were either taking orlistat or placebo. Compared to the placebo group, those taking orlistat had a higher chance of achieving a 5% or 10% weight loss. These types of medications, though, are usually prescribed only for people who are severely obese when other methods of weight loss have not worked. Accordingly, these medications are not without side effects or potential adverse events and should only be used with careful monitoring by your doctor.

The same goes for dietary supplements. Supplements do not undergo the same rigorous approval process as drugs. That being said, certain supplements may provide weight loss benefits since they may contain similar mechanisms of action as drugs. Along the same line, some of the same risks and side effects may be present, as well, which is why you should talk to your doctor before taking any over-the-counter weight loss products.

Also, be sure you know what is in diet medications and supplements. Some medications and supplements that were used in the past have been pulled from the market as it was found that the dangers of taking them were higher than the benefits. Whenever you are considering taking a diet supplement, know exactly what is in the product and share this information with your doctor.

The question is: when should you consider taking these weight loss aids? While it depends on your overall health and medical history, the best approach may be a conservative one. For example, adopt lifestyle changes for 6-12 months before trying a drug or supplement. Your doctor can give you guidance as to which weight loss options you should try first.

by Jackie Hart, MD

RESOURCES:
National Heart, Lung, and Blood Institute
https://www.nhlbi.nih.gov

National Institute of Diabetes and Digestive and Kidney Diseases
http://www.niddk.nih.gov

CANADIAN RESOURCES:
Dietitians of Canada
http://www.dietitians.ca

Health Canada
http://www.hc-sc.gc.ca

REFERENCES:
Choosing a safe and successful weight-loss program. National Institute of Diabetes and Digestive and Kidney Disorders. Available at: http://www.niddk.nih.gov/health-information/health-topics/weight-control/choosing-safe-successful-weight-loss-program/Pages/choosing-safe-successful-weight-loss-program.aspx. Updated December 2012. Accessed January 14, 2016.

Diets for weight loss. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 21, 2015. Accessed January 14, 2016.

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Last reviewed July 2016 by Michael Woods, MD Last Updated: 1/14/2016