Category Archives: General Information

A Healthy Start in 2017

January 5, 2017 Teresa Stockton - Blog, General Information

It’s time to get a healthy start in 2017! We provided some general health and wellness tips to get you on your way to an amazing year! We call it the Pearls of Longevity!

PROTEIN
Eat 25 grams of protein each meal especially breakfast to prevent being hungry from carb cravings and crashes, help maintain and build muscle, and improve your immune system.

DID YOU KNOW?
For every 100 calories of protein you eat, it takes 25 calories to digest meaning you really only ate 75 calories! This is a 25% discount! For carbs and fat, you get less than a 10% discount.

EXERCISE
Exercise at least 30 minutes a day to burn calories and decrease stress. Lift weights or use body weight strengthening exercises to increase lean muscle and boost your metabolism.

DID YOU KNOW?
Exercise relieves symptoms of depression as well or even better than medication. Losing 10 lbs. decreases your risk of knee arthritis by 50%, while losing 10% of your body weight decreases joint pain by 50%!

ANTI INFLAMMATORY & ANTIOXIDANT-RICH FOODS
Fill half your plate at every meal to ensure you eat enough of these power foods.

DID YOU KNOW?
Eating lots of fruits, vegetables, nuts, olive oil, beans, salmon, spices, and even dark chocolate helps reduce inflammation and stress, decreases joint and muscle pain, and reduces your risk heart disease, hypertension, diabetes, cancer and stroke.

RELAXATION & STRESS REDUCTION
Practice inhaling slowly through your nose until you feel your belly button move out and then slowly exhale through your mouth feeling your belly button move in. Practice at least 5 minutes a day while driving, at your computer, while watching TV or when in bed. Smile, laugh and hug someone once a day.

DID YOU KNOW?
Deep breathing reduces stress, muscle pain, and blood pressure, while improving memory, concentration and performance. Happiness and affection are considered by many experts to be the fountain of youth as it lowers stress and releases hormones that help fight aging.

LIQUIDS
Drink 2 cups of water or tea when you wake up and drink 1-2 cups in between meals. Coffee does not count as it can lead to dehydration.

DID YOU KNOW?
Water reduces hunger, improves metabolism, brings nutrients, and hydrates your muscles and connective tissue. This can reduce inflammation and scar tissue which can lead to decreased muscle and joint pain.

SLEEP
Sleep at least 7-8 hours per night consistently going to bed and waking up the same time even on weekends.

DID YOU KNOW?
Sleep releases growth hormone which helps keep you young, increase lean muscle and decrease body fat!

A healthy start can lead to great endings. Best of luck to you and yours and Happy New Year!

Elf Injuries and How PT Can Help: Part 3 of 3

December 21, 2016 Teresa Stockton - Blog, General Information

It’s that time of year, when we check in on Santa’s helpers to see if they can use some physical therapy. With their heavy lifting and high demand job they’re always experiencing injuries. Our new elf friend Ziggy, is the perfect patient for PT.

Previously…

Ziggy was at one of PTandMe’s partnering physical therapy clinics awaiting the arrival of one of our trusted physical therapists.
Our therapist first performed some stretching techniques on Ziggy to help relieve his aches and pains (Don’t worry Santa said it was okay to touch our “elf on the shelf” friend).

Then so more stretching techniques to help out our little friend…

Now the therapist has Ziggy doing some pulls ups on our wonderful clinic’s pull-up bar to help Ziggy get back to working shape.

Time for deep tissue massage on Ziggy’s aching back…

Thanks to the great physical therapy Ziggy got at our wonderful PT & Me clinics he is now ready to lift all the toys into Santa’s sleigh just in time for the holiday!

THE END.

See Ziggy’s complete physical therapy experience here!

Special thanks to Action Physical Therapy, in Houston, TX, for accommodating the demanding work schedule of Santa’s elves. Click Here for more information about Action Physical Therapy.

Tips for Reducing ADHD Related Holiday Stress and Anxiety

December 21, 2016 Teresa Stockton - Blog, General Information

Ah, the holidays. The lights. The carols. The food. The family. It’s the most wonderful time of year. Right? Well, for many of us, the holidays are far more jangled nerves than joyful noise. And if you or a loved one suffers from ADHD, the stress of the holidays can be almost too much to bear. If you have ADHD, you already know how lonely and frustrating it can be when the holidays roll around, and it seems that everyone in the world is in the holiday spirit but you.

Increased Stress, Fatigue, and Sadness are Common During the Holidays
The truth is, though, that the season of celebration is also the season of stress. No one is immune to the pressures of the season. But the disruption of normal, daily routines, the added responsibilities of social engagements and familial obligations, and the abundance of symptom-exacerbating holiday foods make the stresses of the holidays particularly acute for ADHD sufferers.

Nevertheless, whether you or someone close to you has ADHD, or you are just seeking to navigate the season with more pleasure and less pain this year, there are some simple things you can do to manage holiday stress. The following techniques, derived primarily from cognitive-behavioral therapy (CBT), might just help you relax and enjoy the magic of the season.

1. Make a Plan
As much as we hate to admit it, there are only so many hours in a day and there’s a limit to what we can accomplish in those hours. So take some time before the rush and tumult of the holidays begin to prioritize what you want, need, and must do for the holidays. Figure out what matters most to you and yours and set up a clear, incremental strategy for getting it done. Knowing you have a doable action plan in place and working a little each day on your holiday tasks can minimize stress, worry, and fatigue, leaving you with the time and energy to actually enjoy the season. Whether it’s allotting five minutes a day for writing holiday cards or two hours of online gift shopping each Saturday, the best way to eat the elephant is one bite at a time.

2. Be Realistic
Yes, you’re good. You’re a rock star. But as awesome as you are, you’re still just one person. And trying to do it all is just not possible—and it’s also just not fair. The answer? Delegate! Have a sister who is a Mozart in the kitchen? Put her in charge of the meal preparation. Have a spouse who’s a Picasso of design? Let him handle the holiday decorating. Not only will this take some of the pressure off you, but it will enable you to enjoy what the holidays are really all about anyway: spending time and making memories with those you love.

3. Forget Perfection
Face it, life is not a Frank Capra movie (and even good old George Bailey had it pretty rough there for a while). So let go of the fantasy of a Capra Christmas or a humdinger of a Chanukah. Inevitably, something is going to get lost or broken; invariably someone’s going to burn the bread or forget the cookies. And, yes, somebody is going to hurt anyone’s feelings. But that’s life. Real life—the good, the bad, and the ugly. Just remember that the imperfections are what make it real, unique, and, in the long run, beautiful. These screw-ups and squabbles that we put such desperate pressure on ourselves to prevent in our pursuit of some fictitious “perfect” holiday are exactly the things we will remember so fondly, and laugh about most heartily with our dear ones, in the years to come.

4. Practice Extreme Self-Care
No matter what the greeting card companies say, the holidays are not the time for self-sacrifice. The only thing playing the martyr will get you is stress, exhaustion, and resentment. Ho, ho, ho. Instead of running yourself ragged, make sure that you do what you need to do to recharge your batteries, to nourish your mind, body, and spirit. Take an hour each day to do something that gives you joy: a warm bath, a long walk, a good book—a nap.

While you’re at it, don’t forget about exercise and nutrition. Indulging in holiday treats is fine. Complete denial will only lead to resentment. But everything in moderation. Rich, highly processed, sugary, and fatty foods can worsen ADHD symptoms. Be selective about what, when, and how much you eat, and remember that exercise, whether an hour of yoga or a brisk bike ride, can help to dispel the brain fog borne of these less-than-healthy foods—not to mention working off some of that holiday stress when it does come!

Begin Reducing Your Stress Today!
Whether you or a loved one has ADHD, or you only want to thrive and not just survive this holiday season, these few simple techniques can make it possible. For more information about ADD/ADHD in adults, please read: https://openforest.net/attention-deficit-disorder-adults/, Wishing you and yours less stress and more joy this holiday season!

Looking for a way to help manage ADHD? You can find natural remedies here.

Written by Terri Beth Miller, MA, PhD. She is freelance writer and contributor to Open Forest, the online mental health self-help website.

Elf Injuries and How PT Can Help: Part 2 of 3

December 16, 2016 Teresa Stockton - Blog, General Information

When we last left off…

Ziggy was at one of PTandMe’s partnering physical therapy clinics.
He first had to check in with our friendly and helpful receptionist.

Then Ziggy warmed up on one of our many clinic’s treadmills to help strengthen his aching back.

Now Ziggy is awaiting the arrival of one of our trusted physical therapists, who will provide him with stretching techniques and exercises to help relieve his back pain.

To be continued…

See Ziggy’s complete physical therapy experience here!

Special thanks to Action Physical Therapy, in Houston, TX, for accommodating the demanding work schedule of Santa’s elves. Click Here for more information about Action Physical Therapy.

Type 2 Diabetes (Diabetes Mellitus Type 2; Insulin-Resistant Diabetes; Diabetes, Type 2)

November 10, 2016 Teresa Stockton - Blog, General Information

Definition
Glucose is a type of sugar. It comes from food, and is also created in the liver. Glucose travels through the body in the blood. It moves from the blood to cells with the help of a hormone called insulin. Once glucose is in those cells, it can be used for energy.

Diabetes is a condition that makes it difficult for the body to use glucose. This causes a buildup of glucose in the blood. It also means the body is not getting enough energy. Type 2 diabetes is one type of diabetes, and it is the most common.

Medication, lifestyle changes, and monitoring can help control blood glucose levels.

Causes
Type 2 diabetes is often caused by a combination of factors. One factor is that your body begins to make less insulin. A second factor is that your body becomes resistant to insulin. This means there is insulin in your body, but your body cannot use it effectively. Insulin resistance is often related to excess body fat.

Risk Factors
Type 2 diabetes is more common in people who are aged 45 years and older. It is also common in younger people who are obese and belong to at-risk ethnic groups. Other factors that increase your chance for type 2 diabetes include:
• Prediabetes — impaired glucose tolerance and impaired fasting glucose
• Metabolic syndrome — a condition marked by elevated cholesterol, blood glucose, blood pressure, and central obesity
• Excess weight or obesity, especially central obesity
• Lack of exercise
• Poor diet — high intake of processed meats, fats, sugar-sweetened foods and beverages, and calories
• Family history of type 2 diabetes
• High blood pressure
• History of cardiovascular disease
• Depression
• History of gestational diabetes, or having a baby that weighs over 9 pounds at birth
• Endocrine disorders, such as Cushing’s syndrome, hyperthyroidism, acromegaly, polycystic ovary syndrome, pheochromocytoma, or glucagonoma
• Conditions associated with insulin resistance, such as acanthosis nigricans
• Certain medications, such as glucocorticoids or thiazides
• Certain ethnic groups, such as African American, Hispanic, Native American, Hispanic American, Asian American, or Pacific Islander

Symptoms
You may have diabetes for years before you have symptoms. Symptoms caused by high blood sugar or include:
• Increased urination
• Extreme thirst
• Hunger
• Fatigue
• Blurry vision
• Irritability
• Frequent or recurring infections
• Poor wound healing
• Numbness or tingling in the hands or feet
• Problems with gums
• Itching
• Problems having an erection

Diagnosis
The doctor will ask about your symptoms and medical history. You will also be asked about your family history. A physical exam will be done.

Diagnosis is based on the results of blood testing. American Diabetes Association (ADA) recommends diagnosis be made if you have one of the following:
• Symptoms of diabetes and a random blood test with a blood sugar level greater than or equal to 200 mg/dL (11.1 mmol/L)
• Fasting blood sugar test is done after you have not eaten for 8 or more hours—showing blood sugar levels greater than or equal to 126 mg/dL (7 mmol/L) on two different days
• Glucose tolerance test measures blood sugar 2 hours after you eat glucose—showing glucose levels greater than or equal to 200 mg/dL (11.1 mmol/L)
• HbA1c level of 6.5% or higher—indicates poor blood sugar control over the past 2-4 months

* mg/dL = milligrams per deciliter of blood; mmol/L = millimole per liter of blood

Treatment
Treatment aims to:
• Maintain blood sugar at levels as close to normal as possible
• Prevent or delay complications
• Control other conditions that you may have, like high blood pressure and high cholesterol

Diet
Food and drinks have a direct effect on your blood glucose level. Eating healthy meals can help you control your blood glucose. It will also help your overall health. Some basic tips include:
• Follow a balanced meal plan. It should include carbohydrates, proteins, and fats.
• Be aware of appropriate serving size. Measure your food to help understand ideal serving size.
• Do not skip meals. Plan your meals and snacks through the day. Having meals throughout the day can help avoid major changes in glucose levels.
• Eat plenty of vegetables and fiber.
• Limit the amount of fat (especially saturated and trans fats) in your foods.
• Eat moderate amounts of protein and low-fat dairy products.
• Carefully limit foods containing high concentrated sugar.
• Keep a record of your food intake. Share the record with your dietitian or doctor. This will help to create an effective meal plan.

Weight Loss
If you are overweight, weight loss will help your body use insulin better. Talk to your doctor about a healthy weight goal. You and your doctor or dietitian can make a safe meal plan for you.

These options may help you lose weight:
• Use a portion control plate
• Use a prepared meal plan
• Eat a Mediterranean-style diet

Exercise
Physical activity can:
• Make the body more sensitive to insulin
• Help you reach and maintain a healthy weight
• Lower the levels of fat in your blood

Aerobic exercise is any activity that increases your heart rate. Resistance training helps build muscle strength. Both types of exercise help to improve long-term glucose control. Regular exercise can also help reduce your risk of heart disease.

Talk to your doctor about an activity plan. Ask about any precautions you may need to take.

Medication
Certain medications will help to manage blood glucose levels.

Medication taken by mouth may include:
• Biguanides reduce the amount of glucose made by the body
• Sulfonylureas encourage the pancreas to make more insulin
• Insulin sensitizers to help the body use insulin better
• Starch blockers to decrease the amount of glucose absorbed into the blood
• Sodium-glucose co-transporter 2 (SGLT-2) inhibitors to increase glucose excretion in urine
• Bile acid binders

Some medications needs to be given by injection, such as:
• Incretin-mimetics stimulate the pancreas to produce insulin and decrease appetite, which can assist with weight loss
• Amylin analogs replace a protein of the pancreas that is low in people with type 2 diabetes

Insulin
Insulin may be needed if:
• The body does not make enough of its own insulin
• Blood glucose levels cannot be controlled with lifestyle changes and medications

Insulin is given through injections. There is one short-acting inhaled insulin which may be available for select persons.

Blood Glucose Testing
You can check the level of glucose in your blood with a blood glucose meter. Checking your blood glucose levels during the day can help you stay on track. It will also help your doctor determine if your treatment is working. Keeping track of blood sugar levels is especially important if you take insulin.

Regular testing may not be needed if your diabetes is under control and you don’t take insulin. Talk with your doctor before stopping blood sugar monitoring.

An HbA1c test may also be done at your doctor’s office. This is a measure of blood glucose control over a long period of time. Doctors advise that most people keep their HbA1c levels below 7%. Your exact goal may be different. Keeping HbA1c in your goal range can help lower the chance of complications.

Counseling
Depression can undermine your recovery and put you at risk for other complications. Feelings of sadness, hopelessness, and loss of interest in your favorite activities that stay with you for at least 2 weeks should prompt you to call your doctor. Depression is treatable. Your doctor may refer you to counseling to help you better manage your depression and diabetes.

Decreasing Risk of Complications
Over a long period of time, high blood glucose levels can damage vital organs. The kidneys, eyes, and nerves are most affected. Diabetes can also increase your risk of heart disease.

Maintaining goal blood glucose levels is the first step to lowering your risk of these complications. Other steps:
• Take good care of your feet. Be on the lookout for any sores or irritated areas. Keep your feet dry and clean.
• Have your eyes checked once a year.
• Don’t smoke. If you do, look for programs or products that can help you quit.
• Keep track of your moods and be alert for persistent depressive symptoms.
• Plan medical visits as recommended.

Prevention
To help reduce your chance of type 2 diabetes:
• Participate in regular physical activity
• Maintain a healthy weight
• Drink alcohol only in moderation (2 drinks per day for a man, and 1 drink per day for a woman)
• Eat a well-balanced diet:
– Get enough fiber
– Avoid fatty foods
– Limit sugar intake
– Eat more green, leafy vegetables
– Eat whole fruits, especially apples, grapes, and blueberries

by Debra Wood, RN

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

National Diabetes Information Clearinghouse
http://diabetes.niddk.nih.gov

CANADIAN RESOURCES:
Canadian Diabetes Association
http://www.diabetes.ca

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

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11/29/2006 DynaMed Plus Systematic Literature Surveillance.http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Lindstrom J, Ilanne-Parikka P, Peltonen M, Aunola S, Eriksson JG, Hemio K, et al. Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study. Lancet. 2006;368:1673-1679.

9/19/2006 DynaMed Plus Systematic Literature Surveillance.http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Thomas DE, Elliott EJ, Naughton GA. Exercise for type 2 diabetes mellitus. Cochrane Database of Syst Rev. 2006;CD002968.

6/1/2007 DynaMed Plus Systematic Literature Surveillance.http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Nissen SE, Wolski K. Effect of rosiglitazone on the risk of myocardial infarction and death from cardiovascular causes. N Engl J Med. 2007;356(24):2457-2471.

7/13/2007 DynaMed Plus Systematic Literature Surveillance.http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Farmer A, Wade A, Goyder E, et al. Impact of self-monitoring of blood glucose in the management of patients with non-insulin treated diabetes: open parallel group randomised trial. BMJ. 2007;335(7611):132.

12/13/2007 DynaMed Plus Systematic Literature Surveillance.http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Milman U, Blum S, Shapira C, et al. Vitamin E supplementation reduces cardiovascular events in a subgroup of middle-aged individuals with both type 2 diabetes mellitus and the haptoglobin 2-2 genotype. A prospective double-blinded clinical trial. Arterioscler Thromb Vasc Biol. 2008;28(2):341-347.

2/28/2008 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Davies MJ, Heller S, Skinner TC, et al. Effectiveness of the diabetes education and self management for ongoing and newly diagnosed (DESMOND) programme for people with newly diagnosed type 2 diabetes: cluster randomised controlled trial. BMJ. 2008;336(7642):491-495.

2/28/2008 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Christian JG, Bessesen DH, Byers TE, Christian KK, Goldstein MG, Bock BC. Clinic-based support to help overweight patients with type 2 diabetes increase physical activity and lose weight. Arch Intern Med. 2008;168:141-146.

6/18/2008 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: ADVANCE Collaborative Group. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008;358:2560-2572.

2/24/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Liese AD, Weis KE, Schulz M, Tooze JA. Food intake patterns associated with incident type 2 diabetes: the Insulin Resistance Atherosclerosis Study. Diabetes Care. 2009;32:263-268.

5/11/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Loimaala A, Groundstroem K, Rinne M, et al. Effect of long-term endurance and strength training on metabolic control and arterial elasticity in patients with type 2 diabetes mellitus. Am J Cardiol. 2009;103:972-977.

8/19/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Li TY, Brennan AM, Wedick NM, Mantzoros C, Rifai N, Hu FB. Regular consumption of nuts is associated with a lower risk of cardiovascular disease in women with type 2 diabetes. J Nutr. 2009;139:1333-1338.

10/12/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Crandall JP, Polsky S, Howard AA, et al. Alcohol consumption and diabetes risk in the Diabetes Prevention Program. Am J Clin Nutr. 2009;90:595-601.

11/20/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Lund SS, Tarnow L, Frandsen M, et al. Combining insulin with metformin or an insulin secretagogue in non-obese patients with type 2 diabetes: 12 month, randomised, double blind trial. BMJ. 2009;339:b4324.

12/21/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Cappuccio FP, D’Elia L, Strazzullo P, Miller MA. Quantity and quality of sleep and incidence of type 2 diabetes: a systematic review and meta-analysis. Diabetes Care. 2010;33(2):414-420.

2/15/2010 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: American Diabetes Association. Standards of medical care in diabetes—2010. Diabetes Care. 2010;33(suppl 1:S11-61).

2/15/2010 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;33(suppl 1:S62-69).

7/2/2010 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Micha R, Wallace SK, Mozaffarian D. Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus: a systematic review and meta-analysis. Circulation. 2010;121(21):2271-2283.

10/5/2010 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Carter P, Gray LJ, Troughton J, Khunti K, Davies MJ. Fruit and vegetable intake and incidence of type 2 diabetes mellitus: systematic review and meta-analysis. BMJ. 2010;341:c4229.

1/4/2011 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Pan A, Lucas M, Sun Q, et al. Bidirectional association between depression and type 2 diabetes mellitus in women. Arch Intern Med. 2010;170(21):1884-1891.

5/6/2011 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Muraki I, Imamura F, Manson J, et al. Fruit consumption and risk of type 2 diabetes: results from three prospective longitudinal cohort studies. BMJ. 2013;347:f5001.

4/14/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Xi B, Li S, et al. Intake of fruit juice and incidence of type 2 diabetes: a systematic review and meta-analysis. PLoS One. 2014;9(3):e93471.

7/21/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Afshin A, Micha R, et al. Consumption of nuts and legumes and risk of incident ischemic heart disease, stroke, and diabetes: a systematic review and meta-analysis. Am J Clin Nutr. 2014;100(1):278-288.

9/11/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Tovote KA, Fleer J, Snippe E, et al. Individual mindfulness-based cognitive therapy and cognitive behavior therapy for treating depressive symptoms in patients with diabetes: results of a randomized controlled trial. Diabetes Care. 2014;37(9):2427-2434.

9/16/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults: Zhou D, Yu H, He F, et al. Nut consumption in relation to cardiovascular disease risk and type 2 diabetes: a systematic review and meta-analysis of prospective studies. Am J Clin Nutr. 2014;100(1):270-277.

Last reviewed January 2016 by Kim Carmichael, MD

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.

Self-Care: Taking Care of Your Scar at Home

November 3, 2016 Teresa Stockton - Blog, General Information

Taking care of your scar well is an important aspect of your recovery from surgery. You must follow your surgeon’s order faithfully.This includes keeping it dry and covered as long as your doctor tells you it is necessary. If your scar becomes excessively red or painful, notify your doctor or therapist.

When you doctor tells you it is safe, you will need to start treating your scar at home. This is important because excessive scarring can lead to restricted movement and pain. The best approach to controlling your scar formation is to use your hands to free up skin around your scar. Rubbing Vitamin E oil or cocoa butter into your hands before massaging will also help your skin heal.

This information about taking care of your scar was written by Plymouth Physical Therapy Specialists, an outpatient physical therapy group with fourteen locations in the surrounding Plymouth, Michigan area. At Plymouth Physical Therapy Specialists, they are committed to using evidence-based treatments in their practice. This means that their therapists utilize the most current and clinically relevant treatments in their approach to rehabilitation. For more information click here.

What to Expect from Physical Therapy

October 11, 2016 Teresa Stockton - Blog, General Information

PHYSICAL THERAPY IS INTENDED TO MAKE CHANGES WITHIN YOUR BODY

We will accomplish this in several different ways. First, through the use of manual therapies, such as massage and mobilization of the joints. The goals of change are to:

Stretch short tissues to make them longer.
Strengthen weak tissues to make them stronger.
Improve and correct bad/abnormal biomechanics and asymmetries to alleviate pain and take the stress off the body.

THERE ARE SEVERAL THINGS THAT WE EXPECT DURING THE PHYSICAL THERAPY PROCESS, ESPECIALLY IN THE EARLY STAGES OF PT

You can expect that you will be sore after the first visit, and most likely the first 2 – 3 weeks until their body gets adapted to PT. Your body is just not used to doing the things that we are going to ask it to do, so there will be a period of adjustment.
The pain WILL move. As we make changes to your tissues and mechanics, the stresses on your body will change, thus altering where you will feel the pain or your symptoms.
The pain WILL change in terms of intensity, meaning that your pain is expected to fluctuate along the 10 point scale, starting between your high and low levels and changing based on your position, activity, and stress on the body.
The pain may also change in terms of the quality of pain. The pain may be: sharp, dull, achy, throbbing, burning, tingling, numbing.
It is important to know that all of the aforementioned statements are completely normal. There is nothing that you will experience that will surprise us. Everything that you experience will be normal. Even if what you feel is not normal to you, it is normal for your condition and what your body is experiencing.
Physical therapy is not an overnight miracle. Improvement takes time. It is important to understand that no one gets better every day from day one until they leave. Everyone will have good and bad days. In the beginning, you will have more bad days than good. As time progresses, this ratio should flip-flop and you should be having more good days than bad.

If you are looking for a physical therapist, we have you covered with over 500 locations nationwide!

This article was written by Life Fitness Physical Therapy, an outpatient physical therapy group with fourteen locations in the surrounding Baltimore, Maryland area. Life Fitness Physical Therapy is focused on improving the quality of life for their patients. They strive to provide individualized, evidence-based care that meets every patient’s unique needs. Their objective for each patient is to restore their function, achieve their goals and have them resume an active lifestyle as quickly as possible. For more information click here.

Is Aquatic Therapy For You?

July 14, 2016 Teresa Stockton - Aging, Back, Blog, General Information, Sports and Fitness, Women's Health

Aquatic therapy offers an alternative environment for therapeutic exercise. If you have tried traditional physical therapy, or have restrictions on your physical therapy program, aquatic Therapy may be the perfect solution for your physical therapy needs.

Why Aquatic Therapy is Beneficial

Less pressure: The buoyancy of the water decreases the amount of pressure, or compressive forces, on your joints and spine. When you’re immersed in water up to your neck, the weight pressing down on your body is reduced by 90%. When the water is up to your waist, the pressure is reduced by 50%.

Reduced swelling: The pressure of the water helps to move fluid from the injured area back into the body. Decreased swelling is essential for regaining the strength and motion needed for recovery.

Ease of movement: Water is an element that supports and assists movement. It offers a safe setting for regaining strength and joint range of motion.

Faster progress: Aerobic conditioning can often be performed in the water, even when it may be too soon or too difficult to do in the clinic. Staying stable in the water, challenges your core and balance. Plus, sports specific activity can begin earlier than on land.

Who Can Benefit From Aquatic Therapy

• Chronic pain patients requiring a more gentle form of therapy
• Patients at risk of falls due to balance and gait disorders
• Patients with severe arthritis or other weight-bearing restrictions
• Prenatal and postnatal patients
• Patients with general deconditioning
• Sports medicine and orthopedic patients requiring an accelerated component to their rehab protocol

This information was written by Life Fitness Physical Therapy, a privately-owned, outpatient physical therapy practice operating 14 clinics in the metro and surrounding Baltimore, Maryland area. Life Fitness Physical Therapy was founded in 2000 based on the core values of providing the highest level of customer service and clinical excellence in outpatient physical therapy. For more information click here.

Try Physical Therapy First

July 7, 2016 Teresa Stockton - Blog, General Information

Benefits of Physical Therapy Over Pain Killers and Surgery:

Conservative treatment with physical therapy has no side effects
Treat the cause of the problem and not just the symptoms
The best effect is getting you more involved in a healthy lifestyle
Affordable and covered under most insurance plans

As Physical Therapists We Provide:

Improved awareness
Increase strength and flexibility
Education and exercise designed to prevent future injuries
A program that increases your overall strength and flexibility
Modifications of movement for daily living

DID YOU KNOW THAT IF YOU HAVE…

BACK PAIN
If you are experiencing physical pain going to physical or occupational therapy for a musculoskeletal screening first may result in long term solutions without the use of expensive prescriptions or tests such as MRI’s, and reduces the risk of re-injury.
Source: http://www.ncbi.nlm.nih.gov/m/pubmed/22614792/

KNEE INJURY
Physical Therapy is equally effective In treating degenerative knee disease. One of the most common orthopedic procedures in the United States — knee arthroscopic surgery — is proving to be an unnecessary course of action for many patients who have a torn meniscus in their knee.
Source: New England Journal Of Medicine: http://www.nejm.org/doi/full/10.1056/NEJMoa1305189?query=featured_home&

CONCUSSION
Physical Therapists are key to helping in the recovery from concussion by monitoring the physical, mental, and emotional symptoms of an athlete to determine when they are no longer symptomatic.
Source: http://www.momsteam.com/health-safety/post-concussion-treatment-physical-therapy-can-help

We understand that you are concerned with maintaining your health. So ask your medical provider if physical therapy is the right choice for you. By trying physical therapy first, it is likely that you can reduce or remove the need for surgery, as well as remove the risk of dependence on prescription pain killers.

What Does It Really Mean to Have Prediabetes?

June 9, 2016 Teresa Stockton - Blog, General Information

Type 2 diabetes usually occurs as a result of genetics and lifestyle. It is marked by abnormally high levels of blood sugar, known as glucose. Glucose is the primary source of energy for our cells that the body makes from food we ingest. The onset of type 2 diabetes is triggered when the body is no longer able to properly use insulin, the hormone that helps cells take in glucose from the blood. When glucose stays in the blood stream instead of moving into the cells, nerves and blood vessels can be damaged. This increases the risk of cardiovascular disease, stroke, blindness, kidney disease, and circulation problems.

What Is Prediabetes?
Prediabetes is a condition that precedes the onset of type 2 diabetes. It is characterized by blood glucose levels that are elevated, though not high enough to be classified as diabetes. Doctors usually refer to prediabetes as impaired glucose tolerance or impaired fasting glucose. The American Diabetes Association (ADA) recommends screening for all adults 45 years old and older. Also, if you are younger than 45 and are overweight or obese and have risk factors for diabetes, you should be screened. Risk factors include:
• Family history of diabetes
• Having hypertension, high cholesterol, or high triglycerides
• Sedentary lifestyle
• History of gestational diabetes or giving birth to a baby weighing more than 9 pounds (4 kilograms)
• History of cardiovascular disease
• Having a condition associated with insulin resistance, such as polycystic ovary syndrome or metabolic syndrome

People of Hispanic American, Asian American, Pacific Islander, Native American, or African American descent are at higher risk.
Having prediabetes means that you are at high risk for developing diabetes and may already be experiencing adverse effects of elevated blood sugar levels.

How Do You Know If You Have Prediabetes?
During a routine office visit, your doctor can order tests, such as:
• Fasting plasma glucose test—For this test, you fast overnight and have your blood glucose measured in the morning before eating. Results in the range of 100-125 mg/dL (5.6-6.9 mmol/L) may indicate prediabetes.
• Oral glucose tolerance test (OGTT)—Again, you fast overnight and have your blood glucose measured after the fast. Then, you consume a sugary drink and have your blood glucose measured two hours later. Results in the range of 140-199 mg/dL (7.8-11 mmol/L) indicate prediabetes.
• Hemoglobin A1c (HbA1c)—This is an indicator of your average blood sugar levels over the previous three months. Results in the range of 5.7%-6.4% indicate prediabetes.

What Can You Do If You Have Prediabetes?
If you are diagnosed with prediabetes, it is important to take action to manage your condition. If you are overweight, your doctor may recommend that you lose weight. Reducing your body weight, even by 5%-10% can help improve your health. In general, changing your diet and being physically active and exercising at least 30 minutes a day will help you stay on track. Participating in a behavioral modification program may further help you achieve your weight loss goals.

Because many of the lifestyle-related risk factors associated with diabetes are also risk factors for other health issues, making lifestyle changes to reduce your risk of diabetes may have a positive effect on your overall health.

Some people can take medication to manage their blood glucose levels, though lifestyle modification should be the first approach to manage prediabetes. Medications that may be used include metformin, pioglitazone, and acarbose.

How Can You Prevent Prediabetes?
The same strategies that are used to lower your risk of type 2 diabetes can be applied to prediabetes, as well. The American Diabetes Association (ADA) recommends these strategies:
• Lose excess weight.
• Exercise for at least 150 minutes per week.
• Reduce your intake of calories and fat.
• Try to eat more fiber and whole grains.

If you do have prediabetes, you can take steps that may slow or avoid the progression to type 2 diabetes. It will take a lot of effort on your part, but the potential benefits—being healthy and living longer—are worth it.

by Julie J. Martin, MS

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

National Diabetes Education Program
http://www.ndep.nih.gov

CANADIAN RESOURCES:
Canadian Diabetes Association
http://www.diabetes.ca

The College of Family Physicians of Canada
http://www.cfpc.ca

REFERENCES:
Am I at risk for type 2 diabetes? Taking steps to lower the risk of getting diabetes. National Diabetes Information Clearinghouse website. Available at: http://diabetes.niddk.nih.gov/dm/pubs/riskfortype2/risk.pdf. Published June 2012. Accessed April 26, 2016.

American Diabetes Association and National Institute of Diabetes, Digestive and Kidney Diseases. The prevention or delay of type 2 diabetes. Diabetes Care 2002;25:1-8.

Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or Metformin. NEJM. 2002;346:393-403.

Diabetes mellitus type 2 prevention. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 22, 2016. Accessed April 26, 2016.

Diagnosing diabetes and learning about prediabetes. American Diabetes Association website. Available at: http://www.diabetes.org/are-you-at-risk/prediabetes. Updated December 9, 2014. Accessed April 26, 2016.

Kanaya AM, Narayan KM. Prevention of type 2 diabetes: Data from recent trials. Primary Care. 2003;30:511-526.

Narayan K, Imperatore G. Targeting people with prediabetes. British Medical Journal. 2002;325:403-404.

Nathan DM. Diabetes Care. 2007;30:753.

Prediabetes. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 22, 2016. Accessed April 26, 2016.

Tuomilehto J, Lindstorm J. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2004;344:1343-1350.

10/21/2008 DynaMed’s Systematic Literature Surveillance: http://www.ebscohost.com/dynamed: Greaves CJ, Middlebrooke A, O’Loughlin L, et al. Motivational interviewing for modifying diabetes risk: a randomised controlled trial. Br J Gen Pract. 2008;58:535-540.

10/12/2009 DynaMed Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Crandall JP, Polsky S, Howard AA, et al. Alcohol consumption and diabetes risk in the Diabetes Prevention Program. Am J Clin Nutr. 2009;90:595-601.

2/15/2010 DynaMed’s Systematic Literature Surveillance http://www.ebscohost.com/dynamed: American Diabetes Association. Standards of medical care in diabetes—2010. Diabetes Care. 2010;33(suppl 1:S11-S61).

2/15/2010 DynaMed’s Systematic Literature Surveillance http://www.ebscohost.com/dynamed: American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;33(suppl 1:S62-S69).

Last reviewed April 2016 by Michael Woods, MD Last Updated: 6/3/014