Basic description and management of pain(Part 3)

General types of “pain”


Somatic pain arises from the stimulation of your pain receptors either from the surface of your body or from your muscles and bones. After you have undergone any surgical procedure in your muscle or bone, the pain that you experience is a good example of somatic pain. More often than not, it is described as dull or aching, andit is usually aggravated by activity or movement and relieved by rest or inactivity[1].

Somatic pain usually occurs in the shoulder, hip, and hand, including the lower baPhysical Effects of painck and buttocks, and it is usually caused by the combination of several factors, such as inflammation, repetitive injury, and excessive activity[1].

Visceral [1]

When there is a problem in one or more of your internal organs, you might be able to experience pain. When this takes place, this can be classified as visceral pain.It is the most common among the general types of pain, and it is caused by the stimulation of the pain receptors in your chest, abdomen, and pelvic area. Thus, the problem could be in the heart, intestine, liver,   uterus, or ovary—to mention some[1].

Visceral pain is characterized as vague, and it does not clearly indicate its source. It is further described as pressure-like, deep squeezing, dull or diffuse. You will experience this pain when there is obstruction or perforation of your intestine, or when any one of your abdominal organs is inflamed. If you have this problem, aside from the pain, you may experience feeling of vomiting, body weakness, and/or fever[1].


Neuropathic pain originates from the spinal cord and peripheral nerves which are injured or malfunctioning.It is described as burning, tingling, shooting, stinging, and with “pins and needles” sensation. Others describe it as stabbing, piercing, cutting, or drilling pain. It occurs within a period of days, weeks, or months of the injury, and it varies in frequency and intensity. It is wide-spread, and it usually occurs at the level or below the level of the injury. This type of pain is very common in the legs, back, feet, thighs, and toes. In some instances, however, it can also take place in the buttocks, hips, upper back, arms, fingers, abdomen, or neck [1].

Management of the different types of pain

Prior to knowing the exact nature of the painthat you are experiencing, you may, as the first step, take in analgesic whose action is to increase the level of pain that your body could feel, thereby blocking the unpleasant sensation. The first analgesic that you could take is paracetamol, which is very cheap and safe to use.The maximum dose that you could take is 500 mg tablet every 6 hours. If, after 48 hours, you are not significantly relieved with it, and you believe that you have been suffering from either somatic or neuropathic pain, you can shift to taking the so-called non-steroidal anti-inflammatory drugs (NSAIDs), such as diclofenac, ibuprofen, naproxen, celecoxib, mefenamic acid, etoricoxib, and indomethacin[2,3]. Before you start taking any of these drugs, however, you need to consult a medical doctor who would decide if you really need any one of them. If ever you need to take any one of the NSAIDs, take it for some days only. They are not meant to be taken daily for so long because they could have possible side-effect(s) on the kidneys—which may turn out to be irreversible!

If you believe you have been suffering from visceral pain, you need to take an antispasmodic(an agent that quiets spasm)[4], such as hyoscine-n-butylbromide. If the oral medication could not stop your abdominal pain, then you need to consult a medical doctor who could administer the injectable medication.

(To be continued)



[1]RehabTeamSite, Other complications of spinal cord injury: pain: types of pain.

[2] NSAID (List of non-steroidal anti-inflammatories).

[3] eMedExpert, Non-steroidal anti-inflammatory drugs comparison.

[4]Stedman’s Medical Dictionary, Thomas Lathrop Stedman (Dec. 06, 2005).


Basic description and management of pain(Part 2)

Effects of “pain”


Depression, personal distress[1]

When you do not enjoy what you do and when you cannot perform activities which you used to do, you become depressed. Depression is not a simple problem, and it has the following symptoms: (1) difficulty in concentrating, remembering details, and making decisions; (2) fatigue and decreased energy, (3) feelings of guilt, worthlessness, and/or helplessness, (4) feelings of hopelessness and/or pessimism, (5) insomnia [difficulty in sleeping], early-morning wakefulness, or excessive sleeping; (6) irritability, restlessness; (7) loss of interest in activities or hobbies once pleasurable, including sex; (8) overeating or loss of appetite, (9) persistent aches or pains, headaches, cramps, or digestive problems that do not get well even with treatment; (10) persistently sad, anxious, or with “empty” feelings; (10) suicidal thoughts or attempts[2].

It is clear from the above that simple pain could lead to a more serious problem such as depression, and, worse, depression could lead to suicide! Thus, if you have persistent pain, it has to be addressed soonest!Its cause should be determined as soon as possible.

Difficulty in concentrating[1]

When you are suffering from pain, be it in low or high intensity, you cannot concentrate on whatever you do! The quality of your work will be adversely affected, and your productivity will significantly   decrease.

Social [1]

Diminished social relationships[1]

If you are not well and you have been experiencing pain, you tend to withdraw from the society and from friends. You do this not because you suddenly hate your friends but because you cannot withstand long engagement with them. Your attention span is lesser, and your body cannot tolerate prolonged physical activities, like talking, laughing, smiling, preparing foods, and the like. You do not like to frustrate your friends and other people, thus you withdraw from them!

Decreased sexual function, affection[1]

The drive for sex also decreases when you have been suffering from some degree of pain. This ramifies into bigger social problem because then your partner may not be able to understand your refusal to have sex! Your affection, too, becomes less and less, and you are irritable most of the time! All thesebewildering changes could   lead to break-up in marriage and other forms of relationship if adequate and effective communication does not take place between the partners in life. Thus, pain should be addressed with dispatch.

Altered appearance[1]

Grooming and cleanliness in oneself are also neglected if you have been experiencing pain.Your preoccupation on how to control your pain and the energy that you spend to tolerate it consume all your available time and strength that nothing is left for your personal grooming and cleanliness. You could hardly take a bath; you do not have time to change your clothes; you do not have the energy to buy and prepare new clothes for a particular gathering and party—and thus you withdraw from social interactions! All of these are brought about by the pain that lingers in you!

Increased caregiver burden[1]

When you experience pain—be it low or high intensity, be it interrupted or continuous—you tend to become dependent on someone. This change takes place not because you want it but because your capacity to help yourself is largely gone! Thus, your only resort is to ask help from a caregiver who could be a member of your family—a brother, sister—or a friend, or a professional caregiver. The pain paralyzes you, it limits your movements, and your world becomes smaller and smaller everyday—it shrinks!

(To be continued)


[1] United States. U.S. Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research, Clinical Practice Guideline, Number 9, Management of Cancer Pain, Rockville, March 1994.

[2]WebMD, Depression Health Center. Symptoms of depression.

Basic description and management of pain(Part 1)

Definition of “pain”

The International Association for the Study of Pain, Subcommittee on Taxonomy, 1979, defined pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage [1].” In Stedman’sMedical Dictionary, it is defined as “suffering, either physical or mental; an impression on the sensory nerves causing distress or, when extreme, agony [2].”

In a nutshell, painis an unpleasant sensory experience causing distress or agony. As such, it causes unpleasant effects on the person experiencing it. The effects could be classified as physical, psychological, social, and spiritual[1].

Effects of “pain”


Decreased functional capability[1]

If you are experiencing discomfort in any part of your body, such as painful leg(s) or arm(s), you will not be able to perform activities which you used to do. If your arms are aching, for instance, you will not be able to raise a weight consisting of certain number of kilograms. Even if you could previously raise 50-kilogram weight, that you cannot do now if you are experiencing pain in the arms.

Diminished strength, endurance[1]

If you have been experiencing pain in one of your extremities or in any part of your body, your strength and endurance to perform a particular action will be greatly diminished. This is due to the fact that you tend to limit your movements in whatever part is painful so that the intensity of the pain could be diminished. In doing so, you cannot perform a physical action because the strength that you could exert and the endurance that you could maintain are greatly diminished.

Nausea, poor appetite[1]

If the pain that you have been experiencing arises from the abdomen, you may complain of nausea (feeling of vomiting) and poor appetite. This is highly understandable because pain from the abdomen originates, by and large, from the intestines, especially if it was recent in onset.The problem worsens if the pain persists for a long time because then you may lose weight and resistance to diseases because of continuing failure to take in the right quantity and quality of foods.

Poor or interrupted sleep[1]

Pain, even if in mild intensity, could disturb your sleep. It will make your sleep very shallow or it will be interrupted. Whichever, you will not get the right quality and length of sleep that your quality of working the following day will be adversely affected. Your productivity decreases, and you become very irritable!


Diminished leisure, enjoyment[1]

Pain also diminishes your enjoyment of a particular activity. How could you enjoy bowling if your legs and arms are painful? How could you enjoy leisurely walking in the park if any part of your body is aching? It greatly disturbs you, and you will not experience full enjoyment in whatever you do.

Increased anxiety, fear[1]

Paincould be described as either continuous or interrupted. If continuous, day in and day out, it is there! It could vary in intensity, but it is always there! If interrupted, there are times that you experience it, and there are times that it is not there! Worse, you really do not know when it will come! The unpredictable nature of pain—as to when it will take place—generates so much anxiety and fear in you!If, for instance, you make a trip to give yourself some degree of respite from your illness, even if you are free from pain before leaving your place of residence, you could be thinking of the possibility that it will recur during the trip, and this will generate so much anxiety and fear that, more often than not, it could even force you to cancel the trip!

(To be continued)



[1] United States. U.S. Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research, Clinical Practice Guideline, Number 9, Management of Cancer Pain, Rockville, March 1994.

[2] Stedman’s Medical Dictionary, Thomas Lathrop Stedman (Dec. 06, 2005).

Body Mass Index

What is Body Mass Index?

Body Mass Index (BMI) is a measure of the body fat based on the present height and weight of an adult person. It is a very important figure because it predicts the likelihood that a person will suffer from diabetes mellitus, and/or heart diseases, and/or hypertension. It is computed using the ensuing formula:


BMI = {Weight in Pounds/(Height in inches) x (Height in inches)} x 703

The formula states that BMI is derived by dividing the weight in pounds by the square of the height in inches, then the quotient is multiplied by 703.   Thus, if a person weighs 220 pounds (lbs.) and stands at 6 feet and 3 inches, the BMI is computed this way:

BMI = {220 lbs/(75 inches) x (75 inches)} x 703 =27.5

The resulting figure is interpreted in the following manner:

Body Mass Index

If your weight status is either “overweight” or “obese”, you need to lose weight as described in the previous articles of Powertec.

What is abdominal adiposity?

When your BMI is beyond the normal values, in most instances, your elevated body weight is due to the deposition of significant amount of fats in your belly! This is called abdominal adiposity. If you have abdominal adiposity and elevated BMI, the likelihood that you will have diabetes mellitus, and/or heart disease, and/or hypertension will be greater than when you only have elevated BMI. Thus, if your belly is big, due to abdominal adiposity, you need to burn that excess fats not only through dietary means but by some specific physical exercises.


What specific physical exercises could you do to eliminate abdominal adiposity?

Note: The following descriptions were taken from: Exercise, Top 10 Best Abdominal Exercises, written by Paige Waehner.

  1. Bicycle exercise
  2. Lie face up on your mat and place your hands behind your head, lightly supporting it with your fingers.
  3. Bring the knees in to the chest and lift the shoulder blades off the floor without pulling on the neck.
  4. Rotate to the left, bringing the right elbow towards the left knee as you straighten the other leg.
  5. Switch sides, bringing the left elbow towards the right knee.
  6. Continue alternating sides in a ‘pedaling’ motion for 1-3 sets of 12-16 repetitions.
  7. Captain’s chair leg raise
  8. Stand on the chair and grip handholds to stabilize your upper body.
  9. Press your back against the pad and keep the shoulders relaxed.
  10. Bend the knees and contract the abdominal muscles to lift the knees to hip level.
  11. Try not to arch the back or swing the legs up.
  12. Slowly lower back down and repeat for 1-3 sets of 12-16 repetitions.
  13. Exercise ball crunch
  14. Lie on the ball, positioning it under the lower back.
  15. Cross your arms over the chest or place them behind your head.
  16. Contract your abdominal muscles to lift your torso off the ball, pulling the bottom of your ribcage down toward your hips.
  17. As you curl up, keep the ball stable (i.e., the ball shouldn’t roll).
  18. Lower back down, getting a stretch in the abdominal muscles, and repeat for 1-3 sets of 12-16 repetitions.
  19. Vertical leg crunch
  20. Lie on the floor and extend the legs straight up with knees crossed.
  21. Place your hands behind the head for support, but avoid pulling on the neck.
  22. Contract the abdominal muscles to lift the shoulder blades off the floor, as though reaching your chest towards your feet.
  23. Keep the legs in a fixed position and imagine bringing your belly button towards your spine at the top of the movement.
  24. Lower and repeat for 1-3 sets of 12-16 repetitions.

Note: To fully understand the descriptions of the work-out, it is recommended that you watch the video presentations provided in the following website:

(To be continued)


Internet Websites:

Muscle cramps (Part 3)

How can you prevent muscle cramps?

Have adequate hydration

For intense physical exercises, there are quantitative guidelines on how to hydrate yourself. However, for light physical exercises, there are two rules of thumb that you can follow and remember: (1) the moment you feel being thirsty, feeling of dryness in the throat, take enough water to quench it, and (2) if you are not sweating in spite of having your usual physical exercise, it is possible that you are not properly hydrated. As mentioned previously, maintain the intensity and duration of your physical exercises; do not drastically change it. If you have been following that, but now you are not sweating ascompared to previous ones, then it is highly probable that you are not well hydrated. Take whatever hydrating fluid you have, but plain water is still the best!

Adequate stretching before physical exercises

It was stated in previous article of Powertec the need to have stretching prior to, and after,   havingphysical exercises. In most gyms, there are illustrations pasted and displayed on the wall showing how to properly do them. Follow the instructions, and this will help you prevent having muscle cramps.

Let existing injury heal first

If you have an existing injury, don’t be in a hurry to re-start your physical exercises! At the very least, what you can do is to adjust the intensity and duration of your physical exercises to what you can well afford to do, or totally avoid it for the moment! Before you return to the gym, secure medical clearance from your physician to protect you from aggravating your existing injury.

Do not drastically change your usual regimen

Fatigue of muscles is one of the causes of muscle cramps. For this reason, do not drastically change the intensity and duration of your physical exercises. If ever you want to intensify, do it gradually. If you have been out of the gym for so long, bereft of the usual periodic physical exercises, when you return, do not immediately plunge yourself to your usual work out! Start from your baseline intensity and duration and gradually build it up again. Of course, you will feel that your body could very well adjust to the building up! You will easily catch up and return to your usual work out because you have been exercising for so long, and you had been investing in improving your health; your building up will be much easier and faster compared to someone who would start having physical exercises for the first time! You will feel the difference!

Take vitamins and minerals

The different vitamins and minerals are necessary for some chemical reactions in the body to proceed and take place. Without them, vital processes in the systems will be curtailed. Hence, you will feel some discomfort in your body—one of which is muscle cramps! Daily, take ascorbic acid, vitamin B complex, calcium, potassium, magnesium, and glucosamine sulfate tablets. Consult previous articles of Powertec for the right dosages.

However, if you want to lessen your intake of vitamins and minerals in tablet forms, you can take the following foods:prevent muscle cramps


Internet Website:


Roth, Ruth A. Nutrition and Diet Therapy. Singapore: Delmar Learning, 2007.

Suggested further readings:

  • Powertec article titled: Eleven basic rules in doing gym exercises: Importance of proper form in strength training and how Powertec machines help in reducing the risk of injury
  • Powertec article titled: Causes of injury while doing physical exercises
  • Powertec articles titled: Muscle cramps (Part 1 and 2)

Muscle cramps (Part 2)

What are the other causes of muscle cramps?

Low potassium

Low potassium level in the blood could cause muscle cramps. However, this is more associated with muscle weakness.

Body fluid shifts

In his lifetime, if a person has drunk a lot of alcohol for some decades and if he was afflicted with hepatitis, the liver will be injured. When these injuries heal, scarring will be produced, and a lot of fibers will be formed in the liver. This medical condition is known as cirrhosis of the liver.Workout for Health

When the liver is cirrhotic, or filled with scarring and fibers, the flow of blood coming from the (1) hepatic artery and (2) hepatic portal vein through the liver is obstructed. Consequently, fluids (represented by the olive green representations in Figure 1) seeping out from both the hepatic artery and hepatic portal vein will spill in the abdominal cavity, ultimately producing a collection of fluid consisting of proteins, glucose, and electrolytes, like sodium and potassium. This movement of fluid from the blood vessels into the abdominal cavity is called body fluid shift.

When there is body fluid shift, not only fluid distribution is disturbed but also the distribution of electrolytes, such as sodium and potassium. When potassium is taken out from the circulation, this could produce muscle cramps!

Alteration in the distribution of potassium could also take place during dialysis and in some cases of kidney failure. Thus, muscle cramps could also take place in these situations.

Intake of some medications

Intake of some medications could cause muscle cramps. Foremost is the diuretic called furosemide, whose brand name is Lasix, which could effect vigorous removal of body fluids, leading to depletion of some electrolytes, like sodium, potassium, calcium and magnesium. When these electrolytes are significantly removed from the circulation and tissues, they could cause muscle cramps.

Other medications that could cause muscle cramps are the following: donepezil for Alzheimer’s disease, neostigmine for myasthenia gravis, raloxifene for osteoporosis, tolcapone for Pankinson’s disease, nifedipine for high blood pressure, terbutaline for asthma, and lovastatin for lowering cholesterol.

Vitamin Deficiency

Some vitamin deficiencies may lead to muscle cramps. These are deficiencies in thiamine (B1), pantothenic acid, and pyridoxine (B6).Thus, for individuals who go to the gym regularly, and also for some of those who do not, a daily intake of vitamin B complex tablet is recommended, containing around 100 mg of thiamine, 5 mg of pyridoxine, 5 mg of pantothenic acid and 50 mcg of cyanocobalamine.

How can we treat muscle cramps?

Stretching the muscle

Stretching the involved muscle can be used to stop the cramp. For some cramps of the feet and legs, the concerned person can stand up then walk around. For a calf muscle cramp, there are two ways of treating it: (1) the person can stand around 2 to 2.5 feet from the wall (more if the person is taller) and lean by placing the forearms against it with the knees and back straight and the heels in contact with the ground or floor, or (2) while still lying down, the ankle is flexed by pulling the toes up toward the head with the leg extended as straight as possible. For a writer’s cramp, the hand will be pressed against the wall with the palm in contact with it. This will stretch the flexor muscles of the fingers, finally stopping the cramp.


Muscle cramps (Part 1)

What are muscle cramps?

Normally, when we move, there are skeletal muscles involved in it. To execute a particular move, a muscle or a group of muscles will have to alternately contract and relax. In some instances, however, suddenly and without warning, one or more muscle(s) contract(s) in a sustained manner, and the person involved in it has no control over the muscular contraction. This is called muscle crampor true cramps. It is painful, and the concerned individual, in most of the times, will be forced to stop from whatever s/he is doing. The sustained muscular contraction could take place for a few secondsor up to a quarter of an hour.

What are the causes of muscle crmuscle cramp amps?


When there is an existing injury in the musculo-skeletal system, a muscle cramp takes place because the body tends to protect the injured part. In this situation, there is a need to treat the existing injury, lest the muscle cramp keeps on recurring!

Fatigue of muscles

When a muscle or group of muscles isoverused in a physical activity, such as in a gym or outdoor physical exercises, a muscle cramp may take place. Overusing of muscles takes place when a person suddenly executes a physical exercise whose intensity and/or durationis(are) beyond what s/he used to do. If, for instance, you have been doing a treadmill exercise for only 30 minutes in a day, but suddenly you increased it to one hour, you might experience muscle cramp, either during, immediately after, or several hours after the physical exercise.

If you have been doing weightlifting, usually lifting 10 kilograms of weight, but, without proper preparation and training, you suddenly used 15-kilogram weight, you may also experience muscle cramp.

Improper positioning

Proper positioningwhile working or playinggreatly contributes in the prevention of muscle cramps. For instance, if you are using the keyboard of a computer or a laptop, ensure that your wrists are well rested on the working table, and not left hanging beyond its edge! Ensure that your head is well rested at its back against a head support structure of your chair! Ensure that your eyesight level is in line with the computer screen, not very much lower or higher! When you play a particular sport, play it with the right form!

Improper and awkward positioning while asleep could be another cause of muscular cramp! Since you cannot really control your sleeping position, the least that you can do is to have firm and flat bed that will prevent your body from sagging!


When you work out in a gym, or engage in an outdoor sport, you will have perspiration that will release the extra heat generated in your body. However, it is not only water and heat that are released; included is the electrolyte, sodium, that plays a very vital role in maintaining the blood pressure. When significant amount of sodium is taken out from your body, arising mainly from intense physical activity and/or use of medicine, such as diuretics (medicines that promote urination), occurrence of muscle cramp is very likely.

Low blood calcium and/or magnesium

Scientific literatures have established that low calcium and/or magnesium level in the blood could cause muscle cramp. The main reason is that when the blood levels of said electrolytes are low, the excitability of the nerve endings and the muscles being supplied by that nerve is high! Hence, with the slightest provocation, the muscle contracts, producing muscle cramp.

Low calcium and magnesium levels in the blood are caused by pregnancy, vomiting, use of diuretics, vitamin D deficiency and hyperventilation (fast breathing).


Internet Website:

Suggested further readings:

  • Powertec article titled: Eleven basic rules in doing gym exercises: Importance of proper form in strength training and how Powertec machines help in reducing the risk of injury
  • Powertec article titled: Causes of injury while doing physical exercises

Essential medical examinations prior to engaging on a long-term physical exercises (Part 2)

Electrocardiogram (ECG)

Electrocardiogram is an instrument which has some sort of electrical wirings attached to the chest and extremities of a person to be examined. When the machine is run, a white longpaper comes out wherein the tracing of the heart activities is written. This tracing will then be interpreted by a medical expert.

The most important information that can be derived from ECG is the patency of the coronary arteries that supply the heart with the much needed blood. If one or more coronary arteries is/ are blocked, heart attack could take place, and the patient may die. The ECG will not only tell the attending physician that the patient has blockages of the coronary arteries; it will also indicate the location of the blockages.

Knowing beforehand that the patient has coronary blockages is very important because by taking in proper medications, heart attack could be prevented, and the patient may be allowed to engage in a restricted physical exercises. If heart attack was not prevented, and it happened, the ECG could definitely detect it, and proper measures could be done to save the life of the patient.

The heart has four chambers: (1) the left ventricle, (2) the right ventricle, (3) the left atrium, and (4) the right atrium. Through the ECG, the physician will be informed if there is enlargement of any one of the chambers. For instance, if the left ventricle is enlarged, then it can be surmised that the patient may have a long standing hypertension which has been left untreated. If the right ventricle is the one enlarged, then some degree of blood flow obstruction in the lungs can be considered. If the right or left atrium is enlarged, then some defects in the heart valves could be detected. With any one of these findings, would-be participant in gym sessions could be properly advised.

Another important information which the ECG could reveal will be the presence of the so-called atrio-ventricular blocks wherein the electrical current coming from the sinus node, a structure in the upper portion of the heart which produces the spark for electrical current,   is not properly transmitted to the ventricles. With this, the normal rhythm of the heart is disturbed. If this happens, the person concerned will not be able to perform highly strenuous work or physical exercises.

Other information that can be gathered from the ECG tracing are the following: (1) the rate and rhythm of the heart, (2) the position of the heart in relation to the chest cage, and (3) alterations in the blood levels of electrolytes, such as calcium or potassium.

Threadmill Stress Testing

Stress testing is a procedure wherein the patient performs a threadmill exercise, and the load is gradually increased. As he exercises, the pulse rate, symptoms of any heart disease, blood pressure, and tracing of electrocardiogram (ECG) are monitored. Normally, as the person exercises, the pulse rate and blood pressures increase, but there should never be chest pain and/or abnormalities in the ECG tracing. If the blood pressure decreases, or the patient experiences chest pain, or there are ECG abnormalities indicating heart problem, the exercise test will be discontinued.

The thread mill stress testing is usually required for would-be gym enthusiasts who at one time or another experienced chest pain, especially if it was provoked by exerting effort, such as going up the stairs, lifting a heavy object, or running! It was usually relieved by rest! In this case, it is possible that the person concerned is suffering from ischemic heart disease (IHD), wherein some parts of his/her heart is/are not well supplied with the much needed blood, and he/she is prone to suffer from heart attack!

Individuals suspected of suffering from IHD need to undergo this test so as to firmly establish if he/she is really suffering from the disease. If, indeed, the individual has IHD, he/she needs to have daily medication(s) as he/she engages in a long-term physical exercise program. There are cases, however, when a medical doctor will immediately disallow a person to proceed with any physical exercise program if the findings in the threadmill stress test revealed that he/she has heart problem that could endanger his/her life.

Essential medical examinations prior to engaging on a long-term physical exercises


The laboratory examination of urine is called urinalysis. It is one of the cheapest laboratory examinations, but a lot of important information could be derived from the results. Normally, you do not find many white blood cells (WBCs) in the urine; but if there are more than 5 in one microscopic field, it is possible that you have urinary tract infection (UTI). Sometimes, it is accompanied by the presence of red blood cells, which could also be more than 5 in one microscopic field. UTIs can be classified into upper or lower infection. If the presence of significant WBCs is accompanied by the presence of protein in the urine, then it is upper urinary tract infection, which means that the kidneys are involved.If there is no protein in the urine, but there are lot of WBCs, then it is lower infection, which means that the urinary bladder and/or urethra is/are the one(s) involved.

UTIs which are not treated, or attended to, for a long time could lead to end-stage kidney diseases that could lead to hypertension and long standing medical problem. It is advisable that before you embark on a long-term physical exercises, that you need to ensure that your kidneys and urinary bladder are free from infections so that you will be spared from developing hypertension which, most of the time, prevents would-be gym enthusiasts to engage in physical exercises, especially those requiring high intensity.

Another important thing that should be looked at in the results of urinalysis is the presence or absence of sugar. If sugar, or glucose, is positive in the urine, it is possible that you are suffering from diabetes mellitus (DM), which could lead to debilitating medical problem—if untreated for a long time—and that could eventually restrict your participation in any gym activities.If you want to confirm whether you have DM or not, you can request for fasting blood sugar (FBS)! If FBS is elevated, then you probably have DM, and you need to see a medical doctor to correct it!

Chest X-ray (Postero-anterior view)

The chest x-ray helps you evaluate your lungs and your heart.It will help you find out if you are suffering from any infection, such as tuberculosis or pneumonia. If, indeed, you have tuberculosis, then medications should be started with dispatch, because treatment takes some time—from 3 to 6 months! Aside from safeguarding your health, there is also a need to protect the health of those around you—at home and in the gym! Tuberculosis is classified as infectious disease; therefore, it could be transmitted from one person to another, threatening public health! Preventing the spread starts from you! If you have it, do not report to the gym, unless you have been taking your anti-tuberculosis drug(s) for at least 2 weeks! Although medical literatures claim that a tuberculous patient ceases to be infectious after taking anti-tuberculosis drug(s) for at least 2 weeks, you are advised to continue taking them for at least 3 or 6 months, depending on the types of medications prescribed to you by your medical doctor.

Aside from lung infections, the chest x-ray will reveal whether or not you have enlargement of the heart! If, indeed, you have heart enlargement, you are advised not to immediately join any physical exercises, especially those with high intensity; it could endanger your life; you need to see a medical doctor to find out the cause(s) of your heart enlargement. Possible causes of heart enlargement are long-standing hypertension, defects in the valve(s) of the heart, or lung problem. The cause should be pinpointed, and appropriate management needs to be started soonest. If your medical doctor has given you the go-signal to proceed with your gym sessions, then you can start it any time.

Chest x-ray will also reveal any carcinomatous process, or cancer, in your lungs! Although it may not have an immediate adverse effects on your gym activities, in the long run, it will drain your health and your capacity to have gym sessions. Therefore, once you have learned that you have cancer, see a medical doctor!

What are trans fats? Part 1


There are two broad types of trans fats—otherwise known as trans fatty acids—in  foods: (1) the naturally-occurring, and (2) the artificial trans fats. Naturally-occurring trans fats are produced in the gut of some animals, and foods prepared from these animals, such as milk and meat products, may contain small quantities of these fats.  Artificial trans fats, on the other hand, are manufactured in an industrial processes wherein hydrogen is added to the liquid vegetable oils to make them more solid. When you use the hydrogenated oil in preparing your foods, such as cookies, doughnuts, frozen pizza, stick margarines, pie crusts, crackers, pastries and fried foods, it will inevitably follow that you take in trans fatty acids when you take these foods! Thus, unknowingly, your  main source of trans fatty acids  is from your diet [1].

Some companies prefer to use trans fats because they are easy to use, less expensive to produce and have longer shelf life.   They, at the same time, provide foods with a desirable taste and texture. In some countries, however, the use of trans fats is restricted because of its ill effects on health [1].

Adverse effects on health

There are two types of cholesterol in your body: (1) high-density lipoprotein  cholesterol, otherwise known as HDL-cholesterol, and (2)  the low-density lipoprotein cholesterol, also known as LDL-cholesterol. The HDL-cholesterol has been proven to be  “good” while the LDL-cholesterol has been found to be “bad”. The reason for this is that HDL-cholesterol has been established by scientific study that it promotes the so-called “reverse cholesterol transport” wherein cholesterol is eliminated from your body, whereas the LDL-cholesterol promotes the deposition of cholesterol in the different tissues of your body, causing the blockage of both the small and large  arteries. Worse and very fatal, the development of obstruction in the small arteries  could  take place in your heart, which could lead to heart attack—medically known as myocardial infarction. When this takes place, you may die!

When you take a lot of foods rich in trans fats, your “good” cholesterol (HDL)  decreases while your “bad” cholesterol  (LDL)  increases. This will  mean that the rate of deposition of cholesterol in your tissues will be faster than its elimination. When this happens, you are prone to develop diseases of the heart and the blood vessels—otherwise known as cardiovascular diseases. Examples of cardiovascular diseases are hypertension, atherosclerosis (hardening and narrowing of the large arteries), and  arteriolosclerosis (hardening and narrowing  of the small  arteries).  Stroke (bleeding in the brain) and diabetes mellitus could also develop because of high intake of trans fats [1].

Preventing the intake of trans fats 

To find out if the food that you are about to take in contains trans fats, look at the “Nutrition Facts” of the product. You can also look at the “list of ingredients”. If “partially hydrogenated oil” is listed as one of the ingredients, then the food product contains trans fats [1].

Ways of lowering the intake of  trans fats and saturated fatty acids

As mentioned in the preceding paragraph, high level of  LDL in your systems is bad for your health, and  all means must be resorted to lower it. In line with this, the American Heart Association recommends that adults need to lower their intake of trans fat and limit their consumption of saturated fat to 5 to 6% of their total daily caloric intake [1].  This recommendation can be achieved through the following ways:

  • Eat a lot of  fruits, vegetables, whole grains, low-fat dairy products, poultry, fish and nuts. In addition,  limit your intake of  red meat and sugary foods and beverages [1].

(To be continued)