What are the components of your annual medical examination? (Part 2)

Laboratory examinations

Complete blood count

Complete blood count (CBC) is a very simple laboratory procedure, but it could reveal a number ofongoing and persistingmedical problems. One important value that is shown in yourCBC is the hemoglobin content of your blood cell.If the hemoglobin value is below the normal ranges, then you are suffering from anemia;since anemia could only be a tip of an iceberg—so to speak—you might need other laboratory procedures which will help your medical doctor determine what has been causing it.

The other value included in the result of your CBC is the number of red blood cells (RBCs). As mentioned in the previous articles of Powertec, the RBCs transport the oxygen from the lungs and bring carbon dioxide to the lungs. If the number of RBCs is reduced, then you will have a problem in the transfer of both oxygen and carbon dioxide, and you will get tired so easily. You cannot participate in very strenuous activities. Similar to the hemoglobin value, reduction in the number of your RBCs means a lot; it could mean a serious disorder in the blood.

The number of white blood cells (WBCs) is also shown in your CBC. If the number is very much higher than the normal values, then it is possible that you are having infection. If very much lower than the normal values, then it could mean a disorder in the bone marrow—an organ of your body responsible for the production of the different cells of your blood.

The platelet count is also included. To let you know, the platelets are the cellular components of your blood which are needed for producing a clot when any one of your fingers or toes is cut. If your platelet count is low, you are prone to have excessive and prolonged bleeding; but the problem does not stop there; a low platelet count could mean a possible disorder in the bone marrow. In addition, if you have been experiencing moderate to high fever for the last few days, and if your platelet count is low, then it is possible that you are suffering from dengue fever, especially if you come from tropical countries.

If your RBC, WBC, and platelet count are all below the normal values, then the possibility of having problem in the bone marrow is very high. You need to consult a hematologist—an expert in the diseases of the blood.

 

Urinalysis

When urinalysisis done, you need to collect your urine, and it will be submitted to the laboratory for examination within one hour from the time of collection. This laboratory procedure is very cheap and can be done in a short time; however, a lot of information can be gleaned from it.

Normally, RBCs are not found in the urine. However, if they are present, then a number of possibilities could be considered. One important problem that you may have is the presence of stone either in your kidney(s) and/or urinary bladder. However, your medical doctor will ask you more questions to firm up the consideration of this problem.

If, in addition to RBCs, you have pus cells in your urine over the normal values, then it is possible that you have infection in the kidneys and/or urinary bladder or both.This consideration is highly probable if bacteria are found in your urine. Again, your medical doctor may ask some more questions and/or require other tests to confirm and establish that you really have infection.

 

(To be continued)

What are the components of your annual medical examination? (Part 1)

Importance of the annual medical examination

There are three important factors that play vital roles in your health maintenance: (1) adequate physical exercises, (2) well-balanced diet, and (3) submission to annual medical examination (AME). In previous Powertec articles, the first two factors have been well covered and adequately discussed that now the third factor needs to be given the same treatment and attention as the previous two.

The AME could be likened to a scanner which is used to examine and view the whole forest. The forest is composed of different trees, and you really do not know, at a certain time, which tree, or trees, has (have) problem(s). If you scan the whole forest, then you could find out the problematic trees, and, therefore, you could implement preventive measures which will slow down the worsening of their condition. By the same token, your body is composed of different parts and organs, and, at certain time, you really do not know which of your organs have problems. There are times when, without feeling any unpleasant experiences, some of your organs have been having problems. But because they are at the earliest stages of a disease, you do not feel anything bad, and you still feel good and alright.

Following the principles of preventive medicine, you need to have the AME so that your medical doctor will be properly guided on how to implement preventive measures for your health.Without the AME and without its results, your medical doctor will have a hard time knowing your future medical problems; he is lost in the jungle, so to speak; thus, he cannot implement preventive measures at the earliest possible time.

Parts of annual medical examination

History taking

If you will meet your medical doctor for the first time, this part of AME may take some time because he will build up your baseline data from zero. He will get general data from you, such as your name, age, address, place of work, and so on. This is followed by your past history, which is concerned with your past illnesses, previous hospitalizations and surgical operations; your personal history, which is concerned with your personal lifestyle and habits, such as drinking liquor, smoking cigarettes, and other practices and preoccupations which have detrimental effects on your health. Subsequently, your family history will be looked into, searching for the diseases which have been common in your family members, such as hypertension, diabetes mellitus, bronchial asthma, and other diseases. You will asked about the cause(s) of deaths of thedeceased members of your family.

Physical examination

After takingdown your medical history, the medical doctor will then physically examine you. Through inspection, he will look at you, and note down all abnormalities. He will observe how you walk and smile; he will note the color of your skin, eyes, and your tongue. After inspection, he will do palpation wherein he places his hand over your chest,  abdomen or any part of your body, and he will feel for any abnormalities. This is followed by percussion wherein the medical doctor taps any part of your body through the use of his fingers, and feel for any change(s) in the sound emitted by the percussed organ(s). Through auscultation, he will listen to your heart, lungs, and abdomen by using his stethoscope. At the end of the four processes, he will collate all the data that he collected, and he will establish a working impression and tentative conclusion—whether you are totally okay or you have a medical problem.

(To be continued)

 

Basic description and management of pain(Part 5)

Drugs used to control “pain”

In the management of pain, there are several methods being used, and one of them is synthetic drugs. In the ensuing part of this paper, the different classes of drugs being used to control pain are introduced and discussed. This is meant to give you an overall view of what drugs could be used to control your pain. Before you use any one of these drugs, however, you need to consult a medical doctor who will guide you on how to approach your problem in terms of knowing what is causing your pain and what drug to use in controlling it.

Non-opioid analgesic[1]

The frequently used members of this group are the following: paracetamol or acetaminophen, aspirin or acetylsalicylic acid, and the non-steroidal analgesic drugs (NSAIDs). Taken as a group, the following generalizations can be applied to each and every member: (1) by taking the drug(s), you will not develop addiction to it (them), (2) there is a “ceiling” to their analgesic effect—that is, upon reaching a certain dose, increasing it will not lead to further relief of yourpain, (3) the capacity to reduce your body temperature, provide relief of yourpain, and control whatever inflammation you have been experiencing varies from one drug to another within the group, and (4) they provide you withpain relief by preventing the formation of prostaglandins[2].

Prostaglandins are hormone-like substances which participate in the performance of your different body functions, such as the contraction and relaxation of your muscles, the dilation and constriction of your blood vessels, and the modulation of inflammation [3]. By modulating inflammation, it could worsen yourpain; thus, the prevention of its formation would lead to the relief of yourpain.

Paracetamol or acetaminophen[2]

Generally, paracetamolor acetaminophen is used to reduce your body temperature. Thus, when you are having fever, this drug is prescribed to you and to othersby a relatively large number of medical doctors. Aside from this, however, youcan use it to control yourpain. This drug is relatively safe, cheap, and very effective; hence, you are encouraged to use this as the first line drug to control yourpain. However,if you have a history of stomach ulcer and hyperacidity (too much acid in the stomach), you are advised to be more cautious in using it; if none, this medication is generally safe and largely deprived of any life-threatening reactions to your body.

To avoid confusion, you should remember that this drug has two generic names: paracetamol or acetaminophen. In some countries, drug dispensers know paracetamol, but they are not aware of acetaminophen; in other places, however, acetaminophen is well-known as the generic name of this drug.

Aspirin or acetylsalicylic acid[2]

Aspirin or acetylsalicylic acid has the same actions as paracetamol. The main difference is on the possible side-effect. Aspirin is notorious for causing possible bleeding from your stomach when it is used for a long time. Thus, you should exercise extreme caution   when using it. To play safe, useparacetamolif you are not allergic to it, instead of aspirin.

Non-steroidal analgesic drugs (NSAIDs)[2]

If acetaminophen (paracetamol) or aspirin will not be able to relieve your pain, then you can shift to using the NSAIDs. Examples of NSAIDs arediclofenac,ibuprofen, naproxen, celecoxib, mefenamic acid, etoricoxib, and indomethacin[4,5].If you use thesedrugs on a short-term basis, they could be considered as generally safe; however, you need to be more careful if you use them for a long period of time, bearing in mind always their possible side-effects on the kidneys and the inner lining of the stomach [1].

Weak opioids [1]

When the non-opioid analgesics or NSAIDs could not fully control your pain, then the so-called weak opioids, such as codeineandtramadol[6], could be added or could be used as replacement. The purpose of adding the weak opioid is to avoid maximizing or increasing the dose of the non-opioid analgesics or NSAIDswhich could be detrimental to your health[7].

Strong opioids [1]

Strong opioidsare the ultimate treatment for moderate to severe pain. When everything has been tried on you and yet no palliation of pain is observed, then the strong opioids will be resorted to. Examples of strong opioids are morphine[6]and oxycodone.

(Last of a series of 5)

 References:

[1]Mercadante S, Fulfaro F. World Health Organization guidelines for cancer pain: a reappraisal. Annals of Oncology 16 (Supplement 4) 2005: iv132-iv135.

[2] Melmon, Kenneth L., Howard F. Morrelli, Brian B. Hoffman, and David W. Nierenberg. Clinical Pharmacology, Basic Principles in Therapeutics. McGraw-Hill, Inc., Health Professions Division: New York, 1992.

[3] MedicineNet.com. http://www.medicinenet.com/script/main/art.asp?articlekey=16461

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

http://cdn.dupagemedicalgroup.com/userfiles/file/patientForms/nsaid-list.pdf

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

http://www.emedexpert.com/compare/nsaids.shtml

[6] WHO analgesic ladder: which weak opioid to use at step two? http://www.bpac.org.nz/BPJ/2008/December/docs/bpj18_who_ladder_pages_20-23.pdf

[7] 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.

 

Basic description and management of pain(Part 4)

Management of “pain”

Steps to undertake when experiencing “pain”

Determine the cause(s) of “pain”

For every pain that you experience, there is a cause or set of causes. Initially, by yourself, you may be able to determine the cause or causes. However, if you have a hard time doing it, then you need to consult a medical doctor who will help you find out your problem and prescribe you with the necessary medication(s).To help your medical doctor, pay attention to the details of your pain. You should fully describe it in terms of location, time of occurrences, intensity, aggravating and relieving circumstances, and whether it stays in one location or spreads to other area(s).

Have the necessary rest

If your leg or knee, for instance, is painful, you need to have rest. If you have scheduled gym sessions, you need to forego those activities for the moment. If you need to go out to buy something, probably it is better that you stay home and do it on a day that your aching part is no longer painful. There are times when your knees are painful because you are overdoing a certain activity, like running on a concrete road! While in pain, have rest.

Take your medications as prescribed

By the mouth[1]

When you experience pain and you have decided to take analgesic(drug to relieve pain), it is advisable that you take it (them) by mouth. It is easier to do it; you can do it by yourself. In addition, the occurrence of side-effects is lesser because the entry of the said medication(s) to your systems is not as fast as when you use injectable drugs.

By the clock[1]

If you were prescribed with a medication which should be taken every six hours, then take it every six hours. If you missed one dose at a certain time, then you will lack certain amount of the medication in your system, and you will experience the so-called breakthrough pain (BP). After you have been free from pain for several days or months, BP all of a sudden takes place because you lack the necessary medication(s). To prevent this, takeit (them) as prescribed and as scheduled.

By the ladder[1]

The World Health Organization (WHO) prescribes that the medication(s) to be used in treating pain should be selected based on the strength of the drug. In this method, medications for pain are categorized into the following: (1) non-opioid, (2) opioid drugs for mild to moderate pain, and (3) opioid drugs for moderate to severe pain. Based on WHO’sprescription—which is otherwise called as the “by the ladder” method—the first drug to be used should come from the non-opioid group, which include the paracetamol, acetaminophen, aspirin, and the non-steroidal anti-inflammatory drugs[1]. The opioid medications should only be used, and reserved, forpain that cannot be controlled by the non-opioid drugs.

For the individual[1]

Whatever dose of medicine you need, it is only good for you. It cannot be used by another person, for everyone inpain needs individualized dosage.

With attention to detail[1]

Pain treatmentrequires great attention to details. This means that you need to take note of when the pain occurs, what are the aggravating and palliating circumstances, the duration when it occurs, and other details that may help you and your attending physician. The correct determination of your medical problem—relatively dependent on what you tell the medical doctor—is of utmost importance because the ensuing medical management will highly depend on it.

(To be continued)

Reference:

[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.

 

Basic description and management of pain(Part 3)

General types of “pain”

Somatic[1]

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[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)

 

References:

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

http://calder.med.miami.edu/pointis/typepain.html

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

http://cdn.dupagemedicalgroup.com/userfiles/file/patientForms/nsaid-list.pdf

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

http://www.emedexpert.com/compare/nsaids.shtml

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

 

Basic description and management of pain(Part 2)

Effects of “pain”

Psychological[1]

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)

References:

[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. http://www.webmd.com/depression/guide/detecting-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”

Physical[1]

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!

Psychological[1]

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)

 

References:

[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: About.com 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:

http://exercise.about.com/od/abs/ss/abexercises_2.htm

(To be continued)

References:

Internet Websites:

http://www.nhlbi.nih.gov/guidelines/obesity/BMI/bmicalc.htm

http://www.jdmdonline.com/content/12/1/41

http://exercise.about.com/od/abs/ss/abexercises_2.htm

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

References:

Internet Website:

www.medicinenet.com/muscle_cramps/page2.htm

Book:

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.