I AM A FAILURE. Yes, I failed. I did not reach my goal of 56 hours of quality sleep this week. I got 55 instead. I may have failed but I still won. The benefits of getting the proper amount of sleep are well known: more energy, better mood, decreased risk of many diseases and conditions, yadda, yadda, yadda. If you read "Some Sleep Tips from a Professional" (see below) you know that getting quality sleep is more important than just getting a lot of sleep. This means not getting up in the middle of the night. This is best done by avoiding drinking a lot prior to sleeping, and also by taking part in a stress reducing activity like reading prior to going to bed.
Today, more and more people are trying to get ahead, and they think they can get more done by cutting sleep out of their day. After just a week of getting an average of 7.8 hours of sleep I feel much more alert and I feel that I was more efficient while I was awake, therefore; I got more done than I thought possible. I feel more energetic, am able to work out better, am in a MUCH better mood (ask my wife), and just generally feel better overall. It has only been a week so far, but I can definately recommend that if you want to get more done, get more sleep.
My sleep breakdown:
Sunday - 8
Monday - 8
Tuesday - 7.5
Wednesday - 6.5
Thursday - 7
Friday -8
Saturday - 10
Sunday, October 18, 2009
Friday, October 16, 2009
Some sleep tips from a professional
So I treat a sleep doc every so often and I have to say I really enjoy getting professionals' opinions about "recommended" anything: recommended caloric intake, recommended amounts of activity, recommended protein (hot topic), recommended sleep, etc. This doc has tons of great info to talk about and all I can bring to the table are my personal experiences, but none the less, it's always an enjoyable conversation. A couple points that he really emphasized are:
1. 6-8 hours of sleep is what most people require. Most people differ in their needs, so 8 isn't always the best.
2. It is not just the amount of sleep you get, but the quality of sleep you get. He states that sleep aides are great if you just want to shut your eyes for 8 hours, but not the best if you want to feel rested and refreshed.
3. Sometimes getting 4 hours of sleep is better than 6. If you require 8 hours of sleep a night you will go through two circadian rhythms. If you wake at 6 hours, you could be in the middle of REM sleep which will make you feel groggy when you wake up. If you wake up after 4 hours of sleep at the end of your first circadian rhythm (not in REM sleep) you will feel better when waking up. Note: He also states that you will still be more tired at the end of the day with this method.
In high school and for most of college, I noticed that I could get about 4 hours of sleep and function at a reasonable level. My father has been the same way his whole life. But lately I have been getting 5-6.5 and still feeling groggy. Upon waking from a nap last weekend I decided, "I am going to get an average of 8 hours of sleep a night for the next week and see how I feel". Well I am 5 nights deep and things are looking up. I'll go into some more specifics at the end of the week but so far I am at about 37/40 possible hours- averaging 7.4 hours/night. Let me tell you, IT MAKES A HUGE DIFFERENCE! On Sunday while watching the Pats hopefully beat up on the Titans I will divulge a little more. Until then, try to get some rest, because when we rest, our bodies build.
1. 6-8 hours of sleep is what most people require. Most people differ in their needs, so 8 isn't always the best.
2. It is not just the amount of sleep you get, but the quality of sleep you get. He states that sleep aides are great if you just want to shut your eyes for 8 hours, but not the best if you want to feel rested and refreshed.
3. Sometimes getting 4 hours of sleep is better than 6. If you require 8 hours of sleep a night you will go through two circadian rhythms. If you wake at 6 hours, you could be in the middle of REM sleep which will make you feel groggy when you wake up. If you wake up after 4 hours of sleep at the end of your first circadian rhythm (not in REM sleep) you will feel better when waking up. Note: He also states that you will still be more tired at the end of the day with this method.
In high school and for most of college, I noticed that I could get about 4 hours of sleep and function at a reasonable level. My father has been the same way his whole life. But lately I have been getting 5-6.5 and still feeling groggy. Upon waking from a nap last weekend I decided, "I am going to get an average of 8 hours of sleep a night for the next week and see how I feel". Well I am 5 nights deep and things are looking up. I'll go into some more specifics at the end of the week but so far I am at about 37/40 possible hours- averaging 7.4 hours/night. Let me tell you, IT MAKES A HUGE DIFFERENCE! On Sunday while watching the Pats hopefully beat up on the Titans I will divulge a little more. Until then, try to get some rest, because when we rest, our bodies build.
Thursday, October 15, 2009
Rome wasn't built in a day
First, sorry it's been so long. No excuses.
I happened to treat a particular patient this past Tuesday who is my muse for this post. She is an older woman, between my mom's age and my grandmother's age, who initially began being treated 3 months ago for shoulder pain. She says that her shoulder and thoracic spine have been bothering her for the past 5 years. Finally, she thought it was time to start doing something about it over the summer. Unfortunately, for her, she is a very busy women- too busy to come in and see me on a regular basis. As in, she came for 3 visits over the first 6 weeks. On that third visit, I received the always wonderful question that seems to only come from "these" patients, "Why am I not healed?"
Imagine the blank stare on my face. As a physical therapist I hear this question a lot, but it usually comes from patients who:
1. Only came to PT because their doctor told them to
2. Only want hot packs, ultrasound, massage, and stim (HUM-merS for short). Sorry people, you have to go somewhere else to get your hummers
3. Do not do their home exercise program (HEP)
4. Are not used to working hard for results
After having the same old conversation with this patient, we determined that she does not do her HEP, and she has continued to perform activities that cause her constant pain and muscle guarding. Not surprisingly, she has been more consistent with her HEP, her visit scheduling, and her overall adherence to her "plan of care", and she is feeling much better!
As a young and motivated physical therapist it is my routine to tell all patients what their plan of care will be, what the expected treatment course will be, what I expect of my patients, and also ask what they expect of me. It is my responsibility to make sure my patients get complete honesty, and know what to expect from physical therapy WITH ME. Like all professions, there are some among us who just go through the motions, and I hope to never become one of them.
The point is, and this applies to fitness professionals too, that as a patient/client if you do not put in the work, how can you expect the results? When you've been training someone for months and ask "can you show me how you've been doing [exercise A]?" and they say "Huh?" personal trainers must have the same feeling. More and more people are expecting immediate results from their personal trainers and physical therapists, and it is our job to let them know that it is the work they put in at home, when we are not there, that truly makes them better. 5 years of shoulder pain and after only 3 visits (1 of which was an evaluation) over 6 weeks my patient expected to be better? Crazy. Seriously guys, Rome wasn't built in a day.
I happened to treat a particular patient this past Tuesday who is my muse for this post. She is an older woman, between my mom's age and my grandmother's age, who initially began being treated 3 months ago for shoulder pain. She says that her shoulder and thoracic spine have been bothering her for the past 5 years. Finally, she thought it was time to start doing something about it over the summer. Unfortunately, for her, she is a very busy women- too busy to come in and see me on a regular basis. As in, she came for 3 visits over the first 6 weeks. On that third visit, I received the always wonderful question that seems to only come from "these" patients, "Why am I not healed?"
Imagine the blank stare on my face. As a physical therapist I hear this question a lot, but it usually comes from patients who:
1. Only came to PT because their doctor told them to
2. Only want hot packs, ultrasound, massage, and stim (HUM-merS for short). Sorry people, you have to go somewhere else to get your hummers
3. Do not do their home exercise program (HEP)
4. Are not used to working hard for results
After having the same old conversation with this patient, we determined that she does not do her HEP, and she has continued to perform activities that cause her constant pain and muscle guarding. Not surprisingly, she has been more consistent with her HEP, her visit scheduling, and her overall adherence to her "plan of care", and she is feeling much better!
As a young and motivated physical therapist it is my routine to tell all patients what their plan of care will be, what the expected treatment course will be, what I expect of my patients, and also ask what they expect of me. It is my responsibility to make sure my patients get complete honesty, and know what to expect from physical therapy WITH ME. Like all professions, there are some among us who just go through the motions, and I hope to never become one of them.
The point is, and this applies to fitness professionals too, that as a patient/client if you do not put in the work, how can you expect the results? When you've been training someone for months and ask "can you show me how you've been doing [exercise A]?" and they say "Huh?" personal trainers must have the same feeling. More and more people are expecting immediate results from their personal trainers and physical therapists, and it is our job to let them know that it is the work they put in at home, when we are not there, that truly makes them better. 5 years of shoulder pain and after only 3 visits (1 of which was an evaluation) over 6 weeks my patient expected to be better? Crazy. Seriously guys, Rome wasn't built in a day.
Tuesday, September 1, 2009
Motivation in the weirdest place
So the motivation for this post came from one of the most unlikely places. First, I am a physical therapist, so why I was reading the Wall Street Journal is beyond me, and second, I was reading an article about Terrell Owens.
Now I have never been able to make up my mind as to whether or not I like T.O. Of course I will cheer against him at all costs when my beloved Patriots are facing his teams (twice this year!), but the guy has talent, and he produces. But then there are the arrogant comments, irresponsible touchdown dances, and his agent, Drew Rosenhaus (enough said). Essentially, my opinion of T.O. sits on the theoretical fence.
In today's WSJ article written by Jen Murphy found in the Health & Wellness section, she highlights T.O.'s career, but concentrates on his workout routine and diet. It was interesting to hear T.O. say that he has had to adapt his workout routine to fit his position and decrease strain on his body. Coincidentally, he is getting better results on the field. In summary, T.O. stopped caring so much about how much weight he could lift, and started caring about how his body felt. He started using more dumbbell work and increased his resistance band work significantly. If you have ever seen T.O. without a shirt (most people remember him doing crunches in his driveway on ESPN) or know about his production, you cannot criticize his results.
As physical therapists, personal trainers, and athletic trainers, we can actually take something away from what T.O. has done with own body (I'm reluctant to say we can learn something from a man who spit in another player's face). We can watch and chart patient/client/athlete progress and determine what is working for them and what is not.
I see too many health care professionals, MD's included, do what works for most people, and if it doesn't work than they are out of ideas. T.O. found what worked for him, which is not the typical dumbbell/free-weight routine most NFL players take part in. In my setting, I need to find what works for each patient, not what worked for the one before. People's bodies respond differently to different stimuli.
Now I would say this is pretty common sense, except it contradicts what I hear from my patients, and what I have seen throughout my clinical and professional career. We need to treat patients, not injuries.
Staying up to date with research, and simply keeping a desire to provide the best care for our patients/clients is an easy way to prevent "cookie cutter" treatments and workouts; however, it is also up to us to listen to our clients and hear how they are responding.
Lessons from future NFL hall of famers in regards to an unrelated profession are few and far between so I'll take this one. However, on 9/14/09 I will be hoping the Patriots can teach T.O. and the rest of the Bills a lesson.
Now I have never been able to make up my mind as to whether or not I like T.O. Of course I will cheer against him at all costs when my beloved Patriots are facing his teams (twice this year!), but the guy has talent, and he produces. But then there are the arrogant comments, irresponsible touchdown dances, and his agent, Drew Rosenhaus (enough said). Essentially, my opinion of T.O. sits on the theoretical fence.
In today's WSJ article written by Jen Murphy found in the Health & Wellness section, she highlights T.O.'s career, but concentrates on his workout routine and diet. It was interesting to hear T.O. say that he has had to adapt his workout routine to fit his position and decrease strain on his body. Coincidentally, he is getting better results on the field. In summary, T.O. stopped caring so much about how much weight he could lift, and started caring about how his body felt. He started using more dumbbell work and increased his resistance band work significantly. If you have ever seen T.O. without a shirt (most people remember him doing crunches in his driveway on ESPN) or know about his production, you cannot criticize his results.
As physical therapists, personal trainers, and athletic trainers, we can actually take something away from what T.O. has done with own body (I'm reluctant to say we can learn something from a man who spit in another player's face). We can watch and chart patient/client/athlete progress and determine what is working for them and what is not.
I see too many health care professionals, MD's included, do what works for most people, and if it doesn't work than they are out of ideas. T.O. found what worked for him, which is not the typical dumbbell/free-weight routine most NFL players take part in. In my setting, I need to find what works for each patient, not what worked for the one before. People's bodies respond differently to different stimuli.
Now I would say this is pretty common sense, except it contradicts what I hear from my patients, and what I have seen throughout my clinical and professional career. We need to treat patients, not injuries.
Staying up to date with research, and simply keeping a desire to provide the best care for our patients/clients is an easy way to prevent "cookie cutter" treatments and workouts; however, it is also up to us to listen to our clients and hear how they are responding.
Lessons from future NFL hall of famers in regards to an unrelated profession are few and far between so I'll take this one. However, on 9/14/09 I will be hoping the Patriots can teach T.O. and the rest of the Bills a lesson.
Wednesday, August 19, 2009
Pizza and Supermodels
When you were about twelve years-old did you ever play a game that went something like this, "Would you rather make out with Pimple Faced Janet, or lick the bottom or your sneaker?"
Well, this simple game tends to go away as we grow older, Janet loses her pimples, moves to France and becomes a supermodel. However, this simple game could definitely help some in the prevention of over-eating. TIME recently published an article that came to the conclusion that exercise actually does not prevent us from gaining weight. I get what they are saying, but it is actually the amount we eat after working out that does this. But, I'm not really disagreeing with their conclusions because the research is sound, and also it is COMMON SENSE!
Let me rephrase that. It is A LOT easier to prevent weight gain or decrease your weight with eating habits than exercise, but the only way to increase your lean body mass naturally is exercise (not to mention all the other benefits of exercise).
Scenario: Friday night. Janet has come back from France. Party. You and your friends decide on pizza (Janet still loves pizza although it looks like she hasn't eaten any in a while). Three slices (300 Cals each) are yours along with 4 non-light beers (150 Cals each, you think light beers are for sissies).
Caloric total = 1500! Hmm... lets bring back that 'Would you rather' game.
Would you rather eat all that or instead eat two slices and four light beers (1000 Calories total) and spend one less hour on the treadmill?
The decision seems pretty simple to me. It takes five seconds to ask yourself that question above, or it takes, well, one hour to burn off the extras. So what are you going to do with one extra hour in your day? I'm probably going to spend it at the gym with my wife anyway, but I suggest you use it to get to know Janet a little better.
Well, this simple game tends to go away as we grow older, Janet loses her pimples, moves to France and becomes a supermodel. However, this simple game could definitely help some in the prevention of over-eating. TIME recently published an article that came to the conclusion that exercise actually does not prevent us from gaining weight. I get what they are saying, but it is actually the amount we eat after working out that does this. But, I'm not really disagreeing with their conclusions because the research is sound, and also it is COMMON SENSE!
Let me rephrase that. It is A LOT easier to prevent weight gain or decrease your weight with eating habits than exercise, but the only way to increase your lean body mass naturally is exercise (not to mention all the other benefits of exercise).
Scenario: Friday night. Janet has come back from France. Party. You and your friends decide on pizza (Janet still loves pizza although it looks like she hasn't eaten any in a while). Three slices (300 Cals each) are yours along with 4 non-light beers (150 Cals each, you think light beers are for sissies).
Caloric total = 1500! Hmm... lets bring back that 'Would you rather' game.
Would you rather eat all that or instead eat two slices and four light beers (1000 Calories total) and spend one less hour on the treadmill?
The decision seems pretty simple to me. It takes five seconds to ask yourself that question above, or it takes, well, one hour to burn off the extras. So what are you going to do with one extra hour in your day? I'm probably going to spend it at the gym with my wife anyway, but I suggest you use it to get to know Janet a little better.
Monday, August 17, 2009
Diabetes: At least it's keeping America's wallets thin
Let's go over some statistics:
It is estimated that 23.6 million Americans have Diabetes Mellitus (DM)
There were 1.5 million NEW cases of DM in 2007 in 18-70 year-olds (this age range is relevant for a future equation)
It cost $174 billion to treat DM in 2007 -For this post I'll estimate that 80% was paid for by health insurance companies (HIC) ~ $139billion
HIC pay $5900 to treat a person EACH year with DM.
There are 57 million people in the USA with Pre-diabetes
Most Type 2 DM is preventable! <--This is definitely a fact!
Now that we've covered some basic stats we can really get into the meat and potatoes. The average cost of gym membership around the Boston area is roughly $30-60 a month with a low of $10, high of around $110 (kind of ridiculous). That being said, the average cost of a gym membership in the area per year is in the $360-$720 range ($540 average). Now, to me, the $540 a year is definitely worth it. I become a grumpy, unmotivated, unpleasant person if I have missed the gym a couple days in a row. To some the benefits of working out are well known, but the costs are just not possible to maintain without help. My health insurance give me $150 a year for gym memberships which seems pretty average. $150 of $540 is ~25% of the cost of going to the gym.
(Refer to the statistics above) Don't you think that HICs can afford the extra $390 bucks when they're willing to pay out $5900 a year if I were to get DM? For $5900 I could get 11 years of gym memberships! I think more people would go to the gym if their HICs would cover the total cost, and HICs would give more money if people could prove that they were actually using the gym (which is pretty easy to do).
If I got DM at 45 and lived until I was 75 that is $177000 my HIC would probably pay for me!! Enough to pay for over 325 years of gym memberships.
Remember 6th grade math? Let's review.
225million is the population in USA aged 18+ X $540 for gym memberships = 121,000,000,000
139,000,000,000 - 121,000,000,000 = $18,000,000,000/5900 = 3,050,847 people able to still be treated for diabetes. Currently 57 million people have pre-diabetes! The CDC says lifestyle modification can reduce your chances of getting DM by 60%. If all these people got DM it would cost HI $420 billion to treat, plus all the people who already have DM, but if only 40% get it, it will only cost ~$160 billion more. HICs will save $250 billion. Talk about a stimulus plan.
Sure, there are a lot of factors that go into this scenario, but the government and HICs have the resources to figure out the statistics. It will definitely cost HICs money up front to reduce the number of consumers with DM, but their savings in the long run (10-20 years) will be gigantic! I mean I did some pretty basic math with my laptop calculator and seemed to be able to make some sense of it. HICs (Medicare included) are seemingly taking their chances with our futures, to save a couple bucks right now. Okay, a recession may not be the best time for HI companies to take this preventative approach towards DM. However, there are other less prevalent but devastating conditions, such as senior citizen falls, that may warrant a preventative approach.
Don't get me wrong, I'm sure that the HICs and the government have gone over these numbers and figured out why it would cost more to provide preventative medicine instead of retroactive care. As far as I know there are studies out there that actually state this as fact. I'm not saying that every citizen needs to get blood sugar tests, and all the other work ups that would add up to being more expensive than the current methods of care, but regardless of risk level, I do think that HICs need to provide a larger incentive to those who are taking preventative measures into their own hands, BUT, people need to provide their attendence records from their gyms to get these discounts(which is very easy)! That's pretty much the point of this post. HICs and the government cannot be held completely responsible for how we take care of OUR bodies.
In this time when health care is apparently being reformed, the HICs need to figure out how to lower costs as much as they can. They need to think of dishing out some money to help us individuals prevent future DM as an INVESTMENT, not as a loss to their bottom line. Because to Americans, the ultimate health care bottom line just happens to be a flat line.
Statistics can be found at:
http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2007.pdf
http://www.diabetes.org/diabetes-statistics/cost-of-diabetes-in-us.jsp
It is estimated that 23.6 million Americans have Diabetes Mellitus (DM)
There were 1.5 million NEW cases of DM in 2007 in 18-70 year-olds (this age range is relevant for a future equation)
It cost $174 billion to treat DM in 2007 -For this post I'll estimate that 80% was paid for by health insurance companies (HIC) ~ $139billion
HIC pay $5900 to treat a person EACH year with DM.
There are 57 million people in the USA with Pre-diabetes
Most Type 2 DM is preventable! <--This is definitely a fact!
Now that we've covered some basic stats we can really get into the meat and potatoes. The average cost of gym membership around the Boston area is roughly $30-60 a month with a low of $10, high of around $110 (kind of ridiculous). That being said, the average cost of a gym membership in the area per year is in the $360-$720 range ($540 average). Now, to me, the $540 a year is definitely worth it. I become a grumpy, unmotivated, unpleasant person if I have missed the gym a couple days in a row. To some the benefits of working out are well known, but the costs are just not possible to maintain without help. My health insurance give me $150 a year for gym memberships which seems pretty average. $150 of $540 is ~25% of the cost of going to the gym.
(Refer to the statistics above) Don't you think that HICs can afford the extra $390 bucks when they're willing to pay out $5900 a year if I were to get DM? For $5900 I could get 11 years of gym memberships! I think more people would go to the gym if their HICs would cover the total cost, and HICs would give more money if people could prove that they were actually using the gym (which is pretty easy to do).
If I got DM at 45 and lived until I was 75 that is $177000 my HIC would probably pay for me!! Enough to pay for over 325 years of gym memberships.
Remember 6th grade math? Let's review.
225million is the population in USA aged 18+ X $540 for gym memberships = 121,000,000,000
139,000,000,000 - 121,000,000,000 = $18,000,000,000/5900 = 3,050,847 people able to still be treated for diabetes. Currently 57 million people have pre-diabetes! The CDC says lifestyle modification can reduce your chances of getting DM by 60%. If all these people got DM it would cost HI $420 billion to treat, plus all the people who already have DM, but if only 40% get it, it will only cost ~$160 billion more. HICs will save $250 billion. Talk about a stimulus plan.
Sure, there are a lot of factors that go into this scenario, but the government and HICs have the resources to figure out the statistics. It will definitely cost HICs money up front to reduce the number of consumers with DM, but their savings in the long run (10-20 years) will be gigantic! I mean I did some pretty basic math with my laptop calculator and seemed to be able to make some sense of it. HICs (Medicare included) are seemingly taking their chances with our futures, to save a couple bucks right now. Okay, a recession may not be the best time for HI companies to take this preventative approach towards DM. However, there are other less prevalent but devastating conditions, such as senior citizen falls, that may warrant a preventative approach.
Don't get me wrong, I'm sure that the HICs and the government have gone over these numbers and figured out why it would cost more to provide preventative medicine instead of retroactive care. As far as I know there are studies out there that actually state this as fact. I'm not saying that every citizen needs to get blood sugar tests, and all the other work ups that would add up to being more expensive than the current methods of care, but regardless of risk level, I do think that HICs need to provide a larger incentive to those who are taking preventative measures into their own hands, BUT, people need to provide their attendence records from their gyms to get these discounts(which is very easy)! That's pretty much the point of this post. HICs and the government cannot be held completely responsible for how we take care of OUR bodies.
In this time when health care is apparently being reformed, the HICs need to figure out how to lower costs as much as they can. They need to think of dishing out some money to help us individuals prevent future DM as an INVESTMENT, not as a loss to their bottom line. Because to Americans, the ultimate health care bottom line just happens to be a flat line.
Statistics can be found at:
http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2007.pdf
http://www.diabetes.org/diabetes-statistics/cost-of-diabetes-in-us.jsp
Sunday, August 16, 2009
Prevention+Plus' History
P+P started as an idea for a physical therapy business over 2 years ago while a friend and myself were bored one day while finishing up finals at Northeastern University in Boston, MA. When push came to shove, the reality of starting a business so shortly out of school had to be put on the back burner. However, my passion for preventative physical therapy and sports medicine has not diminished. I still feel a need to educate the public about the benefits of preventative care and training methods. If you have any questions or issues you would like addressed regarding physical therapy or general health care please feel free to e-mail me at mikescott.dpt@gmail.com.
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