ROCHESTER, Minn.--(BUSINESS WIRE)--Here are highlights from the May and June issues of Mayo Clinic Health Letter. You may cite this publication as often as you wish. Reprinting is allowed for a fee. Mayo Clinic Health Letter attribution is required. Include the following subscription information as your editorial policies permit: Visit www.HealthLetter.MayoClinic.com or call toll-free for subscription information, 800-333-9037, extension 9771.
Nordic Walking: Pole Pushing Burns More Calories, Helps with Stability
ROCHESTER, Minn. -- Nordic walking -- walking with poles -- burns more calories than ordinary walking of the same intensity. However, most people don’t feel like they are working any harder, according to the May issue of Mayo Clinic Health Letter.
Nordic walking got its start as a summer training method for cross-country skiers. In recent years, its popularity has increased, especially among older adults. Walking poles engage the upper body and can help with stability, improve posture and possibly lessen the impact on joints and muscles.
Practitioners of Nordic walking typically experience slightly higher heart rates than occur with ordinary walking. And, the body consumes more oxygen. In one study, Nordic walking burned about 20 percent more calories over one mile compared to normal walking on the same course. The extra calorie burn may occur because Nordic walking works the muscles of the arms, shoulders, chest, back and torso more than ordinary walking.
The arm and leg movements in Nordic walking are much the same as in ordinary walking. To begin, it’s helpful to take a few strides without touching the pole tips to the ground. Walkers progress to taking strides while lightly dragging the pole tips. The next step is to plant the pole tip, gradually increasing the force from gentle to more powerful pole pushes.
Poles designed for Nordic walking are available at many sporting goods stores and on the Internet. Poles are available in adjustable lengths. The forearm should generally be parallel to the ground when gripping a Nordic pole.
As with any new activity, the recommendation is to start at an easy level and gradually increase effort.
Dental Crowns: Measured, Made and Placed During One Appointment
ROCHESTER, Minn. -- Dental machines that use computer-aided design and computer-aided manufacturing are making it possible to have a crown procedure done in one day, eliminating several visits over a few weeks. The May issue of Mayo Clinic Health Letter explains this technology.
The dentist inserts a thin camera wand into the mouth to take many images of the tooth surface. This replaces use of a U-shaped rubber mold to create a tooth impression. Images are sent to a computer console where software creates a three-dimensional image of the needed crown. The dentist can manipulate the design and make adjustments if needed. Finally, a small cube of artificial tooth material is placed in a machine where computer-guided drills mill the material to the exact shape of the crown. A similar process can be used to create dental implants.
Dental offices are just beginning to offer this technology, but availability is expected to increase. It eliminates the weeks-long process of waiting for a laboratory to create a crown, as well as the need for a temporary crown. In addition, patients often don’t need to return for a follow-up visit.
Same-day crowns or implants aren’t the best option for every situation. For example, front tooth color matching is still best done by a highly skilled dental laboratory technician. And, if crowns are needed for more than three teeth, the traditional approach of making an impression is still recommended. While the computer-aided process offers same-day treatment, patients need to plan for a three- to four-hour appointment.
Surgical Options to Repair Rotator Cuff and Reduce Shoulder Pain
ROCHESTER, Minn. -- When shoulder pain doesn’t respond to physical therapy, medication, rest or prescribed exercises, a range of surgery options can ease the rotator cuff pain or even rebuild the shoulder. The May issue of Mayo Clinic Health Letter provides an overview of rotator cuff injures and surgical repairs.
The rotator cuff is a group of four muscles that run between the ball of the upper arm bone and the shoulder blade. Tendons attach these muscles to the humerus ball. Normally, these muscles work as a group to keep the ball centered in its socket while the larger surrounding muscles make arm movement possible.
When rotator cuff muscles don’t work properly, the result is pain and even disability. Pain is usually felt over the outside of the upper arm, just below the shoulder. Pain can have many underlying causes. Collagen, the tissue that serves as the building block for the rotator cuff muscles and tendons, weakens with age. Normal wear and tear or overuse of the arm may make the tendons and muscles more prone to degeneration and tears. Calcium deposits or arthritic bone spurs can form on the bones overlaying the rotator cuff. They can pinch the tendons and irritate the rotator cuff. A fall on an outstretched arm can bruise or tear a rotator cuff tendon or muscle.
A surgeon may recommend one of these repair approaches:
Open or mini-open repair: This includes detaching or splitting the overlying shoulder muscle (deltoid) to reach and repair a large or complex cuff tear. This is done through one incision over the shoulder or via several smaller incisions.
Arthroscopy: This surgery is done through very tiny incisions just big enough to accommodate pencil-thin surgical tools. This approach may be used to address worn or torn tendons, bone spurs that rub against worn tendons, or abnormal changes to the bursa, the tissue that covers and lubricates the top of the rotator cuff.
Reverse shoulder arthroplasty: When the rotator cuff is worn out or torn beyond repair, the shoulder ball can be replaced by a socket, and the shoulder socket by a ball. This complex procedure changes the shoulder joint mechanics so the arm can be moved comfortably without a functioning rotator cuff. Mayo Clinic surgeons have performed reverse shoulder arthroplasty since 2004 and have done more procedures than any other large medical center in the United States. When the procedure is performed by an experienced surgeon, most patients undergoing reverse shoulder arthroplasty experience pain relief and improved shoulder function.
Palliative Care Offers Symptom Relief at any Stage of Serious Illness
ROCHESTER, Minn. -- Associating palliative care with hospice or end-of-life care is not uncommon -- but they aren’t exactly the same. The June issue of Mayo Clinic Health Letter explains the differences and how palliative care can help people with serious health conditions feel better and even live longer.
Palliative medicine is a relatively new medical specialty that focuses on relieving symptoms and stress associated with serious illness. Palliative care can be delivered with treatment to cure or improve the underlying illness.
Hospice care is generally limited to those whose life expectancy is six months or less. Hospice care focuses on providing physical comfort and support to make the most of the last weeks to months of life. All hospice care is palliative, but at any stage of a chronic or serious illness, palliative care can help people live better.
Palliative care is a team effort and may include a primary care physician, specialists, pharmacists, dietitians, physical or occupational therapists, specially trained nurses, physician assistants, social workers, chaplains and mental health care providers. Treatment could address pain, fatigue, loss of appetite, insomnia, shortness of breath, nausea, constipation, depression, anxiety and grief. Care may be delivered in a hospital, a care center, through in-home services or in outpatient settings.
Recent data shows the benefits of palliative care early in the course of treatment for serious illness. A study found that palliative care, when delivered in tandem with standard cancer treatment, helped patients feel better and live longer when compared with patients who received standard treatment alone.
Gut Feelings: Finding the Causes of Indigestion, Heartburn, Cramps and Bloating
ROCHESTER, Minn. -- Symptoms of gastric discomfort -- indigestion, heartburn and stomach cramps -- usually diminish in just a few hours. But for some people, digestive distress persists and becomes a constant concern. An eight-page Special Report in the June issue of Mayo Clinic Health Letter focuses on digestive health problems, which often can be successfully treated or managed.
Many causes, many treatments: The Special Report covers treatments for digestive problems including ulcers, celiac disease, pancreatitis, Crohn’s disease, diverticular disease, gallstones and liver disease. Seeking medical care sooner, rather than later, can help manage or even cure these conditions. Early action also may prevent a serious condition from becoming life threatening.
Aging alone isn’t the problem: People often blame aging for digestive problems. With aging, changes do occur. For example, the stomach loses elasticity and doesn’t hold as much food. But, in general, changes due to aging have a mild impact on digestion.
Heartburn (or heart attack?): Emergency care is recommended when heartburn seems different or worse than usual, especially if it occurs during physical activity or is accompanied by shortness of breath, sweating, dizziness, nausea or pain radiating into the shoulder and arm.
The heart and esophagus are in close proximity and share similar nerve connections. They both can cause chest pain, ranging from mild to severe. And distinguishing heartburn from heart attack is not always easy.
Don’t blame spicy food: Most ulcers develop because of a bacterial infection or as a side effect of medications, not because of last night’s dinner. The most common ulcer symptom is gnawing pain in the upper abdomen between the navel and breastbone. Treatment usually involves antibiotics and medications to reduce the level of acid in the stomach and give it a chance to heal.
Being ‘regular’ doesn’t mean every day: Constipation -- one of the most common complaints among older adults -- is generally defined as having fewer than three bowel movements a week with stools that are hard and painful. In contrast, easy bowel movements, even if they occur just every other day, would be considered normal.
Constipation may be caused by dehydration, overuse of laxatives, medication side effects, a pattern of delaying bowel movements or underlying medication conditions. Exercise and adequate fiber in the diet can help. A physician can recommend other treatments such as fiber supplements or a brief course of laxatives.
Risks and Benefits of Stopping Smoking
ROCHESTER, Minn. -- Stopping smoking -- at any age -- offers almost immediate health benefits, according to the June issue of Mayo Clinic Health Letter. Recent reports about side effects of drugs used to help stop smoking shouldn’t dissuade smokers from trying to quit. Side effects from these medications are usually infrequent, minor, and manageable -- either by reducing doses or switching to another medication.
Stopping smoking has many significant health benefits. Just 20 minutes after the last cigarette, the heart rate decreases. Twelve hours later, carbon monoxide in the blood returns to normal. A year after stopping, the risk of having a heart attack related to smoking drops by half.
Stopping is difficult, and most smokers make many attempts before they have long-term success. Smokers who are successful often take advantage of behavior counseling and medications.
A variety of drug options can help ease withdrawal symptoms and reduce cravings. Mayo Clinic Health Letter provides an overview of medication options and potential side effects or risks.
Nicotine patch: With a steady dose of nicotine, smokers double their odds of successfully quitting. The odds nearly triple when patches are combined with fast-acting nicotine replacement. Potential side effects include skin irritation, dizziness, racing or irregular heartbeat, sleep problems, headaches and nausea. Sleep problems can be minimized by removing the patch at night.
Nicotine gum, nasal spray, inhalers and lozenges: These fast-acting nicotine replacements help minimize cravings. Using these products doubles the odds of successfully stopping.
However, nicotine replacements may irritate the mouth, nose and throat, plus they can cause coughing, nausea, headache and minor digestive issues.
Varenicline (Chantix): This drug decreases withdrawal symptoms and reduces the feelings of pleasure from smoking. It increases the odds of successfully stopping by at least 2.5 times. Possible side effects are nausea, headache, insomnia and vivid dreams. Rarely, it’s associated with serious psychiatric symptoms such as depressed mood, agitation and suicidal thoughts.
Bupropion (Zyban): Use of bupropion doubles the odds of successfully stopping and may help minimize weight gain. It increases the levels of brain chemicals that are also boosted by nicotine, decreasing withdrawal symptoms and reducing pleasure from smoking. Possible side effects are sleep disturbances, dry mouth and headache. It’s very rarely associated with serious psychiatric symptoms.
Patients taking these medications should consult their physician right away if they experience side effects.
Mayo Clinic Health Letter is an eight-page monthly newsletter of reliable, accurate and practical information on today’s health and medical news. To subscribe, please call 1-800-333-9037 (toll-free), extension 9771, or visit www.HealthLetter.MayoClinic.com.
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