Allison sat in class listening to her professor. She couldn’t concentrate on his complicated formulas and theorems. She had a pounding headache.

Why did she always get a headache right before final exams?

Jessie Mueller, MD, Scott & White Headache Center, explains the physiology behind headaches.

The Causes of Headaches

In the United States, 90 percent of men and 95 percent of women, Dr. Mueller says, will have some sort of headache this year.

But some people have headaches more often. And some of those people have severe headaches more frequently. 

Studies show that “people who suffer from headaches have a sensitive or hyperactive nervous system,” says Dr. Mueller. It’s theorized that headaches happen when the brain releases inflammatory substances around the blood vessels and nerves, perhaps in response to stressors in your life.

“People who are prone to having severe headaches react to sensory information and triggers differently than other people. They have a harder time adjusting to change or stressors, for example,” Dr. Mueller explains.

There’s a genetic element, too. The propensity to get frequent headaches can be inherited. “You just picked the wrong parents,” Dr. Mueller says.

Headaches can also be caused by trauma, either physical or emotional:

• Physical trauma
  • Head injury
  • Car wreck
  • Military accident
• Emotional trauma
  • Assault
  • Abuse
  • Neglect

“We work closely with Mental Health to help you develop stress management techniques as well as work on unresolved issues,” Dr. Mueller says, “so that we can minimize the triggers that set off your headaches.”

Your Trigeminovascular System – Where Headaches Start

“The part of your brain where headaches originate is called the trigeminovascular system. It’s a system of four branches of blood vessels and nerves that go throughout your brain,” explains Dr. Mueller.

“Because your headaches are due to your sensitive nervous system, you’re going to have to make a huge behavioral sacrifice if you want to minimize your headaches.”

Forehead migraines. “One nerve goes to your forehead area. You’ll have blurry vision and eye pain,” says Dr. Mueller.

Rhinogenic migraines. “A second branch of nerves and blood vessels goes to your nose area. You’ll have facial pain and a runny nose. These symptoms can appear as a sinus headache,” says Dr. Mueller.

Temporal migraines. This nerve goes to the area by your temples and above your jaw. You’ll have pain in your temple area, often just on one side of your head.

Occipital migraines. “This branch of the trigeminovascular system is at the back of your head, in the cervical area,” explains Dr. Mueller, “where your head meets your neck. You can often feel tightening in the back of your neck.”

“You can have a headache in one branch or two branches — or all four can be activated for a headache,” says Dr. Mueller.

Types of Headaches

There are two types of headaches:

• Primary
• Secondary

“Primary headaches occur because your sensitive, hyper-excitable nervous system doesn’t tolerate change well. Secondary headaches are caused by another reason or cause, such as a tumor or infection. We treat primary headaches in our headache clinic,” says Dr. Mueller.

There are two kinds of primary headaches:

• Migraine
• Tension

Convergence Theory

“New research — called the convergence theory, developed by Dr. Roger Cady, a world-renowned headache specialist — suggests links between tension and migraine headaches. All headaches fall along a converged line of pain,” explains Dr. Mueller.  Convergence theory is generally accepted by the American Headache Society.

Prodrome stage. This first stage of a headache is marked by:

• General malaise
• Fatigue
• Weakness
• Irritability

Aura stage. “Aura” is the sensation that about 15 percent of migraineurs get before a migraine comes on. Dr. Mueller says it’s sort of a “warning sign,” and may be marked by:

• Tunneling of vision
• Seeing squiggly lines
• Seeing flashing lights

Headache phase. There are three stages of severity:

• Mild – Green zone
• Moderate – Yellow zone
• Severe – Red zone

Postdrome phase. Lasting a few hours to several days, this phase may be marked by:

• Fatigue
• Depression
• Poor concentration

According to the convergence theory, tension headaches are not distinct from migraine headaches; instead, tension headaches are headaches in the green zone that do not progress into the yellow zone.  

The convergence theory suggests that not all migraines advance into the red zone. There are varying degrees of severity. Each migraine is different.

Headaches classified as severe may be accompanied by:

• Sensitivity to movement, sound, light or odor
• Depression, anxiety or panic
• Nausea or vomiting
• Vertigo

Treatment Options

“Each time when you come into the Scott & White Headache Center, we’ll have you fill out two different headache evaluation forms. You rate the level of severity of the headaches you’ve been having and you rate how the headaches impact your life. How we treat you depends on how you assess and grade your headaches,” explains Dr. Mueller.

“We also track your responses over several months or years so that we can make determinations regarding stressors in your life that make your headaches worse,” says Dr. Mueller.

Your treatment depends, Dr. Mueller says, on the stage of your headache. Your headache physician will generally recommend a two-pronged treatment approach:

• Behavior modifications and stress management techniques
• Medications
  • Preventive – prevent headaches from occurring
  • Abortive – stop headaches that are occurring
  • Rescue – stop severe headaches that don’t respond to abortive medications

“When we’re treating headaches, it’s always a bimodal approach. Medications alone won’t be enough. Because your headaches are due to your sensitive nervous system, you’re going to have to make a huge behavioral sacrifice if you want to minimize your headaches,” says Dr. Mueller.

Dr. Mueller: “Your doctor can’t do it alone.” 

NOTE: If you’d like to know whether you should ask your primary care physician for a referral to the Scott & White Headache Clinic, take the migraine disability assessment test at http://www.achenet.org/midas/.

“We know that if the patient had a situation of cancer, the patient would be all ears. We could say, ‘Do this and do that,’ and the patient would say, ‘Sure. I’ll start today.’ But with diabetes we usually hear excuses of why they can’t exercise or why they can’t lose weight,” says J. Marshall Devall, DPM, Podiatrist at the Temple Santa Fe Center.

The excuses have to stop. Your feet — and your nervous, circulation, and renal systems — depend on it.

Dr. Devall discusses Type II diabetes and making the necessary lifestyle changes to live longer and more healthfully.

What Is Dangerous About Type II Diabetes?

“Diabetes is a disease that damages the lining of your blood vessels. Because it’s a small-vessel disease, patients with diabetes are at high risk for problems involving their eyes, feet, skin, heart and kidneys,” explains Dr. Devall.

“Diabetes is a disease that requires a tremendous amount of risk factor modification. You’re talking about metabolic syndrome—obesity, diabetes, high blood pressure, high blood sugar, hyperlipidemia—fats, cholesterol—and poor management of all that,” Dr. Devall warns.

Patients with diabetes often have difficulty controlling their diets, which results in a complex series of problems that affects multiple systems. High-fat, high-sugar diets, coupled with sedentary lifestyles, often raise cholesterol and glucose levels and increases blood pressure, increasing the risk for heart disease, stroke and a host of other problems.

“As patients get older, they tend to have a lot of dietary indiscretions. Eating a lot of unhealthy foods may be fine when you’re 17,” Dr. Devall says, “but you’re not going to be able to do that forever.”

“Many of the side effects of a poor diet, such as poor circulation and neuropathy can be reversed if people just tighten control of their diets.”

For the diabetic, an unhealthy diet causes weight gain, which often makes it difficult to exercise. Without exercising, it becomes even easier to gain more weight.

As people with diabetes become obese, “the fat becomes an endocrine organ. It’s not that they’re not producing insulin, but the insulin isn’t as effective. People with diabetes have to change they way they eat to avoid foot problems, obesity, hyperlipidemia, hypertension—all that,” Dr. Devall says.

What Lifestyle Changes Should I Make?

Dr. Devall’s suggestions for healthier living with Type II diabetes include:

• Get an annual physical exam with your primary physician
  • Or more frequently, if recommended
• Get an annual foot exam with a podiatrist
  • Or more frequently, if recommended
• Make healthy food choices
  • Eat more fruits and vegetables
  • Choose lower-fat meats, such as chicken and turkey
  • Avoid fried foods
• Maintain a healthy body weight
  • Easier to exercise
  • Easier for your body respond to insulin
  • Lowers your risk of heart disease and stroke
• Maintain a healthy blood pressure
  • Lowers your risk of damage to other organs
  • Lowers your risk of heart disease and stroke
• Maintain a healthy cholesterol level
  • Lowers your risk of heart disease and stroke
  • Helps prevent circulation problems, which can cause foot ulcers
• Get regular exercise
  • Helps control your weight
  • Centers for Disease Control recommends at least 30 minutes of exercise 5 days a week
• Don’t smoke
  • Lowers your risk of heart, nerve and kidney disease
  • Easier for your body to respond to insulin

“Our focus is on prevention. We don’t want to wait until you have a disastrous complication. I don’t like to have people walk into my clinic like a patient did recently. He said, ‘Dr. Devall, this is really bad because it stinks.’ Get control of your sugars, your weight, your diet and prevent problems before they start,” advises Dr. Devall. 

“Many of the side effects of a poor diet, such as poor circulation and neuropathy [the loss of sensation in the feet] can be reversed if people just tighten control of their diets,” says Dr. Devall.

It didn’t take long, but now the summer heat is upon us. Whether you are young or young at heart, it’s important to protect your skin from the sun’s rays. It’s a grim statistic, but skin cancer is the most common form of cancer in the United States¹, and one in five people will develop skin cancer during the course of a lifetime².

So as the sun comes out, so should your sunscreen. Or should it be sunblock? What’s the difference, and is one really better than another?

Sun protection comes in two forms: sunscreen and sunblock, and many people do not know the difference. Both work to protect the skin from the sun’s damaging UV rays but in different ways.

“Sunscreen works just as the name implies, as a screen,” says Dr. Kendall Roehl, plastic/reconstructive surgeon at Scott & White. “It is colorless and absorbed into the skin to reflect and screen the skin from damaging UV rays. Sunblock physically blocks the sun’s UV rays from penetrating the skin, acting as a barrier.”

Many of us remember those years as kids, when our mothers would slather our noses with white (or pink if you were lucky – and female) zinc oxide, the most visible example of a good sunblock. Sunblocks contain either zinc oxide or titanium dioxide and protect the skin against both UV-A and UV-B rays. Sunscreen is white but is absorbed into the skin when applied and becomes transparent. When purchasing a sunscreen, check to see if it covers both UV-A and UV-B rays. Most sunscreens only cover UV-B rays.

Both sunscreen and sunblock are packaged based on SPF or sun protection factor. This is a number to give you some indication of the duration of protection.

“Choosing sun protection with a high SPF is always the smart choice,” says Dr. Roehl. “For example, SPF 15 sunscreen/sunblock will allow you to be in the sun 15 times longer than it would normally take to get a sunburn. So if your skin burns in 10 minutes without protection, then SPF 15 will give you 150 minutes of coverage. For most instances, SPF 15 up to SPF 60 is adequate depending upon the length of expected exposure.”

Remember to reapply every hour when participating in water activities or after excessive sweating.

So when you get ready to head outside for some fun in the sun, make sure you are prepared, and do your homework! Read the labels and make sure you have what you need to protect your skin. And don’t forget the floppy hat and sunglasses. The more protection you can give yourself while you are outside the better. The same thing goes for the kids. Make sure to slather on the sunscreen and sunblock, and help them learn early to keep themselves safe from the sun’s potentially harmful rays.

1 American Cancer Society. Cancer Facts & Figures 2009
2 JK Robinson. “Sun Exposure, Sun Protection, and Vitamin D,” JAMA: The Journal of the American Medical Association (2005): 294, 1541-­‐43.

Find Out What Those Hard-To-Pronounce Items Are In Your Favorite Processed Foods

My stomach is grumbling and I just want to grab something at the convenience store to get me through the rest of the afternoon. I pass up the candy aisle and settle for some of my favorite snack cakes. Before I get to the counter to pay for my sweet treat, I flip over the package and read the ingredients.

I feel like I’m reading the ingredients to a science experiment. Xanthan Gum? Potassium Sorbate? Ammonium Bicarbonate? What in the world have I been eating all of these years?

It turns out that these NASA-sounding terms are food additives.

What is a food additive?

“A food additive is anything that is not naturally found in the food—either chemical or plant based,” said Certified Diabetes Educator, Raynelle Shelley. “The additives can be used in food processing to preserve the food and give them a longer shelf life.”

Potassium sorbate, for instance, is added to help prevent bacteria, yeast and mold from growing in baked goods.

Food additives also help to protect the natural color and flavor in foods or to enhance or alter the color of foods, like yellow number 5 used in cake and pudding mixes.

According to the Federal Drug Administration (FDA), food additives are also used to add vitamins and minerals and fiber to make up for those lacking in a person’s diet.

Have food additives become more common in recent years?

“I would say that yes, food additives have increased in recent years, because food now travels longer distances across the country or even from outside of the country,” Ms. Shelley said.

Food would not survive distances without some of the additives.

The FDA has a database of over 3,000 ingredients that are added to foods each year.

If so many foods contain additives, how do I know if they’re safe?

The FDA is legally responsible for determining if a new or existing food or color additive is safe for use. And there’s never been a time in history that food and color additives have been more strictly studied, regulated and monitored than right now.

However, Ms. Shelley said that some people may be more sensitive than others to certain additives and anything in excess can be harmful to the body.

“The liver can only take care of a certain volume of harmful substances at a time,” she said. “If a person over-taxes the organ faster than it can detoxify and clear a substance, than it can certainly be harmful.”

How can I limit the amount of additives in my diet?

“The best way to avoid food additives is to grow a garden and prepare meals from scratch,” Ms. Shelley said. “It is also best to purchase foods with the least amount of processing.”

Here are some other ways to limit food additives:

• Read food labels – manufacturers are required to list all ingredients, including additives.
• Eat a variety of foods – this will decrease the chance of overusing specific additives.
• Eat everything in moderation.

For more information about food additives and how to eat safely and healthfully, visit fda.gov.

We are proud to celebrate those chosen as our Top 25 nurses at Scott & White for 2012. This group of individuals epitomizes the values we try to live up to each day including Patient-Centered, Innovation, Teamwork, Excellence, Accountability and Pride.

After more than 150 entries were submitted, the judging committee, consisting of more than 25 members including nursing leadership, have chosen the following as our Top 25 to be honored this year:

Sandra Barnes, PACU, Temple Hospital

Sharon Brown, Continuing Care Hospital, Temple

Lauretta Byers, 8 North, Temple Hospital

Jennifer Casey, Emergency Department, Round Rock Hospital

Krysta Doyal, STICU, Temple Hospital

Germe Drepaul, ICU, Temple Hospital

Christy Eastman, Med / Surg, Round Rock Hospital

Jenny Gonzales, Med / Surg, Taylor Hospital

Rachel Hatchitt, Med / Surg, Round Rock Hospital

Landon Hickman, Continuing Care Hospital, Temple

Kelly Harris, Emergency Department, Round Rock Hospital

Emily Johnson, Med / Surg, Round Rock Hospital

Andrea “Nikki” Leschber, Labor & Delivery, Round Rock Hospital

Cassie McGee, Taylor Hospital

Scott Morriss, Psychiatry, Round Rock Hospital

Peggy Nations, NICU, Temple Hospital

Jo Ann Nichols, Clinical Research Coordinator, Temple

Irene Obu-Uwaeze, Med / Surg, Round Rock Hospital

Amy Peace, McLane Children’s Hospital, Temple

Marquita Sherrod-Morfin, Emergency Department, Round Rock Hospital

Erin Stanley, 5 North, Temple Hospital

Sherrina Stewart, CTICU, Temple Hospital

Sherrie Sheets, Continuing Care Hospital, Temple

Christine Tabuco, Labor & Delivery, Round Rock Hospital

Angelito Tan, OR, Round Rock Hospital

You can view their pictures and read their nomination letters by going to http://top25nurses.sw.org

Have you had a great experience with a nurse at Scott & White not listed above? Tell us about it by commenting!

Ruby was feeling worn out, tired, run-down, wiped out — and when she moved too quickly, she had to catch her breath; she also had mild chest pain. She went to her doctor, who ran a series of blood tests. Ruby was so badly anemic that she needed a blood transfusion. 

She wasn’t even sure what that was.

Blood Transfusions

A blood transfusion is a common procedure, where you receive donated blood through an IV line inserted into a blood vessel. Generally, the process takes around two hours, depending on how much blood you need.

You may need a blood transfusion if you lost blood due to:

• Surgery
• Accident
• Injury

Sometimes you may have an illness where you no longer make blood properly. Some medications, including some chemotherapy drugs, can interfere with your blood-producing capabilities.

“We’ll first run a thorough analysis of your blood, typing for the ABO blood group and screening for antibodies to these other common antigens before we transfuse you.”

Walter J. Linz, MD, Medical Director of the Scott & White Blood Center and Transfusion Medicine, explains blood transfusions.

“Why do we give people red blood cells? There’s only one reason to give red blood cells and that’s to increase the oxygen-carrying capacity. If you’re anemic, you don’t have enough red blood cells to move oxygen from your lungs to your peripheral tissues,” explains Dr. Linz.

Your blood carries oxygen and nutrients — as well as medication — to the cells throughout your body. An abundant blood supply is necessary to healing and good health.

Blood Transfusions and Blood Type

“By convention, when we ask someone what his blood type is, we’re talking about the ABO system. That was discovered in 1901. It was the first system, and it contains the blood types A, B, AB and O, which we refer to as the ABO blood group,” explains Dr. Linz.

“There is also the Rh system, which was discovered in 1929. The Rh system is composed of 49 antigens, but we talk only about one antigen, and that’s the D antigen. So when people talk about whether they’re Rh-positive or Rh-negative, they’re talking about one antigen out of a group of 49 antigens,” says Dr. Linz.

There are 24 total blood systems, including such systems as Kell, Kidd and Duffy with more than 500 identified antigens. An antigen is actually a carbohydrate or protein on the surface of the red blood cell.

If you’re receiving a non-emergent blood transfusion at Scott & White, we’ll first run a thorough analysis of your blood, typing for the ABO blood group and screening for antibodies to these other common antigens before we transfuse you, Dr. Linz says.

In the event of emergencies, Dr. Linz says, you’ll be transfused with group O blood. Group O is the universal donor.

“Also, if you’re a young woman, all efforts will be made,” Dr. Linz says, “to also transfuse Rh-negative blood as well. ‘Negative’ means it doesn’t contain the Rh D antigen, which is given to prevent you from forming an anti-D antibody.”

To explain: Transfusing women of childbearing age with Rh-negative blood avoids a condition called Rh incompatibility, which occurs when a pregnant woman has Rh-negative blood and the baby in her womb has Rh-positive blood. The Rh baby may develop Rh disease, which is a potentially deadly condition that causes the destruction of red blood cells and other problems.

Incompatible Blood Transfusions

 Why is it important for the lab to check your blood for antibodies to other antigens?

“When you get a blood transfusion, you get someone else’s blood. That blood is unique to that other individual. Your body may recognize that it’s foreign and mount a response to the foreign body in your bloodstream. Your blood might become alloimmunized. That happens about 1 percent of the time. So 99 percent of the time people get a transfusion and don’t develop an immune response,” says Dr. Linz.

“The deal is that if you get a blood transfusion and you make an antibody to one of these systems, it’s possible that the antibody is going to react with the next transfused product that you get and you could have a transfusion reaction with the product,” explains Dr. Linz. 

In other words, you would have an incompatible blood transfusion.

“If we end up giving an incompatible transfusion, one of the big problems is that your body system destroys the blood that we put in to help you,” says Dr. Linz, “so we haven’t gotten the therapeutic effect that we wanted.”

“That’s why we meticulously cross-match blood,” explains Dr. Linz.

Scott & White Allergist Offers Helpful Tips On How Allergy-Proof Your Home

Sniffling, sneezing, and a running nose are not exactly fun outdoor companions. For more than half of the U.S. population¹, who suffer from allergy symptoms, life outdoors can be brutal.

So, how do most of these sneezing, dripping Americans cope? They go inside. The problem is that the allergens often follow us inside or are there waiting for us.

In a recent survey, over 50 percent of homes were found to have at least six detectable allergens present.² The solution: allergy-proofing your home.

Division director of asthma and immunology, Scott & White – Round Rock, Thomas Leath, MD, offers some helpful tips on keeping allergens out and reducing the ones that are in.

Keep Everything Closed

“To keep outdoor allergens out, I recommend keeping your doors and windows closed, even on those tempting beautiful spring or fall days,” Dr. Leath said.

Keeping car windows rolled up can also help.

Control Dust

“I typically recommend allergy-proof encasements for pillows,” Dr. Leath said. “It is also helpful to wash bedding in hot water weekly and place in a hot dryer.”

Wall-to-wall carpeting should be removed if possible and be vacuumed with a vacuum that has a HEPA (high-efficiency particulate) filter or double-layered bag.³

Dr. Leath also recommends removing other dust “reservoirs” like stuffed animals, curtains and throw pillows.

Keep Humidity Low

“Temperature per se doesn’t make a difference, but since warmer temperatures promote humidity, lower room temperatures could help,” he said.

Dust mites and mold thrive in relative humidity above 55 percent. So, reducing dampness can help to decrease their growth.

Remove mold on hard surfaces with a mixture of water, detergent and five percent bleach. And repair leaking roofs or pipes.³

Keep Fido Clean And Out Of The Bedroom

“For pet allergies, the ideal situation is a pet-free home, but that’s not realistic for every family,” Dr. Leath said. “So, keeping the pet out of the bedroom and placing a HEPA filter in the bedroom are the next best steps.”

Bathing pets twice per week has also been proven to reduce the number of indoor pet allergen levels, he said.

And because allergy symptoms related to pets are caused by an allergen in the dander of the animal, vacuuming carpets or replacing carpet with hardwood floors or tile can also help to reduce exposure and irritation.³

Use A Sinus Rinse

“Basically, your nose is a fancy filter for what you’re breathing into your lungs,” Dr. Leath said. “If you’re allergic to what it’s filtering out of the air, then it’s going to sit there and be a problem.”

So, you can rinse out your nose with a salt water nasal rinse during those peak allergy seasons or whenever you think you need it.

And if you have done what you can to allergy-proof your home and are still suffering from allergy symptoms, you may need to make an appointment with an allergist.

Scott & White allergists are board-certified and don’t require a referral*.

For more tips on allergy-proofing your home, visit the American Academy of Allergy Asthma and Immunology’s website.

*Some insurance companies may require a referral, even if Scott & White allergists do not.

What are some ways that you reduce allergens in your home? Share your tips and secrets.

¹                      Arbes SJ et al. Prevalences of positive skin test responses to 10 common allergens in the U.S. population: Results from the Third National Health and Nutrition Examination Survey. J Allergy Clin Immunol. 2005; 116:377-383. (2012) Retrieved from http://www.aaaai.org/about-the-aaaai/newsroom/allergy-statistics.aspx.

²                      Salo PM et al. Exposure to multiple indoor allergens in U.S. homes and its relationship to asthma. J Allergy Clin Immunol. 2008; 121: 678-684.e2. (2012) Retrieved from http://www.aaaai.org/about-the-aaaai/newsroom/allergy-statistics.aspx.

³                      Thanai Pongdee, MD, FAAAAI, Managing Indoor Allergen Culprits (2012) Retrieved from http://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Libraries/EL-indoor-allergies-managing-patient.pdf.

What Is Tai Chi?

The ancient art of Tai Chi began in China as a form of martial arts used for self-defense. Over many years it has evolved into a form of exercise that has been described as “meditation in motion.” The practice of Tai Chi engages mental focus along with controlled breathing to perform a series of slow, gentle movements and stretches. 

What Are the Benefits of Tai Chi?

The virtues of Tai Chi have long been extolled. “Mental focus, increased range of motion and breathing capacity are some of the benefits that my students have noticed from practicing Tai Chi,” says Mrs. Lisa Walker, a certified Yoga instructor for the Scott & White Wellness department with 27 years experience in fitness, personal, weight and cardio training. Mrs. Walker who also has several years experience in Tai Chi instruction says “many of my students have expressed improved mind and body control.” Since Tai Chi focuses the mind on the movement it has been credited with helping to lower blood pressure and improve strength and balance. 

While Tai Chi may not be known as a cardio exercise like running or biking, it has been shown to improve cardiovascular fitness and aid in rehabilitation of common conditions in many older adults. These reasons have given weight to the case that Tai Chi can be employed as an adjunct therapy, a therapy that is used in conjunction with other primary medical treatments to treat a disease or its symptoms.

Some studies have shown that Tai Chi seems to be a helpful adjunct therapy in chronic conditions such as low bone density, heart disease, stroke, arthritis, Alzheimer’s and Parkinson’s disease. Mrs. Walker, who has started incorporating Tai Chi into her Yoga workout with a group of Parkinson’s patients, has found that her patients have experienced a sense of peacefulness. “In fact, a few of the students have even asked for some specific moves that they can practice at home,” she says.

Medical studies have shown a correlation between Tai Chi and better psychological health. According to the National Center for Complementary and Alternative Medicine, those who practice Tai Chi on a regular basis experience feelings of overall well-being along with reduced stress levels, anxiety, and depression. “To achieve the best results, it is recommended that you perform Tai Chi on a regular basis. Tai Chi could be done everyday, but benefits could be derived with just three times a week for about 10 – 15 minutes,” says Mrs. Walker.

Is Tai Chi for Everyone?

Because Tai Chi focuses more on technique and breathing, it is an exercise that is suitable for all age and fitness levels. And, because there is no equipment involved, it can be done anywhere. “You just need some space and a good surface beneath you,” says Mrs. Walker. As with any exercise program, individuals should always consult a physician before starting any exercise regimen, especially if other medical conditions exist, such as joint problems, osteoporosis and problems balancing. If you have these conditions Tai Chi may be practiced, but with assistance from an instructor or an apparatus such as a chair.  

“Since there is currently no accreditation course for Tai Chi it is important to select an instructor that has years of experience,” says Mrs. Walker. 

If it has become harder to bend over, grip small items like jars or scissors or put weight on your hips and knees, you may be suffering from osteoarthritis. And you wouldn’t be alone.

One in two Americans will get some form of OA in their lifetime and 27 million adults currently have it, according to the Center for Disease Control.

Osteoarthritis is basically the breaking down of the cartilage between the joints, said Kindyle L. Brennan, PhD, PT, Director of Clinical Research for the Bone and Joint Institute at Scott & White.

“It is diagnosed through patient symptoms (pain, fatigue and inflammation) and pain patterns,” Dr. Brennan said. “You can also do an X-ray and you’ll see some degeneration of the joint space.”

What causes osteoarthritis?

“Anything that adds [pressure] to the joint,” she said. “That could be due to obesity. If somebody’s overweight, it will increase load beyond tolerance.”

Overusing your joints, like doing vigorous exercise you’re not used to participating in, can also cause wear down the cartilage that helps keep the joints moving smoothly.

When should I see a doctor?

If you are unable to lessen or stop joint pain at home, then seeking a doctor’s help might the best option. A medical professional could offer prescription medication or other treatments that could help.

The Arthritis Foundation recommends getting medical attention if you experience any of the following symptoms:

• Sudden swelling, warmth, redness along with pain in the joint
• Joint pain accompanied by a fever and/or rash
• Severe pain that prevents you from using the joint

How is OA treated?

“Conservative measures are the most popular, when it comes to treatment,” Dr. Brennan said, “which would include controlling weight, strengthening the muscles around the joint by exercising, and keeping the joint moving to increase lubrication of the joint.”

The CDC and the Arthritis Foundation have come up with a campaign that tells people with arthritis that Moving is Medicine. There are four parts to this campaign: weight management, self-management education, physical activity and injury prevention.

For more information about this campaign visit, http://www.fightarthritispain.org/.

Dr. Brennan agrees with the campaign’s philosophy and said that there’s a common misconception that you should stop moving if you’re having joint pain.

“It’s going to get worse if you don’t use it,” she said. “[The patient] needs to find a balance between overstressing the tissue and creating more wear and tear and not stressing it enough and allowing the tissue to atrophy more and become more painful.”

The doctor suggests moving your joints before you even get out of bed in the morning to help with lubrication and increased mobility.

“If [the patient] has back pain, then I have them move their knees side to side for maybe 20 repetitions to flush the fluid out of the joint before you load it,” she said.

And if you are having trouble moving on land, Dr. Brennan suggests getting in the water.

For more information about managing OA, visit arthritis.org or cdc.gov.

Do you have OA? What helps you manage your symptoms?