Since spina bifida is genetic, the severest cases are found very early in a child's life, sometimes before birth. Severe cases in children are often accompanied by a condition called hydrocephalus, which is excessive fluid in the head.
More-or-less on the positive side, for a mother with a spina bifida child, her risk of having another one is 1 in 40. But a future mother in a risk category might benefit from consulting a genetic councilor.
Studies have shown that low dose (100 mcg) folic-acid supplements seem to lower risk, and the American College of Obstetrics and Gynecology recommends such supplements before pregnancy, and through the first trimester.
Some symptoms of spina bifida are weakness in the feet, ankles, or legs; sometimes some numbness in the legs; sometimes some paralysis, requiring a brace or wheelchair; loss of bladder/bowel control; stunted growth; and hydrocephalus, as previously mentioned.
When I was initially introduced to this condition, it was as something that could be treated in children, but not adults. I think that I now understand the source of that position. Since one is born with spina bifida (or not), severe cases are treated early. Severe cases presumably do not reach adulthood untreated. Only minor (minor if it isn't you that's got it) cases survive to adulthood. They would be asymptomatic, or experience discomfort (a nice euphemism for what could be called "pain").
Next, a question from Matt from New Haven, CT. He wants some general information about cervical cancer, which his aunt has contracted. I reiterate, I am not a physician, but I can provide some very non-specific information.
First some very brief anatomy. The cervix is the lower portion, or entry to (or exit from, depending on your perspective), the uterus (baby growing area - sorry for the technical jargon, but it can't be completely avoided).
Cervical cancer is most dangerous when it spreads to other parts of the body - usually through the lymphatic system. Lymph carries bacteria and abnormal cells, like cancer cells, which are then filtered through the lymph nodes. For that reason, lymph nodes near the uterus may be removed first to verify the presence of cancer.
Cervical cancer first invades the outermost layers of the uterus, and if not discovered, can move deeper into the uterus, and finally to other tissues and organs. Once in the lymph system, the whole body becomes vulnerable. That is why Pap smears are important.
Once cervical cancer spreads, it is called invasive cervical cancer. A common symptom is excessive bleeding, without pain.
There is an early precancerous condition called dysplasia (abnormal, but non-cancerous) that may require surgical removal. Early detection is very important. Once cancer spreads into the lymphatic system, one's prognosis declines. In addition to surgery (possible hysterectomy), radiation therapy, or chemotherapy, or both, may be prescribed.
In the event of radiation or chemotherapy treatment, it is important to maintain a healthy diet. Good nutrition helps resist side-affects. And it may be that eating several small meals (grazing), instead of 3-squares-a-day, may be particularly beneficial.
For further information, contact the American Cancer Society (in the phone book).
So, you want to exercise your feet. Well, here's how, and with a few ankle exercises as a bonus:
Can an antioxidant cause health problems? Apparently yes, under special conditions. The antioxidant beta carotene, used in supplement form, seems to have shown that it can raise the risk for cancer.
It has long been known that antioxidants help prevent cancer and heart disease; but, at least two studies have suggested that beta carotene supplements may actually increase the risk of cancer. The most famous of these studies was the Finnish study of 29,000 smokers given either beta carotene supplements, or a dummy pill. Those on beta carotene were 18% more likely to get cancer than those on the dummy pills.
As reported in the March 1997 issue of HEALTH magazine, a University of California researcher has done some work that suggests that beta carotene supplements may not entirely kill free radicals. Instead, damaged cells may be created. Damaged cells can become cancerous.
On the other hand, it has been noted that beta carotene from natural sources (fruit and vegetables) does not exhibit this problem. Probably because it is unknown how antioxidants really work, or even what they are (i.e., some antioxidants are identified, but it is known that there are other still unidentified antioxidant compounds). There seem to be combinations of substances in the free radical-antioxidant war. Together, they prevent some diseases; but as supplemenace, without the other UN-identified participants, they are less effective, if not dangerous. So eat lots of fruits and vegetables, and maybe save your money on beta carotene supplements.
Can too much salt cause loss of bone density? The answer is, apparently, yes. Our bodies work to maintain a balance between sodium and calcium. When the amount of sodium gets too high, calcium is withdrawn from its storage place in the body - bones. According to a 1995 Australian study, a high salt diet appears to promote decreased bone density.
The government recommendation for sodium intake is no more than 2400 milligrams per day. That amount is used up by, for example; a cup of cottage cheese, a small bag of pretzels, and a salad with Italian dressing.
Scientists say we only need 500 milligrams per day, but how much is too much isn't clear yet. Since amounts over 500 mg aren't needed - it seems prudent to avoid excessive amounts. Only about 10 percent of the sodium in our diets comes naturally in our food. Another 15 percent is added during cooking, or at the table. The remaining 75 percent is added during food processing. Check nutrition labels when you shop. Beware of high sodium content. A simple can of soup or something like chicken broth can add a huge amount of sodium. So does most fast food. Everyone knows to be cautious of too much fat, but be aware of sodium content as well.
Here is a cross-training update. Months ago I tried, unsuccessfully, to verify the veracity of Covert Bailey's comments on cross-training. Not the multi-sports type of training for a single event, but a sort of cross-talk between limbs. That is, if one leg, for example, is immobilized (as in a cast), exercising the other leg will provide some benefit to the immobilized leg. (Less than normal atrophy occurs, hence less strength loss.) There are both neural and systemic forces at work to produce this effect. This type of cross-training is successful between arms, legs to legs, legs to arms, but not arms to legs (no neurological connection, and arm muscles are apparently too small to generate systemic benefits). This phenomenon can be fairly valuable for rehab. The benefits are not huge, but they are better than nothing.
Finally, a validation was provided by an unlikely source - Dr. Dean Edel, a local TV news doctor (channel 7). He was talking about President Clinton's accident. Saying that knee rehabilitation would be more difficult than the surgery. And, he more-or-less casually mentioned that even exercising the "good" leg will benefit the "bad" leg.
So it seems that the concept of cross-training as a kind of muscle cross-talk is a valid one, and suggests that continuing to exercise unaffected body parts during injuries makes a lot of sense.
I was recently asked a question about lunges, by a person who liked to do them, but wondered if they were very effective, especially for the butt (otherwise known as the glutes), Lunges are outstanding, and can be done in a dazzling array of techniques -- stationary lunges, step lunges, step-up lunges, backward lunges, side lunges, walking lunges, body-weight lunges, dumbbell lunges, _ _ _ . You can work most of the muscles of the lower-body with the many variations of this exercise. Let's look at some specifics:
The other excellent, lower-body exercise that I like is the squat, done on a Smith Machine. I know, you purists are choking on that statement, but it is SAFE. It also has some useful variations: the hack squat, where you can almost sit on the floor and not hurt your knees, and really work those buns (if you are so disposed), in addition to quads; single-legged squat; or even the plain old, ordinary, by-the-book squat.
Here is a synopsis of a recent Harvard Health Letter article, with the inevitable editorial comments, about aging athletes. Although written about athletes, it applies to everyone, except maybe anyone who has found the Fountain of Youth.
Some athletes remain at a competitive level much longer than others, and the reasons are unknown; but, it is clear that maintaining an athletic life retards what used to be considered the physical inevitabilities of aging - debilitation. Clearly, aging decreases athletic performance, but not as severely as was previously thought. Continued conditioning allows us to retain a higher degree of physical performance well into life. [Examples are 70-80-90 year-old marathon runners. And twenty-six miles is a long distance to cover by foot, regardless of your time.]
Only about 10% of Americans over 65 remain active in serious, regular exercise - tennis, skiing, etc. Those who are relatively inactive between the ages of 20 and 70 lose about 40% of their muscle mass, and 30% of their strength.
With aging, muscle fiber shrinks, or atrophies (both size and number). The neuromuscular connections also degrade, resulting in slower reflexes and loss of muscle endurance. At the same time, the muscles' ability to use oxygen and nutrients becomes less efficient.
With age also comes body composition changes. This is influenced by many factors: genetics, smoking, eating/drinking habits. Exercise and eating habits are high on the list - not overeating (too many calories) and regular exercise to burn the available calories. Aging is usually accompanied by increasing fat, but that is usually a result of diminished activity.
Endurance sports are excellent for controlling weight, but resistance training is necessary to retain as much muscle mass as possible. Resistance training [Weight training is the gold standard, although not the only option.] can help to retain strength, as well as muscle and bone density.
Weight training can enhance athletic performance at any age. And not just improve strength for strength's sake. Even young, fit athletes - tennis players, track competitors, golfers, etc. - all have been shown to improve their performance through strength training.
The March 1997, Harvard Health Letter also included an article on the benefits of whole grain, which is also synopsized here.
The American Cancer Society recommends that we use whole grains, and eliminate processed grains like white rice, or the refined grain in white bread, or most breakfast cereals. During processing, the grain is milled, scraped, refined, and heat extracted. Then maybe extruded, puffed, flaked, and otherwise eviscerated.
Why eat whole grains? It was recently thought that their high fiber content was the primary benefactor; but, now it seems that its nutrients and phytochemicals - may also play a significant role - things like lignans, flavonoids, tocotrienols, saponins, and phytic, ferulic, and caffeic acids. Lignan may help lower breast cancer risk. A flavonoid, rutin, may reduce risk of heart disease. Tocotrienols, in most cereals, are antioxidants that inhibit cholesterol production in the liver, and seem to inhibit LDL from performing its artery clogging function. And some saponins seem to eliminate LDL before it does any damage.
Whole grains also contain significant amounts of vitamin E, a strong antioxidant; as well as many minerals - zinc, selenium, copper, iron, manganese and magnesium. They help muscle contractions, nerve function, and help cells avoid damage from oxidation. Go Whole!
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