health

Taking the First Steps to a Lifetime of Running

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | March 2nd, 2020

Dear Doctor: I’ve read that most New Year’s resolutions don’t even make it to March, and considering what happened to my plan to start running, I totally believe it. What can I do to be successful?

Dear Reader: You’re one of the estimated one-third of Americans who decided to change something about their lives in the new year. And according to a recent survey by YouGov, your goal to start exercising is among the most popular resolutions. (Saving money, losing weight, healthy eating and lessening stress round out the top five.) But as the hundreds of self-help books published each year remind us, change is hard. Even the most disciplined person does better with a game plan.

First, it’s important to be as specific as possible about your goal, which means deciding what success will look like. Is it running a set number of days per week? Running a certain distance? Competing in a specific race? Each of these are concrete objectives in which success is recognizable. Once you’re clear about what you want, you’re ready for the next step, which is a plan for how to achieve it. The trick here is to break down the main goal into reasonable and realistic increments.

For non-runners, a great way to start is with a daily 20-minute walk. Walking is easy, you can do it anywhere and it will jump-start the habit of regular exercise. Once this becomes part of your daily life, you can begin to add a few minutes of running into your walk. Alternate running and walking and gradually -- that’s an important word when it comes to achieving lasting change -- work toward easing that 20-minute walk into a 20-minute run.

If that’s enough, congratulations, you made it! If you want to push further, continue with this approach. Identify your new goal, then break it down into incremental steps you know you can stick with. Track your progress, and when you hit a milestone, celebrate with a reward. Whether the process of attaining the final goal takes weeks or months or even the entire year doesn’t matter. What’s important is that you’re taking the time to weave a new habit into your daily life.

All of which brings us to the flip side of progress, which is the inevitable slips and stalls that happen along the way. Chances are, you’ll fall off the resolution wagon at some point; it’s important to understand that you haven’t failed. If it’s a small blip, forgive yourself and return to your regular routine. If you’ve taken a sustained break and lost ground, forgive yourself and start from scratch.

Rebooting the pursuit of a goal can be a challenge, which is why being part of a like-minded community is so helpful. Whether it’s a friend or family member, a trainer at a gym, an employer’s wellness program or a local running club, having someone to share the journey with can make a big difference. If a running club sounds good to you, the Road Runners Club of America keeps an extensive list at their website, rrca.org.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Fitness
health

Edema Cannot Be Cured, But It Cab Be Managed

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | February 28th, 2020

Dear Doctor: I am a 76-year-old man who has dealt with edema in various intensities for several years. Now I have been diagnosed with early-stage congestive heart failure. I know I’m not the only senior affected by edema, and I hope you might consider devoting a column to it.

Dear Reader: You’re correct that many older adults experience edema, which is the medical term for swelling. It occurs when fluid becomes trapped in the affected tissues.

Edema can occur in any part of the body, and it shows up most commonly in the ankles, feet, legs and hands. This is known as peripheral edema. Symptoms include visible swelling or puffiness and skin that looks tight and shiny. Severe edema causes a condition known as pitting, which is when pressure applied to the swollen area causes an indentation that is slow to fade. Edema can also cause abdominal swelling, shortness of breath, elevated heart rate and chest pain.

A common cause of edema in older adults is venous insufficiency. This is when age, illness, injury or the side effects of medications cause the veins and the valves within them to be less efficient at returning blood to the heart. It’s an uphill journey from the extremities to the heart, and venous insufficiency allows the blood to pool.

Edema is also a symptom of congestive heart failure, a progressive condition in which the heart becomes unable to pump enough blood to meet the body’s needs. The back-up of blood from these conditions causes pressure, which forces fluid from tiny capillaries in the area and into the surrounding tissues.

These types of edema cannot be cured, so the goal is management. Exercise, particularly involving the affected limbs, can help veins return blood to the heart. So does spending time with the affected limbs elevated above the heart. Once swelling has lessened, compression garments, such as sleeves and stockings, can help prevent new fluid accumulation. Limiting dietary salt is important because excess sodium causes fluid retention.

Medications known as diuretics, or water pills, help the body release water and sodium via the urine. They’re helpful in managing congestive heart failure. Diuretics work by changing how the kidneys handle sodium, which increases the amount of water and sodium released in the urine. Studies show that this may also result in a drop in venous pressure, which can help capillaries to reabsorb some of the water they released. Water loss from diuretics can affect the electrolyte balance in the body, particularly potassium, which is crucial to heart function. Supplemental potassium is often prescribed. People who take a potassium-sparing diuretic must be monitored for excess amounts of the mineral.

It’s important to protect areas of edema from pressure and injury, as healing takes longer and infection is a risk. Moreover, if you experience redness, heat or pain; develop an open sore; develop shortness of breath; or start swelling on just one side of the body, seek immediate medical care.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

AgingPhysical Health
health

There Are Many Ways To Get Rid of Warts

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | February 26th, 2020

Dear Doctor: I had a rough spot on the back of my hand that turned into a wart. What caused it? How do I get rid of it?

Dear Reader: You’re describing what is known as a common wart. It’s a small, raised skin growth caused by one of the estimated 150 different varieties of the human papilloma virus, or HPV. Other types of HPV cause different kinds of warts. These include plantar warts, which are callouslike growths on the soles of the feet; genital warts; and smooth, flat-topped growths known as flat warts, often seen on the face and forehead.

Common warts don’t present any health dangers. However, they can be unsightly and cause embarrassment. They’re typically about the size of a pencil eraser or smaller, may be circular or oval, and can appear anywhere on the body. Common warts may grow a smooth, domed top, or they can have a wrinkled appearance, like a head of cauliflower. They’re often a different color than the surrounding skin, including brown, gray, pink or beige. Some may contain what look like small black dots, which are actually tiny blood vessels filled with clotted blood.

If you get a common wart, you’ve come into physical contact with the virus that causes it, either on someone’s skin, or on a surface an infected person has touched. The virus can enter the body through a break in the skin, and if your immune system can’t fight it off, a wart will soon appear. Common warts are painless, but when they crack, or if you pick at them, they can bleed.

In most cases, your body’s immune system will rally, and the wart will eventually vanish, usually within a year or two. Those who would rather not wait have several treatment options. Most people can try over-the-counter wart medications available at the drug store. These are made up of salicylic acid, which is delivered either as a gel, liquid or in a patch. The acid gradually removes the layers of skin until the wart is gone. It’s helpful to soak the wart in warm water prior to applying the salicylic acid, as it will allow the medication to penetrate deeper into the many layers of tissue. In between treatments, use an emery board or pumice stone to remove the dead skin. Be sure to isolate these tools since they can transmit the virus. Side effects of this treatment can include skin irritation and discomfort. Never use salicylic acid on the face or on the genitals. People living with neuropathy or diabetes should not try at-home wart removers and should see a doctor instead.

If you try a home-based treatment and it’s unsuccessful, your doctor also has several options available. One is that same salicylic acid, but in a higher concentration, which requires a prescription. Another approach is cryotherapy, which uses liquid nitrogen to freeze the wart. Warts may also be removed with a laser, burned off or cut away.

Any time that a wart changes shape or color, or if it becomes painful or infected, it’s important to seek medical attention.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Physical Health

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