Thursday, February 22, 2018

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The Prequel to Poor Health is Good Health

Written by  Suzanne Ramsey

With New Year’s being the time for resolutions — those promises we make to ourselves to start exercising, stop smoking or lose the extra 10 pounds we put on during the holidays — how about making a resolution to head off poor health at the pass? After all, it’s been said that it’s “easier to stay well than to get well.”

A couple of years ago, Maureen Green started worrying about her health. It wasn’t because she’d been diagnosed with heart disease, diabetes or some other serious medical problem. It wasn’t that she wasn’t exercising, because Maureen — who goes by “Mo” — had been running marathons.

And every time she went to the doctor for blood work, Mo says her numbers — cholesterol, blood sugar, etc. — were always good. That is, all but one number: the one on the scale.

“My blood work was fine,” she says. “It was just my weight.”

At the time, Mo weighed about 235 pounds, and even though she was training regularly with a Sports Backers running group in Richmond, she noticed she was getting slower and slower. Eventually, she realized that while she had been running a lot she’d been eating a lot, too.

“I didn’t realize it because you don’t think like that when you’re in the moment,” Mo, 55, says. “I got to a point where I was so slow. [I thought,] ‘If I want to continue running marathons I’m going to have to lose weight. This is it, my wake up call.’ I knew, if I didn’t do something, what was ahead of me from a health perspective, because I work in the medical field.”

Mo, director of radiology for a Williamsburg hospital, says she “sees sick people all the time,” people with diabetes and people walking through the hospital with oxygen tank in tow.

“You know what’s ahead of you if you don’t make changes,” she says.

Mo started using a smart phone app called “Lose It!” It helped her track daily calories and exercise, among other things. The app also turns weight loss into a game of sorts, telling you how many calories you have left each day, based on the number of calories you’ve burned. It worked for Mo, who says one night she even went for a four-mile run just so she could earn back the calories to go out to dinner with her husband.

“You work for food,” she says.

Since she’s been using Lose It!, Mo has lost 60 pounds. Her goal is to lose about 30 more and improve her Body Mass Index, or BMI.

“I want to have a healthy BMI,” she says. “I went from a very obese BMI, but I’m still in the overweight category. I’ve got to be around 140 to 145 [pounds] to have a healthy BMI and that’s what my goal is.”

What is body mass index?
Body Mass Index (BMI) is a number calculated from a person's weight and height. BMI provides a reliable indicator of body fat for most people and is used to screen for weight categories that may lead to health problems. (

Mo is currently training for a March marathon in Newport News, where she lives, and a few other shorter races. Still, she wonders how she ever got up to 235 pounds and says being afraid of gaining even more weight was what drove her to make changes.

“The fear was if I didn’t do something I could get up to 300 pounds,” she says. “I was petrified. I didn’t want that to happen. Being in control, that’s the whole thing. You think you’re not in control and it’s so easy to make excuses. Life is crazy, it’s busy, but you just have to stop making excuses and do something.”

Last August, Montez Jennings, of Ashland, also took steps to improve his health before it was too late. Having watched his mother and grandfather struggle with diabetes his whole life, the 24-year-old started experiencing symptoms of diabetes himself: headache, increased urination and dizziness.

“I needed to get it checked out,” he says.

Montez went to Bon Secours Theresa A. Thomas Medical Center, in Ashland, where he saw Mary Stettmeier, MD, a family medicine doctor. Since then, Dr. Stettmeier, a “floater” at the time with Bon Secours, has transferred to Freedom Healthcare Associates, a new Bon Secours practice in Petersburg.

Dr. Stettmeier commends Montez for taking charge of his health and making changes. After being diagnosed with type 2 diabetes, Montez started a diet and exercise program and has been taking the drug Metformin. Dr. Stettmeier says, Metformin is commonly prescribed to help manage type 2 diabetes by physicians because it “slows the progression of the disease.”

What is type 2 diabetes?
Type 2 diabetes, once called non-insulin-dependent diabetes, is the most common form of diabetes, affecting 90% to 95% of the 26 million Americans with diabetes. Unlike people with type 1 diabetes,  the bodies of people with type 2 diabetes make insulin. But either their pancreas does not make enough insulin or the body cannot use the insulin well enough. This is called insulin resistance. When there isn't enough insulin or the insulin is not used as it should be, glucose (sugar) can't get into the body's cells. When glucose builds up in the blood instead of going into cells, the body's cells are not able to function properly. (WebMD)

What are symptoms of type 2 diabetes?
Type 2 diabetes symptoms often develop slowly. In fact, you can have type 2 diabetes for years and not know it. Look for:

-Excessive thirst and frequent urination. Increased hunger. Without enough insulin to move sugar into your cells, your muscles and organs become depleted of energy. This triggers intense hunger.

-Fatigue. If your cells are deprived of sugar, you may become tired and irritable.

-Blurred vision. If your blood sugar is too high, fluid may be pulled from the lenses of your eyes. This may affect your ability to focus.

-Slow-healing sores or frequent infections. Type 2 diabetes affects your ability to heal and resist infections.

-Areas of darkened skin. Some people with type 2 diabetes have patches of dark, velvety skin in the folds and creases of their bodies — usually in the armpits and neck. This condition, called acanthosis nigricans, may be a sign of insulin resistance.

Dr. Stettmeier says Metformin alone “shouldn’t have fixed Montez. The diet and exercise made all the difference. He told me he was watching his sugar, exercising, riding his bike. I thought he would end up on insulin. He’s my big hero success patient.”

Not too long ago, Dr. Stettmeier herself feared she also was headed for trouble with her health. A pharmacist for 20 years before going to medical school, she was finishing up her medical residency last spring when she realized she’d let things get out hand and needed to do something about it.

“I was overeating and not making my health a priority, and being away from an exercise regimen,” Dr. Stettmeier, a 56-year-old former marathon runner, says. “No exercise and too much food. I was finishing my residency and studying for my boards. Sitting and studying, hour after hour each day. No exercise and a lot of eating.”

She says she was in “rough shape,” having gained a lot of weight. “I became very narrowly obese, right on the line, and my cholesterol, for the first time, had gone out of normal range,” she says, adding that none of her clothes fit, which was frustrating. “That is something women will understand. I had all these great clothes and nothing fit.”

Dr. Stettmeier started a diet and exercise program, walking and eventually running six days a week. She has lost 35 pounds, her cholesterol is back to normal, and her clothes fit again.

“It’s improved my quality of life, my functioning, and that’s everything,” she says.

Stand up to ‘sitting disease’

“Sitting disease,” a term coined by scientists to describe the terrible things that can happen to your body from sitting too much, is said to be as bad for you as smoking. In fact, researchers and some in the medical field are calling sitting “the new smoking” because links have been found between excessive sitting and chronic diseases like obesity, type 2 diabetes and heart disease.

You might think you don’t sit all that much, but the website reports that the average American sits or is at least sedentary for 22 hours a day. This includes eight hours sleeping, seven and a half hours at work, three hours eating, and an hour and a half each of watching TV, sitting in front of the computer and sitting in a car.

“We know that getting up and moving helps us,” Lisa Ellis, MD, a women’s health specialist at Virginia Commonwealth University Health System, says. “We want to try to make sure people are active and don’t spend a huge percentage of their hours sitting.

“When you’re up and moving, you increase metabolism some. You can think of it as a fuel thing. ... When you’re sitting, you don’t have to burn a lot of fuel. When you get up, walking around, you burn fuel. You help reduce body fat, help insulin come out faster. I helps your joints and you don’t get arthritis as easily.”

Dr. Ellis says being active also releases endorphins, which make you feel good.

What are endorphins?
Improved self-esteem is a key psychological benefit of regular physical activity. When you exercise, your body releases chemicals called endorphins. These endorphins interact with the receptors in your brain that reduce your perception of pain.

Endorphins also trigger a positive feeling in the body, similar to that of morphine. For example, the feeling that follows a run or workout is often described as "euphoric." That feeling, known as a "runner's high," can be accompanied by a positive and energizing outlook on life. (WebMD)

Dr. Ellis suggests the following ways people — even those who say they don’t have time to exercise — can be more active:
•    Pace while talking on the phone.
•    While watching TV, get up during commercials to walk in place or go up and down the stairs.
•    Get a pedometer and count your steps. (Experts suggest about 10,000 steps a day, which equals about 5 miles.)
•    Start a competition with coworkers to see who can walk or exercise the most.

When it comes to combating “sitting disease,” the people at Sports Backers, a local nonprofit with the mission of making Richmond “the most physically active region in the country,” are practicing what they preach. At their offices on Avenue of Champions, next to The Diamond minor league baseball field in Sports Backers Stadium, most of the organization’s 28 employees use standing or treadmill desks.

For those who might not be familiar with what a standing desk is, it’s pretty self explanatory: a desk that you stand in front of, as opposed to using a chair or stool. With a treadmill desk, the worker walks on a treadmill while working at a standing desk. Some standing desks are adjustable, so the worker can alternately sit or stand throughout the day.

Pete Woody, public relations and communications manager for Sports Backers, made his first standing desk from boxes and milk crates in 2012. He’d been reading articles about the benefits of standing desks and decided to see if he could make one. This initial attempt evolved to a modified IKEA desk held up with brackets and eventually a store-bought standing desk. Woody’s desk is adjustable, enabling him to sit or stand.

Soon, the higher ups got on board and offered standing desks to all Sports Backers employees.

“We’ve really enjoyed them,” Woody says. “Once it became known that the company would provide them, people jumped on it.

Woody, who says he used to sit for most of the workday, noticed that since using the standing desk his back has felt better, and he’s more alert and flexible.

“I’ve noticed it’s nicer to stand for a couple of hours in the morning and a couple of hours after lunch,” he says, adding that he thinks many of his coworkers “would say the same thing.”

For the employees at Sports Backers, it’s also about setting a good example. Among numerous other things, Sports Backers puts on the Monument Avenue 10K, Richmond Marathon and other road races. It promotes walking, biking and other active community events, along with programs aimed at increasing wellness in the workplace and schools.

“For us as an organization, our mission is to make Richmond the most physically active region in the country,” Woody says. “What can we do to live that mission? If we’re pushing workplace wellness, how can we go about doing it? We want to be that example. ... We live that mission and encourage an active work place for our employees.”