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A dults ought to get at least 30 minutes of physical activity five or more days a week.  The good news is that you can split up the time to make it more convenient. You can do three 10-minute or two 15-minute blocks of time.             

It’s easier than you think. Walking briskly, bicycling, swimming or dancing are just some of the activities than you can do. You can play with your kids or your grandchildren, do housework or garden. All of these have health benefits.             

Here are some tips for getting active –              

•  If you are not active now, start gradually.             

•  Gradually increase how often you exercise, the amount of time and the intensity.             

•  Find an activity you enjoy.

•  Try to vary the kinds of activities you do. That’ll help to keep your interest and improve the health benefit.

•  Ask a friend or spouse to join you.

•  Be sure to set reasonable objectives. As you reach them, set new objectives.

Dealing with Setbacks

If something comes up and disrupts your routine, it’s okay. Think of the setback as being temporary and get going again. You can even use the setback to review your activity habit and set some new objectives.

•  Are the times practical? When not, rethink and change time of day for your activity.

•  Are you bored? Try a new activity. Find somebody to exercise with.

•  Too tired? Remember that physical activity can help you to feel more energetic.

•  Too stressed? Exercise is a great stress reducer.

•  Not enough time? Remember, there are 1,440 minutes in a day; take 30 of them for you and your health.

Here are 6 reasons to get up and walk –

1. Regular walking burns calories, which also to a healthful diet can help you to manage your weight.

2. More than half the body s muscles are designed for walking; it is a natural movement that is almost injury-free.

3. Regular brisk walking has many health benefits.

4. Brisk walking is an aerobic activity. It makes your heart, lungs, and muscles stronger.

5. Walking refreshes the mind, lowers fatigue, increases energy, and improves sleep.

6. Walking can be a excellent time for sharing and socializing with family and friend.

Getting began –

o  A little walking everyday is better than an occasional weekend bout of activity. Start with short walks and build from there.

o  Make sure to select routes that are fascinating, safe and convenient. Avoid heavy traffic, loose dogs, and rough ground. Do not forget hills are more challenging.

o  Walking with others can help motivate you.

o  Be safe. Be sure to take a friend when it is dark outside. Tell someone where you’re going, and bring a cell phone when you can.

o  When it’s very hot, walk during the coolest hours, select a shady route, and walk a little slower.

o  When it is cold, avoid icy surfaces.

o  Dress in loose, comfortable clothing. In cold weather, dress in layers and wear mittens and a hat.

o  Wear comfortable, appropriate shoes.

o  Consider using a pedometer to measure the number of steps you walk.

o  Warm-up before and cool-down after activity.

Sample 10 week walking plans to get you started –             

This plan is for those who are not used to physical activity.            

Week   1   2   3   4

Minutes walking   10   10   15   18

Walks per week   2   3   3   3

This plan is for those who are already physically active.            

Week   1   2   3   4

Minutes walking   20   22   25   30

Walks per week   3   3   3   3

Getting the Patient Ready –  

•  Have patient avoid drinking beverages that have caffeine 30 minutes before having blood pressure (BP) taken.

•  Have patient refrain from use of tobacco for at least 30 minutes before having blood pressure taken.

•  Have patient sit calmly, without talking for at least 5 minutes –  with their back supported and feet on the floor.

•  Ask patients not to talk during the actual blood pressure measurement.

Preparation Tips for Blood Pressure (BP) Measurement –  

•  On the first visit, compare readings in both arms. For monitoring, use the arm with the higher reading.

•  Be certain the inflatable part of the cuff encircles at least 80 percent of the arm.

•  Wrap the cuff snugly around a bare arm with the lower edge of the cuff centered 2 finger breadths about the bend of the elbow.

•  The arm ought to be supported and slightly flexed at the patient’s heart level during the reading.

Measurement Tips for Manual Blood Pressure (BP) Cuff Readings –  

•  When taking manual readings, determine the pulse obliteration pressure, where the radial artery pulse is felt to disappear when the cuff is inflated.

•  Place the bell or diaphragm of the stethoscope over the brachial artery.

•  Inflate the cuff to 30 mmHg above pulse obliteration pressure.

•  Deflate cuff at a slow steady drop of about 2 mmHg per second.

•  The systolic reading is the first of 2 to 3 consecutive beats.

•  The diastolic reading is the last even number where sound was heard.

For Measuring Blood Pressure during a Visit –  

•  Make sure to take 2 or 3 readings, waiting briefly between each cuff deflation and next inflation.

•  Average the 2 or 3 readings to obtain a blood pressure (BP) for the visit.

and

•  Tell patients their Blood Pressure (BP) numbers and their Blood Pressure (BP) goals.

•  Congratulate patients when goals are reached.

Does having a healthy lifestyle mean that I will not get heart disease?

No, but it decreases your chances. Heredity still plays a role even if you live a healthy lifestyle. If one of your parents or a close blood relative had heart illness at a young age, you may be at risk. Talk to your healthcare provider about your risk.

Does taking medication to lower cholesterol really prevent heart attacks?

Medicines that lower cholesterol can help prevent a heart attack. These medicines are often used for people  at high risk for a heart attack. Often, people  who have had a heart attack are given cholesterol-lowering medicines to prevent another one.

Should I drink a glass or two of wine with dinner to prevent heart disease?

We’ve all heard that drinking red wine helps to prevent a heart attack. This is true for all kinds of alcohol. Moderate alcohol intake (no more than 1 drink a day for women and 2 drinks a day for men) can decrease the risk of heart disease and heart attacks. One drink equals 12 ounces of beer, 4 ounces of wine, 1. ounces of 80-proof alcohol or 1 ounce of 100-proof alcohol. Speak with your health care provider for specific guidance.

My cholesterol is high but no one in my family has heart illness. Does this mean that I don’t need to worry about my cholesterol?

Not everybody with high cholesterol develops early heart illness. You may want to have your LDL (”bad”) and HDL (”good”) cholesterol tested. Some individuals  with high cholesterol have normal LDL but high HDL. This is a good situation to be in.

Not having a family history of heart disease is good. But, having high cholesterol puts you at risk for developing heart disease. Watching your diet and regular physical activity are excellent ways of lowering your risk, plus they’re good health habits.

Is it true that just taking one aspirin a day helps to prevent heart attacks?

Aspirin has been shown to help prevent heart attacks in men. Aspirin thins the blood in a way that lowers heart attack risk. Acetaminophen (e.g., Tylenol) and ibuprofen (e.g., Motrin) don’t act in the same way. Aspirin could  be a part of your efforts to decrease the risk of developing heart illness.

Speak with your health care provider before starting daily aspirin.

Did you know?

•  About 1 in 6 adults has some form of arthritis.

•  It affects all races and ethnic groups.

•  Arthritis is more common among women than men.

•  People  who get it are typically older than 40.

•  Two out of three individuals  over the age of 65 have arthritis.

•  Because they have arthritis, more than 16 million American Citizens have to change the way they do things.

•  Arthritis is the leading cause of disability in USA  

•  Arthritis may be worse for one individuals than for another. It may be worse on some days than on others.

•  Arthritis mostly affects the knees, hips, hands, and spine.

Arthritis Risk Factors

What You Can’t Change

•  Age.  The risk for arthritis increases with age.

•  Gender. Arthritis is more common among women than men.

•  Genes. Some genes are associated with higher risk arthritis, such as rheumatoid arthritis and lupus.

What You Can Change

•  Weight. Being overweight puts you at risk to develop knee osteoarthritis. It can also make arthritis worse.

•  Repeated knee bending. If you have to bend your knees over and over again at work, this may cause osteoarthritis in your knees.

Other Risk Factors

•  Infection. an infection of a joint can cause  arthritis.

What you are able to do –  

Watch your weight. If you’re overweight, speak with your health care team about how to lose weight and feel better.

Speak with your healthcare team. If you’ve pain, tenderness, or swelling in 1 or more joints; stiffness that lasts at least 1 hour in early morning; constant or frequent pain or tenderness in a joint; or difficulty using or moving a joint ordinarily, let your healthcare team know.

Protect your joints. Joint injuries, such as sports injuries can lead to osteoarthritis.

Drinking alcohol is very common in our society, but drinking alcohol could be harmful. In the USA  more than 17 million individuals  are alcoholics or have alcohol problems. Every year Americans die thus of drinking. About 75,000 individuals  die from “excessive” alcohol use. This is the 3rd leading lifestyle-related cause of death. Each year, there are more than 100,000 deaths from problems related to drinking. Alcohol plays a role in almost half of all traffic deaths.

How much is too much?

Moderate alcohol use is no more than 1 drink a day for adult women and men over the age of 65. For adult men younger than 65, it’s no more than 2 drinks per day.

Heavy drinking is an averageof 2 drinks a day for men younger than 65. For women and men over the age of 65 it’s an averageof more than of 1 drink a day.

Do you’ve an alcohol problem?

Do these actions and questions describe you? When yes, speak with your health care team about getting help.

o  Drinking alone or in secret.

o  Not remembering conversations or commitments. This is referred to as “blacking out”.

o  A habit of having drinks before, with or after dinner. Do you become annoyed when this is changed or questioned?

o  Loss of interest in activities and hobbies that used to bring you pleasure.

o  Feeling a need to drink.

o  Becoming irritable around the time you generally drink. Does it happen particularly if there’s no alcohol available?

o  Keeping alcohol in unusual places at home, at work, or in the car.

o  Gulping drinks or ordering doubles. Do you become drunk intentionally to feel good or do you drink to feel “normal”.

o  Having social problems. These include problems with relationships and legal, financial and employment problems?

o  Developing a tolerance to alcohol. Do you need an increasing number of drinks to feel alcohol’s effects?

o  Experiencing physical withdrawal symptoms, like nausea, sweating and shaking, when you don’t drink.

If you are having a problem with alcohol, speak with your health care team about getting help.

o  Make sure to take care of your diabetes – Make sure to work with your health care team to manage your blood sugar.   
o  Make sure to check your feet every day for cuts, blisters, red spots, and swelling.  Make sure to use a mirror to check the bottoms of your feet or ask a family member for help if you’ve trouble seeing.   

o  Wash your feet every day in warm, not hot, water.  Dry your feet well.  Make sure to dry between the toes.   

o  Make sure to keep the skin soft and smooth.  Rub a thin coat of skin lotion over the tops and bottoms of your feet, but not between your toes.   

o  Smooth corns and calluses gently.  Be certain to check with your healthcare team to see if your feet are at low risk for problems.  If they are low risk, use a pumice stone to smooth corns and calluses.  Don’t use over-the-counter products or sharp objects on corns or calluses.     

o  If you are able to see and reach your toenails, trim them weekly or as needed.  Trim your toenails straight across and file the edges with an emery board or nail file.  If you can’t see your toenails or you see blood when you trim them, contact your health care provider.   

o  Wear shoes and socks at all times.  Wear comfortable shoes that fit well and protect your feet.   
o  Feel inside your footwear before putting them on each time to be sure the lining is smooth and there are no objects inside.   

o  Protect your feet from hot and cold.  Wear footwear at the beach or on hot pavement.  Wear socks at night when your feet get cold. Do not test bath water with your feet.  Do not use hot water bottles or heating pads.

o  Have either your provider or nurse check your bare feet.  Don’t forget that you could not feel the pain of an injury. Call your provider right away when you find a cut, sore, blister, or bruise on your foot that doesn’t start to heal after one day. Follow your provider’s advice about foot care.

o  Make sure to keep the blood flowing to your feet.  Make sure to put your feet up when sitting.  Wiggle your toes and move your ankles up and down for 5 minutes, 2 or 3 times a day.  Do not cross your legs for long periods of time.  Do not smoke.

o  Be physically active.  Talk with your health care team about which physical activities are best for you.

o  Be sure to get began now.  Start taking good care of your feet today. Be sure to set a time every day to check your feet.

Talk with your healthcare team or diabetes educator when you have questions about your foot care.

A standard drink in the United States is any drink that contains about 14 grams of pure alcohol. This is about 0.6 fluid ounces or 1.2 tablespoons. Below are standard drink equivalents for the United States  These are approximate, since the alcohol content of different brands and types of beverages can vary.

Many people  don’t know what counts as a standard drink. Because of this they might not realize how many standard drinks are in the actual container of the drink. Here are some examples –

•  For beer, the approximate number of standard drinks is –  

o  12 oz. = 1

o  16 oz. = 1.3

o  22 oz. = 2

o  40 oz. = 3.3

•  For malt liquor, the approximate number of standard drinks is –  

o  12 oz. = 1.5

o  16 oz. = 2

o  22 oz. = 2.5

o  40 oz. = 4.5

•  For table wine, the approximate number of standard drinks is –  

o  a standard 750 mL (25 oz.) bottle = 5

•  For 80-proof spirits, or “hard liquor,” the approximate number of standard drinks is –  

o  a pint (16 oz.) = 11

o  a mixed drink = 1 or more*

o  a fifth (25 oz.) = 17

o  1.75 L (59 oz.) = 39

*Note –  It can be challenging to estimate the number of standard drinks in a single mixed drink made with hard liquor. It depends on the kind of spirits and the recipe. A mixed drink can contain from one to three or more standard drinks.

Modified from National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health

Do you have a plan for avoidance and control?

Having high blood pressure (BP) lasts a lifetime, but there’s good news. Sometimes high blood pressure (BP) may be treated, controlled and even prevented by changing habits and making healthful options. When you take medicine to lower your blood pressure, these changes can help the medicine work better.

o  Make certain to keep at a healthful weight. When you’re overweight, losing as little as 10 pounds of excess weight may make a difference in your blood pressure. A healthful weight has other health benefits as well. For help to lose weight, speak to your health care team about MOVE. Weight Management Program for Veterans. You can also visit www.move.va.gov for additional

o  Make sure to eat healthful food. Eating fruits, vegetables and foods that containfiber has many health benefits. Fresh and frozen are best as they usually contain less salt and sodium. Limit foods that contain saturatefats and cholesterol, such as red meats and cheeses. Make sure to choose low-fat dairy products. Attempt different ways of preparing and seasoning foods that don’t use salt, butter or cheeses.

o  Make certain to get active. Getting physically active helpkeeping it off.  Another bonus of exercise is that it normally makes you feel better. Make certain to set a goal for 30 minutes of activity for most days of the week. Consider parkyour car further away from the building, taking the stairs and taking walks. When the weather is too hot or too cold, go to the mall and walk there.

o  Watch what you drink. Drinks that contain alcohol or caffeine, like coffee and cola, can cause  blood pressure (BP) to rise. When you drink alcohol, limit the amount to 2 drinks per day when you’re a man and 1 when you arewoman.

o  Stop smoking. When you smoke, find a way to stop. Ask your health care team for help.

o  Manage your stress. Avoiding stress isn’t always an option. Develop healthy ways to handle stress –  take a walk, listen to music, count to 10, and take s

o  Be certain to take your medicine. It’s important to take your medicines as directed. If you having problems with your medicines, tell your healthcare team.

o  Make certain to keep your appointments for your blood pressure (BP) checks.  The only way to know if your blood pressure (BP) is under control is to check it.

Let’s cook out. “Grab the picnic basket.” Sound familiar?

Here are some tips for keeping your food safe in the warm weather.

•  Wash your hands using soap and water. Wash before cooking, before eating, after using the bathroom, after changing a diaper and after petting or playing with a pet.

•  Pack water, disposable wipes, hand sanitizer and paper towels for washing and cleaning.

•  Clean the surfaces where you’ll be preparing and cooking your food.

•  Marinate meats, poultry or fish in the refrigerator. Don’t re-use the marinade.

•  Separate raw food from cooked food.

•  Wrap raw meats tightly to prevent their juices from coming in contact with other foods.

•  Do not use utensils or dishes for both raw food and cooked food.

•  Make sure that food is cooked thoroughly. Make sure to use a meat thermometer to be sure.

•  Refrigerate and freeze food quickly.

•  Make sure to keep hot food hot.

o  to help keep foods hot, place grilled foods to the side of the grill until you’re ready to serve.

•  Be sure to keep cold food cold.

o  Pack cold foods in a cooler with plenty of ice or freezer packs.

o  Make certain to keep foods in the cooler at 40. or colder.

o  Pack the cooler just before leaving home.

o  Transport the cooler in the coolest part of the car.

o  Be certain to store the cooler in the shade.

o  Consider separate coolers, one for beverages and one for food.

o  Replace ice as it melts.

•  Don’t leave food out for additional than 1 hour in the warm weather and never leave food out for additional than 2 hours.

When you do not have a cooler, good options are fruits, vegetables, hard cheeses, canned or dried meats, dry cereal, bread, peanut butter or crackers.

Enjoy the warm weather and remember….When in doubt, throw it out.