Wednesday, January 30, 2019

Take a Break: Kirie

This is made from one sheet of paper
Kirie is the Japanese art of paper cutting. It’s mesmerizing to watch the masters at their craft.

You’ll need an Exacto knife and a mat.  Try your hand at it.

Not interested in today’s activities, try the Take a Break Pinterest Board.

Saturday, January 26, 2019

Life with Chronic Conditions: Staying Tidy/Alternatives to Retail therapy

Several years ago,  I wrote a post The KonMari Method for Tidying When Affected by a Chronic Condition that generated a lot of interest. With the arrival of the Neflix series, “Tidying Up with Marie Kondo,” the popularity of de cluttering by only keeping what “sparks joy” is making headlines. This time it’s because so many people are doing it charity shops and landfills are overwhelmed with the amount of stuff people are dropping off. In short, it’s gone from a cluttering problem to a “waste crisis.”

Because her initial book came out in 2014, there are millions of people who have and continue to use some aspect or all of it. There is a lot to be said for her method of tidying and getting rid of clutter. If you’ve haven’t tried it, read The KonMari Method for Tidying When Affected by a Chronic Condition

However, our buy, buy, buy economy combined with get rid of it if it doesn’t “spark joy” is creating a perfect storm for waste haulers. Yet, there is another Japanese tradition-mottainai-the interdependence and impermanence of things-which we should be aware of along with KonMari

Mottainai follows the four Rs: reduce, reuse, recycle and respect. It attempts to communicate the inherent value in a thing and encourage using objects fully or all the way to the end of their lifespan. It is an ancient Buddhist philosophy deeply rooted in Japanese Culture for centuries, to have respect and not to waste the resources and to use them with a sense of gratitude.

While Konmari appears to incorporate some of these ideas, one has to wonder at the giant bags sitting outside the homes of the Netflix series that have undergone the “spark joy” purge.

The big “miss” of KonMari is that  many find “retail therapy” a  release from life’s anxieties and stressors. They also use it as a way to reward themselves as well as celebrate when good things happen. Very often it’s a social opportunity, with shopping combined with lunch or dinner at a special restaurant or cafe.

Research shows that shopping gives people a “sense of control,” which many of those affected by chronic conditions feel like they don’t have much of. It’s also been found to reduce sadness, and there is also the added bonus of walking and getting exercise if you go to the mall or a big box store.

The down sides of retail therapy are obvious-financial issues; creating more clutter in your home; and ultimately a waste crisis-the landfills are already full.  However, there are ways to turn this around, which is the focus of today’s post.

Tips to help you control your “retail therapy” so you don’t end up amassing “stuff.” Yes you can still indulge in a favorite past time but with some clear guidelines:
• Set a budget and don’t waver. Your better off leaving credit cards at home and only using cash.
• Know your “spending triggers” What moods or things will tempt you to make unplanned purchases? Recognizing them can help reduce their power over you to make unnecessary purchases.
• Follow the 48 hour rule. Before you drop a “want” into your shopping cart, write down the item and price and give yourself 48 hours to think about it.
• Remove spending and coupon apps from your phone and unsubscribe to Emails that will encourage you to spend.
  If you are shopping in a store, don’t give them your e-mail address or agree to a credit card
• Window Shopping can improve moods. Try shopping with a friend where you design a wardrobe, a room in someone’s house etc. Make it a game. Set parameters such as how much money can be spent, what colors can be used, etc.
• Make reminder lists-use your smart phone to create various lists such as-groceries; items you may need from a specific store; gifts-when you learn about items that you think are right for someone add the item along with their name. Only shop from your list.
• Before you make a purchase think about how you will dispose of the item when you are through with it.
• Shop thrift stores over retail, though stick to the needs vs the wants.

Alternatives to Retail Therapy: Shopping provides opportunities for choice, exercising, and socializing. Yet, there are a number of things to do instead that offer the same benefit resulting in your feeling better as well as reducing waste.
• Repair rather than discard. With sites like IFIXIT  (electronics); the Family Handyman and 8 websites to find DIY & Home Repair Tips  learn how to repair items that you may have normally discarded. Do it long enough and you can start helping friends and maybe even turn it into a small business that you can run from home.

• Create a local swap group. You can do this via Facebook or with friends.

• Host an abundance swap. These can be a great deal of fun, particularly if you do this around the holidays when people are looking for gifts and don’t have money to spend. Every year our town holds a town wide tag sale and we have one village green that is designated as a freebie zone.  Check out the Ashland Abundance Swap that has been held every year since 2004.

• Look for, start or host a “fix it clinic.” Basically these clinics will teach you repair skills. At Fix-It Clinics, people small household appliances, clothing, electronics, mobile devices and more and receive free guided assistance from volunteers with repair skills to disassemble, troubleshoot and fix their items. Check out the Fixit Clinic Facebook page.

Shop online, put items in the cart but don’t buy. According to research, the actual act of putting items in a cart and not buying produced the same sadness reducing effects as actually purchasing something. So, it’s not the actual purchase which produces the results, but the selection of items as if you were going to buy them that reduces sadness.

• Go to the library and pick out a book. You have a sense of control over what you choosing but without spending anything.

• Focus on the part of your social circle that don’t use retail therapy. Yes it is fun to go shopping with a friend, where you have lunch or dinner as part of the experience. However, if you are having a rough patch make a social engagement with a friend(s) that isn’t necessarily tied in with the retail therapy scene.

• What alternatives are there in your community to celebrate good news or combat a negative experience? Some options could include inviting friends over for a bonfire; tea; dinner and a movie; game night; or a walk in the park. Check the newspapers and on-line resources for local events that offer entertainment alternatives. You’ll meet new people that way that share a common interest.

• instead of walking the mall, go for a walk in your neighborhood, a park, by the beach etc.

• Join an exercise, Qigong, or yoga class

• Attend in person support groups that pertain to your particular chronic condition

 Ultimately,  if you don’t need it, don’t bring it into your home or, if it’s a gift, don’t allow it to settle in if you don't like it. 

Wednesday, January 23, 2019

Take a Break: Explore the art of Yayoi Kusama

 A celebrated Japanese artist, Yayoi Kusama, has lived voluntarily in a psychiatric hospital since 1977.  With an international following, Kusama was born in 1929 in the mountain town of Matsumoto, began painting from hallucinations she experienced as a young girl. Some of her antiwar sentiments stem from the fact that she lived through World War II in Japan, going to work at a military factory to sew parachutes when she was just 13 years old. “Since I was 10 years old I have been painting every day,” she said. “And even now there is not a day that I do not paint.” She added, “I still see polka dots everywhere.”

As Kusama explains, "one day I was looking at the red flower patterns of the tablecloth on a table, and when I looked up I saw the same pattern covering the ceiling, the windows and the walls, and finally all over the room, my body, and the universe. I felt as if I had begun to self-obliterate, to revolve in the infinity of endless time and the absoluteness of space, and be reduced to nothingness."

How to paint like Kusama

Not interested in today’s activities, try the Take a Break Pinterest Board.

Saturday, January 19, 2019

Journal Watch January 2019

Opioids Offer Small Improvement in Pain, Physical Function: Opioid use is associated with small improvements in pain and physical functioning in patients with chronic noncancer pain, according to research published in the Dec. 18 issue of the Journal of the American Medical Association.

Massage Offers Short Term Relief of Knee Pain in Arthritis Patients: Weekly massage sessions may provide short-term symptom relief for knee osteoarthritis patients, but the benefit is not maintained over one year of follow-up, according to a study published online Dec. 12 in the Journal of General Internal Medicine.

Hormone therapy may be best defense against knee osteoarthritis: There is an ongoing debate regarding the relationship between knee osteoarthritis and hormone therapy (HT), with small-scale studies providing mixed results. A new large-scale study from Korea shows that women receiving HT had a significantly lower prevalence of symptomatic knee osteoarthritis compared with women who did not take hormones. Menopause 

Effect Sizes Uncertain for Meds Versus Placebo in Knee OA: For patients with knee osteoarthritis and at least 12 months of follow-up, there is uncertainty around estimates of effect size for the change in pain in association with medications versus placebo, according to a meta-analysis published in the Dec. 25 issue of the Journal of the American Medical Association.


One in Five Back Pain Patients Experience Persistent Pain: Significant differences seen in patterns of medication, health care use across back pain trajectories. Eighteen percent of patients with back pain experience a persistent trajectory, according to a study published online Jan. 14 in Arthritis Care & Research.

Meta-Analysis: Botulinum A Tops Placebo for Chronic Migraine: For chronic migraine, botulinum type A injections are superior to placebo after three months of therapy, according to a meta-analysis published in the January issue of Plastic and Reconstructive Surgery.

CBD in marijuana may worsen glaucoma, raise eye pressure: A study has found that CBD -- a major chemical component in marijuana -- appears to increase pressure inside the eye of mice, suggesting the use of the substance in the treatment of glaucoma may actually worsen the condition. Investigative Opthalmology & Visual Science

Acupressure relieves long-term symptoms of breast cancer treatment, study finds: Breast cancer survivors reported improvements in depression, pain, anxiety and sleep after self-administered acupressure. A new study finds acupressure could be a low-cost, at-home solution to a suite of persistent side effects that linger after breast cancer treatment ends. JNCI Cancer Spectrum

Many Medical Cannabis Users Drive While Under the Influence: More than half of adults using medical cannabis for chronic pain reported DUIC within two hours of use. Drug and Alcohol Dependence

• Warned that patients taking fluoroquinolones may be at hither risk for ruptures or tears in the aorta. Those at risk include those with hypertension, the elderly and certain genetic disorders.
• Issued safety monitoring measures for the permanent birth control device Essure
• Warned companies on unsafe, unapproved stem cell treatments

Approves first generic version of Sabril to help treat seizures in adults and pediatric patients with epilepsy

Approved Ultomiris (ravulizumab) injection for the treatment of adult patients with paroxysmal nocturnal hemoglobinuria (PNH), a rare and life-threatening blood disease.

New epigenetic cervical cancer test has 100 percent detection rate: A new test for cervical cancer was found to detect all of the cancers in a trial of 15,744 women, outperforming both the current Pap smear and human papillomavirus (HPV) test at a reduced cost, according to a new study. International Journal of Cancer

Endurance Exercise Tied to Anti-Aging at Cellular Level: Endurance exercise has anti-aging effects visible at the cellular level, according to a study published online Nov. 28 in the European Heart Journal.  The effect seen with aerobic endurance and high-intensity training but not resistance training.

Exercise Promotes Executive Functioning in Sedentary Adults: For sedentary adults at risk for cognitive decline, aerobic exercise (AE) is associated with significant improvement in executive functioning, according to a study published online Dec. 19 in Neurology.

Replacing Sitting Time With Activity Lowers Mortality Risk: Replacing prolonged sedentary bouts with physical activity reduces mortality risk, but no benefit is seen for replacement with short sedentary bouts, according to a study recently published in the American Journal of Epidemiology.

Short bouts of stair climbing throughout the day can boost health: A few minutes of stair climbing, at short intervals throughout the day, can improve cardiovascular health, according to new research. The findings, published in the journal Applied Physiology, Nutrition and Metabolism, suggest that virtually anyone can improve their fitness, anywhere, any time.

Patients with Sleep Apnea Have Increased Gout Risk: Patients with obstructive sleep apnea (OSA) are at higher risk for developing gout than patients without OSA for more than a year after diagnosis, according to a study published in the January issue of Arthritis & Rheumatology.

Body-painting protects against bloodsucking insects: A study by researchers from Sweden and Hungary shows that white, painted stripes on the body protect skin from insect bites. It is the first time researchers have successfully shown that body-painting has this effect. Among indigenous peoples who wear body-paint, the markings thus provide a certain protection against insect-borne diseases. Royal Society Open Science

'Happiness' exercises can boost mood in those recovering from substance use disorder:  Brief, text-based, self-administered exercises can significantly increase in-the-moment happiness for adults recovering from substance use disorders, report researchers. Journal of Substance Abuse Treatment

Five Brands of Dental Floss May Expose People to Harmful Chemicals: People may absorbe PFAS perfluorohexane sulfonic acid when they floss. The following products tested positive for PFAS compounds CVS Health EaseBetween SuperSlip Dental Floss Waxed, Oral-B Glide Pro-Health Mint and Glide Pro-Health Original, Crest Glide Deep Clean Cool Mint Floss, Safeway Signature Care Mint Waxed Comfort Floss, and Colgate Total Dental Floss Mint. Buzzfeed

Exercise Can Halve Heart Attack Risk in Healthy People: New research, appearing in the European Heart Journal, suggests that lack of physical activity can drastically increase the risk of a heart attack in the long-term, even if there are no symptoms at present. Higher fitness levels can halve the risk of heart attack.

Stress May Raise the Risk of Alzheimer’s: Vital exhaustion, a marker of psychological distress, may raise the risk of developing Alzheimer’s Disease. Vital exhaustion describes "a mental state of psychological distress" that manifests as irritability, fatigue and a feling of demoralization. Journal of Alzheimer’s Disease 

Binge eating and smoking linked to bullying and sexual abuse: People who ever suffered bullying or sexual abuse have a lower quality of life similar to those living with chronic conditions like heart disease, diabetes, depression or severe anxiety, a new study from the University of Adelaide has found. They are also far more likely to display harmful behaviours like smoking dependence and binge eating. BMC Public Health


Routine Supplements to Prevent Chronic Disease Not Advised: Routine use of vitamin and mineral supplements to prevent chronic disease is not recommended, according to an Academy of Nutrition and Dietetics position paper published in the November issue of the Journal of the Academy of Nutrition and Dietetics. Citing a lack of available scientific evidence, the academy recommends against the routine use of micronutrient supplements for prevention of chronic disease. However, micronutrient supplementation may be beneficial for requirements secondary to growth, specific chronic disease states, medication use, malabsorption, pregnancy and lactation, and aging. The academy is concerned that consumers may not be well informed about the safety and use of micronutrient supplement products and some may have difficulty interpreting product labels.

Health Benefits of Nonsugar Sweeteners Uncertain: There is no compelling evidence to indicate health benefits of nonsugar sweetener (NSS) use on a range of health outcomes, according to a review published online Jan. 2 in The BMJ.

Moderate Drinking Not Harmful for Seniors with Heart Failure: For older adults with heart failure, limited alcohol consumption after diagnosis is associated with survival benefit versus long-term abstinence, according to a study published online Dec. 28 in JAMA Network Open.

Genetics may influence the effects of vitamin E on cancer risk: A new study has investigated whether taking vitamin E supplements could affect risk of cancer and found that genetic variations in the gene COMT influenced whether vitamin E decreased or increased risk of developing cancer during and after the study periods. JNCI


B-group vitamins can improve concentration among people with first episode psychosis: A new study explored the impact of increasing a person's intake of vitamins B12, B6, and folic acid [vitamin B9] after studies in people with schizophrenia revealed that increased intake of these vitamins could decrease patients' levels of an amino acid called homocysteine and improve their symptoms. Science Daily

High-Dose Vitamin D No Better Than Low-Dose: Low blood levels of vitamin D are tied to bone loss that can lead to falls and fractures. But taking vitamin D supplements in high doses showed no benefits over low-dose vitamin D, a randomized trial found. American Journal of Clinical Nutrition 

Magnesium optimizes vitamin D status, study shows: A randomized trial by Vanderbilt-Ingram Cancer Center researchers indicates that magnesium optimizes vitamin D status, raising it in people with deficient levels and lowering it in people with high levels. The American Journal of Clinical Nutrition

Intermittent Fasts Plus Energy Restriction Best for Weight Loss: Intermittent fasting with restricted energy intake may provide better outcomes than daily continuous diet restriction for health and weight loss in obese women, according to a study published in the January issue of Obesity.

Moderate Drinking Linked to Electro anatomic Changes in A-Fib: Moderate alcohol consumption is associated with lower atrial voltage and conduction slowing in patients with atrial fibrillation (AF), according to a study published online Jan. 9 in Heart Rhythm.

High Fiber Intake Tied to Lower Risk for Noncommunicable Disease: High intake of fiber is associated with a reduced risk for several noncommunicable diseases (NCDs), according to research published online Jan. 10 in the The Lancet. With a daily intake of dietary fiber of 25 to 29 g, the risk reduction associated with a range of critical outcomes was greatest. Higher intakes of dietary fiber could confer even greater benefit to protect against cardiovascular diseases, type 2 diabetes, and colorectal and breast cancer, according to the researchers. The findings for whole grain intake were similar.

Metabolic syndrome patients need more vitamin C to break cycle of antioxidant depletion: A higher intake of vitamin C is crucial for metabolic syndrome patients trying to halt a potentially deadly cycle of antioxidant disruption and health-related problems. Estimated 35 percent of the U.S. adult population that suffers from the syndrome. Eat five to 10 servings a day and then you'll get the fiber, you'll get the vitamin C, and you'll really protect your gut with all of those good things." Redox Biology

A-Fib Risk Up for Antidepressant Users, but Higher Before Treatment: The risk for atrial fibrillation (AF) is increased among antidepressant users, particularly before treatment initiation, according to a study recently published in the European Journal of Preventive Cardiology

Age, BMI Predict Obstructive Sleep Apnea Treatment Success: Among patients with obstructive sleep apnea, older age and reduced body mass index (BMI) are predictors of upper airway stimulation (UAS) treatment response, according to a study published online Nov. 28 in the European Respiratory Journal.

Antidepressant Use in Seniors Linked to Risk for HipFracture: Among older adults, antidepressant users sustain more hip fractures than nonusers both before and after therapy initiation, according to a study published online Jan. 2 in JAMA Psychiatry.

Trained Alert Dogs Can Detect Impending T1DM-Related Events: In study, individual dogs' performance varied for detecting hypoglycemic episodes, hyperglycemia. Plos One

USPSTF Recommends Risk-Reducing Meds for Breast Cancer: The U.S. Preventive Services Task Force (USPSTF) recommends risk-reducing medications for women at high risk for breast cancer who are at low risk for adverse events, but medications are not recommended for routine use. These recommendations form the basis of a draft recommendation statement published online Jan. 15 by the task force.

Guideline Issued for Treatment of Mild/Moderate Ulcerative Colitis:A new clinical guideline from the American Gastroenterological Association (AGA) published Dec. 18 in Gastroenterology focuses on the medical management of patients with mild-to-moderate ulcerative colitis (UC).

Stem Cell transplant slows down MS Progression: A preliminary clinical trial shows that stem cell transplantation, along with a tolerable dose of chemotherapy, is safe and more effective at slowing down multiple sclerosis than other existing therapies. JAMA

Many in their 50s and early 60s worried about Health Insurance: Many adults aged 50 to 64 years are concerned about being unable to afford the cost of health insurance, according to the results of the National Poll on Healthy Aging published on Jan. 3.

Low-Priced Generic Drugs Most Likely to Have Shortages: The lowest-priced generic drugs are more likely to experience shortages, according to a study published in the November issue of Value in Health.

Wednesday, January 16, 2019

Take a Break: Decorate for Cozy

January is a bit of a let down. The holiday decorations come down. The weather can be very iffy and while I’m a firm believer of being outside for some portion of every day, I’m also much more of an indoor person in the freezing cold that is Vermont’s winters. So some tips on relieving the January blues and upping the cozy and comfy

• Leave up decorations that are winter related, particularly those with some red in them.
• Decorate for Valentine’s Day
• Make soup, pie, or something that just makes the place smell yummy
• Embrace the light-Lots and lots of candles; fire in the fireplace; soft lighting to read by
• Reduce the amount of wood/tile between you and your feet with throw rugs. Add a bedside rug so your feet stay warm first thing in the morning. Use under pads to keep rugs from slipping. 
• Lots of soft fabrics to snuggle in. Pillows, pillows and more pillows. Throws on couches and overstuffed chairs with ottomans.
• Leave bedroom slippers by the front door so as soon as you come home you can slip off your outdoor shoes and slip into comfy. Have some extra pairs for guests.
• Make your bed every morning. Throw pillows make it look very inviting and cozy. Flannel is incredibly inviting (and warm) so save the crisp cotton and linen for the spring and summer months.
• Decorate your kitchen/dinning table. A table runner adds a pop of color
• Special mugs and array of teas, coffees and hot chocolates sitting out invite you and your family to curl your fingers around something warm.
• Plants, particularly forced bulbs, add a much welcome touch of color as well as remind you that spring will come.
• Let you pet snuggle on the couch with you

January is a good time to check out your local thrift store as they receive a lot of unwanted items people receive over the holidays. Many thrifties have Facebook pages, so worth keeping an eye for items that will bring some extra coziness this winter.

Not interested in today’s activities, try the Take a Break Pinterest Board.

Saturday, January 12, 2019

Life with Chronic Conditions: Medicine vs Lifestyle

I love archeology, particularly the paleoindian period, which is over 11,000 years old. I’ve been working on various digs and am amazed to hold the tools these people made. Now with the advent of DNA research, we’re getting a better handle on who these people were, how they lived and yes their life expectancy.

I was fascinated when Vermont’s state archeologist, Jess Robinson, spoke about how farming was the undoing of the Paleoindians as they had it made with their hunter-gatherer lifestyle. So this week I was immediately drawn to an article in the Huffpost Does Medicine Actually Make People Live Longer?

In spite of the research I’m actively involved with, I had no idea that the paleoindian lifespan (for those surviving childhood) was pretty similar to today's. Once people started cultivating crops, longevity suffered. Populations boomed, unsanitary conditions arose, humans and domestic animals lived in close proximity and it wasn’t long before infectious diseases significantly impacted life expectancy. Note that children, up to the 20th century and the arrival of vaccines, were at high risk for early deaths.

Life expectancy did not start rising again, and finally attain similar levels as our 10,000 year old ancestors, until about 100 years ago. Sanitation/public health was the primary reason. Due to a better understanding of germs, significant changes in drinking water, improved hygiene of those attending births and caring for the sick, building sewers etc. all contributed to a spike in life expectancy. By the mid 20th century, vaccines helped to eradicate many childhood diseases so more people achieved adulthood and the arrival of antibiotics helped to stop some of the diseases that have plagued humans since they began farming.

While heart disease, which hunter-gatherers rarely develop, is the leading cause of death, with cancer in 2nd place, I was surprised to learn of the 2016 British Journal of Medicine study  that found medical error is the third leading cause of death in the US. Interestingly medical error is not included on death certificates or in rankings of cause of death.

I find it fascinating that people are obsessed with a vegan diet, swearing it improves life expectancy, while at the same time there are many who find they feel healthier eating a Paleo diet. In truth, we’re not going to be adopting a hunter-gatherer lifestyle anytime soon-and no they were definitely not vegans.

But let’s not throw the baby out with the bath, medicines have definitely saved lives and they are important. My question is simple, does medicine deserve the power that society today gives it? Might we do better if we had as much promotion for healthy lifestyle choices as we do medications? Would we do better to invest in communities to make the healthy choice the easy choice?

I’ve written about this many times in this blog, but we only need to look at the Blue Zone cultures to see that lifestyle makes a far bigger impact on longevity and quality of life than access to medical care. Programs  are underway in the US to bring the Power Nine lifestyles of the Blue Zones to the US.

The research is showing that it’s not too late to make changes as significant advantages are happening in communities where they are making the healthier choice the easy choice. However, many health professionals I talk to have never heard of the Blue Zones studies and would rather promote medicines (cause it’s easier and people are more likely to do it) than lifestyle changes. Interestingly though, when you look at who is sponsoring a lot of the Blue Zones projects it’s health insurers. They’re not stupid as they save money when people adopt healthier lifestyles and therefore don’t need a lot of medical care.

Ultimately medicine today is a “sick care” model. If we want to be active and healthy for as long as possible we need to start shifting our focus at creating healthy communities. Clearly the early public health pioneers did this when they worked to implement sewers and other measures that resulted in improved lives and life expectancy. We need to be building on that model by creating communities that promote walking; places for people to gather and socialize; ways for people to be involved so they have a sense of purpose; public gardening and more.

Tuesday, January 8, 2019

Take a Break: Make Soup!

It’s cold, snowy, sleety and just plain nasty out. What a wonderful pick me up to have a bowl of nice warm soup that you make yourself. The house smells cozy delicious while it's bubbling away and you can include whatever ingredients you like.

The simplest soups have the same basic method for cooking:
• In a soup pot (Dutch oven) sauté aromatic veggies (onion, garlic, celery, carrot, garlic) in some type of fat (butter, olive oil, bacon drippings)
• Cook your meat if your using it
• Add the base (except for milk or cream), veggies, meat and spices. Your base can be chicken, beef, fish or veggie stock or broth. In general you want your broth to just cover the veggies and meat. Can add tomatoes.
• Allow to simmer for an hour or two. However Instant Pots are great.
• Taste and adjust seasonings as you go.
• Add cream or milk before serving. Another way to get a thicker soup is to take some of the soup and puree it. This will thicken the soup, without using milk or cream,  particularly if you have potatoes in the recipe.

I like roasted vegetable soup. Put cauliflower, garlic cloves skin on, onions and carrots in a sheet pan, sprinkle olive oil, salt & pepper. Mix and bake at 450 for about a half hour or until they start to brown up nicely. I’m pretty casual so I’ve been known to turn the oven off after 20 minutes and let them sit in the oven for a couple of hours. I then put the roasted veggies, removing the skin from the garlic, in a soup pot adding some potato, 4 cups of chicken stock with additional spices if it needs it. After the potatoes are fork tender, I puree in a blender until smooth. Add whatever toppings you like. Crispy Fried Onions are pretty tasty. I also make this soup using butternut squash in place of cauliflower and add a sweet potato instead of white potatoes.

There are many recipes on-line. Check out The Best Soup Recipes of 2018  to get started.

Not interested in today’s activities, try the Take a Break Pinterest Board.

Saturday, January 5, 2019

Life with Chronic Conditions: Buying/Borrowing or Modifying a Recliner

It feels great to kick back in a comfy chair after a long day, watch a little TV, read a book or take a nap. The bane of interior designers, many people have recliners in their homes for just that purpose. Hospitals, same day surgery centers and other medical facilities find them very useful in helping patients to relax and even recover from procedures.

Recliners are generally considered chairs that slide back with a footrest and a headrest. These can include “zero gravity chairs.” Glide rockers (great for nursing moms and colicky babies) come with separate ottomans that also glide and there are plenty of lounge chairs with ottomans that are quite comfortable.

Prices vary significantly based on materials and features. You can certainly pick one up at your local thrift store, or may even know someone who wants to get rid of one. If this is something you wont be using for a long time-e.g. recovering from surgery-you’d do well to check around to see if someone has one that fits and that you can borrow. Don’t borrow a chair that doesn’t fit you as in the long run it could cause you more problems.

 Before buying, loaning or modifying a recliner consider the following:

Types of recliners: There are a lot of different designs of recliners that can fit your needs, wallet as well as decor. Check out Wall Hugger Recliners  for the pros and cons of lift recliner, zero gravity and many other types.

Note that zero gravity chairs are very popular for their sleek design but also because they are comfortable. I’ve known a number of patients, particularly those with pain issues, who prefer them to the conventional recliner as they take pressure off the body and are excellent for circulation issues. During the summer months you’ll often see them advertised as the outdoor chair of choice for as low as $50. These can be modified with cushions and blankets for indoor use. However, they can be hard for some people as they require that you lean back in order to achieve the zero gravity position. Also, the cheaper the chair the more likely it will “slip” so it’s important to get one that locks and has a variety of position options. The outdoor varieties are good for traveling, sitting by the pool etc. If you want this to be a more permanent feature, it’s worth spending the money to get one that fits properly and is made of more durable fabrics.

Proper Fit: There are two “proper fits” you need to consider. The first is where the recliner will sit in your house. Measure carefully and understand how much space the chair will take when it’s in the recline position. A standard or basic recliner typically requires at least 1 foot of travel space in front of the wall to open completely. Give a little more room so when the chair is in fully reclined position it’s not almost toughing the wall.

The second is how it fits your body. You don’t want a chair that is too high where your feet dangle or too low, where your knees rise above the seat. Feet should fit flat on the ground.
While it’s recommended that you try out a chair before you purchase it, it may not be possible and/or if you are purchasing a chair for someone else, measure carefully before shopping. In order to get the best fit, use a tape measure and write down the distance:
• from the back of your knee to your heel
• from your tailbone to the back of your knee
• from your elbow to the end of the palm of your hand, where your fingers attach
• from your right hip to the left hip.

For the correct back support, no gap should exist from your tailbone or lower back when seated against the back and seat cushions, so the measurements from your tailbone to your knees should equal the length of the recliner's seat cushion. When seated -- not reclined -- your feet should rest flat on the floor and not dangle or extend to where your heels are resting on the ground. This will create ample knee and back support as well as allow circulation in your legs and feet. The armrest should extend from your elbow to your hand resting at the end of your palm for wrist support -- so the armrest equals your arm length from your elbow to hand -- and the width of your chair should have at least a small gap -- about 1 inch -- from the armrest to both hips. Finally, when the chair is reclined, the heels of your feet should fit comfortably at the edge of the footrest, not dangling over or stopping in the middle; otherwise, the chair will not provide the correct support for your back and legs.
If it’s possible to test out the recliner do so. Sit on the recliner. Raise the leg platform. Press the back to its most reclining position. If it’s comfortable and you find yourself snuggling into the seat, then consider purchasing the recliner. In a sitting position, be sure your thighs are supported completely, and when sitting and reclined, note the lumbar support. Make sure you can’t feel the frame when your arm presses on the armrest. 

Ask the sales person for the “foam density rating,” meaning the density of the filler. You want a recliner with a rating greater than 1.9 for a long-lasting and comfortable seat.

Manual vs. Motorized: Clearly motorized are more expensive and you can have more mechanical issues with them. However, if it’s going to be hard to operate a side lever or you don’t have the strength to push back into a reclining position, it will be worth the money to get a motorized chair.

Modifying a Recliner: This is a very common practice when a person has a recliner to modify it while they recover from hip or other type of surgery. Watch the video below to learn about modifying one as well as additional tips on selecting a chair that fits your body.