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The "why" behind healthy

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Even Elvis knew one day we'd need help with Peace, Love and Understanding

8/19/2023

 
There are some new acronyms on the acute injury management scene and we want to help you understand why you should be open to them...corny as they may seem.

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Are you breathing...properly?

8/1/2023

 
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When you inhale oxygen enters the lungs and blood cells while CO2 and waste products are exchanged and exhaled. This gas exchange happens at the alveoli via diffusion into the blood cells while waste and CO2 moves out via the capillaries. The newly oxygenated blood exits the lungs and delivers this life sustaining supply to all the tissues and organs of the body. The inflammatory cascade of COVID targets the alveoli - capillary exchange in a deadly way but so too does COPD, pneumonia and TB among other conditions. Inefficient breathing can also occur due to excessive mouth breathing, poor posture, stress induced shallow breathing to name a few.  ​

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An experiment with AI and BARD chat about How To Set Goals

5/1/2023

 
The following is my trial use of the artificial intelligence tool from Google called Bard. No doubt you too are getting many plugs in your inbox for this and Bing's tool as well as other such as Chat GPT this year. They are content generators for conversation, email, assignments (such as homework) and I was curious how they perform and what value it might have for me.  I started with a rough draft of this blog post about goal setting and compared it to the results from Bard on "how to set goals".  The Bard generated results are in black below followed by my editing, add ins and clarifications noted in orange and the commentary I planned.

Here are some tips on how to set goals:
  1. Think about what you want to achieve. Goals are suppose to help us improve, change, start stop, fix, correct or alter something.  So what needs to happen?  For me, I want to ride to DC on my bike. This will require being fit enough to ride 50-70 miles multiple days in a row, be competent fixing my bike when I'm in remote places, be able to pack and have appropriate gear and carry my own supplies.  I've never done this before. Once you know what you want to achieve, you can start to set specific goals.
  2. Make your goals SMART. SMART goals are specific, measurable, attainable, relevant (I say realistic - of course they're relevant...you chose them, of course they are a reach that's why they're called goals...but realistic is my chosen "R" word.  Realistic means...do people do "this thing", or if you're Elon Musk...is there equipment that can be developed to make this happen even if it's not known now, or being done yet? Do people have the capacity to run 10 meters in under 8 seconds? Physiologically unlikely, but at some point someone took the leap that under 9:85 seconds was worth training for and finally the "T" in SMART...time-bound. This means that your goals should be clear, measurable, achievable, relevant to your values, and have a deadline.
  3. Create an action plan. Break them down in to pieces.  I need to start riding my bike more often, I need to take a bike safety course, I need to do some small group rides with people who ride a lot more than me, I need to do longer local rides carrying my bike bags etc. How are you going to achieve your goals? What steps do you need to take? Break your goals down into smaller, more manageable steps.
  4. Consider (very carefully) would a partner help you on this trek?  What you do not want is someone who is not invested in the same thing derailing your goals or supporting your wavering confidence.  Choose wisely or not at all someone who will support you in stages or completion of the gaol.  if it is an athletic endeavor like a marathon there are many charitable groups who will support your training in exchange for you fundraising for them.  The MS Society is well known for their fantastic 150 mile supported bike rides around the country and numerous other groups do Team in Training type programs.  I have done 2 MS 150 mile bike rides in the past and that 
  5. Celebrate your successes. As you achieve your goals, celebrate your successes! This will help you to stay motivated and keep moving forward. This is a fantastic idea I had not included in my outline and is really a great and critical step while doing the hard work toward that challenging goal. 
Here are some additional tips for setting goals:
  • Be realistic about your goals. Don't set yourself up for failure by setting goals that are too ambitious.
  • Be flexible. Things don't always go according to plan, so be prepared to adjust your goals as needed.
  • Don't give up. There will be times when you want to give up, but don't! Keep going and you will eventually achieve your goals.
Setting goals can be a daunting task, but it's worth it. When you set goals and achieve them, you feel a sense of accomplishment and satisfaction. You also become more confident and capable. So what are you waiting for? Start setting goals today!

In summary goal setting is about achieving something for work, pleasure, personal development or as the Stoics would say "for the opportunity to grow and improve".  Iron sharpens iron, right?  The Stoics go further with Seneca saying "we treat the body rigorously so it will not be disobedient to the mind" meaning that discipline of doing physically challenging things strengthens us philosophically as well as physiologically. (The Daily Stoic blog: "Difficult things are good for you")

MY REVIEW of BARD: Much of this summary repeats themes and contains filler. This is a simple search with a non complex or detailed AI generated solution.  The 4th of my points about goals setting was not included in the BARD summary so be prepared for your knowledge at times to be deeper than what is sourced, as well as vice versa obviously.  Overall, my experiment with AI reaffirms that you should have your own understanding of your point of view or the assignment at hand; some idea about what that content might include; a willingness to be surprised by new concepts (but the ability to properly fact check) and expect repetition since the information is sourced from collectives of information.  Newer questions and concepts may not have much information, and validity of data must be assessed.  I don't think this is a good tool for novices because they may not have the aptitude to recognize inaccurate information. It was a time saver for my simple topic.  Overall this piece took almost 45 minutes less to format, edit, design and post. That likely would be much longer if the topic was complex due to more detailed fact checking.  But for simple themes this is a tempting assistant for me trying to keep up with content to post.  Again a knock on AI is that less sophisticated minds may not know what, how, or that they should fact check the results. While advanced AI tools may improve accuracy with better algorithm remember this tool is designed to "present a human like text response" to a prompt - it is not designed to pull sources like a search engine.  

Your Job, Mindfulness and cultivating Awe.

4/4/2023

 
I have had the luxury of seeing many of you over more than 25 years of my career.  Naturally, that means some of you have retired in that time and I have been interested to watch that evolution toward that Last Day "swiping in to work", or that First Day "not at the job". Some of you are concerning me...
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An anatomy refresher for the Health Quiz we should all have to take once a decade at least

2/18/2023

 
Imagine if you had to take a pop quiz in health class right now.  How much do you remember about your body, function, maintenance, healthy eating or basic self care?  How much of this are kids learning in school health?  Try one of these AARP quizzes to see what you never learned, still remember or have forgotten:   How Well Do You Know Your Body and/or  What Do You Really Know About Your Muscles and see.

​And here's a cheat sheet: 
Bone: 
It is living, growing (supplying new blood cells) tissue; it has 2 types, spongy and compact - we'll talk about spongy in a future newsletter but know it is not as soft as it sounds and it is where osteoporosis is most devastating. Bone has an extensive vascular and neurologic network; has 5 general classifications of types related to shapes size, function (consider your knee cap versus your femur); and the ends of long bones are covered with a unique specialized material called articular cartilage.
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​ Cartilage: 
is a very specialized connective tissue which exists in your ears or in specialized structures like the meniscus and spinal discs as well as the ends of bone where movement (ie joints) exist. That (hyaline) cartilage is often called articular cartilage and it has no blood supply (ie healing is limited and nutrition occurs via diffusion) or nerve endings -also something we'll discuss in a future newsletter post about arthritis.  The articular cartilage at the ends of bones is a super specialized covering that is surrounded by a fibrous capsule with a specialized lining and covers a joint space or cavity. Osteoarthritis and rheumatoid arthritis, as well as other arhritis' affect these cartilaginous structures. 
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​Muscle: 
has 3 distinct types: cardiac, smooth (between and around the walls of blood vessels and organs and moves things through and within the viscera) and skeletal; skeletal muscle is between bones connected by cartilage, ligament or fascia and creates movement; skeletal muscle has 5 key designs: sphincter, pennate, flat, fusiform and quadrate; has network blood vessels, nerve innervation and a network of connective tissue holding its bundles of bundles together.
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​Ligament: 
are either extrinsic or intrinsic (one with) synovial joints and connect bone to bone, stabilizing a surface for movement; 
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​Tendon: 
is similar to muscle in its bundling matrix; tendon connects muscle to bone and mitigates forces; it is a cordlike structure with great stiffness from collagen as well as from the structure; tendons have 2 key points of potential injury at the muscle tendon junction and at the invagination (insertion point) of the tendon in to the bone; tendons in the hand and foot that are exposed and glide over bony areas have a specialized covering that supplies nutrition and lubrication to offset the friction from their environment; tendinopathy is a term more commonly used these days to describe the process of tendon injury or inflammatory state with tendonitis indicating swelling is present versus tendonosis indicating nicks and tears in the tendon may be present.  
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A person sprains a ligament, by rolling the ankle when misstepping off of a curb. One strains a muscle or even tendon by over loading or over exerting oneself pushing, pulling, playing, carrying.  Strains can be mistaken for Delayed Onset Muscle Soreness  (or we can conclude DOMS to be a very early very minor muscle strain) from exertion without proper ramp up. DOMS usually is most pronounced 2 days after a stressful workout versus an acute strain which likely occurs more immediately; DOMS usually feels better with light exercise on day 2 or 3 if it is not already receding with time, whereas the strain will feel worse. 

Let us know how you scored - and be sure to suggest some other topics based on questions you missed on the quiz.
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    Author:
    Nancy Foley, PT, DPT
    Board-Certified Clinical Specialist in Orthopedic Physical Therapy
    ​and

    Sean Crandell DPT, ATC

    When people understand why some activities may be safer or better than others, or why a condition might get better with activity modification, or why asking better questions of their doctor leads to better outcomes,  healthy things happen.
    ​Sure, health is the first wealth but knowledge and facts are how you get return on that investment.

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