IFA News and Opinion
Issue Date:  June 1, 2004

Less invasive knee surgery

A new procedure for total knee replacement requires only a 3-inch incision and avoids cutting the quad muscle and tendon which are necessary for the knee to flex. Patients recover three times faster than with standard surgery, according to New Jersey's Robert Wood Johnson Medical School, pioneers of the new method.

Doctors at Rush University Medical Center in Chicago say the procedure takes practice and skill on the part of the surgeon, but the procedure should be common within a year or two. About 300,000 Americans have total knee replacements each year, but not all would be candidates for the new procedure.

New breast cancer treatments

Breast cancer patients may now be given cancer-killing drugs before surgery instead of afterward. Preoperative chemotherapy can shrink a tumor and allow surgeons to perform a lumpectomy instead of breast removal. In some cases, early chemo causes the cancer to disappear entirely.

Using preoperative chemo to shrink tumors reduced mastectomy rates by 20 percent, according to the National Surgical Adjuvant Breast and Bowel Project.

Other shifts in thinking regarding treatment include giving Tamoxifen and Arimidex instead of chemo, which works better in postmenopausal women, or dose-dense chemo which shortens therapy and may lower risk of relapse.

Downside to bariatric surgery

Some patients who have weight-loss surgery regain much or all of their weight after a few years. Anatomical changes make it impossible to eat large quantities of food, but they eat small portions of high-calorie foods throughout the day, according to the American Society for Bariatric Surgery.

One study shows that 80 percent of patients regularly felt a loss of control over eating six months after surgery.


Here comes the sun: Cover up!

The sun provides light, makes the garden grow, and prompts our bodies to produce vitamin D.

But sunshine has its dark side. It ages the skin. It makes some people break out in a rash. It's a main cause of skin cancer, with a million new cases in the U.S. each year.

How can you enjoy summer and still protect yourself?

  • Use a lot of sunscreen. Most users get about a third of the sun protection listed on the bottle. For the full effect, use a full ounce on exposed areas of the body. That could take a quarter of the whole bottle. Most sunscreens protect against both ultraviolet A (UVA) and ultraviolet B (UVB) light. UVB is responsible for sunburn. UVA penetrates deeper into the skin. Both contribute to melanoma, the most serious type of skin cancer.
  • Cover up with clothes. Dark colors are better because they absorb more sunlight. Polyester garments are usually more protective than cotton or linen, but it depends on the weight and the weave. (Sunlight gets through the holes.) Some clothes are marketed as sun-protective. They state the ultraviolet protection factor (UPF) rate. The rating system was developed in Australia, the country with the highest rate of skin cancer in the world. The Australians rate clothing with a UPF rating of 15 or over as good.
  • Watch the clock. Avoid extended exposure between 11 a.m. and 3 p.m.
  • Don't trust the clouds or the shade. On cloudy days, ultraviolet radiation levels are almost the same as in the sunshine. In the shade, you're better off than in the sun, but if you can see the sky, a lot of radiation is getting to your skin. That's especially true near water and other reflective surfaces.
  • Check your altitude. Doctors at Harvard Medical School say the intensity of radiation increases by about 4 percent for every 1,000 feet in altitude.


  • Best mattress for bad backs

    If you have low back pain, a very firm mattress might not be best for you. A recent study published in Lancet shows that medium-firm mattresses soothed backs more than those that are firm or extra-firm. Study participants who used medium-firm mattresses for three months reported less pain while in bed, when rising, and during the day.

    Doctors conclude that the medium-firm mattress puts less pressure on the shoulders and hips, making it easier to lie in the fetal position, which can benefit the back. Lying with knees bent ,either on your side or your back, is considered a correct sleeping posture, say the study authors.

    Go to the guest room?

    Somewhere between 20 and 65 million Americans have mild to severe insomnia. How about their partners? When asked what kept them awake at least once a week, half of those surveyed blamed an insomniac bed partner. If yours sometimes tosses and turns too much, you might get better sleep on the sofa or in the guest room.

    Of those surveyed, this is what they said kept them awake during the last week: Stress, 66 percent; family problems, 20 percent; money or job worries, 33 percent; and current events, 5 percent.

    Meditation boosts immunity

    Scientists at the University of Wisconsin tested the immunity of subjects who had received flu shots, half of whom had learned to meditate six days a week.

    After eight weeks, meditators had higher levels of flu-fighting antibodies. They were better able to deal with stress, and had increased activity in the brain that was linked to good moods. The feel-good effects lasted for up to four months after they stopped meditating.

    The doctors say meditating produces biological changes in the brain and body. It's free, safe, and helpful.


    Prevent heat exhaustion

    The National Safety Council recommends that people who are working outside in hot weather, or in non-air-conditioned environments, should put a wet scarf around their necks. As the moisture evaporates, the body stays cooler.

    Drinking enough water is very important. You can alternate water with a sport drink that has electrolytes. The key is to drink enough so you never get thirsty. If your urine is concentrated, a dark color, you need to drink more. Drink enough water so your urine is pale yellow.

    When you are working outside, be sure to wear a hat and a lightweight, long sleeve shirt with no T-shirt underneath.

    Remember that caffeine and alcohol are dehydrating. Drink decaf, bottled water, or sport drinks.

    Don't wait to report an injury

    Never wait until the end of your shift to report an injury. Do it immediately. This is especially true of puncture wounds on the fingers and hands. They must be treated aggressively, especially if foreign debris is present.

    Hand infections travel up the tendon sheath. It could be only 10 or 12 hours before sepsis, a toxic condition resulting from the spread of bacteria, sets in.

    Look around, walk around

    Get away from your computer. Researchers at the National Institute for Occupational Safety and Health have found that short breaks at the right times reduce eyestrain and muscle discomfort without reducing productivity.



    Creativity is more important than knowledge.
    - Albert Einstein

    I'm not afraid to die, I just don't want to be there when it happens.
    - Woody Allen

    Always do right. This will gratify some people, and astonish the rest.
    - Mark Twain

    Fish and visitors smell after three days.
    - Benjamin Franklin

    Whenever you are asked if you can do a job, tell 'em, Certainly, I can! and get busy and find out how to do it.
    - Theodore Roosevelt

    Pilot Skill #144:

    Always try to keep the number of landings you make equal to the number of take offs you've made.

    Q & A

    Q: How many clases should a aerobic instructor teach a week? Teaching 9 classes of spinning, and 2 of step a week sound stressful. Can I have your recommendation? Thank you.

    A: Yes, it can be stressful. Most instructors over do the training. At a maximum, I would limit it to 1 or 2 classes a day and 3 or possibly 4 times a week. As an instructor you are better able to control your intensity while still directing the class to greater intensity. So you shouldn't be intensifying your workout all the time.

    Q: I'm a 52 year old male and exercise regularly. My resting heart rate is 30 beats per minute but my maximum is 131. Is this anything to be concerned about or am I just 'down shifted' about 40 bpm from the average?

    A: Marathon runners and some athletes have very low resting heart rates. However, 30 seems a bit low. You should not be experiencing dizziness, confusion or shortness of breath. I would still get a stress test usually done in the doctor's office to verify the heart function. Better to be fairly certain than to experience increased stress by not being sure. See your doctor.

    Q: Is my heart rate too fast? It's 120 BPM when sitting.

    A: That is a higher than normal rate. Normal resting heart rates range from 50 bpm (active) to 90 bpm (sedentary). Your maximum heart rate should not be more than 220 minus your age. If you are taking any supplements, stop them immediately. Avoid caffeine and anything that has it as an ingredient. See your doctor.

    Q: I am a long distance runner recovering from peroneal tendonitis (left lateral ankle area). I have also had other soft tissue injuries (I-T Band). I do Yoga/Pilates and other stretching routines. Would jump roping help strengthen my peroneal tendon? Could you reccommend other activities other than running of course that could strengthen the MTUs for distance runners?

    A: Yes, jumping rope would strengthen the musculature. However, your joints may already stressed from excessive running. You may only cause further damage to your joint areas creating a chronic long-term debilitating condition. Rest is the course of action.

    Q: My son is experiencing severe, inner thigh cramping. He is involved in sports. I'm worried that he may experience one of these flair ups during an event. The last episode lasted 20 minutes

    A: If it's a muscle cramp, stretching will help. Also, make sure that he is drinking 4 to 8 glasses of water a day as recommended. Low potassium can trigger muscle cramps as well. Bananas are a good source.

    As for the stretch, we have a special section under Online Books on the website to address this. Go to Stretching. Then click on Performing Splits on the left panel under the Stretching Techniques category.

    Doing the same stretch techniques for performing splits before the event should loosen the muscles in that area. However, stretching before an event too much may decrease short term performance.