Tuesday, May 7, 2013

Knee Pain Treatment - Collagen Did The Job For My Mum


My Mum is over 70 years old. She has been suffering from knee pain for many, many years. It's osteoarthritis, where the cartilage padding her right knee joint has slowly worn out over the years. Much like a car's tyre, through daily wear and tear, the tyre gets worn out. Easy - get a new tyre to replace the old one.

Not quite so easy with our knees. My Mum went through a lot of angst. She used to take glucosamine in her early 60s. She didn't experience much side effects but she also didn't recover. In fact, it got worse. She started limping. After a while, she could only walk down the stairs one step at a time, holding on to the railing. She started going to Tung Shin Hospital 2 to 3 times a week to seek acupuncture and Chinese tui-na therapy. The results were not encouraging. This form of knee pain treatment wasn't working and the injury continued to get worse. Trips for holidays overseas had to be cut down. It was so bad my Dad bought a leg brace for her to ease the pressure on her knee. But she wore the brace only intermittently. It's clunky and uncomfortable.

Knee replacement surgery was considered - a last resort form of knee pain treatment. But always set aside, because half of her friends reported positive results but the other half came out of the operation worse off.

And so 1 year dragged on to the next. Until 2 years ago, when I came to know of a collagen product called Vitaking. The collagen "helps in the repair and replenishment activities of the cartilage tissues to promote the renewal of bone tissues, protect the joints and preserve the skeletal health." At this stage where she did not have much options left, she desperately gave it a try.

She started by taking 3 sachets/day for a few months. After about 6 to 9 months, we noticed amazing improvements. Now she doesn't go to the hospital anymore, she doesn't take the glucosamine anymore, she doesn't use the leg brace anymore, she doesn't need to hold on to the stair railings anymore. Looks like she's finally found a workable knee pain treatment solution.

What are the "side effects" of Vitaking? She has much more energy now. She has received numerous compliments on her facial complexion as it is smoother and more radiant. To me, that's the sign of a quality collagen product.

Anyway, now my Mum takes about 1 to 2 sachets/day for maintenance.

I'm really thankful to come to know about this Vitaking collagen. Because her time is not bogged down with knee pain treatment and her movements are not hindered by the pain, my Mum can do all her usual daily activities with greater ease - going for her morning walks, going to the market, meeting up with her friends etc. And the best part is, she doesn't need to go through the trauma of a knee replacement operation.

How to Manage Your Arthritis Flares


Even when your arthritis is well-controlled, it's still possible to have a flare-up. Arthritis symptoms will get temporarily worse after a time of being less severe. When you experience a flare-up, a joint or joints may swell or become more swollen; you may even feel more pain and stiffness, especially in the morning; then your body may feel more fatigued. When you have all these things happening at the same time, the flare-up is considered more serious. There are ways to deal with your flare-ups, here are three steps you may want to take to help yourself when you have an arthritis flare-up.

Step 1: Recognizing what is happening, when it's happening.

The first step to managing a flare is to first recognize when you are having one. If you can identify that you are having a flare-up then it becomes easier to start managing it. Being aware of your body and how it feels and learning to pay attention to how arthritis affects your body makes it easier to see if there are any changes, then you will be able to recognize it. When you realize there has been a change, admit it, don't go into denial and hope that everything will just get better on its own. It doesn't.

Step 2: Find the reason for the flare-up

Once you've recognized that you are having a flare-up, the next thing and the important thing is to find out why it happened. In most cases flare-ups have no cause and are just part of the natural cycle of arthritis, but sometimes they do have triggers. Managing the symptoms of the flare-up may be controlled by what you think the cause is. By recognizing what stresses there are in your life, you may be able to change them and then you'll be able to lessen the severity of the flare-ups or at best prevent future ones from happening. This information can be very helpful for you and your doctor.

There are other possible triggers for your flare-ups, those being, not taking you medications the way your doctor prescribed, overdoing activities and not getting enough rest, over using certain joints, or experiencing a general worsening of your conditions. Some people think that the weather can trigger their flare-ups. Here are some of those triggers.

Medicine: A flare-up can occur when you are not taking your medicine the way your doctor has prescribed. Some people are afraid of the side effects and try to reduce the amount they are taking or they will even stop taking the medicine all together, even when they are still experiencing symptoms. There are others who will start to feel better and will either stop taking their medicine or forget to take it. Either way not taking your medicines will have serious affects, such as increasing the risk of permanent damage to the joints.

Overdoing it: Overdoing some of your activities and becoming too fatigue, can also bring on a flare-up. On the days that I was feeling really good, I would try to cram everything I could into those few hours I knew I had before I would start to hurt and be totally exhausted. I would always end up paying for it for the next few days. That's why it's important to have a clear idea of what is too much for your body to handle. While exercise and activity are very important, it is also important to balance them with rest and avoiding tiredness as much as possible is a key part of your arthritis treatment. It took me nearly five years before I was able to figure out how to pace myself whenever I did an activity. I also have to pick and choose what I will do based on how long I am going to be down after I do it.

Over using your joints: When you overuse one of your joints, you can cause your arthritis to flare-up. And believe it or not there are many ways to overuse a joint or joints. If you have arthritis of the hands, doing an activity that is too hard on your hands, such as hammering, opening up a jar, or even washing all your homes windows in one day, can trigger a flare-up in the hands. If you have arthritis in your knees, you might have flare-ups if you are on your knees for any length of time. In both of these cases, the swelling may occur any time from soon after the activity to a few days later. When there is swelling in a joint, you will want to look back to see what it was you were doing before the swelling started.

Other triggers: As mentioned earlier in this article, stress can contribute to flare-ups; in addition, some people find that certain weather conditions, such as humidity, can cause increased joint pain. The weather itself isn't what causes the joint pain to be worse but it can make the joint discomfort more obvious. Finally, a flare-up could be a sign that your condition is getting worse. If you have a flare-up that just won't go away, contact your doctor and see if there is a more effective treatment he can put you on.

Step 3: Fighting the flare-up.

The third and final step to managing your flare-ups is the action you take to relieve the pain and inflammation. The following are known to be effective. Do a medicine check. If you haven't been taking your medicine as prescribed, it might be a good idea to get back on track. If you stopped taking your medicine because you think it is causing unwanted side effects, contact your doctor and he should be able to make changes in your medicine. If you are having trouble paying for your medication, your doctor should be able to help you find another way to pay for them or prescribe a less expensive medication. With the growing numbers of people unable to pay for their medications, many of the drug companies have programs that will greatly reduce the cost and if you qualify, you may be able to get them for free. Whatever your reasons were for stopping, it's best to not let it continue for too much longer. Getting back on a regular schedule with your medications will cause the arthritis to respond once again and calm down. Check in with your doctor. You should have already worked out with your doctor, what is the best way to stay in touch in case you should have a flare-up. Some doctors, especially if you are newly diagnosed, prefer that you come in to see them, while others prefer you use emails or the phone. To treat your flare-ups the doctor may change the dose of your medicine, give you a new medicine or advise you on different techniques to reduce your symptoms. You and your doctor can also work out a plan for changing or adding medicines or making other changes to your program that you can do at home before checking in with your doctor. I talk to my doctors all the time and I was given the go ahead to take more than two Tramadol if I need to when my pain is over the top.

Using cold or warmth: If you have one or two joints flare-up, putting ice packs or running cool water over them a few times a day can help reduce the pain and swelling. There are some people who can't tolerate the cold and prefer warm moisture instead. Hot packs, heating pads, paraffin wax baths, warm tub baths, showers, or warm-water pools can all help the joints to feel better. I have used the hot wax baths and I feel that this has helped in keeping my finger joints from becoming twisted and enlarged. My pain and swelling seem to get worse no matter whether I use hot or cold treatments.

Resting your body: During a flare-up, getting plenty of rest will help the medicines you are taking do their job. Doctors usually recommend a good night's sleep, at least eight hours, and additional rest in the afternoon, if possible. During the past 12 years of having arthritis, I hardly ever got eight hours of sleep and on those nights when I didn't sleep or my sleep was intermittent my pain levels are out of this world. My doctor prescribed medication to help keep me asleep and now I hardly ever have pain. Alternating rest and work is another good plan, as long as you stop working before you get too tired. You might want to think of a flare-up as a good time to just be good to yourself and do nothing until you are sure your flare-up has passed.

Resting your joints: Always be careful to not overuse a swollen joint, avoiding aggressive or repetitive activities. This would include some exercises. It would be best to suspend any strenuous exercise routines during an arthritis flare-up. When the swelling has subsided you could continue your exercise program and normal activities.

Doing range-of-motion exercises: Although, you should sustain from strenuous exercise during a flare-up, you should do light range-of-motion exercises. When you do range-of-motion exercises you are putting your joints through its normal range of motion, without stretching or forcing it. You should not force swollen joints to bend too much and you should stop when you experience a lot of pain. You need to make sure the joint stays as flexible as possible during a flare-up because this will help to preserve the joints range of motion and prevent long-term stiffness.

Pacing yourself: Be sure to take your time when you do activities during a flare-up, conserve your energy. Do a little bit each day instead of trying to do everything in one day and then not be able to anything the next. The temptation to do everything in one day, when you are feeling good, is very hard to not do, but the rewards are less pain and stiffness. That's why taking your time doing activities is so important. I still haven't mastered this. It seems that when I am having a flare-up everything I need to get done piles up and then I try to play catch-up when I do feel good. But I can't stress this enough, take your time. You might want to consider getting a joint injection. During a flare-up, if you have one or more joints are very painful and swollen, you may be able to get an injection from your doctor. You may be a candidate for a cortisone injection in the joint, which can reduce the swelling and relieve the pain you are experiencing. Your doctor will determine if you would benefit from a joint injection and will give it to you in his/her office. After your injection, the doctor may want to reevaluate your medications and make changes as needed. I have had these injections across my shoulders and it's been a year since my last shot. I no longer have the pain and stiffness in my back and neck area.

Ask for help when you need it. It may be time to ask for help when you are having a flare-up and you are unable to do a project or just need help with your everyday chores. These tasks can be overwhelming and very possibly harmful to your swollen joints. I know that asking for help can be a very hard but you should consider the damage to your swollen joints if you attempt to do these things when you are having a flare-up. I am the worst when it comes to asking for help. I always thought that it was an admission that I was giving up. It wasn't, it was a smart thing to do because it allowed me to preserve my joints and my energy. Avoid doing a "worst case scenario." Try to stay calm and not worry when you are having a flare-up. Just because your joints are swollen again, doesn't mean your flare-up is going to be a permanent change. More than likely it probably will be short-lived, please avoid the "worse-case" scenario, because negative thinking will cause more stress which then will cause your flare-ups to be more painful. All you can do at this point is to remind yourself that you are doing all you can do to improve the effects of your life with arthritis.

Manage your stress: Stress can be a major reason for your arthritis flare-ups and managing the things that cause you stress can only help with your pain levels. I know that it isn't easy to eliminate your stress but even if you can reduce just a small portion of them, it will have an impact. There is one way to start and that is to try changing how you think about the stress in your life. You may become stressed at the signs of an arthritis flare-up, which can actually make it worse. But if you remember that arthritis does have ups and downs, you can have an impact on the flare-up. Your confidence in yourself and your doctor's ability to manage your flare-ups will increase and as it does, your flare-ups will decrease.

Yoga, deep breathing exercises, and meditation can also help to combat stress and are more effective if you practice them on a regular basis.

Using assistant devices: You might want to consider using assistant devices to avoid causing a swollen joint more pain and discomfort. This can make it easier to do any painful chores or other activities. There is a very wide range of assistant devices that can make it easier to hold a pencil, or even do the reaching for you to get something off of a high shelf, to simple canes and crutches. You might need these devices all the time but it is nice to have them around just in case you need then during a flare-up.

If you work, a flare-up can affect your ability to do your job. When you have a flare-up that is making it difficult for you to do your job and it doesn't seem to be settling down in a few days, get to your doctor early and discuss your work issues. You may find it helpful to take a few days of vacation until your flare-up has subsided and this will allow you to get the rest you need to heal. If you haven't told your employer about your arthritis, now may be a good time to do so. Simply explain that you have your arthritis under control but that on occasion you will have a flare-up that may require you to take a few days off to get through it. Doing this will put you into the position to request some small accommodations. But also remember that your employer, no matter how understanding they are, expect you to do the job you were hired for and to be at work.

Be sure to communicate to your doctor and his staff exactly what is going on and how worried you are so that you get an appointment as soon as possible. When you receive good treatment, the flare-up may be short-lived, and your arthritis will remain under control. When this happens you will then be able to return to your job and to your regular activities and hobbies.

Monday, May 6, 2013

What Is Virtual Surgery and How Does This Benefit Patients?


If you're preparing for surgery of any kind, or if a loved one will be operated on, chances are good you're nervous - maybe even terrified. And the anxiety keeps building from the time you schedule the surgery until the moment the anesthetic starts to take effect. The anxiety stems from uncertainty. Things could go wrong, you may not have a clue as to how the procedure is performed, and you have no idea what is going on inside your body before, during and after surgery.

The Importance Of Being Positive and Calm

The patient's mental and emotional state of being needs to be as calm and positive as possible before and after the surgery. Many people prefer not to know what happens in their body because they are squeamish about it, but ultimately, knowledge of what to expect can have a powerful calming effect - especially if the patient feels a sense of control.

Technology has come to the rescue! If you want to know what the surgery is going to be like, try virtual surgery!

What Is It?

Virtual surgery is a virtual reality simulation of any number of surgical procedures including laser hair removal, open heart surgery, root canals, gastric bypass, tonsillectomies, knee surgery, c-sections and more - even tattoo removal! You can find a number of sites that have great interactive virtual surgery "games" where you take the part of the surgeon and perform the procedure. Of course you're guided through it the entire way!

Become Your Own Surgeon Temporarily

The beauty of virtual surgery is that the patient becomes the surgeon and assumes control of the situation. In some games, the procedure begins with an explanation of the procedure, important safety guidelines and familiarization with the people involved and their duties. This empowering feeling can carry over to the actual physical procedure. The patient will be informed, and much more relaxed about the whole thing.

With all the virtual surgery sites available to choose from, which ones are the best?

Well, it depends in part:

  • on your knowledge of anatomy

  • whether you're squeamish, and

  • whether you prefer to experience the surgery as cartoon representations, or

  • more realistic virtual body parts

Most sites are geared to the public; a few to the medical profession.

On the interactive "virtual surgery games" sites, procedures are simplified for the general public and generally don't show blood.

My only complaint is the oversimplification of some procedures, which may make the user believe that surgery is a piece of cake.

Wrong!

There are many intricate systems at work in the body, and virtual surgery can't possibly replicate them all (at least not with today's technology). That said, these games are very entertaining and educational at the same time.

Be Prepared

Being educated about what's going on in your surgery or the surgery that a loved one will undergo, will put your mind at ease. It will give you enough information to talk to the surgeon and understand the terminology during pre-op consultations, and educated post-op conversations.

Understanding the magnitude of the trauma that any surgery imposes on the body is important for healing, too.

Many people try to do too much, too soon (that's easy to do, when the pain mediation has kicked in!). Some surgeons suggest that their surgery patients should be encouraged to play virtual surgery games so that they understand how much trauma occurs and how much healing the body has to undergo after surgery, in hopes of preventing post-operative problems and speed healing.

The Value of Virtual Surgery

Perhaps the biggest benefit to virtual surgery is the ability to put the patient's mind at ease about the procedure.

A stressed mind impairs healing. If a patient can release stress by knowing what to expect, their mind will be more primed for healing and less worried about the "what ifs" that keep the brain on high alert. This is important both pre-op and post-op; a relaxed brain quickly goes into healing mode and becomes very effective at secreting healing substances - unless it's stressed, in which case healing is put on hold.

Try a virtual surgery game today! They're fun, educational and will put your anxiety about surgery to rest!

A Guide to Boxing


Boxing can be traced back to the 3rd millennium BC from ancient carvings found at historical sites. The range of punches has not changed too much since then. However the way in which they are delivered, in my opinion, is now more clear and accurate in this day and age. The main punches we have are straight, hook, uppercut and over hand. If we bring Muay Thai into the picture we also have the spinning and flying punches.

I would like to take this opportunity to briefly describe each punch and some tips on performing them. Before we get into this I would like you to realise something. Regardless of the type of punch you are throwing the power comes from the floor. If you are off balanced or have your feet in the wrong position on the floor this will reflect in your boxing.

The positioning of your feet on the floor depends on your discipline. For Example, if you are a traditional boxer then you tend to stand side on, because that way you can generate more power for your rear shots and you can make your body a smaller target for body shots. However if you are a Muay Thai boxer you tend to stand more square on, because you need to block those low kicks; as a rule of thumb with Muay Thai your feet position should be able to pass a football between them both from the front and the side. Now that we have got that out of the way lets talk about the different punches.

The Jab

Perhaps one of the most used punches in boxing. It is generally used to keep your opponent at bay or set them up for a power punch or a combination. The jab is a straight punch and when you perform it there are a few things that you should be aware of: (1) ensure your feet position is solid on the floor. The weight should be on your front foot. Also make sure that your rear foot is still on the floor otherwise you will lose power and be off balanced, (2) when you throw the jab ensure that it is straight and direct to your opponent. Your shoulder should come forward to cover your chin. The elbow should be slightly higher than the shoulder when you turn the punch in and your knuckle (the two big ones) should be connecting with your target in a slightly downwards motion. The downwards motion with your knuckles is important, because this is what will knock someone out rather than just pushing them back; and lastly (3) the jab is a quick punch and should be snapped in and out at the same speed for maximum effect. Sometimes doubling it up to keep the opponent at bay or just to give you that fraction of a second to setup your power shot or your combination is a good call.

The Back Hand (Right Cross if you are Orthodox or Left Cross if you are Southpaw)

This punch is probably the second most used punch after the jab and is often used to knock an opponent out or seriously hurt them. To perform this punch effectively it doesn't differ too much to the rules of the jab: (1) again ensure that your feet are firmly planted on the floor. The weight again will be on your front foot, but this time you will be pushing of the back foot when performing the punch. You should be on the ball off your foot on the back foot pushing forward. Similarly to when you just get ready to sprint or run, (2) when you throw the cross again ensure that it is straight and direct to your opponent. Your shoulder should come forward to cover your chin. The elbow should be slightly higher than the shoulder when you turn the punch in and your knuckle should be connecting with your target in a slightly downwards movement; and (3) whilst this is considered a power punch all your boxing should go in and come out at the same speed. I have seen it before when people have thrown the right cross and were slow to bring the hand back to their guard and they got caught. This is sometimes a physiology thing with the boxers, because they think that their punch is harder enough to fell an elephant, but when they don't knock the guy down (due to the opponent been pumped with adrenaline) it's usually too late and they get caught, because they were that split second too slow to return the hand back to their guarding position.

Hook Punches

The hook punch is probably the second most powerful after the right cross. It can be used as a single punch or in a combination. The hook punch can be performed in two different ways: (1) the side of the hand when connecting stays horizontal and you attempt to connect with the two big knuckles; or (2) the size of the hand runs parallel to the ground and you connect with the two big knuckles. Both ways are correct and it's usually up to personal preference which way you want to perform the punch. Personally I prefer the latter because when fighting without gloves there is less chance you are going to break the two small knuckles on your hand if you happen to be slightly off with the punch.

After you have decided which way you are going to perform the punch you should be aware of: (1) your foot positioning. The way your feet are positioned will depend on if you are throwing the hook from the front or the hook from the rear. If you are throwing the hook from the front then your front foot should pivot and the weight will be on the back. If you are throwing the hook from the rear then you should step slightly to the side in the direction of which the punch will travel. For Example, if you are throwing the right hook from the rear you should step slightly to the left and vice versa for the left hook from the rear. In addition you should find your rear foot pivoting slightly when throwing the punch from the rear, (2) the position of your arm should be at a 90 degree angle. You should be punching away from yourself at around 10 inches away from your face. Don't punch into yourself; and (3) for this punch to work effectively the tips mentioned in (1) and (2) must work seamlessly. What I mean by this is that your feet, knees, hip, torso and arms need to turn in one fluent motion.

The Uppercut Punch

Perhaps not one of the most used punches we see in boxing. Mainly because it can be difficult to get through the opponent's guard. However if timed and performed correctly it can knock an individual out or cause a lot of damage. It can also be used to setup an opponent up for that powerful rear hand. There are a couple of things to be aware of when performing this technique: (1) the power on this one definitely comes from the floor. You should be bending your knees and come up (straightening them) at the same time you are connecting with the punch, (2) similar to the hook punch make sure that you punch away from yourself and not into yourself; and (3) aim to connect with the two big knuckles on your hand.

The Over Hand Punch

Often mistaken for a straight punch because some boxers are not clear in the delivery of the over hand punch. This punch is a combination of a straight punch and a hook punch. Sometimes this punch is referred to as a bowling punch. The delivery of this punch is very similar to a straight punch. However the main difference of it is that the aim of it is to come over the opponent's guard and connect with his temple. The way it is performed is as I said like the straight punch, but instead of throwing it straight you bring your elbow up a little higher which will make the punch come over the top of your opponents guard.

The Spinning Punch

This punch I never knew existed until I started training MuayThai. It is a very rare punch to see, but the power generated by it is unbelievable. This punch is quite a difficult one to describe, but let me have a go. As the name suggests it's a spinning punch, so it does involve a bit of footwork to pull this one off. For Example, if you are want to do the right spinning punch. You will step across the centre line that runs down your body with the left foot and come up on the ball of the foot on that foot. You would then push off the floor with the right foot enabling you to spin. At this point you will straighten your arm like a bar keeping it parallel with the floor. You should be aiming to connect with your opponent with the backhand or the side of your hand. The side of your hand is actually safer when not where gloves, because it reduces the risk of breaking the small bones in your hand. If you want to perform the left spinning punch just follow the before mentioned instructions but vice versa. Just ensure that you finish in your original guarding position (you need to spin a little more). Otherwise you will leave your leg open for a low kick.

The Flying Punch or Superman Punch

This punch is essentially a straight cross. However the difference is that when you connect with it you are off the floor. As I mentioned at the start of this post the power comes from the floor with boxing, but this is the only punch which is the exception to that rule. The power for this punch is generate by a kicking back motion. For Example, if you want to perform the right flying punch you would take a couple of steps forward ensuring that you are in the orthodox position after them (if you are right guarding) you would then bring up your right knee and perform a small hop with your left leg whilst kicking back with the right leg and extending the right arm in accordance with performing the right cross instructions. To perform the left flying punch requires a little bit of footwork. It is essentially the same as the right flying punch. However after you have took your few steps to create the momentum you need to end up in southpaw (if you are Orthodox). You will then lift the left knee up and kick back whilst extending your left arm in accordance with the instructions of how you perform a straight punch.

I hope you found this guide informative and interesting. Please feel free to login and comment and share this post with your friends by using the social networking buttons below.

Arthritis Treatment: Injection Therapy for Osteoarthritis of the Knee


The most common form of arthritis is osteoarthritis (OA). It affects almost 30 million Americans and the incidence is expected to rise with the graying of the Baby Boomers.

OA is a disease that affects the hyaline articular cartilage of joints. The exact mechanism of disease development is still being researched but there appears to be a trigger that causes a metabolic abnormality to occur. Cells, called chondrocytes, inside the cartilage begin to elaborate destructive enzymes which cause the surrounding matrix to degrade. In addition, inflammatory changes involving the synovium- the lining of the joint- contribute to further cartilage damage.

OA affects primarily weight-bearing joints such as the neck, low back, hips, and knees. I will focus on the knee.

Treatment for OA of the knee is primarily symptomatic. This involves the use of exercise, weight loss if indicated, patient education, analgesic medications, non-steroidal-anti-inflammatory drugs (NSAIDS) - either oral as well as topical, and injections.

The most common type of injection given for OA of the knee is a corticosteroid ("cortisone") injection. These are effective for reducing pain short-term and also helping to improve quadriceps muscle strength by reducing the inhibition of quadriceps reflex due to the presence of inflammation and swelling. Usually fluid is withdrawn from a swollen joint at the time of corticosteroid injection.

Corticosteroid injections are usually given to patients who are already taking oral medications such as NSAIDS. These injections may be given as often as three times a year. More often and they can actually cause more cartilage damage.

The second type of injection is hyaluronic acid. These types of injections are often referred to as viscosupplements since they are used to reduce pain but also provide a lubricating quality as well. Some preparations are derived from rooster combs and others are synthetically manufactured. There are many different formulations available. Despite claims that one product is superior to others, there is no concrete data that one preparation is superior to others.

These injections are often used as a last-ditch effort to help patients avoid having to undergo knee replacement surgery. As with corticosteroid injection, withdrawal of joint fluid always precedes injection of the viscosupplement.

Whether the injection is corticosteroid or hyaluronic acid, each needs to be administered using ultrasound needle guidance in order to ensure proper delivery of the medication to the joint space. Reports of inadequate response to these preparations probably are more related to poor injection technique rather than to the shortcoming of the medication.

Six-Pack Abs Muscle Building Program


Before we get into the exercises, let's get one thing straight. If you have a layer of fat around your midsection then you'll never see your abs. You could have the best six-pack in the world, but no one will ever know it if it's obscured by fat. If this is the situation you're in, you need to first focus on losing fat by cleaning-up your nutrition and getting on a solid muscle building program.

With that disclaimer out of the way, let's get to some ab-ripping exercises!

Exercise #1: V-ups

Lie on your back on a semi-soft surface. A thin mat on a hard floor works well. Straighten your legs and raise your arms overhead. With your knees straight, raise your feet a few inches off the floor. This is your starting position.

From this position you are going to simultaneously raise your legs up and sit up with your upper body. This is basically a combination of a leg raise and a crunch. In the top position you should touch your toes with your fingertips, or at least come very close.

From this position you reverse the motion and go back to the starting position. Remember that in the starting position your feet are off the floor. This keeps constant tension on the muscles, making this exercise even more effective.

Exercise #2: Hanging Knee Raises

You'll need a chin-up bar or other object you can hold on to without your feet touching the floor. Your starting position is simply hanging from the bar with your arms straight.

From this position, bend the knees and bring them up towards your chest. You want to bring your knees as high as possible. In fact, if you are strong enough you should curl up into a ball by leaning back slightly and bringing the knees up as high as possible.

Don't make the mistake I see most people in the gym making. Most people bring the knees up and then stop when the thighs are parallel to the floor. If you do it this way you only get about 10% of the benefit from the exercise!

When you get really advanced you can do these with the knees straight. From the starting position you raise your feet up all the way until they touch the chin-up bar. You should see the looks you get at the gym when you do these!

Exercise #3: Ab Wheel Rollouts

Remember those "ab rollers" that used to be on all the late-night infomercials? Well, these were just knock-offs of the old school ab wheel you can buy for $10 at any fitness store. If you haven't seen this before it just looks like a small wheel with a stick through it. If you can't find one of these, you can simply use a bar with a plate on each side.

Kneel on the floor with the ab wheel in front of you. Hold on to the handles and put the wheel on the floor directly in front you. From here you simply roll the wheel out as far away from you as possible.

The key here is to make sure you don't roll-out so far that your back arches. If your abs aren't very strong then you won't be able to roll-out very far without this occurring. This puts all the stress on your lower back and off of your abs. This is dangerous and ineffective. Only go as far as your current abilities will allow you to maintain the proper position.

When this becomes easy, you can move on to the super-advanced version. For this version you stand on your feet and bend-over to hold the handles of the ab wheel. From this position you roll-out as far as possible. This is much more difficult from the kneeling version.

Summary

These exercises should be complimented by a well-designed muscle building program for the entire body. Remember that one exercise isn't the answer to achieving your goals. A complimentary training and nutrition program must be designed with your goals in mind.

Arthritis Pain Medication - Dosage Help for The Elderly


Some older people with osteoarthritis discount their pain and are reluctant to take pain relievers. A study of the use of pain medications and seniors indicates that they often have a negative attitude toward the drugs. They frequently don't follow the instructions for use, choosing instead to downplay their pain. As a result, many suffer needlessly. I know I observed my elderly mother behaving this way, and I became curious about other elderly people.

Researchers conducted in-depth interviews with men and women ages 67 to 92, who had severe hip or knee osteoarthritis. They asked the study participants to gather all their prescription and nonprescription medications and then discussed the doses and timing of each. The researchers posed such open-ended questions and as:

What does your osteoarthritis feel like at this time? What are you doing for your osteoarthritis? What other medications are you taking? Do you take your medication in the way your health care professionals suggested? Why or why not? Do you take your medications regularly? Why or why not?

Most participants took medications for other conditions too, but they viewed painkillers as different. They were reluctant to take pain pills and often didn't follow label directions. Although the participants generally follow the instructions on their other medications, most purposely took pain relievers less often than recommended or at lower doses.

The interviewees also followed different medication behaviors when it came to pain relievers. The elderly men and women did not place painkillers in their pill organizer along with their other medicines. One woman filled her prescription for an opioid pain reliever, and then threw away the bottle. Another recorded how many acetaminophen tablets she took each day and put lower dose acetaminophen in the bottle for the extra strength product. Some took less pain medication when it was about to run out, although they did not do this with other medication.

What reasons did people give for not wanting to take pain medications or for cutting back on dosages? Most said that they didn't like to take pills, although several of them took many pills each day, plus dietary supplements. Several feared addiction. One participant referred to a common opioid pain reliever as a hard drug and said it reminded her of drug use on the street. Others had similar concerns, noting that taking pain relievers had become a habit more than a necessity.

Yet some of the participants hold friends and family to a different standard, scolding them for not taking their pain medications as described.

Many of these older people with osteoarthritis dismissed their pain or made light of it, even though pain restricted their activities. They claimed that at their age paint was to be expected. That's how you know you're alive, one man remarked. Several others justify taking less pain medication than prescribed by claiming to have a high tolerance for pain. Or they expressed the need to fight the pain and not give into it. Many participants said they would take pain relievers only if the pain became very bad.

The researchers noted that noncompliance with pain medication may indicate a person's refusal to accept that arthritis - associated pain warrants treatment. As a result, doctors may want to omit or clarify the instruction "as needed" on pain medication.

Also, educating older people with osteoarthritis about the safety of opioid avoid pain relievers and the need to take all pain medications as directed may relieve their concerns about addiction and improve their quality of life.