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Issue Date: December 2009


Stay Healthy, Live Better

Whether you’re hoping to jump-start a stalled exercise regimen, need advice for how to cope with a sudden job loss or just want to avoid catching this year’s big bug, local experts share their advice for building a healthier life for you and your family.
Lynne Thompson
editorial@clevelandmagazine.com
// HOW TO: DEAL WITH H1N1 //
Dr. Tom Tallman, Cleveland Clinic

The symptoms are unremarkable: fever, cough, sore throat, aches and pains. But swine flu, more correctly known as H1N1, has remained in the headlines since the first major outbreak in Mexico last spring.

Dr. Tom Tallman, chairman of the Cleveland Clinic’s Emergency Preparedness Committee, explains that this strain of Influenza A is worrisome not only because it is so contagious but also because the seasonal flu vaccine offers no protection against it. Young people ages 6 months to 24 years are particularly susceptible. Experts speculate that older adults — those typically among the most vulnerable to seasonal flu — acquired some immunity to H1N1 from bouts with viral predecessors, particularly variants of this flu identified and treated in 1976 and 1957.

“Younger patients have not experienced H1N1 and, therefore, have no immunity to it,” Tallman says.

As a result, people who never worried about getting sick are flooding hotlines and Web sites with questions. Tallman offers the following advice for staying healthy and dealing with H1N1 if you get it.

Don’t panic. //// “People are getting sick, but they’re getting better,” Tallman says. He notes that many people who died of H1N1 or complications from it had a pre-existing health problem.

Get the H1N1 vaccine. //// Tallman lists five groups considered a priority for immunization: children and young adults, pregnant women, health care workers, those caring for babies under 6 months of age and anyone with a pre-existing health condition such as lung disease, heart ailments or a compromised immune system.

Two forms of the H1N1 vaccine are available: an injectable and a nasal spray. Although both are considered as safe and effective as the seasonal flu vaccine, Tallman says the injectable vaccine is a must for pregnant women, those over 49 or those with pre-existing health conditions.

“For most people, one shot is going to be effective enough to give their immune system the ability to kick H1N1’s butt,” Tallman says. “It takes one to two weeks before your body produces antibodies that protect you. It’s not instant, but it doesn’t take long.”

Take the usual precautions. //// You know the drill: Eat right, get plenty of sleep, exercise regularly, cover coughs and sneezes with your forearm, avoid touching your eyes, nose and mouth, frequently wash your hands for at least 20 seconds using soap and water, and use alcohol-based hand sanitizers between washes. “You’ve got to make sure you cover the surface of your hands completely,” Tallman says. “Some of the liquids are easier to use than foams and gels.”

Stay home if you feel sick. //// Don’t try to be a hero and drag yourself to work or school. Because H1N1 is the most common flu strain around this season, you can safely assume you’ve caught it if you’ve got flu-like symptoms. If you share a home with others, confine yourself to a single room, and use a separate bathroom if possible.

Tallman urges employers and school officials to relax policies on absenteeism during this flu season. Those who insist employees and students return before they’ve fully recovered from H1N1 — usually five to seven days or 24 hours after a fever breaks — might do more harm than good to their organizations.

“With greater numbers of employees, students and teachers sick, you’re going to have problems maintaining operations,” Tallman says.



// HOW TO: RAISE COMPASSIONATE CHILDREN //
Dr. Carolyn Landis, Rainbow Babies and Children's Hospital

Most parents assume they’ll raise kind, loving children, the sort of kids who rescue kittens from trees, carry bags of groceries for old ladies and support friends and classmates through everything from that first day of preschool to senior prom. But compassionate children don’t just happen. They need examples.

“What we’re talking about is the development of empathy,” says Dr. Carolyn Landis, a clinical psychologist at Rainbow Babies and Children’s Hospital and assistant professor of pediatrics at Case Western Reserve University School of Medicine. “And one of the main ways to encourage it is to demonstrate it yourself.”

Listen. //// The simple act of listening attentively, perhaps while you’re driving the kids home from school every day, shows them that you truly care and encourages them to do the same for others, Landis says. When your child talks about seeing kids being bullied or teased or struggling in some other uncomfortable situation, ask how he or she would feel in their place.

Accentuate the positive. //// Limit your own negative comments about others even if the subjects aren’t within earshot. “If you’re saying unkind things about other people, that’s what your child is learning,” Landis says. When your children express strong dislike for classmates or teachers, ask them to think of something they actually like about the person. “Kids see things in black and white,” Landis says. “This helps them see people in a more nuanced way.”

Practice kindness to animals. //// Don’t hit, kick or otherwise physically abuse pets or livestock and wild animals even if the latter are being raised, hunted or trapped for food.

“Praise your children when they’re being kind and gentle to animals,” she urges. And watch the tone you and others use when talking to pets.

“I don’t know how many times I’ve been in homes where people are screaming at the dog,” Landis says. “This is not a good model for how to treat animals or each other.”

Support anti-bullying programs at school. //// These sessions, which teach kids how to treat one another with kindness and respect, reduce the likelihood that they will bully and fosters their ability to stand up to those who do. “It changes the whole culture of the school,” Landis says.

Teach your child not to become a target. //// Many insensitive brutes were once victims of the actions they perpetrate, Landis says. To reduce your children’s chances of being picked on or excluded, encourage them to hang out with like-minded kids who treat them kindly.

“Sometimes kids try to push themselves into groups that are not as welcoming,” Landis says. Help them understand that every not-so-nice comment (“You still have a Disney Princesses lunchbox?” “Why are you wearing that ugly green sweater?”) shouldn’t be taken personally.

“Throughout life, people are going to question our choices and not agree with us,” she says. “You have to be secure in what you like. If every little thing bothers you, you are more likely to be a target.”

What To Do If Your Child is the Bully
Parents should expect to deal with an insensitive misdeed or two, Landis says. “Every child is probably going to do something that could be perceived as bullying,” she reassures. “Some of it is just learning to negotiate social relationships.” But if your kid is getting a reputation as the neighborhood menace, take action immediately.

  • Discuss the problem. Talk to your child and determine whether his or her actions are provoked by some threat, real or imagined. If so, help devise an acceptable response, such as ignoring the instigator. “A lot of these incidences aren’t happening in isolation,” Landis says.

    Emphasize the consequences of bullying, such as alienating peers, and offer a small reward for improved behavior — say, renting a DVD of the child’s choice after each week that passes without a complaint from a principal, teacher or neighbor.

  • Get professional help. If your child’s bullying behavior persists, consider taking him or her to a child psychologist for evaluation. Bullying could be a symptom of Attention Deficit Hyperactivity Disorder or some sort of impulse control problem.

    “They don’t stop and think, What should I do? They just do it,” Landis says. “Depending on how severe the problem is, these kids might need some special help” — counseling, medication, increased supervision and/or participation in a social-skills group. Seek help immediately if the child is harming animals or voicing thoughts of suicide.

    “You have to take those things seriously,” she says.



// HOW TO: COPE WITH THE LOSS OF A JOB //
Dr. Lori Stevic-Rust, Lake Health System

It’s one of life’s most stressful events, right up there with divorce and the death of a loved one. In the past two years, millions of Americans have experienced the anger, fear and financial hardship that results from losing a job.

But, incredible as it may sound, there might be an upside to the predicament. Clinical health psychologist Dr. Lori Stevic-Rust, director of integrative medicine for Lake Health System, encourages out-of-work clients to look at unemployment as an opportunity.

“When you’re in the midst of a 9-to-5 job, there’s really no time for reflection,” she says. “Really look long and hard at yourself and ask, ‘Is this where I want to be?’ If the answer is ‘No, I ended up in a trap because I had to pay the bills,’ now you have that chance to pursue your passion.”

But to truly take advantage of this time, you first have to cope with the hit you’ve just taken.

Mourn. //// Although necessity might dictate that you begin searching for a new job immediately, try to take at least a day or two off to come to terms with the job loss. Don’t spend too much time wandering the house in your bathrobe, though. “That can very easily turn into a state of depression,” Stevic-Rust says. Signs of a problem that requires professional intervention include pervasive self-doubt, self-destructive behaviors such as drinking and using drugs, sleeping and eating too much or not enough, and a lack of motivation.

Release the anger. //// Stevic-Rust encourages expressing anger and other negative feelings to trusted family members and friends. But she advises against ranting about your past employer to former co-workers and business contacts. “The world is very small,” Stevic-Rust says. “Word gets around as to how gracious somebody was as they exited a company.”

Don’t obsess. //// Unlike being fired for poor performance, being laid off or cut because of a decreased demand for goods or services — whether it’s with five or 1,500 other people — isn’t personal. Remembering that simple fact will help allay any doubts about your worth as an employee. Don’t waste a lot of time contemplating why the company let you go instead of someone else.

“You can’t change the fact that they’re still there and you’re not,” Stevic-Rust says. “You grab hold of those things you have control over and let go of the things you really don’t. And what you have control over is polishing up your résumé and keeping a very positive attitude.”

Reassess your strengths and skills. //// Prepare to update your résumé (and boost your ego in the process) by thinking about what you’ve learned and how you’ve grown as a person since your last job search. Doing this singles out talents you have developed, perhaps without even knowing it, Stevic-Rust says. “Work on those skills,” she urges. “If a job doesn’t come right away, look at some extra training. With that comes the opportunity for some networking.”

Take care of yourself. //// This is no time to park yourself on the couch and embark on a steady diet of junk food and daytime television. Eat right, and exercise daily. (You no longer have the excuse of being too busy at work.) Keep your mind sharp by reading up on the latest developments in your industry, and seek counseling if you feel yourself slipping into a depression. “[If you’re depressed], you’re not going to be at your best,” Stevic-Rust says. “Nobody wants to interview somebody who’s in a negative frame of mind.”

Survivor Strategies
What if you’re one of the lucky employees still taking home a paycheck? Stevic-Rust says layoffs often stress those still on the job, too.
  • Realize that you’re not responsible. Understanding that you couldn’t prevent your colleagues’ bad fortune will make it easier to reach out and support them. And taking stock of your unique strengths and skills may help answer that nagging question, “Why them, not me?”

  • Talk to your employer. If the company hasn’t been upfront about your future, initiate a conversation about it. “Anxiety is best managed when you have knowledge,” Stevic-Rust says. “You don’t want to be passive, waiting every day and wondering, Is the letter coming? Is the phone call coming?” Approachthe appropriate person with something like this: “I’m very anxious because I don’t know if there will be another round of cuts. Is there anything you can share with me that might help me understand the direction and goals of the company in the next six months or year?”

  • Be the best employee you can be. Remain as positive and productive as possible. Refrain from trash talking the board of directors, CEO or whomever you feel is responsible for the company’s problems. Also, point out to your bosses any unrecognized abilities you have that will help shoulder your department’s added duties. “It’s not about saying, ‘Look at me! Look at me!’ ” Stevic-Rust explains. “That’s part of your own survival, creating that niche for yourself.”



// HOW TO: JUMP-START A WEIGHT-LOSS REGIMEN //
Cheryl Matey, EMH Center for Health & Fitness

Increased strength, greater endurance, a shrinking waistline — just when you’re feeling pretty good about your weight-loss progress, you hit the dreaded plateau. That’s often the time people call Cheryl Matey, a personal trainer at EMH Center for Health & Fitness in Avon.

“Basically, your body adapts to the stress you put on it,” she explains. “It just tunes it out.”

Changes both inside and outside the gym are necessary to boost a stalled diet and exercise program and get off that plateau. Here’s Matey’s advice for getting your weight-loss plan rolling again.

Rev up your metabolism. //// It’s the biggest key to seeing results. To do it, Matey says you must bump up the frequency, duration and intensity of your workouts.

She suggests exercising four to six times a week, four or five of which consist of 35 to 45 minutes of cardiovascular work. Two or three of those cardio workouts should be devoted to maintaining 70 to 85 percent of your maximum heart rate for three- to four-minute intervals followed by a three-minute recovery period. (Determine your maximum heart rate by subtracting your age from 220.) Invest in a heart rate monitor to track your progress.

“The peak minutes of your cardio are blasting fat long after your workout is completed,” Matey says.

And what if you’re already doing all of that? Matey suggests increasing your workouts by 20 to 30 minutes two or three days a week, even exercising twice daily a couple of times a week.

Also, changing your cardio routine every two weeks prevents your body from adapting to the effort. Instead of spending, say, 30 minutes on the treadmill, get off after 10 minutes, and try 10 minutes on the elliptical trainer and 10 minutes on the stationary bicycle.

“If you’re working toward a specific goal or (to get in shape) for a specific sport, you’re going to want to tailor that exercise to it,” she says.

Pump iron. //// If you aren’t lifting weights, learn how to use the weight machines at the gym. Matey says they are safer than free weights for novices. To prevent fatigue, overuse and injury while maximizing calories burned, focus on different muscle groups on different days — two to three sets of 12 to 15 repetitions to work the chest and back one day, the biceps and triceps the next, for example.

Exercise with a buddy. //// “You want to pick a person with similar goals, experience and accountability, somebody who is going to be your motivator, not your enabler,” Matey says. Avoid anyone who will slow you down or turn your time at the gym into a social hour followed by drinks and appetizers.

Have three mini meals and two or three mini snacks each day. //// “When you eat your calories all at one meal, you’re actually stalling your metabolism,” Matey says. Conversely, eating every four to five hours keeps your body burning calories, stabilizes your blood-sugar level, and curbs your urge to overeat. Ideally, breakfast should be eaten within an hour of waking; dinner or the last snack of the day should be consumed 2 1/2 to three hours before bedtime.

Eat before exercising. //// Matey warns that working out on an empty stomach prevents you from exerting maximum effort. “Low fuel equals a low workout,” she says. Matey recommends eating a mini meal or snack 60 to 90 minutes before exercising.

Drink plenty of water. //// You’ve heard it before, but it’s worth repeating. Drinking water prevents the dehydration that can actually be mistaken for hunger. “It also helps increase metabolism,” Matey adds. “You have to burn calories to heat it up and flush it through your body.”

Keep a food journal. //// Yes, it’s a pain. But Matey assures that writing down every thing you consume will be eye-opening. Even those who swear they stick to stringent diets discover conveniently forgotten breaches, such as M&Ms pilfered from a co-worker’s candy dish. Finding the 500 calories you need to cut every day to safely lose a pound a week might be easier than you think.

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