We will be open regular business hours on Friday December 30; open from 9am to 2pm on Saturday December 31. We will be closed Sunday January 1 and Monday January 2 in observance of New Years.

We wish you and your families a safe and happy holiday!

First, make an appointment with your health care provider to insure that you are physically able to start a safe program.  You may need to have your provider help you with guidelines that are specific to you.  As soon as you are cleared for regular exercise, it is time to actually DO IT.  Exercise has to become non-negotiable.

Though each of us have different demands on our time, such as employment, family, financial and physical constraints, there are certain basic exercise principles that apply to each of us. These principles include flexibility, cardio or cardiovascular endurance, and strength.  A basic exercise program includes all of these.

Flexibility is your ability to move your joints through their full range of motion. The better your flexibility, the less likelihood there is of injury.  Tight muscles, tendons and ligaments lead to lower than normal flexibility. The tightness may be due to inactivity or failure to stretch on a regular basis.

Stretching should be slow and deliberate. Don’t bounce or force joint movement. Bouncing can injure the muscles being stretched because it makes the muscles respond with a reflex contraction.  When stretching, slowly move to the suggested position just until you feel mild tension. Hold the position for the count of 10 and then slowly move forward about ¼ of an inch.  If the new position leads to only a mild increase in tension then hold it for another 10 –15 seconds before returning to your original position.  If it hurts, pull back to the prior position and hold it for approximately 10 seconds.  Work on each stretching exercise for 2-3 minutes.  If you are very inflexible, it may be beneficial to stretch for approximately 15 minutes several times per day.

Cardio or aerobic exercise improves the efficiency of the cardiovascular system.  These exercises involve the intake, transportation and utilization of oxygen.  Physical endurance and exercise capacity is improved by regular exercise through out a lifetime.  The activity you chose should be one that you enjoy. Pick an activity that uses large muscle groups such as your arm and leg muscles. I t should be repetitive, rhythmic and continuous in nature. This type of activity causes the large muscle groups to contract repeatedly and this pushes the blood in the vessels back to the heart. The heart responds by beating more quickly and with greater force in order to pump more blood from the heart with each beat. This in turn strengthens the heart muscle wall making it more efficient. Examples of effective cardio training include brisk walking, jogging, cycling, elliptical trainer, stair stepper, rowing machine, hiking, even mini-tramp walking or aerobic breathing exercise programs.

Take at least 5 minutes to warm up before exercise and 5 minutes to cool-down after every exercise session.  This is done by completing the same activity you will be doing for your regular exercise, just do it at a lower intensity.  Warming up prepares your heart and muscles and helps minimize strain and injury. Cool down is just as important and should be done to keep blood from pooling in the muscles. It also helps to maintain an adequate supply of blood to the heart and brain.  This is why failure to cool down can lead to fainting and dizziness.

Your heart rate will indicate how hard you are working. The maximum heart rate is the fastest your heart can beat and is approximately 220 minus your age (+/- 12 beats per minute). Research indicates that exercise at a level of less than 60% of this maximal rate does little to promote cardiovascular fitness. It is recommended that we exercise at a heart rate of 65-80% of maximum in order to attain and then maintain optimum physical fitness. This is called the ‘target heart rate’. To calculate yours you can use this equation to determine your maximum heart rate and then multiply by the percentage you are seeking, or, you can use the following table.  (Be certain to count your pulse for 10 seconds when looking for the appropriate level:

Exercise for 10 to 15 minutes for the first 2 weeks of your exercise program (remember this is in addition to your warm-up and cool-down).  If you haven’t fully recovered within one hour after your exercise session, you probably pushed it too far. You should either decrease the intensity (heart rate) or duration of exercise.

Increase your duration by 5 minutes every two weeks.  Do this until you reach approximately 30 to 35 minutes of regular exercise in addition to your warm-up and cool-down.  If your heart rate stays below the 70-85% range on a consistent basis you may want to either increase your intensity or ‘pace’ or you can increase your duration to 50 to 60 minutes at the 60-75% rate (plus warm-up and cool-down).

For the first month, exercise 3 to 4 days each week. After this you may increase to four to five days per week.  Studies have shown that you have less chance of injury if you start your program at three days per week and then increase your frequency after the first month.  Keep an exercise log; it is really helpful in monitoring your progression to fitness!)

Sports physicals cost $40 at time of service. Enter a drawing to win a free backpack!

Lacamas Medical Group will provide immunizations on a walk-in basis on June 16, 2011 from 3pm – 7pm. You must bring your current immunization record. Sports/camp physicals are available by appointment for $40. For more information call 360-838-2440.

Uninsured and low-income children may be served at low or no cost at the Free Clinic 360-313-1390 or at Sea Mar Community Health Center 360-852-9070.

If you got started, congratulations! How’s it going? Are you still motivated to do the exercise? Are you sticking to the diet? If you are like most of us, your resolve may be waffling because the exercise is hard, the diet too confining for your lifestyle, and you are not seeing results that inspire you to continue. If you are the exception, and are toughing it out, I’m in your corner.

If you thought it impossible, you have good reason. Obesity has become the norm. This quote from the CDC website is telling, both in its analysis of our culture and in developing public programs to address it:

American society has become ‘obesogenic,’ characterized by environments that promote increased food intake, non-healthful foods, and physical inactivity. Policy and environmental change initiatives that make healthy choices in nutrition and physical activity available, affordable, and easy will likely prove most effective in combating obesity.

The truth is that most of us can’t lose weight by ourselves. Exercise and dieting alone usually do not produce the results we need. And that gives rise to a multibillion dollar weight-loss industry. You’ve seen the ads, all of which show someone who’s half the size they were mere months ago, along with the disclaimer “results shown are not typical.” But, there are reasons for optimism. Some of these programs offer healthy, nutritionally sound options along with coaches to help you get past the tough patches and stick to your goal. The most successful programs teach you to change your lifestyle in doable ways so that you will achieve long-term results.

If you’re serious about losing weight, but haven’t experienced success yet, become proactive. Look around. Someone you know may have found a long-term solution to maintaining a healthy weight that could work for you. Search the web and investigate weight-loss programs to find one that seems workable to you. Southwest Washington Medical Center also offers medically supervised and non-medically supervised programs for weight loss, here.

Don’t lose your resolve. Do something, today, to make a slimmer, healthier you.

Kristi B. Weber is the LMG Laboratory Director and a freelance medical writer.

This post is designed to help you understand how you can get the most out of your relationship with your medical provider, why the system sometimes doesn’t work as it is supposed to, and what you can do about it.

First, every medical office should have a system in place to contact someone and get advice after hours. If the office is closed, you should still feel free to call about a serious illness, especially if you are on the way to the emergency room. If you have had a serious injury or illness, letting your doctor know to get in touch with the ER sometimes helps open doors, lets the ER doctors know they have someone to send you to for follow-up (which can shorten your stay and helps maintain good information flow), and just motivates people to treat you a little better.

Second, you may get some advice from the physician about your problem. Something like a twisted ankle can be seen more efficiently at a local urgent care. Urgent care is less expensive, more convenient, and typically much less overcrowded than ER.  Copays are lower too.

There is a lot of effort that goes into discouraging people from going to the ER for things that aren’t emergencies. One of the problems that drives high costs, visits to the ER, and a lack of satisfaction with health care in general is the experience of not being able to get appointment for several weeks even though you have an urgent problem. Often, good doctors are popular doctors and their schedules fill up pretty quickly. If your doctor’s office is so crowded you can’t get through and can’t get an appointment, it doesn’t do much good to know he or she is popular.

Our office is a bit different in that we accept patients for urgent care and allow established patients to walk in. Most patients understand that their wait time will be “luck of the draw” depending on how busy it is. A common problem is someone who comes in for an acute problem, such as a cough, and would like their diabetes medication refilled at the same time. While we are sensitive to our patients’ costs and convenience, our concern is one of making sure we do the right thing for the patient. It takes time to review a patient with high blood pressure and diabetes, to make sure they are up-to-date with labs, that they have no unwanted side-effects from the medications, or that their disease is not getting worse.

There is always a trade-off between access and time management. You can get in more easily for urgent problems when we reduce the appointment time to 15 minutes. We prefer to plan for a full 30-minute appointment slot when we will be discussing more complex issues. If you do not use the whole time, count yourself lucky that you did not have the intense care coordination that some of our more complicated patients need. We sometimes take care of what we can, even at an urgent care appointment, but never on one of those crazy busy days when it seems the whole of East County has come down with something.

If you cannot get an appointment for any reason, our phone staff will make every effort to figure out an acceptable solution that does not involve going to the ER unless absolutely necessary. However, at the end of the day, if you as a patient think it is an emergency, you need to go to the ER; but, think about making a call to your doctor and see if there is another solution to your problem.

Adapted from an article by Dr. Dino Ramzi

We wish you and your family a safe and happy holiday!