5 Years Young @ Heart…our celebration

My Friends what a fabulous time we had…what great moves, what spirit and enthusiasm…a true community of friends whom share the love of movement, dance, music and most important friendship and caring….I had emails from 20 of our members who are away or at work and wanted so to be with us…so hello to you all….I am off air for a while…BUT…just you wait…the fun continues 🙂

THANK YOU to you all….and thank you to VIRGIN ACTIVE of course…a place to come, exercise and feel at home.

Gluten Free? Gluten Sensitive? A trend? A way of life?

gluten-free

Double Click to open files below:

NFCA_CeliacDisease_vs_NonCeliacGlutenSensitivity

what is celiac disease – 11-22-2013

Going gluten-free seems to be the newest dietary trend that many people are following, even if it is not mandatory for one’s health. This trend was brought on by an increased number of cases of celiac disease, and gluten sensitivity, also referred to as gluten intolerance. Both diagnoses come with the recommendation of avoiding gluten-containing foods (wheat, rye, barley), however both are different in the way the body is affected.

Celiac disease, also known as gluten sensitive enteropathy, is an autoimmune disease that affects the small intestine causing it to become inflamed when gluten is digested. The immune system then generates an abnormal response to gluten and attacks its own intestinal tissue.  This leads to the wasting away of the villi that line the small intestine, malabsorption of nutrients and thus malnutrition. Symptoms may include Anemia, osteopenia, lactase deficiency, diarrhea, constipation, delayed growth, and weight loss due to malabsorption of nutrients. Other symptoms that may present are arthritis, dermatitis, infertility, muscle weakness, and constant fatigue. A series of tests and evaluations are performed including an examination of one’s family history as genetic predisposition is common, blood tests, and the final confirmation of an intestinal biopsy. Once confirmed a strict adherence to a gluten free diet is necessary.

images
Non-celiac gluten sensitivity is often interchanged with gluten intolerance. There are cases where symptoms are less severe, which may be considered gluten sensitivity, whereas severe cases would be labelled as gluten intolerance due to the intensity and length of time symptoms last. Gluten sensitivity differs from celiac disease in that the body views gluten as an invader causing a direct response in the form of inflammation inside and outside of the digestive tract, and with this disorder one’s own tissue (lining of small intestine) is not attacked, as we see with celiac disease. Once gluten is removed from the body, the inflammation goes away unlike the symptoms associated with celiac disease. Symptoms include bloating, abdominal discomfort, and diarrhoea due to the inflammation of the digestive tract. Headaches, lethargy, attention-deficit disorder, hyperactivity, muscle weakness/disturbances and joint pain may present as well. Tests performed for a diagnosis of celiac disease are usually done with the findings not showing the indicators necessary, leading to a trial gluten-free diet. With the diet, symptoms will disappear, and a diagnosis of gluten sensitivity will be given.

Unfortunately celiac disease and gluten sensitivity are becoming increasingly prevalent. Thus it is important to know how each diagnosis affects the body, and the reasons for being put on a gluten free diet. With more research being done, there may soon be more answers as to why more cases continue to emerge.

url

Celiac and Gluten-Free Fast Facts:

  • Celiac disease is an autoimmune digestive disease that damages the villi of the small intestine and interferes with absorption of nutrients from food.
  • An estimated 1 in 133 Americans, or about 1% of the population, has celiac disease.
  • Celiac disease can affect men and women across all ages and races.
  • It is estimated that 83% of Americans who have celiac disease are undiagnosed or misdiagnosed with other conditions.
  • 6-10 years is the average time a person waits to be correctly diagnosed. (Source: Daniel Leffler, MD, MS, The Celiac Center at Beth Israel Deaconness Medical Center)
  • 5-22% of celiac patients have an immediate family member (1st degree relative) who also has celiac.
  • Celiac disease can lead to a number of other disorders including infertility, reduced bone density, neurological disorders, some cancers, and other autoimmune diseases.
  • Burden of disease over four-year period per patient:
  • Females: $4,019
  • Males:  $14,191
    (Source: Long et al, 2010)
  • There are NO pharmaceutical cures for celiac disease.
  • 100% gluten-free diet is the only existing treatment for celiac today
  • A positive attitude, 100% of the time, helps celiacs create a gluten-free lifestyle for themselves and their affected family members.
  • The celiac disease diagnosis rate may reach 50-60% by 2019, thanks to efforts to raise public awareness of celiac disease. (Source: Datamonitor Group, 2009)
  • Gluten-free sales reached more than $2.6 billion by the end of 2010 and are now expected to exceed more than $5 billion by 2015. (Source: Packaged Facts, 2011)

url-1

Understanding BMR for weight loss ( basal metabolic rate) and using it in your weight loss plan

Your basal metabolic rate (BMR) is the amount of calories your body burns each day just by functioning – for example, through basic things like sustaining internal body temperature, pumping blood, breathing. So even if you did nothing by lie on the couch all day, your body would still be burning calories. Understanding this figure is key to determining the amount of calories you need to consume and burn in order lose weight.

So what determines your BMR? There are a number of different factors that will influence how many calories your body burns at rest, so each person’s result will be different. Some of the things that impact your BMR include:

  • Genetics. Some people are just born with faster metabolisms than others- this is just another part of your genetic makeup.
  • Gender. In general, men tend to have a lower body fat percentage than women, as their bodies are designed to build up muscle more easily. As a result, men will often have a higher BMR than women.
  • Age. As your get older, your BMR will decrease. After the age of 20, it generally drops about 2% per decade.
  • Weight. A heavier body requires more calories to function, so it will have a higher BMR than someone who weighs less.
  • Height-weight ratio. A larger body surface area will have a higher BMR.
  • Body fat percentage. People with less body fat will have a higher BMR.
  • Diet. If you regularly follow very restrictive, low-calorie weight loss diets, you can actually cause your BMR to drop by as much as 20%. This happens when your body goes into starvation mode.
  • Internal temperature. A body temperature increase boosts your BMR, so when you have a fever, your body will use more calories.
  • External temperature. A cold climate increases your BMR, because the body needs to use more energy to warm you up to a normal functioning temperature.
  • Thyroid function. Thyroxin, which is produced by the thyroid gland, plays a key role in regulating your BMR. If you have an overactive or underactive thyroid, this will impact how much energy your body burns at rest.
  • Exercise. Regular physical activity builds up extra lean tissue that helps to raise your BMR.

 

Estimating your BMR

There are a number of scientific formulas that can be used to estimate your BMR, taking into consideration many of the factors above. Of course, no equation can calculate your BMR with absolute accuracy, so keep in mind that these results are approximate.

Some of the most popular BMR estimation formulas include:

The Harris-Benedict formula

 Based on total body weight, considering height, weight, age and gender.

  • Men: BMR = 66 + (13.7 X weight in kg) + (5 X height in cm) – (6.8 X age in years)
  • Women: BMR = 655 + (9.6 X weight in kg) + (1.8 X height in cm) – (4.7 X age in years)

 Katch-McArdle formula

This equation is more accurate, as it is based on lean body weight- but this means you need to know your lean body mass (LBM).

  • Men and women = BMR= 370 + (21.6 X LBM in kg)

 Using your BMR in your weight loss plan

Once you’ve estimated your BMR, you can use this information to more effectively plan your calorie intake to help you reach your weight loss goals. Your BMR tells you how many calories you need per day to stay active and healthy. In other words, this is your daily caloric maintenance level. So, to keep your weight stable, you should remain close to this level.

To lose a few kilos, you need to create a calorie deficit. So, your daily intake of calories should be less than your BMR plus the extra calories burned through exercise. You can either add your exercise calories manually, or use the following formula to approximate based on your usual level of activity:

  • Sedentary (little or no exercise, desk job) = BMR X 1.2
  • Lightly active (exercise/sports 1-3 days a week) = BMR X 1.375
  • Moderately active (exercise/sports 3-5 days a week)= BMR X 1.55
  • Highly active (exercise/sports 6-7 days a week)=BMR X 1.72
  • Extremely active (exercise/sports and physical job or training twice a day)= BMR X 1.9

Just stop and breathe

Written by:

Andrew May:  a performance coach who has spent the past 15 years working with elite sportspeople.

Time spent practising breathing will repay dividends in lowered stress levels.Time spent practising breathing will repay dividends in lowered stress levels. Photo: Getty

This morning my five-year-old daughter was comforting her little brother, who had just tripped over the new truck he received for his 2nd birthday. His joy and elation had quickly turned to tears and two-year-old tragedy after his stack. Then Miss Five, in a calm and soothing voice said “just stop and breathe. It’ll be OK, little man, just stop and breathe”. Two minutes later he was manoeuvring his truck around the lounge room once more.

If a young child can calm her brother with four simple words, what benefit could “just stop and breathe” possibly hold for the busy executive?

Breathing and physiology

For thousands of years, humans have understood breathing has a powerful influence over our physiological and psychological wellbeing. But many people still find it difficult to understand the link between breathing and its impact on our body’s physiology and stress levels.

Advertisement

Research has shown the way we breathe has a powerful effect on how stressed we feel. When we feel stressed, one of the physiological changes that occurs is activation of the sympathetic nervous system (fight/flight response) and an immediate increase in respiration switching from slow, abdominal breathing to faster, shallower, chest breathing.

This is a normal and healthy response in the short-term. If we are constantly triggering the sympathetic nervous system throughout the day however, we begin to habitually take shorter, shallower breaths with our upper chest, even though the stress may have passed.

The danger is that this style of breathing sends signals to the brain that we are under stress when the reality is, it may not really be under stress at all.

Average respiratory rates

The first sign of life in a newborn baby is breath. The average adult will take in approximately 20,000 breaths a day. The number of breaths we take per minute is called respiratory rate. You can work out your respiratory rate by counting the amount of breaths per minute, or bpm. Compare your self to the following:

Newborn baby: 44bpm

Infants: 40-60bpm

Older children: 16-25bpm

Adults: 12-20bpm

Relaxed adults: 8-12bpm

Elite athlete during exercise: 60-70bpm

Types of breathing

1.Relaxed diaphragmatic breathing

Diaphragmatic breathing is a slow, calm style of breathing controlled by a rhythmic contraction and expansion of the diaphragm. When you observe a child or animal (or if you want to be a little creepier, watch your partner while they are sleeping tonight – all in the name of research, of course) that is relaxed and happy, you will see their abdomen (belly button) moves out when they inhale and it deflates when they exhale. There is very little movement in their chest. Studies have shown that practicing this style of diaphragmatic breathing reduces muscle tension and anxiety levels within 60 seconds. Slow, deep breathing stimulates the parasympathetic nervous system or what is commonly referred to as the relaxation response (the exact opposite of what happens with the stress response).

2. Stressed chest breathing

Stressed thoracic or chest breathing involves very little movement in the abdomen and it is predominantly the chest that moves when we breathe in and out. This results in a shallower, faster breath.

Again, observe a child who is distressed or crying. When a child is upset, their breathing switches from slow, diaphragmatic breathing to fast and shallow breathing. Chest breathing stimulates the sympathetic nervous system.

While breathing is controlled mainly through the Autonomic Nervous System, we can voluntarily influence our breathing and help switch off the stress response through changing our breathing style from fast, shallow chest breathing to slow and deep diaphragmatic breathing.

Doing this sends signals to the brain that the threat is over and the parasympathetic part of the Autonomic Nervous System starts to reverse the biochemical and physiological changes brought about by the stress response.

Diaphragmatic breathing is a skill and when performed correctly, is effective in reducing stress levels. It is physically impossible for humans to be relaxed and stressed at the same time.

How to check for diaphragmatic breathing:

1. Lie down on the bed or on a lounge, place one hand (palm face down) on your chest and place the other hand (palm face down) on your abdomen (just below your ribcage).

2. Breathe normally and notice which hand is moving most, ie. the abdominal hand or the chest hand.

3. If the hand on your abdomen is moving and the hand on your upper chest is still, you are using your diaphragm and breathing correctly.

4. If your upper chest hand is moving more than the hand on your abdomen, then you are breathing mainly with your chest and this is a form of stressful breathing.

5. Checking on a regular basis that you are activating diaphragmatic breathing will ensure the majority of your breathing is relaxed abdominal breathing.

6. You may initially find it difficult to breathe using your diaphragm. Don’t give up and keep practising. It is possible you have automatically switched to breathing with your chest and it takes time for your body to relearn to use your diaphragm properly again.

Learning diaphragmatic breathing

Anyone who has studied music, singing or performing arts is taught proper diaphragmatic breathing very early in their training. If you don’t take deep, slow diaphragmatic breaths, don’t despair. You just need to relearn how to breathe properly again.

Learning diaphragmatic is like any other skill and it takes a little bit of practise. Try it two to three times a day for up to five minutes each time. One of the advantages of diaphragmatic breathing is that you can practise it at any time, in any place, and no one will even be aware that you are doing it. It can be used when sitting on a bus or a train travelling to work, before and during a visit to the dentist or doctor, in bed just before going to sleep, or before a job interview, an exam or giving a presentation. Try the following activity:

1. Sit or lie down.

2. Loosen any tight clothing; remove shoes, tie, glasses/contact lenses.

3. Place the palms of your hands flat on your abdomen just beneath your rib cage, middle fingertips touching, at a point 2-3 inches above your navel.

4. Close your eyes and start to focus your thoughts on your breathing. Try not to think of anything but your breathing. This helps distract stressful thoughts. Thoughts will intrude, but don’t fight them; when thoughts come into your mind, try to bring your focus of attention back to your breathing. It is important not to worry how well you are doing but to instead focus on just doing your best to retain a passive, relaxed attitude.

5. Begin to inhale through your nose (not your mouth), feel the air flow through your nostrils. Breathe in for a slow count of 1, 2, 3, then exhale to a slow count of 1, 2, 3. This will give you a breathing rate of 10 breaths per minute.

6. Try to imagine in your mind’s eye that there is a balloon in your abdomen, as you inhale the balloon expands and as you exhale the balloon deflates.

7. Do not take deep breaths. When you inhale your fingertips on your abdomen should only slightly part; this will help to reduce the risk of over-breathing or becoming hypoxic.

8. Start by practising for a few minutes per day and then over time build up to five minutes, twice daily.

Breath is life

While Miss Five hasn’t read up on all of the research and benefits of diaphragmatic breathing (unless kindergarten teaching has really accelerated beyond our wildest dreams), intuitively she knew getting her little brother to “just stop and breathe” would help change his physical state.

When you really stop and think about it, breathing is life. Learning to breathe properly with your diaphragm is a proven way to manage stress and help you stay calm and focused throughout the day. Investing a small amount of time to learn this vital skill will pay for itself over and over again.

How do you build relaxed breathing into your day?

Read more: http://www.smh.com.au/executive-style/management/blogs/performance-matters/just-stop-and-breathe-20130624-2os3f.html#ixzz2X7l8J2Xh

Fall Prevention

The need to focus on Falls among Older People

Falls are common among older people

  • More than one in four people aged 65 or over have at least one fall per year and many fall more than once. Falls are even more common among residents of aged care facilities, up to half of whom fall at least once a year.

Fall-related injury is a major cause of morbidity and mortality for older people

  • In 2009 26% of NSW residents aged 65 years or older fell at least once.
  • In NSW each year falls lead to approximately 27,000 hospitalisations and at least 400 deaths in people aged 65 years and older. The rate (age-standardised) of hospitalisations for falls is over three times higher among residents of aged care facilities than among the other older people.
  • Age-standardised rates of fall-related hospitalisations among older have been increasing for more than 10 years.
  • Even non-injuries falls can have negative impacts such as loss of confidence and activity restriction.
  • Falls are the most commonly reported adverse event among hospital inpatients.

Falls generate substantial costs for the health care system and aged care system

  • Hospital stays and rehabilitation can be long and expensive. Having had a recent fall is one of the leading reasons for premature admission to residential aged care.
  • In NSW, no other single injury cause, including road trauma, costs the health system more than fall injury.
  • In NSW in 2006/07 the total cost of health care associated with fall injury was estimated at $558.5 million. Hospital admitted cases accounted for an estimated 84.5% of total costs and ED presentations for 9% of total costs.

The burden from fall related harm among older people will grow unless action is taken.

  • Projections indicate that without preventative action, the health system costs from fall injury are likely to show a dramatic escalation due to expected large increase in the number of older people in NSW in upcoming years.

Falls can be prevented

  • There has been extensive research demonstrating that many falls among older people can be prevented, even in frail older people.Reference for the above from – Prevention of Falls and Harm from Falls among Older People 2011-2015 NSW Health

Act Your (Nutritional) Age

Let’s challenge our expectations about body transformation by breaking another “rule”: that you need a special meal plan with lots of detailed restrictions to lose fat and get in shape.

Usually when individuals go to professionals to seek help in dieting they ask –

Are you going to give me a meal plan?

Are You Acting Your Nutritional Age?

Do you browse nutrition and fitness blogs… but skip workouts? Is one of your kitchen cupboards full of the latest-and-greatest supplements… and another cupboard full of junk food?

Do you want a custom, fancy meal plan… that you won’t actually follow?

If so, you aren’t acting your nutritional age.

Just like there are age-appropriate outfits (you wouldn’t let your 10-year-old daughter out the door dressed like a showgirl, right?), there are also “nutritional age-appropriate” choices.

Knowing your “nutritional age” can help you make the proper decisions, and keep you focused on what will really make a difference.

Nutritional Age is a Combination of Three Things

.                What you know

.                What you do

.                What you do consistently

The more skilled, accurate, and adherent you are — and the more precise your body transformation has to be — the higher your nutritional age.

Why Is This Important?

Knowing your nutritional age will help you:

determine what you should be doing and why

understand what’s important to you and what isn’t

set realistic expectations and match behaviors to them

3 Levels of Nutritional Age

Nutritional Age is  broken into 3 categories. Unlike actual aging, it’s possible to stay a baby forever. And you don’t have to advance to “old age” if it doesn’t suit you.

Level 1

You’re a regular person who’s just trying to improve things. You want to lose weight and “get in shape.” This is probably where you’re at (most people are)

Level 1’s don’t need a super-complicated custom diet plan to have incredible success and make “holy crap!” changes. And really, a complicated custom diet — like one a professional athlete may use — could actually be the worst thing to try and follow.

We all start at Level 1 and most of us choose to stay there for good. We do enough of the right things to get dramatic results, and we leave the complicated and time-consuming stuff to the people who earn a paycheck for using their bodies. (Besides, they have more to lose.)

Level 1’s should get good at doing the basics regularly. There’s really no need to focus on specific details, since we’re focusing on the big picture here: a dramatic transformation and lasting change without completely overhauling your life. That’s what Lean Eating is all about.

Level 2

At Level 2, you’re a dedicated recreational exerciser or high-performance athlete who already has a pretty good diet. If this is you, you still don’t need a super-complicated custom diet plan to have incredible success.

Level 2’s need to reinforce the basics and then add in a few simple strategies – like learning more about portion sizing and meal timing.

Level 3

Level 3’s are professional performance or physique athletes. These nutrition and exercise ninjas make their living from exercising and eating a certain way. They need detailed custom programs and diets because their job depends on it. (That’s definitely not you. And if it is, may we please have your autograph?)

Being a Level 1 or 2 is just fine. While a few of us have competed in bodybuilding shows or advanced athletics, most of us are just people like you who want to live a healthy, fulfilling life (while looking good in the process).

And there’s certainly nothing wrong with that!

Figure Out Your Nutritional Age

You can probably already guess where you fit. But if you’re not sure, ask yourself a few questions.

Ask yourself three questions about your nutrition.

.                What do I know?

.                What do I do?

.                How well do I do this consistently?

Ask yourself about your goals.

Where do I want to go?

Chances are you don’t want to be a professional athlete. (All right, maybe you do want to be a pro athlete. Unfortunately, it’s not in the cards for most of us.

Work With Your Nutritional Age

Once you’ve figured out your general nutritional age you don’t try to rush ahead. You need to build up the basics for a good block of time (no meal plan). Then you need to adjust a few elements of food amount and timing (again, no meal plan).

Just like you don’t try to run a marathon before you’ve mastered crawling, don’t try to train and eat like a pro athlete before you’re ready – regardless of what the magazines say, what some elite athletic coach suggests, or what your friends think.

What We Learned and What’s Up Next

Now that you know our philosophy on meal plans and nutritional age, it’s time to relax. You don’t have to “do it all” or be “perfect.” In fact, all you have to do is be a little bit better than before. And that means doing today’s workout and following one new habit!

More on that tomorrow — along with tips on how to outrun a bear!

WHAT TO DO TODAY

1 Ask yourself three questions about your nutrition..    What do I know?.    What do I do?.    How well do I do this consistently?
2 Ask yourself about your goals.Where do you want to go?
3 Remind yourself why you’re here.Remember you are in level and if you are either in level 1 or 2. don’t start with complicated meal plans to follow. Because people who try to follow them can only do so for a limited time. Then they quit.
4 Practice a new habit or twoIf you’ve been doing this, high-five yourself. What are your new habits?If you haven’t? Well, it’s time for a clean slate start. Decide what you are going to do to take the first step to good nutrition or exercise.

RUNNING FROM THE BEAR

 

You Don’t Need To Be The Fastest

When you’re running from a bear, all you have to do is run faster than the slowest person. (Remember that the next time you’re on the trails.)

Although we rarely admit it, most of us have perfectionist tendencies. Does this sound like your internal self-talk?

I always need to do better.

I wish I was like _____.

I can’t start a nutrition and fitness plan until I have more free time/get over an injury/get a different job/get over my gym anxiety/“insert perfect life situation here.”

I’m a failure.

If I can’t do _____ then I won’t do it at all

I’m stuck and overwhelmed

Augh! This is a disaster! (Said during a non disaster)

I need to do ___, then run to the bank and do ___, and then I’m baking cookies for ___, and then I’m going to stay up all night to sew a perfect costume for ___…

If any of these sound like you, you might have a teensy bit of perfectionism.

But we don’t need to be perfect. In fact, to see substantial progress we only have to do a little bit better than yesterday. (Or run a little faster than the next person if we’d rather not get mauled.)

 

Perfectionism is a losing game because we’re competing with ourselves. And we’ll be darned if anyone’s gonna beat us.

Plus it makes us ornery. No one wants to hang out with someone who’s anxious, frustrated, unmotivated, irritable, and hyper-aware of every flaw.

But the pressure to be perfect isn’t from outside sources — it emanates from you.

Be “Pretty Good”… Consistently.

Don’t blame yourself. It’s hard out there. There are so many messages flying at women about how we should act, what we should do, and how we should be.

500 years ago, your main job as a woman was to make a baby. Nobody cared how you looked, whether you were a supermom, whether you had a career, or even whether you could read. Your family menus consisted of gruel and boiled turnips for four months straight. Nobody expected you to whip together four-course meals that would accommodate every fussy eater and individual taste. If you survived to age 35 with half of your teeth, you were a champ.

Thankfully times have changed. But with changes have come a lot more pressure: to look perfect, to be a perfect mother, to be a perfect wife, grandmother, to be a perfect friend, to have a perfect house with a perfect lawn, to have a perfect career… man, we got anxious just typing that out.

And, as many of you have discovered, trying to be perfect doesn’t work very well. You end up feeling frustrated, stressed, and overwhelmed. And, eventually, when you snap from the pressure, you end up worse off than you were before you started.

The fix?

Be “pretty good” consistently. This means achieving high overall habit compliance by going for “pretty good” every day — rather than “perfect” every now and then.

Think about all the ways in which you can be pretty good… and all the ways in which you already are pretty good. We bet you’re all pretty good at something (or lots of somethings) already. All you need to do is apply the “pretty good” approach to your nutrition and exercise.

OUR SUMMARY

Don’t wait for the “perfect” day, “perfect” body, or “perfect” schedule full of free time to come. It never will.

Instead, focus on what you have and be pretty good every day. Take perfection off the table, and see how far you get. (Which is quite far, actually.)

 

SO REMEMBER

1. Outrun the bear.

Remember: you don’t need to run the fastest; you just need to run faster than the slowest person.

2. Take perfect off the table.

Don’t worry about being “perfect”. Aim for high habit compliance by shooting for “pretty good” or “better than yesterday” instead.

3. Remember that changing habits can be challenging.

Sometimes you might feel lost or stuck. That’s OK. Keep going. Crawl out of the hole when you need to. Clean the slate.

Don’t quit.

4.  Let your awareness and skills grow slowly.

Do the habits, do the workouts, and read the lessons every day. Practice makes perfect. Give yourself time to adapt and

improve.

5. Anticipate and plan for obstacles.

Think about what might challenge you. How could you anticipate and plan for this?

6. If you fall into the hole, get out immediately.

Don’t linger; start climbing. If you slip up, all you have to do is take the next positive step forward.

7.  Stay focused and patient.

Eventually, that deep hole in the sidewalk won’t be there at all and you can walk confidently on a different street.

Autobiography in Five Short Chapters

Chapter 1

I walk down the street.
There is a deep hole in the sidewalk.
I fall in.
I am lost. I am helpless.
It isn’t my fault.
It takes forever to find a way out.

Chapter 2

I walk down the street.
There is a deep hole in the sidewalk.
I pretend that I don’t see it.
I fall in again.
I can’t believe I am in this same place.
But it isn’t my fault.
It still takes a long time to get out.

Chapter 3

I walk down the same street.
There is a deep hole in the sidewalk.
I see it is there.
I still fall in. It’s a habit. But my eyes are open.
I know where I am.
It is my fault.
I get out immediately.

Chapter 4

I walk down the same street.
There is a deep hole in the sidewalk.
I walk around it.

Chapter 5

I walk down another street.

Thanks to American actress and author Portia Nelson for the poem. 

Miracle’ drugs put thousands at risk

Written in Sydney Morning Herald

Amy Corderoy

March 1, 2012

Miracle drug? ... Simvastatin is the third most commonly prescribed statin in Australia..Miracle drug? … Simvastatin is the third most commonly prescribed statin in Australia. Photo: Bloomberg

THOUSANDS of Australians could be taken off cholesterol-lowering medications because of mounting evidence they increase the risk of diabetes and dementia.

Australian health authorities are reviewing their advice after US regulators announced statins will now carry warnings they could increase the risk of diabetes and cognitive impairment.

Statins are the most commonly prescribed drugs in Australia, with about 2 million people thought to be taking them to reduce their heart disease risk.

Advertisement: Story continues below

The president of the Australasian Society for Clinical and Experimental Pharmacologists and Toxicologists, David Le Couteur, said Australia had one of the highest rates of statin use in the world, and people who were not at high risk of heart disease needed to reconsider using them.

He said doctors and other health practitioners should focus on lifestyle interventions for people with high cholesterol but without other risks such as previous heart attacks, high blood pressure and smoking.

Despite statins being linked to diabetes, he said people with the condition should still use them as diabetes itself put them at risk of heart disease. “If you have diabetes that’s even more reason to be on statins,” he said.

Statins have long been touted as a miracle drug, with some doctors and researchers pushing for their use in all older people. But Professor Le Couteur said that was unwise. “Unfortunately the history of medicine is chequered with hopes that have turned out to be dashed and even caused harm,” he said.

The evidence showing a link with cognitive impairment was not as strong as the links with diabetes, but if a patient developed symptoms he would consider taking them off the drugs.

But the director of the Baker IDI Heart and Diabetes Institute, Garry Jennings, said people should not stop taking statins.

“I hope that pretty much everyone who is on a statin in Australia is on it for a very good reason, although there might be a few lower-risk people on the fringe,” he said. “Statins work and there have been tens of thousands of people in trials … the overall benefit is clear.”

About 500 people would need to take statins for one new case of diabetes to develop, while a major cardiac event would be prevented for every 150 people taking them.

The national director of clinical issues for the Heart Foundation, Robert Grenfell, said he was more concerned by the number of people at high risk of heart disease who were not taking preventive medication. “We still have a high rate of morbidity and mortality from heart disease in this country,” he said.

A University of NSW professor of clinical pharmacology, Ric Day, said there was no doubt a lot of Australians had been prescribed statins when their total risk of heart disease was not high. “It’s a bit of a pity because you are taking a drug that doesn’t contribute much to your protection at all,” he said.

study by the National Prescribing Service found the use of lipid-lowering drugs such as statins had increased from 4.8 per cent of people aged 45 and over in 1995, to more than 30 per cent.

The chief executive of the service, Lynn Weekes, said Australia’s high use of statins compared to the OECD indicated it was likely low-risk people were being treated. “If they are at low risk of heart disease you shouldn’t be putting them at risk for something else,” she said.

A spokeswoman for the Therapeutic Goods Administration said it was considering whether any action is required in Australia.

 

Read more: http://www.smh.com.au/national/health/miracle-drugs-put-thousands-at-risk-20120229-1u3ia.html#ixzz1nnp2OKpz