Staying Healthy Archive

Guideline changes

Some new health guidelines made their entrance in 2016, and others underwent updates. The CDC announced its first-ever guidelines for prescription painkillers, encouraging doctors to stop treating chronic pain by prescribing opioids, such as oxycodone (OxyContin) and hydrocodone (Vicodin). Long-term use of the drugs carries risks for dependence, addiction, overdose, and death.

The U.S. Department of Health and Human Services (HHS) strengthened its guidelines granting access to one's own medical records. Among the rules: you do not have to give a reason for a records request, you can ask for the records by mail or email, and most requests should be granted within 30 days.

Also of note, the U.S. Preventive Services Task Force updated its guidelines to screen for depression, now recommending screening in all people 18 or older, including older adults, when there are systems in place to ensure accurate diagnosis (as opposed to selective screening based on judgment and patient preference).

New medications

This year also brought the news that we'll have to wait for an antidote to stop rare uncontrolled bleeding episodes linked to some newer types of blood thinners, such as apixaban (Eliquis) and rivaroxaban (Xarelto). In August 2016, the FDA rejected the potential antidote AndexXa (andexanet alfa), saying it wanted more information before it could grant approval. Another of the newer blood thinners—dabigatran (Pradaxa)—already has an approved antidote called idarucizumab (Praxbind).

The newer blood thinners are alternatives to warfarin (Coumadin). People who use warfarin require frequent blood tests to see if the dose needs to be adjusted, but if dangerous bleeding does occur, there's a treatment to reverse it. The newer blood thinners don't require lab monitoring. Apixaban and rivaroxaban do not yet have approved treatments to reverse bleeding.

Stretching benefits

When you stretch a muscle, you extend the tissue to its full length. If you hold that tension long enough, the muscle will be longer once it relaxes again. "Stretching your muscle is similar to stretching an elastic band," says Huber-Anderson. "The elastic's resting length becomes longer."

The more often you stretch your muscles, the longer and more flexible they'll become. As a result, you'll

• increase your range of motion

• reduce your risk for muscle and joint injury

• reduce joint and back pain

• improve your balance, thus reducing your risk of falling

• improve your posture.

Types of stretches

It's crucial to warm up the muscles before you stretch them. That means getting blood and oxygen to the tissue to make it more pliable and amenable to change. If you don't warm up, a stretch can damage the muscle fibers.

One way to warm up is dynamic stretching. "This is when you move a joint through its available range of motion repeatedly, without holding a position," says Huber-Anderson. Types of dynamic stretching include rolling your shoulders, lifting your knees, and sweeping your arms out to the sides and up to the ceiling repeatedly. Huber-Anderson recommends two to five minutes of dynamic stretching.

Then you'll be ready for the types of stretches that will help you regain flexibility, known as static stretching. These stretches are held for 10 to 30 seconds. Don't bounce—that can cause injury.

Note: An aerobic or weight-training workout can also prepare the muscles for static stretching. However, static stretching should not be performed before a workout, when the muscles aren't ready.

2. Seated rotation

Primarily stretches the back

Repeat 2–4 times

Hold: 10–30 seconds

Starting position: Sit up straight on a chair with your feet flat on the floor, hip-width apart, and your arms at your sides.

Movement: Slowly rotate your head and torso to the right side, placing your left hand on the outside of your right knee and your right hand next to your right hip. Hold. Slowly return to the starting position. Repeat to the opposite side. This is one rep.

Tips and techniques:

• Stretch to the point of mild tension, not pain.

• As you rotate, keep your hips squared and facing forward.

• Breathe comfortably.

4. Floor hip flexor stretch

Primarily stretches the front of the hip

Repeat: 2–4 times

Hold: 10–30 seconds

Starting position: Lie on your back with your legs extended on the floor.

Movement: Relax your shoulders against the floor. Bend your right knee. Rest your hands on the back of your thigh and pull your knee toward your chest. Flex your left foot and press the thigh and calf of that leg down toward the floor as you do so. Feel the stretch in the front of your left hip and top of your thigh. Hold. Return to the starting position and repeat with the other leg. This is one rep.

Tips and techniques:

• Stretch to the point of mild tension, not pain.

• When holding the stretch, remain as still as possible, without bouncing.

6. Downward dog

Stretches the entire body

Repeat: 2–4 times

Hold: 10–30 seconds

Starting position: Position yourself on all fours, hands shoulder-width apart, legs hip-width apart, and fingers extended.

Movement: Exhale as you lift your knees off the floor, straightening your legs without locking the knees until you are in an upside-down V. While maintaining a neutral neck and spine, align your ears with your biceps. Try to keep your weight evenly distributed between your hands and feet. Press your heels down toward the floor while keeping your shoulders down and rolled back. Hold. Return to the starting position.

Tips and techniques:

• Soften your elbows and keep your shoulders down and rolled back as you lengthen your spine. Brace your abdominal muscles.

• If necessary, bend your knees slightly and let your heels come up off the floor.

Other screening tests

Some screenings are not recommended routinely but may be important based on your cancer risk.

Lung cancer. The American Lung Association recommends low-dose computed tomography to detect early signs of lung cancer for heavy smokers ages 55 to 74 who have a 30 pack-year smoking history (equivalent to one pack per day for 30 years) and who have smoked within the past 15 years. The USPSTF extends the screening age to 80. If you're not in this group, you should not have routine screening; the risk from radiation exposure and potential unnecessary follow-up testing is not worth the small chance of benefit.

Skin cancer. The USPSTF says there's not enough evidence to recommend regular visual skin exams by a doctor to screen for skin cancer, and that screenings increase the risk for unnecessary biopsies, overdiagnosis, and overtreatment. The American Academy of Dermatology suggests that all people conduct skin self-exams and report any unusual spots on their skin to a dermatologist.

People with an increased risk for melanoma, the deadliest form of skin cancer, should talk to a dermatologist about how often they should get a skin exam.