WEEK 4 Last month we told you to make water your main drink (not such a hardship, right?). This week, maintain your water consumption, and aim to add at least one hydrating food a day to your meals. Fruits and veggies can help you sneak more H2O into your diet, Melons and lettuce are the most obvious choices, but don’t overlook apples, oranges, even eggplant (90 percent water!). “Since your body contains a staggering 140-plus cups of water, replenishment is vital,” says Brownlee.

Week 4
Get your food balance right. You may be eating your prescribed number of calories every day, but if it’s Slim Jims and spaghetti that are getting you there, you’re probably not feeling too peppy. To get all your nutrients, you need to eat a certain number of servings a day from each of the various food groups. Check your Daily Portion Planner to help you figure out how many servings a day your body needs.

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WEEK 1 Kick off Month Two by keeping a food diary for the first two days of the week. (It’s a chore, but worth it.) On the third day, look back and circle foods on your list that supply protein: meats, poultry, fish, seafood, dairy, beans and soy foods. Limit fatty meats, fried fish and full-fat dairy products, but make sure you get the protein you need to build strong muscles. Tops on the healthy-protein list: lean beef and pork; skinless chicken; fish; nonfat or lowfat dairy; and soy foods such as tofu. You need to have two servings of dairy and 4 to 6 ounces of meats or meat alternatives daily (60 to 80 grams of protein; visit www.nutrition.gov for a list of protein grams in various foods.) Strive to work protein into all meals, but you can consider your goal met and mark it in your log if you eat protein at two meals daily.

WEEK 2 You goal this week is to eat fat. (Yippee!) Just make sure it’s the right fat. Check out your food diary again; circle fried foods, sources of heart-damaging saturated fat (fatty meats such as ground beef) and trans fats (found in packaged snack foods). Your mission: Replace these villains with “good” fats—olive, peanut or flaxseed oils; nuts; fish and other seafood—at two meals a day.

WEEK 3 This week, aim to weed out unhealthy carbs. Says Brownlee, “We’re hoping you can spot—and nix!—carbs that are loaded with sugar, such as soda, fruit drinks and cookies.” Your goal instead? Eat six or more servings of whole-grain cereals, breads and brown rice per day.

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Benefits of Pilates
Pilates promotes uniform development by focusing on strengthening the core of the body — especially the muscles that support the abdomen, lower back and buttocks.

As Joseph Pilates himself put it, “Physical fitness is the first requisite of happiness. Our interpretation of physical fitness is the attainment and maintenance of a uniformly developed body with a sound mind fully capable of naturally, easily and satisfactorily performing our many and varied daily tasks with zest and pleasure.”

That means that Pilates emphasizes functional movements that bring the body into alignment. It makes you strong but also supple, so you can perform better in your daily life.

Pilates strengthens and lengthens muscles “The method promotes mental and physical harmony through improved balance, flexibility, strength and tone,” explained Beth Downey, a Pilates instructor who is certified through the Pilates Center of Boulder, Colo., and owner of a Pilates studio in Rosemont, Pa. “It works the smaller muscles, not just the large muscle groups like most other exercises, to strengthen and lengthen them.”

As a result, Pilates provides a longer, leaner and less bulky look. It decompresses the spine and improves posture. According to Downey, it’s suitable for virtually everyone because the exercises are progressive and tailored to suit individual ability — beginner, intermediate and advanced.

“It’s also great exercise for people with chronic ailments such as arthritis and fibromyalgia,” Downey said. “The movements are challenging yet gentle because they don’t hurt the joints.” More and more, rehabilitation centers are using Pilates exercises for patients recovering from injuries and other medical conditions. Pilates is also used for injury prevention.

Getting in a Pilates Class
If you’re looking for a Pilates class, Downey recommends finding a teacher who is certified in Pilates. “Ask which organization provided the certification and how many hours of training it involved. A weekend workshop in Pilates is not sufficient.”

The exercises should be pain-free, too. Downey suggests you consult the teacher if you feel any pain during the class. “The movements are very specific and have to be done correctly. It requires a lot of concentration,” she said. Learning the right way to breathe while exercising is also important, Downey adds.

Mat classes as well as classes that use specially designed Pilates equipment are both beneficial, Downey says. Each uses similar movements to achieve the same results. The Pilates equipment, however, uses spring resistance while the mat relies only on your own body weight for resistance.

The most common piece of equipment is the “Reformer,” which Joseph Pilates invented in the 1940s and resembles a twin bed with springs, a carriage and a foot bar. Other Pilates resistance equipment includes the “Cadillac,” the “Wunda Chair” and “Barrels.”

A. Awareness — Be aware both that there are problems and that there is a diagnosis that can help you.
B. Behavioral management — Learn what behavioral strategies you can use to ameliorate or eliminate problems. Give yourself an organizer, add structure, hire a secretary, delegate tasks.

C. Counseling — Discuss the specific problems that affect you at home or at your job with a counselor. That includes issues like spending all your time on the Internet – a minefield for the ADD population with its fast moving, distractible qualities.

D. Drugs — Under a doctor’s care, the right medications can help.

E. Education — Continue ongoing education for yourself, spouse, friends. When the important people in your life know what’s going on, they can support you, for example by not encouraging you to have extra drinks or not ignoring your need for structure.

F. Focus — Set your sights on what you want to make better and target your therapies to your most intensive problems. If it’s work, for example, focus on getting the skills that get you the job you want.

G. Group — Interact with a group — religious, fraternal, ethnic.

H. Help — Reach out beyond yourself. We all have strengths and weaknesses, and this is just one of them.

A. Mobility is a tough thing to give up at any age. I’m sorry to hear of your mother’s condition. It sounds like she may have chronic compressive peripheral mononeuropathy.

Let me explain those terms. “Peripheral neuropathy” is damage, by disease or injury, of nerve tissue outside the brain and spinal cord. “Mono-” refers to a single nerve; “polyneuropathy,” on the other hand, would be damage to a number of peripheral nerves throughout the body, usually caused by systemwide infection, disease or toxic agents (including some drugs).

Peripheral mononeuropathy is usually caused by localized injury and sometimes disease. That physical injury is often prolonged pressure on a nerve that runs alongside a bone. Bending or stretching a nerve can also cause problems.

Strenuous activity, trauma, infection, heat or cold exposure, radiation therapy and, on rare occasions, tumors, are associated with mononeuropathy.

The peroneal nerve in the calf of the leg is one of the peripheral nerves often injured or compressed because of its vulnerable location, close to the surface of the skin at the back of the knee. For example, peroneal compression is regularly seen in thin people who cross their legs a lot.

Femoral or sciatic nerves may also be affected.

Of course, treatment begins with verifying the diagnosis, and identifying and treating underlying factors, if any, such as infection. If the neuropathy is due to compression or other physical problem, the next step is to locate the site and determine the appropriate treatment.

Neurologists or orthopedic specialists are the health care providers best qualified to diagnose your mother’s problem and recommend treatment. That doctor can also point out what activities would aggravate the situation and thus should be avoided.

Steroids injected directly in or around the damaged area can sometimes reduce swelling and inflammation of the nerve and relieve the pain; it is the method of treatment usually tried first. Surgery to relieve the compression is recommended if the steroids aren’t effective.

Electromyograms (EMGs) measure the electrical activity of muscle. And it’s true that some peripheral disorders can cause abnormal readings. X-rays can often show bone spurs or other problems causing nerve inflammation.

However, to verify the diagnosis of mononeuropathy or rule it out, your mother probably needs to have nerve conduction studies done to measure the speed of nerve impulse conduction; an MRI may also be needed.

Accompany your mother the next time goes to her doctor and let him or her know you’re concerned that she gets information on her condition.

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If strep throat goes untreated, it can lead to rheumatic fever, kidney problems and other complications.

Unfortunately, strep symptoms are easily mistaken for signs of cold or flu; so if your child has a sore throat that lasts 48 hours or longer, call your doctor.

A throat culture or strep test can determine whether it’s strep or not.

Prompt treatment with antibiotics — usually penicillin or erythromycin — usually eases symptoms within a day or so.

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“Celebrate Life: New Attitudes for Living With Chronic Illness,” a practical guidebook for health professionals and people living with serious, persistent illnesses. Available from the U.S. Arthritis Foundation.

“Performing the exercises my physical therapist recommended in a water environment has made a difference in my recovery from two recent joint replacement surgeries,” she said. “I look forward to it.”

According to professional physical therapists at Star Physical Therapy of Southern California, in addition to being a valuable physical therapy modality after replacement of osteoarthritic joints, aquatic therapy is also appropriate in conditions such as rheumatoid arthritis, juvenile rheumatoid arthritis, fibromyalgia and ankylosing spondylitis.

Aquatic Therapy Benefits
Star Physical Therapy points out the benefits of aquatic therapy often include the following:
Depending on water depth, arthritic individuals may need to move only one-sixth of their body weight to exercise, affording an opportunity for greater mobility without the risk of injury or setback.

Temperature-controlled aquatic therapy pools produce a warming environment beneficial for arthritis patients without being too hot to exercise.

Because aqua therapy is fun, the arthritic patient is typically more compliant with attendance and his prescribed exercise routine.

Often aquatic therapy in open pool environments produces camaraderie between patients with arthritic conditions and can even promote new friendships.

Aquatic PT promotes a quicker return to activity following surgery on arthritic joints, which is beneficial both physically and psychologically.

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They found that going home on the same day of their surgery gave the women a sense of control.

Of the 204 women in the study, 90 chose to go home quickly, and they suffered no serious side effects as a result.

That choice, and the choice of mastectomy rather than lumpectomy, is an individual decision.

The study showed that for some women it might be as safe — physically and emotionally — as the stay in the hospital.

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A.Sciatica is a condition in which pain radiates from the back down the legs. It is caused by irritation of the sciatic nerve. The sciatic nerve is formed by nerve roots that exit from the lower part of the spine, then come together to form the sciatic nerve. It travels from the buttock into the back of the leg. Sciatica is most typically caused by a disc in the spine pressing on a nerve root. It can also be caused by local irritation of the sciatic nerve in the buttock or leg.

A. Treatment for sciatica is aimed at reducing the irritation of the sciatic nerve. This often initially involves a period of rest and common nonsteroidal anti-inflammatory prescription drugs (NSAIDs) such as aspirin, naproxen and ibuprofen. If these measures fail to alleviate the symptoms, then I often recommend physical therapy to my patients. I have found that chiropractic treatment can at times be effective for treatment of acute sciatica.

If a patient has persistent pain despite conservative measures, then I recommend a workup with a magnetic resonance imaging (MRI) scan, to see if there is a herniated (“slipped” or bulging) disc pressing on a nerve root or another problem that could account for the pain. Although rare, a tumor in the spine can compress a nerve root and cause pain similar to that of sciatica. If the MRI detects nerve root irritation in the spine, then we often give a lumbar epidural injection, which is a cortisone injection to the spine around the nerve roots. These injections often give relief, but it is difficult to predict which patients will get relief and for how long.

In a patient with disabling pain that has not responded to conservative measures and who has a correctable problem, such as a herniated disc, surgery becomes an option. In general, I recommend that surgery be considered as an absolute last resort.

After a patient’s symptoms have subsided, I recommend a general fitness program, including a stretching program for the spine. Some of my patients benefit from a short physical therapy program, specifically aimed at instructing the patient in a home exercise program. In patients with a herniated disc whose symptoms have subsided, it is not unusual to see occasional flare-ups. Typically, after the first episode, these are shorter and less severe.