DEAR DR. DONOHUE: I am a former athlete with 25 years of soccer playing, eight years of ballet, six years of field hockey, 12 high- school varsity letters and a four-year, full-ride athletic scholarship to college. When I was 32, a hockey injury dislocated my knee and caused anterior cruciate ligament damage. At age 40, I injured the other knee. Arthroscopic surgery showed the knee joint is basically shot, and I am not able to run or do any impact exercises involving the knee. They say athletes have two deaths: one that is final and one that forces them to give up athletics. It’s a fact. What can I do? I am 46 now. – L.M.
ANSWER: You have to experiment to find an exercise your knees can tolerate. If you can’t find such an exercise, then you can confine your workouts to upper-body workouts. A stationary bike puts little stress on the knee if the seat is adjusted so that there is only a slight knee bend when the pedal is in the downmost position. Low- impact aerobics is another possible choice. During this kind of exercise one foot is always on the ground, so there is no jumping and no full body weight squashing the knee.
Water aerobics might work. Exercising in chest-to waist-high water gives the knees the protection of water buoyancy. Water shoes are available. They permit you to move about. Manufacturers include Ryka, Avia and H2O Wear.
Deep-water exercise removes all knee stress. You have to wear a flotation device to keep your body vertical in the water. A water- buoyancy belt works well.
As a last resort, exclusive upper-body exercise puts no strain on the knees. It helps if you belong to a gym where you can move from one exercise station to the next. You do arm curls at one station, arm extensions at the next, then bench presses and on and on with little pause between each station so you keep your heart beating somewhat fast. This gives you the benefit of both muscle-building and aerobic exercise.
DEAR DR. DONOHUE: Can I exercise while recovering from postherpetic neuralgia (shingles)? I am 79. I do three hours of weightlifting, three hours of aerobics and four hours of yoga a week. I had shingles five weeks ago and am now recovering from postherpetic neuralgia. I have not exercised for five weeks and am going crazy. – V.P.
ANSWER: You can exercise if exercise doesn’t make the pain worse. I’d resume with a lighter schedule and gradually increase the time spent in exercise until you’re back where you were before shingles struck.
DEAR DR. DONOHUE: I am in my early 70s and have always led an active life. Arthritis of the knees has put a limit to my exercise. I have been told that running or even brisk walking might aggravate the occasional pain of my arthritis.
I enjoy brisk walking on a treadmill three times a week. I have slight pain infrequently. I can work up a sweat. I also do calisthenics and lift light weights. Those exercises don’t make me sweat at all. What is the comparative benefit of brisk walking to calisthenics and light weightlifting? – E.B.
ANSWER: Treadmill brisk walking is said to be one of the easiest exercises on the knees. If it’s not making your knee pain worse, it’s not hurting you. Sweating doesn’t always equate with exercise intensity. However, in the two cases you site, brisk walking is burning more calories than are calisthenics and weightlifting. I’m not making that a general statement. I’m making it a statement applicable only to you. Sweating means you are increasing body heat. Sweating is the body’s way of returning body temperature to normal. Evaporation of sweat cools the body. Body heat increases when you burn more calories. For you, brisk walking is burning more calories.
DEAR DR. DONOHUE: My wife has wet macular degeneration. Should she take the newly approved Macugen treatment for this condition? – P.C.
ANSWER: The macula is a circular area of the retina smaller than a very small shirt button. It’s responsible for the perception of the most detailed sight, the kind involved in reading, sewing and watching TV. Macular degeneration, a common cause of vision loss in older ages, comes in two varieties – dry and wet. Dry macular degeneration – the more common variety, accounting for 85 percent to 90 percent of all cases – comes about from a crumbling of the macula’s cells. The more unusual form, wet macular degeneration, results from a proliferation of blood vessels that sprout beneath the retina. These vessels are fragile. They leak fluid and break, hence the name “wet.” As a consequence, scar tissue forms and can cause rapid and severe vision loss.
Researchers have looked for the reasons why these blood vessels should suddenly spring up, and they finally discovered it was due to VEGF – vascular endothelial growth factor. VEGF is found in the eyes of people with wet macular degeneration, and it is the substance that spurs vessel growth. Armed with that information, other scientists found a medicine that can counteract VEGF – pegaptanib (Macugen). Eye doctors inject Macugen into the eye, a procedure that sounds awful but is not. The medicine reduces vision loss, slows progression of wet macular degeneration and, in a few, improves vision.
Macugen is new, but it is not the only treatment for this condition. Photodynamic inactivation is another good treatment. A drug is injected into an arm vein. This drug makes it to the newly formed, fragile blood vessels lying beneath the retina and lodges in them. An infrared laser, shined in the eye, coagulates the blood vessels that have the drug in them and seals them off. I can’t say what procedure is better or more suitable for your wife. Her eye doctor has to guide her in the choice.
Readers who would like more information on both kinds of macular degeneration can order the booklet on that topic by writing: Dr. Donohue – No. 701, Box 536475, Orlando, Fl 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853- 6475. Readers may also order health newsletters from www.rbmamall.com
(c) 2008 Sun-Journal Lewiston, Me.. Provided by ProQuest Information and Learning. All rights Reserved.
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