While getting adequate exercise is generally recommended in order to maintain optimum overall health, the fact is that even low impact exercises carry with them some element of risk, particularly for the elderly or those with underlying health conditions.  By following some simple and basic rules of thumb, it is possible for virtually anyone and everyone to incorporate some form of exercise safely into their life.

First of all, before beginning any new exercise program, it is important to take stock of your current state of physical health.  You know your body and its limits better than anyone, and you should try to stick to exercises that are within your comfort zone, at least to start out.  Also, do not feel as though you have to overexert yourself to get the benefits of exercising – any exercise you can incorporate into your life is good for your overall physical health.  Generally, it is best to start slow and easy and build the intensity and length of your workouts gradually over time.

If you are in poor physical health, you should take extra precautions when beginning or modifying any exercise program.  For example, anyone with a heart condition, high blood pressure, a thyroid condition, osteoporosis or arthritis, asthma or emphysema, seizure disorder or other potentially dangerous underlying health condition, you should always run your exercise plans by your doctor before beginning a new program.  This can ensure that you do not overdo it and turn a potentially beneficial healthcare decision, such as getting more exercise, into something that may be harmful.

Once you are ready to begin your exercise routine, it is important to start out slow.  Always warm up before you begin any actual exercises to prevent muscle pulls and strains.  Simple stretches such as toe-touches and cardio such as running in place make great warm-ups.  Additionally, it is also important to cool down after exercising.  This prevents muscle cramps and other discomfort from occurring post workout.  Generally, you should plan on at least 5 minutes before and after each workout for warming up and cooling down.  Also, if at any time during your workout you feel as though you may be pushing yourself too hard, stop.  You should not feel actual pain while working out.

The elderly are particularly susceptible to issues such as heat exhaustion and dehydration.  For this reason it is imperative to maintain proper hydration and core temperature while exercising, especially if you are age 60 or older.  This can be accomplished by exercising in an air conditioned facilities or during the cooler parts of the day such as early morning or later in the evening.Additionally, it is important to be aware of the symptoms of overexertion.  Among the most common early symptoms of overexertion are headache, nausea, and dizziness.  If you begin to feel any of these symptoms, it is time to let up on yourself, cool off, and get rehydrated; this can prevent overexertion or heat exhaustion from progressing into a dangerous case of full-blown heatstroke, which can be fatal.

Flu season 2009 is almost here, and it brings with it a new and potentially strain known around the world as H1N1, or Swine Flu.  Since being discovered earlier this year, Swine Flu has become an official pandemic, spreading around the globe with speed and ferocity; as of July 2009 there were nearly 90,000 confirmed cases of the novel virus around the world, with almost 400 of these cases resulting in death.  Because the Swine Flu is a novel virus, virtually no widespread immunities to the illness exist; and with flu season just around the corner, panic is really starting to set in.

If you are like most people in America and around the world, you are wondering how to protect yourself from this new and potentially deadly flu strain.  Fortunately, while Swine Flu is clearly very contagious, most people who have been infected had symptoms that were as mild as or milder than the seasonal flu.  Despite this fact, people have died, and if current trends continue, many more will lose their lives to this virus before flu season comes to a close.  Because of this, it is imperative that we all do our part to protect ourselves and slow the spread of this virus.

Perhaps the most proactive step that you can take to protect yourself from the Swine Flu is to get vaccinated.  The FDA has approved an H1N1 vaccine which is scheduled for distribution beginning in mid October, with those who have been deemed most at risk being first in line.  High risk groups for contracting the Swine Flu include the elderly, young children and infants, pregnant women and those with underlying health conditions.  Because this was very much a fast-tracked vaccine, many people are apprehensive about being inoculated against H1N1; however, under the circumstances, with a global pandemic having already been declared and the potential for millions or even billions of people to get sick, it really is the best option on the table right now.

If you do choose to get the Swine Flu vaccine, it is imperative that you understand that it does not protect against seasonal flu.  Additionally, just because you have been vaccinated does not mean that contracting the illness is impossible, so good hygiene and proper sanitation are absolutely essential in order to keep this virus in check.  This means such basic, fundamental practices as proper hand washing, covering your mouth when you cough or sneeze, covering your mouth with your arm rather than your hand, and staying home when you are sick may be the very things that keep you healthy and ahead of the curve this flu season.

Finally, if you do find yourself presenting Swine Flu symptoms, it is very important that you do not go to the ER or even the doctor unless it is absolutely necessary.  As the flu is a viral infection, it will generally clear up on its own over the course of a few days.  Medical intervention is generally only required in very extreme cases, and staying home while contagious is the best way to prevent the spread of the virus to others.

For Immediate Release:

InterGen Health sends staff into the community to increase awareness of Swine Flu.

In light of the World Health Organization’s increase of the world Pandemic threat level from four (4) to five (5), InterGen Health’s administrator Jason Newman, has elected to close InterGen’s offices and send all office staff into the community to increase the public’s awareness of Swine Flu. Armed with informative flyers, these staff members will be informing the community of the signs and symptoms of the Swine Flu as well as ways to prevent transmission and proper hand washing techniques.

InterGen representatives and informational flyers can be found at the following locations:

• Times Square NYC
• Penn Station NYC
• Grand Central Station NYC
• Grand Concourse and Fordham Road Bronx
• 71st and Continental Ave Subway Queens
• Nostrand and Flatbush Ave Junction Brooklyn

Intergen Health is committed to ensuring the health and well being of our patients as well as the safety of the community at large.

Swine Flu Awareness Flyer [PDF]

With the recent outbreak of Swine Flu across the country, and especially in the New York area, we at InterGen suggest the necessary precautions to ensure the safety and well being of our patients and staff.

Frequent Hand Washing can prevent the spread of the Swine Flu, Antibacterial soap, Gloves and Department of Health recommended N95 face masks are available at all InterGen Locations.

Below is the New York State Department of Health information regarding the outbreak. The team at InterGen is working hard to keep our field staff informed. Feel free to call us with concerns or if you think you or your patient may be exhibiting signs of Swine Flu.

Stay Safe,

Jason

Swine Influenza (swine flu) Questions and Answers

What is swine flu?

Swine Influenza, also called swine flu, is a respiratory disease of pigs caused by type A influenza viruses. Outbreaks of swine flu happen regularly in pigs. People do not normally get swine flu, but human infections can and do happen. Most commonly, human cases of swine flu happen in people who are around pigs but it’s possible for swine flu viruses to spread from person to person also.

Is swine flu the same as seasonal flu?

No. Seasonal flu is a contagious respiratory illness caused by human influenza viruses. It can cause mild to severe illness and at times can lead to death. Human flu viruses change a little bit every year which is why people can get sick from the flu more than once. It is also why a new flu vaccine is produced each year; the vaccine must be made to protect against the particular viruses circulating that year.

Is this the same as the bird flu that has been in the news in recent years?

No. There are many different types of influenza viruses. The bird flu virus that has been watched closely is categorized as influenza A (H5N1), and is transmitted primarily among birds. This virus has not been found in the United States.

Is swine flu the same as pandemic flu?

No. Rarely, an influenza virus undergoes a major change that results in a completely new virus. If the new virus spreads easily from person to person it is called a pandemic. Swine flu is not the same as pandemic flu. All human influenza pandemics in the past have been caused by human influenza viruses. Swine flu viruses have caused human infections before without becoming a pandemic flu virus. It is unknown whether this current swine flu A (H1N1) virus could become a pandemic.

Are there people infected with swine flu in the U.S.?

Yes. Cases of human infection with swine influenza A (H1N1) have been confirmed in California, Texas, Kansas, Ohio and New York City. It is the same virus found in people in Mexico. The current U.S. case count is provided below.

U.S. Human Cases of Swine Flu Infection State # of laboratory
confirmed cases

• California     7 cases
• Kansas     2 cases
• New York City     8 cases
• Ohio     1 case
• Texas     2 cases
• Total Count     20 cases

International Human Cases of Swine Flu Infection
See: World Health Organization WHO – As of April 26, 2009 9:00 AM ET

What is the current swine flu situation in New York State?

New York City health officials report that more than 100 students at the private St. Francis Preparatory School in Queens have come down with mild flu-like symptoms. CDC officials have confirmed that eight of these students have swine flu and it is the same strain of the virus as the one in Mexico. The school is cancelling classes on Monday and Tuesday in response to the outbreak.

The NYCDOHMH has issued recommendations for New York City residents on their web site, at: http://www.nyc.gov/html/doh/html/pr2009/pr015-09.shtml

What is New York State doing to identify additional swine flu cases in New York?

The New York State Department of Health conducts flu surveillance throughout the year. To ensure rapid detection if any swine flu cases occur here, the New York State Department of Health is testing selected laboratory samples from people who are suspected of having swine flu.
Should I keep my child home from school as a precaution?

No. Parents do not need to keep otherwise healthy children home from school unless directed to do so by local school and health officials.

Children who are ill should not attend school. In this case, monitor your child for influenza-like symptoms, including fever, body aches, runny nose, sore throat, nausea, vomiting or diarrhea, and keep your child home if they are sick. You may want to contact their health care provider, particularly if symptoms are severe. Be sure to tell your doctor if you have recently traveled, especially to those areas where swine flu has already been found, including San Diego County and Imperial County, California; San Antonio, Texas; Dickinson County, Kansas; Lorain County, Ohio; and New York City. Your health care provider will determine whether influenza testing or treatment is needed.

How are people getting sick from swine flu?

CDC has determined that this swine flu virus is spreading from person to person. Spread from person to person is thought to occur in the same way as seasonal flu, mainly through coughing or sneezing of infected people. However, at this time, it not known how easily the swine flu virus spreads between people.
What are the signs and symptoms of swine flu in people?

The symptoms of swine flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and vomiting associated with swine flu. Like seasonal flu, swine flu can vary in severity from mild to severe, and may cause a worsening of underlying chronic medical conditions. The severity of illness from the current swine flu strain is not yet clear. The few cases found in the United States so far have been mild.

Can swine flu be treated?

Yes. This swine flu virus is susceptible to certain antiviral drugs used to treat flu infections (oseltamivir, or Tamiflu, and zanamivir, or Relenza). For treatment, antiviral drugs work best if started soon after getting sick (within 2 days of symptoms). If you become ill and are diagnosed with influenza, your doctor can determine if you should take antiviral drugs.

Should I ask my doctor for a prescription anti-flu drug?

No. Antiviral drugs are usually used to treat people who are at risk for developing life-threatening complications from the flu. There is no reason to routinely ask for one of these drugs to keep at home, or to take them just as a precaution. Over-use could result in limited supplies for those who need it most. In addition, over-use of antiviral drugs has been known to lead to flu viruses becoming resistant to the drugs. All drugs, including antivirals, can cause side effects and should only be used when necessary under the direction of a health care provider.

How long can an infected person spread swine flu to others?

People with swine flu infection should be considered potentially contagious as long as they are symptomatic or possibly for up to 7 days following illness onset. Children, especially younger children, might potentially be contagious for longer periods.
Is there a vaccine against swine flu?

There is currently no human vaccine against swine flu. It is not known whether the current human flu vaccine provides partial protection against swine flu. CDC has already begun development of a vaccine for swine flu, but this will not be available for months.
Can I get tested for swine flu?

The New York State Department of Health has provided guidance to health care providers and hospitals throughout the state regarding who should be tested for swine flu and what specimens to collect. If you are severely ill or worried about your symptoms, contact your health care provider who will determine whether testing is necessary.

What can I do to protect myself from getting sick?

There are everyday actions that can help prevent the spread of germs that cause respiratory illnesses like influenza. Take these everyday steps to protect your health:

• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
• Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
• Try to avoid close contact with sick people.
• Avoid touching your eyes, nose or mouth. Germs spread this way.
• If you get sick with influenza, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.

What should I do if I get sick?

If you become ill with influenza-like symptoms, including fever, body aches, runny nose, sore throat, nausea, vomiting or diarrhea, you may want to contact your health care provider particularly if you are worried about your symptoms. Be sure to tell your doctor if you have recently travelled, especially to those areas where swine flu has already been found, including San Diego County and Imperial County, California; San Antonio, Texas; Dickinson County, Kansas; Lorain County, Ohio; and New York City. Your health care provider will determine whether influenza testing or treatment is needed.

If you are sick, you should stay home and avoid contact with other people as much as possible to keep from spreading your illness to others.
Should I avoid travel to other countries or areas of the United States where swine flu has been identified?

CDC maintains a Travelers’ Health web site at: http://wwwn.cdc.gov/travel/contentSwineFluUS.aspx

You should check this site for any restrictions. This site also provides recommendations to help you reduce your risk of infection.
Can I get swine flu from eating or preparing pork?

No. Swine influenza viruses are not spread by food. You cannot get swine influenza from eating pork or pork products. Eating properly handled and cooked pork products is safe.

Additional information can be found at the following web sites:

General influenza information: http://www.nyhealth.gov/diseases/communicable/influenza/

CDC Information about swine flu http://www.cdc.gov/swineflu/general_info.htm

Here is the latest newsletter from our favorite Dietician Sharon Richter MS, RD, CDN — (republished with permission).

For more great tips and articles visit www.sharonrichter.com.