Fitness/ lifestyle

What is the rehabilitation following hip replacement?

What is the cause of unintentional weight loss?

Why don't I put on weight in spite of eating more?

Why does my period cycle vary with lifestyle changes?

How can I lose weight?

Does the GM diet help in reducing weight?

How can I increase my one-year-old daughter's weight?

How do I overcome stress and induce appetite?

Why did I lose shape after leaving the gym?

How can I check if my protein intake is sufficient?

 

What is the rehabilitation following hip replacement?

Q. I am 34 years old woman with sickle cell disease. I recently had a total hip replacement and dislocated two days after the surgery. I was then rushed to the hospital and the hip was put back in place but was asked to wear a brace. I wore that for about 6 weeks and that actually did all the precautions for me. Now my problem is that I can’t bend my hip more than 40 degrees. My hip is very stiff and I can’t even put on my clothes. Life is very difficult now and even though I go for therapy every other day, this is not really helping much. I can’t even open my legs to put a pillow in between. I went to see my doctor for aspiration and the result is negative, the x-rays according to the doctors look great so they don't really know where the problem is. I am very depressed and have lost weight. Is there anything I can do to ease this stiffness and be able to climb stairs?

A. Rehabilitation following total hip replacement (THR) involves therapeutic exercise, transfer training, gait training, and instruction in the activities of daily living. Specific exercises are to be done several times a day to restore movement and strengthen the hip joint. Following surgery, the aim is to concentrate on improving the skills you have already started to work on. These include the exercises, getting off and back onto the bed, walking independently with the crutches, managing the toilet and washing and sitting out in the chair. When fit enough, the patient can begin to dress, bathe and manage functional activities. Appropriate weight-bearing activities are the most useful way of improving muscle power and walking pattern. It takes about 3 months for the new tissue to form around the hip joint, which helps hold it in place but till then the risk of dislocation is there.
The normal hip, in contrast to the artificial hip, is a deep and stable joint with very strong ligaments and much greater force is required to dislocate it. The new joint, in comparison, is shallower and the local anatomy altered so it is more prone to dislocation.
Your stiffness will be helped by the following exercises and activities. The exercises should be done four times a day in a set of ten repetitions each. Tie one end of a rubber around the ankle of the operated leg and the opposite end to a stationary object such as a locked door or heavy furniture. Hold on to a chair or support for balance. Stand with your feet slightly apart. Bring your operated leg forward keeping the knee straight. Allow your leg to return to its previous position. Stand sideways from the door and extend your operated leg out to the side. Allow your leg to return to its previous position. Face the door or heavy object to which the tubing is attached and pull your leg straight back. Allow your leg to return to its previous position.
Cycling (twice a day for 10 to 15 minutes 3-4 times a week) helps regain muscle strength and hip mobility. Adjust height such that the bottom of your foot just touches the pedal with your knee almost straight. Initially pedal only backwards till you are comfortable and only then do forward pedalling. After about 4 to 6 weeks, you can increase the tension on the cycle.
Walking use a cane till you have regained your balance. Begin with a 5 or 10 minutes walk 3 or 4 times a day and as your strength and endurance improves, increase it to 20 or 30 minutes 2 or 3 times a day. Once you have fully recovered, regular walks, 20 or 30 minutes 3 or 4 times a week, will help maintain your strength.

You need to consult a good physiotherapist/occupational therapist who can lead you through the protocol so that an active exercise regimen and rehabilitation programme can be followed.

 

What is the cause of unintentional weight loss?

Q. I lost about 51 pounds in 3 months. I cannot sleep, feel irritable and weak. My EOS percentage is 5.8. What should I do?

A. Unintentional weight loss is a decrease in body weight that is not voluntary and requires medical assessment if it is unexplained and more than 10% of normal body weight. The two basic mechanisms that lead to it are reduced intake of food or increased metabolic rate. Among the many causes are included endocrinal diseases (hyperthyroidism, diabetes, hyperparathyroidism, hypoadrenalism), gastrointestinal (malabsorption, chronic diarrhoea), psychiatric problems (eating disorders, depression, alcoholism), neurological diseases, chronic infections, cancer and medications. You need to be examined by a physician who will decide what investigations are necessary and then plan the treatment

 

Why don't I put on weight in spite of eating more?

Q. I am 15 years old. I weigh 56 kg in the morning. I eat as much as I can everyday. I am on a mission to get fat. By night-time, my weight goes to 58-60 kg. But after going to the toilet the next morning, my weight comes back to 56 kg. I have repeated this for weeks, but to no avail. Where does the food go?

A. The food we eat gets utilised by the body to carry out daily activities. When we eat food, it gets digested in our body and absorbed as energy, fats, minerals and vitamins. We need these nutrients for a healthy body and also to carry on every activity like walk, run, sit, etc. After the food is digested, the waste material is excreted out of the body. This is how we maintain our weight. If our bodies were not made to follow this basic system, we will gain weight every time we eat. In simple words, food that goes inside our body, gets utilised and the waste is excreted out. This is how we maintain our weight. You are still young to understand all the body systems but I am sure you will learn more in higher grades/classes and all these concepts will become much clear.

Q. I am 15 years old. I weigh 56 kg in the morning. I eat as much as I can everyday. I am on a mission to get fat. By night-time, my weight goes to 58-60 kg. But after going to the toilet the next morning, my weight comes back to 56 kg. I have repeated this for weeks, but to no avail. Where does the food go?

A. The food we eat gets utilised by the body to carry out daily activities. When we eat food, it gets digested in our body and absorbed as energy, fats, minerals and vitamins. We need these nutrients for a healthy body and also to carry on every activity like walk, run, sit, etc. After the food is digested, the waste material is excreted out of the body. This is how we maintain our weight. If our bodies were not made to follow this basic system, we will gain weight every time we eat. In simple words, food that goes inside our body, gets utilised and the waste is excreted out. This is how we maintain our weight. You are still young to understand all the body systems but I am sure you will learn more in higher grades/classes and all these concepts will become much clear.

Why does my period cycle vary with lifestyle changes?

Q. I am 32 years old and got married recently. I weigh 42 kg and I am anaemic. My periods cycle is for 21 days only. Is it normal? Earlier my cycle lasted for just 15 days. For this I took an ayurvedic medicine, which was effective. Why does my cycle vary with changes in the life? What diet should I take to increase my haemoglobin? I also have dark circles around my eyes and I get very tired by the end of the day. I am a working lady. Please advise.

A. The menstrual cycle in women ranges, on an average, from 21-35 days and occurs in response to a complex interplay of hormones (oestrogen, progesterone, follicle stimulating hormone and leutinising hormone) and organs (including the hypothalamus & the pituitary gland located in the brain, and the ovary). Nearly 1/5th women experience cycles that are irregular. If your cycles are occasionally irregular, it should not worry you too much but in case they are consistently irregular, you need to be evaluated by your doctor. The cycle can be influenced by stress; thoughts and emotions; a break in routine; anxiety about pregnancy; sexual activity; dietary problems like poor diet, anorexia, bulimia; too much exercise, medicines; and illness (thyroid disease) etc. An irregular cycle suggests a problem with the hypothalamus, pituitary, ovary, or uterus and by carefully and systematically examining each level, a doctor can figure out what is going on.
If your cycles are regular, but you are experiencing irregular bleeding in between, you are probably ovulating, but may be having bleeding associated with ovulation, a polyp, a fibroid, a cervical lesion, infection, or bleeding from a source outside the uterus (non-uterine bleeding - from the urinary tract, vagina, or cervix). If your cycles are not coming at regular intervals, chances are that you are not ovulating regularly. This may be caused by a problem with the hypothalamus, pituitary, or the ovary. Conditions that can affect the hypothalamus include, stress, dieting, anorexia etc. Conditions that can affect the pituitary include increased levels of prolactin from a prolactinoma (a benign pituitary tumour) and certain drugs. The most common condition that can affect the ovary is polycystic ovarian syndrome (PCOD). Being very young or perimenopausal can also affect your cycles. The thyroid gland (hyperthyroidism or hypothyroidism) can also affect menstruation. It is helpful to keep a “menstrual diary” in which you record the pattern and amount of the bleeding.

Anaemia is a condition in which the number of red blood cells or the amount of haemoglobin is below normal for age and sex of the individual. It is defined as a decrease in red blood cell (RBC) mass and is usually discovered and quantified by measurement of the RBC count, haemoglobin (Hb) concentration, and haematocrit (Hct). Anaemia is suggested in males with Hb levels less than 13.0 g/dl and in females with Hb levels less than 12.0 g/dl (less than 11.5 g/dl in pregnant women). It may be due to decreased production of red blood cells, blood loss (haemorrhage) or red cell breakdown (haemolysis). Anaemia is a symptom of disease that requires investigation to determine the underlying cause. It is twice as common in women than in men, especially during the childbearing years due to menstrual blood loss and pregnancies. One of the commonest cause of anaemia in our country is nutritional deficiency - iron deficiency &/or folic acid/vitamin B12 deficiency. Your symptoms are likely due to the anaemia possibly caused by heavy and unpredictable bleeding due to irregular cycles.
Please get yourself examined by a physician and a gynaecologist and get a complete blood count done (which includes red cell indices) along with a reticulocyte count and a peripheral smear examination. This will give an idea of the underlying cause on which the treatment depends.

How can I lose weight?

Q. Please help me out plan out my workout? I am 23 years old, 5 feet 7 inches tall and weigh 60 kg. My vital statistics are 34-30-38 inches. I want to lose weight from 60 kg to 54 kg. I am not under any training. We have a gym at our office but there is no instructor there. I do cycling for 10-15 minutes and burn 100 calories and then run on the treadmill for 10 minutes at the speed of 100 to burn another 100 calories. I also do 50 crunches and in all spend 45 minutes. Please guide.

A. A good way to lose weight is to combine calorie-reduction with spending calories as much as you can. To achieve the first, you have to eat a balanced, nutritious meal, which our dietician will be able to help you with. It may not be a good idea to miss any meal as that slows the metabolism down and hinders weight loss.
To aid that process, you may like to add on any exercise you can manage to get. The best results are when the exercise should be regular and consistent, but the good news is that every bit counts! So find some way of incorporating any activity into your daily routine - walking to the office or school, using the stairs or any weekend routine can also be of help. If you want to get on a serious weight loss plan, besides commitment, you need to go in for a 3-pronged plan
1. Aerobics:
You need to work on building your heart-lung (cardiovascular) endurance. Take up any activity form cycling, to running or jogging to skiing to swimming to even brisk walking to get that gut into its original size. This kind of activity will draw upon the fat stores in the body for generating fuel to last that long. The presence of oxygen (controlled breathing during this workout, instead of huffing and puffing) will mobilise the fat to get utilised instead of stored. This will take care of the fat that lies above the muscles.
Thankfully, any aerobic activity that elevates your heart rate can help you burn fat and take off unwanted pounds. Many experts recommend doing at least three sessions of 20 minutes of aerobic activity per week. Ideally, for long-term weight control, you should engage in at least four sessions per week, for 45 minutes each time.
2. Weight Training or Yoga
Get a yoga teacher to train you in the complete area of yoga or you can join a gym or work out at home with an overall weight-training program so that the lean mass percentage in the entire body increases. Balance your abdominal crunches and leg lifts with an equal amount of effort for the lower back to ensure it is not weak. Work out the rest of the body for the best results. And of course, concentrate on technique and quality of your abdominal crunches and pelvic lifts, rather than higher repetitions. And remember, exercises such as these only improve the tone and endurance of the muscles, they don't burn fat. It is best to have a gap of 48 hour before you work out the same muscle group again. And it will help if you change the routine once in every month or so.

For the upper body, a good exercise is doing the push-up, which takes care of the entire front and back region. For the lower body, a great way to tone it is doing squats and lunges. So combine that with abdominal crunches and lower back extensions and you have a complete workout in a good deal of time.
3. Healthy diet spread through the day, not night
Eating the right food out of habit rather than as a fad, can work wonders for an extra middle. Keep the calories light and spread out through the day rather than bunching them all at night and then sleeping on it, when the body's metabolic rate is the slowest.

Does the GM diet help in reducing weight?

Q. Does the GM diet actually work? If it manages to reduce weight, does one feel lifeless and dead?

A. The GM diet and health program was developed for employees and dependents of General Motors, Inc. and was intended for their use. It recommends that during the first seven days you must abstain from all alcohol and that you must drink 10 glasses of water each day. The weekly recommendation is as follows:
Day One All fruits except bananas in any quantity you want. It is suggested that you consume lots of melons the first day especially watermelon and a loupe. You are preparing your system for the upcoming programme. Your only source of nutrition is fresh or canned fruits. Fruits are nature’s perfect food. They provide everything you could possibly want to sustain life except total balance and variety.

Day Two All vegetables. You are encouraged to eat until you are stuffed with all the raw or cooked vegetables of your choice. There is no limit on the amount or type. For your complex carbohydrate, you can start day two with a large baked potato for breakfast. You may top the potato with one pat of butter. This starts with a fix of complex carbohydrates coupled with an oil dose. This is taken in the morning for energy and balance. The rest of day two consists of vegetables, which are virtually calorie free and provide essential nutrients and fibre.
Day Three A mixture of fruits and vegetables of your choice in any amount, any quantity. No bananas. No potatoes because you get your carbohydrates from the fruits. Your system is now prepared to start burning excess pounds. You will still have cravings, which should start to diminish by day four.
Day Four Bananas and milk and soup. Today you can eat as many as eight bananas and drink three glasses of milk. The bananas are for the potassium you have lost and the sodium you may have missed the past three days.
Day Five You can eat beef and tomatoes. You are allowed two 10 oz. portions of lean beef. Combine this with six whole tomatoes. On day five, water intake must be increased by one quart. This is to cleanse your system of the uric acid. The beef is for iron and proteins, the tomatoes are for digestion and fibre. Lots and lots of water purifies your system.
Day Six Beef and vegetables in an unlimited amount providing Iron and proteins from beef, Vitamins and fibre from vegetables.
Day Seven Today your food intake will consist of brown rice, fruit juices and all the vegetables you care to consume.

These are just highly publicised Western fad diet regimes gaining popularity in
India.
But do these diets actually deliver the promised results? None of the prescribed plans actually offered proof of shedding the pounds and, more important, keeping them off. Besides the lack of concrete evidence to back actual weight loss, there is another point: After completing your diet, will you be able to successfully maintain weight loss? Or will you promptly pile on the kilos at lightning speed?
Most fad diets do not make any allowance for maintaining the weight that is lost. And, eventually, most dieters find the diet too monotonous to stick to for the long term. They then resort to bad dietary habits again. Instead of merely yielding short-term results, a correct and healthy diet programme should help you improve your habits, so you can maintain the weight lost.
Instead follow these simple guidelines:
1. Focus on improving your dietary habits by having all nutrients in moderation.
2. Make sure you have a balanced diet. This ensures that you get your daily dose of minerals, vitamins, fibre, carbohydrate, protein and fat etc.

3. Consult a qualified dietician to work out a diet plan tailor-made to suit your lifestyle, body type and health condition.
4. Exercise regularly.

How can I increase my one-year-old daughter's weight?

Q. My one year and 3 months old daughter is underweight. Her birth weight was 3.37 kg. Her present weight is only 8.7 kg. Her present diet is one or one and a half idly, one chapathi or dosa early in the morning; two or three cashew nuts after an hour. A small banana at noon. Rice with juice for lunch. Chapathi or a dosa for evening snack and rice with or without juice for dinner. I feel that she is not gaining weight according to her food intake. Her mother is suffering from hypothyroidism. My daughter's blood was tested at 3 months and the thyroid was functioning well. When I consulted the doctor, he said that there is nothing to worry. Should I be worried? What can be done to increase her weight?

A. There really isn't anything to worry. The food intake of the child has to simply depend on her likes and dislikes. There may be parts of the diet, which she does not appreciate and may be she is being nagged into eating. Too much nagging leads to loss of appetite in children. More so, they need new ness in food, as they get very bored of routine foods. Increase the quantity of the current foods given to her, only slowly. Also inculcate whole grains, bran, dalia in the diet. Introduce other dry fruits also like almonds, etc and make sure that she enjoys eating whatever little amount she eats.

She may be a slow gainer of weight. Enquire with the paediatrician for the need of an appetiser. It may help.

How do I overcome stress and induce appetite?

Q. I am 29 years old and a mother of two kids, 3 and 2 years old. I personally take care of the children and have a small convenience store. I am also currently studying. Hence, my life is very stressful. I am hoping you could help me have a healthy lifestyle. What vitamins and medications do I take to overcome the stress and induce appetite since I have a very poor appetite? My weight is about 47 kg.

A. From your brief note I can see that you are in a reasonable state running a store, looking after two children and studying in your spare time. Your weight of 47 Kg with a body mass index of just below 19 is adequate for your height, sex and age. However, you have raised some issues, which I am happy to comment on.
Diet - this should be well spread and well balanced containing meat or peas, beans and pulses, vegetables and fruit. Briefly, there are three main constituents of diet - carbohydrates (rice, bread, potatoes, pasta, milk, sugar); proteins (meat, bread, peas, beans, pulses); and fat (oil, butter, milk, meat, cheese) Roughly, you should aim to have about 50% of food intake as carbohydrates and the remainder as proteins and fat with less emphasis on fats. The latter should be mostly of vegetable origin and only a small portion from animal origin (e.g. butter, fat on the meat, red meat, milk, etc.) You should also endeavour to have a wide spread of vegetables, both root (potatoes, carrots, turnips) and leafy products (cabbage, spinach, cauliflower, kale, etc.).
Vitamins - if you take a balanced diet with adequate vegetables and fruit then you will get enough vitamins in your food. The vitamins work on some other components of food to make other microelements needed for a healthy metabolism. It is wasteful to take extra vitamins when the food intake is inadequate because there are no substances to work on for the vitamins.
Eating - if appetite and eating are a problem then one should take an active interest in thinking about food, organising menus, experimenting with newer recipes, and have fixed eating times unhindered by any other activity (e.g. television). Cooking and eating should not be regarded as a chore but incorporated into ones lifestyle as an interesting activity.
Stress – stress is part of living and some of it is necessary for a fruitful working practice. It is only bad when you allow it to rule your life and worry about things that might happen but haven't yet, or things that might have gone wrong but didn't, and so on. You should learn to relax in between your working spells. I would suggest taking up yoga if you haven't already done that.
I hope you will find this information useful.

Why did I lose shape after leaving the gym?

Q. I am 22 year old and weigh 51 kgs. I used to be very slim. I joined a gym and gained 5 kg. But I left exercising due to exams. After leaving the gym, I lost weight but my waist size increased. Gradually it became worse and now I look like 'four sticks coming out of a balloon'. I don't even feel hungry. I joined the gym again but it made the matters even worse, as I started losing hair and got body ache. The doctor said that it is due to anxiety. I wasn't convinced with this statement and refused to take their medicine. I have noticed that I get rashes after eating wheat and banana. Please advise.

A. You need to get an allergy test done at the earliest. Your irregular exercise habits have pushed your body into a negative metabolism due to which you look like what you said. You need to maintain a regular diet pattern in terms of having a sumptuous healthy (low fat) breakfast, and other meals like lunch and dinner in a proper regimen. Go for a brisk walk atleast 4 days a week for 30 minutes and refer the DoctorNDTV website for abdominal exercises. You can get a check up done from a general practitioner in case you have any digestive problems. Include camomile tea in your daily diet (maybe before going to sleep at night) for a restful sleep. Meditate if you feel anxiety of any kind. All will be well, don't worry. Best of luck!

 

How can I check if my protein intake is sufficient?

. I am 43 years old and weigh 81 kg. I am on weight training for the past 2 years. I lost weight initially and went down to 76 kg but I bounced back to 81 kg. I have reduced the fat around my belly significantly and the body looks more toned and muscular. I can bench press about 80 kg now. I work out for one and a half hour 5-6 days a week. How can I know, whether my protein intake is correct? I was told that a protein deficiency might lead to some problems. Is it correct? What are the likely problems? As of now I am not taking any supplements and my diet is also normal. I take chicken and eggs about 2-3 times a week. I am thinking of taking supplements like a Whey Isolate from Ultimate Nutrition Inc of USA. The recommended dosage is 2 servings normally. How much should I take?

  1. To know whether your protein intake is sufficient, you will need to get your intake for the day evaluated by a dietician, who will determine the grams of protein consumption. Given that you weight train and are interested in a protein supplement, I hope this helps you.

    Whey protein is a pure, natural, high quality protein from cow's milk. It is a rich source of the essential amino acids needed on a daily basis by the body. In its purest form, as whey protein isolate, it contains little to no fat, lactose or cholesterol. Protein needs vary by person depending upon age, weight, sex, activity level and overall health. Athletes and individuals with special medical needs often need more protein than the recommended dietary allowance, or RDA. Healthy diets should regularly include high quality, low fat sources of protein, like whey protein. Calories do count and you want to make sure that you are getting the most benefit from the calories you consume. Compared to other proteins, on a gram-to-gram basis whey protein isolate delivers more essential amino acids to the body, but without the fat or cholesterol. To make sure you're getting enough protein, a diet with a variety of protein foods is ideal, but for optimal results make sure that one of them is whey protein.

    To determine how much you should take look at the Nutrition Facts panel on your whey protein product and check the following to make sure you are getting enough whey protein:
    1. Find the number of grams per serving size and subtract the grams of protein per serving. The smaller the difference, the more concentrated the protein.
    Example:
    Whey Protein Powder #1
    One Serving = 29 Grams
    Protein Content = 21 Grams
    Whey Protein Powder #2
    One Serving = 42 Grams
    Protein Content = 14 Grams
    Whey Protein Powder #1 is a more concentrated protein powder vs. Whey Protein Powder #2. Check the ingredient label for product #2 to see what other ingredients it contains.
    2. Compare the grams of protein per serving to your daily protein requirement. How much protein will this specific whey protein product provide?
    Example:
    A = One Serving Whey Protein Powder; A = 20 Grams
    B = Daily Protein Requirement; B = 60 Grams
    A Divided by B = the % of the daily protein requirement provided by 1 serving of this specific whey protein powder. 20/60 = 0.33 or 33%.
    3. Determine the number of calories in one serving. Although some sweetener is helpful to enhance flavour, many products contain excess sugar and other ingredients that can add unwanted calories. The amount of sugar per serving is listed on the label.
    There are no documented side effects provided you do not have an allergy to dairy proteins or does not need to restrict dairy products for medical reasons. If you are allergic to dairy proteins please consult with a physician prior to consuming any type of whey protein. You can take the supplement on all days; on the days that you are working out make sure that you take the supplement post workout.