Charlotte.com: Health and Family

Critters can be cute-but may be rabid

Sun, 06 Jul 2008 06:53 EDT

Ten-year-old Summer Langston is being treated for rabies after a fox chased her and scratched her leg with its teeth two weeks ago as she played in her Clover, S.C., neighborhood.

In May, eight York County residents were treated for rabies after they handled, fed and allowed a pair of baby foxes they were caring for to lick their faces. One fox was later found to be rabid.

State health experts say such encounters with rabid animals are more common during the summer, when people spend more time outdoors.

And, as suburban areas like those in York County and elsewhere encroach on animal habitats, they say such encounters are increasingly likely.

So they're spreading the word about preventing rabies, a virus in mammals that attacks the nervous system, leading to swelling of the brain and death.

The virus is secreted in the saliva of an infected animal and is usually transmitted by a bite. But it can be transmitted when an infected animal's saliva comes in contact with an open cut on the skin or the eyes, nose and mouth, as happened in May.

Officials from the S.C. Department of Health and Environmental Control and York County Animal Control said they advise avoiding wild animals even if they appear to be sick, hurt or orphaned.

Wild animals normally avoid any human activity, said Mike Willis, spokesman for the S.C. Department of Natural Resources.

“If a wild animal is acting tame or allows a person to pet it, that is a red flag that the animal is sick,” Willis said. “What we have seen is that an animal such as a racoon will come out of the woods during the day and seem to be tame. People will pick it up and pet it, and it turns out to be rabid. The best thing is to stay clear of it.”

Willis said the agency has had an increase in reports of wild animals behaving suspiciously – such as acting friendly to people, or nocturnal animals being out during the day.

Even if a baby wild animal seems to have been orphaned, Willis and other officials advise leaving it alone.

“Orphaned wildlife should not be handled,” said Chris Peninger, director of the York County Animal Shelter.

Peninger said it is rare for wildlife to be orphaned, but if it appears they have been, they should be left alone for 24 hours to allow the parents to return. If the babies remain alone after 24 hours, Peninger said they should be reported to animal control.

The recent cases of rabies exposure in York County are among 13 people so far this year in the county who have had to undergo treatment for rabies prevention. Last year, seven people were treated in York County, the same number as in 2006. In South Carolina, an average of 400 people are treated for rabies each year, according to DHEC, a number that has held steady since 2002.

The fox that bit Summer was the fifth confirmed rabid animal found in York County this year, experts report. In 2007, 16 rabid animals were confirmed in the county, and there were 162 confirmed cases of rabid animals in South Carolina. So far this year, 50 rabid animals have been confirmed in South Carolina.

5 Questions for Coretta Robinson

Sun, 06 Jul 2008 09:51 EDT

Former NBC6 traffic reporter Coretta Robinson is now a personal trainer and fitness class instructor.
Robinson, who lives in Steele Creek with her husband and two daughters, takes her strength classes and fitness camps to various gyms and neighborhood sites throughout southern Mecklenburg.
Robinson, who turns 40 this month, talked with Neighbors of Southern Mecklenburg about making the switch from familiar TV face to fitness expert. Her remarks are edited for brevity. Celeste Smith

Are you still on television? I have been gone since November 2006. I have had absolutely no connection with broadcasting. I was at J.T. Williams Middle School for two years, teaching seventh-grade language arts. I will be at Alexander Graham Middle School this year.

I saw a man in the grocery store the other day. He said, “I've wondered where you had gone. I watched you every morning, I saw you in the helicopter.” People stop and talk and chat and they want to know what I'm doing now. It still makes me feel appreciated.

How did you move from broadcasting to fitness? It was (anchor) Colleen Odegaard. She had this idea (in 2000) that we could enter this half marathon and be a group and train together, and come across the finish line together as a group. I had never run a day in my life – I was a cheerleader. Running had never been something I ever wanted to do. It was unbelievable to actually complete it. And I kept running. I would come home from work at noon, I'd have my change of clothes in the kitchen so I wouldn't go to bed, and run an hour and a half every day.

My husband and I worked out in the garage every day. Then when they opened the Steele Creek Y, I started attending there. I got certified to teach fitness classes, and then I got certified to teach indoor cycling. Then I got certified as a personal trainer.

What do you teach? In the neighborhoods where I work, I have worked with most of the residents for some time, so those classes are more advanced. I teach a strength class with hand weights at the Fort Mill Y. Starting Monday, I'm supposed to have two days a week at Highway 521 Recreation Center. I call it a fitness camp. I'm afraid to use boot camp. The idea is to come and get in shape. It's movement, it's cardio, using your own body weight for strength and for sculpting, along with hand weights and bands, and flexibility and endurance.

I'm looking for registrants as we speak. People can register at www.exercise-matters .com (Robinson's Web site.)

Do you suspect people take classes because they recognize you? Charlotte is so ever-changing, with so many new people, especially in the neighborhoods I work at. Some people I've met never knew I was on TV.

What's your favorite workout? My favorite workout includes:

three sets of 12 slow squats with barbell

40 military push-ups or more

one-minute floor jacks (performed with hands and balls of feet on the floor, with the legs moving out in separate directions and back together.)

one-minute mountain climbers (placing hands and balls of feet on the floor, alternately pull each knee to the chest while keeping your hand on the floor.)

one-minute jumping jacks (with ankle bands as resistance)

four-minute rope series

V sit-ups, keeping both head and feet off ground (as many as possible)

(Repeat entire series two times.)

FDA panel: Diabetes drugs need more study

Wed, 02 Jul 2008 23:37 EDT

Diabetes drugs should face tougher safety standards that could cost manufacturers millions but protect patients from unforeseen heart risks, a government panel has recommended.

Advisers to the Food and Drug Administration voted 14-2 Wednesday that all new diabetes drugs should undergo longer studies to assure they don't increase risks of heart problems. The agency currently doesn't screen for heart risks associated with diabetes drugs.

The opinions from diabetes experts, cardiologists and statisticians come less than a year after the FDA was criticized for its handling of heart risks connected with a widely used GlaxoSmithKline pill. The drug was approved in 1999 but the agency didn't add a warning about potential heart risks until last November.

The majority of the panel said drug companies could begin safety testing before they submit drugs to the FDA, and finish the studies after the drugs are on the market. The testing would take an estimated five to seven years to complete, and likely cost tens of millions of dollars.

At least one panelist doubted whether the proposed studies would actually uncover heart risks, and added they could delay important medical breakthroughs.

“If you wait this amount of time for testing you're going to be preventing certain drugs from getting out there that may be better than what we already have,” said Dr. Eric Felner, a pediatric specialist at Emory University School of Medicine.

The FDA is not required to follow the panel's advice, though it often does.

Nearly 24 million Americans have Type 2 diabetes, which can lead to kidney failure, blindness and heart disease.

The FDA was pressured to reconsider how it approves diabetes medications after an analysis released last year showed GlaxoSmithKline's blockbuster drug Avandia may increase patients' risk of heart attack.

The agency currently approves diabetes drugs based on their ability to lower blood sugar. But Dr. Steven Nissen, who authored the analysis on Avandia, said Tuesday that criterion has little value if drugs also increase heart problems.

Nissen, the chairman of cardiology at the Cleveland Clinic, said the FDA is operating under “the irrational belief that lowering blood sugar using virtually any pharmacological means will produce” better results for patients.

Approving drugs based on biological measurements, like blood sugar levels in diabetics, is thought to be a promising method for speeding-up drug development because the results can be gathered relatively quickly.

For Medicare users, vendor choices dive

Tue, 01 Jul 2008 06:54 EDT

As new Medicare rules take effect today, longtime local suppliers of wheelchairs and other medical equipment are complaining that the federal government's new bidding process will devastate their business and degrade service to patients.

“Quite frankly, I believe it's a train wreck in progress,” said Bill Griffin, owner of Griffin Home Health Care on Monroe Road. “Rather than improving the competition, this is actually taking away competition.”

As of today, only 325 approved suppliers nationwide will be allowed to provide Medicare recipients with 10 common home health care items. It's a significant decrease in the number of approved suppliers.

In the Charlotte region, for example, about 75 companies have provided oxygen and respiratory equipment. Starting today, there will be 12.

The new bidding requirements are intended to reduce fraud, cut patients' costs and save Medicare $1 billion a year. But critics have complained to Congress that the new rules will reduce the convenience and quality of some services patients get now.

Some senators, including North Carolina's Elizabeth Dole, say they still hope to get new rules put on hold.

“It's very frustrating that the Senate couldn't get this bill passed,” Dole said in a statement. “Now, it is important for Congress to deliver a retroactive fix – and then a permanent solution.”

Congress mandated the competitive bidding process in its 2003 Medicare modernization bill. Charlotte is one of 10 metropolitan areas where it's being tried first. About 4 million beneficiaries are affected in the 10 markets.

Medicare is a government health care program for the disabled and for seniors 65 and over. Of the $382 billion total Medicare expenses in 2006, about 3 percent was for home medical equipment.

Griffin's business has provided a full line of home health care equipment for 25 years, but the company's bids were rejected because they were too high. He said two out-of-state firms that did win the bid have contacted him about being a subcontractor for them. He can't, he said – because they want to pay him too little for his service.

Of the 1,005 suppliers that competed in the bidding process nationwide, 38 percent were approved. The losers have no right to appeal and will have to wait three years to bid again.

Dennis Loflin – another N.C.-based medical services supplier who lost out – points out that one of the companies that won the bid to provide wheelchairs in the Charlotte area is Scooter Store of San Antonio, Texas. That company paid $4 million last year to settle allegations that it had overbilled Medicare by about $30 million, according to the Department of Justice.

Customers who already have equipment will be “grandfathered” in. They can keep the equipment they have; and the providers, even if they weren't winning bidders, can continue to get reimbursed by Medicare for equipment they've already placed.

Charlottean Eileen Paroff learned about the changes in a letter from Medicare that arrived last week. Her 65-year-old husband, who is disabled, uses an oxygen concentrator and a C-PAP machine to help him breathe and sleep. But the current supplier of that equipment, CMC-Home Infusion, a unit of Carolinas Medical Center, isn't on the list of winning bidders.

She thinks their two machines will be “grandfathered,” but they will have to find a new approved supplier for tubing and filters.

Usually, she said, patients have received prescriptions from a doctor, who suggests companies to use. Now, that's changed.

“They give you no guidance,” Paroff said. “How do you know who the best one is? It's just sort of throw a dart and pick one.”

The Miami Herald contributed.

For some, eateries are the new senior centers

Sat, 28 Jun 2008 18:47 EDT

The coffee is hot and the conversation spiked with laughs as 10 friends, ages 61 to 83, take the big table near the door at Panera Bread on a recent morning.

Don Brown shares news about his daughter and her new boyfriend.

Iolene Brown shows a photo of herself and her husband, Bob, at their wedding in 1950.

Jack Devine (“This is a true story” is his favorite saying) tells the one about the funny phrase on the bottom of his coffee mug.

It's not officially a senior center, but the Ballantyne Panera could easily be the model of the center of the future.

As baby boomers age, experts say they won't want the same type of gathering place their parents and grandparents had.

They're more likely to choose something like Chicago's Mather Café Plus, a neighborhood hangout offering computer access and yoga along with the food.

Mather hasn't brought its Café Plus concept to Charlotte. But seniors are creating similar hangouts at spots like the Ballantyne Panera.

“It's not just a place to eat,” says Gene Francisco, 64, who invited me to meet the “gang” of mostly retired Northern and Midwestern transplants who meet for coffee nearly every morning.

This is where Rhea Caldwell, 60, brought several wigs to the table one morning to ask the gang's opinion on which looked best. She needed one to cover her hair loss from chemotherapy for breast cancer.

“You'd never believe she's sick when she comes to this table,” says Don Brown, 66.

And this is where Francisco's wife, Jane, 64, gets pep talks while caring for her 90-year-old father who “is not aging gracefully,” she says.

It's also where they share news about discounts and sales – like the time Don Brown led a shopping expedition to Dillard's at Eastland Mall after he saw men's shirts on sale for $2.

Panera's manager Deborah Smith, 52, says this is just one of several groups of seniors who meet there regularly. She gives regulars a Panera mug with their names painted on and sometimes reads to them from the book she's writing about her life.

One older woman Smith called “Mama” came in for coffee and a blueberry bagel every morning. When she died recently, her son sent a card saying how much the visits meant to his mom.

Smith has made friends with many of her older customers. She's even the main character in a story Devine tells about the “fork you” written on the bottom of his coffee mug.

Smith jokingly wrote the words there to commemorate the time Devine accidentally poked her with a fork during a particularly lively conversation.

Know of healthy changes? Tell me

Research shows that older adults who exercise, have good social networks and keep their brains nimble with sudoku or a new foreign language are less vulnerable to dementia.

If you or someone you know has made changes such as these to promote healthy aging, I'd like to hear about it: khaight@charlotteobserver.com; 704-358-5999.

Building the donor chain

Mon, 30 Jun 2008 18:29 EDT

When Bill Coram's kidneys started failing, his friend Tim Shain offered to donate one of his.

But their blood types didn't match, and the plan died. Or so they thought.

Coram still got a kidney from his friend, just in a very roundabout way.

The two signed up for a new chain-reaction transplant program that finds matches for pairings of recipients and their incompatible donors throughout the country.

It's run by the Alliance for Paired Donation, and it works like this: A patient who needs a kidney recruits a friend or family member to donate a kidney. That kidney will go to someone who needs it. In return, the APD finds the right match for the recipient.

The system should shorten the amount of time people have to wait for kidneys, according to the National Kidney Foundation. It could also cut back on dialysis treatments, which on average cost twice as much as transplants.

Joining the APD allows people in need of a kidney to take a more active role in finding a match than they would have on other waiting lists. At the same time, it removes some of the pressure for them to find their own direct donor.

The Toledo-based nonprofit has an estimated 130 pairs in its system, and has arranged 19 kidney transplants since it started in January 2007. It expects to do nearly 60 this year.

Coram was the first person in North Carolina to get a kidney through the program. He was the eighth recipient in the longest string of donations that so far includes 10 people. (See box.)

How his story began

Coram, 54, was alarmed when he had blood in his urine 12 years ago. An ultrasound revealed cysts in both of his kidneys: He had polycystic kidney disease, which blocks the kidney from filtering the body's waste products.

He was 42, and his doctor said when Coram hit his 50s or 60s, his kidneys would start failing.

When that happened a decade later, Coram started dialysis, which artificially filters the body's waste products. He hooked up to the dialysis machine for eight hours three times a week. He felt drained and didn't want to depend on dialysis for the rest of his life.

So he started looking for a replacement kidney and hoped to find one from a living donor because those organs last about 16 years, twice as long as cadaver kidneys. (People who donate one kidney are usually able to live normal lives with their remaining kidney.)

Coram asked friends and relatives, and made a plea for a kidney at his church, the First Baptist Church in Lincolnton. About 20 people stepped forward, but no one was a perfect match.

Among them was Sunday school acquaintance Tim Shain, 42, who was determined to help Coram get a kidney. He had heard Coram's teenage kids publicly pray for their dad to get a kidney. Shain, who has kids the same age, knew that he had to do something.

Shain's wife, however, wasn't thrilled about his decision at first. “I was angry,” she said. “I thought he was taking his life for granted and not considering the kids and me. We'd been married 18 years, and had always done everything as a team. This was his first solo act.”

But when Pam realized her husband's gesture was a spiritual act, she found his generosity humbling, she said.

In February, four months after Shain and Coram signed up for the APD, Coram was driving to church when he got a call from the Wake Forest University Baptist Medical Center: The APD had found a kidney for him from a 52-year-old man in Atlanta. They would fly the kidney to Wake Forest two days later so Coram could have his transplant.

This plan would proceed on one condition, Coram recalls: “They told me, ‘Tim still has to donate to someone else. If not, the whole thing is off,'” Coram said. Shain assured them he would follow through. Coram got his transplant. Shain gave up one of his kidneys three weeks later.

Loyal participants

APD Medical Director Dr. Michael Rees, a transplant surgeon at the University of Toledo, says he vetted for potential dropouts early in the program, and no one has backed out so far. The APD does not require participants to sign written contracts. But they do sign consent forms with the transplant centers protecting donors' right to change their minds about donating up until they go into the operating room.

“After the first few donors, I got a sense that people weren't going to cheat. They've already said they're willing to give a kidney to a loved one; then they've made the extraordinary step to give to a stranger. When they are willing to do that, they understood what they got themselves into,” Rees said.

Although Shain's energy dropped after the transplant, he's now training for a marathon.

Many donors want to ensure their kidneys are going to people who will take care of them, Rees added. Steve Zunde, Coram's donor, is also a runner with good dietary habits, and he asked that his kidney be respected. Coram called Zunde his “hero” in their first e-mail exchange, and the two will meet for the first time later this month.

Coram is careful to protect his new kidney by drinking more water and less soda. He feels as energetic as he did before he was diagnosed with kidney disease more than a decade ago.

He recently played tennis for the first time in more than 20 years.

When Bill Coram's kidneys started failing, his friend Tim Shain offered to donate one of his.

But their blood types didn't match, and the plan died. Or so they thought.

Coram still got a kidney from his friend, just in a very roundabout way.

The two signed up for a new chain-reaction transplant program that finds matches for pairings of recipients and their incompatible donors throughout the country.

The Toledo-based nonprofit has an estimated 130 pairs in its system, and has arranged 19 kidney transplants since it started in January 2007. It expects to do nearly 60 this year.

Coram was the first person in North Carolina to get a kidney through the program. He was the eighth recipient in the longest string of donations that so far includes 10 people. (See box.)

How his story began

He was 42, and his doctor said when Coram hit his 50s or 60s, his kidneys would start failing.

Coram asked friends and relatives, and made a plea for a kidney at his church, the First Baptist Church in Lincolnton. About 20 people stepped forward, but no one was a perfect match.

But when Pam realized her husband's gesture was a spiritual act, she found his generosity humbling, she said.

Loyal participants

Although Shain's energy dropped after the transplant, he's now training for a marathon.

Coram is careful to protect his new kidney by drinking more water and less soda. He feels as energetic as he did before he was diagnosed with kidney disease more than a decade ago.

He recently played tennis for the first time in more than 20 years.

How to get fit during lean times

Fri, 27 Jun 2008 18:19 EDT

In these tough economic times, some things have to go, such as bottled water, low-fat lattes and manicures. But you don't have to let your body go. Push-ups, jumping jacks and crunches are priceless. They cost nothing, and you can do them just about anywhere. Throw in a few relatively inexpensive workout gadgets, and it's just like having a gym membership with no fees or contracts.

To help you get started, experts share their favorite gadgets and tips for staying fit on a budget.

Resistance bands

“The most beneficial equipment would be a set of resistance bands,” says Ali Witherspoon, owner of A.L.I. Bootcamp in Hollywood, Fla. “They come in different strengths – light, medium and heavy resistance – to work your upper and lower body” just as gym equipment does. To perform biceps curls or an overhead press, for example, stand on the bands and grip the handles and go through the same motions as you would with dumbbells or machinery. Do just as many reps as you would in the gym.

Expect to pay less than $10 per band, which includes written instructions, or about $50 for a set of bands that comes with an instructional DVD.

More tips: www.alibootcamp.com

Calisthenics

“There's nothing better than old-fashioned body-weight exercises,” says Terrence Thomas, owner of Expert Fitness Solutions in Aventura, Fla. Push-ups and jumping jacks are great. As you get more comfortable, try squat thrusts: With your feet together, squat down and place your hands on the floor next to your feet. In one explosive movement, jump your feet backward into a push-up position, then jump your feet forward and stand up again. A mat is not necessary, but if you prefer one, expect to pay $20-$40.

Swiss ball

In addition to core training, such as sit-ups, which can be done on the Swiss ball, you can perform stretches and explosive athletic exercises, Thomas says. To do the Russian twist, place your back on the ball and keep your feet on the ground with your knees bent. Keep your torso straight, arms straight and hands touching. Then, move your arms from one side to the other, without pausing. You can also add a little weight to the exercise. Swiss balls, depending on the size, cost $20-$50. A 10-pound dumbbell should cost less than $15.

Signs point to thyroid problem

Fri, 27 Jun 2008 18:13 EDT

Q. I have taken thyroid medication for decades. I also take amitriptyline, calcium, multivitamins, Prempro and aspirin. My eyebrows are sparse. I have lost hair on my legs and arms as well as on my head. My dermatologist suggested I try Rogaine.

It hasn't been effective. My TSH level is between 5 and 6, and my cholesterol is over 240. I am a vegetarian and eat a very healthy diet with lots of fruits and vegetables.

No matter how much I exercise or watch my diet, I can't seem to lose weight. When I ask my doctor about all this, he dismisses my symptoms as unimportant. I'd be grateful for any advice.

Many of your symptoms, such as high cholesterol, sparse eyebrows, hair loss, depression and trouble losing weight, are consistent with too little thyroid hormone. Your TSH (thyroid-stimulating hormone) is high, another indication of inadequate thyroid function.

We are sending you our Guide to Thyroid Hormones with more information about symptoms, treatment and lab-test interpretation. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (59 cents), self-addressed envelope to: Graedons' People's Pharmacy, No. DJL-24, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our Web site: www.peoplespharmacy.com.

Estrogen (found in Prempro) may affect your thyroid test. Taking thyroid with a multivitamin or calcium could interfere with absorption and effectiveness.

Glaucoma eyedrops

Q. Can glaucoma eyedrops lower heart rate? Ever since I started using timolol, I haven't been able to reach my target heart rate when I exercise.

Timolol (Timoptic) is a beta blocker, which means it can slow heart rate whether taken orally or as eyedrops.

People's Pharmacy: www.PeoplesPharmacy.com

Link between SIDS, bacteria is growing

Sat, 28 Jun 2008 18:47 EDT

There is now more reason than ever to link common bacteria to sudden infant death syndrome (SIDS) or crib death.

The link was proposed decades ago, but evidence was scarce.

Now researchers from the Great Ormond Street Hospital for Children in London, who trawled through the results of about 500 autopsies, have shown that Staphylococcus aureus and Escherichia coli are more prevalent in SIDS babies than in those whose cause of death was known.

Bacteria are unlikely to be solely to blame, but the body's immune response to bacterial toxins may help explain how several known environmental and genetic risk factors for SIDS might become fatal.

Sleeping on the front increases bacteria in the baby's upper windpipe, smoking during pregnancy alters the fetal immune response, and some genetic differences in SIDS babies relate to immune response.

Let me explain: Kids aren't always due an explanation

Sat, 28 Jun 2008 18:47 EDT

In the mid-1970s, I attended a seminar that promised to train me to become an instructor in positive discipline methods. It turned out that the methods amounted to one: talking.

Any behavior problem could be solved, the trainer told us, by reasoning with a child. Furthermore, he said, adults should answer children's questions honestly. To not do so is to disrespect them, to deny that they are intelligent. By this point, I had had enough experience with trying to reason with my own kids to recognize baloney when I heard it. Many parents today, when their children misbehave, they talk. I call it “yada-yada discipline.”

They also seem to feel that if a child asks a question, he is due an explanation. The problem, as the mother of a 5-year-old girl recently discovered, is that children – to borrow from the title of a popular 1950s television show – sometimes inquire about “the darnedest things.”

Said mother and her daughter are sitting together one afternoon when the child asks what “hump” means. The mother, startled, blurts out that a hump is what one finds on the backs of camels. So far, so good.

This little girl is not so easily bamboozled, however. She persists. “I know that,” she says. “I mean what does it mean for one person to hump another person?”

She asks her daughter why in the world she is asking such a question. Who told her that people hump each other? The child answers that a boy (no surprises here) at school told her adults sometimes hump each other. “Like this,” she says, and then proceeds to demonstrate a pelvic motion familiar to fans of “The Rocky Horror Picture Show.” She then asks the most dreaded question of all: “Do you and Daddy hump?” The mother begins, yes, talking.

She tells her daughter that this is an inappropriate question and so is the motion. All this talking, I will bet, only further inflamed the child's curiosity. She probably went to school and told her friends that her mother said that to talk about humping was “inappropriate”; therefore, they will certainly talk and giggle some more about it and even make that motion with their hips.

The mother's sister asks, “What would you have done?” Easy. I would have given the camel answer, but then, when the child persisted, I would have said, “I have no idea what you are talking about. Your friend at school is mistaken” and I would have followed up on this, immediately, with something like, “I feel like a bowl of ice cream. How about you?” And the matter would have probably died a natural death.

Children are not entitled to answers to all of their questions. They are only entitled to answers to questions that they should be asking. If that means that they are sometimes “disrespected,” I'm all for it.

AGING WITH ACTIVITY

Sat, 28 Jun 2008 18:47 EDT

Fact: Every hour of every day, 330 Americans turn 60.

Fact: By 2030, one in five Americans will be older than 65.

Fact: The number of people over 100 doubles every decade.

Fact: As they age, people lose muscle mass and strength, flexibility and bone.

Fact: The resulting frailty leads to a loss of mobility and independence.

The last two facts may sound discouraging. But they can be countered by another. Regular participation in aerobics, strength training, and balance and flexibility exercises can delay and may even prevent a life-limiting loss of physical abilities into one's 90s and beyond.

This last fact has given rise to a new group of professionals who specialize in what they call “active aging” and an updated series of physical activity recommendations for older adults. These recommendations are expected to match new federal activity guidelines due in October from the U.S. Health and Human Services Department.

But don't wait for the government. Even if you have a chronic health problem or physical limitation, there are safe ways to improve fitness and well-being. Any delay can increase the risk of injury and make it harder to recover.

UNFAMILIARITY AND FEAR

Dr. Miriam E. Nelson, lead author of the new recommendations, has said that “with every increasing decade of age, people become less and less active.”

“But,” Nelson said, “the evidence shows that with every increasing decade, exercise becomes more important in terms of quality of life, independence and having a full life. So as of now, Americans are not on the right path.”

Jim Concotelli of the Horizon Bay Senior Communities in Tampa, who oversees fitness and wellness program development for communities for the elderly in several states, noted this year that many older Americans were unfamiliar with exercise activities and feared that they would cause injury and pain. Yet by strengthening muscles, he said, they can improve joints and bones, and function with less pain and less risk of injury.

The key is to start slowly and build gradually as ability and strength improve. Most important is simply to start – now – perhaps under the guidance of a fitness professional.

A BASIC PROGRAM

Until recently, physical activity recommendations for all ages have emphasized aerobics, or cardiovascular conditioning. For those unable to do 30 minutes at a time, the activities can be broken up into three 10-minute intervals a day.

For people who prefer indoor workouts, a treadmill, step machine or exercise bike can provide excellent aerobic training. Those unable to do weight-bearing exercise might try swimming or water aerobics. Keep in mind that 30 minutes a day of aerobic activity five days a week is the minimum recommendation. More is better and can reduce the risk of chronic disease related to inactivity.

Contrary to what many active adults seem to believe, physical fitness does not end with aerobics. Strength training has long been advocated by the National Institute on Aging.

Strength training can be done in a gym on a series of machines, each working a different set of major muscle groups: hips, legs, chest, back, shoulders, arms and abdomen. Or it can be done at home with resistance bands or tubes, hand-held barbells or dumbbells or even body weight. THE NEW MIX

The new recommendations add flexibility and balance to the mix. Improving balance and reducing the risk of falls is critical as you age – if you fall, break your hip and die of pneumonia, aerobic capacity will not save you. Ten minutes a day stretching legs, arms, shoulders, hips and trunk can help assure continued mobility, and daily exercises like standing on one foot and then the other can improve balance.

Rampaging tot? Drive him to distraction

Sat, 28 Jun 2008 18:47 EDT

Q: ‘'My 18-month-old son and 3-year-old daughter generally get along well, but playtime is becoming difficult as my son is becoming more interested in what my daughter is doing. For example, she'll set up an elaborate picnic of play food, only to have him destroy it like Godzilla. Playing board games when he's around is impossible. Until now, I've been telling her to be patient, saying, ‘Babies can't be naughty.' But he's in toddler-hood now. At what age can I start reprimanding him for messing with her things, and how should I do it?” Mother in Raleigh

Think diversion, not punishment. Board games? Impossible – unless the toddler is napping.

Here's one mother's clever solution to a similar problem:

“I, too, had a Godzilla at 18 months and a frustrated 3-year-old,” writes Ashley Slade of Roswell, Ga. “My older daughter would get so angry when her little brother destroyed all of her well-organized games involving small pieces. I tried keeping my son in a (playpen) for certain parts of the day so she could play, but he hated it.”

The mother offered a role reversal, and the daughter played in the playpen.

“She loved it and would sometimes play for almost an hour in there.”

Slade writes. “She didn't like playing alone in her room at that young age, so this was the perfect solution. My son could roam freely and my daughter could have her protected space, and we could all be in the same room. At the time, I felt like the world's most brilliant mother.”

As you figure out how to adjust with two little people – not just one – keep in mind: Sister's shrieks and mom's anger are sure to make the little boy all the wilder. What fun to have such power!

In the book “Positive Discipline: The First Three Years” (Three Rivers Press, 2007, $16.95), co-authors Jane Nelsen, Cheryl Erwin and Roslyn Ann Duffy emphasize the importance of parents knowing what is developmentally appropriate – the difference between intentional misbehavior and a child's natural need to explore.

Distraction and redirection are among the most useful parenting tools for living with toddlers.

“If you have a child who is doing something you don't like, get real upset about it on a regular basis, and sure enough she will repeat it for you,” according to Thomas Phelan, Ph.D., author of “1-2-3 Magic: Effective Discipline for Children 2-12” (ParentMagic Inc., 2003, $14.95).

To straighten out behavior problems, be consistent and calm, without getting emotional, Phelan advises.

Some ideas:

Get tiny shovels and plastic buckets to use to help you garden.

Set your children up with play dough on plastic place mats at the kitchen table.

As mom or dad prepares dinner, provide plastic kitchen tools that both children will enjoy using.

Ledger burns up screen as Joker

Sat, 28 Jun 2008 18:48 EDT

The buzz over Heath Ledger's performance as the Joker in “The Dark Knight” is justified. With his final full film role, Ledger delivers what may be remembered as the finest performance of his career.

A recent press screening of the “Batman Begins” sequel had the audience cackling along with Ledger's Joker, a depraved creature utterly without conscience whom the late actor played with gleeful anarchy.

At times sounding like a cross between tough guy James Cagney in a gangster flick and Philip Seymour Hoffman's fastidious Truman Capote, Ledger elevates Batman's No. 1 nemesis to a place even Jack Nicholson did not take him in 1989's “Batman.”

The Joker masterminds a series of abductions, assassination attempts, murders and bombings, all aimed at calling out Batman (Christian Bale) and proving to the vigilante hero that they are two sides of the same coin.

“You complete me,” the Joker tells Batman, dementedly borrowing Tom Cruise's sappy romantic line from “Jerry Maguire.”

A best-actor Academy Award nominee for “Brokeback Mountain,” Ledger – who died in January from an accidental prescription drug overdose – has earned fresh Oscar buzz for “The Dark Knight,” which could land him in the supporting-actor race.

Running just over two and a half hours, “The Dark Knight” is a true crime epic. Throughout, the Joker's bag of tricks is bottomless, twisted to the point of horror-flick sick.

“Some men aren't looking for anything logical,” Michael Caine's butler Alfred tells Bruce, who's trying to decipher the Joker's motives. “Some men just want to watch the world burn.”

Come July 18, when “The Dark Knight” lands in theaters, the world will be watching Ledger burn up the screen.

‘Drillbit,' ‘Blueberry' ready for home viewing

Sat, 28 Jun 2008 18:47 EDT

Selected home-video releases:

‘Vantage Point'

Someone's out to kill the president – and this breakneck thriller applies a “Rashomon”-style multiple-viewpoint approach to tell and retell the story through the eyes of people at the epicenter. The same 15 minutes or so of action unfold again and again, each segment providing a different look and revealing more about what's actually happening during a shooting and explosion at the site of the U.S. leader's visit to a counterterrorism conference in Spain. The cast includes Dennis Quaid, William Hurt, Sigourney Weaver and Forest Whitaker. The single-disc DVD, double-disc DVD set and Blu-ray release have a deleted scene, cast and crew interviews and commentary with director Pete Travis. The two-disc DVD set also comes with a digital copy for portable video players.

‘Tyler Perry's Meet the Browns'

The latest from director, writer and co-star Tyler Perry features Angela Bassett as a single mother struggling to raise three kids in Chicago who heads off to Georgia for the funeral of the father she never met – and is initiated into the lively, crazy world of her kinfolk. The DVD is available in a bare-bones single-disc release or a two-disc set with four behind-the-scenes segments and a digital copy of the movie. A two-disc Blu-ray release also comes with a digital copy and has a few extra featurettes.

Also available in a three-disc set is “Tyler Perry's House of Payne: Volume Two,” containing 20 more episodes of his TV comedy about a family dealing with real-life issues, from divorce and child custody to rehab.

‘Drillbit Taylor'

When school bullies knock you around, who you gonna call? Owen Wilson. A rare clunker from the Judd Apatow comedy factory (“Knocked Up,” “Superbad,” “The 40-Year-Old Virgin”), the movie stars Wilson as a supposed ex-mercenary hired by some high school nerds as their personal bodyguard. The movie comes in an extended version on DVD and Blu-ray that adds footage and includes deleted scenes, a variety of behind-the-scenes featurettes and commentary with director Steve Brill, his screenwriter and his teen stars. The original theatrical release also is available in a separate DVD, with commentary and deleted scenes.

‘My Blueberry Nights'

Norah Jones makes her acting debut and Wong Kar Wai does his first English-language film with this tale of a brokenhearted lover on a meandering cross-country foray. Singer Jones takes the lead in Wong's dreamy tale of a woman in the aftermath of a romance that ended badly, first seen spilling her guts to the New York cafe owner (Jude Law) who feeds her blueberry pie, then waitressing down South and watching the painful marital breakup between a cop (David Strathairn) and his bimbo wife (Rachel Weisz), finally hanging with a gambler (Natalie Portman) in Nevada. The DVD has a question-and-answer session with Wong, deleted scenes and a making-of segment.

TV on DVD

“Mad Men: Season One”: The acclaimed series dramatizes the ferociously competitive world of New York advertising men in the 1960s. The first season comes in a four-disc DVD set or three-disc Blu-ray set, with commentary on all 13 episodes, plus segments on the show's music and the explosion of mass media in the 1960s.

“The Closer: The Complete Third Season”: Kyra Sedgwick is back on the job as the boss of a Los Angeles police unit that deals with high-profile murder cases. A four-disc package has year three's 14 episodes, plus deleted scenes, a segment on crime-interrogation techniques and a gag reel.

“'Til Death Do Us Part: The Complete First Season”: It figures that any TV show with “Pink Flamingos” director John Waters as host would be more than a little sick and twisted. Waters plays the “Groom Reaper,” introducing macabre marital tales that end with one spouse deceased. The first 13 episodes are included in a three-disc set.

“The Streets of San Francisco: Season 2, Volume 1”: Karl Malden and Michael Douglas pound the pavement again in the 1970s crime drama about a seasoned detective and his book-smart but inexperienced partner. The first half of season two comes in a three-disc set.

“Walker, Texas Ranger: The Fifth Season”: Chuck Norris brings Old West honor to the lawman business as he resumes rounding up bad guys. A seven-disc set has season five's 26 episodes.

“Anglo-Saxon Attitudes”: Adapted from a novel by Angus Wilson, this 1992 British miniseries stars Richard Johnson and Tara Fitzgerald in the satirical story of an aging historian trying to unravel the mystery of an ancient idol – and the puzzles of his own indiscretions over the years. DVD set, $39.99. (Acorn)

“Rebus: Set 3”: A four-disc set packs four installments of the British crime series starring Ken Stott as a boozy Scottish detective with a brazen, bulldog style of hunting down murderers.

Dead lifts aren't just for bodybuilders

Mon, 30 Jun 2008 18:48 EDT

True or false? Dead lifts are only for buff bodybuilders.

False. Most people can perform a variety of dead lifts. If you're a beginner, you can try the one-legged dead lift with a cone touch.

Once you feel confident and balanced, you can eliminate the cone and hold weights as you extend your hand toward the floor. The version without weights will help to improve your balance, strengthen your ankles and work your glutes, hamstring and core.

While standing, put your left hand behind your back and move your right leg back and up by hinging your hips back.

Simultaneously extend your right arm out and down to tap the cone. This is strictly a hip movement. Your torso will move forward and down as you push back on your hips while raising your legs.

Your hips will move your arm toward the cone as your body and leg become almost parallel to the floor. Keep your left knee soft and slightly bent. If you are very flexible, you may bypass the cone and extend your arm to the floor. If your hamstring lacks flexibility, you can bend your left knee a bit more.

Return to the starting position by moving your hips inward and lowering your right leg. Try 15 repetitions and then switch legs.