Are you in Shape?

What is fitness? Are you in shape? How much exercise do we really need to be considered to be “in shape”? The important variables to consider are frequency, intensity, duration, mode of activity and the initial level of fitness. In general a well-rounded training program should include aerobic and resistance training, and flexibility exercises. Age has not been found to be a limiting factor to exercise training, but a more gradual approach in older age groups is recommended because of a higher risk of potential hidden disease. It has been shown in research that health benefits from physical activity can be achieved at lower intensities of exercise. In this regard, physical activity can be accumulated through the day in shorter bouts of 10 minute duration. One should also have an appropriate warm-up and cool-down period, which would include flexibility exercises.

The American College of Sports Medicine emphasizes factors that result in permanent lifestyle change and encourage a lifetime of physical activity.

The American College of Sports Medicine Recommends:

1. A frequency of training: 3–5 days per week.

2. The intensity of training: 55/65%–90% of maximum heart rate (HRmax). The maximal heart is 220 minus your age.

3. The duration of training: 20–60 min of continuous or intermittent (minimum of 10-min bouts accumulated throughout the day) aerobic activity. Of course the duration is dependent on the intensity of the activity and therefore lower-intensity activity should be requires a longer period of time (30 min or more), and, conversely, individuals training at higher levels of intensity should train at least 20 minutes or longer.

4. The mode of activity: any activity that uses large muscle groups, which can be maintained continuously, and is rhythmical and aerobic in nature, such as running, dancing, skiing, karate, tennis, etc.

Resistance training should not be considered as a primary means of training, but it has significant value for increasing muscular strength. It is recommended that a minimum of 8–10 exercises involving the major muscle groups (arms, shoulders, chest, abdomen, back, hips, and legs) should be performed 2–3 days per week. A minimum of 1 set of 8–12 repetitions or to near fatigue.

American College Of Sports Medicine Position Stand
ACSM Position Stand on the Recommended Quantity
And Quality of Exercise for Developing and Maintaining
Cardiorespiratory and Muscular Fitness and Flexibility
In Adults. Med. Sci. Sports Exerc., Vol. 30, No. 6,
pp. 975–991, 1998.

Management of Fever in Children

Management of Fever in Children

Fever is a rise in core body temperature above the body’s normal set point. Normal body temperature is between 97.5° – 99.5° F. Fever is a temperature of 100.4° F or above.

What causes a fever?

There are various causes for a child to have a rise in temperature. Fever generally occurs in response to an infection, cancer, drug or toxin, autoimmune processes and even allergic reactions can cause a low grade fever. Hyperthermia, or overheating, can be caused by strenuous exercise or environmental exposure.

The hypothalamus regulates your body’s core temperature. During an infection your hypothalamus resets the body’s normal set point. This is why traditional cooling efforts are ineffective.

Treatment of fever

Fever is a very normal response to infection. How high your child’s fever is and how it responds to medication is not a good indicator of the severity of the illness.

Fever can be treated with acetaminophen or ibuprofen, (product names Tylenol and Motrin).  Fever should not be treated with cold baths or alcohol baths. Both can be dangerous and are ineffective in reducing fever. Bathing the child using the temperature normally used for their bath is effective.  Cooling efforts such as wearing light clothing and reducing air temperature may help provide comfort. These will however be more effective if used after medication is given.

When should I call my doctor?

Call your doctor immediately if:

  • Your child is younger than 3 months
  • Your child has a fever above 104°F
  • Your child looks or acts extremely ill
  • Your child has had a seizure
  • Your child has had a fever for more than 3 days
  • Your child has accompanying symptoms that may indicate a bacterial infection such as earache, stiff neck, headache, or sore throat

Flu Season is Here


Somewhere between 20 and 40 million people died in the influenza (flu) pandemic of 1918-1919. This is greater than the number of people killed in World War I. It has been cited in medical literature as the most devastating epidemic in recorded world history.

In the fall of 1918 something erupted that seemed as benign as the common cold. However it was far more than a common cold. In the next two years a fifth of the world’s population was infected with this flu virus. 28% of all Americans became ill and an estimated 675,000 Americans died from the flu during this period. This was ten times the number of Americans that died in World War I. What many people do not realize is that half of all the deaths U.S. soldiers in World War I were the result of the flu. The other half died from the enemy. An estimated 43,000 American soldiers in World War I died from the influenza virus.

Today the Flu activity continues to plague the United States. This year an early flu season with high levels of activity is concentrated in the south central and southeastern regions of the country. The Center for Disease Control (CDC) urges you to get a flu vaccine now if you have not done so already this season. The CDC has created a trivalent vaccine that covers you for the three most prevalent influenza A and B viruses. You could have the flu if you are running a fever, having body aches,  headache, cough, congestion and / or nausea. You could get the flu even if you had a flu shot. There are many mutations of the flu viruses every season. You may be one of the unlucky ones that acquired a viral mutation that was NOT one of the three in the CDC trivalent vaccine. We are seeing a lot of unlucky flu patients at Bellaire ER this season.

There is no cure for the flu. However, Tamiflu has been shown to decrease the number of days of illness if started in the first 48 hours. Along with Tamiflu, you should treat the fever by not covering up and taking Tylenol or ibuprofen. You lose a lot of fluid by evaporation when you run a fever. In addition, people often have nausea and fail to drink enough fluids. Therefore, you must keep well hydrated when you get the flu. The final treatment is pain management. The best treatment is rest, so minimize your activity. Finally remember you are highly contagious when you have the flu and are running a fever and congested. The virus is transferred most commonly with a cough or sneeze in aerosolized droplets. Protect your family by trying to keep your distance – don’t cough, sneeze or even breath near them. Wash your hands and all handles in your house.

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