Special to the Pflag

I recently checked in with Dr. Robert A. Skjonsby at St. David’s Urgent Care in Pflugerville. Dr. Skjonsby said he’s seen several cases of sinusitis, which is an inflammation, or swelling, of your sinuses.

“Everyone has a bunch of cavities in the front of their face that are all connected through the nose and throat, so that they drain,” said Dr. Skjonsby. “Normally, the cavities are filled with air, but when they become filled with fluid it causes this sinusitis infection.”

Dr. Skjonsby said people with allergies are prone to this infection, but this time of year, anyone can see a common cold turn into this infection quickly. Symptoms start with nasal congestion, but with a sinus infection, you’ll also experience pressure, a greenish or yellowish discharge and dripping – down the back of your throat and down the front of your nose.

“Most of the time, the treatment is going to be something to reduce the inflammation,” said DSkjonsby. “We usually will prescribe temporary use of decongestants, such as antihistamines and pseudoephedrine. A humidifier may also help.”

Skjonsby said anytime the patient is having greenish or yellowish discharge, antibiotics are prescribed.

“For people with allergies, taking antihistamines and prevent infection,” said Skjonsby. “People with an onset of sinusitis should stay well-hydrated – you want to keep your mucus thin.”

There are different types of sinusitis, according to Dr. Skjonsby. Acute sinusitis typically lasts less than two months, and it doesn’t usually happen more than three times a year.  Chronic sinusitis usually lasts about 20 days and recurs regularly throughout the year.

Special to the Pflag

Here’s to a happy new year and to getting everything that you want out of 2012.

Today you have a clean slate with a brand new year spread out in front of you, filled with endless possibilities.

How will you harness your potential to create the very best you? I recommend using the teachings of Dr. Maxwell Maltz in his legendary book, “The New Psycho-Cybernetics.”

Dr. Maltz created the original science of self-improvement and success, so who better to turn to when you’re ready to take your life to another level? His teachings have withstood the test of time.

Take the following and get all that you want out of 2012:

1. Use your imagination

If you thought that imaginations were only valued in preschool, think again. One of the key points in “The New Psycho-Cybernetics”

is the technique of using your imagination to reprogram and manage your self-image.

You may have been exposed to self-improvement strategies that tell you to “act as if” or to “fake it till you make it.” Those typically don’t work because your self-image is still the same.

According to Dr. Maltz, your self-image is the key to changing your actions and habits. If you want to lose 50 pounds, you first have to think of yourself as someone 50 pounds lighter.

Spend time in your imagination. See yourself 10-20 pounds lighter. Experience a day in your life at this slimmed down size. Imagine everything down to the smallest detail.

According to Dr. Maltz, this imagination time will begin to change your self-image to that of a person 50 pounds lighter, and your actions and habits will fall into place.

2. Reject negative thoughts

Negative thoughts will undoubtedly arise as you use your imagination to see your ideal self. “I’m not really going to lose 10-20 pounds.” “I’ve tried losing weight before and it never works. I’m always going to be overweight.” “This imagination stuff is bogus. It won’t work for me.”

Dr. Maltz says that the instant you receive a negative thought simply dismiss it. Don’t spend any time on it at all.

The quicker that you dismiss negative thoughts, the less impact they will have on your self-image. Also you’ll find that fewer and fewer negative thoughts arise once you get into the habit of dismissal.

3. Be nostalgic for the future

It’s so easy to be nostalgic for the past, especially when you only remember the good stuff. But what good does it do for you to wish for things that are long gone?

Dr. Maltz recommends developing nostalgia for the future.

In your imagination you’ve already lost the 10-20 pounds, so start pining for the future! Your self-image will lock onto that picture and your nostalgic feelings will fuel the fire.

4. I’m the kind of person that…

What kind of person are you?

• I’m the kind of person that loves sweets.

• I’m the kind of person that hates exercise.

• I’m the kind of person that can’t lose weight.

or

• I’m the kind of person that eats fresh and healthy food.

• I’m the kind of person that keeps fit.

• I’m the kind of person that maintains an ideal body weight.

Your self-image will fulfill any label that you put on yourself. The power is all in your hands.

What kind of a person do you want to be in 2012? The ball is in your court!

Fred Sassani is founder of Bodies By Design Personal Training Services, nationally certified personal trainer and nutrition specialist in Pflugerville. For comments or questions you can reach Fred at getfit@trainerfred.com or visit his new website at trainerfred.com.

Get Fit

Red and green decorations are out, nostalgic tunes fill the airways and the kids are hard at work on their letters for Santa.

I know what’s on your list this year and it isn’t found at your local department store.

You’re wishing for washboard abs – so I’ve put together “The Twelve Days of Christmas – Washboard Abs Edition” just for you.

On the first day… Give yourself the gift of Burpees.

Created in the 1930s by psychologist Royal H. Burpee, the Burpee is an intense full body exercise that helps burn fat and tone muscles. A Burpee is done in the following five steps: 1) Stand with feet shoulder width apart. 2) Drop to a squat with your hands on the ground. 3) Kick feet back while lowering into a push-up. 4) Return to squat position. 5) Jump up with arms overhead.

On the second day…Give yourself the gift of fiber.

Stocking up on fiber will do wonders for your abs. High-fiber foods are nutrient dense and low in calories. Try these high-fiber favorites: raspberries, pear (with skin), artichoke, peas, apples (with skin), broccoli, Brussels sprouts and carrots.

On the third day… Give yourself the gift of a medicine ball.

The first medicine balls were created in Persia over 3,000 years ago, made with sand-filled bladders and used by wrestlers as part of their conditioning. Today you can get the same rippling abs by incorporating medicine balls into your exercise routine. Do a sit-up holding a medicine ball at your chest, then throw it to a partner as you raise your chest toward your knees, or hold a medicine ball with arms straight up in the air as you do crunches.

On the fourth day… Give yourself the gift of reduced salt.

Too much salt leads to water retention – and that spells disaster for your six-pack. Pay attention to the sodium content of your food. Limit salt intake by not eating packaged foods and by putting down the salt shaker.

On the fifth day… Give yourself the gift of oblique v-sits.

Who really wants a muffin top? You don’t, so incorporate oblique v-sits into your routine in 3 simple steps. 1) Lie on your side with legs straight and hands behind your head. 2) Raise your arms and legs simultaneously, while exhaling and squeezing your obliques. 3) Repeat on the other side.

On the sixth day… Give yourself the gift of lean protein.

Along with fiber, your meals should be packed with lean protein. This will help support muscle growth while controlling blood sugar – all important factors when it comes to washboard abs.

On the seventh day… Give yourself the gift of sprints.

The days of long, slow cardio sessions are long gone. We now know that short intense bursts of cardio is the ideal way to melt fat. Run 60-90 second sprints in between resistance training sets to really kick your fat burning mechanism into high gear.

On the eighth day… Give yourself the gift of no sugar.

Sure, sugar tastes good, but indulging in it causes your body to store layers of fat. Enjoy fresh fruit, rather than refined sugar. If you really want washboard abs, then say no to sugar.

On the ninth day… Give yourself the gift of hanging leg raises.

This is one of the most effective ways to strengthen your abdominals. 1) Hang from a pull-up bar with legs fully extended. 2) Exhale and drive your knees up toward your chest. 3) Inhale as you slowly lower your legs back down.

On the 10th day… Give yourself the gift of no grain.

If you’re serious about that six-pack, then put down the bread basket. Grains are full of insulin-spiking carbohydrates – the perfect combination for fattening you up. Learn to love grain-free meals that center around lean meats and vegetables.

On the 11th day… Give yourself the gift of mountain climbers.

Here’s another intense exercise that really targets your abs while also burning fat. 1) Get into push-up position. 2) Exhale as you alternately drive your knees in toward your chest, keeping your back flat.

On the 12th day… Give yourself the gift of washboard abs.

Get in to a local boot camp or work with a local fitness pro to ensure you keep your washboard abs, and continue to improve your technique, endurance and new healthy lifestyle.

Fred Sassani is founder of Bodies By Design Personal Training Services, a nationally certified personal trainer and nutrition specialist in Pflugerville. For comments or questions you can reach Fred at getfit@trainerfred.com or visit his website at trainerfred.com

Pflag Reporter

After its June groundbreaking, construction is complete on a 12-room emergency trauma center in Pflugerville’s Stone Hill Town Center.

The freestanding St. David’s Emergency Center is complete, with a specialty room for ear, nose and throat patients, an OB/GYN room and a fully functional laboratory.

“We’re located in the thriving center of the city of Pflugerville, and this facility was designed to meet the growing need for medical services in Pflugerville, and it’s dedicated to meeting emergency care needs across the area,” St. David’s North Austin CEO Allen Harrison said at the facility’s Dec. 2 VIP open house.

The center houses a radiology room staffed 24 hours a day, seven days a week by radiology technicians who use the 16-slice Computed Tomography scanner to take detailed pictures of internal tissue and software designed to minimize the radiation dose patients receive during procedures.

“The new thing now is to get what you want with less dose, instead of giving patients high doses of radiation,” radiation technician Doug Hosick said. “It’s like a V4 car that can outrun anything.”

The emergency center’s medical director is Dr. Vard Curtis. Curtis is an Air Force veteran and former assistant director of MacDill Hospital in Tampa, Fla. He specializes in emergency medicine and has recently been on staff at St. David’s main Austin branch as well as its North Austin Medical Center.

The emergency center is 10-15 miles closer to many Pflugerville residents than St. David’s North Austin or Round Rock Medical Center, which could mean faster treatment for cases like heart attack, stroke and trauma, during which Curtis said time is critical.

“The golden hour – the first hour after a trauma – is a critical time where we have a good chance to intervene and really help someone,” Curtis said. “After that the chances of survival of a major trauma goes down significantly.”

Curtis said the center is slated to service 12,500 patients in its first year, and gradually increase that number in years to follow. St. David’s officials said that by 2016, that number will increase to approximately 45,800 patients per year.

Twenty-seven employees are expected to be hired during the emergency center’s first year of operation, including a mixture of nursing personnel, imaging personnel, laboratory personnel, registration staff and support personnel. During its fifth year of operation, it will likely employ a total of approximately 35 clinical and support staff members.

The emergency center came to Pflugerville as the result of a three-year cooperative effort between St. David’s, the Pflugerville Chamber of Commerce, Pflugerville Community Development Corporation and the city of Pflugerville.

Councilmember Darelle White, who helped steer the city’s health care initiative, said the emergency center fills an important hole for the city.

“What really got me going with this is, several years ago I was at the H-E-B at [FM] 685 and Pecan Street, and a gentleman came up with his child who had an injured arm and he said, ‘Where do you go for emergency care?’ I didn’t know what to tell him. That really got me thinking about how close those services were to our citizens and why we have this today,” White said.

Pflugerville Chamber CEO Patricia Gervan-Brown said construction of the facility was time-efficient and timely, as the holiday seasons can mean an uptick in trips to the emergency room.

“This really is a holiday gift to the community,” Gervan-Brown said. “This type of development doesn’t usually happen this quickly, so we are so pleased to have this project here at such a critical time.”

Harrison said emergency center patients who need addition medical services will be transferred to an inpatient facility just as they would at a hospital emergency room.

“We refer to this as a freestanding emergency department, but in reality this facility is very closely connected to St. David’s North Austin Medical Center. This is not an urgent care center – it’s an honest to goodness emergency department. It is open around the clock and staffed with board-certified physicians and highly trained nurses,” Harrison said. “We understand that nobody ever wants to go to the hospital or the emergency room, but when life throws those curveballs at us and we need emergency care, we believe it’s important to have services that are nearby and high quality. With this facility you get both of those attributes.”

St. David’s HealthCare opened its first emergency center in Central Texas earlier this year in Bee Cave.

By Anthony Russo, M.D.

Special to the Pflag

Dr. Eric Roehm’s practical nutrition advice on the Internet is very different from a flippant cardiologist speaker I once heard. That speaker, when asked about whether to start with diet before pills, remarked:

“I personally start by writing a prescription that costs a lot. When they return, they seem very interested in my discussion about behavior changes that they could make to eventually get off those expensive meds!”

Let’s have that discussion now. Better yet, stop reading this article and type in NutritionHeart.com, then sit back and watch some entertaining videos that will teach you something.

You will learn about diets that have been proven to lower heart attacks and reduce death rates. In the process you will find out about different types of studies. So the next time your buddy reads some headline in an ad or even in the news like: “95 percent of people who take vitamins are healthy,” you will know what to ask.

“Was that an observational study?” Duh, people who already are health-conscious are more likely to turn to vitamins, and anyway, the majority of people are “healthy” by many definitions). Or you might ask if two groups of similar people were randomized to take vitamins or not.

There is actually a study where they randomized similar groups of people to either go on a diet very similar to that of the Mediterranean island of Crete, or who saw no change in diet. This Lyon Diet Heart Study had amazing end results with those on a Cretan Mediterranean diet. Not only was there a decrease in further heart attacks by 70 percent, there was a decrease in overall death by 60 percent! This is more scientific proof of benefit than has ever been shown by low fat diets, South Beach diet and even the DASH (Dietary Approaches to Stop Hypertension) diet.

Dr. Roehm was in private practice as a cardiologist for over 20 years. While as a cardiologist in private practice, responsibilities included serving as the head of the Cardiopulmonary Department at Round Rock Medical Center for 15 years.

Roehm retired from private practice of cardiology in 2007. He is currently involved in multiple nonprofit projects in the medical field.

On this website you will get Dr. Roehm’s practical advice as an experienced cardiologist. He says that what is important to watch in a study are end results. We care more about how to be a person without a heart attack, even though our numbers, like cholesterol, might be higher than a person with good numbers who died from a heart attack. In this study both groups had similar LDL and HDL cholesterol as well as blood pressure.

So what is this special type of Mediterranean diet? It’s not vegetarian but your vegetarian friends might like seeing that it has low amounts of animal products. Besides lots of fruits and veggies, they like their beans, peas, nuts, whole grains and yogurt. They get plenty of protein without eating much meat, although they do eat chicken and fish. Avoiding fatty meats keeps down the harmful saturated fats.

But don’t think you have to stop all the fat, because you can use good olive oil and canola oil. Instead of white bread and desserts, they enjoy cheese and a five-ounce glass of red wine a day.

But as Dr. Roehm explains in his video, any change in alcohol intake or diet changes should be discussed with your health care provider.

So what’s the best answer: diet and behavior changes or prescription meds? The answer is often both. You will hear how Dr. Roehm dealt with many people with hypertension whose BP could not be controlled even with multiple pills. Individually he worked with his patients to taper off sodium/salt and change some lifestyle behaviors. Many were taken off some of their meds. Now he offers this website for all who want to learn about nutrition and the heart.

Have you heard how to stop high blood pressure with a change in your diet, and you don’t have to lose weight? National Institutes of Health studied the Dietary Approaches to Stop Hypertension. With this diet and lowering your salt in your food, you can lower your BP as much as a mild blood pressure pill.

Who hasn’t heard of the benefits of fish oil? But how does it work and how much do you need? Short answer – check the label for a total of 1,000 mg of omega-3 from fish. Long answer – NutritionHeart.com. But you’ll learn some things about mercury in the oceans and even about reducing joint inflammation and fish oils.

There are quick links to his videos, handouts, transcripts, scientific background and web links for Low Sodium Diet, Mediterranean Diet, DASH Diet and Fish Omega-3 Fat. Also listed are topics on how the Mediterranean diet relates to Alzheimer, diabetes and cancer. Be sure to read about alcohol and heart disease, alcohol and women’s health and future topics on exercise.

NutritionHeart.com not only has the taped tips from a cardiologist, it allows for printable handouts, transcripts and summaries. It is a nice website with no ads, no registering, just down-home health information for you and your loved ones.

Dr. Anthony Russo has been a primary care physician in Pflugerville since 1988. Visit his Internet site for more health information and comment anonymously: PvilleHealth.Blogspot.com

By Fred Sassani

Special to the Pflag

It’s here – whether you’re ready or not. Just look at the seasonal shelves in your favorite store. Retailers like to call it “holiday season” but let’s be more accurate.

“Weight Gain Season” begins now and runs straight through New Year’s.

The next two months will bring ample opportunity for you to expand your waistline. Of course the choice is yours.

Why discuss it now and not midway through December? Because now is your opportunity to plan for the weeks ahead. Once the craziness begins, you’ll be too busy to put a plan into action.

So let’s take this moment of clarity, this calm before the storm, to outline a two-part plan that will save your waist from unwanted holiday inches.

1. Part One:

Your exercise plan.

Exercise is the first thing people cut when they get busy, and the holiday season is notorious for empty gyms. This year do something different – obligate yourself to exercise. Promising to yourself won’t do it. You need to promise to others so that you won’t drop the ball.

• Sign up to work with a fitness expert. This is the perfect solution for consistent, challenging and effective workouts. I’ll give you the attention and assistance that you need to power through the holidays in better shape than ever.

• Join a class – You won’t be as effective exercising on your own during the busy holiday season, so join a class for accountability. Find something challenging that gets your heart rate elevated and uses strength training.

• Get a serious exercise buddy – Some friends can be an awesome help while others end up pulling you down. When looking for an exercise buddy consider the following questions:

Do they share your fitness goals?

Are they fairly encouraging?

Do they give up easily?

Are they at your fitness level?

2. Part Two:

Your diet plan

The holidays offer ample opportunities to indulge, so you need to hammer down some guidelines before hitting that buffet line. I’m not saying that you shouldn’t indulge in any seasonal treats, but use moderation. Don’t use the holidays as an excuse to eat until the point of being uncomfortable – will you really miss that bloated feeling? Decide which treats to cut out this year.

• Don’t bring edible treats to the office or to parties. You know that the leftovers will come home and you’ll end up eating far more than your share. This year do everyone a favor by not gifting fattening treats.

• When faced with a buffet line, load your plate first with greens, vegetables and lean meats before breads and heavier foods. Also drink water with your meal and keep alcoholic beverages to a 2-drink maximum.

• Beware of holiday drinks – most are brimming with calories. Hot drinks from coffee shops, cocktails at parties and creamy eggnog are all very enjoyable and all filled with empty calories. Stick with hot tea or unsweetened coffee.

• Everywhere you go during the holiday season brings you face-to-face with a plate of sweets. To avoid being a bore but without adding inches to your waist, try the one treat rule. Each time you’re in a social situation that involves sweets just eat one, and enjoy your treat slowly.

You don’t have to gain weight this holiday season. The key is your mindset.

If you approach the holidays with the mindset of, “I deserve to indulge and I shouldn’t have to exercise” then you’ll enter 2012 a few pounds heavier, a little less healthy, and with lower energy than ever before.

I believe that you deserve better. I believe that you should enter 2012 in better shape than you are today, healthier than you’ve been in a long time, and with more energy than you thought possible. So don’t fall in to the food trap and be smart about every decision that you make. Trust me: it will pay off when next summer comes around.

Fred Sassani is founder of Bodies By Design Personal Training Services, nationally certified personal trainer and nutrition specialist in Pflugerville. For comments or questions you can reach Fred at getfit@trainerfred.com or visit his new website at trainerfred.com

Special to the Pflag

To be or not to be … a victim of the flu. The question comes up every fall when we are advised to get a flu shot. To help you decide, let’s take a light-hearted look at both sides of the issue.

Reasons why not to get a flu shot

• get time off from work (but you’ll feel like #!*# from influenza symptoms),

• give more money to big pharmacies, doctors and pharmacists (but prescription meds to treat the flu are less effective than preventing it) and

• save a few dollars and be able to brag about it (if you’re lucky enough to avoid the flu, hope you’re lucky next season).

Reasons why you should get a flu shot

• It can be very effective, but it does depend on the strain of influenza going around each year. This year’s flu shot should be very effective for the strains Brisbane, Perth and a H1N1 type called California. Often seven out of 10 people who get the flu vaccine do not come down with the flu.

• It can protect the most vulnerable, like the elderly and infants. Studies have shown that if lots of healthy people get the flu shot, then the overall rate of flu goes down that year and fewer infants and senior citizens end up in the hospital; fewer of them die during the flu season. (Do you need more reasons to get a flu shot?)

• It can lessen the degree of illness if you get the flu. Partial protection is better than none. But flu shots only protect for the influenza virus. It does not help for colds or other viruses that are similar to the flu.

• You can prove to your buddies that you didn’t “catch the flu” from the shot, especially since that is scientifically impossible; see cdc.gov/flu:

“the viruses in the flu shot are inactivated, so you cannot get the flu from a flu shot.”

However, the shot occasionally causes minor side effects like soreness around the shot site, low fever, aches. This would begin soon afterwards and only last a day or two.

• You can miss out on that fun doctor’s office lobby full of sick people. You get to avoid the wait at the pharmacy for the anti-viral medication such as Tamiflu. Prescription meds for the flu must be started within 48 hours of getting the flu and do not work immediately.

• You won’t have to worry as much when the flu is going around. Make sure everyone around you at home and work gets a shot.

• You can even avoid a needle by getting the nasal spray form of the flu shot. This Laiv nasal spray (live attenuated influenza vaccine) is for healthy persons over 2 and under 50. It helps prevent the same three strains of flu anticipated for that season. This vaccine is modified to lower symptoms. The main form is the Tiv flu shot (trivalent influenza vaccine). There is a high dose flu shot available for seniors but the CDC shows no preference for or against it.

… and oh yeah, getting the flu makes you feel like #!*#

Dr. Anthony Russo has been a primary care physician in Pflugerville since 1988. Visit his internet site for more health information and comment anonymously: PvilleHealth.Blogspot .com

Stan Lundrigan (center) is presented with a Seton Nurse Scholarship by Janice McBride and Dr. Brian Aldred.

———————————————————————————————————

Pflugerville resident Stanley Lundrigan, a registered nurse and manager of Seton Medical Center Williamson’s emergency department, is one of 20 Seton Healthcare Family employees selected to receive a $3,000 scholarship from the Seton Foundations.

One of a growing number of male nurses in what has traditionally been a field dominated by women, Lundrigan said he was sometimes teased about his career choice in the beginning, but has no regrets.

“I’ll admit I had my doubts, but after I stepped into the emergency department for the first time, I was hooked for good,” he said.

Lundrigan is studying for his master’s of science in nursing in leadership and management and hopes to become a nursing director at Seton, where he has worked for more than 10 years.

More than 100 Seton associates applied for the scholarship. Winners are selected by a committee of physicians, nurses and Seton Nurse Scholarship Endowment donors.

The Seton Nurse Scholarship Endowment was established in 2005 to provide Seton associates with support for their nursing education. To date, the community has contributed more than $4.6 million to the endowment.

Special to the Pflag

There is nothing quite as frustrating as seeing your results fizzle out.

This is a common place to end up, usually after a few months on the same exercise routine. In the beginning your body responds to your routine with lost pounds and gained muscle tone, then one day all results screech to a stop.

Why does this happen? And, more importantly, how can you prevent it?

Your muscles adapt quickly to any repetitive routine. Remember that the definition of insanity is to do the same thing over and over while expecting different results. This holds true for your workouts.

When your results stop, it’s time to do something new.

• The problem: Your muscles have adapted to your routine.

• The solution: It’s time to apply the concept of muscle confusion.

Muscle confusion is a way to keep your body guessing by changing your routine.

I have good news – the following four strategies are guaranteed to crank your workouts up to the next level and to deliver better results.

Strategy No. 1: Use a drop set

Drop sets are often used to fight off exercise plateaus. This technique is great for increasing muscle strength, endurance and for adding to the cardiovascular benefit of your workout, which results in more fat burn.

This is how to do a drop set: When you perform an exercise to exhaustion, don’t stop there. Drop the weight by 80 percent and do another set.

You could take it a step further by dropping the weight twice, making it a double drop. Or drop the weight three times for a descending drop set. Use this technique only once or twice per workout, on the final set of the exercise.

Strategy No. 2: Focus on negatives

Each time that you do a weightlifting repetition you are using three types of strength.

1. Positive strength: lifting the weight.

2. Static strength: holding weight in a contracted position.

3. Negative strength: lowering the weight.

Most people completely miss the benefit of the negative in each repetition by allowing the weight to drop quickly with little control. It is understood that the negative portion of each repetition is just as important as the positive portion, possibly more important.

Focus on the negative portion of each repetition by lowering the weight very slowly. Concentrate on the negative contraction, and make each repetition count.

If you are advanced, then use a training partner to assist you in moving heavier-than-normal weight into a contracted position, then lower it very slowly.

Another way to utilize negative repetitions on a machine is to lift the weight using two limbs but then lower it with just one. For example, use both legs to lift the weight on a leg extension machine, but then lower it back down slowly using only one leg.

Strategy No. 3: Use active rest

Every minute of your workout is an opportunity to increase intensity and to burn more fat. Don’t waste precious minutes with long rest periods.

While it is important to catch your breath if you feel winded, most of the time you would benefit more from an active rest. Do one of the following activities for 30 seconds between exercises and turn your regular workout into High Intensity Interval Training.

• High knees with alternating punches: Alternately bring each knee high to your chest in a quick jumping movement while alternating forward punches at shoulder level.

• Burpees: Start in a sanding position and bend at the waist. Once your hands hit the floor, push your entire body back, extending your legs until they’re straight and you’re in the push-up position. Go down for a push-up, and when you push yourself up, jump slightly to bring your feet back near your hands. Finally, jump in the air with your arms fully extended over your head.

• Side-to-side jumps on bench: Stand on one side of an exercise bench. Place the foot closest up onto the bench, jump up and switch feet, then land on the opposite side of the bench.

• Mountain climbers: Place your hands wider than shoulder-width apart on the ground in a push-up position. Bring one knee to your chest and then back to the starting position, alternate each leg quickly.

• Side-to-side ab twists: With feet close together, jump and twist your legs left to right – holding your abs tight. Keep a bend in your knees and swing your upper arms with each twist.

• Jump lunges with pop squat: Start in a lunge position, lunge down then quickly jump up, switching your leg position in midair, land in an opposite leg lunge. Once you’ve done both legs, jump straight into a squat.

• Medicine ball squat jumps: With feet wider than shoulder-width apart hold a medicine ball at chest level. Squat down until your knees are at a 90-degree angle. Explosively jump up, raising the medicine ball straight over your head.

Strategy No. 4: Modify the exercise

There are certain exercises that are considered “staples” in the gym.

The squat. The lunge. The chest press. The shoulder press. The bicep curl. You get the idea…

While you shouldn’t throw these exercises out the window, find creative ways to modify the familiar motion in order to challenge your muscles. Try these exercise modifications:

• Squat on a Bosu ball or balance board.

• Place a weighted bar across your shoulders and do walking lunges.

• Use an exercise ball for chest presses instead of the bench.

• Do a full squat between each repetition of shoulder presses.

• Do a shoulder press between each repetition of bicep curls.

Make sure to consult with a fitness professional if you are unsure on how to do some of these exercises. Now get busy, and break through that plateau.

Fred Sassani is founder of Bodies By Design Personal Training Services, nationally certified personal trainer and nutrition specialist in Pflugerville. For comments or questions you can reach Fred at getfit@trainerfred.com or visit his new website at trainerfred.com

• nccn.org • cancer.gov •  FamilyDoctor.org

By Anthony Russo, M.D.

Special to the Pflag

When you are facing a prostate cancer diagnosis, you need a game plan. Often no surgery or treatment is immediately necessary if it is the low- risk type. However, you must work with your doctors and get “active surveillance”.

Some background about prostate cancer and available treatment:

• Cancer cells are developing in the prostate in the majority of men as they become elderly.

• Some prostate cancer cells never grow fast enough to spread outside of the capsule.

• Erectile dysfunction is reported in 75 percent of men treated with surgery or external radiation, but many older men may already have ED problems; meds and other treatment for ED are available.

• Bladder control problems occur, especially after surgery during the first few years, worse while exercising.

• Bowel problems occur more with radiation than with surgery.

• Adverse effects from surgery often show up early but those from radiation treatment show up later.

If you have the low-risk type of prostate cancer, you might have the option to just observe it without jumping into treatment. But what you have to think about is whether you would worry excessively if you knew you had cancer cells that were not being treated. On the other hand, how would you feel if you had complications from treatment? Would you wonder if you jumped into a treatment too soon, if needed at all?

If you choose surgery, you have a 98 percent chance of being cancer-free and according to surveys, the vast majority is happy and would choose this same treatment. Is this the best choice in all cases and does it need to be done immediately?

Please do not try to make the decision for what you would do based on this article or other readings without discussing with your doctor. Guidelines change as new studies are done and any slight misunderstanding could be deadly!

You probably discovered your prostate issue from a screening PSA (prostate-specific antigen) blood test or a rectal exam. Typically there are no early symptoms.

Talk to your doctor about your family history and other risk factors and do screening for prostate cancer at the appropriate age (age 40? 50?). If the PSA test is high, then typically antibiotics are used and the test is repeated to see if it is just an infection.

Know your PSA numbers to see if it is over 2.5 or is rising more than 0.35 per year. Sometimes repeat testing is done months apart to see if there is a steady upward trend.

If a biopsy is indicated, then the urologist will arrange to do this simple procedure in the office. If cancer cells show up, the report will show if the cells are highly aggressive (Gleason score like 7) or less aggressive like 6. Also it states how much of the specimen showed cancer.

Very low risk and low-risk category patients are offered treatment with surgery or radiation if their overall health suggests they would live for decades. However observation is an option. These categories have Gleason 6  or less, and PSA less than 10. Very low risk has limited cancer tissue (less than 2 core positives, less than 50 percent).

Intermediate risk and high risk are usually those with Gleason 7 or more, or a PSA more than 10. In intermediate risk, it is advisable to be treated if you are considered healthy enough to live over 20 years.

Observation is not burying your head in the sand (or elsewhere).

It involves “active surveillance” with scheduled follow-up of PSA blood tests and biopsies over months and years when needed.

With such a game plan you might be one of the many who can safely avoid surgery or radiation treatment. Without a plan with your doctor, you might be blindly going down a road that could involve much more complicated risks and even death. In one study over eight years, 99 percent of those in active surveillance are alive; only 1 in 4 needed treatment. One promising treatment being tested is an ultrasound treatment called HIFU.

Dr. Anthony Russo has been a primary care physician in Pflugerville since 1988. Visit his Internet site for more health information and comment anonymously: PvilleHealth .Blogspot .com

(patient information by the American Academy of Family Physicians: August 2011 update)