Fatigue can be a very frustrating and elusive condition. Fatigue is often confused with “tiredness”. Tiredness is commonly experienced after certain activities or at the end of a long day. Fatigue is defined as generalized lack of energy not relieved by sleep. It can be “acute” and last one month or “chronic” and last greater than six months. Despite the high prevalence of fatigue, little is known about the etiology. It can arise from both physical and psychological stresses. Possible causes should be explored with a health care provider. Some examples of physical causes include hypothyroidism, heart disease, rheumatoid arthritis, asthma, diabetes, emphysema, cancer, congestive heart failure, severe anemia, hepatitis, lyme disease, mononucleosis and other infections. Possible psychological causes are depression, anxiety, sleep disorders or boredom. Medications that treat high blood pressure, allergies, anxiety or depression may have the side effect of fatigue.

It is important to recognize that the term “fatigue” is often used to describe actual muscle weakness, lack of endurance or sleepiness. Regardless of the cause, there are actions that can be taken to help manage fatigue.

1) Keep a Log
Evaluating a daily log will help identify triggers that affect your level of energy. Understanding patterns of fatigue can assist in developing energy conversation techniques.

2) Energy Conservation Techniques
Pace yourself or rest to save energy for participating in activities you enjoy. Taking periodic naps may help but should be limited to one hour. Longer naps may interfere with the ability to sleep at night.

3) Avoid Heat and Humidity
Hot weather and dehydration can contribute to fatigue. An outdoor walk in cool weather has shown to decrease fatigue in a study of nursing home patients. Drinking 64 oz. of water daily is recommended.

4) Proper Nutrition
Balancing your intake of carbohydrates, protein and fat will provide a source of energy for your body. A daily multi-vitamin and minimizing alcohol to 1-2 drinks per day may also be helpful.

5) Weight Loss
Over-eating can exacerbate fatigue. Moving an over weight body can also be very tiring. A ten-pound weight loss can make a difference.

6) Managing Disease
Controlling conditions such as diabetes, pain, asthma, and heart disease can help combat the associated fatigue caused by systemic diseases.

7) Sleep Hygiene
Poor sleep patterns can lead to daytime fatigue. Avoiding caffeine, going to bed at a specific hour daily, and minimizing your restless time in bed are some examples that may improve sleep quality.

8) Stress Management
Meditation or relaxation techniques can help alleviate muscle tension that can lead to fatigue or poor sleep.

9) Exercise
Although exercise is often the most difficult to do when tired, it may help the most. Endurance exercise such as walking, swimming or bicycling can improve air exchange and the efficiency of the heart. Strengthening exercises can improve posture and weak muscles that contribute to generalized fatigue after prolonged standing or physical activity.

10) Managing Depression
Depression plays a role in 80% of people complaining of fatigue, according to a large study at Lahey Clinic. Seeking professional help may assist in recognizing and treating this common condition.

Fatigue can be very powerful and interfere with a person’s quality of life. Practicing healthy lifestyle activities can make a difference and help return energy to your life.

Do you want to learn more about causes of fatigue and ways to improve your energy level? Come to a FREE public lecture at Chatham Health & Swim Club,
Saturday, Sept. 26, 10 – 11am. Call 508-945-3555 to reserve.

Carol Penfield M.S. is the owner of Chatham Health & Swim Club, a nurse practitioner, certified personal trainer and nutritionist. She instructs private and small group fitness programs to members and non-members. Her office phone is 509-945-7761.

Great News!! There are still good investments, especially your health.

The opportunity to hear good news likely caught your attention, why?
Presently everything you read or watch on T.V. is stress producing. With the troubled economy, the stress level for Americans has increased. Now is the time to evaluate your strategies for managing your concerns and fears in an effective way. It is good news to know that there are options that can help. Although the physical reaction to stress may not go away, you can offset the effects with exercise and healthy living!
Exercise is a natural remedy that helps the body reach homeostasis in a hectic world that is continuously trying to throw us out of balance. Stress related issues are often translated into being “all in the mind”, but prolonged emotional stress can have an adverse physical effect.
When threatened or stressed our bodies produce a chemical response that not only affects our outlook but also has physiological effects. Long-term stress plays a role in damaging the immune system, accelerating aging and chronic disease. Adrenaline (a stress hormone) is produced in the body during stressful times. If it remains in the body, it can produce harmful side affects such as elevated blood pressure, pain and other conditions. When exercising, the body utilizes the excess adrenaline that is produced thereby minimizing damage to the body. In addition, during fitness activities the body also releases helpful natural “feel-good” chemicals called endorphins that give the individual a sense of well-being. Mood elevation is very helpful in offsetting the depression produced by challenging times.
You don’t have to take on the stress alone. During difficult times, people stay closer to home and many individuals become isolated and depressed. Exercising in a health club setting has shown to improve socialization and allow people to feel more like a part of a community. Adhering to an exercise routine gives a sense of accomplishment and sharing this empowers other people to be successful.
More good news……..Exercise gives your mind a break!
Fitness programs provide a “time out” to focus on the activity that you are presently performing and away from daily issues. As you concentrate on proper form or breathing techniques, the mind is unable to wander onto undesirable thoughts. The body becomes energized and creative problem solving may be stimulated. If anger is a concern, the physical release of energy dissipates feelings of frustration in a positive way.
According to CIGNA research (a global health service company) one-third of Americans find that the economy is affecting their health and other studies have shown that as many as 92% of corporate employees are losing sleep. Good news again! Exercised muscles relax better at night and physical fatigue from movement helps improve the sleep cycle. It is evident that individuals hold stress in their bodies in different ways. Wherever the body is weakest, pain, tension or possible injury can occur. Strengthening exercises allow the body to manage physical as well as psychological challenges.
There is even more good news, this time for your finances. Investing in an exercise regime can pay off! Health promoting exercise can help offset the need for expensive medications and/or medical care. It can replace poor coping habits that are costly such as excessive drinking or over-eating.
What kind of exercise is best? For those who are seated all day, consider swimming, walking or a structured fitness class. For individuals on their feet all day, the Nu-step (seated elliptical), cycling or mat Pilates classes are suggestions.
Ready to get started? Most people consult their physician prior to starting to exercise for a stress test. It may be more appropriate to consult your doctor before settling into your lounge chair for a day of “bad news” on the T.V.
Fitness is a necessity not a luxury. You cannot live without your health!

Carol Penfield RN, MS, Nurse Practitioner and owner of Chatham Health & Swim Club.

How does your heart health measure up?

Your blood pressure and serum cholesterol level remain the most common screening tools for evaluating your risk for cardiac disease. The following is a list of general ranges.

Total Cholesterol: Less than 200mg/dl = ideal
Above 200 – 239 = borderline high
Over 240 = high

LDL (bad) cholesterol: Below 100mg/dl = Optimal
100 – 129 = above optimal
130 – 159 = borderline high
Over 160 = high

HDL (good) cholesterol: Less than 50mg/dl for women = Low (a major heart disease risk)
Less than 40mg/dl for men = Low
Above 60 = ideal

Triglycerides: Less than 150 = normal
150 – 199 = borderline
Greater than 200 = high risk

Blood Pressure: Less than 120/80 mm Hg = Normal
120/80 – 139/89 = pre-hypertension with twice the risk of developing
140/90 or above = hypertension (stage 1), over 160/100 (stage 2)
Exercise can help decrease our blood pressure, cholesterol levels and triglycerides. It also helps raise the “good” cholesterol. Come visit Chatham Health & Swim Club for more information on how to protect your heart and be healthy! We are now offering a Heart Healthy Program for both members and non-members for prevention and/or recovery from heart disease or stroke.

Nutrition and the Skin

Choices in nutrition may help slow down the skin’s aging process from the inside, however, it does little to protect from the damaging factors of the outside world. The sun’s harmful UVA and UVB rays cause wrinkles by speeding up the skin’s aging process. This is why it is very important to always wear a sunscreen with SPF 30, or higher, no matter where you live or what the weather is like outside. Smoking speeds up the skin’s aging process as well, also creating wrinkles. It is important that you drink plenty of water in order to keep your skin hydrated, 6 to 8 (8 oz.) glasses daily has been recommended. Vitamins, minerals, and essential fatty-acids help keep the skin healthy and rejuvenated. They can be obtained by eating fresh fruits and vegetables.