Exercise For a Longer, Healthier Life

By RehabFit team members – Becky Chase MS, RCEP, and Leah Baron MS

Leah Baron, MS and Rebeccah Chase, MS, CSCS, RCEP

The effect of activity on mental and physical health is discussed frequently in today’s society. However, the benefits can be easily overlooked and taken for granted.  A recent study done by researchers at the Cleveland Clinic has shown having a sedentary lifestyle is worse for health in comparison to smoking, diabetes, and heart disease.  For 23 years, 122,000 people participated in the study and completed treadmill testing regularly.  The participants were divided into groups based on their performance levels to collect data concerning cardiovascular fitness level, health improvements, and overall longevity and quality of life.  Results showed those who did not exercise had a 500% raised risk of death compared to regular exercisers.  This study confirms staying fit and active reduces long-term mortality.

The Center for Disease Control and Prevention, CDC, reported in June only 23% of Americans get enough exercise.  The CDC guidelines suggest 150 minutes of moderate aerobic activity each week, and resistance training twice a week.  A brisk walk, swimming, or mowing the lawn are all examples for moderate intensity.  Being unfit is being viewed as a stronger risk factor compared to hypertension, diabetes, and smoking for mortality.  With this, a sedentary lifestyle should be looked at as a disease, which is treated with a prescription of exercise.  Setting a short-term goal of exercising two to three days a week has shown decreasing the stiffening of arteries.  The resistance that exercise puts on our bodies initiates other cardiovascular adaptations, for example improving the hearts overall function.

The United States spends more than $200 billion every year on treatments and complications for heart disease and diabetes.  These are the most expensive diseases in America, and both are modifiable diseases.  When clearance to exercise from a physician is obtained, there are no limits to the workout intensity unless stated. If we increase fitness education and support for physical activity, diseases and the costs associated with them can be reduced. This will coincide with an overall healthier, and longer, lifestyle.  Exercise is truly medicine, and the benefits are never-ending.

RehabFit is a fitness center for people of all ages and abilities with special attention to members with medical conditions and diseases. RehabFit features cardio machines, dumbbells, TRX suspension trainers and strength machines. Becky and Leah are exercise specialists at RehabFit and are happy to help with any strength training modality and all fitness. Stop by RehabFit to take a tour at Boulder Point in Plymouth or call (603) 238-2225. No referral needed.

Reflecting on Giving Birth at Speare

“My daughter Megan just delivered a baby at Speare and had the most wonderful experience. She was going to have her baby at LRGH and was one of those shocked to learn she would not deliver there. She was scheduled to go to Concord, but two days after her due date was told that her insurance wouldn’t be accepted there. That wasn’t a great introduction to Speare, but it all went up hill from there — as she met and was so professionally handled by the staff in what turned out to be a very challenging delivery. You now have a family singing the praises of Speare. Thought you’d like to know.”

Meg McLean family

The crib was set up. The bags were packed. She was seven days past her due date. The only uncertainty had been where she could give birth. And this morning she woke up in labor.

At the start of her pregnancy, Meg McLean and her husband, Alex, began reading parenting books and preparing the baby room. Everything was going along dreamily. Six months into her pregnancy, however, she learned that her local hospital would no longer deliver babies, and she would be going to Concord. Two days after her due date things took another turn when Concord Hospital declined her insurance. She didn’t know at the time that she was about to have a complicated delivery. But if there is a silver lining, hers was Speare.

Mclean baby

Meg was seen at Plymouth OB/GYN at Speare the same day she called them. Dr. Ebner took time to explain and demonstrate all the things that could happen during her delivery. She was given a tour of the birthing suite and found it warm and equipped with all she needed for a safe and comfortable delivery.

“I was so stressed out when I got there, but everyone was so nice I couldn’t help but feel better,” says Meg. “They even had my birthing plan in place!”

She went home with her spirits up.

“It happened so fast,” Meg remembers. “I woke up the next morning with one contraction after another — each one under 40 seconds as we made the twenty-minute drive to Speare. I was in so much pain; I would have never made it through an hour-long drive to Concord.”

Dr. Blue, a new physician at Plymouth OB/GYN, was on duty. Meg’s uterus was contracting so fast that it was affecting the baby’s heartbeat and both of their oxygen levels.

“Dr. Blue was so calm, confident and soothing that I didn’t realize anything was wrong,” says Meg. Ashley Francis, APRN, from Plymouth Pediatric & Adolescent Medicine was also there, as is protocol at Speare when a baby may need extra care. They explained that due to the lack of oxygen, they needed to get her baby out fast. Meg recognized the tools that Dr. Ebner had shown her the day before and was not concerned as the medical team jumped into action. Daughter Marley was born at 12:51pm. Ashley swept Marley away to be carefully examined and monitored. Both mom and baby were fine.

In the end, Meg says Speare was the very best thing that could have happened.

Mclean baby 1 month old

The young McLean family were so pleased with Ashley, that they now use Plymouth Pediatric & Adolescent Medicine as Marley’s physician group. “It’s nice to go there now because they really know my little family,” says Meg.

As for the future, Meg says they will definitely go to Dr. Blue and Speare again. Next time, however, they will plan on it.

We’ve been selected for the Hannaford Helps Reusable Bag Program

Hannaford HeardTheNews HWe are excited to share that Speare Memorial Hospital at Boulder Point, has been chosen by the Hannaford store located at 389 Tenney Mountain Hwy, Plymouth, NH as a beneficiary of the Hannaford Helps Reusable Bag Program!

This means for every Community Bag purchased at the Plymouth, NH Hannaford during the month of January, we receive $1. This is truly a great opportunity to be chosen again! Please go to the store, find the reusable bag rack and buy the reusable Community Bag!

Preventing Patient Falls

Falls are the leading cause of unintentional injury deaths in New Hampshire among people ages 65 and over.

Fall Prevention help down the hallNew Hampshire Falls Facts
(This information is from WISQARS and NHUDDS)

  • Falls are the leading cause of unintentional injury deaths among people 65-85+ with 210 deaths.
  • There were 12,045 older adults treated for fall-related injuries in emergency departments and hospitals
  • Total approximate cost for NH older adult hospitalizations (inpatient and emergency departments) was $416.5 million
  • Combined cost related to older adult injury deaths (ages 65+) in New Hampshire totaled $33,576,000, including the cost of work lost
  • For those hospitalized for falls, approximately 68% of the falls occurred in or near the home and 18.6% at a residential institution
  • Approximately 33% of hospitalizations falls were due to fracture and 15% was due to traumatic brain injury.

Falls Prevention Group Lauren Sirignano RN, Whitney Fish RN Clinical Leader, Meaghan Ringlein RN, Mary Hulse LNA and in Front Holly Butler RN
(l-r) Lauren Sirignano RN, Whitney Fish RN Clinical Leader, Meaghan Ringlein RN, Mary Hulse LNA and in front Holly Butler RN

Although most of those falls occur in or near the home, a team at Speare has been working diligently to decrease patient falls and harm to patients who may fall in the hospital. The team of nurses and licensed nursing assistants, from the day and night shifts, looked at workflow and reviewed patient falls.

When the Inpatient Fall’s group consisting of team members from Nursing, Lab, Respiratory, Quality, Physical Therapy, Staff Education Development, and the Medical-Surgical Unit came together, they made it a priority to review the fall data; when falls occurred, where they occurred and conditions at the time of the fall. Based on their review they determined that the majority of falls reported are related to using the restroom. The group suggested a trial of additional bars in the bathrooms to increase stability. This trial was successful, and bars will now be added to all the inpatient bathrooms.

Through evidence-based interventions, assessments and teamwork we are working together to prevent falls at SMH.

New After Hours Call Service at Plymouth Pediatric & Adolescent Medicine

Plymouth Pediatric logo 2 color horz

Plymouth Pediatric and Adolescent Medicine is committed to meeting the health care needs of your children 24 hours a day. We have implemented a new service for patients and families that call our office after hours.

When you call after hours, you will be directed to Night Nurse Plus, an outside agency that employs experienced pediatric nurses to answer your questions.  Night Nurse Plus will contact our on-call provider if more assistance is needed.  Our goal is to provide seamless access when a concern arises.

Triage Staff

RNs and NPs who average 18 years of clinical expertise are exclusively assigned to triage the patients of Night Nurse subscribers.

These nurses can be depended upon to competently and compassionately offer accurate treatment options and care advice within the most appropriate levels of care.

nurse phone callPerformance Record

  • Average response to emergent calls within 5 minutes, urgent calls within 10 minutes and non-urgent calls within 30 minutes.*
  • Average time spent on each triage call – 9:27 min/sec.
  • Subscriber satisfaction: over 99.9% subscriber retention since 1999.
  • Satisfied patients/caregivers.
  • Safe effective triage…nearing 2-million triage encounters without incident.

 

If you have any questions or concerns, please reach out to the practice at (603) 536-3700.

RehabFit Member of the Month: Ken Chadderton

Ken Chadderton - RehabFit Member of the Month December 2018Ken joined RehabFit in January 2016 with the goal of increasing ankle strength and mobility and overall fitness. Ken comes in almost every day and likes to talk and joke with fellow RehabFit members. Ken also recently joined the morning strength and balance class and is a great addition to the fun, social group.

Why did you decide to join RehabFit?

I started coming to RehabFit in January of 2016 to help my ankles and keep my body in good condition. Becky made up a program to follow; I stuck to it and it helped. The exercise equipment is high end and fun. The staff is very professional, knowledgeable and will work with you.

What motivates you to keep exercising and coming to RehabFit?

I have always liked exercise, when I was younger I went to the YMCA and Boys Club, played football and was a wrestler in High School. I like coming to RehabFit and socializing while working out. It’s hard to exercise at home on your own.

What changes have you seen in your body, health or general well being since starting at RehabFit?

Since joining RehabFit I find I have more endurance, strength, and I lost some weight. My balance has improved as well.

What changes have you made in your exercise or health routine since joining RehabFit?

I go to RehabFit every day if I can and I also swim at PSU. Exercising twice a day is good. The morning swim loosens me up before I get to RehabFit. I watch what I eat and drink as well.

What kind of advice would you give to other RehabFit members?

I would just keep doing what feels good for your body. When you come here the staff is willing to help anytime. Oh and the TVs will be on line as soon as RehabFit can get them.

The goal of our Medical Fitness Program is to encourage members to take responsibility for their physical well-being and to provide the knowledge, tools and supports necessary to reinforce healthy choices and behaviors. We offer a comprehensive array of exercise, fitness and wellness services to our members, provided by highly qualified, service-oriented staff.

For more information and/or schedule a tour call (603) 238-2225.

New Radiologists Expand Services for Central New Hampshire Communities

Speare is now working with Southern New Hampshire Radiology Consultants (SNHRC) to provide increased services in Central New Hampshire. Dr. Kevin Rivera, chief of radiology at Speare, is leading the expansion with specialty training and the purchase of new equipment and technology.

southern nh radiology consultants doctors

ABOUT SNHRC

SNHRC is comprised of a group of highly trained board-certified radiologists, fellowship trained in the subspecialty areas of neurology, body imaging, musculoskeletal radiology, pediatric radiology, interventional radiology, and breast radiology.

Using various imaging methods that include ultrasound, CT, MRI, and fluoroscopy, new services include:

Radiology reading an xrayBIOPSY PROCEDURES:

• Ultrasound-guided breast biopsy & aspiration
• Stereotactic core breast biopsy
• Liver
• Thyroid
• Soft tissue (muscle, lymph nodes)

Radiology procedures at SpeareOTHER PROCEDURES:

• Abscess drainage procedures
• Pain management for small, medium, large joints
• Epidural steroid injection
• Paracentesis
• Thoracentesis

Helping Patients with Behavioral Health and Substance Use Disorders

Patient Care Management team
Susan Laverack M.Ed, Stephanie Bouchard RN BSN director, Sara Dupont MSW social worker, and Deborah McQuillen RN care manager.

Susan Laverack M.Ed Community Care Coordinator for IDN 5 — the Franklin, Laconia, and Plymouth communities.
Susan Laverack M.Ed – Community Care Coordinator for IDN 5 — the Franklin, Laconia, and Plymouth communities.

Speare’s care management team was enhanced this year with the addition of Susan Laverack, M.Ed., community care coordinator. Susan’s position is funded through New Hampshire’s Medicaid Integrated Delivery Network (IDN) waiver program to combat the state’s opioid crisis. She is responsible for improving coordination between a patient’s healthcare providers and connecting patients to community support across Franklin, Laconia, and Plymouth (IDN 5). Her goals are to:

  • Promote timely access to appropriate care.
  • Increase access to and use of preventative care.
  • Reduce emergency room visits and hospital readmissions.
  • Increase a patient’s ability for self-management and shared decision-making.
  • Facilitate medication management.

As a resource for Medicaid patients with behavioral health or substance use disorders, Susan dedicates her days to working on enhancing a patient’s health and well-being, increasing patient satisfaction, and reducing healthcare costs.

For more information visit our Patient Care Management page or call 603-238-6479.

Reflecting On My Son’s Care

Angel and Jeffery Bray with sons, Harbor Bray (left) and Westley Bray (right) at their family farm stand.
Angel and Jeffery Bray with sons, Harbor Bray (left) and Westley Bray (right) at their family farm stand.

“My son had surgery at Speare Memorial Hospital and I can’t say enough good things about our experience! We received an excellent level of care, knowledge, and professionalism — Speare is an all-around five-star hospital. They were so gentle with my son and took extra measures to make sure he was comfortable and happy during the whole experience. The staff members also made my husband and I informed about everything there possibly is to know of the procedure and made us comfortable with the entire experience. There is not a doubt in our minds that if a family member ever needs another surgery or procedure this is the place it needs to happen! We are truly grateful for the level of care and the compassion they showed our family!”

Westley had ear problems from the time he was born. He had earaches and would grab at his ears. His parents, Angel and Jeff, tried everything. They felt like they lived in the emergency room, primary care office or walk-in clinic. They thought perhaps he had just built up an immunity to all the antibiotics, but then they saw a specialist and learned that Westley had fluid buildup in his ear.

Joan Glidden RN preoperative nurse, Steve Ball MS MBA CRNA APRN director of anesthesiology, and Deborah Majersky RN intraoperative nurse.
Joan Glidden RN preoperative nurse, Steve Ball MS MBA CRNA APRN director of anesthesiology, and Deborah Majersky RN intraoperative nurse.

They were happy to have an answer but nervous about the resolution. He needed to have surgery to insert an ear tube. The operation would relieve his pain, but it involved making a tiny incision in his eardrum to insert the tube. Jeff had a good experience at Speare the previous year when Dr. Gennaro operated on his shoulder, so they felt comfortable with Speare. They were not disappointed.

Angel says they not only found the nurses and anesthetist Steve Ball skilled, but especially kind. Westley was able to hold his toys and wear his pajamas during the procedure, and Steve held him in his arms like he was his own child. Westley started feeling better right away after the operation and has been having a great time on their family farm since.

Joan Glidden RN preoperative nurse, Steve Ball MS MBA CRNA APRN director of anesthesiology, and Deborah Majersky RN intraoperative nurse.Update from Mom

“A year after his surgery, Westley is doing fantastic! He started school as soon as he turned 3 in April to help him catch up with other children his age. He goes four days a week, and it has helped him with his communication, speech, fine and gross motor skills. His ear infections are almost non-existent now. His breathing has improved, as well as his hearing since his surgeries. Overall he is a much healthier and happier boy!”

Click here to learn more about the surgical services available at Speare.  Surgical Services cares for pediatric, adolescent, adult and geriatric patients.

What Form of Strength Training is Right for You?

By: Becky Chase M.S., RCEP
Leah Baron M.S.
JinLyi Mah PSU Exercise & Sports Physiology Student-Intern

 

Leah Baron, MS and Rebeccah Chase, MS, CSCS, RCEP 2The goal of strength training is to build strength, increase our muscle’s body ability to utilize energy without oxygen and to increase the size of skeletal muscle. The body’s muscular strength is used in almost every daily activity from sitting down and standing up to mowing the lawn. Men and women start to lose muscle mass and strength as early as age 30. It is important to maintain our ability to perform activities of daily living with strength training.

RESISTANCE TRAINING

Many people think of dumbbells and barbells when thinking of strength training. There are many other forms of resistance training including bodyweight exercise, suspension training, bands, and machines. No form or type of resistance training is superior to another; what matters is that you are working hard and providing enough of a stimulus to maintain or increase the strength of your muscles during the aging process.

Bodyweight and gravity are used as resistance during bodyweight exercises. Common examples of bodyweight exercises are a push-up, pull up, sit up, and jumping. All bodyweight exercises can be made more or less challenging with small adjustments. A push-up is less challenging when done at an incline with hands on a chair, table or wall. This places less body weight on your arms and chest and more towards the legs making the exercise easier for beginners.

SUSPENSION TRAINING

Suspension training is a mode of strength training that uses bodyweight and a form of straps. The most popular suspension training device is Total Body Resistance Exercise, TRX.  This fitness tool is made out of high-quality nylon straps with handles at the bottom which can hold up to 1,400 pounds. TRX has become very popular and can be seen in most fitness facilities, yet only a handful of people are willing to give it try.  It is designed for all fitness levels and abilities. By changing body position, resistance will increase or decrease making the exercise easier or more difficult. Every muscle group in the body can be trained using the TRX and almost every bodyweight and free weight exercise can be performed using the TRX including some exercises that can only be performed with a suspension trainer.

Bands and tubing are often used in resistance training when dumbbells are not available. The further the band or tube stretches, the more resistance there is provided. Bands and tubes come in a variety of colors, each color dictates a different resistance level. An advantage of using bands and tubes compared to other strength training modalities is only one or a few bands are needed to perform a multitude of exercises. Other advantages include low cost and easy storage.

STRENGTH TRAINING

strength training

Strength machines are even more common than dumbbells or barbells for strength training. Strength machines are usually found at fitness centers, though some multi-use strength machines like a Total Gym are available for home use. There is a strength machine for almost every muscle group in the body and some gyms provide all of these machines in one location. Strength machines are very popular because of their ease of use and safety. However, many strength training experts disapprove of strength machines. Strength machines isolate muscle groups while decreasing the need for supportive stabilization muscles.

Which modality of strength training is best? The answer is none of them! All strength modalities have advantages and disadvantages. To maintain or improve muscular strength throughout the day, it is important to always provide enough resistance to make a positive change in the muscle and to change your exercise routine about once a month, to keep the body responding. Many people like a variety of strength training types to keep their workout fun and exciting. For any exercise, it is crucial to use proper technique to avoid injury and get the most you can out of the exercise. It is advised to have a certified trainer to demonstrate and guide these exercises to ensure proper form and prevent unwanted injuries.

RehabFit is a fitness center for people of all ages and abilities with special attention to members with medical conditions and diseases. RehabFit features cardio machines, dumbbells, TRX suspension trainers and strength machines. Becky and Leah are exercise specialists at RehabFit and are happy to help with any strength training modality and all fitness. Stop by RehabFit to take a tour at Boulder Point in Plymouth or call (603) 238-2225. No referral needed!