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Acetaminophen and NSAIDS are not risk-free

By David Dunaief, M.D.

Dr. David Dunaief

What do you do when you have a headache or a sore knee? Most of us head to our medicine cabinet to grab one of the analgesics we keep on hand for such occasions.

Analgesics are, first and foremost, pain relievers, but they also help lower fever and reduce inflammation. The most common over the counter (OTC) medications include acetaminophen and a variety of non-steroidal anti-inflammatory drugs (NSAIDs), like aspirin, ibuprofen, and naproxen sodium.

Americans consume more than 30 billion doses of NSAIDs a year, including both OTC and prescription-strength (1). As for acetaminophen, one quarter of Americans take it weekly.  Because they’re so accessible and commonplace, many consider them low risk. Many patients don’t even include them in a list of current medications. I need to specifically ask about them.

They are not risk-free, though. According to a poll of regular OTC NSAID users, 60 percent were not aware that they can have dangerous side effects (2).

What are NSAID risks?

NSAIDs, according to the Centers for Disease Control and Prevention, are responsible for more than 70,000 hospitalizations and 7,600 deaths annually (3). 

They increase the risk of heart attacks, gastrointestinal bleeding, stroke, exacerbation of diverticular disease, chronic arrhythmia (abnormal heartbeat) and erectile dysfunction. In some instances, the cardiovascular effects can be fatal.

The FDA strengthened warning labels on non-aspirin NSAID labels 10 years ago, advising that those taking NSAIDs should immediately seek medical attention if they experienced chest pain, shortness of breath or trouble breathing, weakness in one part or side of their body, or slurred speech (4).

Five years ago, the FDA added a warning label to non-aspirin NSAIDs about the risks of fetal kidney damage and pregnancy complications beginning around week 20 of a pregnancy (4).

In a case control study using the UK Primary Care Database, chronic users of NSAIDs between ages 40 and 89 had a significantly increased risk of a serious arrhythmia called atrial fibrillation (5).

Interestingly, researchers defined “chronic users” as patients who took NSAIDs for more than 30 days. These users had a 57 percent increased risk of atrial fibrillation. A Danish study reinforces these results after the first month of use (6). This is not very long to have such a substantial risk. For patients who used NSAIDs longer than one year, the risk increased to 80 percent. 

NSAIDs also increase the risk of mortality in chronic users. Older patients who have heart disease or hypertension (high blood pressure) and are chronic NSAID users are at increased risk of death, according to an observational study (7). Compared to those who never or infrequently used them over about 2.5 years, chronic users had a greater than twofold increase in death due to cardiovascular causes. High blood pressure was not a factor in this study, since chronic users had lower blood pressure; however, I have seen that NSAID use can increase blood pressure with some of my patients.

What are acetaminophen risks?

The FDA announced in 2011 that acetaminophen consumption should not exceed 325 mg every four to six hours when used in a prescription combination pain reliever (4). The goal is to reduce and avoid severe injury to the liver, which can cause liver failure.

There is an intriguing paradox with acetaminophen: Hospitals typically dispense regular-strength 325-mg doses of the drug, whereas OTC doses frequently are found in “extra strength” 500-mg tablets, and often the suggested dose is two tablets, or 1 gram. At the FDA’s request, Tylenol lowered its recommended daily dosage for its extra strength version to no more than 3 grams a day.

One study that showed acute liver failure was due primarily to unintentional overdoses of acetaminophen (8). Accidental overdosing is more likely to occur when taking acetaminophen at the same time as a combination sinus, cough or cold remedy that also contains acetaminophen. OTC and prescription cold medications can contain acetaminophen.

If you already have liver damage or disease, consult your physician before taking any medication.

To protect yourself from potentially adverse events, you must be your own best advocate; read labels, and remember to tell your physician if you are taking any OTC medications.

If you are a chronic user of NSAIDs or acetaminophen because of underlying inflammation, you may find an anti-inflammatory diet and other lifestyle changes can be an effective alternative.

References:

(1) medscape.com. (2) J Rheumatol. 2005;32;2218-2224. (3) Annals of Internal Medicine, 1997;127:429-438. (4) fda.gov. (5) Arch Intern Med. 2010;170(16):1450-1455. (6) BMJ 2011;343:d3450. (7) Am J Med. 2011 Jul;124(7):614-620. (8) Am J Gastroenterol. 2007;102:2459-2463.

Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.

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By Hon. Gail Prudenti, Esq.

Hon. Gail Prudenti, Esq.

Contesting a will can be a complex and sensitive decision, often fraught with emotional implications and legal challenges. Understanding when to object to a will is crucial for anyone who believes that the document does not accurately reflect the deceased’s intentions or who has concerns about the will’s validity. Here are key considerations for when a person may choose to object to a will.

Lack of testamentary capacity

One of the most common grounds for contesting a will is the assertion that the deceased lacked the mental capacity to understand what they were doing when they executed the will. If you believe that your loved one was not of sound mind—due to conditions such as dementia, severe illness, or mental incapacity—at the time the will was created, this may warrant an objection.

Undue influence

If you suspect that the deceased was coerced or manipulated into changing their will in favor of another person, this could be a valid reason to contest the will. Evidence of undue influence may include a significant change in the will that benefits a caregiver or a family member who had undue access to the decedent, especially if the decedent had previously expressed different intentions.

Fraud

If the will was procured through fraudulent means—such as misrepresentation about the contents of the will, deception regarding the nature of the documents, or coercive tactics— this may provide grounds for contesting it. If you believe that fraud was involved, it is essential to gather evidence to support your claim.

Improper execution

In many jurisdictions, including New York, there are specific legal requirements for executing a valid will. This typically includes proper signing and witnessing. If the will does not meet these legal standards—such as being signed by the testator in the presence of two witnesses—this could be a reason to object.

Revocation

If you have evidence that the deceased revoked the will prior to their death—perhaps through a later will or other direct actions indicating their intent to change their estate plan—this could justify an objection. Establishing the revocation of a previous will is critical in this scenario.

Disqualification of beneficiaries

Certain individuals may be disqualified from inheriting under a will due to their actions, such as felonies committed against the deceased or being an estranged spouse. If you believe that a beneficiary should not have been included in the will based on legal grounds, this may be a reason to object.

Timeframe for objection

In New York, for example, you generally have **seven months** from the date you receive notice that the will is being probated to file your objections, as outlined in **SCPA § 1410**. Failing to act within this timeframe could result in losing your right to contest the will, so it’s crucial to be aware of deadlines.

Consulting an attorney

If you are considering contesting a will, consulting with an attorney who specializes in trusts and estate litigation is highly advisable. An experienced attorney can help you evaluate the strength of your case, gather necessary evidence, and navigate the legal complexities involved in the contestation process.

Deciding to object to a will is a significant decision that should not be taken lightly. Understanding the grounds for contesting a will and the appropriate legal procedures is essential. 

Whether due to concerns about capacity, undue influence, improper execution, or other factors, it is important to consult with a qualified attorney to ensure that your rights are protected and that you are acting in accordance with the law. By doing so, you can make informed decisions that honor the memory of your loved one while safeguarding your interests.

Hon. Gail Prudenti, Esq. is the Former Chief Administrative Judge State of New York and a Partner at Burner Prudenti Law, P.C. focusing her practice on Trusts & Estates. Burner Prudenti Law, P.C. serves clients from New York City to the east end of Long Island with offices located in East Setauket, Westhampton Beach, Manhattan and East Hampton.

Julia and Valerie D’Amico. Photo courtesy of D’Amico family

In 2025, labels are toxic, political and problematic.

DEI? Not allowed anymore. Woke? There’s undoubtedly an executive action to rid the nation of anything that fits under this large umbrella.

Fortunately, during last week’s final stage in a contest run by Stony Brook University’s Institute for Advanced Computational Science, politics didn’t enter the room, even though women, girls, families and boys met for a science competition.

The IACS unveiled the winners in their competition a few days after the International Day of Women and Girls in Science.

The competition helped over 150 local students learn about women scientists who may not be household names, but who made significant contributions to their fields.

Some of these historical role models were firsts. Mary Jackson was the first female Black engineer. Marie Curie was the first woman to earn a degree from the University of Paris.

Others made significant, and sometimes overshadowed, contributions to their fields. Rosalind Franklin, for example, provided key x-ray crystallography images that uncovered the double helical structure of DNA.

For students in the area, the competition was not only an opportunity to learn about the history of these women and the challenges they overcame, but was also a chance to conduct their experiments and present them to a receptive audience.

All the competitors were not girls. The participants, whether or not they won, appreciated the opportunity to learn and compete.

Parents of these precocious children were thrilled that this contest provided an enrichment learning opportunity, built their daughters’ confidence, and gave the next generation a sense of the myriad opportunities the sciences might present to them.

Each of these students — and some of them worked in teams — produced a one minute video explaining who the scientist was, why she was important and how they conducted their own experiment.

Some of them extracted DNA from strawberries, while others, like co-winner Allison Wong launched small objects through the air with their own miniature catapults, measuring the time marbles, cotton balls, ping pong balls and bottle caps were in the air and the distance these objects traveled.

Even amid concerns about future funding for all kinds of science and educational programs, this second annual competition was clearly a success for the competitors and a source of great satisfaction for parents, science teachers, and extended family members.

This kind of educational outreach program is exactly what every area needs, as students not only competed to win cash prizes, but also asked about future opportunities for scientific learning and advancement.

We congratulate the IACS and the co-chairs of this effort, Professors Marivi Fernandez-Serra and Monica Buggalo at Stony Brook University, for putting this great event together. We also hope that this kind of community service and outreach continues to provide necessary opportunities for personal growth.

These students expanded on the typical effort to study for a test, memorize dates or answer multiple choice or short answer questions for a class assignment. These videos took days to produce and edit.

We thank women scientists of the past for everything they did in and out of the limelight and we take great comfort in pondering a future led by the boundless enthusiasm of the competitors who are in the early stages of their own journeys.

Rob Martienssen with Nobel Prize winning scientist Barbara McClintock in 1990. Photo by Tim Mulligan, CSHL

By Daniel Dunaief

Cells, like the organisms they are a part of, are trying to balance between staying the same and making the kind of changes that might save a life or increase fitness.

At the cellular level, pieces of important genetic information, called small RNA, have the ability to introduce important so-called epigenetic changes. These alterations allow an individual to survive a potential threat, such as a disease or a toxin in the environment, without altering their DNA.

In a recent publication in the journal Nature Structural & Molecular Biology, scientists at Cold Spring Harbor Laboratory and the University of Cambridge demonstrated that a slightly altered form of uridine, which is a combination of the base uracil and ribosome, can act as something of a master key throughout nature.

“When you see something like that conserved in plants and animals, it has to be basic in terms of inheritance or mechanisms,” said Rob Martienssen, a Howard Hughes Medical Institute Investigator who has been at CSHL since 1989.

Indeed, pseudouridine guides epigenetic inheritance, which, unlike a mutation, can represent a temporary change in gene function.

Pseudouridine helps transport small RNAs into reproductive cells in both plants and mammals.

Without pseudouridine, these small RNAs that lead to epigenetic changes can become the target of the body’s immune system, which reacts to anything that introduces changes into the genetic machinery as a potential threat, such as a virus.

The body’s Rig-1 pathway, which monitors the extracellular space for foreign genetic material, triggers a cascade of reactions that lead to the release of interferon by white blood cells.

“We think a conserved protein called RTL1 might provide this function in plants (and animals),” explained Martienssen.

Pseudouridine can signal to the body that these genetic codes that are heading towards the nucleus are “self,” keeping the immune system’s reaction at bay.

“It is known that pseudouridine (and other RNA modification) prevent recognition of long RNA as a virus by human cells and we think the same is true in plants,” Martienssen said.

Some viruses have effectively slipped behind the immune defenses by incorporating pseudouridine into their codes. The most famous example of this, Martienssen suggested, is the Human Immunodeficiency Virus, or HIV.

Parasitic nematodes and plants also transfer small RNA into the plants they are parasitizing.

Martienssen speculates that those RNA depend on pseudouridine. In his current experiments, he is testing that hypothesis.

Vaccinations

The immune system initially treated the developing mRNA vaccines that were so instrumental in providing an immune defense against COVID-19 as a viral threat, rather than a potential life-saving shot.

A strong immune response prevented the vaccine from providing any benefit.

By adding pseudouridine, among other chemical modifications, to the mix, the pharmaceutical companies created vaccines that functioned effectively without triggering an immune reaction that would otherwise block their effectiveness.

By contributing to a filter that evades immune detection, pseudouridine can also enable the kinds of epigenetic changes — apart and aside from human intervention — that contribute to survival during challenging conditions.

Small RNA that contains pseudouridine can induce epigenetic changes that might be caused by the environment or some disease, enabling an important alteration in the genetic code that could protect an individual against harm.

Martienssen and his team believe pseudourilyation is required to get into the germ line, the cells that are a part of contributing to the next generation. He believes pseudourilyation might also make the germ line more stable.

Martienssen’s collaborator from Cambridge, Tony Kouzarides, independently found pseudouridine in mouse small RNA.

Shorter term changes

As for the long term impact of these changes, epigenetic inheritance typically only lasts a half a dozen generations in animals like worms.

Well known enzymes, such as demethylases, can remove epigenetic marks over time, as several mechanisms are trying to “clean up” the genome before these changes become permanent.

Lower organisms, such as fungi, can become epigenetically resistant to drugs. Epigenetics gives them a lot more variation than they would otherwise have had under natural selection.

An example includes cryptococcus, an infection that can be deadly for immunocompromised people, Martienssen explained.

About five percent of the bases in ribosomal RNA are pseudouridine and 100 percent of ribosomal RNA molecules have these bases rather than uridine at these locations.

Martienssen interfered with the process in his experiments by knocking out an exportin, which is a protein required to export small RNAs. He was able to knock it out without killing the plant.

English origins

Martienssen grew up in Essex, England by the Blackwater estuary near Maldon, which is famous for its sea salt.

Martienssen lived his childhood close to London. Long Island and New York City remind him of home.

When he was eight years old, his father Anthony Kenneth Martienssen gave him the book “The Double Helix’ by former CSHL chair and Nobel Prize winner James Watson.

Martienssen’s father was an author and an aviation consultant who pioneered computer guided air traffic control, his son said. The family recently reprinted some of his father’s books from 50 to 75 years ago.

When he arrived at CSHL, Martienssen worked with Nobel Prize winner Barbara McClintock, who studied transposable genetic elements.

“She showed me how to isolate male germline cells (pollen precursors) from maize plants,” Martienssen recalled. “She told me not to make models, but to stick to the observations.”

McClintock’s earlier models had been more accurate than she realized at the time, he said.

As for his study of epigenetics, Martienssen explained that such alterations are “amazingly useful” in theory, as they can “be induced in many individuals at the same time (random mutations would only occur in one individual at a time), inherited, but then reversed when conditions change.”

Sebastian

Welcome to the 38th edition of Paw Prints, a monthly column for animal lovers dedicated to helping shelter pets find their furever home

Sebastian

Meet Sebastian

With a name lengthier than he is, meet Sebastian, a twelve(+) year old Chihuahua mix at Little Shelter in Huntington. Small, but substantial, this venerable statesman has quickly won the admiration of everyone at the shelter for his confident, charming demeanor. The self-appointed activities director in the small dog kennel, he ensures everyone has the best time while waiting to find forever homes. A big fan of sing-alongs, he has perfect pitch as well as the answer to the age old question of “Who Let the Dogs Out?” If you want to be in the know and start your weekend on a good note, stop by to meet Sebastian today! 631-368-8770

*Sebastian is fully grown and not completely housebroken*

Sheldon

Meet Sheldon

“Tiny but mighty, Chihuahuas embody the strength of a lion in the body of a mouse.”

Small, spirited, and social, meet Sheldon, a one year old Chihuahua mix up for adoption at Little Shelter in Huntington. Bringing plenty of laughs to the table, young Sheldon will always keep you on your toes and entertained with his comical personality. Also seriously intelligent, he is confident in his math skills and knows that breaking one treat in half does not equal two! Always ready for an adventure, even if it’s just a walk around the shelter grounds, he’ll greet you with enthusiasm each time. The bottom line: if you’re looking for a smart, funny, loyal companion who will make each day better, Sheldon fits the bill and then some…see you soon! 631-368-8770

*Sheldon is fully grown and not housebroken

Riley

Meet Riley

Valentine’s Day has come and gone and Riley is still waiting at the Smithtown Animal Shelter for her one true love to give her the loving home she deserves. Estimated to be about 3 years old, this 60 pound black shepherd mix needs to be the only pet in the home. This sweet girl is beyond loving, smart and active. She is slow to trust new people and needs a family that can help her manage new introductions. However, once she loves you, she will show off all of her tricks and ask for love all day long. 631-360-7575

Chanel

Meet Chanel

Chanel is a 2-year-old mixed breed at Brookhaven Animal Shelter who is ready to find her forever home! With her athletic build and energetic personality, she thrives on playtime and outdoor adventures. Chanel loves to run and play in the shelter’s playpens, and would love a big, fenced-in yard where she can burn off all her energy. She would do best in a home with kids 16 and older. She’s got a heart full of potential and would thrive in an experienced, active household where she can get the attention and exercise she loves. Come meet her and see how much fun life could be with this sweet and energetic girl by your side! 631-451-6955

Negan

Meet Negan

This big handsome two-year-old boy is Negan, up for adoption at Kent Animal Shelter in Calverton. Sweet and cuddly, with the softest fur, he began showing up in a feral colony a few months ago. The feeder gained his trust and was able to pet him and eventually pick him up. He was taken to a vet but did not have a microchip. Due to his gentle nature, the feeder did not want to leave him in the colony. With his curious eyes and loving personality, he’s ready to bring warmth and joy to a new home. If you’re looking for a companion to cuddle up with this winter, Negan might be the purrfect match! Adopt a cat — they’re the best! 631-727-573

DID YOU KNOW? 

For the entire month of February, the Town of Brookhaven Animal Shelter, 300 Horseblock Road, Yaphank is waiving all adoption fees for animals who have been in the shelter 6 months or longer — because everyone deserves a chance to find their forever home. Let’s spread the love and help these sweet animals find their happily ever after! 631-451-695

Rescue is a lifestyle. Adopt, don’t shop.

Check out the next Paw Prints in the issue of March 20.

Paw Prints is generously sponsored by Mark T. Freeley, Esq.

 

Chopped Chicken Taco Salad

By Heidi Sutton

As kids and parents return to busy schedules full of sports, homework and weeknight activities after winter break, building a plan for nutritious and easy meals can be challenging. 

Piecing together a menu that fuels active minds without spending hours in the kitchen is a common goal for many families. 

For a customizable kid-pleaser, turn to Chopped Chicken Taco Salad and garnish with your family’s favorite toppings. This recipe require minimal prep and calls for on-hand ingredients that provide nutrients people of all ages need to grow and maintain strong bodies and minds. 

Chopped Chicken Taco Salad

Recipe courtesy of Megan Gundy on behalf of Milk Means More

Chopped Chicken Taco Salad

YIELD: Makes 4 servings

INGREDIENTS: 

For the Dressing

1 cup yogurt, plain Greek

1/3 cup milk, buttermilk

1 tablespoon fresh squeezed lime juice

3 tablespoons chopped cilantro

2 tablespoons taco seasoning

For the Salad

2 pounds boneless skinless chicken breasts

2 tablespoons taco seasoning

2 tablespoons olive oil

1 head leaf lettuce, chopped

1 avocado, chopped into bite-sized pieces

1 cup black beans, drained and rinsed

1 cup corn

1 pint grape or cherry tomatoes, chopped

1 cup cheese, Monterey Jack or Mexican shredded cheese

tortilla strips or crushed tortilla chips, for topping

DIRECTIONS:

To make the dressing: Combine all ingredients in a small bowl and stir until well combined. Taste and adjust lime juice and cilantro as needed. If dressing is too thick, add buttermilk one teaspoon at a time until desired consistency is reached. Refrigerate until ready to serve.

To make the salad: Season the chicken on both sides with the taco seasoning. Heat a large skillet over medium-high heat and add the olive oil. Add chicken to the pan and cook on both sides until the outside is golden brown and the chicken is cooked through. Remove chicken to a cutting board and slice into strips.

To build the salad, heap the chopped lettuce on a large platter. Sprinkle the chicken over top. Add the avocado, beans, corn, tomatoes and shredded cheese. Drizzle the dressing on top and sprinkle on the tortilla strips or crushed tortilla chips right before serving.

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By Daniel Dunaief

Daniel Dunaief

Uh oh. I started to feel sick more than a week ago.

What could it be?

Let’s see: I had a headache, my nose was running, I had a low grade-ish fever, although my thermometer was much more like a magic eight ball than an effective way to determine my temperature, and I was much more exhausted than usual.

Of course, I had…. well, what?

I mean, these days, one person’s virus is another’s bacteria is another’s combination of things.

I went to the pharmacy and picked up a collection of over the counter flu treatments to reduce the symptoms for everything.

You see, the problem is that I know that I had only three or four days to get to a doctor to get a definitive diagnosis.

I felt too sick to go to the doctor and hoped my vague, general symptoms would leave me alone.

Nope, they barnacled their way into my system, leaving me, day after day, wondering what I had, how contagious I was and whether I should see a doctor.

After muddling through four days, I went to a local drug store, where I picked up a test for Covid and the flu.

After receiving negative tests for both, I scheduled a doctor’s visit. I wasn’t sure what she’d be able to tell me, but I was hopeful that she could give me a magic pill or a definitive diagnosis.

After explaining all my symptoms to the nurse, I went through the same routine with the doctor.

“Well, you should be getting better in a few days,” she shrugged. “There’s really no point in testing you at this point.”

“What can I take?” I asked.

“Advil? Tylenol?” she recommended.

Hmm. I felt as if I were hearing the old “take two aspirin and call me in the morning” advice.

I racked my brains trying to think about what might have made me sick. Was it the money I touched? I rarely handle cash, but I didn’t want to pay the extra 3 percent credit card fee for a food purchase in the days before I got sick.

Was it traveling on an airplane? Probably not, because I still wear a mask to keep my hands away from my face.

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Was it the guy at the gym who was exhaling hard in my direction while he race walked on the nearby treadmill? Sometimes, when I can smell someone’s breath at the gym, as I did earlier last week, I figure that’s a sign to move to another apparatus, but those dang endorphins were kicking in, making it hard for me to give up my treadmill before working through my routine.

Much as we might wish that we could return to normal now that Covid is gone, normal, as we might recall, still includes the passing along of all kinds of disagreeable illnesses with their persistent symptoms.

Perhaps it’s the extended winter. After all, usually by now, we’ve had some respite from the lower temperatures and strong winds. We might be spending more indoor time with other people.

Yeah, people can be great, because they can make us laugh, commiserate with us when things don’t go well with our kids or at work, and can share entertaining and enjoyable outings to concerts and sporting events.

And yet, those same people are like walking petri dishes, with their own sets of flora and fauna that can threaten to keep us from feeling completely healthy.

Despite being a bit obsessive compulsive about germs, I am not antisocial and I don’t generally try to avoid people.

I do, at times when I’m feeling sick, wish that I had an app on my phone that’s akin to finding all my friends. Instead of searching for people in my network, this app might warn me about entering a room with a preponderance of viral or bacterial particles.

Maybe this app could be like a GPS with a safety feature.

“No, that bathroom in Grand Central Station is a bad idea. The knob is covered in virus A and the paper towel dispenser has virus B.”

Being sick saps some of the fun from each day. If misery loves company, I suppose I have plenty of friends with stuffy noses, dull headaches, and mild to moderate congestion.

Pixabay photo

By Leah S. Dunaief

Leah Dunaief,
Publisher

Houses are like children. They need constant care and rescuing, especially in this current bout of tempestuous weather we’ve been having. Sometimes they have several needs that just pile up on each other.

The trouble started Saturday, when we plugged the vacuum cleaner into an electric strip and the lights went out. So did the computers. After much hunting and flipping of fuses in the fuse boxes, we finally found the culprit and restored the electricity—but not the computers. That took another long and arduous retracing of procedures, with the help of a kindly electrician, who came over despite his hernia operation four days earlier, until they  worked.

Vowing never again to plug the vacuum into the power strip, we thankfully continued on with our lives. We might have even felt a little smug about figuring out how to solve the various problems. 

That is, until Monday. Now, no one I know loves Mondays. Unless they work on the weekends and have the day off. So it was not a pleasant beginning to the anyway unwelcome start of Monday, when we found that the fearsome winds of Sunday night had knocked down a heavy tree. It had fallen across the driveway, innocently forming a perfect right angle with the blacktop, making the driveway passable only for deer.

Eventually we got out, only to be informed that the toilet bowl in the office was having a bad day. According to prior plans, the plumber had come to restore the grout at the base of the pedestal, from which tiny amounts of water had been seeping onto the floor. In the process, he heard something snap, he said, and suddenly the minute (my-NOOT) leak turned into a gusher. 

We rushed around the building, fumbling for the intake valve. Before we could turn off the water, the plumber somehow stopped the flow, but the problem was not solved. He told us that he needed to replace a particular part. Of course, Monday was Presidents Day, a holiday for plumbing supply stores the world over. After a fashion, our plumber was able to put the crisis on hold until the following day, but not until considerable hysteria was expended, along with the water.

We went home Monday evening, consoling ourselves that these were only inanimate material losses. At least we had personally survived unscathed.

At 7:12 the next morning, a text message arrived, informing us that the managing editor, our only managing editor, had a temperature of 102.3 degrees. She gamely told us that she could do some of her work remotely, but it was going to be a difficult day since the papers are due at the printer Wednesday afternoon. We took some prophylactic action, helped by the good nature and generosity of others, and hoped for the best.

The miseries weren’t over. When we got home, the mixer we were using, that had been valiantly making pulp of the raw fruits and vegetables for a smoothie, suddenly stopped. Just like that, in the middle of making dinner. Unplugging, replugging, restarting, shaking, switching receptacles, giving it a rest, were all to no avail. It was as if a ghost had snuck into the house and jinxed the heretofore powerful mixer, which wasn’t nearly old enough to have died on the job. We looked up the brand on the internet to see if instructions might help us solve the trouble. We found lots of instructions, all of which we had already tried, and the dumb machine just remained on the kitchen counter, silently defying us.

Exasperated, we moved into the living room, picked up the daily newspaper and were ready to turn our attention to exogenous problems about which happily we had no responsibility to solve. 

And there it was. One more impotent machine before us. One more challenge to try and fix. The humidifier that we rely on to keep the heat from drying out our biological pipes, as well as our house, was not sending up its normal stream of vapor. I capitulated and went to bed. 

Those few days, there must have been something in the water. 

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Design strategies that get you up and moving

By David Dunaief, M.D.

Dr. David Dunaief

Exercise helps build long-term physical and mental health, but regular exercise is often a challenge. Even with all the fitness-related apps to prompt us, modern society has an equal number of tech demotivators. It’s just too easy to let the next episode of our favorite series autoplay or to answer those last few emails.

Even if we want to exercise, we “don’t have time.”

I have good news. There is an easy way to get tremendous benefit in very little time. You don’t need expensive equipment, and you don’t have to join a gym. You can even sharpen your wits with your feet.

Esther Tuttle was profiled in a New York Times’ Science Times article a few years ago, when she was 99. Esther was sharp as a tack and was independently mobile, with no mobility aids. She remained active by walking in the morning for 30 minutes and then walking again in the afternoon. 

Of course, this story is only anecdotal; however, evidence-based medicine supports her claim that walking is a simple way to get exercise that shows incredible benefits. One mile of walking a day will help keep the doctor away. For the step-counters among you, that’s about 2,000 steps a day for an adult with an average stride length.

Does walking improve mental acuity?

Walking has a dramatic effect, preserving brain function and even growing certain areas of the brain (1). Study participants who walked between six and nine miles a week, or just one mile a day, reduced the risk of cognitive impairment over 13 years and actually increased the amount of gray matter tissue in the brain over nine years.

Participants who had an increase in brain tissue volume also experienced a substantially reduced risk of developing cognitive impairment. Interestingly, the parts of the brain that grew included the hippocampus, involved with memory, and the frontal cortex, involved with short-term memory and executive decision making. There were 299 participants with a mean age of 78. All were dementia-free at the trial’s start.

In another study, moderate exercise reduced the risk of mild cognitive impairment with exercise begun in mid-to-late life (2).

If you’re pressed for time or building your stamina, you can split a mile into two half-mile increments. How long does it take you to walk a half-mile?

Does walking affect one’s mood?

Researchers performed a meta-analysis of studies related to the relationship between exercise and depression. They found that adults who walked briskly for about 75 minutes per week cut their risk of depression by 18 percent (3).

If you ratchet up your exercise to running, a study showed that mood also improves, reducing anger (4). The act of running increases your levels of serotonin, a hormone that, when low, can make people agitated or angry.

How do I build better habits?

A common challenge I hear is that working from home reduces much of the opportunity to walk. There’s no walking down the hall to a meeting or to get lunch or even from the car or train to the office. Instead, everything is only a few steps away. Our work environment is working against us.

If you need a little help getting motivated, here is a terrific strategy to get you started: set an alarm for specific points throughout your day and use that as a prompt to get up and walk, even if it’s for only 15 minutes. The miles will add up quickly.

A client of my wife’s schedules meetings for no more than 50 minutes, so she can walk a “lap” around her house’s interior between meetings or even do some jumping jacks. She also looks for opportunities to have an old-fashioned phone call, rather than a video call, so she can walk up and down the hallway while she’s meeting. Of course, this is one person, but it might prompt some ideas that will work for you.

Walking has other benefits as well. Weight-bearing exercise helps prevent osteoporosis and osteoporotic fractures. Sadly, if you don’t use them, bones weaken and break. Walking is a weight-bearing exercise that helps strengthen your joints, bones and muscles.

Remember to use your feet to keep your mind sharp and yourself even-tempered. Activities like walking will help you keep a positive attitude, preserve your bones and help increase the plasticity of your brain.

References:

(1) Neurology Oct 2010, 75 (16) 1415-1422. (2) Arch Neurol. 2010;67(1):80-86. (3) JAMA Psychiatry 2022. 79(6), 500-559. (4) J Sport Exerc Psychol. 2010 Apr;32(2):253-261.

Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.