Friday, August 5, 2011

Bone Health, Daily Physical Activity, and Exercise Tolerance in Patients With Cystic Fibrosis

Abstract

Background: Daily physical activity (PA) may be an excellent tool for the maintenance of bone health in patients with cystic fibrosis (CF). The aim of this study was to analyze the possible association between physical capacity and activity and bone mineral density (BMD) in young adults with CF. A secondary goal was to evaluate vertebral fractures in this population.

Methods: A cross-sectional study was conducted in 50 patients with CF who were clinically stable and aged > 16 years but not lung transplant recipients. PA was quantified with a portable motion monitor (BodyMedia Fit Armband). Cardiopulmonary exercise and 6-min walk tests were used to assess exercise capacity. BMD was obtained from dual-energy x-ray absorptiometry of the lumbar column, hip, and whole body. To analyze vertebral fractures and deformity, we performed the Genant and Cobb methods.

Results: Daily PA time at low (3-4.8 metabolic equivalent tasks [METs]) and moderate (4.8-7.2 METs) intensity, respectively, was correlated with Z score (BMD) of the lumbar column (r = 0.36, P < .01 and r = 0.59, P < .001), the neck of femur (r = 0.51, P < .001 and r = 0.72, P < .001), and the total hip (r = 0.54, P < .001 and r = 0.74, P < .001). PA, BMI, age, and sex were predictors of BMD. Vertebral fractures correlated with kyphosis (r = 0.42, P = .02), but not with BMD. Patients who were mildly and severely affected differed in vertebral fracture rate and kyphosis prevalence (P = .002 and P = .013, respectively).

Conclusions: The most active patients with better exercise capacity had higher BMD. Those with more affected pulmonary function had a greater prevalence of vertebral fractures and dorsal kyphosis.

Thursday, August 4, 2011

Thankful Thursday - Birthing Class & Bob/Rob

It's thankful Thursday time! We all have so much to be thankful for and we love to take this opportunity just to write down each and everything that comes to mind. as I mentioned, I no longer have the "linkytools" but I invite you to share your thankful blog in the comments section. Without further ado, here's what we're thankful for:

Mandi's List:

I'm thankful for Chik-fil-A. They have a spicy chicken wrap that tastes like heaven...and I happened to have for dinner last night! It comes with a spicy ranch dressing, which I don't use, but instead I used their buffalo sauce on it, and MAN is it good! I highly recommend you give this tasty treat a try.

I'm thankful for birthing classes. Last night we had the first of 4, 2.5-hour birthing classes through our hospital. In just the first class I feel like I learned a lot and am so glad that we did it. It's a great way to learn what to expect and what all the tips and tricks are. I will say, it makes me REALLY eager to have our little nugget in our arms!

I'm thankful for activity. I am currently 27 weeks pregnant and I'm so thankful that I'm still able to work out and be active. I know I've mentioned this before, but I am just so thankful for this that I foresee it creeping onto my Thankful Thursday list a few more times before the end of the pregnancy. I have been able to maintain my same exercise routine and even up it a bit since getting pregnant, and I'm feeling great. It really helps me feel like a human and like I haven't totally fallen out of shape as a result of the pregnancy.

Ronnie's List:

I'm thankful for Bob, the new spin class instructor. Our regular Tues/Thur teacher will be gone for the next ten weeks as she works on a different certification, so a new guy, Bob, is filling in for her. Bob is a very quirky guy and opened up the first class by rapping for a full two minutes. And this coming from a lanky, white, spin dude was quite interesting. Apart from that, he's a great instructor. His coaching style really gets me going and there's just something about the way he teaches that allows me to get to my max (and stay there) more than with other instructors. I'm really looking forward to the next 10 weeks of spin class with Bob.

I'm thankful for Rob. Rob is my neighbor who helped me out with all of my home projects this weekend. I wasn't really interested in doing things around the house when I was younger, so I really didn't learn your everyday fix-it tips. Rob is a great teacher and really brings out the handyman inside of me. Luckily he's very patient and doesn't roll his eyes at all of my stupid questions. He had to explain to me several times this weekend exactly how electricity is grounded and what completes "the loop". Each and every time he did it with a smile on his face.

I'm thankful for our new birthing classes. I've never been one of those "sit in a class and learn" type of guys, but I've always loved learning a little bit about everything.This birthing course is a nice overview of the whole process from third-trimester of pregnancy to your first couple of weeks home with the baby. We've already learned some valuable tips and I can rest assured that we'll learn many more!

So, what are you thankful for today?

Wednesday, August 3, 2011

Weight Loss Challenge...with Me and Only Me.

About 10 days ago I posted about my attempt to cut some lbs over the course of the next 6 months. If you missed the post and want to catch up, you can find it here. I figured I would update you guys on how I did on achieving my weekly goals plus let you know what my new goals are for this week. Here were my original goals:

Using smaller plates for my meals
Not returning for seconds
Eating more servings of vegetables and fruit
Taking more time to eat my meals

So far, I'm happy to report that I have not broken any of these "rules" with the exception being yesterday as all of our small plates were dirty. I however used the inner ring of the big plate as my guide, so I'm pretty sure that things worked out ok. It's pretty amazing how fast I felt these small changes. I mean, I'm definitely feeling hungry more often now, but as I told my coach, I'd rather feel hungry than feel overstuffed and bloated. The great part is that there are no calorie limits so when I am hungry I can eat. I've never been much of a snacker, just more of an over-eater during meals. Well now I find myself snacking throughout the day on stuff like carrots, grapes and peanuts.

After knocking my first set of goals out of the park, we decided to up the ante a bit and set some tougher goals for me to try and meet. My new goals are as follows:

I will continue with small plates and no second servings
I will eat three servings of vegetables at least 3 days per week.
I will continue to slow down my eating by chewing more and more slowly, and setting food/utensil down between bites.
I will lift 3 days/week and spin 3 days/week. I will also do a separate workout on one of the weekend days.
I will watch the videos (that were sent to me) and begin playing around with the 12 Kg kettlebell.
I will ride my bike while Mandi runs at least 3 mornings/week.

Seems simple enough. I will say though, these have already proven to be much more difficult. The ones that I struggle with the most are eating three servings a vegetables a day and eating more slowly. If it were three servings of fruit a day, I'd knock it out of the park. I'm constantly snacking on grapes, watermelon, pineapple and cherries. I think the main issue for me is I'm not a big raw vegetable fan. The only two that really come to mind are celery (with peanut butter) and carrots (with hummus). Maybe I'm just overlooking some that I would actually like? That's my hope at least. And of course, since I now am always very hungry for my meals, slowing down and setting my utensil down between each bite is quite a challenge.

So I now turn it over to you guys...Any recommendations on ways to get in my three servings of vegetables? Also, how about any tips to make myself slow down as I eat?

Oh yeah, as I reported, I started this journey at 205 and was down to 197 a week later. A week after that I was down to 193. Something's working!!

Tuesday, August 2, 2011

Home Improvement Weekend (Pictures Included)

This weekend I was all by myself while my wife attended the CFRI conference. As you guys found out yesterday, she had a great time and is so glad that she went. One thing about me being all alone at the house - it brings out the project manager in me. I think it's a combination of wanting to surprise Mandi upon her return and also just being able to focus on the tasks at hand. When Mandi is around during the weekend, the last thing I want to do is work. We work all week and for me, the weekend is a time to unwind and spend quality time together. Some of you may be saying, well why don't you do projects with her? The answer is, we do, but there is just simply stuff that we enjoy doing more together. Plus, I tend to get frustrated when I don't understand things and believe me, that happen A LOT with any project around the house. That's why I'm "showing off" with this blog, not to show you all of the cool things I did, but because I'm pretty proud of myself. If you guys knew my handyman abilities, I promise that you would be proud of me too. (And I have to give a shout-out to my handy neighbor who was around to supervise most of these projects to make sure I didn't burn down the house, thanks Rob!!!)

For whatever reason, I have always wanted a cross wall. I didn't care so much where it was, as long as we had one. We've been slowly collecting crosses since we've been married, but I've been way too chicken to actually hang them up on the side of our house. We still have more that we must collect to hang up, but I thought that this was a pretty good start.


In preparation to replace the bathroom lights in the master bath, I first had to remove the old ones. We had those long silver mirrored lights with about 6 bulbs in them that look like they're for a make-up artist. Not that I hate that look, it just didn't fit out bathroom. So after I ripped out the old lights I had to of course measure out where the new lights would be going and then close my eyes and cut the holes. It was a little tough cause before we had one light over the main counter space and one light over the vanity. We decided that we wanted only two lights over the main counter space and no light over the vanity. The first picture is of where the vanity light used to be. This next picture is of where the new lights are now. As you can see we have some dry wall repairs to make, but I wanted to make sure I painted the area so it wasn't a total shock to Mandi. The toughest part of the job was running the electricity to the new lights. We had to go through three separate studs to get the job done. Mandi loves the lights though so it was more every blown drill bit.



While we were at it, we also figured out why the lights over the tub and shower haven't worked since moving in. I did everything that I could think of to get them to work, but I just couldn't solve the mystery. Rob in all his genius tore the first can light out of the ceiling and discovered that a connection was loose in a little box before the first light that then made all lights inoperable. It's amazing how different the bathroom looks with lights on now!

Back to my fear of hanging things on walls. I don't know where it comes from, but I always think I'm going to ruin the wall. We bought this picture about 6 months ago and it has been leaning on our bedroom wall. Not anymore though!


So I didn't install that fan this weekend, but I did have to dismantle it somewhat in order to install some wall controls. Mandi can barely reach the little ropes to turn the light on and off or adjust the fan speed. We decided that we needed a way to control it without pulling the ropes. We found a little wall unit that controlled the light as well as 3 different fan speeds. We also liked the look of the actual wall control as well which is always a plus. We have been dreading taking the fan apart and re-wiring stuff, but I finally got the courage to tackle it this weekend and just get it done. It was a bit frustrating as I stripped a screw in the wall mount that took me 20 minutes to get out and I couldn't figure out which wire controlled the light, but after taking a deep breath and hitting up Google, it all worked out.

My neighbor works out of his garage a lot and I noticed that he always had way more light. Up until this weekend we just had a single little globe light that barley was noticeable. We replaced that with this more industrial fluorescent light that will darn near blind you.


A couple of weekends ago, Mandi attempted to clean our front porch light that was disgustingly dirty. There was only one problem, the bulbs were still hot. Match hot bulbs with cold water and you can have issues. Luckily only one light exploded, but it kind of put a damper on cleaning the light that day since it was supposed to be a quick job. This weekend I really took the time to scrub it all down and scrape some burnt bugs off of the thing. I also replaced all of the bulbs and now it lights up the entire neighborhood.


This one wasn't a big deal, but was sorely needed. I took the ol' shop vac to the master closet and sucked up all of the dog hair that we track in with our shoes. While I was at it I reorganized the way my shoes are displayed since it's the first thing we see when we walk into our closet


This last project may have been the most gratifying of them all. Since we've lived in this house, the fountain has never worked quite right. This was due because of the slight angle that was created when the fountain settled in to the ground. There are four little holes that stream water from top to bottom, but usually two were really strong and the other two were pretty weak. After the haboob (dust storm) rolled though our neighborhood a few weeks ago, not only was it lopsided, but it was super dirty. The water was brown and the motor couldn't even run because of all the dirt. The first step was to suck out all of the water with a shop vac. I then cleaned it all up with outdoor Oxyclean and gave it a good scrubbing. After filling it back up with water, that remained crystal clear, I still had the settling issue. We used shims and a level and many different attempts to get it perfectly level. It now works like an absolute charm. To finish the job, I hulled decorative rock (bucket by bucket since I don't own a wheel barrow) from one side yard that's never used and place it around the fountain and surrounding bushes. My back still hurts, but Mandi's smile acts as a pretty good pain reliever.


Well that's it. Sure feels like I did more, but like I said, with these "handyman" skills, I'll take all of the small victories I can get :)

Monday, August 1, 2011

Home Again, Home Again

So I should probably start by apologizing for the super late post today. I was out of town all weekend for the CFRI Conference in San Francisco, and today has been a little a-typical.

But I'm back in business and thought I'd fill you in on the weekend. The CFRI Conference is always a great time to meet other CF patients and families face-to-face, as well as learn a whole bunch of new information about what's going on in the world of CF. I will say, I am normally a put-my-feet-up-and-relax kind of gal on the weekend, so going non-stop gets to be a little much for me, but the weekend is always so worth it I keep coming back for more (this is my second year going). I really enjoyed meeting some folks face-to-face that I've "known" online for some time, and it was awesome getting to catch up with some people I met there last year. The lectures were all interesting, but Tiffany Christensen's talk was by far my favorite - that cyster is a rockstar and if you ever have a chance to go hear her speak, GO!

While this cat was away, my mouse certainly did not just play. Ronnie spent all weekend doing projects around the house. We're talking a solid 30 hours of work around our house. The really exciting part was that I didn't know what he was doing. So when I got home, we walked through the whole house I had to try to guess what he had done. It was a really fun game and the house looked beautiful - man my hubby is the best!

Just a quick peanut update. Peanut's doing great (as far as we know), I feel like my belly got WAY bigger this weekend, but maybe some of it is just bloating from sodium-filled conference food. We are 27 weeks pregnant tomorrow, and I cannot wait for next week, so we can be into our third trimester...YIPPEE! One fun effect of this pregnancy that I experience in full-force this weekend was serious swelling in my calves and feet. I guess I'm not used to sitting in a chair all day, and so I quickly realized what happens when I do...my legs turn into tree stumps! We're talking so much bigger that my ankles looked a little white-ish...HOT! Oh well, they would go down over night and re-swell by the end of the next day. I'm not complaining though, at least I know what my legs and feet would look like as a 400 lb woman....OR by the end of this pregnancy!

All in all it was a great weekend, but it's even better to be home with my hubby!