Bodybuilding benefits the over 50s

Q: I am a 75 year old woman in excellent health. I walk or exercise everyday with fitness videos which are great and provide lots of body science along the way. The only thing I’m not sure about is that the video instructor doesn’t believe in the use of weights and believes that the use and elevation of our arms, legs, etc. will offer enough heft for those of us over 50. However, most fitness articles say that using weights is essential for all ages, especially for older people. I’ve used 2 and 5 pound weights in the past for walking and exercising, but even these are uncomfortable. I’ve always had very strong legs but not much upper body strength. What’s the best advice?

A: Strength training has benefits that cannot be achieved with aerobic exercise alone. Resistance training, usually with weights, is especially important for older women because when done correctly, it increases muscle strength and balance. It also reduces the risk of falling and improves bone strength, thereby reducing the risk of fracture even in the event of a fall. Exercising with a combination of aerobics, stretching, and weights is ideal, since each provides independent benefits.

However, sometimes we don’t live in an ideal world, and any exercise is better than no exercise. I wouldn’t want you to give up completely because you think you’re not getting benefits without the weights. Exercise using body weight can also increase strength. You don’t need to have physical weights in your hand to reap the benefits of resistance exercise.

I generally advise against holding weights in the hand (or attached to the limbs) while walking or jogging. This can alter your natural gait and put pressure on your lower joints, from toes to hips. It may also have the potential for upper limb injuries. I recommend separating your aerobic activity from your strength training activity.

Q: Three days after receiving a COVID booster, I started a nine-day course of oral prednisone (40mg tapering down to 10mg). Since the nurse practitioner who issued the booster also prescribed prednisone (for psoriasis) I didn’t think there was a problem, but I later read that prednisone can interfere with the recall effectiveness. I saw my doctor and he told me that because I started prednisone three days after the booster, it was “probably effective”. Do you agree? I’m worried because my husband is at very high risk of serious complications from COVID!

A: I agree with your doctor that the booster dose of the vaccine was probably effective. I know you would like to hear me say it was absolutely effective, but there is no solid evidence to prove it.

Most experts say prednisone at more than 20mg a day for more than two weeks is enough to reduce the effectiveness of the booster, but I think the three days you had of the vaccine before you started prednisone – and the fact that you weren’t very high doses or for very long – makes the vaccine most likely effective.

I hope your husband received four doses of the COVID-19 vaccine. If unable to get vaccinated, has a medical condition

or is currently taking medications that are much more concerning than the doses of prednisone you were taking, he should consider Evusheld (a combination of anti-COVID antibodies) to give him extra protection for about six months.

Q: I am a fairly healthy 75 year old male as far as I can tell. I had an ultrasound due to lower abdominal discomfort. The ultrasound showed no reason for the pain, which actually subsided. But it showed that my gallbladder is full of stones. I am terribly worried because in the past I have not done well under anesthesia. With colonoscopies, the doctors say they give you something to relieve the nausea, but that never helps me. I vomit and stay dizzy all day, even the next day.

Should I be worried about the surgery itself? I’m beside myself, because the day of surgery is fast approaching. What can you tell me about the terrible nausea I feel?

A: As for the surgery itself, the removal of a gallbladder is generally well tolerated. This is usually done using a laparoscope rather than traditional open surgery. Laparoscopy accelerates the patient’s recovery. This is still major surgery, and any surgery always has risks, but most people recover and have good results.

Postoperative nausea and vomiting are a significant concern. About 30% of adults will have this complication after undergoing general anesthesia. There are indeed many ways to prevent this complication, and your best friend in this regard is the anesthesiologist. You should tell the anesthesiologist as much as possible about any previous procedures you have had, as well as your symptoms of dizziness and vomiting. The anesthesiologist can adjust the type of anesthesia and use not one, but potentially several different treatments to prevent this complication.

Q: I am an 86 year old female and quite active. I have a plantar fibroma on the arch of my foot.
Can you explain what it is, the treatment is for this condition and if surgery is needed? How is the recovery going?

A: A fibroid is a benign tumor of connective tissue. They can occur in a host of different tissues, from skin to muscle, from blood vessels to bone. When they occur on the plantar surface of the foot (“plantar” comes from the Latin word meaning “sole” of the foot), they occur in the thick band of connective tissue called the plantar fascia. The pain comes from pressure on the nodule by your shoes or from being barefoot on the floor, but symptoms are often worse when you’re wearing shoes.

Foot experts don’t rush into surgery. If you have no symptoms, no treatment is necessary. If you are in pain, stretching, shoe inserts, or physical therapy are usually tried before treatment with a steroid injection. If symptoms are not relieved by conservative treatments, if the injection is not helpful, or if symptoms return after initial relief, surgical treatment is sometimes done. But potential complications, including arch flattening, mean surgery should only be considered after other therapies have been given a good chance.

Dr Roach regrets that he cannot respond to individual letters, but will incorporate them into the column whenever possible. Readers can email questions to toyourgoodhealth@med.cornell.edu or send mail to 628 Virginia Drive, Orlando, FL 32803.

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