Ray Kurzweil blew my mind the other night. His credentials as an inventor, scientist and entrepreneur are rivaled only by Edison and Einstein. He has his hand in so many arenas, all related to his world view of the exponential growth of technology in juxtaposition to our linear view of time. He talked about how rapidly something like computer processing is currently progressing. An iphone is billions times more powerful than the most advanced computer of 50 years ago - and it’s a million times less expensive. A teenager with a smartphone in Africa has access to more information than President Clinton did when he was the ruler of the free world.
Kurzweil’s massive theory, his “relativity,” is Singularity. He didn’t invent the concept, but he has popularized it in his writing. For Kurzweil, the Singularity is defined by a massive expansion of human intelligence and the potential for immortality facilitated by computer superintelligence.
Factors influencing this nearing possibility are:
- The falling cost of manufacturing transistors
- The rising clock speed of microprocessors
- The plummeting price of dynamic RAM
- The falling cost of sequencing DNA
- The decreasing cost of wireless data service
- The rising numbers of Internet hosts and nanotechnology patents
If these predictable trends continue, he anticipates the Singularity to occur around 2045.
What does that mean for our physical existence? I can foresee a distant future where we just download our brains onto a hard drive and exist as heads in a jar. Even the benefits of exercise could potentially be simulated with software programming. Isn’t all experience just our perception of what is happening? How is doing something any different than simply thinking, feeling and believing that we are actually doing it?
Imagine your brain could be programmed to simulate the experience of you riding a mountain bike through the woods of Aspen, programmed in such detail that you experience every sensation that you would if you were actually on that trail. You could even have the full sensation smelling the trees and feeling the bumps or falling off your bike and bruising your shoulder. Except your shoulder wouldn’t be bruised and you could get right back on the trail, at least in your mind.
That may be a bit far-fetched. So, more realistic is the arriving prevalence of
nanotechnology in medicine. As per Sahoo in “Nanomedicine: Nanotechnology, Biology and Medicine,” “...materials and devices designed to interact with the body at subcellular (i.e., molecular) scales with a high degree of specificity. This can be potentially translated into targeted cellular and tissue-specific clinical applications designed to achieve maximal therapeutic efficacy with minimal side effects.” The applications are endless. What if there were procedures that instantly cured patients with either rejuvenating cell injections or microbots that mended broken bones and ligaments and eradicated diseases. That time may not be far off. It may be sooner than you think.
I have to wonder when PTs will become obsolete. (Hopefully, not in my lifetime.) For now, we help our patients recover from injuries, regain normal function, and manage arthritis and complications from diabetes. We are an adjunct to medications and surgery for many patients. We are an essential piece of the medical puzzle. Even if physical recovery is significantly expedited, neural and muscular re-education still has to occur. People still need to relearn how to walk, run, throw a ball.
Technology has the ability to change lives with health improvements, but even an amputee with a new arm faces the massive challenge of learning how to integrate it into their life. A NY Times article this week told the story of a US Marine with a $110,000 prosthetic arm and the work he’s doing with his therapists to learn how to use it.
In Kurzweil’s world, maybe technology advances us to the point where the Marine is given injections to recreate his original arm, but we’re not there yet. Maybe there won’t even be any more war. We’re definitely not there yet. For now, we still have injuries, diseases and traditional rehabilitation. Medicine and surgery works wonders and PT is an important piece of the medical solution.
People with diabetes often experience the effects of diabetic neuropathy. Symptoms include pain, tingling and numbness. As a result, diabetic neuropathy often leads sufferers to become less active which only makes the symptoms worse. Neuropathy can’t be cured, but if you do have it, the good news is that it can be managed and you can lead a normal life.
With a few simple tips, you can effectively decrease your diabetic neuropathy symptoms.
The 6 most effective ways to manage Diabetic Neuropathy:
- Examine your feet every day. A small cut or blister can turn into an ulcer in less than a week. Inspect both feet entirely either using a mirror or having a family member assist you.
- Wear properly fitting footwear. Large or small shoes can cause blisters that lead to larger complications.
- Eat a healthy diet. Large fluctuations in sugar levels can exacerbate symptoms associated with diabetic neuropathy.
- Physical therapy modalities, including massage and infrared light treatment (often referred to as Anodyne Therapy) can reduce pain and enable increased activity.
- Be active. Decreased activity leads to weak muscles and stiff joints. Movement and activity increases healthy blood flow to the extremities, minimizing the effects of neuropathy.
- Rest and repair. Sleep deprivation has been shown to increase susceptibility to diabetes and increase symptoms. Consistently get 7-8 hours of sleep per night to reverse that effect.
If you have diabetes and diabetic neuropathy, follow these simple rules and you’ll find that your symptoms will reduce significantly. If you’d like more information on the management of diabetic neuropathy visit us at http://www.wspt.org/diabetes/. For Anodyne Therapy treatment call 914.771.9666 to schedule an appointment.
You may find this hard to believe, but until recently, the ADA and the ACSM guidelines had recommended that people with Diabetes Mellitus (DM) and Peripheral Neuropathy (PN) refrain from weight-bearing activity. Just to be clear, this means they were recommending that people with DM+PN should do exactly what was contributing to their condition.
The rationale was that the risk of skin breakdown was greater than the rewards associated with getting off their butts and moving around a little. Skin breakdown and ulceration can lead to gangrene, amputation and potentially death. These are extreme risks, but they are easily monitored and controlled, enabling a person with DM+PN to live a normal life.
A case study published in Physical Therapy (Jan 2012) details the benefits of weight-bearing activity. The study utilized a moderate intensity 12-week, progressive walking and resistance program reflecting the recently changed guidelines for people with DM+PN. Three times a week for 12-weeks, the 76-year old man (with a 30-year history of DM+PN) performed the following exercises:
- Stretching - toes, hamstrings, quadriceps, calves
- Balance - progressively challenging exercises with decreased support
- Strengthening - body-weight ankle strengthening exercises, stair climbing, sit-to-stand
- Aerobics - progressive treadmill walking
Precautions were taken to avoid skin injury and all exercise sessions were monitored by a physical therapist. Overall the program was successful in increasing some measures of muscle strength, physical function, and activity without causing injury in an individual with DM+PN.
This is very encouraging for patients with DM+PN. PTs should be encouraging this population to be more active and we can even design programs based on the protocol outlined in this study. I know we will be doing exactly that here at
WSPT.
If you have Diabetes Mellitus and are interested in a program to safely increase your activity level, strength, balance and overall conditioning reach out to WSPT @
info@wspt.org.
The late comedian Patrice O’Neal is now famous for saying, “My doctor has told me that if I don’t lose weight, it will kill me. That’s not motivation enough for me.” O’Neal had severe diabetes, which led to a stroke that killed him in November 2011 at the young age of 41.
Obesity can affect every system in the human body. In physical therapy we most commonly see obese patients who have complications associated with diabetes, arthritis and heart disease. There is a genetic component to each of these diseases, but for the most part, they are preventable. Diabetes, arthritis, and heart disease are non-communicable diseases. You don’t catch them from being in a room with someone who has them. You don’t get them from kissing or getting sneezed on.
The human condition is such that the possibility of being sick or dying is not enough to persuade most people to change the way they live. Most of us need to get a diagnosis from a professional or see someone close to us get sick or die to make significant changes in the way we manage our health. Diabetes, arthritis and heart disease are acquired subtly; you don’t just wake up with arthritis in all your joints one day. They take time to make their way into your life, usually without you even knowing. This can be a double-edged sword. If you choose to make a change, this can be a positive. Small tweaks in your diet and increases in your exercise volume can decrease your weight and improve your overall health. On the other hand, the slow creep of these obesity-related diseases allow people to rationalize doing nothing, with the excuse that they have plenty of time before it gets serious.
Obese patients usually see a Physical Therapist because the arthritis in their knee is so bad they can’t climb steps or the diabetic neuropathy in their feet is so painful that they barely walk any more. By this stage, these symptoms are very challenging for the PT to treat. Multiple medical issues coupled with a lack of mobility creates a complicated scenario. This patient has to get moving despite the pain.
Arthritis is caused by a constant wear and tear on a joint to the point of irritation and chronic inflammation. The inflammation leads to breakdown of cartilage and bone, causing pain and dysfunction. Obesity makes it nearly impossible to allow that joint to rest and heal. The patient’s de-conditioned state also makes it very challenging for them to get active enough to lose weight.
The complications associated with diabetes and heart disease are similar. A major element of healing is blood flow. Blood supplies oxygen to the body and oxygen fuels chemical interactions, including cell reproduction and growth. Healing is essentially growth of new, healthy cells and it can’t happen without ample blood supply. Heart disease prevents sufficient amounts of blood to be pumped throughout the body while diabetes affects the quality of that blood supply. Both diseases make it extremely challenging for the body to heal itself.
Movement and exercise are the key components of helping obese patients improve. A Physical Therapist is extremely aware of the risks and complications associated with obesity, arthritis, diabetes and heart disease. The major obstacle that most of these patients face is a fear that they are too overweight to exercise. This couldn’t be further from the truth. In fact, it’s necessary that they exercise. They just need to be guided by a professional.
Every patient is different and a PT will always do a thorough evaluation before designing a custom plan of care for each patient, but here is a typical program for someone who is experiencing complications related to obesity:
1. Pain control modalities if necessary
2. Cardiovascular exercise
3. Strengthening exercise
4. Balance training
5. Gait training
6. Aquatic exercise
7. Functional activity (ADL) training
8. General nutrition education and consult to nutritionist/dietician if necessary
Ask the Physical Therapists at WSPT how PT can help you manage Obesity and Obesity related conditions.
Some of the worst and most harmful symptoms of diabetes can be warded off by lowering your blood sugar. Exercise is a great way to manage your diabetes. It can help improve your blood sugar control as well as boost your overall fitness levels and reduce your risk of heart disease and liver damage.
Here are some exercise suggestions:
- Be sure to check your blood sugar levels before you workout and watch for symptoms of low blood sugar while working out. Be sure to have a snack on hand if you sugar levels go low and make sure you check your levels again 45 minutes after working out.
- When you understand how exercise works, you are more likely to do it. When you exercise, your muscles use sugar for energy. When your muscles are using sugar, there is less sugar in your blood resulting in a lower blood sugar reading. The more strenuous the exercise, the longer the lower blood sugar will last.
- Cardiovascular exercise is the best choice for someone looking to lower their blood sugar. The best thing is find an exercise you enjoy such as jogging, walking, dancing, biking, swimming, or even taking an aerobic class.
- Do a minimum of 30 minutes of cardiovascular exercise to help you with your blood sugar.
Type II Diabetes is usually a result of poor nutrition combined with a lack of exercise or activity. The body’s ability to produce insulin or use it to break down sugar becomes compromised from being overworked for a prolonged period of time. Some people are born with a predisposition for acquiring Type II Diabetes, but ultimately it is a preventable disease. For the same reasons, it also is manageable to the point that it’s effects are minimal if approached effectively.
If you do have diabetes, it’s important that you have a plan and you stick with it. Complications from diabetes tend to build and become more difficult to reverse over time. An effective means of managing diabetes is to have a capable health care team on your side to advise and work with you. A good doctor, nurse, pharmacist, nutritionist and Physical Therapist should all be on your speed dial if you have diabetes. A Physical Therapist can be an extremely valuable member of your team because of their knowledge, skills, and accessibility.
Ways a Physical Therapist can help someone with Diabetes
- 1. The key to managing diabetes is being able to balance your blood-sugar levels. This can be accomplished through proper nutrition, exercise and medication. By prescribing an appropriate exercise program, a PT can be a vital piece of the diabetes management puzzle. Diabetes has varying effects on each person. Nutrition, exercise and medicine dosages have different effects on every person. These effects even change over time. By prescribing an appropriate exercise program, a PT can help you effectively manage your sugar levels and avoid many of the complications associated with dips and spikes in blood-sugar levels.
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2. Many people with diabetes are either physically deconditioned or become less fit over time due to the complications of the disease. Deconditioning leads to additional complications and makes managing blood-sugar levels extremely difficult. I often hear from people with diabetes that they can’t exercise because they’re not in good enough shape. I understand this and I also realize that if you are obese, it may be painful to even walk due to complications such as arthritis or back pain. PTs are very experienced at working with people who have multiple complications. Treating conditions like arthritis is the norm for us, so we can help diabetics overcome the roadblocks that are preventing them from starting an exercise program. Once pain and orthopedic challenges are addressed, patients with diabetes can get down to the business of improving their overall heath.
- 3. One very serious effect of diabetes is diabetic neuropathy. Neuropathy is due to poor circulation associated with diabetes and results in pain, tingling, numbness and other discomfort in the feet and hands. It can also gradually spread more proximally up the limbs if not addressed. This pain and altered sensation leads to inactivity and feeds into the cycle of deconditioning mentioned above. In addition, due to poor sensation, a diabetic can easily injure, cut, or even puncture part of their feet and not become aware of the injury unless he or she is carefully inspecting their body.
A PT can help treat diabetic neuropathy with infrared light modalities such as Anodyne Therapy combined with massage, aquatic therapy, balance/gait training, and general conditioning. The first step is to get the diabetic patient back on their feet and out of the cycle of pain and inactivity. A PT uses their skills and motivation to make this happen safely and effectively.Since diabetes can potentially affect every system of the body, the complications are potentially endless if not managed appropriately. PTs are very knowledgeable in the causes and effects of diabetes, so we have multiple solutions to the problems that arise for diabetics. Every patient is different, so we develop individual programs for the complications that each person is coping with. If you have diabetes or are pre-diabetic, it’s extremely important that you address it immediately and a PT can be a beneficial part of your team.
