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ByMelanieBretz healthmatters@montereyher- ald.com @MontereyHealth on Twitter Every body needs exer- cise. Experts say that's es- pecially true for people with disabilities, whether short or long term. Exer- cise not only increases en- durance, strength and mo- bility regardless of disabil- ity or age, it also boosts confidence and promotes better health in body, mind and spirit. "One of the benefits of exercise for people with physical disabilities is that it gives them a measure of control over their body, and their life," says Eric Walberg, a physical ther- apist at Natividad Medical Center in Monterey. His pa- tients might be recovering from an injury or stroke, or dealing with a long-term chronic disability like ce- rebral palsy or Parkinson's. "The better a person's fitness level, the easier it is to get back into life," Walberg says. "Even if it's small, gradual amounts of activity, patients get the aerobic benefit and it gives them more stamina to do the things they need and want to do." "The goal for everyone, regardless of physical abil- ities or challenges, should be to improve health and wellness," says Jeanine Yip, a physical therapist with Community Hospi- tal of the Monterey Pen- insula's Outpatient Reha- bilitation Services. "In ad- dition to a program that addresses specific needs like strength, balance or posture, I always encour- age some sort of aerobic activity. It's good for the body and the brain, espe- cially for people who have a chronic neurological dis- ability like MS or Parkin- son's." She points out that many people don't realize that you can get aerobic benefit working out while seated or in a pool. Many fitness centers have pools with entry lifts where people can partici- pate in group and individ- ual exercise, whether inde- pendently or with a physi- cal therapist. Many consider the non- profit Josephine Kernes Memorial Pool in Marina to be a place where people of all ages with any type of disability can participate in tailored, supervised ex- ercise that helps improve their mobility, and quality of life. The Kernes Pool was a lifesaver for 69-year-old Marsha Zeitlin. Diagnosed with a rare form of spinal stenosis at age 9, she had her first back surgery when she was only 20. She's had 17 more surgeries since 1985. "Twenty years ago, be- fore I found my current surgeon, Dr. Hu, my doc- tors advised against doing anything," she says. "They told me to plan on being in a wheelchair at some point. Dr. Hu encouraged me to start walking right away. She said the more seden- tary people with a disabil- ity are, the worse they can get." Zeitlin was referred to Kernes in 1992, where they developed a personal exer- cise program for her that shenowdoesindependently twice a week. "I walk in the water with hand weights, tread water and do stretch- ing exercises," says Zeitlin. "It's a full-body workout and the warm water eases my pain so much that I of- ten don't have to take pain medication." Working out in the pool also makes it possible for her to do other activities, like taking Balance and Strength classes and go- ing for walks. "I don't have a choice about needing surgeries, but I do have a choice about staying active," says Zeitlin. Peter Bolton, her hus- band of 33 years, couldn't be happier. "This program has helped Marsha get up and out with less pain so she can enjoy doing things like traveling with me again," he says. "I don't have to do anything. I just get to enjoy the results." Melanie Bretz lives in Monterey and has written on a wide range of topics, including health care, during her 33-year writing career. HEALTH Pe op le w it h di sa bi li ti es c an fi nd numerous exercise options PHOTOSCONTRIBUTED Marsha Zeitlin was referred to the Josephine Kernes Memorial Pool in Marina in 1992, where they developed a personal exercise program for her that she now does independently twice a week. Equipment at the pool in Marina. By Matthew Perrone The Associated Press WASHINGTON Federal health regulators will add their strongest warning labels to the most widely prescribed painkillers, part of a multi-pronged government campaign to stem an epidemic of abuse and death tied to drugs like Vicodin and Percocet. The Food and Drug Ad- ministration announced Tuesday plans to add a boxed warning — the most serious type — to all immediate-release opi- oid painkillers, including some 175 branded and ge- neric drugs. Those medications, which often combine oxy- codone with lower-grade medications, are among the most commonly used drugs in the U.S. and ac- count for 90 percent of all opioid painkillers pre- scribed. Roughly three years ago the FDA added similar warnings to long- acting opioid drugs like OxyContin, which slowly release their doses over 12 hours or more. Now both immediate and extended- release formulations will highlight the risks of ad- diction, abuse, overdose and death. T he long-awaited changes come as federal and state officials strug- gle to curb a wave of over- doses fueled by the over- prescribing of medica- tions and a steady supply of cheap heroin. "We're at a time when the unfathomable trage- dies resulting from addic- tion, overdose and death have become one of the most urgent and devas- tating public health crises facing our country," FDA Commissioner Dr. Robert Califf said on a call with reporters. "I can't stress enough how critical it is for pre- scribers to have the most current information." But lawmakers from states that have been rav- aged by opioid addiction said such labeling changes have "done little" to help their communities. "Unfortunately, it has taken FDA far too long to address the grave risks of these drugs that have claimed the lives of thou- sands this year alone," said Sen. Edward Markey, D- Mass. Opioids are a class of powerful and highly ad- dictive drugs that include both prescription drugs like codeine and hydroco- done, as well as illegal nar- cotics, like heroin. Deaths linked to misuse and abuse of prescription opioids climbed to 19,000 in 2014, the highest figure on record, according to the Centers for Disease Con- trol and Prevention. Her- oin and opioid painkillers combined caused 28,650 fatal overdoses. Doctors are not re- quired to follow the FDA's instructions on drug la- bels, though they are often used as prescribing guide- lines by hospitals, medical groups and insurers. Critics of the FDA, in- cluding Physicians for Re- sponsible Opioid Prescrib- ing, called on the agency to add such warnings years ago. "The main driver of our opioid epidemic is addic- tion, and the immediate- release products are just as addictive," said the group's founder, Dr. An- drew Kolodny, an addic- tion therapist with Phoe- nix House, a network of re- habilitation clinics. The new FDA label will specify that the drugs like Percocet should only be used when other medica- tions and alternative ther- apies cannot control pa- tients' pain. "This new indication, once finalized, will remind prescribers that immedi- ate-release opioids are also powerful drugs with im- portant safety concerns," said Dr. Doug Throckmor- ton, a deputy director in the FDA's drug center. Throckmorton said the agency's 2013 labeling change focused on long- acting drugs like OxyCon- tin because they repre- sented a "disproportion- ate risk" to patients, since they contain larger opioid levels. Government officials have tried a variety of approaches to tackling painkiller abuse in re- cent years. The FDA pre- viously restricted combi- nation pills like Vicodin to limit refills and who can prescribe them. States like Florida and New York have cracked down on "pill mills" using databases to monitor what doctors are prescribing. The Obama administra- tion has asked Congress to provide $1.1 billion to com- bat opioid addiction. On Tuesday, the White House sent letters to all 50 gov- ernors outlining steps for reducing opioid over-pre- scribing and enhancing addiction treatment. The administration's drug czar praised the move by the FDA and Califf, who was confirmed to lead the agency last month. "I think we're very heartened by the new di- rector of the FDA and his enhanced focus on opioid issues," said Michael Bot- ticelli, National Drug Con- trol Policy Director. "This is an all-of-government effort and clearly the FDA has a key role to play." In addition to the boxed warning, the FDA said it would add new informa- tion about the risks of opioid use for pregnant women and their new- borns as well as drug in- teractions with antide- pressants and other med- ications. The FDA announcement comes less than a week af- ter the CDC released the first-ever national pre- scribing guidelines for us- ing opioids. The agency said pri- mary care doctors should only turn to opioids after considering physical ther- apy, over-the-counter med- ications, counseling and other methods for treat- ing chronic pain. This story corrects the number of immediate-re- lease opioids affected by the FDA action to 175, not 220. DRUG ABUSE FD A ad ds b ol d wa rn in g to widely used painkillers SUE OGROCKI — THE ASSOCIATED PRESS FILE Federal health regulators will bolster warning labels on the most widely used prescription painkillers, such as Vicodin, seen here. By Gonzalo Figueroa Landerso National Holistic Institute One of the best things we can do for our health is not only free, but for many also easy to do. Walking on a regular ba- sis helps our lymphatic, circulatory, skeletal, in- tegumentary and nervous systems. And because we want our body to be in ho- meostasis, whenever we strengthen one system, we directly or indirectly strengthen the others. If we stop to think about it, there are many ways of walking. If we work in a big city, or we are running to that dis- count rack to find the elu- sive bargain, we might find ourselves holding our breath, our sympa- thetic nervous system on high alert to ward us from crazy drivers or speeding shopping carts. Maybe we have time to go to the gym, and our nervous systems might also be under attack with loud noises, dumbbells freefalling, machines clinging and clanging, and crowded stations. If we are already walking we can think of a couple of tips to make the expe- rience an even healthier one. Trying to find tran- quility in the busy world around us can be a chal- lenge. Focusing on our breath and on relaxing images around us can be very helpful, like holding hands with a loved one in a garden, enjoying a view. Because our lymphatic system relies on mus- cle contraction to pump lymph up the body, a nice brisk walk, incorporating arm movement, can help push lymph up the sys- tem. Lymph is also moved when we breath, so maxi- mizing lung capacity will help move lymph and in- crease the amount of ox- ygen we intake. Focusing on your breath might help the experience be a relax- ing one vs. one that gets our nervous system even more taxed than it might be. In through the nose and out through mouth. Laughing assists mov- ing lymph through the system, so if you are not laughing on a regular ba- sis, it's a great idea to schedule some time for it. Our circulatory system benefits by strengthening and conditioning the heart. As we move more blood into the system we bring nutrients to the muscles. If we want to get some more cardio in, we can think about adding some hills, if they are available. And the simple impact of walking can help strengthen bones in our legs. A calming meditative walk might help us focus on longer breaths, calm- ing the mind and there- fore bringing our stress levels down. Slow walk- ing can also help us strengthen those muscles that are designed for sta- bilizing vs. muscles that are designed for quick big movements. This can help us with our balance as well. As with any new exer- cise routine, it's impor- tant to get medical advice especially if the activity is relatively new and you are currently experiencing health problems that com- promise any of the major systems of the body. Gonzalo Figueroa Landeros is Campus Manager at the National Holistic Institute, Petaluma Campus, and is a partner of Solano Coalition for Better Health. COALITION FOR BETTER HEALTH Givewalkingashot—it'sfreeandeasytodo (530) 529-1220 100 Jackson St. Red Bluff $ 25 .00 No Enrollment Fee month Rates as low as 750DavidAvenue,RedBluff•527-9193• www.tehamaestatesretirement.com findusonFacebook Tehama Estates The areas #1 Senior Housing Provider SeniorRetirementApartments •3DeliciousHealthyMealsEachDay • Daily Housekeeping • 24 Hour Staffing, 365 Days of the Year • Utilities Included (except phone & cable) • Transportation • Fun Activities and Events Call For Rent Special TehamaEstatesProvides: Newpatientsalwayswelcome! 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