Greg Nicholaides

By Dr. Barry M. Zisholtz, M.D., F. A. C. S

Kidney stones have been documented for thousands of years. They have been discovered in ancient Egyptian mummies, clearly well before we had the type of instrumentation and technology that we have in the 21st century. It is almost impossible to comprehend how ancient man dealt with something so painful without the proper instrumentation.

It is estimated that up to 3% of people will develop kidney stone disease by the age of 70, and, once you develop one stone, the recurrence rate ranges from 10% to 35% over the next five years.

For this reason and because kidney stones are such a painful condition, it is imperative that we do our best to take care of our bodies and avoid the pain of kidney stones.

Understand Your Risk

Kidney stones are most commonly seen in people between the ages of 20 and 40 but can present at almost any age. There are certain types of kidney stones that are hereditary and certain types of kidney stones are related to geography and climate as well.

The state of Georgia is in a location which we call “The Stone Belt” where the prevalence of kidney stone disease is at a much higher incidence than other parts of the United States. Therefore, especially in our state of Georgia, we should try and focus on prevention.

Most people think that kidney stones are just very painful conditions, but at times if associated with concurrent infection it could be a life-threatening condition. Kidney stones can even lead to loss of a kidney if left untreated. Sometimes kidney stones can even be painless!

The fact is, that all kidney stones are not the same. We will focus on dealing with prevention in a global sense but depending upon an individual‘s history, genetics, and other medical issues, there may be other factors and medications required to prevent kidney stones.

Prevent Kidney Stones from Happening to You

The consistent recommendation for people at risk for kidney stones is to drink plenty of fluids and be sure that one voids well over 2 liters of urine a day. A healthy lifestyle with proper diet and exercise will also help.

In addition, preventing urinary tract infections by using the restroom at regular intervals and ensuring that the bladder completely empties at those times may help prevent certain types of kidney stones from forming.

The Types of Kidney Stones

The most common kidney stones are made of calcium oxalate but that doesn’t mean in any shape or form that one has to avoid calcium. Based upon the type of stone, a full of evaluation can be made to determine how to prevent those specific stones.

For example, some stones may be related to a diet that is rich in oxalates which are found in nuts, spinach rhubarb cranberries, and asparagus. Some stones may be related to people living a sedentary lifestyle or with neurologic diseases that don’t allow them much mobility. There are some stones, such as uric acid stones, that are related to eating too much protein or may be related to a condition called gout. Certain type of stones such as Cystine stones are inherited as a genetic condition.

So, the take-home message is to drink plenty of fluids, live a healthy lifestyle, and if you do get a stone, once it is treated, an evaluation can be performed. Certainly, if multiple stones are found, a visit with a urologist can determine the cause, and the patient can be put on a specific individualized regimen to prevent further recurrences and to avoid the pain of kidney stones.

But unemployment resulting from Covid could temporarily reverse that positive trend.

InvestmentNews – May 27, 2021 – By Mary Beth Franklin

The percentage of Social Security recipients who file for benefits at the earliest age of 62 has been declining steadily for decades. That’s a positive trend for American retirement security since benefits increase for each year a recipient postpones filing for Social Security up to age 70.

But the decline in applications at the earliest claiming age may be more dramatic than previously published Social Security Administration data suggest. A new study by the Center for Retirement Research at Boston College says a better metric for capturing claiming behavior over time when the population is aging is the share of all workers turning age 62 who claim at 62. The CRR researchers note that the number of men who turned 62 has more than doubled from 829,000 in 1997 to about 1.7 million in 2019.

“The growing number of 62-year-olds makes it look like age 62 claiming is more prevalent than it actually is,” CRR director Alicia Munnell and assistant director Anqi Chen explained in their paper, Pre-Covid Trends in Social Security Claiming.

“The number we are after is the percentage of people reaching age 62 each year who claim at that age,” they wrote. They refer to this measure as “cohort” data.

The official data published in Social Security’s Annual Statistical Supplement shows that 34% of women and 31% of men who claimed retirement benefits in 2019 were age 62. But the CRR alternative measure, based on unpublished Social Security data, shows a steeper drop, with just one in four individuals claiming at 62 in 2019, the latest year for which data are available.

The percentage of retirees claiming retirement benefits at the earliest age of 62 has been dropping gradually for decades, aside from a brief reversal during the Great Recession, after which earliest claim applications resumed their downward trend.

From 1985 through 2005, the proportion of women claiming at 62 hovered around 60%, then it gradually dropped to 34% by 2019. During the same period, the proportion of men claiming at 62 stayed around 55% and then declined gradually to 31% by 2019.

Individuals whose full retirement age is 66 can claim benefits as early as age 62, but benefits are reduced by 25% when they claim four years early. The consequences of claiming benefits at 62 will be even more significant as the full retirement age gradually increases to 67 for people born in 1960 and later. For those people, claiming benefits five years early at age 62 will result in a 30% cut in lifetime benefits.

This year marks a major change in Social Security claiming rules as the full retirement age increases to 66 and 2 months in 2021, the first increase in the full retirement age in a dozen years.

In 2019, the other most popular claiming age was 66. That year, 30% of women and 36% of men filed for Social Security retirement benefits at their full retirement age, when benefits are worth 100% of their earned amount and restrictions on earnings from a job disappear.

“The big news here is that not only has the percentage of 62-year-olds claiming at 62 declined dramatically, but those who forgo early claiming appear to wait to the full retirement age to claim benefits,” Munnell and Chen wrote.

Only 9% of men and 6% of women waited until age 70 to claim their maximum retirement benefits, according to the CRR analysis. Benefits increase by 8% per year for every year an individual postpones claiming beyond full retirement age up to age 70. It makes no sense to delay claiming Social Security beyond age 70 as that is when the delayed retirement incentives end.

A major question remains: How has the Covid-19 pandemic affected Social Security claiming age behavior? Preliminary reports indicate that some older workers who lost their jobs or were fearful of the virus turned to Social Security to replace lost income. But an official accounting won’t be available for another year. The purpose of the CRR analysis is to provide a baseline against which to assess Covid’s impact.

“Our reading of the early evidence is that Covid and the ensuing recession have not pushed large numbers into early retirement — perhaps because those most affected cannot afford to stop working,” the authors concluded. “Regardless of the ultimate impact, Covid is not likely to permanently reverse the trend towards later claiming.”

By Laura Williamson, American Heart Association News

It can literally be as easy as a walk in the park.

Just 30 minutes of movement – anything that gets your heart beating faster – five times a week is all it takes to meet federal guidelines for physical activity. In fact, the goal is 150 minutes a week, whether it’s split up daily or not.

And there’s plenty of reason to do it: Study after study finds physical activity – especially in midlife – is critical to preserving good heart and brain health as people age. Yet despite the wealth of research that shows staying active is one of the most effective, and affordable, means of warding off chronic illnesses such as heart disease, diabetes and dementia, statistics show relatively few people in midlife move as much as health experts say they should.

According to the Centers for Disease Control and Prevention, nearly one-third of U.S. adults over the age of 50 get no physical activity outside of work.

“Midlife is a busy time,” said Margie Lachman, a professor of psychology at Brandeis University and director of the Boston Roybal Center for Active Lifestyle Interventions. Her team studies the barriers to physical activity as well as ways to keep people moving in midlife and beyond.

“What we have found is the biggest barrier is not having enough time,” she said. “Typically, people in midlife have multiple roles and they are multi-tasking like crazy, working, raising children and sometimes also caregiving (for) older parents, not to mention other responsibilities they might have in the community.”  And all those responsibilities contribute to another barrier to exercise – fatigue.

If they do have any free time or energy, exercise might not make the priority list, Lachman said. “They may also feel guilty doing something perceived as taking time for themselves, versus working late or spending more time with family.”  These obstacles – while daunting – don’t have to be insurmountable, Lachman said.

She recommends setting goals and following up with a plan for where and when to exercise. Her research published in the journal Psychology & Health found middle-aged adults who believed they didn’t have enough time to exercise increased physical activity, as well as their confidence in achieving exercise goals, if they used planning tools.

“Just like we have reminders for meetings and things we need to do for work, we need to put physical activity in our calendar and block off time. If not every day, then maybe start with two or three times a week,” said Vanessa Xanthakis, assistant professor of medicine and biostatistics at Boston University School of Medicine.

“If you put physical activity on your calendar ahead of time, you’re not going to schedule meetings at that time,” she said. “You will go out and walk, go to the gym, go swimming, go cycling. That’s what blocked time means.”

Competition for the most steps and the social support of exercising with friends and family also can help keep adults motivated, shows another study from Lachman in the journal Research on Aging.

“One thing that I think is useful in midlife is to try to integrate physical activity with other things you want to do as well,” Lachman said.

Incorporate movement throughout the day to make every moment count, she said. “Take the stairs instead of the elevator. Walk your child to school, if that’s an option. Take a walk with a co-worker instead of sitting down for a meeting. Every little bit you do adds up.”

“Goal setting does not have to be overly ambitious,” Xanthakis said, “and should be tailored to individual fitness levels. Those who are not active at all can start slowly, while those who are already moderately active can increase the intensity or frequency of their activity.

“Just start moving your body. There are easy things you can do. Park your car as far away as possible from the grocery store to get the extra steps. Try walking to an errand if it’s close by, rather than driving.”  If nothing else, Lachman said, just walk.

“Walking regularly has huge benefits. You don’t necessarily need equipment or to join a gym. For the most part, it’s something people can do without having to make an investment.”  The rewards will follow.

On days people exercise, they feel better, said Lachman, who co-authored a study in Sleep Health showing women in midlife who exercised more also slept better.

Once you establish a habit, it gets easier, she said. “You feel better, physically and mentally, psychologically, and that’s a self-reinforcing experience because you want to do it again it feels good. When you don’t exercise, you miss it. It takes a while to establish this.”

And it’s a heart and brain health risk factor over which people have total control, Xanthakis said. She recently led a study published in the Journal of the American Heart Association showing regular exercise and eating a healthy diet during midlife helped achieve good cardiometabolic health later in life.

“This is something we can tackle,” she said. “It’s not easy to lower blood pressure or cholesterol from one day to the next, but something we can definitely control is we can exercise more in quantity and quality.”

For every hour of brisk walking, life expectancy for some people may increase by two hours.

by American Heart Association editorial staff – 2017

You can get active in lots of ways, but walking is one of the easiest! For most people, it’s safe, easy to stick with, and low- or no-cost. It doesn’t require any special skills or equipment. For such a simple activity, it has so many benefits.

Research has shown that walking at a lively pace at least 150 minutes a week can help you:

• Think better, feel better and sleep better.
• Reduce your risk of serious diseases like heart disease, stroke, diabetes and several types of cancer.
• Improve your blood pressure, blood sugar and blood cholesterol levels.
• Increase your energy and stamina.
• Improve your mental and emotional well-being and reduce risk of depression.
• Improve memory and reduce your risk of dementia.
• Boost bone strength and reduce your risk of osteoporosis.
• Prevent weight gain.

If 150 minutes sounds like a lot, remember that even short activity sessions can be added up over the week to reach this goal. And it’s easy to fit in a few minutes of walking a several times a day.

Walking vs. Running

Did you know more Americans walk for fitness than run? Maybe you’re not that into running. Or maybe you’ve had an injury and can’t run anymore. Then just walk – every step counts. In fact, walking briskly can help your health as much as running, according to a 2013 research study.

How to walk for fitness

• Gear up. All you need to get started are comfortable clothes and supportive shoes. Keep your cool by layering clothing, because exercise raises your body’s temperature. Shoes designed for walking or running are best, but not required. Just make sure you have a little wiggle room (about half an inch) between your longest toe and the end of the shoe. Avoid cotton socks because they retain moisture and can lead to blisters. (Who knew?!)
• Easy does it. If you’re out of shape, begin with short distances. Start with a stroll that feels comfortable (perhaps 10-15 minutes) and gradually increase your time or distance. If it’s easier on your body and your schedule, stick with a couple of 10 to 20-minute walks a day instead of one long walk.
• Focus on form. Keep your head lifted (no texting!), abs engaged and shoulders relaxed. Swing your arms naturally. Avoid carrying heavy items or hand weights because they can put extra stress on your elbows and shoulders – try a backpack instead. Stick to a comfortable, natural stride.
• Breathe. If you can’t talk or catch your breath while walking, slow down. At first, forget about speed. Just get out there and walk!
• Pick up the pace. To warm up, walk at an easy pace for the first several minutes. Then gradually increase your speed.
• Add variety and challenge. Try brisk intervals. For example, walk one block fast, two blocks slow and repeat several times. Over time you’ll be able to add more fast intervals with shorter recovery periods. Walking hills or stairs is a great way to increase muscle tone and burn more calories.
• Stretch. The end of your walk is a great time to stretch since your body is warmed up. Stretch your hamstrings, calves, chest, shoulders and back. Hold each stretch for 15 to 30 seconds.
• Track your progress. Fit walking into your schedule whenever you can. That may mean three several short walks a day. When you can fit it in, longer walks will help you improve your stamina. Just remember your overall goal is at least 150 minutes each week.

Stay safe while walking

• Be alert. Listening to music while you walk can help keep you energized. And making phone calls is a good way to multitask. But if you use headphones, keep the volume low and watch out for traffic that you may not hear. Don’t text or stare at your device while walking, so you can keep your eyes on the road.
• Stand out. Wear light colors or reflective clothing and carry a flashlight or glow stick (it adds to the fun!) if you walk when visibility is low.
• Be street smart. Walking on sidewalks is best, but if you have to walk on the street, stick to streets with lower speed limits and make sure drivers can see you.
• Know the neighborhood. Note which businesses are open when you’ll be walking and the location of emergency telephones. Walk on well-traveled streets rather than taking shortcuts through alleys or parking lots.
  
• Listen to your body. If you have foot, knee, hip or back pain when walking, STOP and check with your doctor to find out the cause. You may need different shoes or another form of activity like cycling or water exercise. But don’t give up! Find the activity that’s right for you.

Just Walk

Maybe you haven’t been active for a while. No problem! Just get started. It’s not all or nothing… it’s step by step. Even if you’re already active, here are some easy ways you can add more steps into your day:

• Grab the leash and take the dog out for a walk.
• Forget about rock star parking. Park a bit farther from the entrance to your workplace, school, grocery store, restaurants, etc.
• Take the stairs instead of the elevator, even if just for one or two floors.
• Catch up with a friend by walking around the block while you chat on the phone.

The American Heart Association Blog

Tasty food, refreshing drinks, and good company are all elements of a great barbecue. As you’re spending time with friends and family this summer, keep these few heart-healthy summer BBQ tips in mind for those sunny days by the grill.

1. Add color. Add lots of color to your meal in the forms of fruits and veggies. Almost all of your favorite veggies can be grilled alone or in a kebab, giving them a delicious flavor. Fruits could be made into salads, stand alone on a tray with a dip, or used to enhance the dessert table. Another fun addition to a summer cookout is creating a smoothie station. A perfect smoothie uses one or two fruits with milk or yogurt for protein. Using plant-based milk like almond or soy milk is also an option for a low calorie, non-dairy smoothie.

2. Grill smart. Try to choose lean meats, like skinless chicken breasts, lean ground poultry, or fish such as salmon or trout. These types of proteins are lower in saturated fat than red meat and fish contains healthy fats that are good for brain and heart health. Instead of using a lot of salt, make a simple rub of your favorite spices, such as allspice, chili powder, cinnamon, cumin, garlic powder, paprika, rosemary, or black pepper. Marinating or rubbing spices on poultry, fish and meat can add amazing flavor. A half cup of marinade or one tablespoon of spice rub is all you need for each pound of food. 

3. Make your own marinades. Making your own marinades can help you skip out on the high fat, sodium, and sugar content that these store-bought versions have. 

The basic components of a marinade are acid, oil and flavorings.

• Common acid options are citrus juice, vinegar and yogurt. 
  • For oils, use canola or safflower or a blend of both. Swap them in for recipes that call for olive oil. These oils have a higher smoke point than olive oil, so they can withstand the high heats of grilling without breaking down, oxidizing and producing carcinogens.
  • Flavorings include onion, shallots, garlic, herbs, salt, or Worcestershire sauce.

4. Choose Whole Grains. Whole-grain buns and breads will complement your healthy feast with extra fiber, flavor and texture. If you’re staying away from grains altogether, lettuce wraps are a great and delicious alternative. 

5. Hydrate, hydrate, hydrate! Keeping hydrated is crucial while being out in the hot weather during the summer. Sodas and tea include caffeine and sugars that may taste delicious, but cause dehydration. Drinking water doesn’t have to be boring. Spice up water by adding herbs, sliced cucumbers or sliced fruit such as oranges, strawberries, peaches, nectarines or pineapple. Fun flavor pairings include watermelon and basil, cucumber and mint, blackberry and sage, and strawberry and mint or basil. If you need a bubbly taste, use seltzer water.

We hope these tips got you thinking about your summer plans to host or attend a great outdoor BBQ with family and friends.