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sinus, cough/cold, and pain medications.”

      Diet can also play a role. Opt for an anti-inflammatory dietary regimen (see Rung 3—Nutrition) and go easy on acidic foods such as sugar, white flours, and alcohol. “Also, some foods and beverages can block the effects of arthritis medications,” Crockett adds. “These include grapefruit, apple, and orange juice, as well as milk and yogurt. Wait at least four hours after taking medications before eating or drinking these. Exact times can vary depending on the disease and the treatment. Check with a trained clinician.”

      Arthritis, in its many forms, is a continuing challenge. But with continuing focus it is possible to manage it successfully.

      Osteoporosis

      While we are discussing bones, we need to talk about osteoporosis, literally porous bones. After you turn 50, it’s a good idea to measure your height every year, which will assess your posture and skeletal health. A decrease in stature can be as informative as a change in a bone density test for monitoring your overall bone health.

      If your doctor determines that you have osteoporosis—or osteopenia, a precursor to it—it’s still no reason to stress. True, the diagnosis creates visions of shattered bones and rounded backs, but it may just mean that you have a higher risk for fractures. And in the past 15 years or so, doctors have learned a lot about how to prevent those breaks.

      Says Ethel S. Siris, M.D., director of the Toni Stabile Osteoporosis Center of the Columbia University Medical Center at New York-Presbyterian Hospital, “We now know that bone density loss is tied to decreases in calcium and impacted by low levels of vitamin D. So just make sure you take enough calcium and vitamin D every day. I generally recommend 1,200 milligrams of calcium from food or supplements, and 1,000 to 2,000 international units (IU) of vitamin D.” Your doctor may also prescribe a bisphosphonate drug to lower fracture risk.

      But don’t sit around in fear of breaking your bones, which can actually be counterproductive. Load-bearing exercise, such as walking, is good for all bones. An exercise routine can not only preserve bone mass, it can improve flexibility, strength, coordination, and balance—all of which can help a person avoid falls.

      Don’t overdo it, though. And if you are close to someone with osteoporosis, try to sensitively steer her or him into sensible habits. As Dr. Hammerness advises: “Be clear about what concerns you, and get the facts so that you can have a reasonable conversation. Emphasize that you want your loved one to keep enjoying her favorite activities—as long as she makes her health an equal priority. If she’s a hiker, for example, propose that she go only in daylight, avoid areas known for unstable terrain, wear boots with good traction, carry a walking stick or trekking poles for balance, and take a hiking partner. Remind her that by minding her own safety, she can do what she loves for much longer.”

      While for the moment, arthritis and osteoporosis may be incurable, the symptoms can largely or wholly be managed or even prevented.

      Breathe Easy

      There is nothing we take more for granted than breathing. Until we can’t! Many moons ago, working through weeks of intense negotiations in smoke-filled conference rooms, The Lawyer began to suffer from what he thought were allergies. He ended up in the hospital for eight days with pneumonia. Happily, antismoking rules and more powerful antibiotics lessen the incidences of that now. However, in its place, we have almost an epidemic of asthma and, whether you believe in global warming or not, seemingly the same for allergies, and the two can be related. So much so that 50 million Americans are affected by them, and the numbers are growing.

      The first time I came face to face with asthma was when my daughter, Elise, was in ninth grade and I got an urgent call from the school nurse, who told me Lisi was having trouble breathing. I dropped everything and raced up to her school. When I arrived, her chest was tight and she was still coughing and wheezing—all classic symptoms of asthma. What possibly could have triggered this sudden attack?

      The nurse had an answer: “It came on right after she ate a pear. Probably some chemical in the skin.”

      As we drove off to the pediatrician, I noticed the nurse running after the car, frantically flailing her arms, a half-eaten pear dangling by the stem in one hand. She caught up and tossed in the offending fruit. “Here, take this with you,” insisted the nurse, no doubt a CSI devotee, “to be inspected.”

      The good news? My daughter wasn’t poisoned. But we were faced with the diagnosis that she had childhood asthma. Fortunately, after a few years of needing an inhaler from time to time before she exercised, she eventually outgrew it. Nevertheless, to this day, she has never eaten another pear.

      No one is certain what causes asthma—most scientists believe it is partly genetic, partly environmental—and while some children, like Elise, see symptoms resolve with age, there is no cure. It is known that inhaled allergens and irritants, such as smoke, pollen, dust, mold, and strong odors and fumes, as well as certain common products and foods, even a beloved furry pet, can cause the airways leading to the lungs to become inflamed and swollen. Furthermore, the difficulty in breathing experienced by asthmatics often leads to anxiety attacks. And when stress levels increase, so do asthma symptoms. It’s a vicious cycle.

      Living with chronic asthma is challenging. So the first thing to do is to approach it head-on. “Managing asthma is a team effort,” advises Dr. Norman H. Edelman, the American Lung Association’s (ALA) leading medical authority. “Patients (or parents) should work with their healthcare provider to develop an ‘asthma action plan’ such as the one developed by the ALA, specifying medications and how to alter them if the condition worsens. For children, the action plan should involve teachers and school officials.”

      It is important to know that asthma and allergy triggers can come from the unlikeliest of places. For example, our homes can carry five times more pollutants than stepping outside since we breathe the same air over and over again. And The Lawyer, who seems to be allergic to exercise classes, was thrilled to learn that triggers can also be found lurking in health clubs. Unfortunately, Richard Weber, M.D., former president of the American College of Allergy, Asthma, and Immunology Organization of America (ACAAI) confirmed his suspicions: “Not only can new workout routines be difficult for those with asthma or allergies,” he said, “but yes, many allergens that cause coughing, sneezing, wheezing, or rashes and watery eyes can indeed be found in gyms.”

      So be wary of the following culprits:

       • The Pool—If you are sensitive to chlorine and don’t have access to a saltwater pool that naturally disinfects the water, be sure to shower immediately after swimming.

       • The Locker Room—A study published in the Journal of Environmental Health Perspectives found a link between triclosan, a common ingredient in antibacterial soap, and allergies. Since these cleansers are found in practically every locker room, bring along your own unscented products.

       • The Mats (yoga or exercise)—According to the ACAAI, most rubber mats contain allergy-inducing latex and other available options could be laced with toxic PVCs. If you have had allergic reactions to either of these, it’s best to tote along your own mats made of hemp or organic cotton.

       • Workout Outfits—The ACAAI recommends staying away from materials such as polyester and nylon, which can also be itch-inducing, especially anything that says it’s “odor-free” or “antimicrobial.” Better to look for natural fiber or naturally wicking wool.

      Fortunately, allergies can usually be treated with over-the-counter antihistamines. If symptoms are more chronic, your doctor may prescribe medication to take on a regular basis or even desensitization shots. If you want to know what you are allergic to, you can see your local allergist and be tested.

      Dr. Joan Lehach, an integrative medicine physician specializing in allergy, asthma, and clinical immunology at Montefiore Medical Center in New York City, offers a few suggestions on how those with pollen allergies can breathe a bit easier during the high-pollen times:

       • If you live in a suburban area, keep your grass short and have someone else mow it. If you are going to do yard

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