Walking program for dialysis patients; easing adolescent anxiety about world affairs

Q: My grandfather, 78, always was a positive guy, but he's been pretty down-in-the-dumps lately. He's been on dialysis (and a kidney transplant list) for a couple of years now. His blood pressure is high, then low after treatments; he has trouble sleeping; and he doesn't move around much. He used to be a basketball player. What can I do to help him out?-Winnie P., Atlanta

A: When it comes to helping dialysis patients, a couple of things are of primary importance. First, make sure he's sticking to his diet. Usually (but check with his doc) he should be avoiding salt; phosphorus-, potassium- and magnesium-rich foods; and eating lots of protein. And make sure he's getting plenty of fluids. He can get fluids not just from water, but from fruits that his doc recommends. It'll probably be apples and berries, because they have less potassium than oranges and bananas.

Second, ask his doc about exercise. We know that may sound counterintuitive for someone with kidney failure, but a recent multicenter study published in the Journal of the American Society of Nephrology found that for people on dialysis, a simple, personalized, home-based exercise program "significantly" improved their cognitive functioning, raised their levels of social interaction and improved their kidney disease. The six-month program consisted of a six-minute walking program (three consecutive two-minute intervals each day) and a sit-to-stand exercise, repeated five times a day.

Although the study had dialysis staff members supervising the exercises, with his doctor's input, you could help your grandfather do them and help him track his improvement over six months of training. Since he was a basketball player, you may be able to light some competitive fires! And when you can't be there in person a daily, a call asking him to read his pedometer will work wonders. Also, remind him that when it's his time for that new kidney, he'll be in better shape to receive it if he works out with this exercise program.

 

Q: My 15-year-old daughter seems to be increasingly anxious about the world in general-everything from global warming and pollution to the recent political season has fueled her worries that the future isn't very bright. She's not a natural worry-wort, and I want to make sure her anxiety doesn't become permanent. Any ideas?-Connie S., Dallas

A: The teen years are challenging, what with becoming independent, contending with puberty and thinking about making choices that will influence the rest of her life. Repeated studies find that most adolescents worry to some degree about themselves: their appearance, relationships, school and career, health, substance abuse, sexual behavior and birth control. On top of that, pile the bully-behavior childishness of the past political season, the 24/7 news cycle of gloom and doom, global warming, pollution or war, and she's dealing with a lot. It doesn't, however, sound like your daughter has a diagnosable anxiety disorder, just teen angst. But if you do suspect something more serious, see a specialist ASAP; treatment can be effective and life-changing.

We're betting she'd like Mom to be a sounding board. If your daughter is focusing on political and social problems, help her discover how others are addressing them responsibly and positively. That will help her feel there are people who have found effective ways to improve the world. Then you can help her take action. The combination of a belief that action can make a difference coupled with doing something is the key to transforming anxiety into hope.

Our suggestion: Have your daughter write out her top concerns and interests. Get her to talk about them with you. Then work together to identify organizations and activities with which she can become affiliated. Whether she wants to volunteer at an animal shelter or a school-based club that focuses on one concern (maybe global warming), be supportive. She'll feel empowered and less anxious when she works to further positive change.

 

Mehmet Oz, M.D. is host of "The Dr. Oz Show," and Mike Roizen, M.D. is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. Email your health and wellness questions to Dr. Oz and Dr. Roizen at [email protected].

 

(c) 2017 Michael Roizen, M.D. and Mehmet Oz, M.D.

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