In the midst of covid-19 virus T


his


Dr. Gillian Aldous Foot Notes


is written on Wednesday, April 15th, 2020. The world is anxiously gripped by the ongoing spread and fear of the Covid virus, although we are all optimistic about the future trends – perhaps too optimistic. Many of us who are older and frailer are concerned about our health and mortality. Working peo- ple are concerned about the economic impact. Everyone is concerned about their own mental health. Podiatrists as all health


article


workers are trained in infection seemed


control. reasonable


this article to remember some of the basics. Airborne particles can spread to other people or surfaces


So, to make sure I got this right, I researched it. This


new virus is unknown, and so not totally understood. If you sneeze, and fail to cover your mouth, then the air borne particles can spread to another person (hence the two-metre distance rule: make sure you stay away from others), and to surfaces. Some particles may stay on hard, non-porous surfaces, such as computer key- boards for some time. It is not known for how long these virus particles may be active on surfaces, but it could be for days. Hence, the two-pronged approach: wash our own hands often, including the nails and fingertips. Remember to clean and disinfect surfaces. Hand washing


I know we have all been shown. We all have been taught to hand wash longer than normal, usually ac- companied by a song. (I prefer Gloria Gaynor’s ren- dition of “I will survive”. This is probably because I think disco is under rated.)


Cleaning, disinfecting, and sanitising So, for information. For anyone who sees a podia-


It in


On Mr. Tomato’s front sidewalk.


trist, as well as hand washing and wearing one use gloves, we also make sure that surfaces that will be touched by you, the patient are wiped clean with a disinfectant. This means all surfaces: arm rests, chair, door handles. The disinfectant I use is bactericidal and fungicidal. Masks and eye protection are worn for protection of the practitioner, and you the patient. The instruments we use go through the process:


clean; removal of any particles; clean and disinfect; the instruments are put into an ultrasonic bath, which uses ionised water to agitate any smaller par- ticles from the instrument surfaces. Finally, sanitis- ing. The autoclaves we use are monitored to make sure they work correctly. They are like a pressure cooker: under pressure the temperature is raised to 126 degrees C or 273 degrees F. This means that the instruments will be sterilised and clean for the next person to be treated. Patience, kindness and understanding


When there is a new, not known danger we all become very concerned for ourselves and our loved ones. Reason tells us that the situation will change, but the anxious reality doesn’t always back this up. Be careful, and clean. Human nature is optimistic, but this is a tough


one.


Gillian Aldous is a podiatrist working at the Madison Square Orthorehab Clinic.


people's health at about 60. It’s the pri- mary reason those over the age of 70 are at the greatest risk of COVID-19, par- ticularly those already dealing with un- derlying health conditions. According to Shai Shen-Orr, an immunologist at the Technion Israel Institute of Technol- ogy, some people have an ‘immune sys- tem age’ that differs significantly from their chronological age. In a typical winter flu season, it's


Lowering your immune age A


s we age, our immune system gets weaker. This natural, gradual deterioration is called "immunosenescence" and starts to affect most


rare that people under 65 become sick enough to be hospitalized. In the next age group up to 75, about 20% may be hospitalized, but it's still uncom- mon that someone dies of the flu. But as many as half of those over 75 are hospitalized, with a mortality rate ap- proaching 40%. Additionally, many of those over 75 who do survive don't fully recover. This pattern is also being seen with COVID-19. According to Janet Lord at the University of Birmingham, the difference for most people is immunosenescence. Immune function decline begins during puber- ty and can be affected by many modifiable lifestyle choices. If you're overweight, smoke, don't eat well, are deficient in important nutrients, are sedentary, of- ten under stress, or you don't get 8 hours of sleep each night, you're likely to have an immune system age older than your chronological years. Chronological age and biological age are usually


similar, but some believe they can differ by as much as 20 years. Lifestyle changes can cause biological and immune age to go up or down. Epigenetics is an ac- tive area of research that has proven that our health and longevity aren’t only controlled by our genetic in- heritance. As G.A. Bray stated, “Genes load the gun, the environment pulls the trigger.” Fortunately, the dietary and lifestyle choices we make can affect our genes positively. Sleep: Getting at least 8 hours of restorative sleep


each night is critical to allowing the immune system to respond to pathogens, while allowing the brain to do necessary housekeeping to remove cells that are as- sociated with dementia and Alzheimer’s disease. Ac-


May 2020


ADVANCING HEALTHCARE


Your


healthcare heroes


need your help.


Nathan Zassman Natural Health


cording to Mathew Walker, sleep is a "non-negotiable biological necessity." Short sleep predicts a shorter life. Insulin Control: Insulin is a hormone produced by the pancreas that allows the body to use glucose from carbohydrates for energy or to store as fat for future use. It also plays a key role in transporting amino acids into cells, including the brain. In- sulin helps keep blood sugar levels from becoming too high or too low. Insulin resistance (also called hyperinsulinemia or type 2 diabetes) is a condition where certain cells don't respond normally to insulin. Insulin can become elevated in the body, but the cells remain resistant to its effects. The resulting chronically high insulin levels can potentially lead to an increase in cholesterol levels, higher blood pressure, and weight gain. Insu- lin is also a satiety hormone, so when there’s too much, we don't experience the signals that tell us to stop eating.


Implementing timed nutrition or fasting can turn


on two important processes: ketosis and autophagy. Ketosis is a process where the body switches from us- ing glucose as its main fuel source to using ketones – compounds produced by breaking down fat to serve as an alternate energy source. Autophagy is turned on by fasting and activates many longevity pathways and processes that are crucial for our cells to survive. Autophagy destroys viruses, bacteria, and cancer cells. In a Yale University study, researchers found that a ketogenic diet activated a special subset of T cells in the lungs that helped trap the influenza virus. Some people find that eating strictly in an 8-hour window works well for weight loss and stabilization. Others prefer fasting for two non-consecutive days (i.e. every Monday and Thursday). You have to discipline your- self to stop snacking between meals or you will never achieve ketosis or autophagy, though it does get easier once you’re used to it. I recommend stopping break- fast and eating two meals a day. Making a few deliberate changes to your daily rou-


tine can help lower your immune age. Improving your sleep, diet, and when you eat can lead to a wide range of health benefits. Nathan Zassman is the owner and president of Aviva Natural Health Solutions.


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