Be Fit For Life

with Ellen Cohen-Kaplan

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Habit Change: Part II


As detailed in the last blog, there are certain techniques that will orient you toward success in changing and keeping new habits. I left off discussing accountability, e.g. like keeping a record of your progress or checking in with others, such as a coach or trainer.

Once you have a system for accountability, the next step in “Better than Before” discusses taking the initial action toward habit change.  Here’s some ways to get started.

1. Begin now.  There’s no reason to equivocate about when is the best time.  When starting, don’t go for the gold immediately. The beginning is not as intimidating if you break the habit down into smaller nuggets.  Instead of saying, I’ll work out an hour a day, every day,  how about committing to walking 15 minutes 5 days a week?  You’ll likely be able to reach or exceed that goal, which will encourage further  progress.  Some people do better when they push themselves to commit to bigger first steps, because it’s more exhilarating to have a “blast” start.  Know that you’re unlikely to continue with the intensity if you choose the bigger start.

2.  Clean Slate. – Another way to think of and start habits is to try doing it with a “clean slate”. This is beginning something on a Monday, at a new job, with a new relationship or anything else that marks a natural beginning. This is why New Year’s Day is a popular time to make changes. At the same time, if you decide that you must change a habit, today is usually the best time to start.

3. Lightening bolt – This is a useful strategy when you are confronted with a new reality, a new idea, or a meaningful event that compels you to change a habit immediately, and often in a dramatic way.  An excellent example of this is when a person with an unhealthy addiction becomes pregnant.  Although she may have failed in many other programs, being healthy for another person’s sake is enough to trigger her to change her lifestyle for good.

The following are additional strategies for maintaining your new habits:

a) Abstaining-  If we don’t start, we don’t have to think about how to stop- this works well for all-or-nothing types. If you are a moderator, one bite of dessert will be enough for you.  Research suggests that when you indulge in something less over time, you want it less.  Carbohydrate cravings are an excellent example of this.

b) Convenience- Make the desired habit more convenient to attain.  Conversely, make it inconvenient to break the habit.  A strategy that I use frequently is ensuring that I don’t have a supply of cookies in the house. I won’t go out and get one, if it’s not here already. If a pack of cookies “lands” in my house, I freeze them, so the added act of defrosting is often enough to deter me from eating one.  If they are brought to my house as dessert after a dinner, I send them home with people so I don’t indulge, or leave a small piece here (because I can be a moderator) so I don’t overindulge.

c) Anticipate and minimize temptations- Use safeguards to ensure you keep your new productive habit.  Eliminate the trigger or the cue for the temptation, such as doing work in other parts of the house, besides the kitchen, if you have a tendency to overeat when at home.

If we stumble, we may get a better idea of those triggers that cause a lapse in our healthy habit forming. Planned exceptions for worthwhile indulgences have an advantage over spur-of-the-moment decision-making when trying to maintain a habit.  For example, when going to a cocktail hour, I make a decision to eat only 2 of the most tempting hors-d’oeuvres, instead of eating anything that looks good that is passed my way.

d) Loophole spotting- Most of us are naturals at creating loopholes for ourselves, in order to avoid and make special exceptions for reasons why we fall short of expectations. For example, you might think,  “I can’t exercise today, it’s too hot/cold/rainy or I’m too busy.” Chances are, with a little creativity, you could find a way to exercise inside, even if it’s for a short time.

e) Distraction – Often distracting yourself for 15 minutes by doing a competing activity can allow you to use more will power. For example, when tempted to make an impulse purchase, I’ll try to do the rest of my shopping, and see if I still want that item when I’m finished with my shopping.  If so, maybe it’s not so impulsive, it may be something that’s a practical purchase.

f) Reward- Sometimes rewards can sabotage your achievement of your goal. For instance, if you decide to reward yourself with a piece of chocolate cake after avoiding avoid sugar for 2 weeks, it could begin a downward spiral of your return to eating sweets. It also may condition you to accomplish a goal only to get an extrinsic reward, instead of the goal attainment being its own reward. Let’s say you finally fit into the clothing that you wore a few years ago, after exercising and reducing your food portions.  If you decide that you’ll buy more clothing that fits your new size, that would be an excellent choice, because that would fit the goal of the behavior.

Many studies have shown that when children are rewarded for good grades or behavior on a consistent basis, they don’t learn  to derive the intrinsic benefit of the better behavior.  This holds true for adults as well, even though we have more evolved control over our behavior.   Try to think of the habit itself as being the reward, and enjoy the natural consequences that come from the improved lifestyle. For example, if you begin an exercise program, and feel more energetic and stronger, you’ll be able to partake in more physical activities and enjoy your time with children and/or grandchildren, as opposed to saying, if I stay consistent with my workout program, I’ll celebrate with a big purchase. If you think about the natural benefits of being stronger and more fit, how about taking a family trip that has you hiking and doing more strenuous things that you may not have been able to do without your improved fitness level?

Some habits are more fragile, and unusual circumstances may cause you to stop.   A change in schedule such as business or acute illness may disrupt your habit maintenance.  Once the circumstances allow, make sure you “start now”. That way, the fragile habit isn’t broken, just paused.

The major take-away from this section is to use some simple strategies to move you toward your desired habit change, and let the improved behavior be its own reward.




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Better than before- secrets of habit change

“Habit is habit, and not to be flung out of the window by any man, but coaxed downstairs a step at a time.” – Mark Twain


Because the end of summer is near, or maybe because fall signals a time for new routines, I’ve been reading a book called “Better than Before” by Gretchen Rubin. This book discusses how best to change and/or uphold desired habits, and it details where to begin, how to make changes, and how to maintain them.

One of the first steps is to know yourself, and what your tendencies are. We all have both internal and external expectations, and we each have our unique ways of managing them. Ms. Rubin describes four different personality types as it pertains to meeting expectations:

  1.  The upholder- one who readily accepts and meets both internal and external  expectations- a rule follower who is most comfortable when guidelines are clear
  2.  The questioner – one who questions both internal and external expectations, and if  he/she determines that the rationale for them is merited, he/she will meet them
  3.  The obliger – one who meets others’ expectations, but may fall short of their own
  4.  The rebel – one who has to do things his/her own way, and doesn’t attend to others’ expectations

When motivating yourself or others, it behooves you to understand these types, and which types dominate the personalities in question. For example, if you are an obliger, you may need accountability to other people for habit change, but if you are an upholder, this may help, but you may already have expectations of your own that you regularly meet. If you are a rebel, it may be helpful to be directed to resources for habit change, but you will need to do it in your own way in your own time. If you are a questioner, you will need solid proof of why certain strategies are effective, and you will not change habits just because you think you “should” or others recommend it. Of courses, most of us are combinations of a two or more types, but we also have dominant tendencies that favor one or two types. Our “type” can also depend on specific circumstances. You may be an obliger in one situation, but an upholder in another.

Knowing yourself also helps you figure out when to tackle the most difficult tasks of the day.  If you’re a morning person, then you schedule the most challenging obstacles soon after you awaken. If you’re a night owl, then your creativity and energy are at their highest in the evening and even later, and you’ll likely make the best progress toward your goals at those times. There are many other examples of how insight about your innate tendencies can set you up for success. Are you a(n) …

procrastinator or marathoner or sprinter?

underbuyer or overbuyer?

simplicity or abundance lover?

opener or finisher?

familiarity or novel lover?

promotion focused or prevention focused?

small step or big step taker?

Let’s take the example of trying to begin and maintain an exercise program.

  • Would you say, OK, I’ll start tomorrow or right now?
  • Would you want to buy a fitbit, polar heart monitor, great workout gear, and the best sneakers before you begin?
  • Would you enjoy the start of the program, but have difficulty maintaining it once you got into a routine?
  • Would you need the program to be repetitive so you could memorize it and get it ingrained, or would you want a new challenge and set of activities on a frequent basis?
  • Would you do it because you know if would give you more energy, or because you don’t want to get weak and/or stiff?
  • Would you join a gym, decide you’ll devote an hour a day to it, or begin by walking 10-20 minutes a few days a week to get started?
  • Would you decide you would exercise in the morning or in the evening?

The answers to these questions can help you orient yourself for success in reaching your goals.

There are some pillars of habits that have been shown to be invaluable. The author has studied which strategies have proven to be most effective in helping habits stick.  Let’s take the example of improving eating habits. The following are examples of ways to help you change your habits for good.

  1. Monitoring- keeping a food journal and really keeping track of your food intake
  2. Foundations of healthy habits:
  • sleep
  • movement/activity
  • eating and drinking in moderation
  • uncluttering

If we take the example of healthy eating, one would set up the foundation by ensuring at least 7-8 hours of sleep a night to decrease sugar cravings and be rested enough to use will power.  Obtaining enough activity each day- at least ½ hour-1 hour of walking, exercise or other activity will set you up for success. Being diligent about avoiding too much alcohol, excessive food or sweets intake, is essential to lose weight and feel your best. Finally, clearing out any enticing high calorie, low nutrition food from your kitchen would round out the foundation.

3.  Scheduling- Taking the time to schedule in your new healthy habit is essential, and             should be regarded with as much care and deliberation as any other worthy task.               You may need to schedule time to shop for and prepare healthy snacks and meals               at the beginning of the week to make sure you have them ready after a long days               when you have no time to prepare healthy foods.

4.  Accountability –Being accountable to others or yourself by writing things down                  and checking in with another person, and declaring and keeping track of your                    new habit may help keep you honest –for example, keeping a food journal has                    proven to be very effective.

If you want to start or change a habit, take a look at the information above to see which strategy may be useful for you based on your personality type.  Then stay tuned for Part 2 for tips for habit change that I will post next time. Good luck and let me know your thoughts!


1. Goal setting and Training 2. Performance and Goal Attainment 3. Maintenance


Training team (Newton and Needham gang)


The reason I ride- to help fund a cure for cancer, and the specific team I ride for


Goal attainment at the Provincetown finish with my best riding partner

Each year, the build-up to the Pan Mass Challenge is different. This year, unpredictable, cool and rainy weather delayed the start of training, and we needed to catch up during the last few months. Luckily, we trained on plenty of hills this year in the Berkshires, and this seemed to make up for our late start. We also allowed time for recovery in between long or intense rides. This has become more important as we get older. Every exercise trend has its moment, and it has arrived for the evidence supporting recovery.   The large number of baby boomers in their 50s, 60s and 70s who want to maintain high levels of fitness need recovery, which includes rest, foam rolling and gentle movement as an essential part of our routine.

So, what are some ways to set and reach your goal through the proper training?  Below are some tips to get you there:

Goal Setting and Training

  1. Set a reasonable goal and give yourself time to build up your muscles and cardio capacity in increments in order to avoid injury.  For the PMC, we begin training in April as soon as the weather permits to build up our endurance for the big weekend in early August.
  2.  Examine your motives. What does the goal mean to you? Why are you doing it?
  3. Plot out your workout schedule to ensure adequate time for your body to adapt to higher demand.  A minimum of 3 times a week of cycling is our magic number, ramping up to longer rides as the event approaches.
  4. Be diligent about your nutrition to allow your body to make the changes needed to accomplish your goal to meet your energy demands.
  5. Constantly assess your progress, and make changes when necessary. For example, if you find that you need more cardio work, you may add interval training on machines or walking outside to your regimen.
  6. Go to the app store to find training regimens that are tailored to specific types of sports like half or full marathons or sprint triathlons. For example, there’s 10K trainer, couch to 10K training, or Running Trainer.
  7.  Because training is sport specific, you must practice the same sport in which you’ll compete.  Even though you may be in good overall shape, or good running shape, it may not translate to good biking shape, so you must cycle frequently for a biking event, run frequently for a 5, 10K or marathon.

Performance Day and Goal Attainment (if all goes well)

  1.  Get good sleep the night before. Allow yourself time to wind down and consider that you may have before-race day jitters.
  2.  Get proper nutrition. Before the PMC weekend, we always have a pot luck dinner with plenty of protein and carbs to have the energy needed to complete the weekend.
  3.  Don’t put additional pressure on yourself the day of the event. Just tell yourself you’ll do the best you can, and count on your preparation to take care of the rest.
  4. Hydrate and nourish yourself plenty during the event if it’s an endurance event, or plenty afterwards if it’s more of a sprint,  (less than 1.5 hours).
  5. Give yourself a recovery day if needed.

Maintenance– the hardest part.   You may feel unmotivated to continue the ramped-up training after the event, so….

  1. Plan for your next event or decide on a new one that piques your interest, so you can keep up your fitness level.
  2.  Get a fitness buddy for impetus when your motivation flags.
  3.  Find a professional who can keep you interested, accountable and knows how to motivate you. You don’t have to do it alone !
  4.  Assess how good you feel when you’re in top form, write it down, and refer back to it to remind yourself to continue your training.
  5. Lay out your workout clothing and put it in a prominent place the night before to set your intentions to continue your workout habit.

So, there you have it. Go for a new challenge and enjoy the rewards !


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You know baths are good for you… but have you tried forest bathing?

“You didn’t come into this world.
You came out of it, like a wave from the ocean.
You are not a stranger here.”
Alan Watts

Summer is a perfect time to immerse yourself in nature. A walk outdoors anywhere, but especially in the woods, may confer additional benefits. “Shinrin-yoku”, or forest bathing, has been shown to reduce blood pressure, heart rate, and strengthen our immune systems.

One may wonder if relaxing in a bar, on one’s porch or in a lounge chair anywhere may offer the same benefits. Possibly, but…. Japanese scientists have been researching Shinrin- yoku since the 1980s, and have found that spending a minimum of 20 minutes in the woods has a notable effect on our physiology. Specific benefits were found to be the following:

  • Boosted immune system functioning, with an increase in the count of the body’s Natural Killer (NK) cells.
  • Reduced blood pressure
  • Reduced stress
  • Improved mood
  • Increased ability to focus, even in children with ADHD
  • Accelerated recovery from surgery or illness
  • Increased energy level
  • Improved sleep

What accounts for these additional changes to our physical wellbeing?

Forest bathing has a major effect on our parasympathetic nervous system, which controls stress, ability to conserve energy,  relax, and slows down our heart rate, while stimulating glandular activity.  In a study out of Nippon Medical School in Tokyo in 2006, Dr. Qing Li and other researchers discovered that there are natural chemicals secreted by evergreen trees, collectively known as phytoncides. These essential oils increase the activity of our frontline immune defenders, known as killer cells, which promote healing.  This has lead to research correlating forest bathing with an increase in the activity and presence of intra-cellular cancer-fighting proteins. To learn about the myriad of research studies on Shinrin-yoku, see

Being in the moment, without thinking of what you have to do next, what you should have done already, or how much more productive you could be, is essential to give your mind a rest.  Mystics throughout the ages have known that meditating, being still, listening without speaking, and walking and absorbing nature through all our senses promotes a sense of calm and has healing properties.

Fortunately, we live in an area with many opportunities to be at one with nature. There are walking trails from easy to challenging, all within an hour’s drive of Boston. Here are some places to get you started on your walk through the woods:

Try World’s End in Hingham, Blue Hills reservation which offers 125 miles of trails and scenic views from the top, Mount Misery in Lincoln (nothing like its name), Noanet Woods in Dover, and Medford’s Middlesex Fells Reservation which are all no more than half an hour to 45 minutes away. If you’re pressed for time, try a walk around Lake Waban at Wellesley College, Cold Springs Park in Newton, or the Weston Reservoir- all within 15 minutes of here.

Ready, set, bath time !

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Here’s to the bounty of the season- fresh picks that are delicious and nutritious


I love summer for so many reasons, one of which is the great fruits and vegetables that are garden fresh. There is so much produce that is harvested during this time of year. Following is some important information about the health of the following superfoods and recipes you can try.

There’s nothing like watermelon to quench your thirst, and give you the needed hydration for those hot days of summer. In addition, watermelon is full of vitamins A, B6, C, lycopene, antioxidants and minerals.  There’s also evidence that watermelon helps with cardiovascular health, and has a protective effect against strokes, because of its extremely high levels of lycopene.  See  for the full study.  Lycopene, which is also found in tomatoes, helps reduce cholesterol, relaxes blood vessel walls, and protects the skin from UV rays among other benefits.  I love making watermelon, mint and feta salad in the summer. Here’s a quick and easy recipe that’s healthy and satisfying from Tory Avey’s kitchen. You can also add arugula to round out the taste.


  • 1 7-8 lb. seedless watermelon, chilled
  • 1/2 cup extra virgin olive oil
  • 3 limes, juiced
  • 1 1/2 tsp salt
  • 3/4 tsp black pepper
  • 1 cup fresh chopped mint leaves
  • 1 1/2 cups crumbled feta cheese (goat or sheep milk feta is best) 
Total Time: 20 Minutes

Servings: 8 servings

See the full post:

Cherries from Oregon and Washington state are also in season.  There’s lots of varieties from tart to sweet, although the tart kind have been found to have the most benefits. Cherries have recently been identified as a superfood, due to their high level of anti-oxidants such as super-nutrients quercetin, hydroxycinnamates, potassium, carotenoids and melatonin. These have been found to have substantial anti-inflammatory properties, and in some experiments have been shown to be as effective as ibuprofen and tylenol in decreasing pain.  In a randomized, double blind trial of runners, some of whom were ingesting cherry juice for the 7 days prior and right after a running event, the runners who drank cherry juice reported significantly lower pain. For the full study, see / It’s also been shown to help gout, arthritis pain, and autoimmune diseases.

Artichokes are great to add to salads, and also pack a major nutrient punch. They are contain two natural chemicals cynarin, and silymarin, which aid in detoxifying the liver, stimulating the kidneys, and increasing the flow of bile. They are also jam-packed with iron, and essential minerals like manganese, copper, calcium and phosphorus. These minerals help build red blood cells, optimize fluid balance, and control heart rate and blood pressure. Vitamin K and B complex vitamins contained in artichokes help in bone, brain and skin health.

Debby Doktor’s luscious artichokes:

1.   Using a jar of Trader Joe’s whole artichokes, drain the artichokes ( in a colander)  & lightly rinse with cold water.
2.  Gently squeeze to release excess water.
3.  Slice each artichoke in half vertically & place cut side down on paper towels.  Cover top with more paper towels & press down lightly – or use dish towels.  Let rest until artichokes are free of moisture.
4.  Heat a heavy large skillet with Evoo to coat the bottom of the pan completely on medium-high heat.
5.  When the oil is hot, add the artichokes, one piece at a time, cut side down & not touching.  Sauté until nicely “grilled” & then turn carefully to “grill” the other side.
6. Place on a serving platter, cut side up.  Drizzle with the warm oil from the pan and/or with additional Evoo of your choice(I used Meyer lemon olive oil.  Sometimes I use Spanish or Greek Evoo).  Sprinkle with finely diced fresh herbs (I used Italian parsley, basil, lemon thyme, & oregano) & a sprinkling of smoked paprika.
7.  Serve warm or at room temp.

Last but not least, beets are one of nature’s most perfect foods. They are low in calories, high in fiber and phytonutrients, have loads of Vitamin C, (a powerful anti-inflammatory and immune-system booster), iron, manganese and potassium. Beets (also known as beetroot)  help blood flow, may reduce blood pressure, and help build lean muscle mass. They are versatile and have a long shelf life, but are best used when fresh picked.  Beet greens are also rich in vitamins and minerals. You can substitute beet greens for kale and spinach in salads, soups or smoothies. Here’s a great recipe for lunch for a beet and hummus wrap, along with one of my personal favorites, beet dip with yogurt. 





Hummus Beet Wrap


1 Tbsp. Hummus
1 6-inch Sprouted Grain Tortilla (Gluten Free available )
½ c. (75g) Peeled and Grated Beet (TIP: Cut beet into 3 or 4 big chunks and grate using thegrating disk for a food processor or large holes of box grater.)
2 tbsp. Feta (½ oz.)(15g)
¼ Packed c. (5g) Arugula, roughly chopped


Spread hummus on tortilla, leaving a 1 ½ inch(4cm) border. Sprinkle evenly with beets, feta, and
arugula. To roll up, fold in 2 opposite sides of tortilla and roll, starting with the end closet to you.
Slice each wrap in half on the diagonal. Wrap each wrap tightly in foil or parchment paper and
refrigerate in an airtight container or zip-top bag. (Make Ahead: May be made up to 1 day in

Beet dip with yogurt from the Jerusalem cook book:

900g  (2 medium beets
2 garlic cloves, crushed
1 small red chilli, deseeded and finely chopped
250g  (1 cup) Greek yoghurt
1 1/2 tbsp date molasses or date syrup
3 tbsp olive oil, plus extra to finish the dish
1 tbsp za’atar

To garnish:
2 spring onions (scallions) , thinly sliced
15g  (3 tbs) toasted hazelnuts, roughly crushed
60g (1/3 cup) soft goat’s cheese, crumbled

Summer is a great time to experiment with different salads, wraps, and simple vegetable preparations using olive oil, lime juice or lemon juice. Fruits with high levels of water help with hydration, while providing loads of essential vitamins and minerals. Eating these superfoods is a form of multi-tasking!  You get high doses of anti-oxidants, which contain important nutrients that strengthen your immune system, control caloric intake while feeling satiated, and aid in the health of your organs and cardiovascular systems.

Bon appetit – your body will thank you!


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Don’t sweat it- on second thought, it’s good for you!



I’m often asked by clients, “Why am I sweating so much, or is my lack of sweating a sign that I’m not working out hard enough? ”  Many factors contribute to excessive sweating, but reasons for profuse sweating, or not sweating enough, differ.

Our body’s built-in mechanism of sweating is an excellent thermo-regulator.  As our core temperatures increases with activity, sweating serves a cooling function as the sweat evaporates.

People have varying numbers and size of sweat glands, which accounts for some people being prodigious sweaters, and others not sweating much at all.

For the full article, go to

For example, an overweight, unfit person may sweat a lot because their body is working hard to manage the exercise. On the other hand, a well trained athlete may sweat early and profusely through a workout because their sweat response is well conditioned, and their system is better acclimated toward maintaining a comfortable temperature during exertion. Note that humidity curtails the cooling effect of sweating, since the air contains too much moisture for efficient evaporation.

The amount you sweat has a lot to do with several factors:

  • age
  • the size of your sweat glands  – we’re all different.
  • how well hydrated you are. Watch this closely in high heat and read on for more specifics.
  • how well acclimated you are to exercise. The better acclimated you are , the more efficient a sweater you’re likely to be.
  • how intensive your workout is, or how much heavier it is than your normal workout. Sweating may not always be a good barometer of how hard you’re working. In cooler temperatures, we can go for longer and harder, as our bodies don’t have to work as hard to maintain a comfortable core temperature.
  • your body fat percentage- Heavier people will sweat more than lean people.

What are some ways to stay cool while exercising outside in the brutally hot and humid weather? Here are some tips as we go through the dog days of summer:

First and foremost, stay hydrated. We’ve all heard this before, but how much fluid is enough?  At least 16 ounces for each hour of exercise is a good rule of thumb, but for very hot weather, add another 8 ounces to the mix. Also, we lose a lot of sodium when we sweat, so you must add electrolytes to your drink if  you’ll be outside for more than half an hour.  Although many sports drinks like Gatorade or Powerade contain a lot of sugar, they do provide needed electrolytes. There are others that contain much less sugar, but still provide what’s needed. Fruit or vegetable juice is another good option. Eating things high in salt content, like pickles or nuts,  will provide you with the essentials.

Other important ways to stay safe and cool while exercising in the hot weather follow:

  • Wear light-colored and moisture-wicking clothing.
  • Avoid direct sunlight; try to find shadier areas as temperatures can vary as much as 10-15 degrees from sun to shade.
  • Hydrate before, during and after your workout with fluids as above.
  • After your workout, be sure to refuel with foods or drinks with potassium, sodium and magnesium.
  • Monitor how your body (heart rate, muscle function, sweating) is responding to the heat. Today on my 30 mile bike ride, I went slower than usual, as I could feel I was working harder in the heat and humidity.  If you experience cramps, dizziness or lightheadedness, this is your sign to stop, take it easier and rehydrate or take a break.
  • Avoid the most intense heat of the day, which is between 11-3:30. Most of us do best in the earlier morning before we’re tired, and before many of the day’s activities divert us from exercise.
  • Be sure to wear sunscreen to avoid the effects of sunburn. Wear a hat and sunglasses to keep your head cooler and eyes protected.
  • Wet a towel, and wear it around your neck to stay cool. When your neck is cool, your whole body will stay more comfortable.
  • Check your weather app on your phone or website on your computer to see the safety index for exercising. On wunderground, you can see how good the weather is for various activities. For example,  since I set it for biking,  it will tell me the temperature, wind speed, chance of precipitation and humidity.  It can also be set for air quality alerts.

So, there you have it. You can enjoy being outside while still getting all the benefits of exercise, as long as you pay attention to what your body is telling you. If the mercury exceeds what’s comfortable for you,  there’s always the air-conditioning of your home or gym as a back-up.

Welcome to summer, and happy July 4th to all !

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Staying safe during tick season

This is my favorite time of year to be outside. But alas, there’s a record number of tick-borne illnesses that are being reported and treated. It’s a good thing that there are precautions that can keep us safe, despite the annoyance of the extra preparation before venturing out in the woods.

The wetter winter and spring has produced a bumper crop of ticks from larvae that were not killed off during a winter that was fairly mild, with long stretches of warmer than usual weather.  Scientists are blaming climate change, as larger stretches of the U.S. population are experiencing tick-borne illnesses that were once confined to specific regions.  For example, Rocky Mountain Fever, named because it was first diagnosed in Montana, is now being seen in the Midwest and even in southern climes. Lyme disease, which earned its name from Lyme, Connecticut, and was seen mostly in New England states, is now commonly seen in most parts of the U.S. One cattle rancher in Florida reported that 20% of his cattle was afflicted by tick borne diseases.

Many of us have memories of jumping in leaves, rolling down hills in the grass, playing in the woods and climbing trees. These days, forewarned is forearmed, as we need protection from potentially serious illnesses before we come in close contact with forests, mountains, bushes and meadows.

Ticks don’t jump, fly, or drop from trees. The only way that ticks transfer to humans is by direct contact with shrubs, trees, and tall grasses.  Dogs often get ticks, and although dogs can’t catch Lyme disease, they can transmit it. Tick collars are minimally useful; one should check his/her dog after every walk outside to make sure your home and body remain tick free.

Most of us know about the bullseye shaped rash that is a hallmark of Lyme disease. But only 70% of people who contract this have the telltale skin rash. If it goes undiagnosed, serious joint, muscle and even cognitive symptoms may result. The best treatment is early detection and strong antibiotics.

Lyme isn’t the only, nor the most serious disease that ticks may carry. Powassan is a rarer strain of virus that has even more damaging effects. Thirteen people have been diagnosed with Powassan in our state since 2014, with 3 fatalities. This disease can cause encephalitis, and has a 10-15% mortality rate.  Although the initial symptoms like headache, vomiting, high fever, confusion, loss of coordination and speech difficulties are very serious, people can recover, but it’s essential to get medical treatment as early as possible.  Other common viruses carried by ticks are babesiosis, ehrlichiosis, Rocky Mountain Spotted Fever, anaplasmosis, Southern Tick-Associated Rash Illness, Tick-Borne Relapsing Fever, and tularemia.

Babesiosis is a tick-borne illness that was originally seen only in cattle, but now also has been diagnosed in humans. Symptoms are more vague than that of other illnesses, and malaise and intermittent fevers may go on for months before a diagnosis is made. Long courses of antibiotics is the antidote, but the sooner it is detected, the better the prognosis.

Anaplasmosis is another strain of virus that has similar symptoms of fever, headache and general arthralgias and fatigue. Suffice to say early treatment is essential, as this global virus can has serious long term effects. For more information about tick-borne illnesses, see

So what can you do to enjoy the great outdoors but protect yourself at the same time?

Here are the experts’ suggestions:


  • DEET is the most effective mosquito and tick repellent, and strengths between 20-50% are ideal for any exposed skin when walking outside in leafy areas. For a handy guide to the best tick repellents, see
  • Use Permethrin, which is a spray for your clothing that lasts through 6 washings. This formula actually kills ticks, rather than just repelling them, and has proven to be very effective.
  • Cover your arms and legs, and particularly your lower body, or body parts that come into contact with brush, bushes, grasses and leaves.
  • Do a very thorough tick check after being outside and be sure to check all the crevices, as ticks like warm, moist areas.  The groin, armpits and scalp, the back of knees, behind the ears and around the waist are common areas for ticks to attach.
  • You may not feel a tick bite, since they are very small, with the larvae being about the size of pinpoint, the nymphs the size of a period, and the adults the size of an apple seed.
  • Be sure to check your hair, as they often will try to migrate to the scalp.
  • Take a hot shower right after being outside, which should kill any ticks that may be on you. Ticks take up to 36 hours to attach and begin to suck blood, so they can be easily taken off before they latch on.
  • Wash your clothing and put it in the dryer for at least 10 minutes to be sure that all ticks are killed.
  • If you find a tick on you, the best way to remove it is to get fine pointed tweezers, grab the tick as close to the skin as you can, and pull gently and firmly straight up. You should  keep the tick and bring it to the doctor for identification if you think you’ve been infected.
  • If you’ve found a tick on your body, tune in closely to any changes in your health. Lyme disease takes 24-36 hours to show symptoms, but Powassan takes only 15 minutes.
  • Get immediate medical help if you suspect you have been infected and have any symptoms including but not limited to:
  1. a red spot or rash near the bite site
  2. a full body rash
  3. neck stiffness
  4. a headache
  5. nausea and/or vomiting
  6. weakness
  7. muscle or joint pain or achiness
  8. a fever
  9. confusion or any change in your cognition

One piece of promising news is that there  is a vaccine in development that is slated to be widely available by 2018. Researchers are hoping that this public health approach will go a long way toward preventing these potentially deadly viruses.

So, suit up, spray yourself and your clothing, and check yourself and your dog after walks for these tiny but outsize threats. Then you can still enjoy the wonders of the season!