DEAR DR. DONOHUE: I have started to take a 30-minute walk daily and wonder if hand and ankle weights are safe to use in this situation. Do they add anything to the exercise? – L.L.

ANSWER: I want everyone to know that I don’t have a lot of backup information that supports what I am going to say, so I am happy to revise my opinion if readers provide me with evidence that supports a contrary point of view.

Although ankle weights do increase the calorie cost of walking, they have the potential to not be in the walker’s best interest. They increase the force of the foot striking the ground, and that transmits a more powerful shock wave to the leg and its joints, from ankle to hip.

Furthermore, they can throw off the alignment of the thigh, lower leg and foot so that the footstrike brings additional stress to leg joints. Constantly stressing the joints in this way could lead to their injury.

Handheld weights are a different story. Like ankle weights, they increase the calorie cost of walking, so if calorie burning and weight loss are your goals, they help you meet those goals. Furthermore, handheld weights are less likely to stress joints and cause injuries.

Be aware, however, that the normal, unfettered arm swing that takes place while walking helps lift the body off the ground. Hand weights can negate or attenuate this protective effect.

You can increase the calorie cost of walking by wearing a weighted vest or by strapping on a backpack that contains some weight. If you are going to do so, start out with a modest amount of weight. Three pounds is enough.

Neither a vest nor a backpack alters your normal stride or the way your feet strike the ground, so they are less likely to have a deleterious effect on your joints.

DEAR DR. DONOHUE: I figure that the stronger my grip is on my tennis racket, the more power I will have in my strokes. Can you give me exercises that strengthen wrist muscles? – D.K.

ANSWER: The wrist has no muscles. Muscles that control the wrist and increase grip strength are the forearm muscles. There are lots of forearm muscle exercises. Seated, with arms resting on the thighs, hands projecting past the knees and fingers wrapped over a dumbbell or weight, palm downward, bend the wrist upward as far as possible and then slowly lower it as far as possible. The standard rule of three sets of eight repetitions applies here, with a one- or two-minute rest between sets.

Then reverse your grip on the dumbbell. Wrap the fingers around the underside of the dumbbell with your palm facing upward. Again, bend the wrists slowly upward and downward. Do three sets of eight repetitions in this position.

I don’t know if your theory is correct. I have read that a strong grip contributes to baseball bat velocity and hitting distance and power. Perhaps this transfers to hitting a tennis ball. I await your report.

DEAR DR. DONOHUE: Is it safe for a middle-aged man – 53 – to lift weights? I have no heart or blood pressure problems, and I have a yearly physical, which I always pass with flying colors. However, I have heard that weightlifting raises blood pressure. Is that so? – K.J.

ANSWER: Excessive straining to lift prodigious amounts of weight transiently raises blood pressure to possibly dangerous levels. Lifters in training for Olympic events have gotten into trouble when lifting extremely heavy weights. A few lifters have raised their blood pressure to such heights that they brought about a split in their aorta. That’s an uncommon complication, and it’s not one you are likely to face unless you try herculean lifts and unless you have not gotten a go-ahead for a lifting program from your doctor.

DEAR DR. DONOHUE: My mother, 92, has Alzheimer’s disease. She doesn’t recognize me or my brothers and sisters, and she doesn’t know where she is. It has been a terrible ordeal for her, and we wonder how much longer she will have to put up with this. Are there any new breakthroughs in Alzheimer’s treatment? – R.C.

ANSWER: From the time they are diagnosed until the time of death, men who have Alzheimer’s live an average of 4.2 years. With women it is 5.7 years. Those statistics are rough estimates. Some Alzheimer’s patients last 10 or more years, and some die much more rapidly.

The severity of mental impairment is a factor that shortens life span. Another factor that has some predictive value in estimating the time of death is the difficulty a patient has in walking. Frequent falls are also a sign of shortened life expectancy.

There are no miracle breakthroughs in treatment. Namenda, however, is a new medicine that appears to make an appreciable difference in an Alzheimer’s patient’s ability to remember and reason. Sometimes this medicine is used in combination with one of the older Alzheimer’s medications – Aricept, for example.

The Alzheimer’s pamphlet gives a succinct summary of this illness and its treatments. Readers can order a copy by writing to: Dr. Donohue – No. 903, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I am 72 years old, and I take a multivitamin and calcium. I also take hydrochlorothiazide (HydroDIURIL) for blood pressure. It makes me urinate often. Am I flushing out the vitamins and the calcium with this medicine? – A.N.

ANSWER: You are not flushing out the vitamins or the calcium by taking a diuretic (a water pill). Diuretics are often the first treatment doctors prescribe for blood pressure control. The increased urine production has no effect on the absorption or utilization of vitamins and minerals. The only mineral that bears watching with your medicine is potassium. Its blood level can fall because the drug pushes potassium into the urine with the excess water it takes from the body.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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