Today is the day! April 7th: National Start! Walking Day!!!!!

Wherever you are, sometime before the clock strikes midnight, get out and walk for  thirty minutes today - even twenty minutes if it comes down to squeezing it in while you're at work (on your morning or afternoon break?!).  Start walking for a healthier lifestyle (yup, I stole that last phrase from the American Heart Association website, but it's soooo true and simple).  You have to make the time for yourself.  Your well-being and health are priceless; you'll even feel a little less stressful after going for a thirty minute walk (I can pretty much guarantee it).  The American Heart Association even has a nifty online tracker, if you're like me, and prefer to see your progress in the days and months to come.  There is no time like the present!  I'll be doing the same thing today - I confess, I've slacked off ;-)  Begin the change today.  

More Reasons To Walk, Not Only For Your Heart, But For Your Brain! From HealthDay News

With the American Heart Association's (AHA) National Start! Walking Day fast approaching this Wednesday (just two days away!), read the article below to learn about another great reason to start walking regularly.   Participate in National Start! Walking Day wherever you are this April 7th!  Check out the details here.  When it really comes down to it, all you need is yourself, 30 minutes and a pair of comfortable shoes!!! 

Exercise May Stave Off Mental Decline

Monday,January 11, 2010 (Healthday News)

FRIDAY, Jan. 8 (HealthDay News) -- Exercise appears to help prevent and improve mild cognitive impairment, two new studies show.

Researchers found that people who did moderate physical activity in midlife or later had a reduced risk of mild cognitive impairment and that six months of high-intensity aerobic exercise improved cognitive function in people with mild cognitive impairment.

Mild cognitive impairment is an in-between state between the normal changes in thinking, learning and memory changes that come with age and dementia, one of the studies explained. Up to 15 percent of people with mild cognitive impairment develop dementia each year, compared with 1 percent or 2 percent of the general population.

The first study included 1,324 dementia-free volunteers taking part in the Mayo Clinic Study of Aging. The participants completed a physical exercise questionnaire and were assessed and classified as having normal cognition (1,126) or mild cognitive impairment (198).

Those who said they did moderate exercise -- such as swimming, brisk walking, yoga, aerobics or strength training -- during midlife were 39 percent less likely to have mild cognitive impairment, while those who did moderate exercise later in life were 32 percent less likely to have the condition.

The Mayo team said exercise may guard against mild cognitive impairment through production of nerve-protecting compounds, increased blood flow to the brain, improved development and survival of neurons, and decreased risk of heart and blood vessel diseases.

The second study included 33 adults, average age 70, with mild cognitive impairment. Some were randomly assigned to do high-intensity aerobics for 45 to 60 minutes a day, four days a week. Others were put in a control group that had the same workout schedule, but did stretching exercises and kept their heart rate low.

After six months, the patients who did high-intensity aerobic exercise had improved cognitive function compared to those in the control group. The beneficial effects were more pronounced in women than in men, possibly because the body's use of and production of insulin, glucose and the stress hormone cortisol differed in women and men.

"Aerobic exercise is a cost-effective practice that is associated with numerous physical benefits. The results of this study suggest that exercise also provides a cognitive benefit for some adults with mild cognitive impairment," wrote Laura D. Baker, of the University of Washington School of Medicine and Veterans Affairs Puget Sound Health Care System in Seattle, and colleagues.

The studies appear in the January issue of the Archives of Neurology.

More information

The Alzheimer's Association has more about mild cognitive impairment.

cardiologist appt

went very well all things considered!

Geography of the Vote (link to map) Patient Protection and Affordable Care Act

House Vote 163 - On Agreeing to the Resolution Providing for consideration of the Senate Amendments to H.R. 3590 , Patient Protection and Affordable Care Act, and providing for the consideration of the bill H.R. 4872, Reconciliation Act of 2010. On Agreeing to the Resolution Other Recent Votes MARCH 21, 2010 H.RES.925: On Motion to Suspend the Rules and Agree, as Amended Expressing the sense of the House of Representatives regarding the meritorio... MARCH 21, 2010 On Agreeing to the Resolution: Providing for consideration of the Senate Amendments to H.R. 3590 , Patient ... MARCH 21, 2010 On Ordering the Previous Question: Providing for consideration of the Senate Amendments to H.R. 3590 , Patient ... MARCH 21, 2010 H.RES.900: On Motion to Suspend the Rules and Agree, as Amended Supporting the goals and ideals of a Cold War Veterans Recognition Day to ho... MARCH 21, 2010 Will the House Now Consider the Resolution: Providing for consideration of the Senate Amendments to H.R. 3590 , Patient ... Result: Passed by 18 votes Date of Vote: March 21, 2010 Roll Call Number: 163 Related Story: House Clears Path for Final Health Vote Geography of the Vote Complete Roll Call Yes Votes (224) Member Party Dist. Gary L. Ackerman D N.Y.-5 Jason Altmire D Pa.-4 Robert E. Andrews D N.J.-1 Joe Baca D Calif.-43 Brian Baird D Wash.-3 Tammy Baldwin D Wis.-2 Melissa Bean D Ill.-8 Xavier Becerra D Calif.-31 Shelley Berkley D Nev.-1 Howard L. Berman D Calif.-28 Marion Berry D Ark.-1 Timothy H. Bishop D N.Y.-1 Sanford D. Bishop Jr. D Ga.-2 Earl Blumenauer D Ore.-3 John Boccieri D Ohio-16 Leonard L. Boswell D Iowa-3 Allen Boyd D Fla.-2 Robert A. Brady D Pa.-1 Bruce Braley D Iowa-1 Corrine Brown D Fla.-3 G. K. Butterfield D N.C.-1 Lois Capps D Calif.-23 Michael E. Capuano D Mass.-8 Dennis Cardoza D Calif.-18 Russ Carnahan D Mo.-3 Christopher Carney D Pa.-10 André Carson D Ind.-7 Kathy Castor D Fla.-11 Judy Chu D Calif.-32 Yvette Clarke D N.Y.-11 William Lacy Clay D Mo.-1 Emanuel Cleaver II D Mo.-5 James E. Clyburn D S.C.-6 Steve Cohen D Tenn.-9 Gerald E. Connolly D Va.-11 John Conyers Jr. D Mich.-14 Jim Cooper D Tenn.-5 Jim Costa D Calif.-20 Jerry F. Costello D Ill.-12 Joe Courtney D Conn.-2 Joseph Crowley D N.Y.-7 Henry Cuellar D Tex.-28 Elijah E. Cummings D Md.-7 Kathy Dahlkemper D Pa.-3 Danny K. Davis D Ill.-7 Susan A. Davis D Calif.-53 Peter A. DeFazio D Ore.-4 Diana DeGette D Colo.-1 Bill Delahunt D Mass.-10 Rosa DeLauro D Conn.-3 Norman D. Dicks D Wash.-6 John D. Dingell D Mich.-15 Lloyd Doggett D Tex.-25 Joe Donnelly D Ind.-2 Mike Doyle D Pa.-14 Steve Driehaus D Ohio-1 Donna Edwards D Md.-4 Keith Ellison D Minn.-5 Brad Ellsworth D Ind.-8 Eliot L. Engel D N.Y.-17 Anna G. Eshoo D Calif.-14 Bob Etheridge D N.C.-2 Sam Farr D Calif.-17 Chaka Fattah D Pa.-2 Bob Filner D Calif.-51 Bill Foster D Ill.-14 Barney Frank D Mass.-4 Marcia L. Fudge D Ohio-11 John Garamendi D Calif.-10 Gabrielle Giffords D Ariz.-8 Charlie Gonzalez D Tex.-20 Bart Gordon D Tenn.-6 Alan Grayson D Fla.-8 Al Green D Tex.-9 Gene Green D Tex.-29 Raúl M. Grijalva D Ariz.-7 Luis V. Gutierrez D Ill.-4 John Hall D N.Y.-19 Debbie Halvorson D Ill.-11 Phil Hare D Ill.-17 Jane Harman D Calif.-36 Alcee L. Hastings D Fla.-23 Martin Heinrich D N.M.-1 Brian Higgins D N.Y.-27 Baron P. Hill D Ind.-9 Jim Himes D Conn.-4 Maurice D. Hinchey D N.Y.-22 Rubén Hinojosa D Tex.-15 Mazie K. Hirono D Hawaii-2 Paul W. Hodes D N.H.-2 Rush Holt D N.J.-12 Michael M. Honda D Calif.-15 Steny H. Hoyer D Md.-5 Jay Inslee D Wash.-1 Steve Israel D N.Y.-2 Jesse L. Jackson Jr. D Ill.-2 Sheila Jackson-Lee D Tex.-18 Eddie Bernice Johnson D Tex.-30 Hank Johnson D Ga.-4 Steve Kagen D Wis.-8 Paul E. Kanjorski D Pa.-11 Marcy Kaptur D Ohio-9 Patrick J. Kennedy D R.I.-1 Dale E. Kildee D Mich.-5 Carolyn Cheeks Kilpatrick D Mich.-13 Mary Jo Kilroy D Ohio-15 Ron Kind D Wis.-3 Ann Kirkpatrick D Ariz.-1 Larry Kissell D N.C.-8 Ron Klein D Fla.-22 Suzanne Kosmas D Fla.-24 Dennis J. Kucinich D Ohio-10 Jim Langevin D R.I.-2 Rick Larsen D Wash.-2 John B. Larson D Conn.-1 Barbara Lee D Calif.-9 Sander M. Levin D Mich.-12 John Lewis D Ga.-5 Dave Loebsack D Iowa-2 Zoe Lofgren D Calif.-16 Nita M. Lowey D N.Y.-18 Ben Ray Lujan D N.M.-3 Dan Maffei D N.Y.-25 Carolyn B. Maloney D N.Y.-14 Betsy Markey D Colo.-4 Edward J. Markey D Mass.-7 Doris Matsui D Calif.-5 Carolyn McCarthy D N.Y.-4 Betty McCollum D Minn.-4 Jim McDermott D Wash.-7 Jim McGovern D Mass.-3 Michael E. McMahon D N.Y.-13 Jerry McNerney D Calif.-11 Kendrick B. Meek D Fla.-17 Gregory W. Meeks D N.Y.-6 Michael H. Michaud D Me.-2 Brad Miller D N.C.-13 George Miller D Calif.-7 Alan B. Mollohan D W.Va.-1 Dennis Moore D Kan.-3 Gwen Moore D Wis.-4 James P. Moran D Va.-8 Christopher S. Murphy D Conn.-5 Patrick J. Murphy D Pa.-8 Scott Murphy D N.Y.-20 Jerrold Nadler D N.Y.-8 Grace F. Napolitano D Calif.-38 Richard E. Neal D Mass.-2 James L. Oberstar D Minn.-8 David R. Obey D Wis.-7 John W. Olver D Mass.-1 Solomon P. Ortiz D Tex.-27 Bill Owens D N.Y.-23 Frank Pallone D N.J.-6 Bill Pascrell Jr. D N.J.-8 Ed Pastor D Ariz.-4 Donald M. Payne D N.J.-10 Ed Perlmutter D Colo.-7 Tom Perriello D Va.-5 Gary Peters D Mich.-9 Collin C. Peterson D Minn.-7 Chellie Pingree D Me.-1 Jared Polis D Colo.-2 Earl Pomeroy D N.D.-1 David E. Price D N.C.-4 Mike Quigley D Ill.-5 Nick J. Rahall II D W.Va.-3 Charles B. Rangel D N.Y.-15 Silvestre Reyes D Tex.-16 Laura Richardson D Calif.-37 Ciro D. Rodriguez D Tex.-23 Steven R. Rothman D N.J.-9 Lucille Roybal-Allard D Calif.-34 C.A. Dutch Ruppersberger D Md.-2 Bobby L. Rush D Ill.-1 Tim Ryan D Ohio-17 John Salazar D Colo.-3 Linda T. Sanchez D Calif.-39 Loretta Sanchez D Calif.-47 John Sarbanes D Md.-3 Jan Schakowsky D Ill.-9 Mark Schauer D Mich.-7 Adam B. Schiff D Calif.-29 Kurt Schrader D Ore.-5 Allyson Y. Schwartz D Pa.-13 David Scott D Ga.-13 Robert C. Scott D Va.-3 José E. Serrano D N.Y.-16 Joe Sestak D Pa.-7 Carol Shea-Porter D N.H.-1 Brad Sherman D Calif.-27 Albio Sires D N.J.-13 Louise M. Slaughter D N.Y.-28 Adam Smith D Wash.-9 Vic Snyder D Ark.-2 Jackie Speier D Calif.-12 John M. Spratt Jr. D S.C.-5 Pete Stark D Calif.-13 Bart Stupak D Mich.-1 Betty Sutton D Ohio-13 John Tanner D Tenn.-8 Harry Teague D N.M.-2 Bennie Thompson D Miss.-2 Mike Thompson D Calif.-1 John F. Tierney D Mass.-6 Dina Titus D Nev.-3 Paul Tonko D N.Y.-21 Edolphus Towns D N.Y.-10 Niki Tsongas D Mass.-5 Chris Van Hollen D Md.-8 Nydia M. Velázquez D N.Y.-12 Peter J. Visclosky D Ind.-1 Tim Walz D Minn.-1 Debbie Wasserman Schultz D Fla.-20 Maxine Waters D Calif.-35 Diane Watson D Calif.-33 Melvin Watt D N.C.-12 Henry A. Waxman D Calif.-30 Anthony Weiner D N.Y.-9 Peter Welch D Vt.-1 Charlie Wilson D Ohio-6 Lynn Woolsey D Calif.-6 David Wu D Ore.-1 John Yarmuth D Ky.-3 No Votes (206) Member Party Dist. Robert B. Aderholt R Ala.-4 John Adler D N.J.-3 Todd Akin R Mo.-2 Rodney Alexander R La.-5 Michael Arcuri D N.Y.-24 Steve Austria R Ohio-7 Michele Bachmann R Minn.-6 Spencer Bachus R Ala.-6 J. Gresham Barrett R S.C.-3 John Barrow D Ga.-12 Roscoe G. Bartlett R Md.-6 Joe L. Barton R Tex.-6 Judy Biggert R Ill.-13 Brian P. Bilbray R Calif.-50 Gus Bilirakis R Fla.-9 Rob Bishop R Utah-1 Marsha Blackburn R Tenn.-7 Roy Blunt R Mo.-7 John A. Boehner R Ohio-8 Jo Bonner R Ala.-1 Mary Bono Mack R Calif.-45 John Boozman R Ark.-3 Dan Boren D Okla.-2 Rick Boucher D Va.-9 Charles Boustany Jr. R La.-7 Kevin Brady R Tex.-8 Bobby Bright D Ala.-2 Paul Broun R Ga.-10 Henry E. Brown Jr. R S.C.-1 Ginny Brown-Waite R Fla.-5 Vern Buchanan R Fla.-13 Michael C. Burgess R Tex.-26 Dan Burton R Ind.-5 Steve Buyer R Ind.-4 Ken Calvert R Calif.-44 Dave Camp R Mich.-4 John Campbell R Calif.-48 Eric Cantor R Va.-7 Anh Cao R La.-2 Shelley Moore Capito R W.Va.-2 John Carter R Tex.-31 Bill Cassidy R La.-6 Michael N. Castle R Del.-1 Jason Chaffetz R Utah-3 Ben Chandler D Ky.-6 Travis Childers D Miss.-1 Howard Coble R N.C.-6 Mike Coffman R Colo.-6 Tom Cole R Okla.-4 K. Michael Conaway R Tex.-11 Ander Crenshaw R Fla.-4 John Culberson R Tex.-7 Artur Davis D Ala.-7 Geoff Davis R Ky.-4 Lincoln Davis D Tenn.-4 Charlie Dent R Pa.-15 Lincoln Diaz-Balart R Fla.-21 Mario Diaz-Balart R Fla.-25 David Dreier R Calif.-26 John J. Duncan Jr. R Tenn.-2 Chet Edwards D Tex.-17 Vernon J. Ehlers R Mich.-3 Jo Ann Emerson R Mo.-8 Mary Fallin R Okla.-5 Jeff Flake R Ariz.-6 John Fleming R La.-4 J. Randy Forbes R Va.-4 Jeff Fortenberry R Neb.-1 Virginia Foxx R N.C.-5 Trent Franks R Ariz.-2 Rodney Frelinghuysen R N.J.-11 Elton Gallegly R Calif.-24 Scott Garrett R N.J.-5 Jim Gerlach R Pa.-6 Phil Gingrey R Ga.-11 Louie Gohmert R Tex.-1 Robert W. Goodlatte R Va.-6 Kay Granger R Tex.-12 Sam Graves R Mo.-6 Parker Griffith R Ala.-5 Brett Guthrie R Ky.-2 Ralph M. Hall R Tex.-4 Gregg Harper R Miss.-3 Doc Hastings R Wash.-4 Dean Heller R Nev.-2 Jeb Hensarling R Tex.-5 Wally Herger R Calif.-2 Stephanie Herseth Sandlin D S.D.-1 Peter Hoekstra R Mich.-2 Tim Holden D Pa.-17 Duncan D. Hunter R Calif.-52 Bob Inglis R S.C.-4 Darrell Issa R Calif.-49 Lynn Jenkins R Kan.-2 Sam Johnson R Tex.-3 Timothy V. Johnson R Ill.-15 Walter B. Jones R N.C.-3 Jim Jordan R Ohio-4 Peter T. King R N.Y.-3 Steve King R Iowa-5 Jack Kingston R Ga.-1 Mark Steven Kirk R Ill.-10 John Kline R Minn.-2 Frank Kratovil Jr. D Md.-1 Doug Lamborn R Colo.-5 Leonard Lance R N.J.-7 Tom Latham R Iowa-4 Steven C. LaTourette R Ohio-14 Robert E. Latta R Ohio-5 Christopher Lee R N.Y.-26 Jerry Lewis R Calif.-41 John Linder R Ga.-7 Daniel Lipinski D Ill.-3 Frank A. LoBiondo R N.J.-2 Frank D. Lucas R Okla.-3 Blaine Luetkemeyer R Mo.-9 Cynthia M. Lummis R Wyo.-1 Dan Lungren R Calif.-3 Stephen F. Lynch D Mass.-9 Connie Mack R Fla.-14 Donald Manzullo R Ill.-16 Kenny Marchant R Tex.-24 Jim Marshall D Ga.-8 Jim Matheson D Utah-2 Kevin McCarthy R Calif.-22 Michael McCaul R Tex.-10 Tom McClintock R Calif.-4 Thaddeus McCotter R Mich.-11 Patrick T. McHenry R N.C.-10 Mike McIntyre D N.C.-7 Howard P. McKeon R Calif.-25 Cathy McMorris Rodgers R Wash.-5 Charlie Melancon D La.-3 John L. Mica R Fla.-7 Candice S. Miller R Mich.-10 Gary G. Miller R Calif.-42 Jeff Miller R Fla.-1 Walt Minnick D Idaho-1 Harry E. Mitchell D Ariz.-5 Jerry Moran R Kan.-1 Tim Murphy R Pa.-18 Sue Myrick R N.C.-9 Randy Neugebauer R Tex.-19 Devin Nunes R Calif.-21 Glenn Nye D Va.-2 Pete Olson R Tex.-22 Ron Paul R Tex.-14 Erik Paulsen R Minn.-3 Mike Pence R Ind.-6 Tom Petri R Wis.-6 Joe Pitts R Pa.-16 Todd R. Platts R Pa.-19 Ted Poe R Tex.-2 Bill Posey R Fla.-15 Tom Price R Ga.-6 Adam H. Putnam R Fla.-12 George P. Radanovich R Calif.-19 Denny Rehberg R Mont.-1 Dave Reichert R Wash.-8 Phil Roe R Tenn.-1 Harold Rogers R Ky.-5 Mike Rogers R Mich.-8 Mike D. Rogers R Ala.-3 Dana Rohrabacher R Calif.-46 Tom Rooney R Fla.-16 Ileana Ros-Lehtinen R Fla.-18 Peter Roskam R Ill.-6 Mike Ross D Ark.-4 Ed Royce R Calif.-40 Paul D. Ryan R Wis.-1 Steve Scalise R La.-1 Jean Schmidt R Ohio-2 Aaron Schock R Ill.-18 F. James Sensenbrenner R Wis.-5 Pete Sessions R Tex.-32 John Shadegg R Ariz.-3 John Shimkus R Ill.-19 Heath Shuler D N.C.-11 Bill Shuster R Pa.-9 Mike Simpson R Idaho-2 Ike Skelton D Mo.-4 Adrian Smith R Neb.-3 Christopher H. Smith R N.J.-4 Lamar Smith R Tex.-21 Mark Souder R Ind.-3 Zack Space D Ohio-18 Cliff Stearns R Fla.-6 John Sullivan R Okla.-1 Gene Taylor D Miss.-4 Lee Terry R Neb.-2 Glenn Thompson R Pa.-5 William M. Thornberry R Tex.-13 Todd Tiahrt R Kan.-4 Pat Tiberi R Ohio-12 Michael R. Turner R Ohio-3 Fred Upton R Mich.-6 Greg Walden R Ore.-2 Zach Wamp R Tenn.-3 Lynn Westmoreland R Ga.-3 Edward Whitfield R Ky.-1 Joe Wilson R S.C.-2 Robert J. Wittman R Va.-1 Frank R. Wolf R Va.-10 C. W. Bill Young R Fla.-10 Don Young R Alaska-1 Did Not Vote (0) Member Party Dist. Nancy Pelosi D Calif.-8 Present (0) Member Party Dist. From New York Times

Geographic Primary-Stroke-Center Placement

I've noticed several comments from heart attack and/or stroke survivors lately regarding the lack of available facilities where they reside.  The article below (courtesy of International Media News Group http://egmnblog.wordpress.com ) peaked my interest; heck, there is a map included which would explain exactly why survivors are expressing frustration about lack of facilities.  Look at all of the gaping white spaces on the map pictured below - I'm very thankful to the writer, Mitchel Zoler, for making this information available:

The Uncoordinated U.S. Primary Stroke Centers

From the International Stroke Conference in San Antonio

The good news for U.S. stroke patients is that in March 2010, 685 certified primary stroke centers existed in America. The bad news is that no one makes sure they’re optimally placed to maximize coverage of the U.S. population.

The Joint Commission, a U.S. hospital accreditation organization, began certifying primary stroke centers in December 2003. The idea was that these centers would specialize in state-of-the-art stroke care and become the prime locations for acute stroke patients to receive care.

The concept has certainly taken root. According to Dr. Karen C. Albright, a neurologist at the University of California, San Diego, 524 certified American primary stroke centers existed by November 2008, and another 102 came on board during the following year, through late September, 2009. The pace for new center certifications has held steady, with another 59 centers added to the list during a little more than another 5 months.

Stroke patients who live in the white areas have a greater than 60 minute trip to their nearest primary stroke center (photo by Mitchel Zoler).

But according to Dr. Albright, many of the new centers added during Nov. 2008-Sept. 2009 were “in proximity to existing centers.” No person or group controls where new stroke centers open, and they’ve left big gaps of uncovered population. Based on the centers that existed last September, Dr. Albright estimated that roughly 63 million to 135 million Americans lived more than 60 minutes away from the closest primary stroke center (see map). The upper end number, 135 million, applied if all emergency stroke transport was by ambulance. The number fell to 63 million if all centers had helicopter transport available, but that’s a big if because in reality many centers don’t use air transport.

Some excellent models exist for better emergency-care coordination, most notably the way trauma care is integrated and delivered across the U.S., particularly by regional systems like the Southeast Texas Trauma Regional Advisory Council.  Recently, SETTRAC set up regional coordination of emergency stroke care in the Houston area.

Now all that has to happen is for this approach to spread through the rest of Texas, and then the rest of the United States.

—Mitchel Zoler