Geisinger Discusses Isometric Exercise

By: Geisinger, interventional cardiologist, Sandy Green, MD

Exercises to combat high blood pressure
New evidence points to wall sits, planks and other isometric exercises as the most effective at lowering high blood pressure.

Movement is the key to combating hypertension, right? Not so fast.

It’s long been thought that aerobic exercise — think brisk walking, running and cycling — strengthens your heart and reduces blood pressure. And that’s true. But new evidence shows wall sits, planks and other isometric or static exercises are more effective at lowering high blood pressure.

While research shows all forms of exercise are good for your heart, isometric training is a promising exercise mode for people with high blood pressure. The good news is isometric exercises also bolster joint stability, promote better posture and can be beneficial for preventing injuries and aiding in rehabilitation.

What is isometric exercise?

Isometric exercise is a low-intensity form of strength training where you contract or tighten a muscle group and then hold still — without any joint movement.

While holding in a static position, the exercise relies on your body’s weight to help maintain strength and stabilize your joints and core.

Isometric exercise is convenient, can be done in just a few minutes and doesn’t require any equipment and you can perform it easily at home or in the office during breaks.

Why are isometric holds the best exercise to lower blood pressure?

A study published in the fall of 2023 in the British Journal of Sports Medicine revealed that while most types of exercise helped lower blood pressure, isometric training was the most effective at lowering both systolic and diastolic blood pressure — especially in people with high blood pressure.

When doing a plank or other isometric hold, your muscles contract and generate tension. That makes your blood vessels constrict, causing more demand for oxygen and nutrients. Decreased blood flow stimulates the production of nitric oxide, which dilates blood vessels to improve blood flow and supply these required resources. As a result, more blood can flow through the blood vessels and blood pressure is reduced.

Strength training also engages the muscles and constricts blood vessels, but not for an extended time. When you do a bicep curl, you don’t hold it for several minutes. You lift it quickly and go back down, so you’re not getting the decreased blood flow to the area and increased production of nitric oxide from holding the position.

An isometric hold also increases your heart rate and cardiac output to supply more oxygen to your muscles. Over time, this strengthens and conditions your heart to pump blood more efficiently and reduces stress on blood vessels, leading to lower blood pressure.

What are isometric exercise examples?

While all isometric exercises can contribute to lowering blood pressure, some are more effective than others. In the study, researchers studied three isometric exercise examples in particular: squeezing a handgrip, leg extensions and wall sits, also called wall squats. The wall sits were found to be the most effective isometric exercise of them all.

To do a wall sit, position yourself with your back against a wall and slide down until your knees are bent at a 90-degree angle. Hold this position for 20 seconds or more. The wall sit primarily focuses on your quadriceps and glutes. The optimal isometric exercises for lowering blood pressure are those that engage multiple muscle groups and increase your heart rate.

The study found doing four sets of two minutes each with a rest period in between, three to four days a week, yields maximum benefits. Other isometric exercise examples include:

  • Plank, side plank and reverse plank
  • Glute bridge
  • Dead hang from a pull-up bar
  • Static lunge
  • V-sit
  • Standing wall push-ups
  • Calf raise and hold
  • Tricep dip and hold
  • Bicep curl and hold
  • Overhead hold
  • Kettle ball hold in front of you

When doing any isometric hold, breathe slowly and regularly to make sure your muscles get plenty of oxygen. You can start by holding the position for 20 seconds and slowly working your way up to holding it for two minutes. Just be sure to talk with your doctor before starting any new exercise routine.

Adding isometric holds as “exercise snacks”

There is increasing evidence that points to the health benefits of “exercise snacks,” short bursts of vigorous activity spread throughout the day. If you struggle to find 30 minutes to work out each day, these two-minute or so “snacks” can quickly add up to help you meet your daily fitness goals.

Incorporating exercise snacks into your daily routine is a great way to vary your workouts. For office workers, this is an easy way to get in exercise snacks throughout the day and positively impact blood pressure.

So do wall sits between phone calls, hold a plank if you’ve been sitting too long or grip a stress ball before heading to a meeting.

It breaks up your day at the office and can get you up and out of your chair even if you do it three or four times a week, that’s enough to lower blood pressure. Small changes can make a big difference.

Adding isometric exercises doesn’t mean you should stop doing all other types of exercise, like strength training and cardiovascular workouts. It’s important to include all forms of exercise for your overall health and heart health.

The American Heart Association recommends 150 minutes of moderate-intensity exercise (hiking, biking, water aerobics) or 75 minutes of vigorous aerobic activity (running, swimming laps) each week.

Research is well established that aerobic training is just as important as strength training, which is just as important as stretching and isometric exercise for longevity. Each type of exercise plays a vital role in building the body’s strength, endurance, coordination, flexibility and functionality.

For the latest health and wellness tips and advice, visit geisinger.org/balance.

United Way of Lackawanna Receives Donation

The United Way of Lackawanna, Wayne & Pike is excited to announce a generous donation of $2,500 from RJ Burne Cadillac, Scranton, in support of the Dolly Parton Imagination Library. This generous contribution will help provide free books to children, fostering a love of reading and promoting early childhood literacy.

The donation was presented on June 12th, 2024 in RJ Burne Cadillac’s showroom, highlighting the dealership’s commitment to community engagement and support for educational initiatives. The Dolly Parton Imagination Library, a beloved program by many, mails free, high-quality books to children from birth until they begin school, regardless of the family’s income.

“We are incredibly grateful to RJ Burne Cadillac for their substantial support of the Dolly Parton Imagination Library,” said Gary Drapek, President & CEO of the United Way of Lackawanna, Wayne & Pike. “This donation will have a profound impact on the lives of many children in our community, giving them access to books and the joy of reading from an early age. Investing in early literacy is crucial for the future success of our children, and we are thrilled to have RJ Burne Cadillac as a partner in this important initiative.”

The United Way of Lackawanna, Wayne & Pike remains dedicated to improving the lives of individuals and families in the community through education, health, and economic mobility programs. This donation from RJ Burne Cadillac will help further the mission of the United Way and ensure that children have the resources they need to succeed.

For more information about the United Way of Lackawanna, Wayne & Pike and the Dolly Parton Imagination Library, please visit uwlc.net or contact Matt Ceruti, Vice President of Resource Development and Campaign, 570.343.1267 x234 or mceruti@uwlc.net

Misericordia University Means Opportunities

At Misericordia University, we believe in opening doors to endless possibilities. Whether it’s through our diverse academic programs, engaging campus life, or community partnerships, we are committed to providing opportunities that empower our students to achieve their fullest potential. Join us and discover how Misericordia can help you turn your aspirations into achievements. Learn more at https://www.misericordia.edu

Crystal Windows Welcomes New CEO

National manufacturer Crystal Window & Door Systems is pleased to welcome Mr. Jeffrey D. Smith to its leadership team as the new Chief Executive Officer.  He joins Crystal Chairman and founder Thomas Chen and President Steve Chen to guide the company in its future growth and expansion.

“Jeff brings a stellar track record of leadership, running large profitable businesses, and strong customer relationships to Crystal,” says Chairman Thomas Chen.  “From start-up 34 years ago until today, Crystal has flourished.  Jeff is very highly regarded in our industry, and working with our dedicated employees, he will build on this strong foundation of success and position Crystal for exciting growth and continued prosperity in the coming years.”

“I am thrilled and honored to join a company whose culture is committed to product excellence, superior customer service, and an unwavering commitment to its employees,” said CEO Jeffrey Smith.  “My approach is quite simple: continue striving for the highest product quality and best-in-class service to our customers, ensure production operations continue efficiently and sustainably, and seize opportunities to advance the company.”

Since its inception in 1990, Crystal has progressively grown to be one of the largest window manufacturers in North America.  Now with over 1,000,000 sq. ft. of manufacturing space at five facilities and over 750 employees across the country, and with one of the broadest product lines in the industry, the company continues its growth and success.  With new products in the pipeline, new production capabilities coming online, and expansion opportunities being realized, the company is poised for even greater achievement.

“While Crystal has established its prominent national presence in the building products industry through times of both economic boom and challenge, we want to take the company to even greater heights,” said President Steve Chen.  “Jeff is the right executive with the right experience to make that a reality.”

Smith brings a wealth of broad building materials industry experience to the role of CEO.  He has held top leadership roles as President and CEO of Trussway Manufacturing of Houston, Texas, High Industries of Lancaster, Pennsylvania, and most recently as Senior Vice President of Multifamily Components for Builders FirstSource, Inc. of Dallas, Texas, one of the nation’s largest building material dealers and manufacturers.

Smith also brings to Crystal a well-rounded background of progressively responsible roles in management, engineering, and manufacturing operations from respected leading brands, including Colgate Palmolive, GAF Materials Corporation, and CertainTeed Corporation. While at CertainTeed, Smith held operations leadership roles in the company’s roofing and siding divisions, most notably running the company’s vinyl siding and window lineal extrusion operations.

Smith holds a Bachelor of Science degree in Mechanical Engineering from the Stevens Institute of Technology (Hoboken, NJ), and an MBA in Finance from Southern Methodist University (Dallas, TX).  Throughout his career he has specialized in key areas such as lean manufacturing, quality improvement, sustainability, new product development, and sales growth.

The Wright Center Encourages Men to be Proactive

The Wright Center believes stereotypes aside, it’s safe to say that men often tend to be less proactive about their health than women.

That’s why public health campaigns like Men’s Health Month in June play an admirable role. The annual monthlong observance raises awareness on the many ways in which males – boys and adults – need to take charge of their health care.

June is also home to International Men’s Health Week, which took place last week, and June 14’s Wear Blue Day, which is sponsored by the Men’s Health Network and encourages individuals, organizations, and employers to wear blue and host awareness and/or fundraising events on behalf of the cause.

If we’re being honest, society hasn’t done the greatest job of promoting proactive health care among males, no matter the age group. According to the Centers for Disease Control and Prevention, the average life expectancy for men in the United States is 5.4 years less than it is for women. Meanwhile, males are at a higher risk for a number of serious diseases, among them heart disease, lung cancer, and HIV, and experience illnesses completely unique to the gender, such as prostate cancer.

And for men from underrepresented groups, the numbers are even worse. So, it’s a good thing that for this year’s Men’s Health Month, the U.S. Department of Health and Human Services (HHS) Office of Minority Health (OMH) is focused on bettering health outcomes for racial and ethnic minority and American Indian/Alaska Native (AI/AN) men through its theme, “Be the Source for Better Health: Improving Health Outcomes Through Our Cultures, Communities, and Connections.” The initiative aims to understand better how the unique environments, cultures, histories, and circumstances – the social determinants of health or SDOH – of minority men impact their overall health.

OMH has committed to working with public health and community-based partners to provide racial and ethnic minority and AI/AN men and boys with high-quality medical care and services that are “responsive to diverse cultural health beliefs and practices, preferred languages, economic and environmental circumstances, and health literacy levels.” The thinking is that when patients are provided with culturally and linguistically appropriate information, they’ll ultimately have healthier outcomes for themselves, their families, and their communities as a whole. And by communities, we can certainly include our own right here in Northeast Pennsylvania.

With encouragement from health care professionals, as well as family members and friends, there’s no reason why men can’t adopt more healthful practices, whether it’s improving their diet and getting a gym membership or better managing their stress levels through yoga, meditation, or therapy. That also includes making a long-term investment in their medical care, from annual visits to their primary care physician to receiving regular prostate testing and colonoscopies, or Cologuard stool testing, to reduce the chance of metastatic prostate or colorectal cancer. Health education should also start at a very young age so families can instill the importance of lifelong healthy habits in their boys.

Most people do not seem to appreciate exercise’s profound impact on reducing the risk of most diseases and even slowing the aging process. Thirty minutes of exercise can prevent decline and decay for both men and women.

Let’s all do our part to promote better men’s health by encouraging the important men in our lives – fathers, husbands, sons, friends, coworkers, etc. – to take their long-term health seriously.

Douglas Klamp, M.D., is a board-certified internal medicine physician who serves as senior vice president, chief medical education officer, and physician chair of resident and fellow talent acquisition of The Wright Center for Graduate Medical Education, as well as program director of the Internal Medicine Residency Program. Dr. Klamp is accepting adult patients at The Wright Center for Community Health – Scranton, 501 S. Washington Ave.

Geisinger Doctor Discusses Headache Pain

By Geisinger neurologist Abigail Chua, DO

How to stop waking up with a headache:

Ever realized your head is pounding before you even get out of bed in the morning? Waking up with a headache is — well, a pain. Here’s why they happen and how you can find relief.

Like other common symptoms, headaches vary in cause and strength. Some intense headaches can last for hours. Others might be a minute or two of dull but manageable discomfort. Most headaches are grouped into primary and secondary categories.

Primary headaches are usually caused by pain sensors in your head that aren’t working right. These headaches may run in your family. Or you might get them from foods you eat (or don’t eat enough of), alcoholic drinks or changes in sleep patterns.

Primary headaches are what most people have. The good news is, these types of headaches are preventable and treatable.

The two most common kinds:

  • Tension headaches – This type causes mild pain around the head, face or neck.
  • Migraine headaches – This neurological disease can cause sharp pain on one side of the head and may last for hours or even days. 

Secondary headaches are typically caused by underlying medical conditions, including:

  • Dehydration – Not drinking enough fluids on a regular basis contributes to headaches.
  • Medication overuse – Taking too much of a variety of medications — like Tylenol or forms of ibuprofen, ironically — can make your head hurt. 

For most people, morning headaches result from lifestyle factors. The good news: You can adjust those to ease your pain. Lack of sleep, whether due to insomnia or just an occasional restless night, often leads to waking with an aching head. Others include:

  • Dehydration
  • Poor sleep quality
  • Medication side effects
  • Sleep apnea
  • Jaw clenching or teeth grinding

If poor sleep quality is causing your headaches, your doctor may recommend some changes to your sleep routine. 

Besides getting a better night’s sleep, minor adjustments to your daily routine to reduce the frequency of morning headaches. 

Simple changes you can make include everything from skipping that extra glass of red wine after dinner to drinking more water before bed. Luckily, there are a number of things you can do to make your morning headache go away.

  • Hydrate: Drink lots of water to start the day. Dehydration can bring on a headache or make an existing one worse. 
  • Dim the lights: Many people are sensitive to bright light, especially early in the morning. Give your eyes and head time to adjust.
  • Use a cold compress: Grab a bag of frozen veggies or a cold pack and put it on your forehead or the back of your neck. The cold eases pressure and can soothe a morning headache. 
  • Try light massage: It’s simple — but effective. Use your fingers to apply gentle pressure on the part of your head or neck where you’re having pain. This trick can help relieve a tension headache.
  • Get plenty of sleep: Some headaches are related to sleep apnea or other factors causing a lack of quality rest. Try going to bed a little earlier to give your body more time to rest.

Digging out the root cause is the first step in treating your early morning headaches. If you’ve tried to troubleshoot on your own with no success, it’s time to talk to your doctor — especially if you have frequent or daily morning headaches.

Once you and your doctor determine the right treatment plan, you can wake up refreshed, rested and ready to take on your day.

For more health and wellness tops, visit Geisinger.org/balance.

The Dime Bank Transitions to ‘.Bank’

The Dime Bank recently transitioned their website from thedimebank.com to thedime.bank domain to provide customers with an even more secure banking experience. This change provides another layer of enhanced security and verification requirements to reduce the risk of cyber threats and enable The Dime Bank to provide a greater level of digital security.

The American Bankers Association (ABA) reports that banking has consistently been one of the most targeted industries for phishing for over a decade. The accessibility of publicly available, unregulated, and affordable domains like .com and .net allow malicious entities to acquire similar-looking domains effortlessly for conducting business email compromises, phishing, and spoofing attacks, resulting in data breaches, identity theft, and financial fraud.

The Dime Bank’s email addresses and website URL will now use ‘.bank’ as their ending. Thedime.bank has enhanced security requirements which help mitigate the risk for fraud. There is an extensive vetting process in place so that only legitimate banking institutions can utilize ‘.bank’, thereby preventing bad actors from creating imposter domains.

To verify the authenticity of The Dime Bank’s emails and website, customers can easily spot the ‘.bank’. With the ‘.bank’ in place, consumers can quickly confirm emails and websites are real, and avoid interactions that could lead to identity theft and financial fraud. This authentication is also an additional layer of protection for internal and vendor communications, helping to further secure against potential breaches.

President and Chief Executive Officer Peter Bochnovich stated, “Customer security is a paramount concern at The Dime Bank, encompassing both personal and financial information. The ‘.bank’ domain is a gated domain, like .gov, and is exclusive for verified banks. Providing cutting-edge technology that caters to customers’ need for high-speed convenience along with security remains a key consideration in all our choices. By transitioning our domain name to ‘thedime.bank’ from ‘thedimebank.com’, customers can interact with confidence when they see the ‘.bank’ at the end of The Dime Bank’s email address and website URL.”

Emails from thedimebank.com will be forwarded to the new thedime.bank addresses, and the website previously ending in ‘.com’ will now redirect to the new ‘.bank’ site. Customers are advised to update their address books and bookmarks for thedime.bank.

The Wright Center and NE PA AHEC Workshop Collaboration

Nevena Barjaktarovic, M.D., a dually board-certified physician in internal medicine and rheumatology at The Wright Centers for Community Health and Graduate Medical Education, will present a free educational session on lupus for Northeast Pennsylvania primary care and emergency room doctors, nurse practitioners, and physician assistants.

The Northeast Pennsylvania Area Health Education Center (NE PA AHEC) is sponsoring the internal medicine didactic session, which will be held from 8-10 a.m., Wednesday, July 31, in The Wright Center for Community Health – Scranton Auditorium, 501 S. Washington Ave.

Participation is limited and registration is required by Friday, July 19. To register, visit bit.ly/3QRJqTf. Participants may join in person or virtually through Webex video conferencing. The video conferencing link will be provided after registration.

The session is a part of the American College of Rheumatology Rural Health Outreach Project, aimed at improving lupus referral, diagnosis, and treatment in underserved communities. It also will help raise awareness among health care providers of lupus signs and symptoms, what to do if lupus is suspected, and when to consider lupus in the differential diagnosis for individuals at high risk.

About 1.5 million Americans have a form of lupus, 90% of whom are women, with about 16,000 new cases annually, according to the Lupus Foundation of America. Lupus is two to three times more prevalent among Black, Hispanic/Latina, Asian American, Native American, Alaska Native, Native Hawaiian, and other Pacific Islander women than white women.

Those with lupus can experience significant symptoms, including pain, extreme fatigue, hair loss, cognitive issues, and physical impairments that affect every facet of their lives. Many suffer from cardiovascular disease, strokes, disfiguring rashes, and painful joints. For others, there may be no visible symptoms.

Dr. Barjaktarovic specializes in diagnosing and treating a broad spectrum of rheumatic and inflammatory conditions, such as arthritis, back pain, connective tissue disease, fibromyalgia, gout, joint pain, osteoporosis, psoriasis, and lupus. She also serves as a physician-faculty member at The Wright Center for Graduate Medical Education, where she mentors residents and fellows.

A Clarks Summit resident, Dr. Barjaktarovic joined The Wright Centers in 2020 and earned her medical degree from the Medical School of Belgrade University, Serbia. She completed her residency in internal medicine at the Icahn School of Medicine at James J. Peters VA Medical Center, affiliated with Mount Sinai School of Medicine in the Bronx, New York, and her rheumatology fellowship training at Albert Einstein College of Medicine-Montefiore Medical Center, also in the Bronx.

Geisinger-led Study on Weight Loss and Diabetes Drugs

A recent Geisinger-led study has determined that GLP-1s, a popular class of weight loss and diabetes drugs, may make it unsafe for patients to undergo a common gastroenterology procedure.

Researchers from Geisinger Medical Center and Geisinger Commonwealth School of Medicine collected data from 2019 to 2023 on 35,183 patients who had esophagogastroduodenoscopy (EGD) procedures. An EGD, or upper endoscopy, is one of the most common diagnostic procedures to examine the lining of the esophagus, stomach and first part of the small intestine. 

Among 756 patients with diabetes who took GLP-1s and had an EGD, those patients were:

  • Four times more likely to have retained food in their stomach during the procedure
  • About three times more likely to have aborted procedures
  • Twice as likely to need a repeat EGD

Among 166 patients without diabetes who took GLP-1s and had an EGD, those patients were:

  • About five times more likely to have retained food in their stomach
  • Five times more likely to have aborted procedures
  • As likely as nonusers to need another EGD

GLP-1s, such as the popular Ozempic medication, decreases how fast the stomach empties, regardless of a patient’s diabetes status, the study found. 

“Having food in the stomach during one of these procedures can increase the risk as well as decrease the ability of your doctor to perform a complete examination,” said Amitpal S. Johal, M.D., Geisinger chair of gastroenterology and one of the co-authors of the study.

The researchers cautioned that clinicians responsible for scheduling and performing EGDs on patients taking GLP-1s, should carefully assess the impact of the medication on the procedure’s safe completion, stating “healthcare providers must consider the implications of delayed gastric emptying when planning an EGD for GLP-1 patients.” 

“If you are taking a medication for weight loss, please let you doctor know before scheduling a procedure,” Dr. Johal said.

The Wright Center Announces Fellowship

Dr. Kristina Tanovic, a board-certified internal medicine hospitalist at The Wright Center for Community Health, has been elected a fellow of the American College of Physicians (ACP), the society of internists. The distinction recognizes achievements in internal medicine, the specialty of adult medical care.

Dr. Tanovic was elected upon the recommendation of peers and the review of ACP’s Credentials Subcommittee. She may now use the letters “FACP” after her name in recognition of this honor.

Dr. Tanovic see patients of all ages at The Wright Center for Community Health – Scranton Counseling Center, 329 Cherry St., where she is accepting new patients. Certified by the American Board of Internal Medicine and the American Board of Obesity Medicine, Dr. Tanovic is also a core faculty member of The Wright Center for Graduate Medical Education’s Internal Medicine Residency, where she trains the physicians of tomorrow. The Wright Center’s residency and fellowship programs are accredited by the Accreditation Council for Graduate Medical Education.

A graduate of the University of Belgrade School of Medicine in Serbia, Dr. Tanovic completed her internal medicine residency at Icahn School of Medicine at James J. Peters VA Medical Center, a Mount Sinai School of Medicine-affiliated facility in the Bronx, New York.

Dr. Tanovic and her husband, Dr. Ivan Cvorovic, live in Scranton, with their daughter Iskra Cvorovic.

The Wright Center, headquartered in Scranton, operates 10 community health centers in Northeast Pennsylvania, including a mobile medical and dental unit called Driving Better Health. Its locations offer affordable, high-quality, indiscriminate whole-person primary health services, meaning patients typically have the convenience of going to a single location to access integrated medical, dental, and behavioral health care, as well as community-based addiction treatment and recovery services. For more information, go to TheWrightCenter.org or call 570-230-0019.

ACP is the largest medical specialty organization and the second physician group in the United States. ACP members include 143,000 internal medicine physicians, related subspecialists, and medical students. Internal medicine physician are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. For more information about ACP, go to acponline.org.