Meningitis is an inflammation of the delicate membranes that cover the spinal cord and brain. Bacteria, viruses and fungi can cause it.

Meningitis Symptoms

headache and fever

nausea and vomiting

stiff neck aversion to light confusionsometimes, red rash

If you experience these symptoms, call your doctor for immediate advice, call 911 or go to an emergency facility.

Elena,

Welcome to the program! It looks like you are off to a good start!

It is true that when you begin an exercise program you are struck by how good it makes you feel. You appreciate feeling so invigorated and want to experience that again. That’s part of what motivates us to continue our quest for fitness.

As far as your routine, it sounds like the videotape suits your schedule for now. Is it the Tae Bo tape you have? Just make sure your body is properly warmed up before doing intense movements. I’m glad there is stretching at the end of the tape. This will help reduce the soreness that you may experience from exercise.

I would encourage you to sign up for the weight-training class you mentioned. The class should provide not only the facilities and guidance you need, but also the added benefit of support from classmates who are striving for similar goals. Let me know the format of the class once you begin.

As for your home routine for strengthening and toning, perform all of the exercises I prescribed. It is a well-balanced regimen targeting your major muscle groups. It’s a good idea to print out and post the routine in your exercise area so that you can follow it precisely. Don’t leave it up to memory! Be sure to record your weights and reps accurately and report them to me each week.

Again, welcome aboard. I look forward to hearing from you each week and seeing your progress. Feel free to ask me any questions related to fitness, and try to be detailed in your exercise log. The more you tell me, the more I can help!

Good luck, Elena!

Armand

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On Friday, I anticipated this and had a small bowl of a filling cereal before dinner. Otherwise, I would have gone way overboard with the pizza. I’m proud of that. Also, this week I drank alcohol more frequently than I usually do. That was unusual and probably won’t happen again.

My toughest episode was the ziti night. I felt like I was restricting myself too much and went into a semi-binge. My New Year’s resolution for this year was to never “diet” again, because I always end up doing much worse than I did in the first place. I think I will approach this more as a quest to eat more vegetables and fruits.

Armand, as for exercise, I didn’t quite have all the time I had hoped for. I did an exercise video for 25 minutes three times this week. I was working hard the whole time, and pink-faced a half-hour afterward. I forgot how much fun it was and how good I feel after exercising. I also did some pushups, but not the whole routine like you had recommended. I will print it out and put it somewhere to remind myself. I’m going to try to sign up for a weight-training class at our community college to keep me on track. I did that last semester with a walking class and it was wonderful. I’ll get back into the walking as soon as I can. I can’t really walk too much right now because of the schedule with the kids. I’ll probably keep doing tapes from home until I can get out by myself again.

Sharon’s Reply
Dear Elena,

Good start on the food records and fat gram counting. I think it also helps to check the calories to be sure you are not overeating non-fat calories. You do need to include more fruits and vegetables into your diet, and that will help you eat less of the high-calorie foods. Fill half your plate with veggies, and then put a half-cup of starch and 3 to 4 ounces of protein on your plate. You will feel more satisfied and not have as much hunger for the next meal.

This program is not about dieting, but about learning to make better choices, eating healthier, feeling better and empowering yourself with more knowledge about your relationship with food. As you learn where those extra calories can be saved, you will see your weight drop.

Sharon

A complete first-aid kit may help you react quickly and effectively to emergencies, injuries. Everyone should have a first aid kit handy in the workplace and in the car.

These trees have stood long before these United States was even an idea. I looked up towards the top, held out my arms, and just took in the magnitude of what this means and how lucky I am to be able reach out and touch this amazing living entity.”

The non-ponderer might respond, “Did you drive your car through one?”

But if the conversation in this group shifted to such things as, while on the way to this Redwood forest, passing through a massive number of people walking on the road making their way to a reggae/marijuana-fest.

Stopping at a small restaurant where people were getting crazy drunk and partying, this same non-ponderer would get all excited.

Samuel Wiebe, M.D. and colleagues from several medical and health centers in London, Ontario, Canada report in the August 2 issue of the New England Journal of Medicine that surgical treatment of some patients with epilepsy may provide a better result and quality of life than does the usual medical therapy.

The investigators identified 80 individuals who exhibited temporal lobe epilepsy — a form in which the abnormal electrical activity originates in the temporal lobe of the brain. After epilepsy specialists ascertained the type of epilepsy, and the suitability of each person for surgery, the researchers randomly assigned half of the patients to receive surgical treatment, and half to standard medical treatment.

The subjects in both groups were similar in most characteristics. All were typically in their mid-thirties, had begun having epileptic seizures as young teenagers, had consciousness-impairing seizures about five times per month, and had similar scores on tests to determine quality of life and general health status. Patients’ health status and quality of life were followed for one year post surgery: primary outcome measure was freedom from seizures.

By one year after surgery, 38 percent of patients who had had the operation were free from seizures of any type, compared to only 3 percent of the patients who had been treated with drugs. The difference was more pronounced with respect to seizures that impaired patient’ awareness. Fifty-eight percent of the surgically treated subjects had no such seizures, compared to 8 percent of the medically managed patients. Dr. Wiebe and colleagues reported that the quality of life among the patients in the surgical group was significantly better than among those in the medical group, and that it increased in both groups over time.

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1. For health clubs to be viewed as an extension of healthcare, they need to be set up as such. For example, pools should be heated for lap swimmers and individuals dealing with arthritis; staff members should be ACSM certified; weight machines should have small incremental increases of 1 to 2 pounds instead of standard 5-, 10- or 20-pound increments.

2. Health clubs should become better producers and deliverers of services. For example, staff members should be trained in the individual needs of clinically-referred members. Individuals need to feel that staff members are extremely qualified to deal with their specific issues.

3. Health clubs must be committed to quality as defined by healthcare standards, not necessarily health clubs’ standards. For example, healthcare providers require that records be kept to demonstrate progress (or lack thereof), including standardized protocols and outcome measurements.

4. Health club directors need to focus on outcome measures that demonstrate and improve the health and fitness of its participants. Examples include how many times individuals participate, what improvements are observed, and whether improvements can be predicted with standard protocols. Other examples of outcomes include individuals’ perceptions of how they are doing and the benefits they feel they are receiving.

Clubs should be able to demonstrate similar or better outcomes for members as a result of services being rendered in the club rather than the clinical setting.

5. Health club managers must look at healthcare as an opportunity to develop new and profitable revenues, such as opening up pools for outside therapy classes, selling hourly screening services to local healthcare providers, and offering club facilities to outside groups who need the space and environment but not the staff.

St. John’s wort extract has also been shown to be antimutagenic in E. coli [Vukovic-Gacic et al., 1993]. However, it has been recognized that hypericin can accumulate in the nucleus of cells exposed to the compound and directly bind to DNA [Miskovsky et al., 1995]. The relevance of these findings is unclear, and no long-term carcinogenicity testing has been done with St. John’s wort.

St. John’s wort is generally very well tolerated. In the extensive German experience with St. John’s wort as a treatment for depression, no reports of serious adverse consequences or drug interactions have been published [De Smet et al., 1996]. In particular, no MAO-inhibitor-type reactions have ever been reported.

A drug monitoring study of 3,250 patients taking St. John’s wort extract for 4 weeks [Woelk et al., 1994] revealed an overall incidence of side effects of 2.4%. The most common were mild stomach discomfort (0.6%); allergic reactions, primarily rash (0.5%); tiredness (0.4%); and restlessness (0.3%). Only 1.5% of the patients dropped out of the study because of adverse reactions. For comparison, about 17% of patients on fluoxetine and 31% of patients given tricyclics stopped taking the drug because of side effects [Stokes, 1993]. Furthermore, as many as one in three patients on SSRIs develop symptoms of sexual dysfunction [Balon et al., 1993]. However, cross-study comparisons of this type are of questionable validity.

The overall incidence of side effects in the double-blind studies that compared St. John’s wort to a placebo was 4.1% [Linde et al., 1996].

Like other antidepressants, St. John’s wort may cause manic episodes in individuals with bipolar disorder.

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More legal matters are going to arbitration than court. The marketing arena has seen decreases, with the focus only on certain peak months. The radius for direct mail has been narrowed, with much more emphasis on member referral programs. Yellow pages advertising has been reduced, and image advertising eliminated. Online communication has led to discontinuing the mailing of member statements, and posting newsletters online rather than printing them.

Other cost savings were found by leasing certain space (spa/beauty salon, snack bar/cafe, landscaping, pro shop, IT), especially where the club had failed previously.

As the economy continues to struggle, focusing on the expense side is the mandate. Many clubs have held or even increased their bottom lines during these recessionary times.

Allman at Frog’s Club One finds that the age group for his class “tends to be 40 years and under, with a 60-percent men [to] 40-percent women ratio.” While Fitness & Image Results markets its program as a four-week package at an additional cost (discounted for Gold’s members), Frog’s Club One has boot camp as a regular class that is held throughout the year, at no additional cost for members, and daily rates for non-members.

To attract people to your program, the boot camp class should emphasize a variety of activities and exercises. Examples include running laps with a brick in each hand or up stairs with a sack of 10-pound dumbbells.

Emphasize this variety when promoting your program to members and the general public, as it can attract free publicity. Both the Frog’s and Fitness & Image programs receive frequent free media coverage through newspapers, and local and national television stations.

To market these classes, use pictures and personal testimonials on posterboards to help attract existing members. Club newsletters, along with local newspapers and television stations, are other commonly used marketing vehicles, and Fitness & Image Results also has a Website

So it’s important that people can perform some type of on-line monitoring of their business environment. To avoid being blindsided by developments, you should be prepared to track what your competition is doing, assess the changes in your industry and monitor how other actions may affect you. The Internet is a rich resource for undertaking these activities.

One of the most useful, yet least known tools to keep up on changes is Mind-it (mindit.netmind.com). This free service allows you to set up a number of “minders” that notify you by E-mail when particular Web pages are changed or updated.

It’s a simple but powerful concept: You simply track your competitors’ pages on “what’s new,” products or other topics. Because you are advised as soon as new information appears, you can put in place a
simple monitoring method to stay on top of what the competition is doing.

Keeping an eye on new developments among rivals or within your industry can also be accomplished by tracking media releases or news articles. There are all kinds of options to monitor releases — for
example, you can sign up for “Hot Off the Wire” from Canadian Corporate News (http://www2.cdn-news.com/hotw) or other similar services.

Once you’ve signed up, you will automatically receive E-mail messages containing the press releases of the companies you choose. You should also check out NewsPage, an extremely flexible service that lets you follow news stories and press releases from multiple sources (http://www.newspage.com).

NewsPage has organized information into about 1,400 categories, so you can focus in on selected topics. You can receive new information via E-mail, the Web or both.

Don’t restrict yourself to these services. Keep in mind that an extremely important source of regular competitive and industry information will be local or national newspapers and magazines, as well as industry trade publications.

Start out at JournalismNet, which contains an extensive list of on-line publications, to figure out which ones you want to track (http://www.journalismnet.com). Then examine which of these publications lets you do an on-line search of their archives, usually for a seven-day period or so.

If you revisit them on a weekly or biweekly basis to do a search for any articles on the company or industry you are monitoring, you’ve got another tool in place.

You can even make this process automatic, to a degree. Visit the Web site of this newspaper, for example, and do a search for the name of competitors. A list of matching news articles from the past
week will appear — then bookmark the page. Revisit this bookmark every seven days for an instant list of all of relevant articles that have appeared recently.

If you are serious about this type of tracking, be aware that there are more elaborate fee-based services. The Dow Jones Interactive Custom Clips service is an example of the type of sophisticated tool
that is available — you can use it to develop advanced monitoring capabilities (djinteractive.com).

You receive the headline of matching news articles for free, and then pay a fee to access the stories that interest you.

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