In the news

Get ready for the next big (medical) thing.

            Gene-editing treatment is here, and it’s more meaningful than most people can imagine. For the first time the FDA has approved two methods for the treatment of sickle cell disease, a genetic defect that affects primarily dark-skinned people and that leads to years of pain episodes, strokes and other complications, including early death.

            The Nobel Prize-winning discovery of the structure of DNA was reported in 1953, just five years before I entered medical school. Multiple advances in the science of genetics have finally led to the manipulation of genes that can reverse the abnormality that causes sickle cell disease. We now have the basic framework that will eventually lead to the cure of brain-destroying conditions like Tay-Sachs disease and Huntington disease, as well as common diseases such as cystic fibrosis and neurofibromatosis. There are scores more such diseases that are relatively rare but that are devastating for the families in which they occur.

            There are – and will be – challenges, of course. The cost is staggering — more than two million dollars per patient. Side effects are inevitable, and some may be fatal. It will always be thus with brand-new technologies.

            Early in my career I watched the explosion in the field of antibiotics. Penicillin got off to a slow start, in which producing it was so difficult that the urine of patients that were being treated was collected so that the precious substance could be recovered and re-administered. Within about fifteen years diseases such scarlet fever, pneumonia and meningitis were no longer highly fatal. We are going to see the same surge of advances in the treatment, cure and elimination of many more diseases.

Lifestyle

The value and the psychology of the push-up

            The simple push-up, with its few variations, is IMHO (In My Humble Opinion) the most valuable exercise that one can do without equipment. It involves every major muscle group: back, abdomen, shoulders, chest, arms and legs. It even helps to strengthen the muscles of the neck, and if you are eventually able to rest on your fingertips and not your palms – yes, Virginia, you will be able to do that someday – some of the smallest muscles in your body will become stronger.

            Most people (53 percent), according to a study reported last September, cannot do TEN push-ups. A third cannot do five! Considering how important those major muscle groups are in daily living, that is a dismal situation.

            But here’s the good news: if you start doing push-ups every day or even every other day, you will be amazed at how quickly your numbers will rise. Begin by doing only five on the first day, then add only one more at each session. I guarantee that by the end of the second week you’ll be doing ten with ease. From then on it’s a matter of how hard you want to push yourself and whether you’ll get satisfaction from doing 30, 50 or even 100 push-ups at a time. Remember that because so many muscles are involved no single group has to handle a large load.

            Some tips:

            If you are not exercising regularly, begin with modified push-ups by resting on your knees and not your toes.

            Instead of resting your hands on the floor, rest them on a small platform or cushion. It can be three feet high in the beginning, gradually making that platform/cushion lower until you are hands-on-the-floor.

            After the first session you might want to rest for a couple of days, for two reasons. One is that if you work any muscle hard after a long period of inactivity you will experience DOMS (Delayed Onset Muscle Soreness). It’s the pain that often sabotages the desire to get in shape. The second reason is that dormant muscles are filled with dormant blood vessels. When you begin to activate a muscle those small vessels need to be awakened so that they will adequately supply muscle fibers with nutrients and carry away waste products.

            Bragging rights

            How do you think you’ll feel the day that you have done 50 or 100 push-ups? (Don’t get too cocky. When I told my brother how many push-ups I was doing he said “Of course! You don’t have much to push up!”)

            A New Year’s resolution

            I hope that this column will motivate you to take advantage of the psychological phenomenon called A New Year’s Resolution – most of which have been discarded by Valentine’s Day. But I know that when you have been able to do more push-ups than half the population you’ll find psychological as well as physiological energy to make 2024 your healthiest year ever!