Daily Activity vs. Physical Activity

Q: Whenever I go to the doctor, they always say I should increase my activity level. I feel like I’m always on the go with housework, walking the dog, and running errands. Am I not doing enough already? Is my activity level really the problem?

A: The recommended Physical Activity requirements for adults is 150 minutes per week. If you divide it throughout the week that’s only 30 minutes a day for 5 days. This should be a continuous session at a moderate intensity. While you may be doing a lot of work at home or running errands, your heart rate is most likely not elevated for a long enough period of time to elicit the benefits of aerobic activity. I would count walking your dog as aerobic activity but only if it last for 30+ minutes and you are not stopping every couple of feet to wait for your pup! Continuous time under tension is key. There is also a second part of this suggested physical activity that tends to get overlooked. While you may be meeting your aerobic or cardio activity requirements, the CDC also recommends muscle strengthening activities in conjunction with aerobic exercise! Strength or resistance training is the number one form of both fat loss AND muscle building. If I had to choose to implement only one of these forms of training, resistance training would be the winner solely based on the amount of benefits it holds over cardio-based activity.

Some of these benefits include:

  • increasing your metabolism,
  • strengthening your bones,
  • increasing muscle mass,
  • balancing out hormones in males and females, and
  • improving your overall functional mobility in everyday life, which is the ability to move through full ranges of motions with complete control and stability.

Resistance training doesn’t have to be overly intense and can be performed in the comfort of your home which is convenient given the cold weather and current COVID restrictions. For more information or to set up a consultation with our fitness expert, please contact us at (360) 572-2202 or drop us a note at info@camanoislandhealth.com.

RA and COVID-19

Q:  I am on Renvoq.  Can I receive any of the COVID-19 Vaccines? 

A:  Based on the current information, yes.  People with rheumatic diseases will not be able to get any of the live vaccines under development for the novel coronavirus. However, according to William Chen, MD, Chief of the Adult Clinical Studies, Center for Vaccine Development and Global Health, University of Maryland, “…we don’t expect that there will be any issue with non-live vaccines.”  The currently announced vaccines use a new technology whereby a genetic molecule called messenger RNA (mRNA) teaches cells to create a version of the coronavirus spike protein. This prompts the immune system to make antibodies against this protein so the body can recognize the virus and fend off future infections. Unlike traditional vaccines that use weakened live or dead versions of the entire virus, these new types of vaccines are expected to be as safe for immunocompromised patients and patients on immunosuppressant medications. 

Current, although limited, evidence shows that people taking disease-modifying antirheumatic drugs (DMARDs), including biologics, are not at a higher risk for getting COVID-19 and the death rate is the same as the regular population.  2.8% of those hospitalized for COVID have autoimmune disease which is about equal or even less than the percentage of those in the general public.  European League Against Rheumatism (EULAR) suggests that the majority of people with rheumatic diseases who contract COVID-19 have similar outcomes to the general population, regardless of which disease-modifying medication they take. There is some limited, observational data that there are some medications taken for rheumatic disease that may be slightly protective. 

Do note that certain medications may need to be temporarily stopped if you have a confirmed COVID-19 infection, have been exposed to someone with a COVID-19 infection, or are experiencing common COVID-19 symptoms such as fever, dry cough, or shortness of breath. However, please do not stop or change medication dosage without contacting your rheumatologist or primary care provider. This is especially important with corticosteroids, which should never be stopped suddenly.

COVID-19 Vaccine Pre-Testing for Reactions

Q: Flu shots have been making me progressively sicker. Skin rashes, large irritated area at shot site, etc. Might there be something like an allergy test with micro dosing to test COVID-19 vaccine reaction?


A: No, but as far as allergic reactions to previous influenza vaccines are concerned, none of these newly announced COVID-19 vaccines are grown in eggs, so egg allergies (the most common cause of reaction from influenza vaccine) should not be a problem. Also, make sure your provider knows of your reactions from influenza vaccine as there are egg-free options (for flu shots) that might work better for you.

HPV – Who Should Get Vaccinated

Q: Who should receive the HPV Vaccine and why should they get it?

A: The HPV vaccine (Gardasil) is recommended for boys, girls, men, and women age 9 to 45.  HPV is a sexually transmitted virus that causes cervical & vaginal cancer, penile cancer, anal cancer, and cancers of the mouth and throat.  It also causes genital warts.  Data shows that the immune system has a better response when it is given at a younger age.  Once a person is infected with HPV, they may remain infected with HPV long-term.  While the HPV vaccine can help prevent infection, the vaccine does not cure an infection that is already present, so it is most beneficial to get the vaccine long before becoming sexually active.  It is thus recommended to get the HPV vaccine at age 11-12 to provide maximum benefit.

Travel for the Holidays

Q: I know a lot of people who are traveling for the holidays, do you think that is safe?

A: Travel dramatically increases your chance of getting infected and infecting others and should be undertaken with caution. The CDC recommends you stay at home as much as possible and social distance. If you do decide to travel and take that risk to yourself and others, be aware that some communities within the United States may require visitors to quarantine themselves for 14 days upon entering the community or when returning home from a trip. When my family was in Africa and my grandmother could not come out to see us for Thanksgiving, she sent dozens of cookies packed in old Folgers cans. When we opened them up, it was if she was there. Please understand this is a temporary crisis we are having, and we will reunite in the same room with long hugs soon.