Nuclear Medicine Heart Scan – Stroke Prevention Testing & Screening Near Me

Stroke Prevention  as well as Screening near me
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5 Preventive Health Screenings for these Diseases:

 

 

Carotid Artery Disease – Nuclear Medicine Heart Scan

An ultrasound is executed to evaluate the carotid arteries (a set of capillary in the neck that provides blood to your brain) for the develop of fatty plaque. Nuclear medicine heart scan.  This accumulation, called atherosclerosis, is just one of the leading sources of stroke.

Carotid (kuh-ROT-id) ultrasound is a secure, pain free treatment that uses sound waves to take a look at the blood circulation with the carotid arteries. Nuclear medicine heart scan.

Your two carotid arteries are located on each side of your neck. They  supply blood from your heart to your brain.

Carotid ultrasound  examinations for blocked or narrowed carotid arteries, which can  boost the  danger of stroke. Nuclear medicine heart scan.  The results can assist your physician determine a treatment to reduce your stroke threat.

Ischemic stroke. A carotid ultrasound is  carried out to  examine for narrowed carotid arteries, which  boost the risk of stroke.

Carotid arteries are generally tightened by a buildup of plaque – composed of fat, cholesterol, calcium and also various other compounds that flow in the blood stream. Early medical diagnosis and also therapy of a narrowed carotid artery can decrease stroke risk.

Your medical professional will certainly suggest carotid ultrasound if you have transient ischemic strikes (TIAs) or certain types of stroke and also might recommend a carotid ultrasound if you have clinical problems that enhance the threat of stroke, including:

  • Hypertension.
  • Diabetes mellitus.
  • High cholesterol.
  • Family history of stroke or heart disease
  • Current transient ischemic attack (TIA) or stroke.
  • Irregular audio in carotid arteries (bruit), discovered by your doctor using a stethoscope.
  • Coronary artery disease.

To evaluate for tightened or blocked capillary in various other locations of the body, you might require added tests, consisting of:

 Stomach ultrasound. Nuclear medicine heart scan.  You might have an abdominal ultrasound to evaluate for problems influencing the blood vessels or organs in your stomach location.

Ankle-brachial index examination. This test procedures as well as compares the blood pressure in between your ankle and also your arm. The examination shows minimized or blocked blood flow to your legs.

Cardiac stress test. Nuclear medicine heart scan.  This examination demonstrates how well your heart performs when under stress, such as throughout exercise. Outcomes can show poor blood circulation to the heart.

Nuclear medicine heart scan.  Your medical professional may likewise order imaging tests to detect coronary artery disease.

Other uses of carotid ultrasound.
Your  medical professional may  get a carotid ultrasound to:.

 Review blood flow  with the artery after surgery to remove plaques (carotid endarterectomy).

Review the positioning and also performance of a stent, a mesh tube utilized to enhance blood circulation via an artery.

Locate a collection of thickened blood (hematoma) that may protect against blood flow.

 Discover  various other carotid artery  problems that may  interrupt blood  circulation.

 

 

Outer Arterial Disease (PAD) – Nuclear Medicine Heart Scan

Nuclear medicine heart scan.  An Ankle-Brachial Index (ABI) test is executed using high blood pressure cuffs on the arms and legs. It is very important to evaluate for PAD because it boosts the threat of coronary artery condition, cardiac arrest, or stroke.

 Outer artery  condition (also called peripheral arterial disease) is a  usual  problem in which narrowed arteries reduce blood  circulation to the arms or legs.

In peripheral artery  illness (PAD), the legs or arms–  normally the legs–  do not  get enough blood  circulation to keep up with demand. Nuclear medicine heart scan.  This might create leg pain when walking (claudication) as well as various other signs.

Peripheral artery condition is generally a sign of a buildup of fatty deposits in the arteries (atherosclerosis). Atherosclerosis causes narrowing of the arteries that can reduce blood flow in the legs and, in some cases, the arms.

 Outer artery  illness  therapy  consists of exercising, eating a  healthy and balanced diet  and also not  smoking cigarettes or  utilizing  cigarette.

 Signs and symptoms.
 Many individuals with  outer artery  illness have  moderate or no symptoms. Some people have leg pain when  strolling (claudication).

Claudication signs consist of muscular tissue pain or cramping in the legs or arms that starts throughout workout and also ends with rest. Serious leg discomfort may make it tough to stroll or do other kinds of physical activity.

Other  outer artery  condition symptoms may include:

  • Coldness in the lower leg or foot, especially when compared with the opposite side.
  • Leg tingling or weakness.
  • No pulse or a weak pulse in the legs or feet.
  • Agonizing cramping in one or both of the hips, upper legs or calf muscular tissues after particular activities, such as strolling or climbing stairways.
  • Shiny skin on the legs. Nuclear medicine heart scan.
  • Skin color modifications on the legs.
  • Slower growth of the nails.
  • Sores on the toes, feet or legs that will not {heal| recover,
  • Discomfort when utilizing the arms, such as aching and cramping when weaving, writing or doing various other hands-on jobs.
  • Erectile dysfunction.
  •  Loss of hair or slower hair  development on the legs.

If  outer artery disease  becomes worse,  discomfort  might  take place during  remainder or when  resting. The  discomfort  might  disturb sleep. Hanging the legs over the edge of the bed or  strolling may  briefly  eliminate the  discomfort.

 Reasons.
Development of atherosclerosis. Nuclear medicine heart scan.  Outer artery condition is typically brought on by a build-up of fatty, cholesterol-containing deposits (plaques) on artery wall surfaces. This procedure is called atherosclerosis. It minimizes blood circulation through the arteries.

Atherosclerosis  impacts arteries throughout the body. When it  happens in the arteries supplying blood to the  arm or legs, it causes  outer artery  condition.

 Much less common  reasons for peripheral artery  illness include:

  • Capillary inflammation.
  • Injury to the arms or legs.
  • Adjustments in the muscle mass or ligaments.
  • Radiation exposure.
  • Danger variables.
  •  Cigarette smoking or having diabetes  substantially  boosts the risk of  creating peripheral artery disease.

 

Other things that  enhance the  danger of  outer artery  condition include:.

  • A family history of outer artery condition, heart problem or stroke.
  • High blood pressure.
  • High cholesterol. Nuclear medicine heart scan.
  • High degrees of an amino acid called homocysteine, which raise the danger for coronary artery illness.
  • Increasing age, especially after 65 (or after 50 if you have threat factors for atherosclerosis).
  •  Weight problems (a body mass index over 30).

 

 Issues.
Difficulties of outer artery disease caused by atherosclerosis include:

Nuclear medicine heart scan.  Essential arm or leg anemia. In this condition, an injury or infection creates tissue to pass away. Symptoms include open sores on the limbs that do not heal.

 Therapy may include amputation of the affected limb. 

Stroke and also cardiac arrest. Plaque buildup in the arteries can additionally influence the capillary in the heart and also mind.

Prevention.
The best  method  to stop leg pain  because of peripheral artery disease is to  keep a  healthy and balanced  way of living.

That  implies:.

  • Don’t smoke.
  • Control blood sugar.
  • Eat foods that are reduced in saturated fat.
  • Get regular workout – but consult your treatment provider concerning what type and how much is ideal for you.
  • Keep a healthy and balanced weight
  •  Take care of blood pressure  and also cholesterol.

 

Abdominal Aortic Aneurysm (AAA) – Nuclear Medicine Heart Scan

Nuclear medicine heart scan.  An ultrasound is executed to evaluate the abdominal aorta for the presence of an augmentation or aneurysm. AAA can result in a fractured aortic artery, which is a severe clinical emergency.

An  stomach aortic aneurysm is an  bigger  location in the  reduced part of the major vessel that  provides blood to the body (aorta). Nuclear medicine heart scan.  The aorta runs from the heart via the center of the breast and also abdominal area.

The aorta is the largest blood vessel in the body, so a ruptured abdominal aortic aneurysm can cause deadly bleeding.

 Depending upon the size of the aneurysm and  exactly how fast it’s  expanding,  therapy  differs from watchful waiting to emergency  surgical treatment.

Symptoms.
  Stomach aortic aneurysms  frequently  expand slowly without  visible symptoms, making them  tough to  spot. Some aneurysms  never ever  fracture. 

If you have an expanding abdominal aortic aneurysm, you may discover:

  • Deep, constant discomfort in the stubborn belly area or side of the tummy ( abdominal area).
  • Neck and back pain.
  • A pulse near the belly button.

Causes.
Aneurysms can  create anywhere along the aorta, but  a lot of aortic aneurysms  take place in the part of the aorta that’s in the  stubborn belly area (abdomen).

Several points can play a role in the advancement of an abdominal aortic aneurysm, including:

  • Hardening of the arteries (atherosclerosis). Atherosclerosis occurs when fat as well as various other substances build up on the cellular lining of a blood vessel.
  • High blood pressure. High blood pressure can damage and also damage the aorta’s wall surfaces.
  •  Capillary diseases. These are  conditions that cause blood vessels to become inflamed.
    Infection in the aorta. Seldom, a microbial or fungal infection could trigger an stomach aortic aneurysms.
  • Trauma. Being injured in a car mishap can create an abdominal aortic aneurysms.
  •  Danger  aspects.

Stomach aortic aneurysm risk aspects consist of:

Cigarette smoking is the greatest threat aspect for aortic aneurysms. Smoking can compromise the wall surfaces of the aorta, increasing the danger of aortic aneurysm and also aneurysm rupture.

Age. Stomach aortic aneurysms happen most often in individuals age 65 and older.

Being  man. Nuclear medicine heart scan.  Men establish abdominal aortic aneurysms much more commonly than ladies do.
Being white. People who are white  go to  greater risk of  stomach aortic aneurysms.

Family history. Having a family history of  stomach aortic aneurysms  enhances the risk of having the  problem.

Other aneurysms. Having an aneurysm in  an additional  big  capillary, such as the artery behind the knee or the aorta in the  breast (thoracic aortic aneurysm),  may  raise the risk of an  stomach aortic aneurysm.

Nuclear medicine heart scan.  If you’re at threat of an aortic aneurysm, your medical professional might suggest other steps, such as drugs to reduce your blood pressure and also eliminate anxiety on damaged arteries.

 Difficulties.
Tears in one or more of the layers of the wall surface of the aorta (aortic dissection) or a burst aneurysm are the main difficulties. A rupture can trigger serious interior bleeding. In general, the larger the aneurysm as well as the much faster it expands, the better the danger of rupture.

Signs and symptoms that an aortic aneurysm has actually ruptured can include:

  • Abrupt, intense as well as persistent stomach or pain in the back, which can be described as a tearing experience.
  • Reduced high blood pressure.
  • Fast pulse.
  • Aortic aneurysms also  enhance the risk of  creating blood clots in the area. If a blood clot  break out from the inside wall of an aneurysm and blocks a  capillary elsewhere in your body, it can  trigger pain or block blood  circulation to the legs, toes, kidneys or abdominal  body organs.

 

 Avoidance.
To prevent an aortic aneurysm or maintain an aortic aneurysm from getting worse, do the following:

  • Do not smoke or utilize cigarette items. Stopped smoking cigarettes or eating cigarette and also stay clear of secondhand smoke. If you need help stopping, speak to your physician concerning medicines and also treatments that might aid. Nuclear medicine heart scan.
  • Eat a healthy and balanced diet plan. Focus on consuming a selection of vegetables and fruits, whole grains, fowl, fish, and also low-fat dairy products. Avoid saturated and trans fats and also limit salt.
  • Maintain your high blood pressure and cholesterol controlled. If your physician has suggested medicines, take them as instructed.
  •   Obtain  routine  workout.  Attempt to  obtain at  the very least 150 minutes a week of moderate aerobic activity. 

 

Atrial Fibrillation (AFib) – Nuclear Medicine Heart Scan

A 6-lead electrocardiogram (EKG) is done by placing sensors on the arms and also legs to evaluate for Atrial Fibrillation.  Nuclear medicine heart scan. AFib can lead to blood clots, stroke, and also cardiac arrest, as well as other heart-related problems.

Atrial fibrillation (A-fib) is an irregular and typically very rapid heart rhythm (arrhythmia) that can cause embolism in the heart. A-fib boosts the danger of stroke, heart failure as well as various other heart-related difficulties.

Throughout atrial fibrillation, the heart’s upper chambers (the atria) beat chaotically and off-and-on – out of sync with the lower chambers (the ventricles) of the heart. For many people, A-fib may have no signs. Nuclear medicine heart scan.  Nonetheless, A-fib may trigger a quick, pounding heart beat (palpitations), lack of breath or weak point.

Episodes of atrial fibrillation may reoccur, or they might be persistent. Although A-fib itself normally isn’t deadly, it’s a major medical condition that requires proper treatment to avoid stroke.

Treatment for atrial fibrillation may include medications,  treatment to reset the heart rhythm  and also catheter  treatments to  obstruct faulty heart signals.

A person with atrial fibrillation may  likewise have a related heart rhythm problem called atrial flutter.  Atrial flutter is a different arrhythmia, the  therapy is  rather similar to atrial fibrillation. 

 Signs.
Some people with atrial fibrillation (A-fib)  do not  discover  any type of symptoms. Nuclear medicine heart scan.  Those who do have atrial fibrillation signs may have symptoms and signs such as:.

  • Feelings of a quickly, fluttering or pounding heart beat (palpitations).
  • Upper body discomfort.
  • Dizziness.
  • Fatigue.
  • Faintness.
  • Minimized ability to workout.
  • Shortness of breath.
  • Weakness.

 

Atrial fibrillation may be:

Occasional (paroxysmal atrial fibrillation). Some people with periodic A-fib requirement treatment.

Relentless. With this sort of atrial fibrillation, the heart rhythm doesn’t return to regular on its own. If a individual has A-fib signs and symptoms, cardioversion or therapy with medicines may be utilized to restore and also preserve a normal heart rhythm.

Long-standing relentless. This kind of atrial fibrillation is constant and lasts longer than 12 months.
Irreversible. Nuclear medicine heart scan.  In this type of atrial fibrillation, the irregular heart rhythm can’t be restored. Drugs are needed to regulate the heart rate and also to avoid embolism.

 Reasons.
To understand the  sources of A-fib, it may be  valuable to know how the heart  commonly beats.

The regular heart has four chambers – 2 top chambers (atria) as well as 2 lower chambers (ventricles). It generates the signal that begins each heart beat.

In a normal heart rhythm:

  • The signal travels from the sinus node through both top heart chambers (atria).
  • The signal goes through a pathway between the top and also lower chambers called the atrioventricular (AV) node.
  • The movement of the signal causes your heart to capture ( agreement), sending out blood to your heart as well as body.
  •  In atrial fibrillation, the signals in the  top chambers of the heart are  disorderly. The AV node is then  pounded with signals  attempting to get through to the  reduced heart chambers (ventricles). 

 

The heart rate in atrial fibrillation  might  vary from 100 to 175 beats a  min. The  typical  variety for a heart  price is 60 to 100 beats a  min.

 Sources of atrial fibrillation.
 Issues with the heart’s structure are the most  usual  reason for atrial fibrillation. Nuclear medicine heart scan.  Feasible root causes of atrial fibrillation consist of:.

  • Coronary artery disease.
  • Cardiac arrest.
  • Heart flaw that you’re born with ( genetic heart problem).
  • Heart shutoff issues.
  • Hypertension.
  • Lung diseases.
  • Physical stress because of surgical procedure, pneumonia or various other diseases.
  • Previous heart surgical procedure.
  • Problem with the heart’s all natural pacemaker ( unwell sinus syndrome).
  • Sleep apnea.
  • Thyroid illness such as an over active thyroid (hyperthyroidism) and also various other metabolic discrepancies.
  • Use of energizers, including specific medicines, high levels of caffeine, cigarette and alcohol.
  • Viral infections.

Some people  that have atrial fibrillation have no known heart problems or heart  damages.

Risk elements. Nuclear medicine heart scan.
 Points that can increase the  danger of atrial fibrillation (A-fib)  consist of:.

Age. The older a person is, the  higher the  danger of developing atrial fibrillation.

Heart disease. Anybody with heart problem– such as heart valve issues, congenital heart disease, coronary infarction, coronary artery disease, or a history of cardiac arrest or heart surgical treatment– has an enhanced threat of atrial fibrillation.

High blood pressure. Having high blood pressure, specifically if it’s not well managed with way of living changes or medicines, can raise the risk of atrial fibrillation.

Thyroid illness. In some people, thyroid troubles may set off heart rhythm troubles (arrhythmias), including atrial fibrillation.

Other persistent health and wellness problems. Individuals with specific persistent problems such as diabetes mellitus, metabolic syndrome, chronic kidney condition, lung disease or rest apnea have actually an boosted danger of atrial fibrillation.

Consuming alcohol. For some individuals, drinking alcohol can activate an episode of atrial fibrillation. Binge drinking more rises the threat.

Weight problems.  Nuclear medicine heart scan.  Individuals who have excessive weight are at greater danger of developing atrial fibrillation.

Family history. An boosted risk of atrial fibrillation happens in some families.

Issues.
Blood clots are a  unsafe  issue of atrial fibrillation that can lead to stroke.

In atrial fibrillation, the  disorderly heart rhythm can cause blood to  accumulate in the heart’s upper chambers ( room) and  type  embolisms. Nuclear medicine heart scan.  If a embolism in the left top chamber (left atrium) breaks without the heart location, it can take a trip to the mind as well as cause a stroke.

The  danger of stroke from atrial fibrillation increases as you  age.  Various other  wellness  problems  likewise may increase your  threat of a stroke  as a result of A-fib,  consisting of:.

  • Hypertension.
  • Diabetes.
  • Heart failure.
  • Some valvular cardiovascular disease.
  • Blood  slimmers are  typically  suggested  to avoid  embolism  and also strokes in  individuals with atrial fibrillation.

Prevention.
Healthy and balanced lifestyle selections can reduce the danger of cardiovascular disease and might prevent atrial fibrillation. Nuclear medicine heart scan.  Below are some standard heart-healthy ideas:

  • Eat a healthy diet.
  • Get regular workout as well as keep a healthy weight.
  •  Do not smoke.
    Prevent or restrict alcohol and also high levels of caffeine.
  •  Handle stress, as  extreme  anxiety and  rage can  create heart rhythm problems.

 

Osteoporosis Risk – Nuclear Medicine Heart Scan

An ultrasound is  carried out to  gauge the shin bone for  unusual bone mass  thickness. Nuclear medicine heart scan.  This can assist assess the danger of weakening of bones, a condition where bones become weak and also weak.

Osteoporosis creates bones to become weak and brittle – so fragile that a autumn or even light stress and anxieties such as flexing over or coughing can cause a fracture. Osteoporosis-related cracks most generally take place in the hip, wrist or spinal column.

Osteoporosis influences males and females of all races. White and Asian females, specifically older women that are previous menopause, are at greatest danger. Medications, healthy and balanced diet plan and also weight bearing workout can aid avoid bone loss or reinforce already weak bones.

 Signs.
There typically are no signs and symptoms in the beginning of bone loss. Once your bones have been compromised by weakening of bones, you might have signs and also signs and symptoms that consist of:

  • Back pain, triggered by a fractured or collapsed vertebra.
  • Loss of height over time.
  • A stooped stance.
  • A bone that  damages  a lot more  conveniently than expected.

Causes.
 Contrasting the interior of a  healthy and balanced bone with one that has  come to be  permeable from osteoporosis.
Osteoporosis  compromises bone.

 Exactly how likely you are to  establish osteoporosis depends  partially on how much bone mass you attained in your  young people. Peak bone mass is  partially  acquired  and also varies also by ethnic group. The higher your  optimal bone mass, the more bone you have “in the  financial institution”  and also the  much less  most likely you are to  create  weakening of bones as you age.

 Danger  variables.
A number of aspects can enhance the chance that you’ll establish osteoporosis– including your age, race, way of life choices, as well as medical problems and also therapies. Nuclear medicine heart scan.

 Stable risks.
Some danger factors for weakening of bones run out your control, consisting of:

  • Your sex. Females are a lot more most likely to create weakening of bones than are guys.
  • Age. The older you obtain, the greater your threat of weakening of bones.
  • Race. You’re at greatest risk of osteoporosis if you’re white or of Asian descent.
  • Family history. Having a moms and dad or sibling with weakening of bones puts you at higher risk, particularly if your mother or daddy fractured a hip.
  • Body frame size. Men and women that have small body structures have a tendency to have a higher risk due to the fact that they might have much less bone mass to draw from as they age.
  • Hormone  degrees.

Weakening of bones is more typical in individuals who have way too much or too little of certain hormones in their bodies. Examples consist of:

 The  autumn in estrogen  degrees in women at menopause is one of the  best  threat  aspects for  creating osteoporosis. Treatments for prostate  cancer cells that  decrease testosterone levels in  males  and also treatments for breast  cancer cells that  lower estrogen  degrees in women are likely to accelerate bone loss. 

 Nutritional  aspects.
Osteoporosis is more likely to  take place in  individuals  that have:

Low calcium consumption. A long lasting lack of calcium contributes in the development of osteoporosis. Reduced calcium consumption adds to decreased bone density, early bone loss as well as an increased danger of cracks.

Eating disorders. Severely limiting food consumption and being underweight damages bone in both males and females.

Lasting use of oral or infused corticosteroid medications, such as prednisone and also cortisone, hinders the bone-rebuilding process. Nuclear medicine heart scan.  Weakening of bones has also been connected with drugs used to combat or protect against:

  • Seizures.
  • Gastric reflux.
  • Cancer cells.
  • Transplant rejection.
  • Medical  problems.

The  danger of osteoporosis is  greater in  individuals  that have certain medical  troubles, including:.

  • Gastric condition.
  • Inflammatory bowel disease.
  • Kidney or liver condition.
  • Cancer.
  • Several myeloma.
  • Rheumatoid joint inflammation
  •  Way of living  selections.

Some bad habits can raise your danger of weakening of bones. Examples include:

Sedentary way of life. People that invest a great deal of time sitting have a greater threat of weakening of bones than do those who are more active. Any kind of weight bearing workout and also tasks that promote balance and also excellent pose are valuable for your bones, however walking, running, jumping, dancing and also weight-lifting seem particularly useful.
 Too much alcohol  intake. Nuclear medicine heart scan.  Routine intake of more than two alcoholic drinks a day boosts the danger of osteoporosis.

Cigarette use. The exact role tobacco plays in weakening of bones isn’t clear, yet it has been revealed that tobacco use contributes to weak bones.

Difficulties.
 Just how osteoporosis can cause vertebrae to crumple and collapse.
Compression fractures.

In some cases,  spine  cracks can  happen even if you haven’t  dropped. The bones that  comprise your  spinal column (vertebrae) can  damage to the point of  breaking down, which can  lead to  pain in the back, lost height  and also a hunched forward  pose.

Prevention.
Good nutrition  and also  routine exercise are  crucial for  maintaining your bones healthy throughout your life.

Calcium.
Men and women  in between the ages of 18  as well as 50 need 1,000 milligrams of calcium a day. This  day-to-day  quantity  enhances to 1,200 milligrams when  ladies turn 50 and  guys turn 70.

Good resources of calcium consist of:

  • Low-fat milk items.
  • Dark environment-friendly leafy {vegetables| veggies
  • Canned salmon or sardines with bones.
  • Soy products, such as tofu.
  • Calcium-fortified cereals  and also orange juice.

 

The Health and Medicine Division of the National Academies of Sciences, Engineering,  as well as Medicine  advises that  overall calcium  consumption, from supplements  as well as  diet regimen  incorporated, should be no more than 2,000 milligrams daily for  individuals older than 50.

Vitamin D.
Vitamin D improves the body’s  capability to  take in calcium  and also improves bone  health and wellness in  various other ways. Nuclear medicine heart scan.  People can obtain a few of their vitamin D from sunlight, however this might not be a good resource if you reside in a high latitude, if you’re housebound, or if you frequently make use of sunscreen or avoid the sun due to the risk of skin cancer.

 Nutritional  resources of vitamin D include cod liver oil, trout  and also salmon.  Numerous types of milk and cereal have been  strengthened with vitamin D.

Most people  require at least 600  worldwide  devices (IU) of vitamin D a day. That  referral increases to 800 IU a day after age 70.

Individuals without various other resources of vitamin D and specifically with minimal sunlight exposure could need a supplement. A lot of multivitamin products have between 600 and also 800 IU of vitamin D. Up to 4,000 IU of vitamin D a day is secure for the majority of people.

 Workout.
Workout can aid you construct strong bones and also slow moving bone loss. Nuclear medicine heart scan.  Workout will profit your bones anytime you begin, yet you’ll gain the most advantages if you begin exercising on a regular basis when you’re young and continue to exercise throughout your life.

Weight-bearing workouts– such as strolling, running, running, stair climbing, skipping rope, skiing as well as impact-producing sporting activities– influence mostly the bones in your legs, hips and lower spinal column. Balance workouts such as tai chi can lower your danger of dropping especially as you get older.

 

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