Healthysport
Healthysport
General facts about HealthySport
Lifestyle Change
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For the last couple of years I have been planning on resuming my half marathons but school and work virtually wiped all my free time.Then I was diagnosed with diabetes (something I expected due to family history). Then a family member got sick so I had to be a caregiver in my own home. The half-marathon training was placed at a standstill.
But my work as a Physical Therapist continues, albeit as per diem (after 20 years of full time). I work in an acute trauma hospital. I used to be the official ‘floater’, one who gets assigned anywhere there is a need for PT. Recently my daily work is focused on acute-rehab. Each of my patients is required up to 3 hours of rehab per day (with rest during sessions of course) and the main goal for them is home discharge with community/family support.
Every now and then I go out to acute. I have been an acute PT all my life. Two weeks ago I offered a few hours of PT work in a local nursing home close to my place to get acquainted with their software (casamba). Being a dual degree holder of PT and IT, I am very very interested with the latest apps and softwares being utilized in hospitals and PT-related facilities.
Because I am a lot older now in this business, I feel more inclined to frequently reflect on my job, my patients and myself. My empathy gets the better of me because most of my patients belong to my age now. And I am not far behind from the age-group of my nursing home patients either. There is no day when I am reminded how the patient I am treating now could be me. And lemme tell you, the outlook can be scary with the current healthcare system. Just let me give you this advice : Stay as healthy for as long as you can. It is no fun being old and debilitated and poor and alone during non-productive years.
I am a PT inclined to self-reflection. I check my patients’ labs and make a ‘mental’ data collection and correlation between them and their conditions. For example, if I have 5 patients with acute stroke on one particular day, I take a mental picture of what is common among them. High blood pressure? High sugar? Stress? Heart problems? Weight? Race? Gender? I am focused on stroke because it is one of my most dreaded medical conditions. I also have a family history of it and I know how much it can destroy quality of life in its aftermath.
So far, two significant conditions are prominent in my very unscientific sampling of stroke patients. High blood pressure and high blood sugar. The other thing that I find interesting too is this - a few of these patients stroked out on account of ‘missing’ their meds due to having no money to buy them. I wish all of them rely on the cheaper metformin and lisinopril and generic statin (which you can get free or at only a few dollars in any drugstore) but a lot of them have too many co-morbidities (other medical problems) that need meds as well. I have read ER admission lines that begins with, “The patient developed right-sided weakness, numbness and slurring of speech after missing to take his BP meds for three days”. Delving deeper, and in private conversations, the patient confesses with extreme embarrassment that, “I could not afford all my pills.”
Then I sit down and reflect on this. If this patient cannot afford a few dollars worth of medicine, how in the world can he afford healthy food, fitness gyms, nutritionist? We can create all these wonderful gadgets and apps but this particular patient in my list will have the remotest chance to avail them. And so, I sit down with this patient and talk.
Talking about healthy lifestyle with patients sometimes feels like talking to the choir. Sometimes I get dumbfounded reactions. Sometimes I see bored faces. Occasionally I see a face lighting up with new understanding.
But it is a good start.
I often wonder how Hippocrates and Florence Nightingale would react to the current healthcare system in the US. Yes, it can be highly advanced thanks to the billions spent for its research and development but what happens to its heart and soul?
It seems to me that being healthy today costs money. I conclude that because that is what I see everyday. Pay premiums to see a Doctor regularly, buy meds, healthy food will cost money, being fit may cost extra more in joining a gym and that precludes the training and diet programs guaranteed to work if you’d let the ‘experts’ manage your lifestyle for a fee (of course). Health Coach, Fitness Coach, Personal Trainer, Nutritionist, heck, even a personal Physical Therapist can be available to trim your body good for a fee.
And I certainly do not think all this is bad - if you have the resources please use all the experts to keep healthy. But the real question is : what happens to those who can’t afford any of these?
This is where the problem of present day health care system lies : the propagation of the belief that ‘someone can manage my health as long as I hire the right expert’. In other words, a lot of people believe that no matter how unhealthy they live, it is ok since there is a Doctor or a Specialist or a pill for that. Much like saying, ‘don’t worry about your problem, there is an app for that’.
Surprisingly, not all medical problems can be solved medically or surgically. In fact, most of the health related problems of the USA are lifestyle related and can be resolved through lifestyle changes. It goes without saying that a lot of our medical conditions are better treated behaviorally than medically.
Just look: type 2 diabetes, heart disease, certain cancers, kidney disease, depression, stroke, obesity - these top killers are reducible by lifestyle changes. And you don’t need thousands of dollars to manage those changes. Stop smoking, eat proper food, be active, avoid stress, increase rest, do you really need an expert to handle these?
All you need is discipline, resolve, courage and willingness to adapt and change. Yes. All of these involve behavior modification. And change of life perspective.
The Quadrangle of Life
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There is no doubt about it. Computer programming renders me immobile for hours and I need to get away from my ‘learning’ momentarily (currently I am immersed in cloud computing via AWS and digital ocean) and focus on lighter side of things, like, life. Oh yeah, I need to get a life. I am a late bloomer in computer languages and sometimes I act like a freshly minted college graduate who just got his first job, and, well, that is basically true. I just graduated in I T last December. A few days ago I was offered days off from clinical work on account of having low hospital census (summer). That excited me. It meant I could work on my coding which I was dying to do. It doesn’t earn me a penny but wow, what I can do with it in my free time! But (despite pursuing my passion), sitting on a chair for hours can be dangerous to my physical health. Being old and wise now, I need to press the brakes when I get too concentrated. Prolonged immobility is no good.
I remember a patient who recently had surgery of a fractured hip asking me, “I am in so much pain, why must I sit up on chair? What is so important in sitting up?”
Obviously the patient haven’t had been in a hospital before or he subscribes to the old notion of bedrest in times of injury or disease. I said there are things that happen when you go vertical. You move the muscles, you inhale more air that expands the lungs, your circulation goes down the legs to be pushed up back, which makes the heart work more, gravity pulls down whatever needs to get expelled out of your system, you prevent hypotension, you prevent blood clots, all your organs will rev up and of course, you eat better when you are sitting and looking better when visited by friends and families.
I guess my answer did register something as he asked to be assisted to the bathroom. Yeah, unfortunately, I need to deal with THAT when people go vertical the first time after being sick. He just couldn’t wait to use the bathroom.
That is the reason why movement, no matter how little, matters to everyone. For seniors like me, it is much more important. There is a quadrangle of needs a person must meet at this stage in life, like 4 corners required to stabilize it.
Movement, Nutrition, Mental Stability, Rest.
We need to balance all these to maintain an optimally functional and good quality life. One should not be tempted to focus on one and ignore the rest. Too much movement or exercise at the expense of the other three leads to injury and depressed immune system. Too much dieting or the opposite will lead to starvation or obesity and related problems, too much stress or mental anguish will lead to stress hormones affecting the whole being, and absence of rest will lead to fatigue and again, compromised immunity.
These components of the quadrangle are very dynamic, much like setting up a pole supported by 4 wires. All those wires should be equal or at least each compensatory for the others as need be. The goal is perfect harmony and balance. Do not ignore any of them.
A lot of health care workers nowadays are looking more closely into the mental component since it appears it is the main driving force of all 4. If we seriously consider them all, the mental discipline seems to drive the resolve and concentration and consistency for the quadrangle. It is the motivation to keep us moving. It is the mental discipline to choose the right food. It is mental power for us to turn the light off at night so we can complete our daily sleep.
There are a few ways to address the mental component of the quadrangle:
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To keep motivated to exercise, read exercise books, internet blogs, health and lifestyle magazines. Spend time with people who are regular exercisers, talk to family about giving you space and time to exercise, keep a journal of your routine. Shoot for self-data progress. Data progress includes weight loss, improved sugar and blood pressure, feeling of well being. Keep these data so you can evaluate progress.
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Keep a journal of what you eat. Educate yourself on proper nutrition. If you have no time to cook healthy meals, subscribe to programs who can do it for you. Personally, I always look for natural cooking in my own kitchen.
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Make sure that no matter how hard working you are or how passionate you are with what you do, set a time to pause and stop to resume at another time. That applies well on me. It is important to mentally shift your gears to sleep mode, rest mode, exercise mode, meal mode. Don’t get complacent. When you say you finish work at 5 pm, try your best to finish at 5pm. If you determined sleeping 7 to 8 hours a day means retiring at 10, try to drop everything you do and sleep at that time.
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Again, it’s all about mental power.