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Healthy Life in Times of Recession
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Of course everyone around the world is now worried about the economic debacle confronting mostly the US, Europe and China. These are nervous times for a lot of people highly invested in the stock market. Today alone the Dow Jones dropped by 630 points which is worth trillions of dollars thrown out to some unknown dark space. This can spark a tremendous restlessness and blame game among the rich and politicians. And for middle class people like me, well, my interest in the stock market isn't panicky, I am invested mostly and modestly in bonds and money market but still, I am curious about the appropriate healthy response to situations like this.
One of the best responses I heard so far today was from a Doctor in the hospital where I work. He said, "I don't want to know."
Which brings me to something I deal with everyday at work. How do you manage loss? Loss can take many forms. There is loss of money, loss of strength, loss of hope, loss of love, loss of pride, loss of health, loss of a loved one, loss of everything. I see this loss not only among my patients but more so among their family members. Yesterday (Sunday) I was in another Trauma hospital and while wheeling my Rehab patient to the gym for work out, I passed by a middle aged man kneeling against the glass wall, head bowed and though I could not see his face, I knew he was in agony, because, the poor guy was bawling. He was being comforted by other members of his family. I did not have to ask anything, neither was there anything to do to appease him, he was agonizing over his child. I knew that because he was in the Pediatric Ward.
I always see this situation in my work area. Though I think I have been toughened up by all the miseries I have witnessed in my career, I still feel that knot in my throat when I see a mother or a father or a brother or sister or children or spouse breaking apart because of an impending or a concluded loss. And one of my rules is never to show emotions in this situation. Or else I will ask someone to deal with it while I go away from the scene. So far, I haven't reached that emotional break down when dealing with some of the most horrendous losses I have seen in this world.
I recently had a patient who was in his mid-90s who was recently admitted to the hospital for shingles. The pain was so terrible that he lost his appetite and sleep. Guess who ended up being sicker than him because of worry? His wife.
There she stood in front of me, haggard-looking, eyes swollen for lack of sleep and her walk was so heavy I thought she would fall every time she took a step."I don't know what to do," she cried. "I am begging him to eat something and he won't. I am asking all the Doctors to help him get some sleep and they won't listen. Now, he is having diarrhea. What else can I do? Please tell me what to do."
Every time she agonized, the husband would raise his hands and start rubbing his head. I could sense he was suffering additionally just by listening to her. I understand her fears and emotions but to be honest, if there is anything worse that can happen in this situation is she having a heart attack for worrying too much. And I've seen a case like that in the past.
What can worrying really do? It can probably help worrier in coping but it can not help the patient. Sometimes I tell families to just leave the room, go to the chapel or a quiet place, spend time with friends, even watch a movie if needed just so they could save themselves from the damages caused by worry. I know this is easier said and advised but if you look at it from the logical scheme of things, there is no way worrying can help anybody. Worry can increase blood pressure, heart rate, and will release lots of free radicals into the body that cause major damage. It affects sleep, appetite, strength. Worst of all, it affects the psyche and can lead to things like depression and anxiety. With all these damages, the saddest part of it is - it will not solve anything.
The wife I am talking about ended up being in the care of the Nurse and myself because her blood pressure rose as high as above 200/100. All because of worry. She soon developed a TIA. The couple ended bed ridden, he was worried about her, she about him. If I did not have the right sense I'd probably end up being sick also because I too worried about them. Their children took their leaves from work to watch over them (and obviously worried about them). Now the sick couple felt so sorry they had to drag their children into their sickness adding more worry on top of the old worry they already have).
Man has to be strong.
I used to be a worrier myself and I need to understand people under extreme duress. It is so easy to say "stop worrying" to someone who is facing job loss, loss of funds, loss of health and loss of home at the same time. The last things he'd like to hear are these words.
But after everything is said and done, when everything collapses and when everything is lost, what do you think is the last most precious asset left for you to bank on? What will be the asset that will make you recover and start all over again? Obviously it is good health. Some people don't realize how profitable good health as an investment is. First you have the strength to build up, the brain to maneuver the complex recovery, the assurance that you won't need to spend a single cent for medications, diseases or illness because you are healthy.
Do you know the number one cause of bankruptcy among small businesses in the US? You guess it, it is medical bills. People's finances collapse due to illnesses and most of these can easily be corrected by healthy lifestyle. There is a thousand discrepancy in the cost between medical bills/medications and good food and daily exercise. Being healthy will save the nation unnecessary expenses, or at least, the money saved will be allotted to the ones who are really really vulnerable like sick children and sick elderly.
We are all barking at the wrong tree when we talk about increasing taxes and cutting down on Medicare or imposing universal health. What we want to talk about everyday is how to promote good health to every John and Jane Doe in the US. And maintaining good health does not require an expensive gym membership or classy gears. You don't need to look like Lance Armstrong to be considered healthy. All you need is to walk outside or run or go to the beach or a river to swim. You can have your friends come with you to go fishing by walking from your house to the pier and walking back with your catch. You can play with your kids or teach them new sports techniques. You can walk to the store or bike to the store to buy your groceries. You can - well, clean the house, repair something broken, fix something. I don't need to spell all the potential things one can do.
You can plant your own vegetables, raise your own chickens, catch your own fish, learn a new skill at the local school. You can learn how to cook healthy food for the family. You can actually study more on proper nutrition and make it a goal for the whole family to stay within normal BMI.
There are so many things one can do for this particular investment called health that offers the highest return in all the world. This country, instead of debating about whose fault it is that caused the downgrade of economy should start thinking of means and ways to facilitate and encourage healthy lifestyle among the population. It will save us a bunch.
Muscle Specificity versus Confusion
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[What I use to swim]
I recently went to the gym, NOT to swim this time but to use their elliptical and incline machines (I am not good at the gym equipment's terminologies - sorry) as a diversion from my usual swim or run routines. I was intending to run at the park after working in the hospital but something happened to me two days ago, this is not worth re-telling but it might benefit others with regards to new shoes, training and fasciitis.
First I decided to replace my old worn-out running shoes. I usually buy Mizuno which I think fit my feet the best. My first mistake was that I assumed certain things. I thought I could just go on with my usual running routine even with new shoes. I did an interval training. Big mistake. My left heel was burning the following morning. I pretty much knew that shoes need 'breaking in' but for some reason I thought having the same brand would not make any difference. Wrong!
Being a PT I knew that off-pounding will be the next step to avoid this from getting full blown. I decided to use these new shoes at work place for now, just to 'break' them in. I might use them for slow jogging until they conform to the contour of my feet. Meanwhile I will stick to the old shoes for speed training.
So my next move was to replace my running with something similar but has less stress on the heels. Well, here comes the elliptical and incline. I deferred my swimming today due to some other issues (that will require another article later). And it worked just fine. The elliptical provided the challenge much similar to running without the extreme impact.
Which brings me to a topic that is not really new and perhaps everybody knows about already: Muscle Specificity versus Muscle Confusion. There are so many terminologies that sports enthusiasts have been coming up with lately that they can get confusing at times. Pacing, Intervals, LSDR, Aerobic, Anaerobic, VMax, Lactic, sub-lactic threshold, cross-training - these are just a few. Lately, every time I turn on the TV, people talk about intervals and muscle confusion. It is claimed that muscles work the best when they are not routinized or in layman's parlance, they are surprised. Some TV gurus claim it to be 'the secret' to maximal work-out benefits.
In PT, we have been working on a similar concept for decades now, it's called PNF. (Proprioceptive Neuromuscular Facilitation) which basically applies the concept of working on all groups of muscles with one stroke called 'pattern' which usually is diagonal in direction. It's really good when you want to 'involve as many muscles as you can given a limited time or session' or if you want to increase 'proprioception' which is basically an 'awareness' of the limb or muscles in terms of position, movement or direction. But there were studies that had concluded it's not much different from the regular active ROM exercises. Perhaps there are current trends in PNF that I am not much familiar with but the main reason I mention it (on account of muscle confusion) is because for me the most important aspect of exercise is exercise itself no matter the form, technique or rationale.
When people ask me what is the best exercise, I say, 'Exercise'. In my years as a PT, what matters is not much about what exercise a person does, but 'how compliant' the person is with his or her exercise. I can give you the best exercise program in the world but if you go home to sit it out and lay on the couch and eat anything you want and get driven wherever you go, really, what's the point of those wonderfully, scientifically proven effective exercises I just handed to you? This is one of the biggest frustrations of PTs like me: Lack of Motivation and Poor Compliance.
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