I just resigned from Rex Healthcare after more than 20 years of service. The following are the events leading up to this decision:
My husband died almost 5 months ago. He had acquired an infection in the brain during a surgery to remove a benign brain tumor. The complication brought on bleeding in the brain and a massive stroke which left him paralyzed on the left side of his body to the degree that he could not even sit up or turn himself over in the bed. He was completely dependent, a fate that most people would consider worse than death, and he certainly viewed it that way.
He suffered all the indignities that go along with such total dependency, and in the end all I could do is take him home and afford him the comfort to die at home in familiar surroundings with friends visiting him to the very end.
Never in my worst nightmares could I have imagined such a scenario. The week before the surgery, my husband and I had made our annual trip to the IDEA World Fitness Convention in California. He even indulged my craving for art, and we visited the Getty Museum together on a beautiful California day.
I have been a wellness instructor at Rex Hospital for more than 20 years, teaching first water aerobics and then MELT. I had always been proud to be associated with Rex Hospital, and when my husband needed to be admitted to a hospital, Rex was my first and only choice.
Watching the proceedings leading to my husband’s death has caused me a great deal of anguish as I dealt with my increasingly ambivalent relationship to Rex. My first impulse was to resign, and I did not teach any classes at all for several months. I had a sense of loyalty, though, if not so much to Rex as to the members of the wellness center, and decided to teach on a very limited base. Stepping back on hospital grounds was more difficult than I had imagined. I had made the trip to the hospital over and over again during the months of my husband’s hospitalizations and rehabilitations.
It is not easy to get one’s life back together after events like those. I know that many other people have suffered a similar fate but this is of very little consolation. In addition to the grief, there is anger over an unnecessary death. My husband should still be alive, and we should be planning for our next conference. His clients should still have a trainer, and I should still have a husband. Thoughts like that rear up even if one tries to ‘move on’ as the saying goes.
I was dealing with all that when I got an unexpected piece of mail this week. Rather, it was a mailing addressed to my husband. Of course, much mail is still addressed to him but the sender of this letter was unique. It was a letter from the Rex Healthcare Foundation and it was the request for a donation so that Rex can continue to provide excellent care to its patients.
At first, I was baffled. Then I tried to decide whether to laugh or to cry. The longer I looked at the letter, the angrier I got. I wrote a cynical note to the Rex Healthcare Foundation which made me feel a little better temporarily. I felt and still feel as if somebody had slapped me in the face, adding insult to injury. I have been trampled upon by a hospital bureaucracy that simply doesn’t give a damn. Pardon my French, I am usually not given to outbreaks of profanity. This is how I feel: “How dare they send this letter? First they kill my husband, and then they have the nerve to send this!”
I cannot possibly continue to be associated with an organization where such instances can occur. Yesterday, I sent my letter of resignation.
Not too many years ago, the term “fascia” was hardly heard. It was viewed as the body’s inert ‘packaging material’ just as bubble wrap or packaging peanuts. It was also regarded as the domain of hands-on bodyworders such as massage therapists and Rolfers. This view has changed radically over the last years, and its wording has begun to infiltrate the fitness industry.
Let’s go back to basics with a definition of what “fascia” actually is. It is not so much packaging material as it provides a stabilizing structure in the body. Better known examples of fascial tissue are tendons and ligaments, the plantar fascia and the notorious IT band. But it goes well beyond that in that it surrounds every bone, every muscle and even every muscle cell. Think of it as the membranes of an orange which give the fruit its shape.
The fascia in the human body creates an internal scaffolding which can reorganize itself constantly to the requirements of movement and rest. It is a fluid filled system based on collagen. Because of its job as a support structure, it provides stabilization particularly for those postures and movements which we execute repeatedly. It accomplishes that but laying down extra tissue much as we would use duct tape to reinforce weak structures.
Unfortunately, the one position that we as humans in our modern world assume the most is sitting, be it at a desk, in the car or even for recreational activities such as reading. When fascia deforms and reinforces itself to accommodate a sitting posture, it becomes denser (de-hydrated) and loses its ability to extend easily to provide support for other positions such as standing and walking. The consequences of this discrepancy are frequently shoulder, neck and low back pain.
Another important aspect of fascia is that it is the host tissue for a variety of sensors which form part of our autonomous nervous system. I am right now only referring to the sensors (mechanoreceptors) which allow us to sense ourselves in space, also called ‘proprioception’. (There are others but this would lead us too far.) When those sensors are in the healthy environment of easily moveable fascia, they can sense their surroundings with accuracy and relay this information rapidly so that subsequent movements can be executed correctly. Watching athletes gives an excellent opportunity to see this perfect response, be it a downhill skier or a basketball player. However, when those sensors happen to be in areas of dehydrated fascia, then the sensory input is skewed, and information travels at a slower speed. A very sad example of such flawed input and slow response is when people, often older, fall. The main reason why those falls can have such catastrophic consequences is that no corrective response occurs to counteract the fall. Simply put, by the time the information about the impending fall has been received by the brain, the person has already fallen without any attempt at bracing the fall.
With all this said, it seems obvious that we should take care of our fascia much as we take care of our skin and teeth.
As an instructor for MELT (Myofascial Energetic Length Technique), TBMM (The BioMechanics Method) and (soon-to-be) RTR (Relief through Rolling), foam rollers and balls are my preferred method of massaging and manipulating fascia with the goal of lengthening and re-hydrating this tissue. The beauty of all these techniques is that they are meant for self-treatment, and a participant in a class will have take-home techniques.
At the last personal training conference, I attended a session on “Posture and Core for the Aging Spine” presented by Shari Kalkstein.
I walked away with many good ideas on how to work the core without further jeopardizing clients with osteoporosis but I also learned one fact that I had not known before.
I knew that not only women can get osteoporosis but also men. I had heard the statistics of a ratio of about 1 : 10. I have never really questioned it. It was in my textbooks, and I did not give it any further thought.
While is seem to be true that women are at greater risk for osteoporosis than men, it is definitely true that men are not screened for it. In fact, I do not know of one man who had been screened for osteoporosis. That makes me wonder whether the low prevalence is the result of lack of early detection and not because of the fact that “men are at much lesser risk”. A google search revealed that men are more likely to die after a hip fracture than women.
So here is my suggestion if you are a guy: talk to your doctor to see whether a screening for osteoporosis is right for you.
A life-changing event like my husband’s death brings a lot of insight in the quality of the relationships that one has and had. Those insights can be a source of disappointment but also of surprise and gratitude.
One of my fondest surprises came from IDEA. With 250,000 fitness professionals world-wide, IDEA has grown to a force in the industry, and being just one out of 250,000 makes one a very small fish in a big pond. Imagine my surprise when I got a card from the family of Peter and Kathy Davis with a wonderful gardenia plant. When I went to the conference two weeks ago in Alexandria, I got a big hug from Marco. The process of terminating my husband’s membership was made as painless as possible. My interaction with IDEA over the last few months made me feel a part of the IDEA family. I have always cherished IDEA for the quality of their programs, and now I have yet another reason to love them.
The last conference was another example of great information and impeccable organization. I have summarized my impressions about the sessions I attended on my website, and here is a link for those who want to know what one does at a conference. You'll need to copy and paste it. http://www.meltnc.com/page23a.html
It’s been almost two months since my husband passed away, and I am becoming an expert at stress management, at least for my own stressors.
I have always been preaching to accept what is to direct the energy toward a solution, and those beliefs have been sorely tested. They have been holding up for the most part. I find that dwelling in “what ifs” and “should have beens” takes a lot of energy away from the search toward the way to deal with curve balls and unwanted realities. I am also blessed beyond words to have friends who I can call and who will listen and give good advice.
I have been told over and over that I am a strong person and will be able to deal with everything that comes my way. Except that, sometimes, I am sick and tired of being strong.
And then there are moments when the wall comes down temporarily, and they are usually unexpected. It happened when I was asked to complete a questionnaire. The question was “Marital Status”, and I realized that I was suddenly single.
Those are the moments when I am glad that I have my dog Mr. Darcy.
A few days ago, my husband passed away. He has been a trainer for the last 21 years and had intended to train at least another five. As an NASM certified trainer, he had taken advantage of the one-time charge for life-time re-certification. While he was in one the recovering phases over the last few months, he told me that he would announce those plans to his clients, thus reassuring them that he was very serious about getting well and returning to duty.
Nobody could have been more passionate about training than my husband. Fitness has been a major factor in his personal life. It started when he was in high school and college where he played football and continued when he was in the army as an airborne ranger. After that, he continued with fitness, and I never knew him not working out for the almost 27 year that I knew him.
As trainers and instructors, we are also prone to portray ourselves always as very healthy and to gloss over those little warning signs which may the non-fitness guru cause to seek medical advice. As trainers, exercise is the answer to almost all questions, and we can hardly imagine that there is a malady which cannot be improved by it.
Looking over the sequence of events leading up to my husband’s death, I could see all the hallmarks of a perfect storm. With his athletic and military background, being sick was not an option. For all I know, he never missed a day of work. He also went to regular medical check-ups but dismissed little warning signs as nothing worth mentioning.
With the brutal clarity of 20/20 hindsight, it is possible that there may have been warning signs both for the growing brain tumor (no matter how benign) and even for the subsequent infection caused by the surgery. We will never know whether there might have been a better outcome if they had been heeded but I sure would have liked to have given it a try.
In an effort to have something good come out of all of this, here is my appeal to all the guys out there who are as tough as nails and indestructible: If there is something happening in your body which does not fit with your image of yourself, please take courage and have it checked. And if you are really brave, please tell your significant other. They are the ones that will have to deal with the consequences if you don’t.
I would have never thought that this could become so personal. Statistics are usually abstract ideas, possibilities in percentages, usually too small to consider as anything that could have an impact on one’s life.
Until it does!
According to the CDC, there were 157,500 surgery site infections in the United States in 2011. These are 157,500 lives which have been, to a greater or lesser degree, altered, maybe forever.
As in the case of my husband!
July 21, my husband had a surgery to remove a benign brain tumor, called meningioma. He delayed the surgery by one week because we had signed up to go to the IDEA World Fitness Convention, and he really wanted to go. We had a good time, as always. Two days after our return was the surgery which was supposed to be not much of a big deal because these tumors are usually self-contained. This one was not, though, and there were a few functional deficits on his left side after the surgery. Prompt rehab improved things, and my husband came back home and started training his clients again.
Then, suddenly, there was a day when the progress on his left side was all but wiped out. There was the suggestion of a stroke. We found a great physical therapist, and soon we saw signs of improvement again.
A few weeks later, there was a complete breakdown of function. My husband was back in the hospital, and a CT scan revealed an infection. The surgery the next day let us to hope that we had conquered all complications and would soon be on the road of recovery. Wrong again. There was bleeding and fluid build-up in the brain which caused another stroke.
It has been four months since the initial surgery. My husband is in a rehab facility, at present completely paralyzed on his left side. The physical therapists have now determined that he has not progressed enough to continue, and he will be discharged home on December 4. I have arranged for home health care but most of it will be done by myself.
So that is what’s meant by the statement that every surgery has some risk of infection ……
PS: My husband Rufus passed away December 22, 2015.
Fibromyalgia is a multi-layered condition, and those who are suffering from it often have a difficult time communicating the complexities to others. Here is an excerpt from the Fibromyalgia Foundation’s website:
“Fibromyalgia pain typically waxes and wanes in intensity; flares are associated with unaccustomed exertion, soft tissue injuries, lack of sleep, cold exposure, and psychological stressors. Although most patients have widespread body pain, there are typically one or two locations that are the major foci. These pain foci often shift to other locations, often in response to new biomechanical stresses or trauma. Fibromyalgia is more than a muscle pain syndrome, as most patients have an array of other somatic complaints. Nearly all fibromyalgia patients have severe fatigue, poor sleep, and post-exertional pain. Other symptoms include: tension type headaches, cold intolerance, dry mouth, unexplained bruising, poor memory and concentration, fluid retention, chest pain, jaw pain, dyspnea, dizziness, abdominal pain, paresthesia, and low grade depression and anxiety. Some symptoms relate to specific syndromes whose prevalence appears to be increased; these include: irritable bowel syndrome, irritable bladder syndrome, migraine, premenstrual syndrome, Raynaud’s and restless leg syndrome.”
How can MELT help? While MELT cannot ‘cure’ fibromyalgia, its unique way to calm the body’s stress response can assist in alleviating some of the symptoms above. People who MELT regularly often report improved sleep and better digestion, greater body awareness and better posture and body alignment. After a MELT session, people often tell me that they feel that they just had a massage, and this feeling of well-being makes movement easier and more enjoyable.
People who suffer from fibromyalgia often use an array of modalities to deal with the condition, and MELT can be one part of the overall management.
I will have a workshop at my studio on November 3.
As the connective tissue, aka fascia, which until recently was treated like the ugly duckling is morphing into a beautiful swan, it has been attracting more and more interest from practitioners of different modalities.
MELT has been at the forefront of this movement, and it still forms a foundation stone of my training. But there are others now, and as a trainer, it is important to evaluate its effectiveness and even integrate it into practice where it is of benefit to the clients and students.
Two of those modalities stand out in my mind. The first is called ‘Yoga Tune Up’ and is by Jill Miller who wrote the book ‘The Roll Model’ which is very extensive and gives a lot of options. Maybe too many for my taste. It requires special balls, and some of the techniques are very intense. But is very well worth checking out.
The other is called ‘Relief through Rolling’ and is by Kevin Lucas. He is just using a roller (hear, hear) in different, yet similar patterns. It is a modality which is very compatible with MELT, and which I intend to integrate into classes and workshops and my personal training.
I love to walk. And I love to walk outdoors, even when the weather is less than inviting. I own a treadmill, but to me it’s not the same.
And indeed it is not. While the movement seems to be the same, there are many significant differences which make walking outdoors the better option if all else is equal.
The biggest difference is that walking on a treadmill requires less force production to push yourself forward against the ground. The band keeps moving, and that creates a bit the effect as if somebody is standing behind you, pushing you forward as your walk. This has an impact on the development of the muscles of the entire posterior chain of the body, namely glutes, hamstrings and calves. Treadmill walking also means that you are on an entire even flat surface which places no demands on your foot and ankle muscles for stabilization to compensate for the unevenness of a pavement.
Having said that, I understand that a treadmill may be the only good option for some. The safety of the environment can be a concern and the outdoor air quality.
Bottom line: Go outside if you can. But if that’s not a good option, a treadmill is still a viable alternative.