I got the call on Sunday, November 25th. My favorite aunt who is in her early 70s was rushed to the hospital with pneumonia and was on a ventilator in the ICU. Her vitals weren’t stable and a blood culture showed that the infection had overwhelmed her bloodstream and she was now septic. The illness had started as a cold which quickly became bronchitis and then pneumonia. I got in the car and rushed from Chicago to Pittsburgh in the hope that I could see her alive. My aunt has been obese for at least 30 years but her weight ballooned while she cared for my uncle who died from cancer this past July. After a long evening at the hospital, my cousin (her son) and I drove to her home to spend the night. This home had been the source of many happy family gatherings and it was tremendously sad to think that we might only have memories.
Nine days have passed and my aunt is still on the ventilator and nonresponsive. Her vitals are stable and the pneumonia and sepsis seem to be resolving. But complicating the recovery is the fact that her liver and gallbladder aren’t healthy. Many years of obesity have put an enormous strain on these organs. Her gallbladder is infected and we found out that she has non-alcoholic fatty liver.
My aunt is one of six children and most of the brothers, sisters and offspring have put their lives on hold and in some cases packed up little ones and pets to get to Pittsburgh. The toll of stress, worry, travel and time away from work has been huge. If you haven’t been taking care of your health and think it doesn’t impact your entire family, think again. While we are cautiously optimistic, the prognosis for my aunt is still uncertain. But if you are obese or have a chronic health condition and are reading this, know that it's OK to put your own health needs first when it comes to your health and well-being. Taking care of yourself first is actually the best way to take care of your family. If you see yourself in this picture, maybe you need a new mantra. It might go something like this: "taking care of my own health first is the best way for me to take care of my loved ones."
Takeaway: Check out the CDC’s website for information on obesity and BMI. http://www.cdc.gov/obesity/adult/defining.html
I always think of Thanksgiving Day and New Year’s Day as the bookends on a fun time of celebration. But unfortunately, many people will slide into January with unwanted weight gain. If you want to start 2013 feeling and looking good, now is the time to be proactive. I used the livestrong.com website to estimate the calories in a typical Thanksgiving dinner (2007 calories) and the Health Status website to calculate ways for a 160lb. person to burn those calories. Of course, this is just an estimate, but it sure was fun.
Calorie Content of Typical Thanksgiving Dinner
Turkey, white meat
Sweet potato casserole
Green bean casserole
wine or beer
Now here are some activities (based upon a 160lb. individual) that can help burn off Thanksgiving dinner. You can do your own calculations for dozens of activities at http://www.healthstatus.com/cgi-bin/calc/calculator.cgi by selecting "health calculators." Get moving today and you’ll have about a week to devote to extra activity. And whatever you decide, try to avoid too much sitting. We drive or fly to relatives and we sit; we eat and we sit; we talk and we sit. Ugh! Get everyone moving if you can.
Activities That Can Help Burn a 2000 Calorie Thanksgiving Dinner
14 to 16 mph
Back in the days when I was working as an investment advisor and trying to raise young children, I had little time for anything but work in the office and work at home. One day, I was lamenting that fact that I wasn’t exercising and was lectured by my single, childless admin assistant for failing to prioritize exercise. I finally started getting up at 4:30 am to go to the gym but I was so tired that I kept falling asleep on the treadmill and actually fell off twice. I quickly realized that giving up sleep for exercise wasn’t a healthy solution. However, if I had had some guidance I could have slept later and done 20-30 minutes of exercise at home. If you see yourself in this picture, here are a few ideas that might help.
- For cardio, alternate marching and jumping jacks. Try marching for a minute, jacks for 10 to 30 seconds and keep repeating. Try to work up to 15 minutes. If you want to rev up the intensity, add in some rope jumping or even pretend rope jumping where you move your hands and wrists and hop as if you are using a rope. If you are truly deconditioned, just march.
- For a full body exercise, sit back against a wall and slide down until your thighs are parallel with the floor. You should be wearing shoes to avoid sliding out. Your ankles and knees should be at 90 degree angles. (If it is difficult to slide down that far, only slide partway.) This is called an “air bench” because it looks like you are sitting on air. Hold two medium weight dumbbells near your thighs. Keeping your elbows at your sides, bend your arms so that you lift the dumbbells up near the shoulders (bicep curl). At this point, you can lower the dumbbells and repeat the bicep curl or press the dumbbells overhead, lower them to your shoulders, lower them to your hips and then continue the curl and press all over again. Continue with 8 to 20 curls and presses while you hold the air bench position.
- For your core, get prone on the floor, bend your arms so that your elbows are directly under your shoulders, tuck your toes under, straighten your legs, contract your butt muscles and lift yourself off the floor holding the body in a prone plank position for 10 to 30 seconds. Look down at the floor to keep your head in alignment with the spine. Draw your belly inward but keep breathing. Alternate each plank with 20 seconds of yoga arches and curls. Repeat this two to five times. If holding a plank on the floor is too difficult, regress it by elevating your arms on a bench, sturdy table or even kitchen counter.
- For your upper back, back your body up to a wall, raise your arms out to each side so that the wrists are above the elbows and your wrists, elbows and shoulders form a 90 degree angle, like goal posts. Slide your elbows down toward your ribs keeping your forearms back near the wall ONLY if you have pain-free range of motion. These are called “wall angels.” You should feel a contraction in your mid back.
- For chest and shoulders, do some push- ups. They can be done on hands and toes with full body extension, on your knees, or standing and pushing off of a wall or sturdy piece of furniture. If you can’t do at least 12 on the floor, regress to a standing position until you get stronger.
Takeaway: Working with a personal trainer can be expensive. But many trainers (including myself) are more than happy to work with a client for a limited time frame (i.e. 4 to 8 sessions) with the goal of teaching the client to work out safely and efficiently on their own. A personal trainer can also help you progress or regress the exercises I have suggested.
What would you do if your doctor said that you would most likely die in the next few years if you didn’t change your health habits? Most of us believe that we could change if our lives were on the line. But the sobering reality is that nine out of ten people just can’t make the changes that can save their lives. A book titled “Change or Die” by Alan Deutschman offers up a number of studies that prove this reality. But the book also explores what works and this is what today’s blog is about.
First, three things that don’t work are facts, fear and force. For example, if an individual with extremely high blood pressure hears that he has a 500% higher risk of a heart attack or stroke in the next five years unless he loses weight and stops smoking, he will most likely join the 9 out of 10 individuals who fail to make the necessary lifestyle changes. It’s much easier to live in a state of denial than face the prospect of death.
Now let’s look at three concepts that do work. The concepts are “relate, repeat and reframe”. To relate, a patient needs to develop a new relationship with an individual or group that supports the change. This is when a good personal trainer, wellness coach, nutritionist, support group or group exercise instructor can be worth their weight in gold. To repeat, the new “relationship” must inspire the individual to keep going until the change becomes habit. We had a cardiac rehab class in my prior job and all of the participants became extremely close friends. The social support was so positive that the participants would come out in a snowstorm to avoid missing a class. To reframe, the new relationship should enable the individual to view life from a “new” lens. For example, the individual who once hated exercise might find new joy in movement. The individual who lived on junk food may find new joy in cooking.
Takeaway: By now, most people are familiar with SparkPeople, Weight Watchers and similar support groups. But here are a few more ideas for groups that can make healthy change fun.
- Go to www.meetup.com and select “fitness.” I found everything from an underwater hockey club to yoga groups to a beer runner’s club.
- Try www.americancanoe.org and look under paddling clubs for canoe, kayak and whitewater paddling clubs in your area.
- Try www.wellcoaches.com and select “Find a Wellness Coach” for personalized support.
My first job in fitness was in a large Y which offered many group exercise classes and for the most part, served its members well. But I now work with two physical therapists and many of our new clients come to us because they’ve been injured in group classes. Unfortunately, I’ve observed classes where students repeatedly pull on their heads and necks to initiate crunches. I’ve seen exercisers struggle to hold planks and hurt their shoulders and backs. Here are a few things to think about when it comes to training your abs.
- The space between the vocal chords can close during crunches forcing pressure down to the abdomen (causing it to stick out) or to the pelvic floor. Repeated pressure on the pelvic floor can eventually contribute to incontinence. And by the way, men do have a pelvic floor.
- According to the New York Times (“Forget About Crunches, Here’s How to Protect Your Back”, 6/28/2011) there are 1.5 million vertebral fractures diagnosed every year in the U.S. Crunches can put exercisers at risk for these spinal fractures.
- Planks on the floor can be effective if you can maintain good form. To regress a plank, elevate your upper body by putting your elbows and forearms on a weight bench or massage table with feet on the floor. If this is still too difficult, get a physical therapist or a trainer to help you with some appropriate alternatives.
Takeaway: One of the best ways to get a flat belly is to eat a balanced diet and reduce your overall body fat. And please don’t tolerate urge or stress incontinence. A good source of help (besides appropriate medical care and possibly physical therapy) is the Total Control Program - http://www.totalcontrolprogram.com/. They’ve got a DVD with some very effective exercises and information about classes as well.
It’s not unusual for fear to keep us from trying new exercise classes or physical challenges. If you find that you are avoiding a new activity because you think you won’t measure up, the only way out is through. Sign up for the activity, put the date and time in your calendar and get your butt out the door. No excuses!
Here’s my example. I’ve always wanted to try Bikram Yoga and an “instructor friend” invited me to her class. Unfortunately, I feel quite a bit of pressure to perform when the instructor knows that I’m a trainer. Also, after years of taking tamoxifen for the breast cancer I had in 2006, I don’t always tolerate extreme heat well. As you may or may not know, the class is done in a room heated to about 100 degrees. Well, I went to my first Bikram Yoga class last night and I don’t think I’ve ever sweat like that. I found it profoundly therapeutic and can’t wait to go back. Learning a new activity will keep both your exercise adherence and your personal confidence high. If you don't have any medical contraindications, I challenge you to schedule your class or activity in the next 15 minutes.
Takeaway: If you do decide to try Bikram Yoga, drink plenty of fluids during the day, have a piece of fruit or light snack several hours prior to the class and take an extra towel or two and a water bottle with you. And be sure to tell your instructor that it’s your first time. If you have any health conditions that might make hot yoga unsafe, be sure to get your MDs OK first.
I have a number of clients who have jobs that require many hours of sitting. With long days in a chair, they typically have weak glutes (butt muscles), and chronically shortened hip flexors (the muscles that run from the upper leg to the pelvis and spine). Unfortunately, weak glutes and shortened hip flexors can cause a lot of pain and dysfunction and can make efficient walking, biking and cycling difficult.
If you happen to sit a lot, there are a few easy exercises you can do to offset weak glutes and short hip flexors. First, stand up with toes facing forward and feet at hip width. Pretend that you are holding a lemon or a $100 bill between your butt cheeks and squeeze, hold and release the lemon or bill 15 or 20 times. Try to avoid using your shoulders, torso or legs to help. This exercise may seem comical, but you’d be surprised at the number of people who struggle to isolate and activate their glute muscles. Second, find a step or stool that is about a foot or more high and put one foot up on it. Stand tall and shift the weight of your hips over the elevated foot, keeping the back leg straight. This can help stretch the hip flexors that must lengthen when the glutes contract. Try doing these two simple exercises four or five times during the day.
Takeaway: Sometimes when we do new client assessments, we discover that the client is taking 3 or 4 or more drugs. If you are taking multiple drugs, there is a wonderful, free website called www.drugs.com. You can enter all of your prescriptions and click an interaction button to see if the combination has any potentially harmful interactions.
By now, most of us know the many benefits of exercise including cardiovascular health, less risk of some cancers, weight control, better sleep, controlling diabetes and so on. I could fill a few pages just listing the benefits. But to stick with exercise for the long run, it is helpful for each of us to articulate the one or two reasons that tip the balance. By tip the balance, I mean the reason that will get you out of bed in the morning when it is still dark, the reason that will enable you to put a work project on hold and walk or run, the reason that will keep you going when boredom, bad weather, or any number of cons outweigh the pros. For me, the reason is participation in sports like kayaking, hiking, cycling and cross country skiing. For someone else, it might be the need to offset the stress of a demanding career, or to maintain health well into older age in order to continue care of a disabled child. If you are trying to make the transition from someone who is thinking about starting an exercise program or you are struggling with consistency, sit down in a quiet place and write out your reasons, type them out on a sheet of paper and add some descriptive pictures if necessary. Keep your reasons on your night table or in your wallet or above your desk. This way, when the going gets tough, you’ll have your reasons to keep going.
Takeaway: I frequently have clients who are struggling with weight loss tell me that they don’t have the time to cook. I recently discovered a website called www.thefresh20.com that will provide a plan for 5 weekly dinners with shopping list and recipes (choice of classic, veggie or non-gluten) all made from just 20 fresh ingredients. Add one dinner of grilled salmon and one dinner out and you’re done.
First, my apologies for a lack of blog entrees during the past month. In addition to being a fitness trainer, I also work as a wilderness guide and kayak instructor. I’ve spent so many hours on the water that I’ve had little time for writing.
I’m always amazed when someone who won’t tolerate the smallest problem with their car or home will live for years with pain. If pain is stopping you from doing things that you enjoy, keep looking for a solution. Realistically speaking, there are illnesses and problems that can’t be fixed. But even something that can’t be fixed can usually be improved. Here’s my example.
I’ve had pain in the joint of my left big toe off and on since I was 19 years old. Over the summer, the pain became chronic and even walking was painful. I went to a podiatrist who I’ve seen for years and her proposal was to give me a steroid shot every 3 months. She also recommended a running shoe with gel built into the sole. The gel shoe actually made my pain worse and treating the symptom with 4 cortisone shots a year didn’t make sense to me. Luckily, I found another podiatrist who happens to be an avid runner. He took a closer look at the biomechanics of my foot, ankle and calf and suggested a stability running shoe and a soft toe separator to keep the joint in perfect alignment. Now I’m pain free and back to all of my usual activities.
Pain is never OK. If you are suffering, get a second, third, fourth or fifth opinion if need be. But don’t settle.
Takeaway: If you are vacationing on a large body of water and notice that the water is as smooth as glass and perfect for swimming, check for offshore winds. Many a swimmer or recreational boater gets caught by surprise when they find theselves "blown" out and away from the shore. Sometimes the most benign looking conditions can actually be dangerous. If you have offshore winds of 10mph or more, take care.
We have an event coming up in September and I’d like to lose 5 lbs. to look my best. In a weak moment, I signed up for an online diet plan and after logging in realized that I’d either need to either follow a complicated self-cook program or spend $650 this month ordering their food.
So I came up with my own plan which isn’t nutritionally perfect, but I’ll share it and report back in mid-September with results.
Breakfast: Steel cut oats with blueberries, TBSP of walnuts, almond milk, and tsp. of agave nectar and ½ cup of low fat cottage cheese. If I’m rushed, I’ll substitute one or two of Luna’s new high fiber bars or a piece of toasted Ezekiel bread with almond butter and some fruit. Done!
Lunch: On Sunday and Wednesday, I’ll make hearty vegan salads from Caldwell Esselsyn’s “Prevent and Reserve Heart Disease” and the “build a soup” recipes from page 50 of “The Ultimate Volumetrics Diet.” I’ll put the vegan salad on two cups of greens and eat each salad over 3 days and include a cup of soup if I’m still hungry. I’ll add another piece of fruit. Done!
Dinner: I’ll marinate a 3 to 6 oz. piece of lean protein like chicken, fish or flank steak in a medium fat, low sugar salad dressing and broil or grill it with a few servings of steamed veggies. I’ll add a cup of brown rice or quinoa. Done!
Snacks can include hummus and veggies, homemade smoothies, fruit, a controlled portion of chips and salsa, almond butter on Ezekiel bread, a cup of soup from my “build a soup” stash, some low fat yogurt, Skinny Pop popcorn or even a 130 calorie Diana’s frozen chocolate covered banana. I’ll record all of this on Livestrong.com’s nutrition site to check calories and nutritional balance. Done!
Takeaway: I’m teaching a new 6 session Stand Up Paddle Board class beginning on Monday and Wednesday mornings from 7am to 8:15am. If you want to try one free class, email me through this site and I’ll get back to you. There are a few prerequisites, like being able to swim 20 yards wearing a PFD (personal flotation device).
Personal Fitness Training is hosting a free jeans “fitting clinic” on Monday, August 20th from 6:30pm to 8:30pm. You can find more information about my class and the clinic under the events and classes tab on this site.