Archive for the ‘My Soapbox’ category

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Stop Using Pain As An Excuse to Avoid Exercise!

April 27th, 2011

I hear the “I can’t” excuse sometimes from clients when I ask them to do various moves.  Some of their fear is warranted, and I can understand some of it for a week or two, but there comes a point when the “I can’t” really does sound a lot like “I won’t.” 

I read this today and thought it was so good I wanted to share.  The author is, by the way, an orthopedic surgeon.

Don’t Use Pain As an Excuse

by AOSSM April 20, 2011

By Dr. David Geier, AOSSM

One of the most common reasons patients give for not exercising is an injury or pain. People often use knee or shoulder pain or some other limitation as an excuse for not playing sports or being physically active. And while certainly musculoskeletal injuries can affect participation, rarely should these injuries keep people on the sidelines permanently.

Joint pain is unfortunately a fairly common affliction among the United States population. According to the Centers for Disease Control and Prevention, in 2006 approximately 30% of adults reported that they experienced some sort of joint pain in the previous 30 days. Musculoskeletal injuries are rarely completely incapacitating, however. While many weekend warriors cite old knee or shoulder injuries as reasons that they can’t exercise now, with so many options available, even people with real injuries should be able to modify their routines and still get in a good workout.

For example, a female with early knee arthritis can still perform cardiovascular-enhancing exercise. She might not be able to run long distances six or seven days a week, but she might be able to run two days a week and swim or ride a bicycle the other days to decrease the repetitive impact on her knees. A male with rotator cuff impingement from overuse at work or in the yard might have to back off from tennis or baseball, which might aggravate his shoulder, but he could play soccer or another non-throwing sport. And for athletes who enjoy lifting weights, simply adjusting a few of the exercises might be enough to exercise in spite of a current injury.

For those who fear that they are making an injury worse, they should see a sports medicine physician. Most injuries do not need surgery, and often there are simple initial treatments, such as physical therapy, home exercises, taping, or anti-inflammatory medications. And while patients are often reluctant to go to the doctor for fear of being completely shut down from a sport or activity, sports medicine physicians usually try to encourage treatments and rehabilitation that get people back to sports and exercise as quickly as possible.

Finally, even if the activity is potentially detrimental to a joint, it might not always be that bad. Someone with near bone-on-bone knee arthritis is possibly making his knee worse running every day. Having said that, if he wants to keep running, the benefits of his overall health might outweigh the risks to his knee. Daily exercise can provide multiple medical benefits, including improved cardiovascular function, lower blood pressure, and weight loss, as well as improved sleep and mood. Even if he needs a knee replacement in the future, the medical upside to exercise is significant.

While aches and pains can be an obstacle to physical activity, they shouldn’t be permanent barriers to all exercise. If you are worried about injuries or exercise modification discuss it with a doctor [or speak with a trained fitness professional!] and know that being physically active is possible despite these pains.

As always, contact me if you need help finding a way to stay active and pain-free.

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Posted in My Soapbox, My Workouts, Random Musings, Uncategorized

H is for Happy

April 26th, 2011

Hey!  Remember how I’m not a doctor?  Me, too!  If you have specific questions about any of this, please ask your doctor about it—I’m just presenting my understanding of this study.

If you have either type 1 or type 2 diabetes, you know cardiovascular (heart) disease is a major risk.  You may also know that my personal approach to dealing with that looming unknown is to keep myself fit and active every day to take care of my heart.

You may know the common positive risk factors that signify a higher risk for developing cardiovascular disease: smoking, poor diet, inactivity, and (ut oh) diabetes.

You should probably know, whether you have diabetes or not, what your cholesterol situation is.  You need to know this so that you can understand how at risk you are of developing coronary heart disease. 

We should each want to do all we can to decrease our risk.  One way to do this is to look at negative risk factors for cardiovascular disease. 

High-density lipoprotein (HDL) cholesterol can be a negative risk factor for developing cardiovascular disease.  This is because HDL’s main role in metabolism is to transfer cholesterol from plaque deposits in our blood vessels to the liver for excretion. 

So the HDL cholesterol actually functions to remove cholesterol.  (Tell me THAT makes sense, calling them both cholesterol.)  The more HDL we have, the better off we are.

H is for HAPPY!

Want to raise your HDL?  A recent study suggests a four-pronged approach: (1) aerobic exercise; (2) diet; (3) moderate alcohol intake; and (4) stop smoking already!

Since I’m a trainer and exercise is my specialty, that’s the one I’ll discuss.  (You can Google the others.) 

The greater your aerobic capacity, the greater the association with elevated HDL levels.  Sweet! 

At minimum, get 120 minutes a week of aerobic exercise and you are doing yourself a world of good.  Happy-HDL levels-protecting-your-heart kind of good!

You want to have a great volume of blood pumped by your heart per beat, and you want the amount of oxygen travelling through your blood into your muscles at high levels while simultaneously having a high amount of oxygen-poor blood travelling back from the muscles to your heart.  (V02 max)  The higher each of these is, the higher your aerobic capacity.

You want to challenge your cardiovascular system so that it improves in response.  To improve your aerobic capacity during those 120 minimum minutes per week, yes, you’ve guess it: INTERVAL TRAINING. 

Work as hard as you can for 3-5 minutes, then recover for 1-2 minutes.  Recovering isn’t sitting down, though.  Stay moving during your recovery and get back to the hard work ASAP!!

Makes me HAPPY just to think about all the great things we are doing for our hearts.

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Posted in I Can't Believe Someone Got Paid to Conduct This Study, Living with Type 1 Diabetes, My Soapbox, My Workouts, Random Musings, Uncategorized

The Yearly “Fun” Side of Life With Type One Diabetes

April 18th, 2011

My husband started a new job a few months ago, which is fantastic in general, but also a sort of a pain for me a couple months after he starts.

It’s time to choose a health insurance plan.

Which again I should say is a blessing to have a husband who works for a large company that has fairly good health insurance coverage.  (This company “is so good” this one will even provide pet insurance, if you pay for it.)

But the fancy colored brochure and the guy who came to explain the plans to the employees and all of the fancypants HR people employed to help us decide what plan will work best for us don’t really mean much, as they aren’t really helping.

Do you know what I mean?

Sure, I can figure out that if I took Drug X every day and that didn’t change and I saw my doctor once a year and had labwork it would be better for me to sign up for Plan A instead of Plan C.  That would be easy. 

I can even sign into my account at the medical clinic and look up what visits I had, and add up those copays and see how much a pair of glasses or contacts costs and see how much I should set aside in a flexible benefits plan.  I can estimate based on my records and prior year’s expenses just like anyone else. 

But life with diabetes isn’t that easy.

The thing I can’t figure out, mainly because it isn’t in the brochure, is how much they cover for Durable Medical Equipment, or if they cover test strips and how much I pay for either of those.

And, not to ignore the fact I’m an attorney and I did medical billing for eleven years so it isn’t like I don’t know how to read the book.

So I read the brochure and it says “for any other questions contact your HR department”.  I show it to my husband, who dutifully heads to his HR department and asks.  (He asked the guy who came to explain the plans and that guy didn’t know nor has he gotten back to my husband as promised.)

They don’t know.  So, they (which I think is nice) call up the main insurer, who suggests they call the plan administrator, who says it’s different whether it’s prescribed by my doctor or if it isn’t prescribed by my doctor.

Gee, thanks for the help.  (And FYI, I can’t get pump infusion sets without a prescription.  But that shouldn’t change the allowed amount for payment of the code.)

So now I have to go through my records and find the codes for my pump supplies, and find the codes for my CGM, and my husband has to go ask for the specific code payments/classifications. 

I’m serious.  This is what he’s spending his day at work doing today.

Two years ago, I just did what I think most people do, and looked at the prescription coverage and saw it was identical for each option, and I looked at what I actually see doctors for, and I made my best decision at the time.  I didn’t go into the code-by-code analysis.  I tried to simplify things and not treat myself like I needed special treatment.

THAT was a bad decision!  We ended up with some hefty medical bills that year.

It just frustrates me sometimes.  I am a rather healthy and fit person, were it not for this one little thing, also known as 250.01…

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Posted in Living with Type 1 Diabetes, My Soapbox, Random Musings, Uncategorized

Finding Balance

April 15th, 2011

Have you seen that commercial for some low-glycemic index milkshake of some sort that is supposed to help keep your blood glucose levels even?  (Side note: this is marketed to those living with Type 2 diabetes not Type 1 diabetes.) The camera moves as the woman talks about trying to balance her blood glucose levels as pots and pans in her kitchen swing about.  Until, of course, she opens the milkshake can and everything is hunky dory again.

“Balance” is one of those catch phrases these days as we are inundated with too much to do and too little time in which to do it. 

But I’m talking about the kind of balance you CAN and SHOULD work on, every day.  The physical kind of balance!

One of my bootcampers commented today that she feels like she has lost all of her balance.  We kindly reminded her that she has twins younger than 2 years old so she has an entirely different body now than she used to have.

It also reminded me of another bootcamper who came one day about a week after her 40th birthday and reported she read something that said you start to lose your balance capability after the age of 40.  Poor thing, as soon as she read that she felt like she was tripping all over the place.

I’m just saying: (physical) balance is something we should always be aware of, and always work on.

It’s kind of fun to throw a few balance exercises into your daily life!  Brush your bottom teeth standing only on your left foot and brush your top teeth while standing only on your right foot.

Without touching a wall or door jam, try to spell out letters A through E with each foot.  Make the letters as big as possible!

Or you can try this one, which I hadn’t done before I Googled “balance exercises” for this blog.

With either no shoes, or in flat shoes, stand by a chair or table. If during the exercise you begin to feel very unstable, then you can grab and hold onto the chair or table. It is normal to feel slightly unstable doing balance exercises, so only grab if you think you are going to fall. Learning to adjust is how balance will improve.

Put one foot infront of the other, so that the toe of one foot touches the heel of the foot infront. Make sure your feet touch. Pick a point out infront of you and focus on it. Do not look down. Balancing in this position is not as easy as it sounds.

Whenever you feel confident balancing in this position, you can try closing your eyes. When you feel comfortable with this try moving your arms around. Eventually if you have good balance work up to moving upper body backwards and forwards and side to side. Then finally you may be able to try tilting your head back.

If you can close your eyes you are doing really well.

Swap feet. Usually this exercise is easier with the feet one way round. Make sure you do it with both ways.

Fun (and very important) stuff!!

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Posted in My Soapbox, My Workouts, Random Musings, Uncategorized

You Smarty(Exerciser)Pants!

April 14th, 2011

We are always trying to separate things out in a somewhat strange way… I mean, do you really ever think you can isolate one muscle group?  Try moving your bicep without recruiting any of your shoulder muscles.  Try doing a pushup or lunge without using your back muscles.

Difficult, isn’t it?  I’d say it is actually impossible.  (A lot like trying to separate emotions from blood glucose swings sometimes… sure, they are different… but they are also inseparable.) 

Those weight machines may not be as useful or functional as you’d like.  Try grabbing a set of dumbbells to enhance your body knowledge and shoot for functional movements instead!

But why should your brain be any different?

Every year more research comes out that supports my long-held belief that exercise supports brain health as well as physical health.  Not only does regular physical exercise support your body, it supports your moods and can help stave off depression. 

More specifically:

One of the more exciting discoveries in neuroscience in the last 20 years has been that the adult brain can continue to make new neurons throughout the lifespan.  It doesn’t happen equally in all brain areas, for reasons that are not totally understood, but it happens readily in one specific area: the hippocampus.  This is an evolutionary older part of the brain that is concerned with forming memories and processing emotion, which may help explain some of the cognitive and emotional benefits of exercise.

Interestingly, aerobic exercise can increase neurogenesis (generation of new neurons) within the hippocampus at many stages of development, including in the neonatal (Kim et al. 2007), juvenile (Lou et al. 2008) and adult brains (van Praag, Kempermann & Gage 1999).  The fact that the hippocampus is a critical brain structure used in memory may explain why aerobic exercise can enhance learning (Vaynman & Gomez-Pinilla 2006).  Furthermore, we know that stress reduces neurogenesis, an effect that may contribute to depression and anxiety (Lucassen et al. 2010).  Therefore, the enhanced neurogenesis brought about by exercise may represent the neurobiological mechanism by which regular exercise reduces depression.

(“Exercise and the Brain” Jeffrey Kleim, PhD March 2011 IDEA Fitness Journal)

Just think of all the benefits regular aerobic exercise can bring not only your body, but your brain as well!! 

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Posted in I Can't Believe Someone Got Paid to Conduct This Study, Living with Type 1 Diabetes, My Soapbox, Random Musings, Uncategorized

Big Efforts, Small Rewards Day 2

April 13th, 2011

 (Hasn’t changed; losing weight is still work.)

As you work at losing weight, you need to congratulate yourself on each mini milestone you reach.  Some celebrate with a pedicure, some with a new workout outfit, some with a massage… and some (ironically) with a nice dinner.  How about a new pair of shoes!

But how do you know which milestone to celebrate?

Weight Watchers used to recognize every five pounds.  Maybe they still do?  But I’m not talking about milestones being numbers—I’m talking about those milestones that make a massive difference in your daily life once you achieve them.

I’ll just list a couple milestones you might want to celebrate.

  1. (A client told me this one the other day and I am still smiling at her progress!) No longer needing to shop in “the big girls” section of a store.  Woot!!
  2. Climbing to your front door while holding groceries… and not being out of breath when you get there!
  3. The XXL pants falling off as you wear them.
  4. Climbing a flight of steps without your knees and/or back hurting.
  5. Going to the grocery store and not once thinking about going down the cracker/chips/cookies aisle… or, thinking about it and deciding to skip the trip down the aisle.
  6. Recognizing that getting in and out of your car is easier than it used to be.
  7. Reaching a certain destination/distance before you need to take a break to catch your breath.
  8. The glorious sound of a zipper zipping up without the painful groans, gasps, or sucks as you struggle.
  9. Hearing yourself say “yes” to an invitation you might not have said yes to previously.
  10. Recognizing that today you made a great effort to take care of that one body you’ve got to make last your entire life. 

If you think about these for a minute or two, you’ll see that these are in no way “small” rewards.  THEY ARE HUGE.  It’s just sometimes we forget them and get discouraged all over again if we’ve had a bad day or the scale says something we don’t want to see.

Try making a list of reasons you want to lose weight.  Yes, an actual, physical, pen and paper list.  Make it full of small reasons and big reasons.  Once you’ve accomplished something on that list, celebrate your progress.

You can do this.

I’m here if you need help.

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Posted in My Soapbox, Random Musings, Uncategorized, Weight, Weight, Don't Tell Me-- Does it have to do with what I eat?

Big Efforts, Small Rewards Part 1

April 12th, 2011

(You thought it should be the other way around, didn’t you?)

There is no way around it: losing weight takes a LOT of effort.  It is a heck of a lot easier to gain weight by not paying attention to every calorie (most of us already count carbs; now you want us to count calories too?!) than it is to lose weight by following the calories in, calories out fail-proof method.

Especially when that jug of peanut butter or ice cream is calling to us.

We all have a special notion of how big we are, and we all have a special notion of how big we should be.  (That’s “should” for ourselves, from our own mind.)  When we find out those two notions are very far away from each other, it can be a life-changing moment.

For me, I was 23 years old, standing in the second floor women’s department at the Robinson’s-May in Santa Barbara.  I was staring at the displays of QUEEN-sized underwear, about make a purchase.

Yeah; that’s a life-changer right there. 

(And yes, in case you didn’t know, the size on the label is literally in all caps: QUEEN.)

But then once you are fortunate enough to have that moment and know there is no going back for you, there is a heck of a lot of work for the next several months and years ahead.

So you’ve got to recognize that you have a lot of work ahead of you AND you have to work on ways to mark your sure progress along the way.

If you think you should be a size 6 yet all of your pants you can put on say size 22 on their labels, you’d better make temporary friends with size 20, 18, 16, 14, 12, and so forth.  (I say “temporary” friends because you want to make this journey a ONE WAY ticket, never to return to the bigger sizes.  Never ever is your goal!  Seriously; are you enjoying the work of losing weight?  If not, do it right and only do it once.)

I can also tell you the day I was standing in a Macy’s and realized I could shop just as easily in the women’s department, plus sizes, and petite department.  Wacky!  It was kind of like standing in that spot where you can stand in four states at once…. (I think I spent a lot of time shopping for clothes before I realized some self confidence was in order.) 

Recognizing and marking your progress as you move towards a weight loss goal is essential.  Without recognizing the progress you are making, you will undoubtedly lose momentum, lose your way, begin to feel badly about yourself, and head back to the jug of food.

Some weight loss plans suggest you stand on a scale every week.  Some say every day, and some say never stand on a scale but judge your progress by the way your clothes fit and feel.  I think there are ways that work for each of us, but I do think that avoiding a scale altogether can be as dangerous as avoiding the idea of losing weight.

I think you need to see for yourself the way the numbers on the scale change: how they climb, how they fall, and how they seem to stand still for days on end.  It’s exactly like a blood glucose check: just data. 

Just data to help you figure out the next steps you will take.

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Posted in Living with Type 1 Diabetes, My Soapbox, My Workouts, Random Musings, Uncategorized

Yes or No?

April 8th, 2011

I went for a run last night after my afternoon D.O. it Bootcamp class.  Going out for 7 miles at 5:30pm was one of the last things I wanted to do right then, and knowing I had some tough hills ahead didn’t make it any easier!

It was really cold, and I only had a pair of shorts to run in.  I was very glad I had a long sleeved shirt and gloves if I wanted them.  But still: it was very windy, and just the thought of being out for an additional hour was just making me sad and tired!

So I puttered around for a few minutes, checking my voicemail and email.  Anything to put off my departure!

And then I realized I had puttered away 15 minutes, waiting around in the cold in my shorts.  That seemed pretty silly, so off I went.

I got to run downhill for about a mile, and then start the trek up my first hill.  I was running at a busy time for cars, in an area I needed to watch the sidewalks for cracks, so I was concentrating on being aware of my surroundings as I went.  I was happy gravity was helping me start my first mile.

After about 15 minutes, I was on my way up my first steep hill and suddenly it dawned on me: I never regret getting out there and DOING something. 

My run was still only a third of the way done and here I am getting all nostalgic over what running has brought to my life!

Great.  Maybe I should run by a friend’s house and ask for a tissue.

But in all seriousness, this is a very good thing for each of us to think about.  What are you going to let stand in your way?  What are you going to learn how to figure out so that you can keep going toward your goals?

I was lucky a number of years ago to work for a doctor who ended up being a friend as well.  I still remember the day he came out of an exam room after seeing an 85 year old woman.  I guess the two of them were discussing her life and he asked her if she was happy with what she had experienced over her eight and a half decades or if she had any regrets.  In response, she hit the arm of the chair and said “I wish I had said YES more!”

That lady and her saying that to her doctor has stayed with me ever since. 

I try to say YES to new experiences even if they scare me.  The way I see it, saying NO can be the scarier option.

It’s why I never regret getting out there: I’m saying YES.

What about you?

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Posted in Living with Type 1 Diabetes, My Soapbox, My Workouts, Random Musings, Uncategorized

Hats Off!

April 7th, 2011

Feeling a bit scattered as I sit down to write today: I’ve got a couple things I’ve been meaning to say but none of them are really worth a full 500 word post… so I’ll just jot a few here and we’ll see if we can’t cobble something together in which you can find something  useful.

  1. Hats off to my mom, reporting in from my sister’s place where my mom and dad are visiting to help my sister get ready for the Spring.  My mom says “For me personally, I just helped Dad hoist a 4×8′ sheet of pressed board up into [my sister]’s garage rafters, and I was far more concerned about his shoulder than anything to do with me.” Sweet!
  2. Hats off to my dad, for returning after taking six boring months off of his 12 plus years of daily bootcamp routine for some shoulder surgery, and for his working hard to get his cardio capacity back to what it once was!  Every time I see him he reports how many additional laps he can get in around the track since the previous week.  Awesome!
  3. Hats off to my parents’ friend, also a regular bootcamper, who is in her 70s and considers straight-legged pushups her “party trick”.  J  She just had some stomach surgery and was able to come home from the hospital within 24 hours of the surgery. Impressive on both counts!
  4. Hats off to my bootcamper last year who won a trophy for being the first finisher at a stair climbing fundraiser at the Transamerica building… he made the (approximately) 50 flight climb in 6 minutes!!  (This year he wasn’t able to attend and the first finisher came in at 8 minutes!)
  5. Hats off to my other bootcampers who joined in the fun this year at the Transamerica building… and they went up TWICE that morning, finishing their second trip 9 minutes FASTER than their first trip!
  6. Hats off to one of my personal training clients who has mastered her fear of climbing hills!  I got an email report from her the other day that she and two of her friends spent the afternoon that day not only climbing her dreaded hill once, but TWO TIMES.  That makes me so happy for her!
  7. Hats off to my teacher bootcampers for all the work they have been doing on themselves since September!  It is SO FUN to walk on campus and get stopped by other teachers.  Most conversations begin “are you the bootcamp lady?” and end up with huge massive compliments paid to how great the campers are looking and feeling and sounding as they embrace a more active life through exercise!!

Tell me why I should take my hat off to honor YOUR efforts!  I’m all ears!!!

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Posted in Living with Type 1 Diabetes, My Soapbox, My Workouts, Random Musings, Uncategorized

Wilderness Survival

April 6th, 2011

Do you remember when you were diagnosed with diabetes?  Did the world suddenly become a crazy disorienting dangerous place?

Or did you take the diagnosis in stride, leave the doctor or hospital thinking “I can do this” and learn in the coming weeks or years how perhaps incorrect that initial assumption really was?

Reading this article at Active.com today made me smile.  What it takes to survive in the wild isn’t all that different from what it takes to survive living with diabetes!

I will paraphrase the article, although I do think it’s worth a read on its own.  They say that a six year old survives better than an accomplished adventurer or wildlife expert, overall.  (Shout out to the kids on this one!)  Why?

A kid recognizes he or she is lost, and stays close to where they are, unlike an adult who keeps thinking they can find their way and keeps wandering… making it harder for rescue teams to find them!

A kid will rest when he or she is tired, drink when thirsty, and look for shelter when tired.  These things seem like no-brainers, but honestly, now, when was the last time YOU took a nap when you were tired?  By resting when tired, a child will be better able to reduce their stress and mental fatigue.

Think about the kids in your life who are living with diabetes.  Do they ask for help?  Do you think they recognize they need help when it comes to checking blood sugar or help with a low or taking insulin?  (No fair to count teens in this category!  Teens get their own category.  And, for that matter, their own wilderness.)

Does a kid with diabetes sometimes say “I’m tired of this disease” or words like it?  Do they ask a parent to take away their diabetes? 

Six year olds can be so smart.  (And adults can be so silly.)

Go kids!

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Posted in Living with Type 1 Diabetes, My Soapbox, Random Musings, Uncategorized