All MFN blog – Page 100

Shower Safety Tips for Seniors

Joe Fleming/23 October 2017/ All MFN blog/

According to CDC, people over 75 are twice as likely as younger people to have a nonfatal injury in the bathroom. The risk for people over 85 is four times higher. Every year, more than 400 people drown in bathtubs, while thousands fall, which leads to fractures and injuries. There are three main reasons behind this: firstly, seniors have limited mobility, moreover many medicines they take can also cause hypotension or dizziness. Lastly, many surfaces in the bath, such as metal, porcelain, tiles, etc., are slippery, and even with very little moistures on them, they can turn into a skating rink.

You can do a few things to minimize the risk of injury, which might otherwise lead to permanent disability or even death.

Make sure the water isn’t too hot

Seniors are at a twofold risk from hot water. The ability to feel heat decreases with age, and certain medications or neurological damage can further diminish this ability. Besides, older citizens have a comparatively thinner skin, which means even a brief exposure to hot water can result in burns. Therefore, make sure your water heater temperature doesn’t exceed 120F degrees.

Make your bathroom a skid proof zone

The biggest culprit behind bathroom injuries are the slippery surfaces. Some people use non-slip decals to address this, however, they don’t cover the entire bathroom. Your bathtub can be extremely slippery because it stays wet most of the time. Seniors can not only slip while stepping into it but also when trying to get up. A CDC study shows that seniors are more like to fall when sitting down on or getting up from the toilet. In addition to your shower stall, the bathtub and the whole bathroom floor should be covered with a mat and rugs with rubber backing.

Ensure better accessibility

Remove any obstacles that are close to the bathroom door, and ensure adequate lighting. Many seniors will feel the urge to urinate at night; poor lighting can be a significant hazard in this case. Remove anything that can easily be tripped over. Also make sure that the commonly used items such as shampoo, soap, towel, etc. are within easy reach. Consider getting door locks that can be opened from the outside as well, so they can have privacy and caregivers can reach out in case of any mishap.

Install safety fixtures

This can be an extremely beneficial investment as it can help older citizens move around without risk of falling. Consider shower grab bars, raised toilet seats, and non-slip grip tape to help prevent falls. Grab bars are particularly beneficial as they can be used as an anchor point when moving in or out of the shower. Also, grab bars can help you loved senior brace themselves in case of a fall.

Offer supervision

If possible, have someone at the ready when your senior is in the bathroom. This can be hard, but you don’t have to stand outside the bathroom all the time. Just make sure you are attentive when they’re in. Seniors with mobility issues might be aided by someone who can assist them with bathing like a caregiver or home health aid. At the very least, they should be assisted in and out of the bath tub to prevent a fall.

Some of these tips are easy while others require more effort, however, they can all go a long way in ensuring the safety of your loved ones and minimizing the risk of injuries in the bathroom.

Joe Fleming is the President at ViveHealth.com. Interested in all things related to living a healthy lifestyle, he enjoys sharing and expressing his passion through writing. Working to motivate others and defeat aging stereotypes, Joe uses his writing to help all people overcome the obstacles of life. Covering topics that range from physical health, wellness, and aging all the way to social, news, and inspirational pieces…the goal is help others “rebel against age”.

Therapist doing massage releasing tension by pressing chest on p

Massage and Breast Cancer

Dr. Ben E. Benjamin/20 October 2017/ All MFN blog/

Jane is a breast cancer survivor. She has dealt with the diagnosis and the life-changing stress it brings. She has gone through radiation to shrink her tumor to an operable size. She endured surgery that took not only her breast, but many critical lymph nodes from her armpit as well. She has undergone chemotherapy to be sure that no rogue cells may survive. She emerges from this ordeal feeling battered and bruised inside and out. The chemo has left her thin, bald, and exhausted. She experiences lasting achiness and pain in the affected arm, where circulation is sluggish at best. Her surgical scars continue to generate pain long after they have healed. She wonders when, if ever, she’ll feel like herself again. Her caregivers suggest that she “learn to live with it.”

Breast cancer survivors face so many challenges. One of the most frustrating is the challenge to “learn to live with the pain” that so often follows breast cancer surgery and treatment. Wouldn’t it be great if there were a therapy available that would ameliorate many of the worst side effects of breast cancer treatment? What if there was something a person could do that would reduce postsurgical pain, limit edema, and raise energy levels – all without drugs or further surgical intervention?

Therapist doing massage releasing tension by pressing chest on p There is: more and more breast cancer survivors are discovering two adjunct treatments that help them to cope with the changes their illness and surgery bring about: friction therapy and massage therapy.

Many massage and bodywork therapists have traditionally been concerned about the possibility that bodywork, through its impact on the circulatory and lymphatic systems, could put cancer patients at risk of exacerbating their disease. Recently the profession has begun questioning this anxiety, and techniques have been developed that allow massage and bodywork therapists to work safely and effectively with many cancer patients. Such therapy is done in conjunction with general cancer care, always with the knowledge and understanding of the rest of the patient’s healthcare team. Friction or massage therapy is never done without the specific approval from the treating physician.

Friction Therapy Can Reduce Post-Surgical Pain

When a person undergoes surgery for any reason, the accumulation of scar tissue can cause lasting pain. Scar tissue grows wherever the skin, muscle, fascia, or other types of tissue have been injured. When a body is recovering from injury, new fibers of dense proteins begin to knit the tissues back together. These protein fibers, called collagen, are strong and sticky. They are very good at holding things together, but they can create “adhesions” – places where layers of tissue that should move freely become literally glued together. Scar tissue adhesions can limit mobility. As the scar tissue matures it begins to contract, which limits mobility even further.

Friction therapy can reverse this process in two ways. If it is applied in the first three or four months of scar tissue formation, it can influence the quality of the healing for maximum efficiency and minimize unnecessary scar tissue build-up. But even if friction therapy isn’t tried until many months after the tissue has healed incorrectly, it can still free the tissue by reversing much of the adhesion process.

Friction therapy is a non-invasive, hands-on treatment performed by a skilled therapist. No oils or creams are used so there can be no gliding over the skin. The pain producing scar tissue formation is identified first. Then the therapist uses gentle strokes, performed at a ninety degree angle to the scar, to slowly and carefully break useless, pain-causing scar tissue apart.

The client is then given gentle movements to perform daily at home to prevent new scar tissue from forming in the same places. The process is slow and steady, relieving the pain due to the formation of adhesive scar tissue.

Massage Therapy and Stress Reduction

Stress has a profound impact on the body, which devastates our disease fighting mechanisms. The chemicals we secrete when we are under stress interfere with digestion and sleep, slowing down the healing process. Research with breast cancer patients has shown that massage therapy reduces the level of stress-related chemicals in the body. Breast cancer patients who receive massage also report lower levels of anxiety and depression than recipients of other interventions. This phenomenon has been observed in other populations as well.

Massage Therapy Immune System Activity

Cortisol and adrenaline, the hormones we secrete during short and long-term stress, have been seen to diminish immune system activity. Some immune system agents that are especially disabled by a stress reaction are called natural killer cells. These natural killer cells target developing tumors for destruction.

In some populations, massage therapy has been shown to not only decrease the secretion of stress hormones, but also to increase the number of natural killer cells circulating in the blood.

Counteracting the Side Effects of Cancer Therapies

Radiation and chemotherapy are physically exhausting for the body. It can take every iota of energy simply to get up in the morning when you are in these stages of fighting cancer. Massage therapy helps to increase overall levels of energy by reducing unnecessary levels of muscle tension and stress that can make it hard to get the rest and sleep a person in recovery needs.

Positive Body Image

Massage therapist next to massage table A woman who has been through breast cancer surgery, whether it’s a simple lumpectomy or a radical double mastectomy, emerges with a body that is fundamentally different from the one she began with. Many women struggle with body image issues following surgery. Breasts can help define a woman’s femininity, and to lose part or both of them can change how she feels about herself as a person. One of the most precious gifts massage therapy can give is a time of intimate non-sexual touch during which the whole goal of the session is to focus on how wonderful the client’s body can feel. Time spent in the simple enjoyment of physical touch can go a long way in the journey toward self-acceptance and the joy of being alive.

Massage therapy can increase energy, improve circulation and mobility, decrease soreness, help with body image, and alleviate stress. So the next time you ask about your pain and you’re told to “learn to live with it,” be aware that you have other options. Look up a massage therapist in your area who specializes in working with cancer survivors. You don’t have to live with the pain.

Finding a Massage Therapist

It is important to remember that not all massage and bodywork therapists are trained to work with cancer survivors. There are specific precautions that accompany different stages of treatment and recovery. Make sure your massage therapist is well informed and up to date on these guidelines. Check that your therapist has received training in working with people who have had or who have cancer. Be certain that they work with your medical staff, educating them about massage therapy and obtaining their permission for different massage techniques. Be clear that they understand pertinent precautions, pressure restrictions, or any areas to avoid.

Authored by Ben Benjamin, PhD and Ruth Werner, LMT. Reprinted with permission from Health Touch Issue #4. Other articles by Dr. Benjamin are available on his website.

Trainer helping senior woman exercising with a bosu balance

Strategies to Improve Your Balance and Stability

Carisa Campanella/19 October 2017/ All MFN blog/

Challenges with balance and stability can happen to all of us as we get older, but is certainly more prevalent in our Parkinson’s community. Maintaining lower body strength in conjunction with balance is very important as it decreases one’s chances of falling. Balance is defines as the state of having your weight spread equally so you do not fall; stability is the quality or state of something that is not easily moved. In order to maintain balance and stability, we need to have our center of gravity over a strong base of support. If your center of gravity standing upright is the area of your belly button – then your feet are your base of support. Standing with both feet on the ground spread just past shoulder width offers a stronger base of support than standing on one leg or with your feet very close together.

There are many issues that can affect your ability to balance yourself while standing or walking. Trouble with vision, lack of lower body strength, poor posture, medications, low blood pressure, and inability to properly lift our feet are all contributors. So how can you better prepare yourself to stay strong on your feet?

Slow Rise: When standing up from a chair or rising out of bed – do so slowly and wait about 5 seconds before you begin to walk. This enables your body to adjust to the change of position.

Hands Free: Keep at least one hand free at all times while walking – carrying an object with both hands can interfere with your ability to balance.

Arm Swing: Attempt to swing both arms from front to back while walking – this also helps maintain an upright posture and reduces fatigue.

Walk Consciously: Always strive to consciously lift your feet off the ground while walking; a shuffling gait can cause one to trip.

Make a U-Turn: When trying to navigate a turn while walking, use a “U” technique of facing forward and making a wide turn as opposed to pivoting sharply.

Helping Aides: Don’t be intimidated by canes, walking sticks, walkers or grab bars. These helpful devices can keep you safe and prevent a fall.

Keep it Simple: Only do one thing at a time when you are on your feet. Using a phone, gazing around, or even drinking a beverage can be a distraction and affect your balance.

In addition to taking these steps to maintain your balance and stability – take precautions in your home to make it safe. Loose throw rugs, scurrying pets, wet bathtubs and slippery staircases can cause danger in your home and throw even the most strong and stable person off balance. Also, working with a fitness professional to strengthen your stomach and leg muscles will help keep you more stable and lessen your likelihood of falling if you were to lose your balance. A strong body is a more stable body!

Carisa Campanella, BA, AS, is an ACE Health Coach and ACSM Personal Trainer. She is the Program Manager at the Neuro Challenge Foundation for Parkinson’s. Neuro Challenge provides ongoing monthly support groups and educational programs, individualized care advising and community resource referrals to help empower people with Parkinson’s and their caregivers.

For Optimal Workouts, Learn to RECOVER Like the Pros

Nicholas A. DiNubile, MD/18 October 2017/ All MFN blog/

Your body was built to move but to move effectively and efficiently, especially over the long haul, it needs to rest. At any given point in time a significant percentage of competitive athletes and even fitness buffs are over-trained. The “overtraining syndrome” is brought on by athletes falling into the ‘too much, too hard, too frequent and too little rest’ mode. Usually done to improve performance, but ultimately resulting in a point of diminishing returns- or gains actually turned to losses. Common symptoms can include all of some of the following: fatigue, irritability, muscle soreness, difficulty sleeping, elevated resting heart rate, decline in performance and even the onset of overuse injuries.

Exercise and the training associated with it, are a very powerful stimulus. Your body is challenged on multiple levels, from individual body parts to the system as a whole. For example, if you do a typical weight training session, each muscle that you work is stimulated and there is a local response in that muscle. There is also a cumulative metabolic cost to your entire system from that workout. This is true also of any vigorous workout including running, cycling and swimming. Local body parts are challenged as is the entire system. Your body needs to recover from both, and each has its own timetable.

To make gains – either muscle growth with weight training or cardiovascular with aerobic exercise – you need the exercise stimulus (ideally a near maximal effort) followed by adequate rest and recovery. It is on that rest stop where gains are actually made, as the body repairs itself, adapts, and you are taken to the next level. It should be clear why the mindset of “if a little is good, more is better” does not work here. It is also why smart successful professional and high performance athletes schedule recovery time as they would a workout, practice or a training session. It is critical to optimal performance. In fact, in recent years, we have made such tremendous gains in the areas of training and nutrition, that we may be reaching the point of maximum benefit for those variables. I believe that recovery is the next frontier in optimal training and achieving peak performance.

Also recovery doesn’t mean you need to be on the coach doing nothing. There are forms of “active rest” that can actually enhance and speed recovery. Take a walk or do a very light aerobic activity. Blood-flow to the nooks and crannies of the body enhances recovery and the repair process. Also, try yoga, get a massage, or hit the whirlpool. Water is a great medium for recovery, so hit the pool and try some light movements like treading water. But think twice before taking the ice plunge as recent research suggests that ice baths may delay or interfere with the recovery process. Drinking plenty of water and eating properly are also critical. The timing of your nutrition is also important, especially after a hard workout, as there is a golden 30-60 minute post-workout window where certain nutrients can make a recovery difference. Chocolate milk is one nearly perfect choice. And never underestimate the power of getting adequate shut-eye. The body repairs itself mentally and physically during sleep. I recently saw a funny but astute tweet (by Shower Thoughts @TheWeirdWorld) that said, “your bed is pretty much just a charger for your body.”

When it comes to the body’s adaptability and recovery response, the key is not pounding your body the same way everyday. Also follow the 10% rule-never increase your program (i.e. the amount of weight lifted or miles logged) more than 10% per week. This especially true when coming off an injury. Trying to make up for lost time courts disaster. Increasing the intensity, duration or frequency of your workouts too rapidly can interfere with your body’s amazing ability to adapt, resulting in overtraining, injury or both. Also there are new technologies like the Marc Pro device that can enhance muscle recovery and it is no surprise that so many professional and high level athletes are using it regularly. For those aging athletes and Master’s athletes, remember that the body does not recover as efficiently as we age, so you may need a little longer time to bounce back.

Remember what Lau Tzu said many years ago, “a bow that is stretched to its fullest capacity may certainly snap”. In your effort to constantly improve your fitness or specific sports skills you are probably at times pushing yourself to that very brink. Be aware of that predictable time of vulnerability for you, one that is usually remedied by a little R&R thrown into the mix.

So, for optimal gains, in the gym or on the field, learn to kick back at times. Give yourself a break – you will comeback even stronger.

Originally published on the Huffington Post. Reprinted with permission from Dr. DiNubile.

Nicholas DiNubile, MD is an Orthopedic Surgeon, Sports Medicine Doc, Team Physician & Best Selling Author. He is dedicated to keeping you healthy in body, mind & spirit. Follow him MD on Twitter: twitter.com/drnickUSA

Pregnant woman using exercise bike at the gym

Prenatal Exercise Program Design: Exercise Type

Catherine Cram/17 October 2017/ All MFN blog/

Choosing the type of exercise that is best tolerated during pregnancy depends on the following considerations:

Which activities the client enjoys or is skilled at performing
Whether the activity poses any risk to the mother or fetus
Is she is able to do the activity without being compromised by balance and center of gravity changes
Can the activity be easily modified as pregnancy progresses

Weight-bearing exercise such as walking, dancing, and running help maintain bone mass and some studies suggest they are more effective for keeping pregnancy weight gain within normal limits. As pregnancy progresses some women may not be able to continue weight-bearing exercise because of back or round ligament pain. If modifications such as wearing a belly support don’t relieve discomfort, switching to non-weight-bearing activities such as swimming, stationary biking, or other types of stationary exercise equipment is recommended.

Absolute and relative contraindicated activities for pregnant women are listed below. Pregnant women should always consult with their healthcare provider before taking part in any exercise program and assess the risk/benefit ratio whenever there is a question about the safety of any activity during pregnancy. Keep in mind that activities such as downhill skiing must be assessed for risks that are not controllable, such as the effect of high altitude on oxygen delivery to the fetus.

Contraindicated Activities for Pregnant Women

High-altitude sports
Water-skiing
Hockey
Gymnastics
Horseback riding
Absolute
Downhill skiing
Scuba diving

You can also view Catherine’s previous articles on exercise intensity and duration.

For more information on prenatal and postpartum exercise and our CE correspondence course, “Prenatal and Postpartum Exercise Design” please visit, www.ppfconsulting.com

Article reprinted from Catherine’s Maternal Fitness blog with permission.

Catherine Cram, MS, is the owner of Comprehensive Fitness Consulting, a company that provides pre- and postnatal fitness certifications and information to hospitals, health & wellness organizations and the military.

Objecting to Aging

Adrienne Ione/16 October 2017/ All MFN blog/

In the above court case, “Persons who Object to Aging v. United States of Aging” plaintiffs filed this action challenging the Aging’s Executive Order on natural processes. The People seek a finding that certain sections of the Executive Order are contrary to their desires to live forever, be young and abstain from societal objectification. Constitution and laws of the United States of Aging, and enjoining Defendants from implementing or enforcing those sections of the natural aging process. The People further seek entry of a nationwide temporary restraining order against all acts of aging – biological, social, cultural, internal and political. The judge presiding over the matter: Honorable Time, concludes “Before us today is present not a case of wanton and reckless behavior. Rather, we witness an unveiling of the beauty of time in all of its folds and uncertainties.” A bench warrant has been issued on the grounds of the written accusation of United States of Aging being guilty for a natural act. The case has been relegated to collections until further notice.

Seated in the courtroom, among a group of people diverse in ages and thoughts, you quickly rise to your feet and let out a screech, “Objection your Honor.” Also seated in the courtroom is Stevie Nicks who exclaims, “I want to be age appropriate. I don’t want to be that girl you see walking away and she looks 25 and then she turns around and she looks 90.”^[1]

In an era that is ripe with resisting, anti-everything, detesting and protesting, perhaps we can find comfort in shared experiences. It may behoove us to seek out similarities rather than differences. Discussions in the courtroom among proponents of objecting to aging, are quick to rely on arguments that are toothless tigers. They quip, “Hey, objecting beats the alternative. You know, succumbing to the decay.” In the United States of Aging, no one wants to be seen waving their white flag, a symbol of surrender, and more pointedly, weakness. However, what if we change the script? And shift the meaning of what it means to be old. What if the images and the bodies of aging were more closely aligned with models in advertisements for Benetton?^[2] On an individual level, how would a social and cultural aging situate the way people internalize their aging process?

Perched on high, Honorable Time demands, “Please be seated.” Proponents of your objection turn the volume up on their snickering and clamor and the commotion and fracas crescendos until, “Order in the courtroom,” gruffly and vehemently reverberates among the walls from the booming voice of Honorable Time. Honorable Time delivers the verdict:

Today, we have been presented an incomplete case. It is unclear whether the plaintiff is requesting youth be on trial, the mind, the demeaning social inculcations of aging, the cultural misunderstandings of aging, or everyone else who does not object to aging. Therefore, it is in our dutiful interest, as a civilized United States of Aging, to further investigate the true and whole indecency of the quasi-crime presented before us today. At this point, it is paramount to understand the complexities and total gravity of the aging process and the social and cultural extensions of roots. I have not been convinced, beyond a reasonable doubt that aging is indeed a crime. I have heard witnesses from all sides, and yet it is still not clear to me how the plaintiffs would be satisfied in this situation.

Steven Tyler once wrote, “You have to lose to know how to win.”^[3] In a similar vein, perhaps you need to be old to know how to be young. Or maybe old and young are purely made up categories that reinforce the social construction of certainty and uncertainty. As previously noted, perhaps it is time to write a different script on what it means to be old. The current working definitions of old, predate contemporary technologies and social categories. Prince concurs with his remarks on time. “Time is a mind construct.”^[4] Times change. Minds change. Let us come together in our shared experiences. Rather than resist, give a hug. Hug yourself. Hug your old self. Hug your young self. Old and young are constructs. To the sun, we are all young.

Adrienne Ione is a cognitive behavioral therapist and personal trainer who integrates these fields in support of people thriving across the lifespan. As a pro-aging advocate, she specializes in the self-compassion of dementia.

Website: yes2aging.com
Guided Meditations: insighttimer.com/adrienneIone
Facebook: silverliningsintegrativehealth

References

[1] Stevie Nick did not actually appear in this hypothetical courtroom. Rather, her comment was from an interview that appeared in Rolling Stone.

[2] For an example of United Colors of Benetton advertisements, please visit Benetton.com

[3] Steven Tyler, American singer-songwriter for Aerosmith, wrote these lyrics for “Dream On.”

[4] Dorian Lynskey, “Prince: ‘I’m a musician. And I am music.’” The Guardian (June 23, 2011).

Exercise and Endorphins

Jaclyn Chadbourne/11 October 2017/ All MFN blog/

Feeling too grumpy or stressed out to exercise? Think again.

A little exercise can go a long way in reducing stress and making you feel good, along with its many other health benefits, like improving/maintaining physical fitness, preventing disease and treating symptoms.

Life is complicated. We are all busy with our own personal challenges and to-do lists. Not to mention the winter months, which can make even the hardiest New Englander want to curl up into a ball and stay in bed until spring finally arrives. But, as tempting as that sounds, it’s not likely to improve your mood at all. If you’re feeling down, resist the urge to mope and get moving.

Studies have shown that moderate to intense exercise can help…

Minimize stress or improve ability to handle stressful situations
Minimize anxiety and reduce of depression
Improve self-esteem and perception of self
Improve sleep patterns and hence energy during awake hours

For those interested in the science behind it, when your body is subjected to certain stimuli (including exercise) your hypothalamus calls for the release of endorphins, and the cells in your body that contain them respond. When endorphins lock into special receptor cells, they block the transmission of pain signals and also produce feelings of euphoria. But endorphins can’t do it alone…. exercise also raises levels of other mood-boosting chemicals like serotonin, dopamine and norepinephrine. The combination of endorphins and these other neurotransmitters produces and effect often referred to as “the runners high”.

In reflecting back on my time as a distance runner, I remember saying many times that it wasn’t always the act of running that got me out there day after day – but rather, the tremendous feeling that I got after my run that had such a positive impact on my outlook. But you don’t have to be a runner to enjoy the benefit of the runners high….just 30 minutes of physical activity can elicit this effect on the body and improve our mood on a chemical level.

How else can it affect us?

During a fast-paced tennis match or an intense kickboxing class, you’ll find that you concentrate more on your body’s movements than on the things that are irritating you or stressing you out. Redirecting your focus can help calm and clear your mind. This is referred to as “Active Relaxation” or the capacity to focus on rhythmic motion that can produce a relaxation response within the body.
By reducing our levels of stress, anxiety and depression, we can also sleep better at night, thus improving our energy during our awake hours and reducing irritability and depression often associated with inadequate sleep. How to get started? Consult your doctor or an exercise professional if you’re new to exercise or have health concerns. Safety first! Start with small, manageable goals and choose an activity that you enjoy. Exercise shouldn’t feel like a chore. Then make room in your schedule! Make your health a priority and set aside time each day to focus on you. You’ll be glad you did.

Jaclyn Chadbourne, MA is a Clinical Exercise Physiologist and Principal, Director of Research and Development – ‎Universal Medical Technology, LLC and United Medical Gym, Inc in South Portland, ME. With a passion for sustainable healthy living and desire to advocate for patient-centered care, Jaclyn works to help support community resources for all special populations and to implement and oversee clinical protocols.

References
http://www.nbcnews.com/id/18043835/ns/health-fitness/t/getting-high-exercise/#.UwJ-wvldXtI
http://www.mayoclinic.org/healthy-living/stress-management/in-depth/exercise-and-stress/art-20044469
http://www.webmd.com/fitness-exercise/features/runners-high-is-it-for-real

Still a Gym Rat: Exercise & MS

Mitch Sturgeon/10 October 2017/ All MFN blog/

Before I was diagnosed with MS, and for the first few years afterward, I was dedicated to my exercise programs. My ideal workout time was early morning, because all I had to do was wake up, get my feet on the floor, and lean forward. The next thing I knew I was at the gym.

After my MS diagnosis, I continued to visit the gym on a regular basis. Eventually, when my legs became too weak, I had to give up on the aerobic exercise and the lower body weight lifting. But I still maintained my upper body workouts – even when I started using a cane, two forearm crutches, and then a scooter. Finally, it became too much, and I stopped going to the gym in 2006.

MOG Fast-forward to 2013. My neurologist told me about a facility in South Portland called the Medically Oriented Gym, or MOG. Saco Bay Physical Therapy works one-on-one with patients like me at the MOG. In September, I had my first appointment with Gabe, a physical therapist. We talked about goals. I wanted to maintain or improve the range of motion and strength in my upper extremities. Also, I would welcome anything they could do for leg strength and flexibility, but I knew that would be a more difficult task.

Gabe measured my strength and range of motion to establish a baseline. He then worked with his associate, Jodi, to develop a program for me. Over the past nine months Jodi has incorporated a variety of stretching routines and exercises to strengthen specific muscles and maintain or improve my flexibility. Gabe has evaluated my progress on a regular basis. I have at least maintained and even improved in some of his measures. It’s a beautiful thing.

Gabe, Jodi, and the rest of the team are consummate professionals. Not only do they understand the mobility issues I’m facing, but they exhibit sincere empathy. They know when to push me hard and when to back off. They constantly come up with creative new ways to challenge my muscles to do anything and everything they are still able to do.

I generally have two one-hour sessions per week, and I plan to keep this up indefinitely. In my case, insurance is picking up 100% of the costs.

The benefits I experience from my workouts at the MOG are more than physical. There is an emotional component as well. I always feel more positive about my life when I am fighting back against this creeping paralysis. And even in the days before I became disabled, I experienced a boost from my gym workouts if for no other reason than I was getting out of the house and moving around. That still applies.

This physical therapy program isn’t going to overcome the relentless attack that MS is waging on my central nervous system. My overall physical well-being is continuing to deteriorate, and I don’t expect it to stop. But the work I am doing at the MOG allows me to maintain as much strength and flexibility as I possibly can, for as long as I possibly can. I encourage everyone with MS or other similar conditions to “use it or lose it.” If you live in the greater Portland area, I recommend Saco Bay Physical Therapy and the MOG. If you live elsewhere, find a physical therapist and a gym that you can work with.

If you’re a healthy person, and you’re not getting regular exercise, are you just trying to piss me off? You enjoy such good fortune, yet you do nothing to nurture and protect it. Don’t make me come over there and kick you in the ass, because I will.

One of the exercises Jodi has me do is to lie on my back (which is no small feat) and execute bench presses. Before MS, I could do three sets of ten with a substantial weight on the bar. I would grunt and strain and put everything I had into each repetition. When working with free weights, I always had a spotter, because if the weight were to land on my chest or neck it could have been dangerous. But today I am bench pressing a broomstick, and I still grunt and strain and put everything I have into each repetition. Last week I said to Jodi, “You better stay here and spot me, because if I get pinned by this broomstick I’m not sure I’ll be able to breathe.”

We laughed and laughed. I’m a funny guy.

Read more from Mitch at his blog, Enjoying the Ride.
Learn more about the MOG on their website.

Why Am I Not Getting Leaner…?

Nancy Clark, RD/9 October 2017/ All MFN blog/

“I religiously track my food and exercise. I’m eating 1,300 calories (the number my tracker told me to eat if I want to lose 2 pounds a week). I’ve been following a strict diet and the scale hasn’t budged. My friends tell me I am eating too little. I think I must be eating too much because I am not losing weight. I feel so confused… What am I doing wrong?”

I often hear this complaint from weight conscious people who don’t know if they are eating too much or too little. They believe fat loss is mathematical. Exercising 500 calories more, or eating 500 calories less, per day will result in losing 1 pound (3,500 calories) of fat per week, correct? Not always. Weight reduction is not as mathematical as we would like it to be.

Is it a diet or a famine?

If you are already exercising like crazy and are eating far less than you deserve—but the scale doesn’t budge—you might wonder if something is wrong with your metabolism? Are you eating the wrong kinds of foods? What’s going on…?

When athletes have excess body fat to lose, they tend to lose it relatively easily. But when they get close to their race- and/or dream-weight, fat loss can slow to a crawl. That’s when frustration sets in. You might think reducing your calorie intake even more would be a good idea. No. You would deprive your body of too many nutrients, to say nothing of lack energy to perform well.

When you significantly restrict calories, your brain perceives the lack of food as a famine. Doing extra exercise makes the situation worse, especially when your body is at a low weight. With no excess fat to lose, your body conserves energy and maintains weight at a calorie intake that historically would have resulted in fat loss.

Nature protects the body from losing weight during a (perceived) famine by slowing your calorie-burn: The heart rate slows (not due to fitness but rather to lack of fuel). Blood flow to extremities slows in order to keep your organs warm. Your hands and feet feel cold all the time. The stomach/intestinal tract slows; constipation can become an issue. The hormonal system reverts to pre-adolescence. Women produce less estrogen and stop having regular menstrual periods. Men produce less testosterone. You feel excessively tired. You can muster up energy to exercise, but then are droopy the rest of the day. Fatigue becomes your middle name.

Role of genetics

When an athlete complains about lack of fat-loss despite rigid food restriction, one of my first questions is “How do you look compared to others in your genetic family? Are you leaner—or far leaner—than they are? The standard response is far leaner. Remember, the apple doesn’t fall too far from the tree. Nature’s blueprint for your body might differ from your dream physique.

Pay attention to what others say about your body. If your mom or partner says you are too thin, listen up and stop striving to be leaner yet. Rather than struggle to lose those last few pounds, gently accept your physique and be grateful for what your body does for you. It is strong, healthy, powerful, and able to do what you ask it to do (run a marathon, raise a family, train for and complete an Ironman, bike 100 miles, etc.). It is a resilient vehicle that carries you through each day. It’s good enough. Hopefully, you will not have to experience a broken leg or be diagnosed with cancer before you learn to be grateful for your body and how it allows you to walk, run, and live an active lifestyle—regardless of your size or shape.

Eat more, get fat?

You can stop the diet/famine by eating more; you will not instantly get fat. Rather, your metabolism will quickly return to normal. If your body is too thin, it will strive to restore itself to a genetic weight. This is why athletes can have a hard time staying at their “racing weights.” Being too thin is very hard to maintain.

If you believe you still have excess flab to lose, yet the scale doesn’t budge despite your strict diet, what can you do? I generally recommend eating more and exercising less. To the shock of many of my calorie-deprived clients, this tends to work better than exercising more and eating less. Sounds counter-intuitive. How can that be true?

Think of your body as being a campfire. When it has three logs to burn, it generates a lot of heat. When it has just one log, it produces just a small flame. The same with your body, the more fuel it has, the more calories you will burn.
While adding calories, focus on the benefits: how much better you feel, the power in your workouts, your happier mood, and better quality of life. If you don’t trust your body and are fearful that eating more will end up with your regaining the weight you worked so hard to lose, get help. A sports dietitian can guide you through this process. Use the referral network at SCANdpg.org to find your local expert.

Are fitness trackers helpful?

Fitness trackers offer information that is interesting but not precise. Something strapped on your wrist can sort of measure what your legs are doing, but many variables impact accuracy. For example, pushing a baby jogger with straight arms gives a different step count than if you were to run with freely swinging arms. (1)

As for energy expenditure, note that some of the calories reported as being burned during your workout include calories you would have burned in that hour regardless of exercise. Knowing calories burned can be dangerous… “Oh, I just burned 500 calories, so now I deserve to eat ice cream!!!” Tracking might not enhance fat loss. (2)

Your body is your best calorie counter. Instead of tracking calories to determine if you have eaten the correct amount, try listening to your body. Before you eat, ask yourself, Am I eating because my body needs fuel—or because I am bored, lonely, or stressed? … Am I stopping eating because I am satisfied? Or just because I think I should? By eating mindfully, you will not over-eat nor under-eat. You’ll simply relearn skills from childhood, when you ate when you were hungry, stopped when you were content, maintained a good weight, and never ran out of energy. Life is better when you are free from being in food-jail.

Sports nutritionist Nancy Clark MS RD CSSD has a private practice in the Boston-area (Newton; 617-795-1875), where she helps both fitness exercisers and competitive athletes create winning food plans. Her best-selling Sports Nutrition Guidebook, and food guides for marathoners, cyclists and soccer are available at nancyclarkrd.com. For her online sports nutrition workshop, co-presented with exercise physiologist John Ivy, see www.NutritionSportsExerciseCEUs.com.

References

1. Nelson et al. Validity of Consumer-Based Physical Activity Monitors for Specific Activity Types. Med Sci Sports Exercise, 48(8):1619-28, 2016.

2. Jakicic et al. Effect of Wearable Technology Combined With a Life-style Intervention on Long-term Weight loss. JAMA 316(11):1161-71, 2016