Posture For the Sick and Happy

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A few days ago, I uploaded the above video to YouTube.  I think posture is an incredibly important thing to think about when living with a pulmonary disease, so I thought it deserved a blog post.

Think about it:  When you have cystic fibrosis, or any other pulmonary disease, every single alveolus is precious (“alveolus” is medical speak for the tiny little air sac that, together with it’s millions of comrades, comprise the lung and allow for oxygen exchange–I like to think like a doctor sometimes).

As we get older, (happily, we all are now, aren’t we) there are two forces working against our lungs–gravity, and CF.  We tend to think that we have little control over either, but we do!  I write all the time about how we can positively influence our health by controlling what we can about CF.  We can do our treatments.  We can eat nutritiously.  We can exercise religiously.  We can get enough sleep.  We can make sure we go to all of our clinic appointments….etc.

Today, my focus is on how to control gravity!  Really.

Now mind you, I like gravity.  It does many very positive things!  It would be quite a chore to sit here and type without the assistance of gravity.  But, gravity can wreak havoc on your body if you don’t learn to use it properly.

Huh?

Our bodies were designed by a genius(es…who knows?).  The bottom line is that our bones, muscles, tendons and ligaments all start out aligned to oppose gravity perfectly…until we screw it up.  As I sit and type right now, my shoulders are rounded, my upper back is hunched over my computer, and my chin is jutted out over my chest.  I know that’s sort of a scary image, but stick with me here.

Look around.  Isn’t just about everyone assuming that position?  It doesn’t just happen when typing or sitting at a computer all day.  We gravitate unconsciously to this position  when we play video games (watch your kids do this for a good shock), when we drive, when we play poker, when we slouch on the couch, you name it.  It happens as we rush from one thing to the next.  Isn’t your chin usually the first thing to enter the room?  There are opportunities for this posture all day long!  Over time–and not that much time– our default position consists of forward rounded shoulders, hunched over upper backs, and forward jutting chins.  Compensating for all of this often comes a sway-back position of the lumbar spine.  Suddenly, gravity is our arch enemy.

When you throw your body into this position, the muscles, ligaments and tendons  of your back and neck HAVE to work overtime to simply keep you upright.  These poor muscles become chronically overworked…and they let you know it.  Slowly, the muscles of your upper back become stretched to a position that is not optimal, and they are thus weakened.  At the same time, the muscles of the front of your shoulders and chest, low back and hip flexors (remember that sway back thing?) becomes tight and shorter than their optimal length, thus weakened.  So, front and back muscles are weak, and working over time to keep you from falling on your face.

Ok, now throw in a chronic cough.  Does your back and chest wall  go into spasm just thinking about this?  Now you understand REASON ONE for establishing good posture when you have CF.

Now for REASON TWO:  Conjure up that image again, the one of the rounded shoulders, and slumped upper back.  Do you think it is possible to take a full breath using all available lung tissue when in this position?  Not a chance.  You  can use most of your upper lungs when you are collapsed that way.

It is estimated that poor posture can rob you of __% of lung tissue.  Now, I don’t know about you, but I need every bit of my lung tissue with every breath I take.  I can’t afford the improper effects of gravity1

So watch the video, and try to incorporate at least one or two of these exercises every day.  They aren’t hard, and they don’t take much time.  They will slowly work to strengthen and shorten those overstretched back muscles, and stretch and strengthen those tight chest and shoulder muscles.  The result will be that you will be able to pull your shoulder blades back and down, thus opening your chest and allowing for full expansion of your lungs.

The next trick will be actually remembering to do this!  I have some tricks for this, too.  Watch for my “mindful breathing intervals” in a blog post coming to you soon!

The Pros and Cons of Working Out at a Gym

I like to start an article off with a bang!

I read an article online a couple of days ago entitled,  “The Four Germiest Places at the Gym,” and it made me a little ill.  You can read it for yourself (I recommend this), but in a nutshell, you want to avoid public yoga mats, dumbbells, bike seats, and shower floors and walls.

Now I don’t know about you, but I actually touch dumbbells when I go to the gym.  Not only that, but I always have to adjust the exercise bike seat height!  Now, I can definitely avoid yoga mats (I bring my own), and I rarely (by rarely, I mean never) use a locker room shower anymore.  Still, the article got me thinking about the good and bad points of public gyms for someone with CF.  So, here’s my take.

THE PROS

1)  The first that come to mind is obvious, and the video above is a perfect example:  PEOPLE WATCHING!  Let’s face it, treadmill running, or elliptical training, or stationary cycling, or (fill-in-the-blank) for 30 minutes at 70% of your estimated maximum heart rate can be BORING.  Watching those around you, especially when they are doing unusual things, can be very entertaining.

2)  Variety of equipment:  My gym is a great example of this.  I could be there all day, and not have enough time to try every machine.  It’s mind blowing.  For an exercise nerd like me, it’s like being a kid in a candy shop!  Chest day, you say?  Well, let’s see…I can use dumbbells, or barbells, or cables, or stack machines, or take a group weight lifting class.  The possibilities are endless.

3) Vicarious experience:  If you are short on inspiration or motivation, the gym can be a perfect remedy.  All you need to do is look around.  There are always people there who can provide inspiration.  You can see yourself in others, and aspire to push yourself a little harder.  When I see a woman who can do 10 pull ups, I am both impressed and motivated to work harder, because, darn it, if she can do it, so can I!

4)  Variety:  Let’s say you get sick of your “usual” aerobic or lifting routines.  Check out the group classes!  Again, if your gym is like mine, you can choose from anything from “Zumba” (I don’t know what that is…it sounds like a soup to me) to kickboxing to group “body bar” classes to yoge to (fill-in-the-blank again).  Never even THINK of a boring exercise session again!

5)  Social connection:  Working out alone, either jogging or lifting weights in your living room, is kind of lonely, isn’t it?  A gym is a much more social experience, even if you don’t know anyone around.  There are people there!  You can talk with them, or not, but you are not alone.  You might even make friends with people there.  Some people have hooked up romantically after gazing from afar for months at the gym…

6)  Guidance:  Let’s say you have no clue what you are doing, for instance.  At a gym, you can a) watch what others are doing on the machine in question, or b) ask for help.  There are people who get paid to answer your questions.  And there are people who aren’t getting paid for it who will answer your questions.  And, of course, there are people who want to answer all of what they perceive to be your unspoken questions (but they go in the other column).  Last, if you have the cash, there are people you can hire (personal trainers) to teach to what to do and set up a program designed specifically for you.

THE CONS

1)  This one is easy.  I alluded to it earlier.  GERMS!!!  Gyms are germ havens.  Ask around, I bet you can’t find any self-respecting microbiologist at your gym.  They know better.  Now, this freaks out many “normal” people (i.e. CFTR-able).  Imagine how it might affect those with CF!  If you have a transplant, forget about it…there’s no way you should go into a gym.  So this is serious business.  I go back and forth on this, and I am addicted to my gym!  The best I can say is if you are like me, and can’t stay away from your  gym, wash your hands…wash your hands…wash your hands!!!  And until you can wash your hand after touching the machines or weights, keep your hands AWAY FROM YOUR FACE.

And avoid the locker rooms…and the yoga mats.

2)  Inconvenience:  Getting dressed, packing your bag and water, finding your keys, driving down the block, returning home because you forgot your membership card, and driving to the gym take time.  For some, this series of events take longer than the entire workout.  This is not efficient use of time, nor is it good for the environment.  The worst part is that often this series of events presents an insurmountable obstacle to the exercise itself.

3)  Being “Noticed:” This one is only sometimes the case for people with observable health issues:  When I look or sound sick (you know…”the cough”) it can be embarrassing to exercise in public.  Once I was at the end of a course of IV antibiotics, and I went to the gym with my PICC, infusing Tobramycin.  I was on the treadmill, jogging I think, and this guy came up and asked what was wrong with my arm.  “Nothing,” I responded, “I’m just getting antibiotics for a lung infection.”  I wish I had words for the look on his face.  He truly thought I was a nutcase that should perhaps be carted off in a straitjacket.

At least I wasn’t dancing.

Move That Picture!

I’m writing this post for one reason only––to move  that picture down the page!  Sorry about that.  I’m better now.

Seriously, I have a question, and it seems that I have a few readers now.  So I’m going to ask for your opinions and hope that you will provide them to me by commenting on this blog.  That is the great thing about blogs, of course.  In distinction to a static website, where you just throw stuff up and hope people read it, a blog format allows for an actual discussion to occur.

What I would like to know is this:  what do you want to read about here?  Right now, I base what I write about on what I am thinking about.  But I would like to have it more focused on what you would like to talk about.  Then, we can get some real discussion going, through comments here, through Twitter, through Facebook, with YouTube, etc.  This social media world is really quite amazing, and I would like to take advantage of it as much as possible.

So, send me your thoughts, as well as your Twitter, FB, blog or whatever you have URL’s, and we can get connected and go from there.  Thanks.

julie

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Rant

Ok, so sometimes it’s hard to be both sick and happy.  I will admit this.  Today, I am going to allow myself exactly the time it takes  to write this post to be less than happy.  So pardon me while I rant.

Sometimes having CF sucks.  There is no better way to say it.  This is one of those times.  Two weeks after pulling my IV from a three week course of antibiotics, I found myself in the Emergency Department with a fever and chest pain.   Bad chest pain…the kind that, when you have CF, you know is not going to end well.

Sure enough, the chest film shows an infiltrate and I need another course of meds.  So yes, at some point, I will get to “it’s a good thing there are antibiotics,” but right now, not so much.

Ok, enough.  I’m done ranting.

First Sick and Happy Video!

More to follow with real exercises…

Five Reasons You Must Start Resistance Training Today!

I love list posts.  They are so easy to write, and even easier to read.  If only adopting the habit they propose were so easy…

But in this case, it is!  Resistance training is not difficult to do.  You don’t need to join a gym.  There is no requirement for fancy equipment or expensive clothing.  While a routine does take a little bit of time, you will begin to see and feel significant results in as little as 20 minutes 2 or (ideally) 3 sessions per week.  You could multitask, and do your routine while watching Scrubs reruns.  How simple is that?

Your own body weight can provide all the resistance you want or need, or if you are so inclined, you can purchase some very reasonably priced resistance tubing to use in your living room.

Here’s the trick.  Don’t fall for the fitness magazine articles that suggest complex moves, or drop sets, or supersets, or unbelievably crazy-sets.  Pick exercises that target multiple muscle groups like squats, lunges, front and side plank, or good old fashioned push-ups, and just start doing them!  Here is why you should start today:

Reason 1) Resistance training is a friend of your metabolism.  Why is this?  As you begin to overload your muscles beyond what they are used to, you injure them slightly (don’t go for major injury…that doesn’t do any good at all).  You cause little tiny microtears in the muscle fibers, and this is why you are sore one or two days later.  But this is good news, because as your muscle fibers heal, they become stronger and bigger.  You add muscle mass, and over time, this increases your metabolic rate.

How does that work?  Body fat doesn’t do much.  It just sits there and looks back at you in the
mirror.  It doesn’t use up much energy.  Heck, it doesn’t even need much of a blood supply since it requires so little maintenance.  As a result, it burns very few calories.

On the other hand, muscle is very active.  It requires food (glucose and amino acids) and burns tons of calories by just being there.  Clearly, if you want to be a lean, mean, calorie burning machine, you want as much muscle as you can get.

Reason 2) Muscle, because it requires glucose and amino acids, is very sensitive to insulin.  Insulin opens the doorway to  to the little muscle cells, so glucose and amino acids can get in.  If you are insulin resistant, as in Type II diabetes  (and possibly CFRD), lifting weights will increase your insulin sensitivity as you build muscle mass.  A finely tuned insulin sensitivity mechanism is required for a stable blood glucose level, which leads to good health.

Reason 3) This is a big one for me, and maybe you can relate.  Building muscle and feeling and being strong physically is one area of my life where having cystic fibrosis doesn’t even matter!  My lungs may not be the best in the gym, but I will take on any woman my age in a push up or pull up contest!  This is a very empowering feeling…I have at least a modicum of control over my body which is otherwise at the mercy of my lung status.  Now, some days my lungs even interfere with my time at the gym, and that is OK.  I know that when I recover, I will be back, strutting around the gym with the big boys, knowing that my muscle fibers are no different than theirs:-)

If you have an illness other than CF, lifting may just provide the same benefit.  Lifting weights is a very black or white thing to do.  You do it and you see and feel results in as little as two or three weeks.  You have control of this.  It may not feel like you have control of much else, sometimes.  But you do have control over this.
Reason 4) More and more studies are showing that well-designed resistance training programs in post-treatment management of cancer patients and survivors are beneficial in improving health status and quality of life.   This is true in other chronic diseases as well.  Weight training is anabolic, meaning it builds up the body.  Often, treatment for illness is catabolic, or breaks down the body (think steroids or chemotherapy).  While these treatments are necessary, we can counter their bad side effect of breaking down tissue by weight training.

Reason 5) Weight training is fun!  Ok, maybe I’m in the minority thinking this, but stand by this statement.  When you get over the initial “I have no clue what I’m doing,” and move through the “Oh my God this huts,” you begin to see improvement!  And this is fun!

Are you ready to begin?  I’m starting a YouTube channel where I will teach easy, and very modifiable exercises that anyone can start doing today.  Check it out, and subscribe today!

Shame on You, Wally Koala

So there I was walking to my mindfulness movement class with my PICC line in my arm, when I noticed the brilliant blue and yellow writing on the white background of a Children’s Hospital van, “Wally Koala says TO BE HAPPY, YOU MUST BE HEALTHY!”

I proceeded to look at my right arm, where antibiotics were being pumped straight to my right atrium, and thought that no reasonable person would call me healthy right now!  Does that mean I can’t be happy?  Of course not.  I was immensely happy!  I knew that I was receiving what I needed to feel better.  I knew that I was lucky to be able to get needed meds this way, OUT of the hospital, so I could still live my life while I was getting better.  I knew that it was a gorgeous night, and that even with a catheter in my arm, I was walking briskly and breathing with no problem.  I knew that when the class was over, I was going to sleep on a fabulous new king matress  completely surrounded by dogs.  I wasn’t just happy, I was ecstatic!

Shame on you, Wally Koala!  What kind of message are you sending to the patients at your hospital?

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Can I Exercise When I’m Sick?

Not that I’m an expert on this… The last time I had a PICC line I ended up with a DVT (blood clot) in my arm and had to be on blood thinners for 3 months.   Why?  Well, I’m not exactly sure, but it could be because I didn’t want to atrophy away, so I was doing push ups as well as my daily walk.  Dumb.

So maybe this does make me an expert because I definitely know what NOT to do.

Here’s my take:

If you have a PICC, NO UPPER BODY RESISTANCE TRAINING NOT EVEN PUSH UPS WHAT ARE YOU THINKING?!  But when you start feeling better after the first few days of “happy juice,” as I now call it, you can definitely go out for a nice walk every day.  Or get on an stationary exercise bicycle.  Basically, the bottom line is don’t push it too hard, but it is good to move! If you don’t move for three weeks, it will be very difficult to get motivated again, and you will lose muscle mass, a very bad thing indeed.  Be gentle.  Be mindful.  But, move.

If you have a fever, no exercise.  Rest.

If you are just coughing more than usual, but don’t feel too bad…well, this is a tricky one.  Are you losing weight?  Are you eating well?  Do you have energy?  This is probably a good time to call the clinic, let them know what’s going on, and ask for your doctor’s opinion on the exercise question.  Do I do that?  No (well, I ask myself and I usually tell myself to quit being a wimp and do some push ups). But I’m learning to not listen to that inner little sergeant.

Last week (Week One), was the “walk every day” week.  My dogs loved it.  I also did daily Qigong (gentle stretching).

This week, I’m adding some lower body exercises (squats) and curl ups to the above.  Feeling good!  Zero cough.  I love this happy juice.

Next week, who knows…but it won’t include push ups.

SixtyFive Roses Review and Giveaway | Lisa Reviews

SixtyFive Roses Review and Giveaway | Lisa Reviews

I just stumbled (literally) across this site, and thought both the book and the contest looked interesting.  I usually love a memoir, and this one has gotten great reviews.  You know when a book is being made into a movie, it must be pretty good.
Check out the contest.  You can win a copy of the book!

ANTS AND ELEPHANTS

Well, it’s been awhile.  I’ve been a bit under the weather lately and haven’t posted anything as I’ve dealt with illness.  Now, I have a PICC line, through which I am receiving antibiotics, and the magic medicine is starting to work, so…I’m back..

This current illness has prompted several ideas for blog posts, although up until now, I haven’t had the energy to act on the ideas.  One topic that comes up frequently when I deal with my cystic fibrosis and it’s ever-present ups and downs is what my mind does with the very simple information that my body is not perfect.

Do you have ANTs?  By ANTs, I mean automatic negative thoughts.  Do you remember the last time you watched a colony of ants, as the workers stream in perfect lines to and from the ant colony with the single goal of procuring food and whatever else an ant needs to live a good ant life.  Perfect, tiny little single file lines of ants, determined to stay in line and do what is expected for an ant to do.

This is the way unhelpful thoughts travel in your brain.  They are a series of repetitive synapses that have traveled the same neuronal pathways in your brain so many times that they have worn grooves in the sand of your brain.  Now, they are automatic, as are their emotional and behavioral consequences.  So it is very appropriate for the acronym for “automatic negative thoughts” to be A.N.T.  I’ve read that humans have about 50,000 to 70,000 thoughts per day, and that 90% of them are repeats.  We think the same things, over and over and over.  It reminds me of that ant in a single file line, doing exactly what the ant in front of him/her (probably him I guess) does, without question.

Here are some examples of my ANTs:  “This disease sucks.  You just got through two months of P90X, only to have to stop!  You’ll never get through this 3 month program.  IV”s again?  I  (sometimes I’m “you” and sometimes I’m “I”  If you lived in my brain, you would have me committed.) already had 3 weeks of IV’s just a few months ago…My CF is progressing.  My lung function probably stinks right now…God, what if it doesn’t come back.  What if I am now on that downhill slope?  Oh man, I am coughing so hard…what if I start to bleed and never stop?  No one is here to help if I have massive hemoptysis…what would I do?  WHAT?  103 pounds…oh no… You’re disappearing.  How can you be losing so much weight?  What does THAT mean?  Do you now have to deal with CFRD and insulin, too?  That would really suck.  You know Julie, that CFRD usually means worsening of CF.  The good days are over.  Your luck has run out….” and on and on and on

They are automatic.  I don’t try to think them.  They just happen.  And they’ve happened before.  It doesn’t seem to matter to my brain that it is thinking useless, negative thoughts that it has already informed me of a million times, thank you.  They keep on coming.  I’ve tried to stop them..but that definitely does NOT work!  You can’t successfully tell yourself not to think something.  Just try…right now, try to NOT think of a pink elephant lying belly up in your living room.  See?  You can’t do it.  Just by imagining what you don’t want to think, you think it.

But I’ve learned a trick in dealing with these thoughts.  It’s come with practicing mindfulness, which simply means being aware of what is happening while it is happening.  In other words, I’m watching my thoughts.  And at the same time, I am watching what my body feels in response to these thoughts.  It’s not pretty.  What I see is a direct connection between negative thoughts and bad feelings.  “Duh,” you say.  “That’s a no-brainer!”  Exactly.  These processes occur below the level of your “brain,” or consciousness.  But when you become conscious of them, something pretty cool happens.  It turns out that you can’t be fully conscious of something you are doing that is harming you, and continue doing it.  When you directly experience the fact that negative thoughts lead to bad feelings, you will appreciate that you have direct control of how you feel.  All you need to do is decide to think alternative, more positive thoughts.

So instead of, “Your lung function probably sucks right now!” I can gently decide (consciously) to change the thought to, “Yes, my lungs are a bit under the weather now…..and that is why I am taking care of them by resting and infusing wonder drugs.  Thank God I have health insurance and access to  great health care!”  The ANT will try to take over, and I will have to be very alert for this, as the grooves run deep.  But as long as I catch them, I can always substitute a life and health affirming thought for the negative one.  Over time, the affirming thought grooves will deepen and the negative grooves will smooth over from disuse.

Try to catch your ANTs.  Remember, don’t try to force them away (remember the elephant).  When you catch and ANT, replace him with an affirming thought that carries with it positive feelings.  Is this Pollyanna, New Age garble thinking?  I don’t know.  But would you rather feel bad, anxious, worried and depressed, or hopeful and grateful for what is good in your life?  Which feelings do you think are healthier overall and better for you?  Does being depressed and worried help you in any way at all?  Will it change the outcome?  I would argue that being optimistic and grateful can change the outcome…for the better.  So why not give it a try?

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