Five Reasons You Must Start Resistance Training Today!

Welcome back!

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!

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?

Do you ever feel like you are in over your head?

Today, I am taking a crash course in internet marketing.  Why?  This is what I keep asking myself.

The reason is that I really want to figure out how to get my upcoming e-book, “The CF Wellness Boot Camp” out to as many people as possible.

To do that, I am learning, I need a “LIST.”   So I am madly learning  about how to create “opt in” boxes everywhere, and how to create  an e-newsletter (to entice ya’ll to sign up to my “LIST),” to use FTP to do weird things to my blog, to tweak HTML to make things look better, and generally, to do all kinds of things that ARE NOT IN MY JOB DESCRIPTION!

But, alas, one  of my strengths is “love of learning,” so I should be very happy for a  very long time.  Please be patient with me.  I have great ideas for the newsletter, including exercise instruction and demonstration, interviews with nutrition and stress management gurus, and so much more.  Please sign up.  I promise you won’t be sorry!

E: Envision The Opportunity

The following is a quote from experts in the field of “Appreciative Inquiry,” a technique used in coaching (as well as other endeavors) which draws on the best of the past to inspire the present and create a better future.

“We see what we look for and we miss much of
what we are not looking for even though it is
there…  Our experience of the world is heavily
influenced by where we place our attention.”
Stavros and Torres

How can we apply this to our quest of living well within the context of a chronic illness?

The challenge in writing about this topic is to not come off sounding like a rose-tinted fluff producer.  Believe me, I understand that a chronic disease brings with it significant struggle, frequent frustration, and unsettling uncertainty.  Sometimes, when someone tells me that I should “look for the positive” in a situation that seems unbearable, I get downright mad. “THERE IS NOTHING POSITIVE HERE,” I want to scream.  In fact, until the initial emotion is confronted and worked through, my visual field can include nothing positive about the situation.  I don’t believe I am alone regarding this.

So step one in looking for the “opportunity” in a health challenge must be confronting and understanding the grief, anger and fear that accompanies illness.  You can’t ignore or look past these valid emotions in order to get to the other side, where opportunity lies.

As I write this, my brother Tom lays in a hospice house in Omaha, Nebraska, where he will spend his last days and weeks before succumbing to cystic fibrosis.  I love my brother more than I can describe.  He has been a role model to me, an example of how a fighting, stubborn spirit can overcome lungs that have been failing him for over a decade.  He has been like the Eveready Bunny for over 10 years, refusing to stop and give up, despite pulmonary function numbers that would cause most people to roll over and die.  Instead, Tom has maintained a job, maintained friendships, and continued to amaze his healthcare team (and family) with his resiliency.

Now that my PICC is out, I am traveling to see Tom in a week, to say good-bye and to tell him how much I love him.  There are obviously a lot of emotions to work through here…I am very sad, and I am very afraid of what I will see when I walk into his room.  But there is absolutely no way of ceasing this opportunity to say good-bye without acknowledging and facing my own fear of looking at Death by CF. I have been letting this fear get in the way of getting close to Tom for years…just as I let it keep me from Kathy when she was ill.  It is the same fear that made me cover my ears and go to the far reaches of the house when I was a young child, and Tom or Kathy was doing a treatment and coughing their brains out.  I have been missing the opportunity of knowing my brother better, because I have let my own fear and sadness cover my heart. This has been a great example of how to not find opportunity in a bad situation…until now.

Fortunately, I see now that the reward of knowing and loving my brother will come with facing this fear, not avoiding it.

Similarly, the reward and opportunity found in any health challenge can only come after living with and through the emotion that accompanies it.

Discover Your Strengths and USE Them Every Day

I am a personal fan of the field of positive psychology.  I love to read about what it is and what it is teaching us about the science of happiness.  I like to take courses and attend conferences about the subject.  In fact, the whole purpose of this blog (and hopefully of a future book) is what the scientific study of positive emotion can teach people with serious health concerns about optimizing their happiness and wellness within the context of illness (hence the title of the blog).

The “D” in my acronym stands for “Discover Your Strengths and Use Them Every Day.”  First, I want to describe why this is important when it comes to happiness.  Then I will show you how to discover your strengths the high tech way (an online resource).  Of course, you could just ask you mother.  Then I’m going to describe a project I am designing for this blog that allows me to use my strengths as an example of putting this “rule” into action.

It used to be that to “improve ourselves,” we were to work on our weaknesses. However, new research shows that living and working from our unique strengths rather than paying attention to deficits creates lasting personal happiness and allows for peak performance. When we identify and further develop our unique talents and character strengths, we contribute more effectively and enjoy the process more.

It makes sense, really.  Imagine that you are doing something that you are really good at, working towards a goal that you strongly believe is important.  In fact, go ahead and close your eyes and remember such a time.  Remember the feeling of mastery and  flow you might have felt during the activity, and the sense of accomplishment when you were finished.

Now remember the last time you struggled to do something that was beyond your skill level.  It was likely something that you were not innately good at, and likely caused great frustration and a feeling of inadequacy.

Clearly, the first situation leads to positive emotion; the latter, not so much.

What are your strengths?  You probably have a good idea without a scientifically designed questionnaire.  But, if you take it, you might be surprised.  I know I was.

In his book, Authentic Happiness, Martin Seligman describes how he and his colleagues came up with the Values In Action (VIA) classification of character strengths. There are 24 character strengths each describing a specific aspect of positive human character. The strengths are grouped into six categories termed virtues. These virtues have been determined cherished among most religious and philosophical traditions.  Collectively, they are said to capture the notion of good character.  The characteristics of character strengths are:

•    They are moral traits and can be developed and strengthened by choice.
•    They are valued for themselves rather than as a means to an end.
•    Using them elevates rather than diminishes others.
•    They are ubiquitous.

We all have the ability to exhibit any of the 24 character strengths but tend to rely on some more than others. The website www.authentichappiness.com offers a free, online survey called the VIA (Values in Action) Signature Strengths Questionnaire, which ranks your strengths in order of importance to you. Your top five strengths are your Signature Strengths.

When I took this questionnaire, I was intrigued by what turned out to be my top five strengths.  I won’t go into them all now, but one that struck me as quite useful for me to have was number two:

Hope, optimism, and future-mindedness
You expect the best in the future, and you work to achieve it. You believe that the future is something that you can control.

Maybe that has something to do with why I have done so well (so far) even though I have cystic fibrosis.

I love to do projects…especially projects related to either learning something, or achieving an athletic goal.  I love to set a goal, and then plan my strategy to achieve it.  I am now, and always have been, very goal oriented.  Goals excite me…they challenge me, and bring out the same self-discipline that carried me through medical school.

Not surprisingly, I was a sucker for the P90X home exercise program this spring, and have written about that experience and the unexpected results in a previous post, “How I Grew a New Lung in 90 Days.”  Now that I have a PICC in for IV antibiotics again, I am already starting to plan for the next round of “get Julie back in shape”.  And, now that I have this blog, I am going to post what I do and how it felt each day.  Why?  So that if any of you are interested in joining me, you can do so, and we can motivate each other!  The best thing about a blog is that it allows comments…both to and from the blogger.

So, if you want to join me, the start date is Monday, September 29.  This will be a three-month program (unless my lungs say differently).  I am creating a program that merges the P90X program with a weight-training regimen I have done in the past to successfully gain muscle mass.  There will be six exercise sessions per week with one rest day.  Each session will take about an hour…except on ab days (ouch).  You will go at your own pace, but I will recommend a given “perceived exertion level.”

The equipment needed is: you, water, supportive athletic shoes, some light free weights, and a chin up bar.  If you can, buy the P90X program.  I will use their aerobic and ab routines because they are great!  Also, if you don’t want to go to a gym, you can do the weight training sessions with just the above equipment.  The program I am doing is a modified P90X because I love going to the gym and lifting heavier weights.  The P90X weight workouts are good, and if you do them, you will definitely get stronger.  I just need to atmosphere of my gym, and want to use heavier weights because I have some significant strength to regain.

Are you game?

“D” is for: Decide what you will think and how you will act

One of the most influential books I ever read was Victor Frankl’s “Man’s Search for Meaning.” So much can be gleaned from this masterpiece, but one of my favorite lines has to do with the “choice” of what and how to think.  As Frankl writes from the concentration camp in which he was a prisoner, “Everything can be taken from a man but …the last of the human freedoms – to choose one’s attitude in any given set of circumstances, to choose one’s own way.”  Indeed, everything was taken from him and his fellow prisoners as they lived through unthinkable suffering at the hands of the Nazis.  And yet, his choice was to not only live through the experience with grace and dignity, but to describe an entirely unique therapeutic method of finding meaning and a reason to live.

It’s a bit of a stretch, but perhaps it can be useful to compare living with a severe chronic disease with living in a concentration camp…at least this might work with the chronic diseases that are not self imposed, that cause pain and suffering, and that end in death.  Extrapolating Frankl’s quote to chronic diseases such as these would be something like, “Every part of health can be taken from a person except the choice of how he/she will respond to the situation.”

Yesterday, I had an “opportunity” to try out this tip.  As many of you probably know, the experience of going in for “routine” pulmonary function testing can be quite anxiety provoking for someone with CF.   It’s just a number…a measly “percentage of predicted”…. but that FEV1 result (the volume of air you can blow out in one second) carries with it amazing psychological power.  It’s no wonder, really.  Doctors use it to gauge how much of your lung tissue is still useful.  A sudden drop will land you in the hospital faster than you can say “pseudomonas.”  Transplantation becomes a dinner table topic when it drops to around 30%.  The progressive nature of CF dictates that it doesn’t improve much really (unless it drops acutely due to an infection that is then  treated successfully).  Over the long haul…it only drops.  We all just pray that it drops VERY slowly.  We worry about it.  Some lose sleep over it.  The kicker is that we have virtually no control over how well we do.

So yesterday, as part of a clinical trial I am volunteering for, I went in to Stanford for my baseline exam, and of course, spirometry was done.  I was a bit nervous about it, because the previous time I had been tested, I did so well that I didn’t believe it (see previous post).  My hope was that I would do as well this time, but deep down, I didn’t believe I would.  I would then have to accept that the previous measurement was a fluke (and I really didn’t grow a new lung in 90 days).

My nervousness turned out to be justified.  In fact, I was a good 25% below that previous unbelievable number.  Worse, I was 10% below the baseline I had been at for years.  The maddening part is that I had no idea why my numbers were down.  Not being artificially high, I could handle.  10% down made no sense.  I didn’t feel sick.  I had been coughing a bit more…but not that much.  I was bummed, and my research nurse friends knew it.  It was all I could do not to cry right then and there.

Driving home, I had a tiny epiphany.   I had already started this post.  In fact, I was stuck at comparing disease to concentration camps.  Suddenly, I knew that the “universe” had just presented me with a way to finish my article.  I realized I needed to “decide” how to think about this new development, and what to do about it.

Guess what I decided to do?  That’s right.  I went directly to the gym.  I did not pass GO.   I did not collect $200.  I hopped on a treadmill and ran intervals.  I proved to myself that a number was a number, and what mattered was how I felt.  And I felt great on that treadmill!  Then I lifted weights.  Then I decided that for the rest of the day, I wasn’t going to think about it…period.  And I didn’t.  I got busy working on a project and busied myself doing what I love to do.

The next day, when I was calm enough to be rational, I came up with a plan.  I will have to repeat my PFT’s next week when I go in for my quarterly appointment, so I’m not going to overreact.  If my numbers are truly down as much as it appears, I will talk to my doctor and get his input.  Maybe I will need some sort of intervention, maybe not.  What I do know is that I need to go back to the P90X program (or something equally intense).  It seemed to work before, so this would be a good chance to recreate my previous success.

What I will not do is panic and let fear cloud my decision making.  The worse case scenario is that I have a new baseline. If this is the case, I will choose to respond rationally.

How I Grew A Lung in 90 Days

I am 47 and have garden variety, homozygous delta F508 CF. While it is true that I probably benefit from a helpful modifier gene or two, I am convinced that the reason I am so healthy today is that I have exercised regularly and vigorously my entire adult life. As I write this, I have rivulets of sweat dripping down my shins making tiny little puddles on the floor. My schnauzer loves it. The reason: I just completed the “Plyometrics” DVD from the P90X Home Fitness Program (have you seen the infomercials?). I am on round two of P90X now. I don’t know what the “P” stands for, but “90” is the number of days the program lasts, and “X” is for Extreme.

I’m not really endorsing P90X here. I like it because it is HARD, it is different from my usual routine, and because it is a home workout program…no germ-infested expensive gym is needed. With a few dumbbells and a chin up bar, anyone in pretty good shape can do it. For example, the DVD I just finished included about 45 minutes of jumping up and down in various ways. Imagine wearing the Vest while riding a racehorse and being the horse, all at the same time. It’s hard! But this program has changed the way I look at and do my exercise, and that is what I want to share.

I was sicker than I have ever been this winter. When my energy started drifting down, we discovered that my lung function was doing the same thing, so I did a three-week home IV treatment. Not surprisingly, except for drug allergy issues and a DVT in my arm from the PICC, I felt GREAT when it was over…for two days.

Then, as luck would have it, I caught a nasty virus, which resulted in a week in bed, followed by a week in the hospital with pneumonia, followed by ANOTHER three weeks of IV antibiotics.

Not surprisingly (to me, anyway), as soon as the line was out, I was searching for a workout program to get me back to the shape I had been in before all of this began. P90X was the way I did it, but there is a myriad of ways to get moving.

So every day, I followed the program. I exercised to the DVD’s six days a week in my garage. These were short sessions, about an hour long each

Now, here is the part that is hard to believe. Between the antibiotics and the exercise program (nothing else changed), I seem to have grown a new lobe of lung tissue! Kidding. Not really, of course. However, I am a bit of a nerd about my pulmonary function tests. I have them dating back over 20 years. When I blew for the first time this spring after finishing the exercise program (and six weeks of antibiotics, don’t forget). The volume of air I blew out in one second (FEV1) increased by 39% since the previous, and the small airway number (the FEF25-75%) improved by 70%!

I was a bit shocked by the “percent predicted” figures, having not heard those numbers in decades, so I decided it was a mistake. Maybe the norms being used were different. Maybe the machine was wrong. Then, I blew again. Same numbers. I drove home wondering how in the world scar tissue could turn into lung tissue (I’m sorry, but I still have a Pathologist sense of humor, despite retirement).

So I did what a nerd would do, and I dug out all the previous reports and compared volumes. Volumes don’t lie. Sure enough, the last time I saw numbers even close to these were in my 20’s. Did I mention that I’m 47?

Yes, this is an anecdotal story (but a true one). I did not do a randomized, double blinded, placebo controlled study demonstrating unequivocally that exercise caused my lung function to improve (although several well designed studies HAVE shown that exercise slows down decline in lung function in CF). I know that the antibiotics helped immensely. But it isn’t like I haven’t had antibiotics before…

The bottom line: You must move! It helps to push yourself a bit. Breathe hard! Cough! Repeat! If you tend to desaturate, use oxygen! It gets easier. Even though we have CF, we do show a training effect, just like everyone else. It is hard work to stay alive and well with CF. This is undeniable. But the reward is worth it.