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.

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CF and Time

I am researching for a talk I will give to a CF Education Day in a couple of weeks, and found this article that I wrote three years ago.  The talk is going to be about exercise, of course, and how to find both time and motivation to move when you live with CF.  But re-reading this made me slow down a bit (hard to do on Prednisone), and remember what this time thing is all about.  I hope you enjoy:
CF and Time
As a fellow anatomic pathologist, I fully respect Dr. Dorothy Anderson’s description and naming of the constellation of signs and symptoms that we now call Cystic Fibrosis back in 1938.  Her observations marked the beginning of several decades of medical research, the outcome of which allows me  to sit at my computer at age 45 and write this. But for now, I would like to think way, way outside the box, and ask a question posed by one of my favorite spiritual teachers, Eckhart Tolle.  Does chronic disease really exist?  Does CF really exist?

In “The Power of Now”, Tolle differentiates your “life” from your “life situation”.  He speaks of your “life” as this very ”moment”, as opposed to your “life situation”, which is comprised of the circumstances or conditions of your life.  As such, your life situation is your “story”, which has a beginning, middle, and eventually, an end.  It exists on the horizontal axis of time.  However, there is a part of each of us that is unchanged over time and exists outside of time.  Think back to that day you learned to ride a bicycle.  Or think of throwing that high school graduation hat into the air with a big cheer.  Or perhaps, think to the moment when you said, “I do”….  In each of these situations, there was an awareness of what was happening, and that same awareness, unchanged, is aware that you are reading this page now.  That awareness is what Tolle would call “life”, and it does not exist in time.  It is NOW.  It does not change, because it lies on a “vertical” axis, with no past and no future.

Try not be offended by this (many of us are very attached to our CF), but imagine for a moment the possibility that CF is part of your “story”, existing on the horizontal axis of time.  At some point you were diagnosed.  In other words, a combination of sounds emitted from your doctor’s mouth (copied from the sounds Dr. Anderson decided best described this disease) was suddenly ascribed to YOU.  Those sounds became part of “who you were”.  The beginning of your CF story may have been when you were a baby, or later, but part of your identity was now as a “sufferer of” CF. The story then continued, with a different trajectory for each of us.  For some of us, the story has already ended.

Your story isn’t just CF, of course.  There is the story of what you do for a living, how your body has grown and changed, what you have learned over time, who you know, who is in your family, how many dogs you have loved and lost….If you think about it honestly, whenever you ask yourself the question “Who am I?”, the answer is usually just more of the story.  “I am a lawyer”, you say.  Then who were you before you got your JD?  “I am a father and husband”.  Who were you before you were married?  “I am sick” really means the physical part of “you” is not completely healthy at this point on the horizontal axis of time.  Yes, your body has weird and unusual chloride channels lining its epithelium.  But is your brain “sick”?  Is your heart “sick”?  Are your bones intact?  Can you see?  Are you breathing? Can you love?

“I” (the author) am a 45-year-old female “sufferer” of CF, retired physician, mother of two, partner, wellness coach, friend, daughter, sister…  Yeeeees, but other than being “female”, all of that has been variable throughout my life (and as I understand it, even being female could be changed, if I wished…).   Who was I when I was 9 months old, and had no language yet?

But, you argue, my brain is the same…!  No it isn’t.  Neuronal pathways are always changing; cells are dying; plaques and tangles are forming (at least, in our “old survivor” brains).  I’m sure you’ve heard that all of your cells are dying off and regenerating constantly. Nothing is constant on the horizontal axis of time.  The “life story” is ongoing, and ever changing, just as the body is.

Do you see the point of this tirade?  A part of you, and I would argue, the ”real” you, is the observer of your story, or as Tolle would say, “the awareness” within which your story unfolds.  Does that “awareness” have CF?  NO!  The body in which the “awareness” resides has CF!  So does CF really exist?  Only in time!  Only in the content of your life, the content that always changes and that describes you, but is NOT you.  The content is your life story, but is not your LIFE.  The real you is life itself, and that life is now, this moment.  “CF,” then, in this moment, is really reduced to what you are actually experiencing now.  Maybe that is a cough.  Maybe it is rapid breathing.  Perhaps it is pain in your joints as you walk.  Or, possibly, in THIS MOMENT, it is nothing at all.

“Wow,” you say, “Julie has completely lost it!”  But if it sounds kind of interesting to explore the idea of “this moment” where CF possibly doesn’t even exist, maybe you are asking, “How do I get there?”

I’m glad you asked.  This is the cool part.  Tolle describes “portals” into the NOW.  Entering these portals is sort of like a meditation, yet it is not meditation in the way we usually think of it.  I don’t know about you, but when I focus on my breath, I do NOT enter a state of bliss!  These portals are much easier to use.

One portal, my personal favorite, is to become aware of the “inner body”.  Another way to describe the inner body is your “life force”, or “life energy”.  To do this, you simple sit or lie in a comfortable place, close your eyes, and ask yourself without moving it or looking at it, “Is there life in my left hand?”  This may take a few moments.  You probably will be tempted to move your hand, but don’t.  Just sit or lie in stillness and find out, “How do I know that my left hand is there…without looking at it or moving it?”  After awhile you become aware of the energy of your hand.  That is your “inner body”.  When you become aware of it in one hand, you then move your attention to the other hand.  Then, when you can feel it there, you try to feel it in both hands at once.  After that, you get adventurous, and move to your feet, and up your legs, to your torso, then arms, then neck and head.  With some practice, you can soon, at will, become aware of the “inner body” within your entire “outer body” (the one you can see and move).

Here’s the catch:  the only way to feel this “inner body” is in the NOW.  You can’t do it if you are remembering the past, or worrying about or anticipating something in the future.  You can only feel your inner body in THIS MOMENT.  This technique essentially forces you into the “NOW,” the vertical, timeless dimension called awareness.  In this space, I would argue that there IS NO CF.   There may be a cough (see if you can maintain awareness of this life energy while you cough), but the energy is separate from the cough… from the body… from your thinking mind.  It’s wild.

If you get really into it, you can practice this awareness throughout the day.  You can do it during a treatment.  You can practice while folding clothes, or while walking, or while in a particularly unpleasant conversation with an ex-partner.  The more you practice, of course, the easier it becomes.

There are other portals, of course.  But this is getting way too long.  I would be happy to share my experiences with them (all very legal!).  Just give me a call or email.  Until next time: BE FIT…BE STRONG…BE WELL!

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Sick and Happy: The Book?

Since this blog is a prologue to a book idea, I think it is appropriate that I lay out my idea in a series of short entries. So here it is.

This came to me at 12:30 pm one night when I could not sleep. I had been brewing an idea for a membership website which would be a place where people with a chronic illness could hang out to get support, ideas, coaching, and other products that would help them to live as healthfully as possible. While on vacation with me, a friend suggested jokingly that a good name might be “notdeadyet.com.” Of course, everyone laughed at the absurdity of such a name, but apparently, it stuck in my subconscious mind.

So that night the idea hit me like a gale force wind. Notdeadyet is not a website name…for so many reasons. I’ll let you figure those out.

But, perhaps, it is an acronym! I sat up immediately and took out my journal. Each letter in the acronym began a phrase that summed up what I have learned (through living with CF, being a physician, coaching others, and studying positive psychology) about being HAPPY while being SICK.

The weird thing was…I didn’t even really think. These phrases just sort of came to me…quickly. I had to write them immediately because I was afraid I would forget them (there is a precedent for this, trust me).

It was clear – Sick and Happy was the title (or at least the main part of it), and each of the chapters was going to cover one of the phrases, delineated by the acronym N O T D E A D Y E T.

And here they are…virtual drum roll please:

Notice what your body still can do, and take pleasure and pride in those things.

Only eat, drink, say and think healthy food, drink, words, and thoughts (i.e. cut out the crap).

Take complete control and responsibility for everything you can.

Decide how you will think and act.

Engage fully in life.


A
ccept what you cannot change without becoming a victim.
Discover your strengths and use them every day.

You are not alone – connect with others and give and receive support.

Envision the meaning of and opportunities found within your illness.

Thank everyone for everything.

My next 10 posts will go into more detail about each phrase, so come on back.

Pretty much everyone I have told about this idea says that I absolutely CANNOT use the word dead anywhere in this book. I would appreciate your feedback. It’s a joke, of course. But is it too morbid???

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Why Exercise?

I listened to a great podcast today, Fitness Rocks, by Dr. Monte Ladner, who is a retired physician like myself.  He didn’t get out for health reasons like I did, but more from a case of “burnout,” and a desire to help people with health and fitness information rather than fostering reliance on medication to put a “band aid” on chronic problems resulting from poor diet and sedentary living.

I discovered this podcast about a month ago, and am ravenously listening to all of his shows, from beginning to end.  Today, I listened to one about the benefits of weight training, and how, according to one study, lifting weights regularly can actually act at a genetic level to cause skeletal muscle from older people (>60) to behave like “young” muscle.  Now THAT is cool!
I have been a weight lifter for almost 30 years now.  I didn’t consciously do it, and still don’t, to alter genetic expression in my skeletal muscle.  I do it because I like to feel strong, and because I know that this is one area where Cystic Fibrosis has NO say in what I can do.  The sense of control and self-confidence I get from keeping my “shell” strong goes a long way to making up for the lack of control I feel about my next sputum culture, or the inevitable decline in lung function that I see over the years.
Now, I realize that I’ve been altering gene expression all these years!  What a rush.
Besides the rush, here is why you should lift weights regularly if you have CF, or pretty much any other chronic disease:
You will inhibit significantly the inevitable loss of muscle mass that occurs with aging.
You will increase you basal metabolic rate
You will improve you body composition
You may improve your insulin sensitivity ( not clear with CFRD because it hasn’t been studied, but very clear with standard, run-of-the-mill Type II DM, and glucose intolerance)
You will be stronger, and more able to to the basic activities of daily life with ease
You will improve self confidence, decrease anxiety and depression
You will reduce your risk of premature death from all causes
You will improve your quality of life
Why not?
Not sure how to add an exercise program including weight lifting to your regimen?  Drop me a line.
Take care,
Julie 
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