Stability Ball vs Lower Body

Welcome back!

Try out these exercises with your ball.  They are great for your legs and abs! And don’t worry, you can do them with a PICC in your arm!

Another Great PICC-time Exercise: The Lunge

This is a little experiment I am doing in anticipation of the upcoming Stanford/UCSF research project I’m involved with.  “MRSA-schmeRSA,” I say.  So what if I can’t coach the little guys in person? This is 2010 and I have YOUTUBE!

Lower Body Time!!!

When you are addicted to weights as I am, those weeks with a PICC line can be a pain the the butt, and psyche.  In order to not get completely depressed (i.e. to stay sick-but-getting-less-sick and happy), I always at least walk every day, and then as the magic juice starts working and I feel better, I’ll add in resistance work for my lower body. So I’m starting to add in some video blogs because a) they are easy to do, and b) it is much easier to demonstrate exercises than to describe them in words.

Here is the first of this weeks focus videos–LOWER BODY TIME.  Today is the squat, a very basic exercise that targets multiple muscle groups.  Go for it.  Add weight if you can (hold dumbbells at your sides).

Operation Exacerbation

Rule Number One that I hear myself telling people who are bummed out about their illness, whatever it is, is to remember, “there is more right with you than wrong with you.“

And that’s true, right?  Think about it, by some miracle you are here on this earth, breathing, most likely able to walk around, enjoy food, listen to good music, pet your dog, watch Survivor…

Why is that?  Because most of the 100 trillion cells in the body, each of which are probably performing thousands of events per second, are actually doing their jobs perfectly well right now.  If not; well, you would not likely be reading this.

Now I’m not preaching here.  I am mostly writing this for my own edification, because I just learned that I am now infected with MRSA in my lungs.  I really can’t convey in words what happened in my consciousness when I learned of this last week.  Maybe you know the feeling that really bad news carries with it.  The sinking feeling in the pit of the stomach, the tight chest and throat, the heart racing and the blood draining from seemingly everywhere…  Sh_t!

Then the anger, and the self-pity arrive.  Sh_t (again)!  Why me, why now?  This is a REALLY bad time for this.  I’ve got plans, Universe!

And then, the tears.

So, now I’m officially a CF Pariah.  Gown, glove and mask everyone…here comes Julie.  Man, I’m pissed.  And of course, really what I am is scared.  What does this mean?  Is my CF going to get worse?  Will the freakin IV’s even work this time?

So, I allowed this to go on for a couple of hours.  Then, I was better.  Then, it came back with a full and serious vengeance over several days.  And now, finally, I’ve decided to respond instead of reacting.  Or at least…to try.

The first thing that came to my mind was to write the post I was going to write before the fateful telephone call.  It seemed to me that writing about having a “positive exacerbation” could only be credible if it were to be created during an exacerbation.

So, even though this is a slightly unusual (for me) situation, it is most certainly a “CF adverse event” and just as certainly would be best handled with a positive attitude.

Here are a few things I do to make my three weeks of IV’s…my “home vacation:”

1) First, since I can’t exercise strenuously, I don’t.  I legitimately and compassionately stop pushing myself.  A gentle walk every day that I feel like it is about as hard as I’ll push these days.  After the port goes in and the PICC comes out today, my arms will be free at last, free at last.  So as I feel stronger…I’m back to those kettlebells!  Have I told you about my favorite new exercise?  Something else to post about.

2) I have incredible friends who have been incredibly kind.  I will appreciate them every day, in some way.  By telling them what they mean to me, I will add positive energy to their world and mine.

3) Sometimes it takes a real blow to the illusion of stability to wake me up.  This has been a great one.  I will resolve to appreciate what is good in my life.  The best way I’ve done that in the past is to keep a gratitude journal, and vow to write in it every night three good things that happened that day.

4) I have a post that I have been writing in my head for weeks now about the growing importance of meditation in my life.  I have been trying to figure out how to stress this without sounding like a preacher…hence the silence about meditation.  But it has been SO key for me this last week, that I will write this post.  It will be the next one.  I will pour my soul into it, for both myself and for those two or three readers I have:-).

So if you like this plan, or if you have some suggestions, or if you’d like to share how you deal with your own “operation exacerbation,” please leave a comment!

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.

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.

Time out for a PICC

A post from the hospital:

Last week, I was admitted to the hospital to get a central line placed for a course of home IV antibiotics. I was in for two days…not bad, really. The only reason I had to be admitted was because in order to get it put in as an outpatient, I would have had to wait two weeks. Not good when you need antibiotics. The experience was SO different from the one I had last winter because I actually didn’t feel sick this time My PFT’s were significantly down though, and it seemed like a good thing to do. In fact, it was kind of comical. Below are some of my observations, which I had been diligently jotting down:

First, if you really want to confuse nurses, go into the hospital relatively healthy. Bless their hearts, the poor things don’t know what to do with you! I was bopping around the nurses station, asking if I could go find a coke machine my first afternoon, and the look of pure incredulity I received was priceless. I couldn’t help it…I had asked for a coke at 2:00, and by 4:30, I was getting really thirsty! They told me that “my doctor didn’t write an order that would allow me to ambulate” (I so love that word). I told them, “Well, I’m a doctor. Can I write the order? Clearly, I am capable of walking…even without an order.” They weren’t amused, but they did go raid the staff refrigerator and get a coke for me.

When the fifth year medical student from Stanford came in, I was in a feisty mood, so I didn’t tell him that I was a doctor at first. He was taking the usual exhaustive history that you take when you are on the wards for the first couple of years. A typical dialogue is below. I have changed the name of the med student because he was very nice and I liked him…green as he was…to “Doogy Howser” because I swear he was the spitting image. It goes like this:

Doogy, ascertaining the chief complain (cc): “So, tell me why you’re here?”
Me: “I have CF.”
Doogy, digging deeper: “Well, tell me how your last couple of days have gone?”
Me: “Pretty well. I went running this morning.”
Doogy, confused: So…why do you need antibiotics?”
Me: “My doctor said so.” And on it went for awhile. Then I felt bad, and started to be nicer, answering all of his questions with a smile. He got back at me though, I found out the next morning when the nurse came in with my meds.
First, she tried to give me a shot of sub-cutaneous heparin. I said, a bit bewildered, “I don’t need that.” I’m not sure anyone has turned her down before. She looked sad.
It turns out that if you are in the hospital, they assume you are bed-ridden (imagine that) and need to be guarded against blood clots. She apparently hadn’t seen me do my yoga routine earlier.
Then came the stool softener and the Prilosec. If you even get close to a hospital, you get a stool softener and a Prilosec. Try it. Drive by, and see what happens.

When the PICC nurse couldn’t get the line in the next morning, I had to go to interventional radiology. This was quite a treat, because they have very cool imaging in radiology that you get to watch…in real time. So, after I got over the humiliation of riding in a wheelchair (the RULE…there are a lot of RULES), when I could have taken the stairs at a run, and beat the transport person taking the elevator, I hopped up on the table and asked if I could watch the line snake its way from my elbow to my heart. That was definitely the highlight of the visit for me.

The weird thing was, after the line was placed successfully, I had to wait to show them that I knew how to give myself the antibiotic. Now this RULE was really annoying, but humorous nonetheless. I’ve probably given myself IV infusions 600-700 times (rough estimate) but I had to prove my prowess.

Finally, at about 5:30, I was informed that my meds had been delivered from the central pharmacy, but I had to wait while they changed the labels…don’t even ask…another RULE. Then the call came, the drugs were ready. Do you think I got to go get them and leave? Nope…had to wait for transport again. This time, I drew the line. I walked to the pharmacy, next to transport. We had a nice chat.