Inspired by 600-lb Lives

As 2018 came to an end, I realized that I needed to become more physically active. So, I took an online class. Yes, I see the irony in that decision. I need to move, so I sat and read and took exams. Yet, when the course was over I had reviewed the recommendations for physical activity, set a few SMART goals, and purchased a very simple step counter (1).

During January of 2019, I counted steps and I counted calories. I also made the arrangements for the trial of a spinal cord stimulator (scs). A psychiatrist completed the psychological evaluation required before the trial. My pain management specialist agreed to conduct the trial and we set a date. Everything was going along smoothly. Then a set of new but familiar symptoms flipped my script.

On January 30, 2019 these symptoms sent me to Patient First, an urgent care facility. Laboratory tests indicated that I had a urinary tract infection. The need for antibiotics required that my spinal cord stimulator trial be postponed. The infection was a reminder of a kidney birth defect, another surgery, and a very dark period in my life. I felt deflated. When I returned home, I climbed into bed and went to sleep.

I awoke to a voice describing a life of full body pain and limited mobility. I immediately identified with the speaker and continued to listen. When I opened my eyes, I had a very up-close-and-personal view of a human being who was obese in the extreme. The auto-play function of Hulu had taken me to My 600-lb Lifehttps://g.co/kgs/YxKGV. When the scene shifted to Dr. Nowzaradan’s consulting room, I knew that this could be a meaningful viewing experience.


How Y’all Doing?’

Watching Dr. Nowzaradan and his patients reinforced my commitment to resist the barriers to physical activity. I needed this reinforcement because my brain and my mind hold two very dissonant cognitions about movement. My brain is constantly receiving the message that movement is both painful AND dangerous. This is not a message that I can ignore because it is true. I have the falls, the fractures, the concussions, and the surgical scars to prove that this is the reality in which I live. The pain signals that reach my brain are not delusions.

The compression of nerve roots in my lumbar spine produces pain, weakness, and numbness in my lower back, buttocks, thighs, legs and feet. Since my last surgery, my right leg no longer collapses unexpectedly. However, it has not fully recovered and my brain, wisely, does not trust it. I cannot walk and chew bubble gum at the same time. Every step, every foot placement requires the active participation of a brain that has been traumatized on multiple occasions. Unfortunately, the brain, my brain, now insists that the proper course of action is to find a comfortable position and stay in it. My brain is a strong advocate for a sedentary lifestyle.

I am not naïve enough to consider being sedentary as a long term solution. I have 62 years of personal experience in coping with chronic pain. I know that my brain can exaggerate and sometimes lie to me. I have a master’s degree in health and nutrition education. I am a lifelong learner and continuing education is something about which I am passionate. I also have a mind that tends toward the rational. That mind, my mind, knows that physical activity is essential to life. At this point, my logical mind believed that if I did not move more, I would become sicker and die sooner than expected. I needed a specific type of push to break free of the uncomfortable dissonance produced by the contradictory cognitions held by my brain and my mind.

Dr. Nowzaradan and his patients provided the inspiration that I needed. Dr. Nowzaradan encourages movement using a rational approach that resonates with me. When his patients explain that movement causes pain, Dr. Nowzaradan’s response is “So what?” I have been adopting that approach to negotiate an amicable agreement between my brain and my mind.

When I first bought my step counter I was taking between 200 and 1200 steps per day. Two weeks of binge watching My 600-lb Life and my average was up to 3000 steps per day. Occasionally, I reach 6000-7000 steps in a day. This is acceptable progress for a 72 year old woman coping with multiple autoimmune diseases, lumbar radiculopathy, and a problematic kidney.

The bargaining starts every time that I stand up. My brain is uncertain that my legs will support me. It anticipates a fall with every step. My mind fights the prediction of catastrophe. I can only reach about 2000 steps before the peace talks between my brain and my mind break down. At that point I must sit and recover before moving again or the brain will make its prophecy self fulfilling. If you don’t understand how that works, I can’t help you.

Taking steps then resting several times throughout the day, requires a commitment to time and planning. It also requires that I give up some of those activities that promote a sedentary lifestyle. I just don’t have time for them.

I have an appointment for a CT Scan and a consultation with my kidney surgeon in late March. In the weeks leading up to that appointment, I need to move. As a 72 year old adult with chronic illnesses, I need to be as physically active as my abilities and conditions allow. I have definitely been inspired by Dr. Nowzaradan and his patients.

How many steps per day are enough? https://www.verywellfit.com/how-many-pedometer-steps-per-day-are-enough-3432827

ADDITIONAL RESOURCES


Sit Less, Get Active
https://www.coursera.org/learn/get-active


Physical Activity Guidelines for Americans
https://www.hhs.gov/fitness/be-active/physical-activity-guidelines-for-americans/index.html

SMART Goals
https://www.mindtools.com/pages/article/smart-goals.htm

Fitbud Step Counter
https://sites.google.com/site/smartdigitalsportpedometer/3dfitbud-simple-step-counter-walking-3d-pedometer-with-lanyard-a420s-black

Saving My Own Life First

 

I love to walk, even when it hurts. And when it hurts, I am going to say that it hurts. It is simply an empirical observation. It is not always possible for me to walk the outside paths that I prefer. Then I exercise inside. I am developing a long term and somewhat intimate relationship with a stationary bike. That relationship has been influenced by the body mechanics of cornerbacks.[1]

Cornerbacks

My recent interest in cornerbacks came from a YouTube channel which presents comic exaggerations of those who play various football positions.

 

Watch “CORNER BACKS BE LIKE..” on YouTube

 

Eventually it “clicked in” that I found the backpedaling of cornerbacks so fascinating because of what it demonstrated about the working relationship between the muscles that act on the posterior aspect of the thigh and those that act on the anterior aspect. I switched to viewing videos of great cornerbacks[2] and then to younger ones being trained to back pedal

Watch “Football Tips (Defensive Back): How To Back Pedal” on YouTube

 

For two decades physical therapists have noted that my hamstrings are over developed in relationship to my quadriceps. The imbalance is usually in the other direction. None of the programs that physical therapists designed for me solved my imbalance issue and some even lead to injuries.

I believe that the problem starts with the scoliosis and leg length discrepancy combined with a really “wonky” pelvis. I also think that the structural defects in my lumbar spine and the damage they have caused to nerves play an important role in what is going on in my legs. The nerve damage which has atrophied the adductors in my right thigh, also plays a role in the weakness of my quads. Of course, knee replacement surgeries have played a role. When surgeons take you apart you may find yourself in “Humpty Dumpty” land and never properly put together again.

I have now been to physical therapy so many times that I know what I need to be doing at this stage of my rehabilitation. I am not minimizing the importance of those who have earned the title Doctor of Physical Therapy. I am saying that the last time I started what was supposed to be an eight-day program they kicked me out after day three. They simply told me that since I already knew the program, I should work it on my own. That is what I am doing now.

I think it “rocks” that I can approximate the stance required from a backpedaling cornerback. It is like the ¼ squat that was on the list of exercises given to me by my home care physical therapist a few days after my last surgery. Check out the ¼`squat and compare it to the initial back pedal stance of cornerbacks.

Watch “1/4 Squats to Regain Knee Strength After an Injury” on YouTube https://youtu.be/bhv871C66wI

We started those ¼ squats with me holding onto the kitchen counter. I put in the work and I got stronger. It is now a standard part of my morning workout with no chair or counter top required. Yes, I include ¼ squats and other movements during my morning walk.

The back pedal is more of a challenge. However, I do add a few back pedals and shuffles to my morning walk. Defensive back exercises improve not only muscle strength but also balance and agility. My hamstrings are still doing most of the work. That is why on the bike, I  backpedal and dream of being a great defensive back. I DO NOT TRY TO TURN AND ACCELERATE. I am imaginative, not totally insane.

In my fantasy life, I am a Mike Singletary quality middle linebacker. That is why I sometimes take down offensive people without a second thought. You offend me, I sack you. It is just that simple. Bye. I am fighting for my life. I don’t have the energy to deal with shade and snarkiness politely. Comeback when you are ready to be on my team, to offer me support and encouragement.

If the removal of the cyst allows the damaged nerves to regenerate, then my quads might start doing some of the work required to walk. I am responsible for the effort. The outcome is beyond my control.

GIRLTREK.ORG

GirlTrek.org is helping me to be inspired by “the baddest freedom fighter our country has ever seen.” I am only on step one. It is a step that requires honesty, openness, and directness. I am up to that part of the task. Inspired by Miss Harriet Tubman, I am saving my own life first.[3]

 

  1. My first undergraduate anatomy and physiology professor was a kinesiologist for the Chicago Bears. His approach to teaching this introductory course was to put 10 questions on the blackboard during the first class of the quarter and inform several hundred students that half of them would be on the midterm and the other half would be on the final exam. We were expected to learn the answers to those questions from the textbook and from the laboratory in which we dissected cadavers. Then he lectured on the what the Bears had done wrong in a game, with a strong focus on the quarterback. This delighted the students who were also required to take a kinesiology course with him. It gave them a leg up on those students who took intro with other professors. The physical education majors and pre-med students in the class were very competitive and always looking for a leg up. After all these years, I still can’t think of basic anatomical mechanics without thinking about football players.
  2. I am not providing a list because then someone will want to argue about their rankings and that is not the goal of this post.
  3. I AM NOT FLAKING OUT ON PAYING CLIENTS. While I work on saving my own life, I will continue to provide consultation services to paying clients.