During all my patient visits, I ask them what they do for exercise. It has been well established that the physician asking about quitting smoking has a positive effect on quitting rates. Thus, I make it a habit to ask about exercise routines. When they hem and haw about it, I press on. What time do they go to work? When do they return? Do they have a lunch break? Do they climb the stairs at work, rather than take the elevator? As we get through these questions, we find the obstacles to establishing an exercise routine, and work on finding solutions.
These can be getting up a half an hour earlier than necessary, to get on that treadmill in the basement, or pop in an exercise DVD. That way, it is done, your metabolism is revved up, and you are energized for the rest of the day. Usually, it is best to get it done in the morning, as life gets in the way later on.
If early morning is not possible, there are other ways to improve activity during the day. The activity trackers have been a useful tool, encouraging people to ratchet up their step count, parking further away in the parking lot, getting off a subway stop earlier than needed, and walking the rest of the way. Climbing the stairs, instead of the elevator, and using the lunch interval for a walk, is ways to fit in some exercise.
One of my patients reported that her cohort of workers contributed to buy a treadmill. They got permission from their boss, and installed it in their lunchroom, where they could take turns using it. That was quite enterprising, and provided group motivation.
My older patients have arthritis problems. They can’t go for long walks or do high impact exercise. For them, I suggest water aerobics. There are local swimming pools at the YMCAs, or the high schools, where there are programs for senior citizens. You don’t need to know how to swim, as the class is conducted in shallow water. The legs and arms work against the force of the water, which also provided buoyancy, and takes the pressure off the joints.
Another obstacle to exercise is weather. A lot of my patients get their exercise by walking, which is a wonderful and effective exercise. However, in the cold north east of the United States, we are snow bound for several months, and in the hot South or South West, the summer months are not conducive outside exercise. The rainy season is a challenge as well. One solution is to walk in the malls. They provide a climate-controlled environment, and often, malls open for the walkers an hour before the shops do. The challenge is finish the walk, and then, not stop for a muffin or donut.
So how do I get over the difficulty of working exercise into my life? I get up earlier than I need to, and if my motivation is low, I give myself permission to only do 15 minutes on the treadmill. If that’s all I can do, then I will work another 15 minutes later into my day. I will take the stairs up to the 5th floor offices, and run up and down from the 5th floor to the 3rd floor infusion suite. My treadmill is in the basement, where it cannot become a clothes hanger. My husband and I both use it daily. When I lived in a city where I could not have a home treadmill, I went to the gym in the morning, before I went to my classes or clinics. Or ran outside if it was still daylight. During residency, I swam at the YMCA. I am not skinny, but my BMI is normal. I am short, so I have to be very vigilant, and work hard at it. Our body types are all different, and we don’t have to aspire to be models, just to be healthy.
Exercise is fun when you work it into your fun activities. If you golf, walk the course, don’t take the cart. Use a cycle for your errands. Hit some tennis balls when you can. After a snowfall, do some cross country skiing. Go snowshoeing. Use a jump rope. If you have a desk job, look into a standing desk, or get up and move around frequently.
Maintaining a healthy weight with a proper diet and active lifestyle has established benefits to decreasing the effects of chronic diseases. The Body Mass Index is a calculation based on your height and weight, and presents a range of low, normal, overweight and obese. Maintaining a healthy BMI is combination of exercise and dietary management.