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Friday, April 30, 2010

After the Aqua and Beyond

Last night I was hoping I would not have any cramps or other untoward events. But that was not to be. I got a cramp in my right ankle, on the right side. I discovered that flexing my foot helped, but it still took a while to ease it. I suspect this came from my jumps in the pool yesterday, when I landed on the balls of my feet instead of my whole feet. I was having trouble enough with my knees and tried to land gently. I must remember to land on my whole foot regardless.

Later in the night I had a similar cramp, but much less painful, in my left ankle. It eased on its own.

This morning I did my usual little workout, at the usual levels. I limped into the building and left a little less stiff and in pain, so it did some good. It didn't feel wonderful, especially the bike. I wonder if I should be doing more sets rather than heavier weights. I really need to call Clara and set up an appointment.

Thursday, April 29, 2010

Back in the Water Again

Today I made it back to an Aqua class at the gym. With the first instructor I'd had here, Mary Ann. She is very nice and careful in her instructions but the exercises she has used for that aerobic portion of the class have hurt me more than the ones Karey used. I felt I'd gotten a good workout but it wasn't necessarily as beneficial for my joints as other moves might have been. Mary Ann did emphasize that if we feel pain we should back off. I need to do that and to change one move with another at times. It will take a little practice. Overall, it's a good class and it's actually quite serious, in spite of the fun many people have in it.

I couldn't help but think about documentaries. Last week I was at a "flyball" competition with my daughter, son-in-law, and dog Bella. Flyball is a dog sport that is becoming increasingly popular and this tournament featured so many teams I could not keep track. The sport, the people who go for it, the dogs, the drama, all cry out for a documentary similar to that done about weiner dog races (Weiner Takes All, I think it's called). And today, as I looked around at my fellow elderly, shape-shifting, unglam classmates, and as I listened to the music - California Girls - I couldn't help but think what a documentary these classes could make as well.

Afterwards I did not experience that lightness and freedom from pain that I had after my second Aqua class. I was limping as ever, tired, a little discouraged, but still, still, hopeful. I think it will get easier and my body will respond more positively over time.

Wednesday, April 28, 2010

traveling back

I did go to the multigen one more time before leaving Las Vegas. It may have helped, couldn't have hurt.

The morning I left I also took two acetaminophen tablets to dull the pain during the trip. I don't know if they were responsible but I did have an easier time on the way back than I did on the way there. I didn't fear getting out of the car at rest stops quite so much. I didn't have to sit there contemplating the best way to rise to my feet. I just got up and dealt with the stiffness and discomfort because it wasn't as bad as before.

Yesterday, my off day, was also sewing day. I did not do any exercise. I felt quite tired and when I got home I was glad to lounge around and rest and read.

This morning I made it back to the gym. I didn't feel like going, which is really a first, but I was okay once I got there. Level four on the bike (although it said resistance was "eight"), ten minutes; rowing at 65 pounds, lat pulldowns - did I go up to 65 lbs? I think I stayed at 50 but I am not sure; bench press 140 pounds for the first time. The arm and calf stretches I kept at 30 seconds each. I found it easier to stretch my left arm, straight. Maybe I wasn't doing it right.

I limped in, my right hip in pain, and limped out somewhat less in pain. I took no drugs for the last two nights, and none during the day either. Slept well.

Sunday, April 25, 2010

Another time at the multigen

Yesterday I made it to the multigenerational center again. Did my little routine, including something approximating lat pulldowns but not really.

I am still stiff and often in pain, and I have been taking acetaminophen pm tablets every night on this trip. I think it is the right decision at this time. Too much pain and discomfort just causes too much sleep interruption.

I had hoped to get in some other activities, like a hike or an aqua class, but it is not to be. I leave tomorrow morning. Perhaps I should hit the multigen before I leave. Yes.

Friday, April 23, 2010

Adjusting during travel

I was lucky. The Henderson Multigenerational Center's fitness room has quite an array of weight machines, and I was able to substitute for two out of the three I normally use. The lat pulldown machine did not work for me with my shoulder as it is because I would have to open my arm too wide, which I can't do just yet. So I was able to do most of my regular little workout here.

I hoped to be able to do a water workout too but it's been really busy and that has not happened and I don't expect it will. There is turmoil among family members, various crises, and I am here too short a time to do everything.

The pain continued yesterday. Last night I drugged myself again with acetaminophen pm, and I think that has taken the edge off the pain today. I don't like taking any drugs for this but there do come times when it seems the right thing to do. I'll get through this and hope in the right direction.

Thursday, April 22, 2010

The pain continues

I am in Las Vegas today. I drove here yesterday. I was still in a lot of pain in my knees and shoulder, also often my hip (all of it, in other words), so that when I stopped to rest it was hard for me to get out of the car. It didn't feel good, seeming so incapacitated. I am hoping that this is one of those cases where it gets worse before it gets better.

I am dressed for the gym. I am going to the Henderson multigenerational facility to use the bike and weight machines. I don't know what weight machines they have and if I can adjust them to do the things I normally do (row, pull-down, leg press), so we'll see. It's a bit frustrating to have to be away from my gym so soon after I started.

Tuesday, April 20, 2010

the day after second aqua

No cramps last night, and good sleep (for me; trip to the bathroom just once, and moving to accommodate cat from time to time). I went to the gym for the little workout today and found my knees quite hurting. Getting up and down from the lower seats was painful. Ah well. Can't have everything. It's raining today - I have found no correlation between weather and arthritis but maybe there is something.

I increased the row weight from 50 to 65 pounds.

Monday, April 19, 2010

Now that's what I'm talkin' 'bout

Today I did my second aqua class. Much larger class this time, different teacher, named Karey. Somewhere between a dozen and 20 people, which at times meant I ran into others. We have two long lanes but we can’t spread the whole length because of the differences in depth and because we then would not hear the teacher.

Karey led us through a different set of aerobic exercises and I liked them better than last Friday’s. I felt they were really getting something done and I was having less pain. When we were done I knew I’d done something, yet...I wasn’t as tired as I was last time, or even as tired as I was yesterday.

I took a shower, changed, and knew I was feeling good! Not all better, no pain or anything, but wooo! So much better. I felt stronger and stretched out and in less pain. It seems like a turning point.

I met a couple of fellow passengers this time, both in the locker room and in the pool. I asked about a class a couple of them also take, called “Active”, and they said you do what you can in there, whatever shape you are in. So I figure I am going to give that one a try too.

pain and suffering

I'll admit it: I indulge in self-pity from time to time. Probably more than I have a right to. I certainly indulged yesterday.

I woke achey and in pain. My right hip - thigh was hurting, my left calf was feeling that weird arthritis tension and translates into discomfort when standing or walking, my left arm, upper, hurt no matter what I did. I was also not feeling terrifically energetic. I didn't feel much like doing anything.

Nevertheless, I did go do my little workout. I want to be sure this workout stays relatively small or I will start skipping it, is what I suspect. I did the same as Friday, 10 minutes at level 3 on the bike, 50# on the row, 50# on the lat pulldowns, 120# on the leg press. I think I can increase the lat pulldowns next time. Just a wee bit. I am still using my right hand to bring it down to where I can grasp it with my left without pain.

I left the gym not really any more energetic than before. I did some errands, including going to the farmers' market that takes place in the parking lot right there at the gym, and came home to vegetate. As the day wore on I got up a few times to do this or that and felt better toward the end of the day than I had at the beginning. But I felt sleepy and went to bed early. This isn't such a wonderful idea in general - I woke several times, read, went back to sleep. I am sure I got enough sleep but I think it would be better if I kept myself up longer to begin with.

Today I will be doing the aqua workout for the second time. I got myself some water shoes and sunscreen so will be better prepared. I don't feel like I have the energy for it, but I will just do it.

Friday, April 16, 2010

a night and a day

Last night, night after my first water workout, I had no cramps. I did have restless legs for a while, but ultimately I fell rather soundly asleep. I usually wake a few times and sometimes end up reading a bit, and last night was no exception, but overall I got plenty of sleep.

Today I went back to the gym to do my regular little workout. Ten minutes at level 3 on the bike, and the others the same as last time. This time I headed for the steam room afterwards. I had been feeling not all that energetic and quite stiff, and I thought the steam might be helpful. It did feel good, the hot white cloud obliterating all vision, a bit frightening actually.

After completing a few errands I came home and lay around, feeling stiff, tired, and achey. I took a bit of a nap in the middle of the day.

I am now still stiff, achey, tired. I may just turn in soon. Tomorrow I will not go to the gym.

It has been just over a week now.

Thursday, April 15, 2010

Another workout, another two nights, and water

The night before last I had another episode of tightness and pain in my calf, but this time my left calf, again around the ankle. It wasn't as severe as the one the night before and I was able to relax it enough to get back to sleep without heading for the shower. I did get up, limp into the bathroom, and back, and was able to handle the weight on that foot.

Yesterday I did another workout, my fourth and last of my four free passes at the gym. I did the bike ten minutes at level 3, handled it well. I upped the rows to 50 pounds from 35. The rest stayed the same. As I was reaching to grab the lat pulldown handle with my left hand (I had already pulled it partway with my right) I wrenched that arm and it hurt like blazes. But it eased off and I was able to finish the reps. All good.

After showering I headed for the membership desk and paid for a membership for a year ahead. I felt good about the decision, about doing this for myself, and good about my prospects.

And now that I am a member I got to thinking what else I might want to do. Today I took an aqua class. I had done a few of these in a former gym a few years back and felt unsteady on my feet, not all that comfortable with it. But I thought I'd give it another try. This class was a full hour long and was run much as a typical aerobics class is, with cardio, then weights, then stretches, with the difference that we were mostly underwater and using foam "weights" and noodles. There are some times when I felt twinges in my left knee in particular, and near the end I couldn't raise my left arm, of course, for a stretch, but I did what I could, which was a lot. I will need to bring sunscreen next time because it's outdoors.

Overall I am finding that I am stiffer. Stiffer when I get up in the morning, stiffer after exercise, before exercise, generally stiffer. I suspect that this stiffness will ease off and I will start to loosen a little over time.

Tuesday, April 13, 2010

and the day after that...

"There is no gain without pain"? I am sure that's true to an extent. What I am concerned about is if my pain is simply a matter of getting adjusted to the use of these muscles and not just another manifestation of arthritis. Right now I am willing to believe it's all good.

Last night I had something similar to cramps in my right calf, actually close to the ankle. A tight, painful feeling that intensified when I stood on that foot. I managed to limp my way into the bathroom and turn on the shower. I stayed in there a while, with hot water on the leg, until it finally eased up. After that no further issues.

This morning I am feeling some back pain. Lower back. I am stiffer than usual today. I am chalking it up to the exercises, minor though they may be, and will be paying attention as time goes on to whether I adjust or not.

Monday, April 12, 2010

call from the trainer

On my way to the gym today I got a call from Carla, the trainer. She wanted to know how it was going. I told her about the pain in my knee Saturday, the cramps, and that I was adjusting and it is going well. We agreed that I would call her in a week or two, when I feel it's time to up the ante, when I am not pushing myself sufficiently.

Third day

Today I went to the gym for the third time, to work out. I had no trouble with the recumbent bike, probably because I pushed the seat far enough back and used the Precor instead of the Star Trac. The Star Trac wanted things from me that I could not give it, or at least could not figure out how to give it, in terms of information. The Precor just let me sit there and pedal, and eventually I figured out how to up the level to 2. Next time I'm going for level 3. Devilish!

I got there at about ten this morning. It seemed the height of the unemployed workers time! So many people on machines! It was funny to sit on the bike and look around me at so many others, on bikes, treadmills, elliptical machines, steppers, and each in her own little world, looking at the televisions or into the vast mirrors in front. All ages, all fitness conditions. When I got off the bike to get to the towel station to get stuff to wipe the bike off with I almost collided with an old man who was clearly slower than I was.

Thus it was that I had to work my way through the rest of the workout by grabbing the machine I wanted when it became available. When I got to the rowing machine I realized I could do more. I will increase the weight next time. I did better on using the lat pull-downs more evenly between my arms. I think I'm not ready to up that weight, or the leg press weight either, yet. 

The wall stretches are a bit painful on my left arm still. It will be a real turning point when this changes. I also found it a little painful to stand on my left leg while doing a calf stretch on the right. I hope this eases.

I plan to get there earlier Wednesday to see if I beat that particular crowd.

Sunday, April 11, 2010

and the day after

At this stage of my new exercise routine I am posting in greater detail than I will later. I want to track what's happening now and compare it.

Last night I had leg cramps. First my right inner thigh, then my left foot, then my left inner thigh. Excruciating. It felt like forever before they eased and I worried that after I got settled in bed it would happen again (this has happened in the past) but it didn't.  It seems that the best I can do for such cramps is to get into a hot shower but it is too difficult even to step one foot on the floor when I am in that pain. Sometimes when it is easing off a little I can limp into the shower and take it from there.

I suspect the bike but it could have been something else that was worked yesterday, like the leg press. I expect these cramps did indeed come from my little workout, and I expect that my muscles will adjust and I won't have this kind of pain after a while.

Saturday, April 10, 2010

Second time at the gym

Today I went to the gym to do the set of exercises alone for the first time. It took me a total of 35 minutes.

I started with the recumbent bike. I set it at the same seat distance as last time but realized immediately that my left leg as a lot stiffer than it was last Thursday. Yesterday I did a very small hike but it was probably enough to set off that joint.

After about three minutes that knee seized up suddenly. It didn't actually "seize" but it went into a sudden sharp pain. I had to stop immediately. I pushed the seat back farther and tried again. That took care of the problem and felt good enough that I continued until I had done ten minutes on it, and I kept it at level 2. My workout calls for five minutes but of course ten is better if I can handle it.

Next was the rowing machine. I wasn't sure I chose the right machine but I think so. I did the fifteen reps slowly, cleaned it off and headed for the next. Next, lateral pulldowns. I pulled them down with my right hand to the level where I could grab with my left without pain. I noticed that I tended to use one arm or the other to do all the work sometimes. I think I need to be careful about using both evenly.

The last machine as the leg press. I had to push the seat all the way back to get my legs up there. I wasn't remembering exactly how to do it at first, but then it came back. I took it slowly and I think it went well too.

After the machines there was the window and wall, the arm stretches and the calf stretches. I found that 30 seconds was as much as I wanted to handle on all of those. Each of those, I should say.

I wasn't particularly sweaty but I took a shower and changed so I'd be presentable at Trader Joe's, where I wanted to pick up some groceries. The gym is very close to TJ's so it makes sense to schedule them together when I need to shop.

I feel good now. I think this is the right thing to be doing.

Thursday, April 8, 2010

The first training session

I met with Clara, the head trainer, today. She seems very nice and genuinely excited about working with me. She asked about my goals, then moved into the details of my arthritis, and finally we filled out the medical information form for liability purposes. Her conclusion? I'm really healthy inside, it's just the outside, the arthritis, that is holding me back.

While she was asking me about the pain she jotted notes about what exercises she thought would be good and she drew conclusions about what was going on with me in different areas. As we walked up the stairs she went behind me so she could see how I walk. She noticed my severe pronation, of course, and the fact that I am not standing or walking straight. Understandable, of course, because I am trying to adjust to the pain and difficulties of the arthritis. But she had ideas for how to strengthen what I need to compensate for the arthritis damage.

I tried a recumbent bike, then a standard one, and I noticed that I had less pain with the recumbent, so I'll go with that. Then I tried various exercises using Nautilus machines, and last she showed me a couple of things I can do at home with a window sill and a wall. My routine at this time:

Recumbent bike: 5 minutes, level 1 - 3
Row: 25#, 1 X 15 reps
Lat pulldown: 50#, 1 X 15 reps
Leg press: 120# with band around knees, 1 X 20 reps
Walk with band around knees, keep from slipping
Doorway or window: chest stretch - 30-60 sec, 1 - 2X/day each side
Calf stretch against a wall - 30 - 60 sec, 1 - 2X/day each side

She suggested I start out doing this twice a week and work up. She is going to call me Monday to see how I am doing, and we go from there. If I join - and at this point I am sure that I will join - I will get two more sessions free, then will have to pay for individual training from time to time.

When we were done she said she had to revise her plan as we went, because her assumptions were not necessarily correct, and that this may actually be easier than she thought at first. I am really hopeful.

Help with exercise

For years I have resisted going back to a gym, because my experience with the trainers is that they know nothing about arthritis. I would love to do some strength training that will actually help me with my knees, hip, and shoulder, but I don't know what's good and what will simply damage those areas. This may change, though.

A week or so ago I took advantage of an offer a friend had gotten in the mail. We both went to an arthritis seminar at a health club in Arroyo Grande (not far from here). The seminar was led by two physicians from a local hospital, who talked about treatments for knee, hip, and shoulder arthritis. They were surprisingly open about the options, not pushing any particular treatment. Because I had recently read a booklet and watched a video from the Foundation for Informed Medical Decision Making in Boston (a non-profit that gets no funds from any medical industry), I knew that there is no optimal time to have surgery, for example, and that many people do well without it, that treatment is as individual as we are. They even used the term "evidence-based medicine", which is what we all should be using all the time.

One comment got me thinking: one doctor mentioned that the health club has specialized trainers who work with physical therapists to help with pre- and post-operative therapy for patients. My ears perked up. These trainers probably know something about arthritis!

A few days later I got a phone call from the health club, Kennedy Fitness, offering me a four-day pass free. Naturally the reason they sponsored the seminar is that it gave them an opportunity to recruit new members. I said sure, I'd go for it, and the next day I went down to the club nearest me (they have four) to pick up my pass and talk to one of the people there. I asked for a tour and I asked about these specialized trainers. He didn't know much about them but said he'd have the head trainer call me to discuss options.

She didn't call that day or the next but soon I was talking to Clara. She said sure, she could probably help me out. I have an appointment with her today at noon. She will show me exercises that might help with my joints. I will ask her, too, once she sees how I am, what classes I might be able to take as well. I am hopeful, still!

Wednesday, April 7, 2010

Exercising in water

Exercising with Arthritis: Aquatic Therapy

This is a guest post by Genevieve Lawrence, representative from

If you are suffering from arthritis, you may enjoy a love/hate relationship with exercise. No doubt you have been told that exercise will help improve your situation in some of the following ways:

* Exercise will help keep you at a healthy weight and reduce pressure from your joints.
* Moderate exercise will help keep the muscles and surrounding tissues strong to improve support for your bones.
* Keeping moving helps reduce painful inflammation and protect your joints from further damage.

But when exercise is agonizing and it may take some time to see the results, it can be difficult to embark on a fitness program. Even though the potential benefits over the short and long term may be huge, the effort is difficult and painful as stiff joints slow you down. One way to make exercise a more enjoyable and effective experience is to start a water-based exercise program. Simply the pressure of the water alone can help decrease swelling and increase circulation!

Aquatic therapy provides many benefits that traditional exercises may not to an arthritic individual. Because of the low-impact environment that water creates, it is an ideal and safe place to gently exercise joints and muscles. The water supports joints, encourages free movement and also acts as a gentle resistance to help improve muscle strength. By being shoulder-high in water, you will have reduced the percentage of your body weight that is acting on your joints down to 10%!

There are many different methods for water exercise, from water aerobics to more condition-specific treatments that use a specialized rehab pool or swim spa. These exercises include range of motion exercises and a gentle cardiovascular exercise. A therapeutic swim spa or pool can be used to warm and massage stiff and aching joints and decrease swelling. You may find one of these at a gym, rehabilitation center, or may be purchased for in home use. There is even a water treadmill for those who like the motion of walking but want to drastically reduce the impact on joints.

There are some precautions and items to consider before embarking on any aquatic exercise program:

* You may need help getting in and out of a spa or pool. Take that into consideration when looking into both public and private pools for aquatic exercise. There are pools and pool equipment specifically design to make access easier. Look for these when considering where you want to exercise.

* Always consult a doctor before starting a new exercise program. If you have any other health conditions that may make an aquatic exercise program less than ideal for you, they will be able to let you know in advance.

* Check the temperature of the pool. Ideal conditions for comfortable exercise are between 83 and 88˚ F according to the Arthritis Foundation. Water that is too cold may not impart the same benefits and too hot water may cause dizziness or nausea.

Finding the right water exercises for you can also be fun! Check with your local health facilities and see what programs they offer. They may not only have the facilities, but also may have groups and classes where you can work out with others, making exercising a fun social activity. Once you find a suitable location, you will find that aquatic therapy is a relaxing and enjoyable way to relieve the pain and stress associated with arthritis.