Baby steps

Over the past few workouts I have made some minor changes to my routine. So now it is:

13 .5 minutes on upright bike at level 9
1 set of 15 reps on row machine at 80 lbs
1 set of 15 reps on lat pulldown machine at 80 lbs
1 set of 20 reps on leg press at 180 lbs
chest stretch, 30 sec each side
calf stretch, 30 sec each foot

rubber band exercises:
compound row, red & green bands, 3 sets of 15
shoulder external rotation, red, 3 sets of 15
empty can, green, 3 sets of 15
lat pulldown, red, 3 sets of 15 - I often don't do this because it's hard to find a door or other place in the gym that I can use.

squats on ball on wall - I put large ball in small of my back, put weight in heels, do squats - I'm doing five, sometimes six
squats at rail - weight in heels too, I'm doing five, carefully, sometimes two sets of five
stick stretch - I'm doing two stretches where my right arm helps stretch my left (the problem arm). Right now I am stretching three sets of ten seconds each
treadmill - walk normally, focusing on feet, knees, posture - I am up to 5.5 minutes. Could go longer if it weren't for my hip pain.

Lately I have been a little discouraged by the hip pain. It makes it hard to get around and I am disappointed in myself when my daughters visit - or I visit them - and I am unable to do the things they want to do. No hiking, no walking around malls, no strolling near the ocean.  I am considering making another appointment with a doctor to consider two things: possibly get corticosteroid injection in hip, if that's a reasonable pain relief alternative, and possibly referral to physical therapist.

Study finds persons with knee arthritis often choose own treatment

The Arthritis Foundation reports on a study done in Canada that suggests that a majority of persons with arthritis of the knee choose their own course of treatment. The participants in the study were recruited by pharmacists and the majority were white heavy women, average age 63. (The report calls them "overweight" or "obese". I reject these terms because there is no perfect weight and "obese" is a word with no medical basis. I am fine with calling myself "fat".) I laughed because I fit that description, almost perfectly.

The researchers were surprised to find that so many of these participants started exercise programs or took drugs or supplements without advice from a doctor. Interestingly, at the start of the study about half of the participants exercised regularly, and at the end over 3/4 did. This is far higher than the average in this country, where about 15% of adults exercise regularly. This suggests to me that this is a group of take-charge persons.

It does not surprise me that so many went out on their own, without medical advice. The times I have gone to doctors for help with my arthritis have been many, and the assistance I have gotten has been minimal. In the early days of my arthritis, when I was in my 30s, the condition was not even diagnosed but I was sent to a physical therapist a couple of times. I think this was good but I did not keep it up and it was only when I started bicycling (something I did on my own) that I started to see results.

I cannot recall any suggestion from any physician that a physical fitness program could be designed specifically for me. Losing weight has been suggested and of course that's a good idea (easier to recommend than to do) but the main treatments suggested have been the use of drugs and, if possible, knee replacement. More than once I have been in such pain that I left the medical office feeling I was not heard, that my pain was not recognized. Perhaps because arthritis is not life-threatening it is also just not interesting enough. Many people have it so it's a big boring pain to the medical personnel as well.

Wouldn't it be nice if some of these doctors really thought, "How can this person really be helped?" Wouldn't it be great if some of them were enthusiastic about working with us to achieve results? When I met with Clara, my "trainer", I was most struck by her enthusiasm and hope for me, as well as her care in determining just what was hurting and how I responded to different moves. Would that I had even heard that it would be possible to design a workout specifically for me, from a doctor.

Seems like same ol' same ol'

Today I went to the gym feeling pain and left feeling a little less pain. That seems to be the story every day. But it isn't all of the story. And because I am documenting this trip to help myself and others, I want to be more specific.

Today's pain was in my right leg mostly, in my ankle, foot, calf. It hurt to walk when I got to the gym and I was happy to find a parking space nearby. Sometimes when I plod up the stairs to the weight room I find it hard to imagine that this body can do anything at all. Yet I get through the steps. The bike: for much of the ride I felt some discomfort in that right leg and foot but it wasn't real pain, and I considered going more than 13 minutes, but didn't. Walking on the treadmill was similar in that I felt some pain with every step but it wasn't enough to make me stifle a self-pitying cry.

I think I like my workout in general. I don't do any one thing for a really long time so it never gets tedious. I get through one thing, move to the next, and when I do the resistance band exercises I often use the breaks between sets to do other things, like shoulder stretches, calf stretches, and squats at the rail. I get it done in about 45 minutes and I feel better, sometimes the tiniest smidgeon but a little better.

It doesn't always last or it doesn't seem to. I went to the farmers' market afterwards and found it painful to walk through it. I struggled up the small set of steps into my house, dragging my bags. Sometimes I just want to lie down. I wonder, though, how I would feel if I didn't do any of this at all? I do think I'd feel worse.

Pain here, pain there

This morning I had to get to the gym early because I had a dentist appointment at 8:40. So I set out limping. The pain was in my right leg, more in the calf and foot and knee than in the hip, which is how it's been for the past couple of days. It hurt a lot just to get up to get a cup of water.

After my regular workout I walked down the steps with less pain and went to the dentist (all is well) and came home, still improved. So maybe the good results are starting to hold longer?

Today

Today I went to the gym to do my regular routine. I did it, except the pull-downs with the resistance bands, as usual. When I went into the gym I was limping an hurting and when I left I was feeling much better. I had less pain and I felt more hopeful.

I did five minutes on the treadmill and I didn't feel pain as I usually do. Let this continue!

I did 13 minutes on the bike and it went fine. My left knee was giving me trouble but even though I limped away from the bike I felt better.

The machine exercises went well. I had upped the weights the last time and this time it seemed already I was adjusting to them.

I felt hopeful. I still do.

Some range-of-motion exercises

The Arthritis Foundation offers these exercises for getting started. Range-of-motion.

1.  Head turns
   1. Look straight ahead
   2. Turn your head to look over your shoulder
   3. Hold for three seconds
   4. Return to front
   5. Repeat to other side
2. Forward arm reach
   1. Put arms out in front, palms facing one another
   2. Raise one or both arms as high as possible (one arm may help the other if needed)
   3. Lower your arms slowly
3. 
   
   
   
4. Knee Lift
   1. Sit in good posture
   2. Lift one knee three or four inches off chair
   3. Hold for three seconds and lower
   4. Repeat with other knee (you may help by lifting with your hands under your thigh
5. Back pat and rub
   1. Reach one arm up to pat back
   2. Reach the other arm behind lower back
   3. Slide hands toward each other
   4. Hold for three seconds
   5. Alternate arm position
6. Elbow bend and turn
   1. With arms at your sides, bend the elbows bringing palms towards the shoulders
   2. Turn palms down as you straighten elbows down to your sides
7. By performing these exercises daily, you can begin to reap the benefits of improved flexibility and movement. Before starting this exercise regimen, keep these tips in mind:
   • Always cool down after exercising
   • Keep a positive attitude about yourself and your exercise program
   • You will get better at doing these exercises the more you do them
   • The more you do them the better you will feel
   
   
   
   

Some good advice, I'd say. I do think, though, that it helps a lot to have somebody specific to help you through this process. Doing these moves is good but then what? And I wonder what happened to number 3?

No shame to cutting it short

Today I decided to try a hike. The hike I had in mind is at the end of Madonna Road here in San Luis Obispo, a hike in the Irish Hills. It is a bit steep going up, then levels a while, winds around, comes down again. Nice views, particularly if you get up high.

I left my new stick at home, and I forgot to bring my water with me, so I started out at a bit of a disadvantage. Then my back started to hurt a bit and I felt a little off-balance. Not unusual for me, that. I kept climbing up, taking pix and stopping here and there, and then decided I had had enough after just 20 minutes. I went back the way I came, just shy of forty minutes total.

There have been times in the past when I have felt driven to finish a hike or I would be really disappointed in myself. Not finishing seemed like not doing it at all. I didn't feel that way this time. I got out there, did some climbs, turned around. Better than nothing and it gave me a sense of where I am physically.

I am drinking some grapefruit juice now. I don't often buy juices but today grapefruit called to me. SO good.

upping it

Today, as I promised myself, I increased weights on the machines. So as of today, this is my routine:

12 minutes on upright bike at level 9
1 set of 15 reps on row machine at 80 lbs
1 set of 15 reps on lat pulldown machine at 80 lbs
1 set of 20 reps on leg press at 160 lbs
chest stretch, 30 sec each side
calf stretch, 30 sec each foot

rubber band exercises:
compound row, red & green bands, 3 sets of 15
shoulder external rotation, red, 3 sets of 15
empty can, green, 3 sets of 15
lat pulldown, red, 3 sets of 15 - I often don't do this because it's hard to find a door or other place in the gym that I can use.

squats on ball on wall - I put large ball in small of my back, put weight in heels, do squats - I'm doing five, sometimes six
squats at rail - weight in heels too, I'm doing five, carefully, sometimes two sets of five
stick stretch - I'm doing two stretches where my right arm helps stretch my left (the problem arm). Right now I am stretching three sets of ten seconds each
treadmill - walk normally, focusing on feet, knees, posture - I have managed all of four minutes

Today the gym was crowded when I came and I did not get on the treadmill and I did not get to a weight bench with the stick. On my way home I purchased a rake handle to use as a stick at home and I did the stick stretches at home. I am thinking that I will go on the treadmill twice the next time. Four minutes isn't much but it hurts and I don't want to keep doing things when they hurt, so that's where I end it for now.

Arch Support

The first time I met with Clara she mentioned arch supports, noting that I have flat feet or whatever they call it. I said that I used to wear Birkenstock's arch supports, 3/4 length, because they were recommended by a physical therapist I was seeing years ago. I used them in my Earth shoes initially but later took them out when it seemed like the two things - the design of the shoe and the arch support - might be contradicting each other.

I decided to add arch supports back in. Today I went to CVS and found Dr. Scholl's Arthritis Pain Relief supports. They are supposed to relieve pain from knee, foot, or hip. You can read what Dr. Scholl's says about them.  I put them in just a little while ago and I think they may actually be helping! I don't know if they negate the value of the Earth shoes, but I don't think so.

hanging in

I continue to do my workout about three days a week and do Aqua classes three other days, and sometimes I do something else the seventh day. I have moved up to a huge 12 minutes on the upright bike and four on the treadmill. The rest of the elements are about the same. I had the sense today that I could up the weights on the machines now, that I'm ready for the next step.

I have continued pain, especially in my right leg (the hip - thigh) and getting up and ready in the morning is not very much fun. After a workout I am usually a little looser - it doesn't last but that seems like a good thing. No major changes other than the ability to swim, albeit awkwardly, without much pain.