When I think of all the years I lived with MS before I began making the changes that I teach in this book, one of the things that seems the most unsettling to me now is how little I moved.
In fact, I tried my best not to move.
That's because my balance was so poor that even the simple
act of walking could lead to falling and injury. Ultimately, I chose to use a
cane for assistance, and as a young physician, wife, and mother, this was very
embarrassing for me. I didn't want my children, my husband, or my patients to
see me with a cane, to view me as someone who was having so much difficulty just
getting around. In the early days, I would try to hide my illness by forcing
myself to go without a cane. I was supposed to be helping others, and I didn't
want anyone to feel sorry for me or be distracted from their own issues by
having to think about mine.
I now regret all that time and energy I put into hiding my
condition, and I wonder if my readiness to change might have come sooner if I'd
been willing to accept where I was, been honest with myself about it, and worked
from there.
If you are suffering from a chronic illness and the very
thought of physical activity is frightening to you, I can relate. Looking back,
I sometimes wonder how I knew I was ready to start
moving more, much less start an exercise routine, but after my blueberry aha
moment and resulting diet change, I knew the next thing I needed to address was
movement. Doing so was not easy, and outside of my husband I had almost no
support. My doctors advised against it, as much of the medical thinking at the
time was that people with MS should limit exercise, out of fear that doing so
could actually exacerbate the disease. 1 This is not surprising when you consider that
in my own case, my MS symptoms would actually worsen when I tried to exercise.
For example, if I peddled on a stationary bike for even five minutes, I would
begin to lose feeling in both legs. My initial reaction would be to stop, in
fear of hurting myself.
For people with MS and other demyelinating diseases,
worsening symptoms can occur when the body's temperature is elevated as in
exercising, going in a sauna, or even being outside on a hot, sunny day; this is
known as Uhthoff's syndrome or phenomenon. 2 What I didn't know then, but
would soon figure out, was that by doing a little each day, and building on it
over time, I could overcome this.
When I first started, my husband had to help me get on the
bike every morning (when I placed my feet in the pedal straps I could not even
feel them!). I was only able to complete a few minutes of pedaling before my
body temperature would rise, Uhthoff's syndrome would kick in, and my MS
symptoms would emerge. After my husband helped me off the bike, I had to sit for
fifteen minutes drinking cool water as a shower of pins and needles continued
through my body.
Early on, I was concerned that even this short regimen
might be worsening my MS. It sure seemed that way. Over time, however, I noted
less and less difficulty. Today, I run, hike, or walk every day, typically three
miles in the morning. Twice a week, I work on strength conditioning—my regimen
consists of push-ups, planks, squats, burpees, and dumbbells. I never could have
imagined in those early days that I would make it to this level of fitness, but
this willingness only came after I accepted where I was,
and became willing to start from there, no matter how small.
I am now a firm believer in the importance of movement when
it comes to achieving optimal health. However, I definitely understand the
obstacles facing many of us when it comes to adding exercise and movement into
our lives. For me, it strikes me as especially ironic that I am such a proponent
of movement and exercise when I consider the fact that for much of my life, well
before I had MS, this was not the case.
Growing up, no one I knew would have described me as an
athlete. Those who knew me as a kid are shocked that running is now a part of my
movement routine. That's because back then, I developed a near hatred for
running, largely due to the fact that I was so slow compared to other kids. I
remember in elementary school, when it came time for organized footraces, we
were divided into two groups: the fast kids and the slow kids. I was always in
the latter group, and my nervous hope was simply that I would not finish
last.
Furthermore, coming from an immigrant family, formal
exercise wasn't something that was important to us culturally. Going to the gym
or pool was largely seen as a leisure activity, something we had neither the
time nor money to do. I see now how experiences like this would affect my view
of myself as someone who is not “athletic,†and consequently influence my
movement habits as I got older.
When I think back to my formative years, it's clear that
societal messages and cultural views influenced my actions around movement and
exercise. Just as we discussed in the last chapter on food, this messaging can
affect our personal choices in whether we choose to exercise or not, but unlike
food, the messages we get in these areas can be more subtle and harder to
spot.
Let me explain. As young children, almost all of us moved
and exercised. Of course, we didn't call it that—we called it playtime. We
chased each other in games of tag, swung on the monkey bars, and jumped in a swimming pool whenever the chance presented itself. But for
many of us, as we grew older, this playtime, and more importantly physical
movement in general, fell by the wayside. Always the curious scientist, I wanted
to know why this occurs for so many. Was it just a consequence of growing up? If
so, why do some people continue with exercise and movement and others do
not?
When I talk to my patients who haven't been regularly
physically active in years, one of the most common themes I hear is that at some
point in their lives they adopted the idea that exercise and movement are
something best done by those who are “athletic,†and that this was simply
not how they would describe themselves. When I dug deeper, I found that those
who were even just a little overweight often said that going to the gym felt
more like an exercise in negative self-judgment and comparison than a means to
improve their physical health.
If you are someone who doesn't have a regular exercise
routine, I'd invite you to consider how societal and cultural messages may have
affected your ideas about topics such as exercise and physical movement. If
you've had personal experiences like I did growing up, or if you see those
fitness models on television and immediately go into comparison and
self-shaming, my hope is that by the end of this chapter you will feel
differently about physical movement and exercise. To begin this shift, I'd like
to dispel a popular yet mythical idea about exercise as a cure-all.
I recently had a patient referred to my practice, a
sixty-one-year-old man whom I'll call Jim, who had just had a stent placement
for a 90 percent blocked coronary artery. Jim had been living on the edge of a
mortal cliff—in danger of having a massive heart attack at any moment that
most certainly would have ended his life in a matter of minutes.
Yet you never would have guessed that by looking at
him.
Here he sat in front of me, looking as slim and fit as the
models we see in gym membership advertisements and bragging about his physical
accomplishments. He said his friends joked he had the body of an Adonis, and his
employees at the multimillion-dollar business he owned referred to him as Iron
Man. When I reviewed his medical history, I learned that
he had been an avid college athlete, breaking records at the Ivy League school
he attended, and had continued this athleticism after college, running several
marathons over the course of his life.
Do you want to know how he celebrated after those marathons
he ran? With steak dinners, alcohol, and cigars. As I probed further, I found he
also spent eighty to one hundred hours a week at the office in what was an
incredibly high-stress environment, lived alone after a nasty divorce from a few
years earlier, and hadn't talked to his adult kids in months. Does this surprise
you? Not me. Sadly, I see cases like this all the time.
Distorted social norms falsely lull some of us into
believing that high-level athleticism is the trump card when it comes to
achieving optimal health. Loosely put, the idea seems to be, “If I can do all
of these superathletic things and I look like the models in the ads, then my
health must be great.†So this messaging can not only lead to feelings of
shame for people who run slower than others or have different body types, but
can also mask serious health problems hidden behind a “healthy-lookingâ€
body, just like Jim's.
So often when we think of physical activity, we think of it
in terms of improving how we look. We are bombarded with cultural images that
tell us that health and beauty are dependent on small waists or huge muscles,
but this is the skin-deep view of exercise that advertisers want us to see. The
truth is that the positive effects of movement go far beyond appearances, as
exercise improves our sleep, our mood, and our metabolism. These are just a few
of the benefits you're likely to feel almost immediately. The long-term benefits
include increased bone, brain, and heart health, all of which lead to
significant increases in longevity and healthier, happier lives.
Tags:
self improvement