New Knees Please

A startling statistic came to me via email a couple weeks back.  Did you know that 1 out of every 50 people now has an artificial knee?  It is hard to imagine, but with my recent exposure to the senior population, I  think it is safe to say that the numbers might be 1 out of every 25 for those 75 years and up.

When treatments to manage knee pain fail to be effective, knee replacement surgery is often pursued.  Typically, knee replacement falls into two different categories.  There is total knee replacement, and partial knee replacement. 

• Total knee replacement consists of three components: a femoral component, the tibial component, and the patellar component.  Total knee replacement is often good for individuals suffering from arthritis, or for younger, more active individuals. 
• Partial knee replacement is pursued when only one of the three components are in need of replacement.  If more problems exist, then partial knee replacement is not recommended. 

I have one long-time client that underwent a total knee replacement a couple years back.  I had the opportunity to observe her immediately post-surgery and closely followed her progress until she was cleared to return to regular exercise activity.  Her doctors had her up and out of bed- walking from one side of it to the other, within 24 hours of her surgery.  While at rest, she also had her leg in an automated machine that flexed her knee repetitively with the degree of flexion steadily increased.  She was also a good patient, and did every minute of her prescribed physical therapy and exercise homework for the following six to twelve weeks after surgery.  She had a very successful outcome as a result of good care, and being so diligent with her rehabilitation.

Most knee replacement patients undergo physical therapy for six to twelve weeks, with goals of increasing range of motion, strength and balance to resume regular activities of daily living.  Some may be eligible for clearance to restorative/progressive fitness activities as early as six to eight weeks post-surgery.  It is not unusual for there to be general tightness surrounding the knee, for the patient to experience unusual sensations surrounding the surgery site, and to have balance issues (temporarily) due to restricted movement.  These issues do resolve themselves with more healing and once more normal patterns of activity resume.

Fitness is Not an Age

I have been working part time at the Dorothy Visser Senior Center Fitness Center in San Clemente for the past four months.  Anyone aged 50 and up can join, and I am proud to say that two of our members are very close to turning 90. 

I adore the senior population, and am so grateful to have this opportunity to work with them in the arena I  am so passionate about.  Even better, I get to witness their fitness progression.  It means a lot to them, and it might mean even more to me.  I know fitness is not an age, and that improvement in strength, flexibility, endurance and balance will occur for everyone putting forth consistent effort in an exercise program.  When I see them stand up straighter, maintain better balance and walk with ease of motion, I am soulfully rewarded.

My seniors impart their wisdom and life experience on me daily, and when I have opportunity to help them, it is my small way of giving back.  Their generation did not have the wealth of knowledge and resources that we have today with health education, medical advances and prescription medications.  If they knew then what they know now, many would have opted earlier for healthier lifestyles.  Though many seniors have multiple health challenges, they all can be better managed with exercise intervention.  It is never too late to start an exercise program, and for those willing- await tremendous rewards.

Happiness is Not a Weight

More and more people are pursuing gastric bypass as a last attempt at weight loss.  Many complications can arise from the surgery, but I do not want to get into the particulars of that in this post.  I am not against gastric bypass, I only want to discuss a certain angle within its context.  Working with gastric bypass clients has reaffirmed for me what I already know...that happiness is an inside job. 

People I meet and get to know wake me up to the challenges they face, challenges very different from my own.  I have never struggled with my weight, attempted a diet or felt like I even needed to "lose a couple of pounds".  Therefore, I have never created a fantasy world around "being the perfect weight" or established a pattern of "I'll be happy when I ...(fill in the blank)".  I think it is easy to romanticize weight loss when you are always chasing it and it remains elusive.

All of the desire, hard work and efforts surrounding attempts at weight loss create a heavy attachment to the desired end result.  The end result for many, is a magical weight that also provides the key to personal happiness.   I had to gently explain to one of my clients the other day that happiness is not a weight, and it never will be.  Individuals that weigh 132 lbs, and those that weigh 270 lbs are both struggling to be happy.  Happiness must be self-generated, and the sooner we realize this, the better off we will be.  Feeling good about ourselves is truly the key to happiness, and this has more to do with the type of person we choose to be and how we choose to live life, versus how we appear to others.

We are all a work in progress, and we must take responsibility for our own happiness and learn to self-generate it in the NOW vs. in the future.  One of my favorite expressions is "Wherever you go, there you are".  So, if one doesn't bring a healthy mindset to a certain set of circumstances, there will no escaping the same end result elsewhere in time. 

Ode To My Customers

It dawned on me today just how much I love what I do professionally.  Typically, I gloss over things and am not very grateful because I am future focused and often worried about something else.  In any case, today I was writing and explaining to a high school group what I do professionally.  This was to provide insight into different vocations, the positives and negatives and how a day in my trade typically goes.  With every sentence I wrote, I became increasingly aware that I really do love my job. 

I have had many jobs over the years.  Money at times was great, but I typically hated what I did, the sacrifices I made while I was doing it, and always resented the office bullshit and co-workers' petty, personality problems.  Those days, thankfully, are now a distant memory.  Five years ago when I started my business, I had no idea what lie ahead in the future.  Five years later, I know.  Today, I find my job so rewarding and to be truly important work.  My work now, is profoundly meaningful.  I get to help people embrace their health and improve the quality of their lives. I am not contributing to a company's bottom line, I am contributing to LIVES.

I always knew I was a "self-starter" as loosely as that term gets thrown around in job interviews and offices, but I've proven it by going into business for myself.  I have put some long hours in over the past five years, but I have gotten more out of these past five years than the entire rest of my life.  Knowing people intimately, understanding what their challenges are, understanding what makes them tick and how to get them where they want to go is a daily experience for me.  I have learned so much from talking & listening to clients, their stories and different life experiences, that it rivals lifetimes of higher education from anywhere.

My profession allows me to intersect different races, cultures, ages and religions.  People I would normally never have opportunity to interact with cross my path every month. I have forged incredible relationships with people that will remain in tact for the rest of my life.  I had no clue that I would receive so much in the health and fitness industry. Starting my business was a huge risk, and interestingly, I did not enter into it with so much of a strong interest to do it, it was more of a "I can't do the other stuff" anymore. 

Over time, I have built an "extended family" that have woven their way deep into my heart.  When they win, I win, when they overcome obstacles, I overcome obstacles.  I feel like I get to walk in a different pair of shoes with every new trail blazed.  Tonight, when I go to bed, I might even give myself a small pat on the back (never do) and remind myself that by affecting change in people's lives is the ultimate paycheck.

Arthritis and Exercise

Two basic types of arthritis exist. One is osteoarthritis which results from a degeneration of synovial fluid (a joint lubricant), typically progressing into a loss of articular cartilage (cartilage that allows ends of bones to glide without friction).  The other is rheumatoid arthritis , a chronic autoimmune disease that results in inflammation of the synovium and leads to long term joint damage, pain and loss of function.  Rheumatoid arthritis (R.A.) is progressive and progresses through three distinct phases I will not elaborate on in this blog posting.

Good news exists for arthritis sufferers, and that is whether you suffer from R.A. or osteoarthritis, exercise will help manage symptoms and slow down the breakdown of joint integrity, which, further assists in slowing down the decline of functional capacity.   Maintaining functional capacity is important, as without it, we become more sedentary in lifestyle.  As we are aware, sedentary lifestyles lead to weight gain and other health problems.

If you, or someone you know is an arthritis sufferer, please encourage them to discuss with their physician what they can and cannot do to better manage their symptoms outside of pharmacotherapy.  Exercise prescriptions will follow a certain protocol where safety is paramount, and a slow progression of difficulty will be implemented over time, with every necessary precaution taken along the way to prevent unnecessary degradation within ailing joints. "Easing symptoms" is a typical goal of an exercise program for arthritis and one of the best approaches to minimize pain and preserve joint range of motion and strength.

Water and Weight Loss

Sometimes we fill up on food when we should be filling up on water.  We do confuse thirst for hunger, so it is important that we stay hydrated.  Current recommendations for the average individual are to try and get 64 oz. of water consumed every day.  This amount should be increased with exercise.

I stumbled across some information in one of my fitness publications the other day that discussed the role of water in weight loss and the results of a recent study.  The study followed a large group of adults divided into two groups.  One group drank 2 cups of water prior to meals, while the other did not.  All of the test subjects were following a low-calorie diet for the course of the study.  Over 12 weeks, the water drinkers lost about 15.5 pounds whereas the non water-drinkers lost about 11 pounds.  That is a substantial difference that cannot be ignored.

If you think about it, it makes perfectly good sense to try and fill up on zero calories instead filling up on snack and meal calories over the course of each day.  If you are a "grazer", or someone aiming to eat five, small meals per day, think of the amount of calories that could possibly be eliminated from consumption over the course of a week if you are doing some filling up on water.  If you are attempting weight loss, and do not have proper water intake included in your bag of tricks, do not delay in implementing this as part of your daily regimen.

If the achievement of more weight loss wasn't enough for you, keep in mind that proper hydration helps us with mental focus, prevents small, nagging headaches, eliminates bloat and keeps our skin looking radiant.  With the unknown correlation between artificial sweeteners and weight gain, it makes good sense to steer towards water whenever possible and away from diet sodas and other flavored beverages.  Why consume extra sodium, food coloring, carbonation and other unknown additives unnecessarily?  We know our bodies are largely comprised of water, so hydrate and take your weight loss efforts to the next level.

Exercise During Your Pregnancy

If you are pregnant and a regular exerciser, congratulations!  Women that consistently exercise over the course of a pregnancy gain less weight, fat and shed fat more quickly post-pregnancy.  Regular exercise during pregnancy helps maintain a leaner body composition whereas the opposite will occur taking the route of a sedentary lifestyle.

In recent years, maternal obesity has become a growing problem in this country.  The number of overweight women of childbearing age has climbed substantially.  As you might expect, maternal obesity and pregnancy do not mesh well.  The risk of maternal and fetal complications increases with the degree of obesity.  Risks could include gestational diabetes, preeclampsia and large birth weight babies prompting the need for C-sections.  The "stacking up" of risks, or poor management of them can ultimately lead to a very high risk pregnancy, an uncomfortable pregnancy, and one that requires constant monitoring and often bed rest.  Worse, forced bed rest can translate into more significant, unwanted weight gain.   

A woman's pregnancy is a special time and it should be honored and met with proper nutrition and physical activity.  Many overweight individuals I have met over the years have shared with me that their initial weight gain began with a pregnancy where 1) They gained too much weight while pregnant, and 2) Struggled to get the baby weight off.  These factors coupled with a major lifestyle change post-pregnancy (having a newborn to look after), and a gradually slowing metabolism (with age), can create the perfect storm for considerable weight gain and retention of it. 

As I always say, it is better to be proactive than reactive.  Early intervention to be more active and eat properly throughout a pregnancy is the best line of defense.  A pregnancy should not be used as free license to eat whatever one wants, or as an excuse to be waited on hand & foot.  Keep problems away and protect your health and the health of your unborn child by taking the best possible care of yourself.  Make your pregnancy memorable for the right reasons.  Talk to your doctor about recommendations for safe and appropriate exercise during your pregnancy.