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2004-08-23 - 3:55 p.m.

Faith, Hope & Therapy

Exercise? Physical Fitness? � We never gave it a thought. I grew up on a farm. I�m guessing that just the normal day-to-day activities provided all of the exercise necessary for cardiovascular fitness for everyone � mother, father, and children of all ages. Aerobic exercise was not part of our vocabulary. Little wonder that no one gave a thought to going to a gym for exercise or for a run. It just didn�t have to be built into our day�s activities. Just think about doing the laundry and all the stretching, bending over involved with hanging the clothes to dry on a line outside to dry. The garden to plant and cultivate. Who needed a gym?

Even after we moved into town, I walked three miles to and from school every day (yes, it was uphill both ways!), rain or shine (and in Hoquiam, Washington, it was most likely drizzling at least for several months of the year.) My bedroom was upstairs so there were stairs to be climbed several times each day.

[I'm the one without any books. Not a good sign. Hmmm?]

When I met Glen, he had two part-time jobs in addition to going to high school full time. He played tennis on the Varsity team and was also on the bowling team � for fun, not for exercise. His bowling team activity introduced him to one of his part time jobs � pin setting. As I recall, the pin-setter not only picked up all of the pins after the first ball was thrown, but sent the ball back, placed the pins in the rack, and then jumped up on a wall to get some protection for his legs from the next ball thrown. This procedure was repeated after the second ball with all ten pins restored to original position at the beginning of each frame. A pin setter for every two alleys meant jobs (and exercise) for eight to ten young men.

Today most modern bowling facilities have computerized bowling lanes that display your score automatically throughout the game, and the electronics and sensors in the pinsetter also help keep track of the score. Pinsetting in today�s bowling alley can be handled by just one person for the whole alley. This is yet another example of automation replacing jobs (and physical activity) � jobs that teen-age boys used to perform.

Even in college there was some understanding that young people needed some physical exercise. When I went to the University of Washington, I took bowling as my physical education class. Because we were using the lanes during a slow time of the day, we were allowed to take turns setting pins for our classmates in exchange for free bowling. I learned that setting the pins was actually far better exercise than bowling! At Reed I played badminton and learned to fence. Since I lived on campus in Kerr Hall, I also occasionally, when studies permitted, enjoyed square dancing on Wednesday evenings � a campus activity. Glen played tennis during good weather, badminton and volleyball at other times, but lived a long bike ride away from campus after he started teaching French to two young boys for his board and room. For certain, we were both too busy with classes to do any bowling.

Just when did automation take over? When did our lives become so physically undemanding that we have to write into our planners or Palm Pilots time for physical activity? As I�m writing this, I�m wondering if the handicap accessibility requirement for our schools and office buildings hasn�t perhaps contributed to the obesity problem. We don�t walk up and down stairs anymore, so we have to go to the gym and use the Stairmaster? We drive to the gym to walk on the treadmill or ride the exercycle? We use machines to replace the activity our arms used to get hanging up the clothes, ironing, mashing the potatoes, kneading the bread, gardening, etc. This is progress?

At age 73, having had three foot and ankle surgeries, bilateral knee replacement, and still experiencing discomfort and weakness in my feet and knees, I frequently lost my balance and experienced discomfort when walking any distance. An MRI indicated spinal stenosis; surgery was recommended. I decided to put off the spinal surgery and instead asked my primary care physician to refer me for physical therapy to work on my gait and perhaps incidentally strengthen my back. While I had been riding my semi-recumbent exercycle at home 20 to 40 minutes a day, it had not improved my walking any. The script Dr. Riggle wrote read �three times a week� to work on gait, strength, and mobility with special consideration for spinal stenosis.

My first meeting with Mat Moore, my physical therapist at the Physical Edge, consisted primarily of a long chat, based on, �What do you hope to accomplish?�

�I want my life back. I want to be able to go to the theatre and not have to worry about whether I�ll be able to get to my seat. I want to be able to drive my car again. I want to be able to get out and about and not feel so isolated. I don�t want to have to worry about falling and not being able to get up. And I�d like to be able to avoid back surgery, if possible.�

So we began to work. We started with simple leg lifts. Lying flat on my back with one knee bent, foot flat on the table, I was unable to raise the other leg without assistance. After two weeks of doing exercises at home, as well as three times at the gym, I was able to raise the right leg without assistance. Six weeks later, I could do the leg lifts unassisted.

After the leg lifts (2x10 per leg) and pelvic tilts, I was allowed to rest for a few minutes before standing precariously on a half squishy ball, clasping the table at first in a white knuckle stance, wobbling about. The goal was to be able to stand on this half-ball for 60 seconds without holding onto the table. By the end of eight weeks, I could not only balance on the ball, standing still, I could weave from one foot to the other for as long as ten minutes. Who would guess that this challenging endeavor would be aerobic exercise � I never failed to break out in a �glow!� From the squishy ball (and yes, I know it has another name, but that�s what I call it), I moved on to the Wobble Board, which provided mobility to ankles, as well as balance. This was never particularly challenging for me.

After a couple of weeks, Mat ntroduced me to the leg and calf press and the Pec Fly and Reverse Pec Fly machines. I started out with very light weights and over the mext six weeks worked up to 105# for both Leg and Calf Press and to 40# for the upper body machines. During the next few weeks, a new machine was added each week, so that by the time I �graduated� to independent work at the gym, I had a full complement, including treadmill, semi-recumbent bike � a full hour�s work-out.

My balance has improved to the point that I can now walk up and down steps without the assistance of my walking stick or a helping hand. I am feeling confident enough in my ability to get around that I�m now ready to have my drivers� license renewed � just need to study for the test! I continue to go to the gym three times a week, ride my semi-recumbent exercycle at home on alternate days, and am gradually increasing the weights and reps on the machines, as well as my time on the treadmill.

Had I known then what I know now, I would have continued this more rigorous exercise regime right after my second knee surgery, even given the impending back surgery. I think, however, I had given up hope of ever getting back to a normal life. Perhaps I just needed time to recuperate from all the surgery. The messages here, I think, are three-fold: �Use it or lose it!� Faith, hope and therapy! Carpe diem!

P.S. Ed is going hiking on the Pacific Crest Trail next weekend. It has been his goal to hike from Tahoe to Ashland, Oregon 30 miles at a time. He's working out at the gym and walking on alternate days to build up stamina after his surgery this spring.

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