As 2018 came to an end, I realized that I needed to become more physically active. So, I took an online class. Yes, I see the irony in that decision. I need to move, so I sat and read and took exams. Yet, when the course was over I had reviewed the recommendations for physical activity, set a few SMART goals, and purchased a very simple step counter (1).
During January of 2019, I counted steps and I counted calories. I also made the arrangements for the trial of a spinal cord stimulator (scs). A psychiatrist completed the psychological evaluation required before the trial. My pain management specialist agreed to conduct the trial and we set a date. Everything was going along smoothly. Then a set of new but familiar symptoms flipped my script.
On January 30, 2019 these symptoms sent me to Patient First, an urgent care facility. Laboratory tests indicated that I had a urinary tract infection. The need for antibiotics required that my spinal cord stimulator trial be postponed. The infection was a reminder of a kidney birth defect, another surgery, and a very dark period in my life. I felt deflated. When I returned home, I climbed into bed and went to sleep.
I awoke to a voice describing a life of full body pain and limited mobility. I immediately identified with the speaker and continued to listen. When I opened my eyes, I had a very up-close-and-personal view of a human being who was obese in the extreme. The auto-play function of Hulu had taken me to My 600-lb Life – https://g.co/kgs/YxKGV. When the scene shifted to Dr. Nowzaradan’s consulting room, I knew that this could be a meaningful viewing experience.
“How Y’all Doing?’
Watching Dr. Nowzaradan and his patients reinforced my commitment to resist the barriers to physical activity. I needed this reinforcement because my brain and my mind hold two very dissonant cognitions about movement. My brain is constantly receiving the message that movement is both painful AND dangerous. This is not a message that I can ignore because it is true. I have the falls, the fractures, the concussions, and the surgical scars to prove that this is the reality in which I live. The pain signals that reach my brain are not delusions.
The compression of nerve roots in my lumbar spine produces pain, weakness, and numbness in my lower back, buttocks, thighs, legs and feet. Since my last surgery, my right leg no longer collapses unexpectedly. However, it has not fully recovered and my brain, wisely, does not trust it. I cannot walk and chew bubble gum at the same time. Every step, every foot placement requires the active participation of a brain that has been traumatized on multiple occasions. Unfortunately, the brain, my brain, now insists that the proper course of action is to find a comfortable position and stay in it. My brain is a strong advocate for a sedentary lifestyle.
I am not naïve enough to consider being sedentary as a long term solution. I have 62 years of personal experience in coping with chronic pain. I know that my brain can exaggerate and sometimes lie to me. I have a master’s degree in health and nutrition education. I am a lifelong learner and continuing education is something about which I am passionate. I also have a mind that tends toward the rational. That mind, my mind, knows that physical activity is essential to life. At this point, my logical mind believed that if I did not move more, I would become sicker and die sooner than expected. I needed a specific type of push to break free of the uncomfortable dissonance produced by the contradictory cognitions held by my brain and my mind.
Dr. Nowzaradan and his patients provided the inspiration that I needed. Dr. Nowzaradan encourages movement using a rational approach that resonates with me. When his patients explain that movement causes pain, Dr. Nowzaradan’s response is “So what?” I have been adopting that approach to negotiate an amicable agreement between my brain and my mind.
When I first bought my step counter I was taking between 200 and 1200 steps per day. Two weeks of binge watching My 600-lb Life and my average was up to 3000 steps per day. Occasionally, I reach 6000-7000 steps in a day. This is acceptable progress for a 72 year old woman coping with multiple autoimmune diseases, lumbar radiculopathy, and a problematic kidney.
The bargaining starts every time that I stand up. My brain is uncertain that my legs will support me. It anticipates a fall with every step. My mind fights the prediction of catastrophe. I can only reach about 2000 steps before the peace talks between my brain and my mind break down. At that point I must sit and recover before moving again or the brain will make its prophecy self fulfilling. If you don’t understand how that works, I can’t help you.
Taking steps then resting several times throughout the day, requires a commitment to time and planning. It also requires that I give up some of those activities that promote a sedentary lifestyle. I just don’t have time for them.
I have an appointment for a CT Scan and a consultation with my kidney surgeon in late March. In the weeks leading up to that appointment, I need to move. As a 72 year old adult with chronic illnesses, I need to be as physically active as my abilities and conditions allow. I have definitely been inspired by Dr. Nowzaradan and his patients.
How many steps per day are enough? https://www.verywellfit.com/how-many-pedometer-steps-per-day-are-enough-3432827
Sit Less, Get Active
Physical Activity Guidelines for Americans