Remember What You Wrote
Things I’ll Do Differently When I’m Old
Steven Petrow of the New York Times wrote a great article, Things I’ll Do Differently When I’m Old. As a physical therapist that has guided thousands of 60 year plus individuals through the rehabilitation process, I have some suggestions.
I will work with a professional on developing a sustainable fitness program. The preventative against age related physical decline is a program of exercise. Consistent exercise reduces fall risk and maintains independence. No other modality has a greater impact on health. Blood sugar levels, respiratory capacity, mental health, and cardiac fitness all respond favorably to exercise. Do not be a fitness “do it yourselfer”. Older, deconditioned, and previously injured individuals get much better results when under the direction of a qualified professional. One way or the other, you are going to spend time and money on your health. Spend it up front–you will be much happier.
I will not let pain linger. Pain is not a “normal part of aging”. Chronic pain alters brain chemistry and destroys healthy movement patterns. Left untreated, pain has the capacity to weaken and spread damage to joints not involved with the initial pain provocation. See a physical therapist and find out what you can do to resolve pain issues before they become chronic.
I will exercise caution with medications that have an effect on the central nervous system. Many older people take multiple medications that impact brain neurochemistry. More brain real estate is devoted to movement than reading, writing, and arithmetic. A steady diet of pain medications, sleeping pills, and anti-depressants takes a toll on coordination, balance, and the ability to safely get around town. Add in a cocktail or three and you have a dangerous combination.
I will make a sustained effort to recover from any and all physical challenges. As we travel through our senior years, most of us will experience a health setback that requires rehabilitation. Full recovery of strength, mobility, and function takes eight to twelve months. Many physical therapy patients stop all rehab efforts way too soon. More of the rehabilitation battle is being fought in isolation as reimbursement for physical therapy care is shrinking. You may be done with formal physical therapy in four weeks, but you need to continue with a restorative exercise program for much longer.
I will not get fat. Physical therapy patients that are overweight have much more difficulty recovering from an injury or a challenge to their health. Sarcopenia is the medical name given to age related loss of muscle mass. Adding extra fat onto a body that is losing muscle creates an environment that makes movement more difficult and pain more prevalent.
I will listen and answer all questions from my health care provider to the best of my ability. The answers we get from the patient are the clues that lead us to the proper care. We need to know how your pain / symptom behaves and the effect it has on your life. Please do not omit any information that you feel is not important or unrelated to your condition. Do not lie about any aspect of your functional status, medications, mental health, etc… Your therapist, doctor, or physician assistant cannot help if we do not have all of the information.
I will plan ahead. In my dealings with older physical therapy patients, these are the three things that make life easier for both the patient and their families. Do what you can to manage these issues while you are healthy and clear headed.
- Have a Will with end of life directives.
- Insurance coverage that reduces the expense of long-term care.
- Pre-planned funeral services and insurance
Michael S. O’Hara, PT, OCS, CSCS
Read the NY Times article here: https://www.nytimes.com/2017/12/05/well/family/thing-ill-do-differently-when-im-old.html?_r=0
Americans are far behind the rest of the world when it comes to the number of steps we take in a day. The body mass index numbers and mortality rates of our fellow citizens are rising in direct proportion to time spent seated. Human physiology operates optimally under the physical demands of a significant amount of standing and walking. Much of the now rampant obesity, heart disease, diabetes, and metabolic syndrome can be linked to our species sudden fall into sustained sitting. Standing for most of your workday and a daily habit of walking pays huge health and fitness benefits.
We are de-evolving into a nation of sitters. Between internet, television, driving, and computer work, it is not uncommon for many of my physical therapy patients and fitness clients to sit for ten hours a day. Unfortunately, you cannot train away the metabolic and physical damage created by prolonged sitting with a few 45 minute exercise sessions every week.
Seventy years ago, the London Transit Workers Study provided the initial scientific insights into the powerful health benefits of sitting less and standing more. Take the time to read the recent *article by Gretchen Reynolds in the March 23, 2017 edition of the New York Times. Ms. Reynolds’ provides some valuable information on the benefits of standing up and moving as much as possible. Now go for a walk and then Google Varidesk.
–Michael S. O’Hara, PT, OCS, CSCS
*Should 15,000 Steps a Day Be Our New Exercise Target?, Gretchen Reynolds, New York Times, March 23, 2017