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
The holidays offer ample opportunity to eat, drink, and be merry with family and friends. Unfortunately, this may not be in the best interest of our health or our waistline. Every other week, we will feature a nutrition tip to help minimize the damage during the holiday season and avoid feeling so guilty come January 1st.
When it comes to avoiding weight/fat gain, energy balance is the name of the game. Many of our favorite holiday treats are high calorie/fat/sugar which is what makes them taste so great. One of the simplest things we can do to combat the impulse of overeating is plan ahead by adjusting our eating habits surrounding a given meal accordingly. Ideally, we won’t have more than one holiday party/gathering in a given week. The day of the party, eat a meal that consists solely of very lean protein (extra lean turkey, chicken breast, extra lean ground beef, egg whites, or Whey Protein Isolate, etc.) and lots of fibrous/low calorie vegetables (broccoli, cauliflower, spinach, asparagus, brussel sprouts, etc.). Vegetables and lean protein have repeatedly demonstrated their ability to increase satiety (feelings of fullness) and should cause you to eat less later on at the party. Try to consume at least 0.5g/lb of body weight in protein before leaving for the big meal and shoot for 3-5 cups of vegetables. Not only will you be less hungry later, but you will have met your daily protein and vegetable requirements which many people tend to skimp on at large dinners. When making your selections, try to fill at least a portion of your plate with a leaner protein choice and vegetables (if there are any without sauces/cheese on them). Eat, drink, lift, and be merry!
-Jeff Tirrell, CSCS, Pn1