Following her adventures in California, Sara is trying to move about a bit more. I was going to give her some tips about this, but found I had too much to say. But then I wasn't well and forgot about it for a few days (or uh, weeks). Of course, this is much more general advice than applies just to Sara, but here is my
Goldfish Guide To Moving About (when moving about is hard work)
1. Objectives, Goals and the Top Priority.
I'm not sure anybody can embark on any change in lifestyle just because it is good for you, so I reckon it's useful to have an objective. For me, exercise is primarily about improving my circulation. When my circulation improves, various other bodily functions improve, but most especially my concentration.
Motivation is also greatly assisted by having goals to aim for. Unfortunately, this is a little more problematic if you are a duffer; personally, I have aimed for goals which, with hindsight, far beyond what I might expect to achieve. Other times they have been a little fanciful; currently my objective is to be able perform the splits, simply because this is something I can't do now which I could train my body to do.
In order for exercise to be sustained, especially if you have an impairment associated with pain or fatigue, avoiding injury or over-exertion must be the Top Priority. It is so easy to set yourself back or give yourself a brand new limitation. Everyone needs to look after themselves, but the stakes are often higher for duffers.
2. Identifying Atrophy
There are, of course, a great big group of conditions which are characterised by muscle atrophy - the bastard is going to waste regardless of what you try to do with it . However, for the rest of us, atrophy is a delightful form of discomfort because we can, at least theoretically, make it go away.
The weakening of muscles through disuse is not to be taken lightly. If I swallowed a magic pill today and found myself in 100% full health, I might still collapse - and perhaps sustain injury - attempting to walk to the post office because my muscles just wouldn't be ready. But I could build myself up to it. Thus it is very useful to know how atrophy is distinct from the pain of a condition.
The easiest way to do this - providing you have two equally functional hands - is to try writing or performing another task you usually perform with your dominant hand, with your wrong hand. You know how much you can do with your dominant hand without experiencing any discomfort, but if you use your wrong hand, because it isn't used to it, it will start aching and become weak very quickly. That ache, that weakness, is what atrophy feels like. If you did the same thing everyday, it wouldn't ache so much. Of course your handwriting wouldn't ever be as good as with your dominant hand on account of your wonky brain. But most of us have slightly wonky brains.
3. Frequency above Quantity.
As part of combating atrophy as well as avoiding injury and over-exertion, it is much much much better to do small amounts of exercise often than larger amounts less often. This is even more important for someone with poor mobility than for a able-bod. Plus, you can usually do much more that way; it may seem impossible to exercise for an hour once a week, when it is perfectly viable to exercise for eight minutes every day. And that eight minutes is going to have a much greater positive effect on your ongoing health than the hour, as well as being much safer.
Someone who is physically healthy but has an big motivational block may be able to do much more in many little bouts. Five minutes four times a day, for example, would make a tremendous difference to one's physical health.
4. Make it as Easy as Possible
I don't consider fitness to be a moral issue, but I do get very pissed off with non-disabled people who chose to complain to me how they'd love to exercise but it's just not practical; the gym is too expensive, the swimming baths aren't open at the right time or the exercise bike's got a puncture. You've got a body that works, dammit, just stand on the spot and shake it about a bit!
Us duffers have to keep it simple; anything that involves going to some place, getting changed before and after and coming home again is going to use up spoons far above and beyond the actual exercise bit. Swimming or moving about in the water is excellent for any fragile body, but I haven't been swimming for years because afterwards, after you've done the exercise bit, you have to get dried and dressed as quickly as possible to avoid having your bits freeze off.
Personally, my exercise involves a yoga mat and enough space around it so I don't break anything if a limb flails in an unexpected direction. Which happens.
5. Listen To Music
Music distracts you from the pain and enables you to concentrate on movement. Any other stimuli, speech radio or the television are likely to be too great a distraction. And silence makes you bored and boredom makes you acutely aware of how uncomfortable you are.
It is also easier to take breaks and relax for periods when listening to music; if you're bored, you get impatient and are in danger of getting on with it before you're completely ready.
Music also helps you keep your sessions within a strict time frame. The very best I've managed to build myself up to is Part One of Tubular Bells which is twenty-five minutes! At such times, I have felt very good about my body indeed, even if I haven't been able to walk much further or do anything particularly useful with it. Some interim examples have including Madame George by Van Morrison (9.45) the Adagio of Concerto D'Aranjuez (11.06 mins) and The Lark Ascending (16.16 mins). Under nine minutes, there are lots of appropriate tracks to be had, so I won't bother listing them.
6. Anticipate and Accept Plateaus and Setbacks.
Over time, you should be able to build up the amount of exercise you can do, but exercise is unlikely to cure you of any chronic health condition. Therefore you are destined to reach a point where you can't really do any more than you're doing. You might have a lot of room for improvement before you hit this point or it might come very soon. Whenever it happens it is going to be disappointing and is necessarily going to involve trying something, trying to push further, and failing.
You must accept this is going to happen - if you don't, you may be inclined to push even harder and wind up doing yourself a mischief.
Then again - and it's certainly the story of my life - you may experience fluctuations in your health so that you spend a period of time patiently building up your strength only to have a bug or some other relapse trigger that puts you out of action. During my bad spells, I can't exercise; I get dizzy and very badly co-ordinated. I have unrolled my yoga mat, lain down on it and promptly fallen asleep. So I have to wait for this to pass and start again.
Relapses are frustrating and demoralising for all sorts of reasons, but it can completely crush your motivation to do this stuff. You forget the ways in which it was helpful. And it marks a tangible deterioration; a month ago you could practice yoga for ten minutes at a time, now you're finished at two. If you're not ready for that stuff, it can put you off permanently.
7. It has to be said...
Sex is one of the best physical activities available to people with pain and fatigue, especially for women who are capable of having many orgasms of significant length and potency. Orgasm can have an extraordinary pain-killing effect, which allows for exertions which are not otherwise possible. But even masturbation gets the heart beating fast and the blood moving about the body in a way that can't otherwise be achieved without sprinting up a flight of stairs. Sexual activity is good for you, on a purely physical level, especially if you struggle to exercise in other ways.