Overcoming Obstacles

CHAPTER 14

  

Overcoming Obstacles

Nearly every person can exercise, but some have chronic illnesses or conditions that make working out extra challenging. They may need extra support and supervision, but in many cases, exercise can help them manage their chronic health challenges, and improve their symptoms.

PART 1

Diabetics

If you have diabetes, regular exercise has many benefits. Exercise can improve your insulin sensitivity, and help you manage your disease. Of course, not all diabetics start out in optimal physical condition. Your doctor must be in on the plan, taking a full assessment of the health of your heart, blood vessels, eyes, kidneys, feet and nervous system before you start. The effects of any medications you take could be altered by increased exercise, and your doctor should talk with you about that as well. READ MORE

Here are some tips from the American Diabetes Association for diabetics who aim to start a new exercise program.

  • Learn your blood glucose response to exercise. Checking your blood glucose before and after exercise can show you the benefits of activity. The readings will help you time your food intake and medications.

  • If your blood glucose is high before you exercise (above 300), physical activity can make it go even higher, so be cautious about doing something active.

  • Keep in mind that low blood glucose can occur during or long after physical activity. Low blood glucose most likely occurs if you take insulin, skip a meal, exercise for a long time, or exercise very strenuously.

  • If low blood glucose is interfering with your exercise routine, eating a snack before you exercise or adjusting your medication may help. Talk to your health care team about what is right for you.

  • Check your blood glucose right away and treat hypoglycemia if you need to.

  • If you want to continue your workout, eat a snack, take a 15-minute break, and check to make sure your blood glucose has come back up above 100 mg/dl before restarting. If you start too soon, your blood glucose may drop again, quickly.

  • Studies show that hypoglycemia is even more likely to occur 4–10 hours after you exercise than during the activity or shortly after.

  • Plan to have water and snacks handy during activity. Drink plenty of water before, during, and after activity. If you are at risk for low blood glucose, always carry a source of carbohydrate to so you’ll be ready to treat low blood glucose.

  • Wear a medical identification bracelet, necklace, or a medical ID tag to protect yourself in case of emergency.

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PART 2

Overweight or Obese

People who are trying to reach a healthier weight must stay active. To improve cardiovascular health and achieve a modest weight loss, someone overweight should exercise at least 150 minutes at medium intensity per week. However, weight-loss experts at the Mayo Clinic in Rochester, MN, say that to achieve significant weight loss, obese people may have to exercise twice that much!

Again, your medical practitioner is the first stop. Most people are able to begin a modest walking program if they can support their own weight. The heavier you are, and the longer you have been sedentary, the greater the chance that you'll have some joint soreness and other discomfort at the beginning. Talk to your doctor about a phase-in plan to start exercising and gradually increase your active time as you build endurance and strength. READ MORE

People who are clinically obese may not be able to start walking right away. Sitting exercises can build strength and flexibility when regularly performed in a chair. (Some examples can be found here: www.exercisefortheobese.com/exercises-for-the-obese) Anyone whose weight is causing them discomfort might want to consider including water exercise. Swimming, water aerobic dance and water jogging provide a great aerobic workout, but take pressure off of joints. Keep in mind, however, that as you gain strength, weight-bearing exercises such as jogging and jumping rope are important for building and maintaining bone density.

Finally, being enthusiastic about exercising and eating right will be necessary to keep you on track as you work your way toward a healthier weight. In your zeal, you may be tempted to overdo it. Pace yourself. That's the best way to build slowly and safely toward better health, and avoid the setback of being sidelined by an exercise-induced injury. LESS
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PART 3

Asthma Sufferers

If you have asthma, your exercise routine should focus on sports and activities in which periods of exertion are broken up by equally long periods of recovery. Such a rhythm allows your respiratory system to pace itself. Team sports such as baseball and volleyball are a good place to start. Sports that require long stretches of intense activity or continual running (soccer, basketball, distance running) present more challenges to asthmatics. But moderate walking, biking and swimming are good choices for asthmatics. READ MORE

Plan for success by always carrying asthma medications, especially to the gym or sporting events. If you have a bronchodilator (inhaler) use it before exercise as directed. Keep an eye on pollen counts and other air-quality issues if you have allergic asthma, and do not exercise outdoors when allergens are dense in the air. Finally, if you feel an asthma attack coming on while you are exercising, stop and take medication (if you have it). Your symptoms may resolve as you rest, but if they don't, get in touch with your health-care provider for more support. LESS
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PART 4

Arthritis

The chronic joint pain of arthritis can be debilitating and depressing. The temptation to avoid movement and try to rest might seem irresistible, and it was once accepted. Now, doctors know that even in those with severe arthritis, low impact exercises help improve joint mobility and strength, and alleviate pain. READ MORE

Working out in the water is one way to take pressure off of the joints, especially if your arthritis is advanced. Seated exercises are another option for those whose joint pain prevents them from more challenging workouts. Those with milder arthritis can work their way up to a walking regimen, perhaps even including some jogging, as these weight-bearing exercises build joint strength and mobility. The Arthritis Foundation also recommends trying tai chi or yoga to improve balance and strength, and alleviate stress without overtaxing your sore joints.

Do you want to work out with other arthritis patients who have similar challenges? You can find a place to join an Arthritis Foundation Exercise Program class in your area. Go to arthritis.org and enter your ZIP code in the “local program” finder. LESS
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