Walking to Wellness
A few years ago I visited my primary care physician for an annual check-up. She gave me a good going-over, studied my blood and urinalysis test results without commenting, and, as I sat there on the exam table, asked me some general questions along the lines of “How do you feel?”
I answered them easily. With the exception of my slowly increasing rheumatoid diseasesymptoms, I was feeling fine. I hadn’t had a cold in ages, I always got a flu shot, and I’d stopped smoking years before. This, I thought, was going well. She’d release me with a bill of good health any minute and I’d be on my way.
Not so fast. “Do you exercise?” she asked, fixing me with her steely, blue-eyed gaze.
I could have said that yes, I did, all the time, but my canny doctor would have known better. I obviously didn’t look like I exercised.
“Well, yes, sometimes,” I offered, a little embarrassed. After all, the importance of diet and exercise had been all over the media, social and otherwise, for years. I knew I should exercise. We all know that.
“What kind?” she prodded.
“I walk. There’s a nature trail not far from my house.”
This was true. I hoped that would be good enough for her. After all, walking is a perfectly acceptable form of exercise, especially for someone over 50, like me. Never mind it wasn’t exactly a habit, but rather something I did in spurts. I’d get all motivated, walk four or five times a week for a couple of weeks, then start finding reasons I couldn’t spare the time. Before long I’d be back to not-walking, time would pass, and finally, the cycle would start again.
It wasn’t good enough. “How often do you walk? And how far?”
This was getting uncomfortable. “I try for a couple times a week, at least. I walk about a mile and a half. Sometimes more.” It wasn’t exactly a lie. Just … an embellishment.
“Mmm. You try?”
"Well, I … don’t always get to it.” I was squirming now.
“Come on over here and sit down.” She pointed at the chair near the desk. “You’ve developed metabolic syndrome.”
I blinked. I’d never heard of it. My heart sank. Just what I needed, another disease, syndrome, whatever on top of my rheumatoid arthritis. Sheesh!
“It’s not a disease,” she said, as if she’d read my thoughts. “Metabolic syndrome is a combination of factors that, when they start occurring together, can be really dangerous.” My doctor leaned forward. “I mean deadly dangerous, Wren. It doubles your risk of blood vessel and heart disease, which makes you a prime candidate for a heart attack or stroke. And it makes you five times more likely to develop type 2 diabetes.”
And then she went on to tell me what the factors forming metabolic syndrome are: middle-age; obesity (particularly the kind that puts most of your fat around your middle); high blood sugar; and high blood pressure. “It doesn’t help that your cholesterol is higher than it ought to be, either,” she added.
But there was more. She said that having RA may actually make you more prone to contracting metabolic syndrome, too.
I was slack-jawed. “Why?”
She reminded me that RA is a systemic disease that causes inflammation and damage throughout the body, not just in the joints, tendons, and ligaments. RA also affects the heart and other soft tissues, including the lungs, eyes, and vascular system. So, she said, having both RA and metabolic syndrome is even more serious.
Well! I couldn’t help that I was middle-aged and becoming more so with each passing year. I knew I was chubby—OK really chubby—but obese? I hadn’t known about my blood pressure and blood sugar, though. I felt a protest rise in my throat. “But,” I wanted to say, “I don’t eat lots of sugary stuff!” And I didn’t, really, unless you counted donuts at the office three or four mornings a week, high-carbohydrate fast-food lunches, and dinners made most nights, in an after-work state of exhaustion, straight from cans and boxes.
I worked hard every day. I really felt I didn’t have much time free for exercising unless I wanted to get up even earlier in the morning than I already did. The idea of going on a serious diet demoralized me, too. But my doctor came to my rescue: she gave me a do-able list of goals.
By the time I saw her again in six months, she wanted me to have lost at least 10 percent of my body weight. At the time, that meant about 12 pounds. To do it, I should say “no” to donuts, sugary drinks, processed foods, and fast food, and “yes” to meals cooked from fresh ingredients. The biggest portion on my plate should always be vegetables—and as much of them as I could eat—but I could also eat small portions of whole grain breads, pastas, and brown rice; low-fat dairy foods, protein from nuts, beans, chicken, and fish, and “good” oils like olive or canola oil. If I craved something sweet, I should grab an apple instead of a cookie. By doing this and sticking to it, she said, I’d get my dangerously high blood sugar and cholesterol levels back down into the normal range.
She wanted to see my blood pressure back down in the normal range, too, so she suggested I get deadly serious about walking. No, I didn’t have to dedicate myself to spending hours on a treadmill every day. All I had to do was get outside and walk, briskly and without dawdling, for at least 30 minutes a day, five days a week. By doing that along with watching my diet, my blood pressure would soon normalize, she said. And while walking probably wouldn’t help me lose weight, it would help me keep it under control.
When I saw my doctor again six months later, I’d lost 30 pounds and everything else was back to normal. I’d been lucky: my RA never flared bad enough to affect my daily walks, which I took during lunchtime or after dinner. Thirty minutes was totally doable. I’d adopted the Mediterranean diet and enjoyed it, discovering that cooking simple meals from fresh ingredients was even easier than opening a box and some cans. If RA made my hands hurt too much, I asked my husband to chop vegetables—something I’d never done before. Turned out heliked it, so we enjoyed making dinner together.
My life has changed quite a lot since then, and I’m facing metabolic syndrome again. But I know what to do this time; I don’t need to wait for my doctor to scold me. I can walk 30 minutes a day and make healthy meals. I live with and care for my elderly mother, now, and she’s good at chopping veggies. All I need to do is get busy and do it. Anyone out there want to join me?
When was your last flare?