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Old 06-23-03, 10:23 PM   #1
Max
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CNN article: "Heart group: Doctors should prescribe exercise" ...cycle...

http://www.cnn.com/2003/HEALTH/diet....eut/index.html
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Old 06-23-03, 11:01 PM   #2
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Yes it's amazing how 90 percent of the patients find an excuse not to excercise. Perhaps that's why most doctors have given up.
This is a typical example of excuses.

#1 I don't have time doc, I work up to twelve hours a day.

My response: You watch at least half an hour of TV; walk, run or bike instead. If you have a hour of lunch break..... see the above. (Of course it's no use telling them a 12 hour work day is a short day for me since they don't believe me, remember, we are all out playing golf!)

#2 There is nothing around my house to do and I can't afford a gym membership.

My response: Walking is free. If the neighborhood is bad, invest in a walking treadmilll that costs far less than a running treadmill (the cost of two pairs of expensive sneakers.... approx. 250.00 at Kmart). And give up cigarettes. The amount you spend on cigarettes in 6 months will more than pay for it.

#3 The answer to the answer above... I think I have heel spurs.

My response: Take up biking!!!!!!(always my favorite)

#4 The answer to the above..there are too many hillls around my neighborhood.

My answer: Get a stationary bike or rower.

#5. The answer to the above , I can't afford it (once again)

My answer: Do you have dish or cable TV? If yes, get rid of it and use the money to invest in some excercise equiptment.

#6 I have to get dinner ready for the family (This is the South afterall)

My answer: Tell your husband to cook at least two working days of the week. (If not, he's a loser..just kidding)

#7 I am just too tired to excercise.

My response: Your energy level will get better as you lose weight and get more excercise. Your sleep will improve and you will need less sleep.

#8 But Doc..I'm on my feet all day. That's excercise.

My answer: No it is not.

it goes on and on. You can see why most docs don't even bother after a 20 minute session like this.
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Old 06-23-03, 11:06 PM   #3
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Originally posted by cbhungry

it goes on and on. You can see why most docs don't even bother after a 20 minute session like this.
And you can add, "in the amount of time it took for you to argue excuses with me, you could have almost had a decent day's workout."
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Old 06-23-03, 11:14 PM   #4
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I could solve my problem of the excessive weight only after I started to to commute by bicycle every day.

I had been running in the morning, going to gym for years, but it did not help much.

There were days when I really had no time.

But this inevitable 15 km commute every day did the job. I look like a human again more or less. I am not there yet, but I see that it works already. Besides I enjoy the bike commute.

Strangely I like most cycling in winter, when there is snow. The bike is very clean in winter, there is less traffic, and no dust (one needs special tires in winter).

So I would say: exercise + bike commute.
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Old 06-23-03, 11:24 PM   #5
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So I would say: exercise + bike commute.
I gave up on that line when most people looked at me aghast with shock. Their answer: Are you trying to kill me? It's too dangerous!

Oh well, at least I tried. One of my other favorites I forgot to add was

But I will sweat!

My answer: You are supposed to or else your core body temperature will overheat and you will have a heat stroke and possibly die.

They are not too amused by that response unfortunately.
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Old 06-23-03, 11:38 PM   #6
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Originally posted by cbhungry
I gave up on that line when most people looked at me aghast with shock. Their answer: Are you trying to kill me? It's too dangerous!

Oh well, at least I tried. One of my other favorites I forgot to add was

But I will sweat!

My answer: YOu are supposed to or else your core body temperature will overheat and you will have a heat stroke and possibly die.
They are not too amused by that response unfortunately.
Indeed commuting is dangerous, especially for the weak beginner. One has to come to it.

For some reason the toxic exhaust, which fills our cities, is considered to be OK. But harmless sweat is a "catastrophe".

I think people should accept themselves for what they are. Following the normal hygienic rules solves the "sweat problem".
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Old 06-23-03, 11:47 PM   #7
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Originally posted by Max
For some reason the toxic exhaust, which fills our cities, is considered to be OK. But harmless sweat is a "catastrophe".
What's worse is that the same people who would complain about sweating during a bike-commute end up sweating just climbing the stairs at work. If they got out more and exercised, it's unlikely they'd break out into a sweat just to walk to the cafeteria for lunch.
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Old 06-23-03, 11:48 PM   #8
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Originally posted by Max
Indeed commuting is dangerous, especially for the weak beginner. One has to come to it.

For some reason the toxic exhaust, which fills our cities, is considered to be OK. But harmless sweat is a "catastrophe".

I think people should accept themselves for what they are. Following the normal hygienic rules solves the "sweat problem".

So true. Of course most athletes consider sweat clean and natural but for those unaccustomed to excercise, it is strangely seen as pathological as you stated. How perversed and skewed are modern man's perception of his body and the environment!

Regarding biking in the winter, when I lived in New Hampshire I did not own a bike for two years and lived 8 miles from campus. It was nice biking in every day, even in the iceand cold as you stated. (And this is coming from someone raised on the equator!) I had a very old steel 10 speed bike at the time so I think the weight alone gave me a good coefficient of kinetic friction so that I wasn't all over the road! In addition, when it snowed heavily, I cross country skiiied into town. wow what a work out that is! It was very peaceful and beautiful.

Take care. Good talking with you, it is now 1:40 am here and I need to get up in a few hours. Chow.


By the way
Quote:
What's worse is that the same people who would complain about sweating during a bike-commute end up sweating just climbing the stairs at work. If they got out more and exercised, it's unlikely they'd break out into a sweat just to walk to the cafeteria for lunch.





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Old 06-23-03, 11:59 PM   #9
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For so many people these days, it's far easier to take a prescription drug than change lifestyle. My parents are examples of a lifetime on prescription drugs because they led less-than-active lifestyles (my mother particularly), and I really, really don't want to end up like them.

I fronted up to a doctor two years ago who assessed my cholesterol levels to be a little high. He prescribed some fantastic new drug to reduce the levels. It had side-effects I did not like and I stopped taking it before the first course finished. I cut down on the intake of animal fats and kept on cycling instead. I'm still alive two years later and my blood pressure has reduced from 120/80 to 110/70, plus my resting heart rate has gone from 72bpm to just above 60.

It's difficult for cycling (and other physical activity) to compete against the easy-fixes such as that new-fangled pill that is supposed to melt fat away so you don't have to exercise, and you can keep on eating as much rubbish as you like.

Beside, I hate seeing my money disappear into the pockets of a multinational drug company (or oil company, or car company, or bank).

Give me a green prescription every time. It's better for me... and probably makes me out to be a tight-@ss. Oh well, I'm a happy and healthy tight-@ss!

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Old 06-24-03, 04:54 AM   #10
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Cholesterol can be a litttle tricky. I have mountaineers, runners and bicyclists on cholesterol meds if it is genetic. If your Lp(a) is high or your LDL subfractions are of the B or A/B type, it can be very hard to lower it even with aggressive measures. Triglycerides, HDL and LDL subfraction A are easily modified by diet and excercise. Remeber Jim Fitz the marathoner who died of a heart attack at 43 and autopsy showed 90 percent blockage of his left main artery. His LDL was over 300 despite being fit,thin and ate right. He did not take meds despite urging from his docs. THEre is a runner who ran 60 miles a week, resting heart rate of 38 and bp of 98/60/ His Lp(a) and LDL levels were skyhigh for years. He refused the meds until one day after he ran the peachtree race his legs swelled up. He ended up having ischemic cardiomyopathy and now one bypass and implantable biventricular pacemaker later, he is back to running 60 miles a week but does not win races anymore. He is also on Pravachol to prevent restenosis since he is only 40. But in general, this case is not common but at the same time it is not uncommon. Have your cholesterol checked again after the lifestyle changes just to be sure.
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Old 06-24-03, 06:35 AM   #11
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I think what could help is if the doctors themselves would exercise and see what the health benefits are- then maybe they'd be more aggressive with perscribing exercise instead of perscription!

While I was at the Y on the northside, I met a doctor who was an enthusiastic exerciser (cardiologist), and we tried pretty hard to get other doctors in to do exercise- we even tried to put together a "Doctors only" spin class, but we couldn't ever get any doctors to come in for the class.

At one of my other clubs, there was a doctor there who was also a cardiologist-and one of the best cyclists I've ever met. He lived for cycling, running and weightlifting-he has one of those perfect cycling bodies- thin, but muscular, and tall- but not too tall. Oh, and one of the most humble, sweetest guys you could hope to meet. He is one of the most athletic people I know, and he could FLY on his bike- averaging about 30 miles per hour, and this was his AVERAGE... and with a healthy eating lifestyle, there's no way you could tell he was in his 40s. He spends quite a lot of his time advocating exercise to his patients, and when his patients see how fit he is, and how happy he is from just generally leading such a healthy lifestyle, I think he really makes an impact on them, and provides a good example of what exercise and healthy eating can do for you.

CB you never sleep! Do you know very many doctors that actually exercise themselves?
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Old 06-24-03, 06:45 AM   #12
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Do you know very many doctors that actually exercise themselves?
Of course I only gravitate towards those that do. A thoracic surgeon I know does alot of road rides, a fellow internist bikes 200 miles a week and attends spin classes with me, another anesthesiolgist does pilates and runs, etc. But I would say those who excercise as much as I do comprise twenty percent of the doctors I know. It is hard with our schedules but it is no excuse. It basically means prioritising and getting used to less sleep. (i went on a long moountain bike ride yest evening so had to make up for it with extra work in the wee hours of the morning after i got in some quality play time with daughter and husband).
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Old 06-24-03, 06:58 AM   #13
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Oh my Gawd, you mean I've gotta Sweat?


I'd recommend suggesting that patients look for
stationary bike at yard sales, Lots of folks buy em
and then use em for clothes racks, eventually sell them.
Also can find cheap ones at Goodwill etc.

CB, one important thing here, Unless the patient actually
wants to change lifestyle (no matter what the EKG, SMA23
etc. says) you can talk till you're blue in the face and
it goes in one ear and out the other (unless it gets lost
in that vacuous cranial cavity).

Its funny how patients can find excuses even when facing
an EKG with ischemia and other anomolies.

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Old 06-24-03, 07:03 AM   #14
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Originally posted by lotek
Oh my Gawd, you mean I've gotta Sweat?


I'd recommend suggesting that patients look for
stationary bike at yard sales, Lots of folks buy em
and then use em for clothes racks, eventually sell them.
Also can find cheap ones at Goodwill etc.

CB, one important thing here, Unless the patient actually
wants to change lifestyle (no matter what the EKG, SMA23
etc. says) you can talk till you're blue in the face and
it goes in one ear and out the other (unless it gets lost
in that vacuous cranial cavity).

Its funny how patients can find excuses even when facing
an EKG with ischemia and other anomolies.

Marty
Your'e right, it is similar to quiting smoking....unless someone has made up their minds, all the data thrown in their face does nothing. However, I think it doesn't hurt to keep trying. Hopefully, one patient will say, "yeah, my doctor kept telling me to quit smoking/excercise more/ eat less etc. " so I finally did it. This has happened on rare occassions and can be quite rewarding but they are so few and far between it gets frustrating sometimes.
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Old 06-24-03, 09:08 AM   #15
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Originally posted by cbhungry
...
This is a typical example of excuses.

#1 I don't have time doc, I work up to twelve hours a day.
...

I saw my favorite response to this excuse on a running discussion board that I belong to:

"If you slept last night, then you had time to run."

I have found DOs to be much more likely than MDs to know about and discuss exercise, diet, and other "lifestyle" sort of health topics. The sterotypical MD starts scribbling on a perscription pad after a 5-10 minute conversation. I have even heard of one MD describing a daily 3 mile run as excessive. This reduced his patient (a longtime runner who has no trouble running a sub-20 5K) to stuttering. DOs on the other hand seem to be less inclined to suggest drugs as a first resort and tend to be more knowlegable about even "fringe" topics like supplementation, stretching, bio-feedback, food additives and the like.

I don't know exactly what makes a DO different than an MD but they seem to behave differently.

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Old 06-24-03, 09:53 AM   #16
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Originally posted by cbhungry
Your'e right, it is similar to quiting smoking....unless someone has made up their minds, all the data thrown in their face does nothing. However, I think it doesn't hurt to keep trying
Wow! Some sure do have their minds made up about things! Maybe we have some common ground here, I'll keep trying too!

This article just repeats what I've posted many times, that the medical benefits for cyclists far outweigh any risks they may encounter.

On "Culture of Fear" I posted "The British Medical Association has said the benefits of riding a bike outweigh the risks by a ratio of 20 to 1.

The American Medical Association concluded: "Even after adjustment for other risk factors, including leisure time physical activity, those who did not cycle to work experienced a 39% higher mortality rate than those who did."

The Harvard Center for Risk Analysis says the risk of death for heart disease is 1 in 397, a motor vehicle accident is 1 in 6745, and for a bicycle acident is 1 in 376,165."

On "Confessions of a helmet hater" (Confesions of a Helmet Hater)

I posted a photo of someone having the "paddles" applied (presumably after his heart stopped) and said "...and for every cyclist there, you'll see 1,000 of these. (let's keep things in perspective) cardiovascular disease accounted for 79,389 Canadian deaths, and the average yearly death toll for cyclists in Canada according to Health Canada - 70.


on "light not heat" (light not heat)
I posted, I also agree with Canadian physician Thomas J. Demarco when he says Whenever someone chooses to cycle rather than drive, both personal and public health benefit. Cyclists, therefore, are allies of the medical profession. We should be doing all we can to encourage the activity. Increased participation in this activity would not only benefit the national health and environment, but also would contribute significantly to road safety. Cycling is not a problem -- it is a solution.

I've posted fatality stats by Failure Analysis Associates, Inc. found on the Bicycle helmet safety Institute website where tht show cycling is safer than living! A good explanation for this can be found at http://kenkifer.com/bikepages/health/risks.htm where Ken says, "Based on these figures, bicycling is nearly six times as safe as living! What does that mean? It means that the risk of dying from some other cause (more about these other risks later) is six times as great as the risk from bicycling on an hourly basis, even though we face these other risks 24 hours a day, not just the one or two hours that a regular cyclist would spend on a bicycle."



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Old 06-24-03, 10:48 AM   #17
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Another problem -- doctors are not reimbursed by insurers for exercise training. And drug companies spend millions to promote medicines and train doctors in their use, but no one does the same thing for exercise, Thompson said.
That was in the article. Kind of an interesting take on part of the issue.
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Old 06-24-03, 10:49 AM   #18
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Originally posted by DanFromDetroit
.....DOs on the other hand seem to be less inclined to suggest drugs as a first resort and tend to be more knowlegable about even "fringe" topics like supplementation, stretching, bio-feedback, food additives and the like.

I don't know exactly what makes a DO different than an MD but they seem to behave differently.

Dan
I love DOs. I work with quite a few of them in the community. They have gotten a bad rap because historically, it has been easier to gain entrance into a DO(osteopathic) medical school vs. Md (allopathic) medical school. However, keep in mind they study the same material and have to pass the same medical boards!!!

They include in their treatment of patients the concept of manipulative therapy and adjustements as an adjuvant therapy. (Similar to chiropractors but with the the other medical, clinical background).

How allopathic medicine superseded oseopathic medicine in this country was very political an has nothiing to do with the quality of sevices they provide.

Currently, allopathic medicine emphasizes a strong research focus and hard science focus while osteopathic medicine concentrates on holistice, preventative medicine but both cross sides often enough. (Ie: I know DOs that do hard line neursurgical research etc. and mds that concentrate on alternative, preventative medicine.) I like to incorporate both.

I believe in England, most of the docs are DO's.

Here is a link. http://www.aacom.org/om.html
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Old 06-24-03, 01:37 PM   #19
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The National Center for Health Statistics reported in May that a quarter of all Americans get virtually no exercise. Only 19 percent engage in a "high" level of physical activity.

Heart disease is the No. 1 killer in the United States and other industrialized countries, killing more than 700,000 Americans a year.
81% of the population are slowly killing themselves. Compare this to traffic fatalities (a mole hill in comparison) and we can see where we can best spend our efforts to save the most lives.

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Old 06-24-03, 09:38 PM   #20
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Originally posted by cbhungry
Your'e right, it is similar to quiting smoking....unless someone has made up their minds, all the data thrown in their face does nothing. However, I think it doesn't hurt to keep trying. Hopefully, one patient will say, "yeah, my doctor kept telling me to quit smoking/excercise more/ eat less etc. " so I finally did it. This has happened on rare occassions and can be quite rewarding but they are so few and far between it gets frustrating sometimes.
Hey everyone

I reckon it's just great since cb came on to BFs. Good advice, right there from a qualified practitioner. A greeat asset for us all, cb.

Anyway, I'll take on board what you say about the cholesterol. Pravachol was the prescribed drug.

However, as to the quote above... a long time ago, a GP said to me: There is a certain inevitability about smoking. It will kill you in the long run." It almost did some 15 years later. So chalk me up as someone who finally did listen to the doctor and his body.
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Old 06-24-03, 10:18 PM   #21
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Originally posted by closetbiker

This article just repeats what I've posted many times, that the medical benefits for cyclists far outweigh any risks they may encounter.

"The British Medical Association has said the benefits of riding a bike outweigh the risks by a ratio of 20 to 1.

I can not agree more.

Still cycling has its risks. If, say, an obese person wants to start cycling it is for sure risky for him/ her. The center of gravity would be high and consequently the risk of crash also high.

One should start cycling, and especially commuting, only step by step with understanding the risk and its nature.

I know personally one lady, who went to the aerobics class and had her muscle torn during the first class. She spent month in the hospital. They removed that muscle from her leg during the surgery, and this changed the appearance of the leg permanently.

So any activity has its risks. But usually there are safety techniques for any activity too. For example kayaking is very healthy sport, but without some learning one will be lost.

I would recommend cycling with the additional clause that one should also read and learn about such things as dooring, right cross, night cycling, etc.
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Old 06-25-03, 02:34 AM   #22
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In my office, there are some people who simply refuse to take the stairs even if they are going one flight up. NO WONDER THEY ARE FAT.

In my office there are some people who SMOKE at every opputunity they get.

In my office there are some people who apply for a gym membership, and never show up AT ALL...what a waste of money!
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Old 06-25-03, 08:05 AM   #23
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cbhungry- what would you recomend as a good amount to ride to someone who is in their 30's and in decent shape?

I try to get out as much as I can but, like most people, often don't have time(yea, yea I don't wanna hear it)

I rode about 11 miles on Thursday 3 of which were uphill on gravel, 20 miles on Sunday 9 of which were uphill and the 11 mile ride again on Monday. I'll be doing the 11 miler again on Thursday. This is mountain biking not road riding.

is there a way to tell if I'm doing OK without buying alot of equipment like a heart rate monitor and other electronic devices?

my thought is, any exersice is better than none..... but any suggestions would be great.

thank you
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Old 06-25-03, 09:45 AM   #24
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Pnj-

In order to access how many times a week someone should be riding, we first have to know what your goals are. Are you trying to burn fat? Are you doing it for health reasons? Races? How much have you cycled before? Are you new to cycling or exercise? How is your nutrition?

If you answer those questions, it may be easier to answer your other question. And while on this topic, you will definitely generate a better response if you take that exact post and create a new thread in the "Fitness and Nutrition" section of the forum instead.

Good luck!

Koffee
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Old 06-25-03, 09:59 AM   #25
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thanks Koffee, will do.
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