Let’s Get Physical by Amanda Taka

With the festive season looming towards us, the last thing you want to be told is to get physical right? However with 8 weeks to Christmas, we still have plenty of time before we carve the turkey. The Physical Activity Guidelines for adults recommend that we build up to 30 minutes of moderate intensity activity 5 days out of 7. But how do we fit this in to our busy working lives? And is it worth the effort?

We’ve all heard of the benefits of exercising, but here’s a recap:

Regular exercise:

  • reduces the risk of many diseases such as type 2 diabetes, coronary heart disease and stroke
  • helps us to maintain a healthy weight
  • improves our self esteem
  • promotes a sense of wellbeing
  • reduces symptoms of depression and anxiety

Working in the NHS we can’t fail to be reminded of what we should be doing and why. However, being ready, willing and able to make those lifestyle changes can be another matter.

Amanda 1And before you write me off as one of those typical fitness fanatics, let me tell you a bit of my story. At school I was always the last to be picked for team games, I didn’t learn to swim until I was 16 because I was frightened to put my head under water, I hated PE and used to hide in the Geography block toilets to avoid detection. My Mum and Dad told me to stay as I was because playing squash and golf gave you a heart attack. My Dad’s motto was ‘built for comfort not for speed’. They were both overweight and although I wasn’t, I always knew I would be too because that’s what happened to us in our family. And so it would have gone on if I hadn’t returned to Uni and trained to be a nurse.

Anyone who has trained to be a nurse knows that it changes you. It changes the way you look at people, the way to speak to people and the way you react to people. Furthermore, it challenges hard held beliefs and preconceptions. Studying at UWS under the influence of Julie Orr and her colleagues, I began to see that getting older doesn’t need to mean that we inevitably get bigger and slower. I realised that the ability to change was within me and additionally I had the power to influence my young daughters’ long term health.

This Eureka moment happened to me in the middle of one lecture towards the end of my training. Julie was telling us about when she was doing her Masters and how she fitted it into family life “and I still went to the gym three times a week” was the phrase that hit home for me. Like a bolt of lightning I realised that I needed to make physical activity a priority for me. I started to take up yoga again – something that I hadn’t done regularly since I’d had my children. Slowly I began to build physical activity into my day, feeling very smug about it too thank-you very much.

After qualifying, I got a job on a fast paced 22 bedded respiratory ward. Working full time was enough to achieve my 30 minutes a day. Life doesn’t stay static though, and I moved to a 6 bedded Coronary Care Unit. My daily steps dropped, my waistband started to feel a bit tighter and I put half a stone on. I realised that I had to change tactics. I began to walk into town on my days off, I got myself a Fitbit and tried to do 10,000 steps a day, challenging nurses on other wards inspired my competitive streak. Obviously when you put physical activity first, other things slide. I won’t be winning any Good Housekeeping awards imminently and I don’t have time to watch TV. But as I see it, the benefits outweigh the costs.

Then earlier this year I left Coronary Care and moved to the Keep Well project here in Dumfries and Galloway. Keep Well is an anticipatory person-centred service that aims to reduce health inequalities. Part of this role involves delivering brief interventions for physical activity. I started to see that the guidelines weren’t going to be achievable for everyone – like the 64 year old lady who had to use a wheelchair because of her COPD. In that case, the message is do what you can, keep doing it and try and build on what you can do. Most of my clients with long term conditions are very aware of their limitations and they know better than I do, what is achievable for them.

Amanda 2Changing from a shift based work life to a ‘normal’ 8.30 to 4.30 job required further readjustment to my physical activity routine. Covering the whole of D&G has found me spending large amounts of time in the car. But the advantage is that I now have my weekends free and I make sure I do something active with my children. But I was struggling to do something on week days. So I started a 90 day Yoga challenge – 30 minutes of aerobic yoga for 90 days. The only time of the day I could fit this in was before everyone else got up. I found that I was so used to getting up at 5am to go to Carlisle that doing yoga at 6.30am was achievable for me. In all honesty, I haven’t made it onto my yoga mat every single day because sometimes life gets in the way, but I didn’t beat myself up because I knew that tomorrow was another day.

Now I realise that getting up at 6am to exercise isn’t going to work for everyone. So, I suppose the main message I’m trying to share is

  • Find an activity that you enjoy
  • Small changes really make the difference if you do them often enough
  • Give yourself permission to exercise – no one else can do it for you
  • Don’t give up if you miss a few days/weeks/months. Life gets busy and big events sometimes engulf us.
  • Set a SMART goal, running the London marathon next April is not appropriate for everyone. Parking the car as far away from the office 3 days a week could be more achievable.

As the largest occupational group in Scotland, we nurses are in an incredible position to reach a huge number of people. If we start with ourselves, this will ripple out to our families, our communities and ultimately to the Scottish population.

Lesley Fightmaster Yoga Fix 90 – 90 day to build a healthy habit https://www.youtube.com/watch?v=ArZDT5zXSR0

Amanda Taka is a Keep Well Nurse based in Public Health, Crichton Royal Hospital and a Coronary Care Nurse with North Cumbria University Hospitals NHS Trust.

Amanda 3

Be Willing to Make the Change by Sylvia Crosby

Sylvia 1Having always been a “Border Collie” person and admiring their qualities – attractive, loving, caring and hardworking, I was never very keen on Black Labradors and felt them to be a bit slow and boring ( we admire the traits in our pets that we aspire to in ourselves).

However, after spending a few months on Isle of Islay, escaping the rat race of the mainland, we felt the need of a new 4 legged addition to the family and, through a series of circumstances, and not many puppies available and a potential owner who may have had too much whisky to look after a new puppy, we became the proud owners of a Beautiful Intelligent Labrador puppy who turned into one of the most lovely, caring and attractive dogs we have ever had! !

Sylvia 2So lesson learned and we CAN learn to ignore our lifelong prejudice and accept new thoughts and ideas.

In the World of Physiotherapy, much has changed since I started twenty something years ago, when there was no waiting lists and no computers and lots of electrotherapy (which is still relevant, evidence based but out of vogue). We heated, microwaved and pulsed electric currents of various voltage , type and intensity, lots of exercise therapy and lots of time for group exercise ( which is still relevant but again less fashionable than in the past) and patients got better.

Now we embrace a world of statistics, computers, waiting lists, and are welcoming Manipulation, T’ai chi, Acupuncture and Craniosacral therapy into our treatment plans to name just a few. The new Electrotherapy treatments include Laser, Shock wave therapy and Electroacupuncture, which all have a VERY definite evidence base . And Exercise Therapy remains our constant for everything from Major Heart surgery, MS, and Orthopaedics to an effective treatment for many mental illnesses.

Sylvia 3Hopefully we will continue to embrace change while still holding onto our Core Values, (following a recurring theme in these blogs) and at all times put the patient first in all our patient contacts and treatments to provide a service which embraces the Best of the Old with the Challenges of the New. 

 

PS I now have a Collie/Labrador cross!

Sylvia Crosby is a Senior Physiotherapist at Moffat Hospital