January 25th, 2008

ozarque figure

Eldering; deconditioning....

Thank you for all your comments and responses; they are very much appreciated.

I'm a bit frazzled this morning -- worn out from being so cold all the time for so many days in a row -- and can't promise you sparkling prose. [This is part of being 70; all my life I've been indifferent to cold. I used to wait only till I was out of sight of my house on my way to school and then take off my coat and mittens and whatnots; when I was living in the dorms at the University of Chicago I found them so overheated in the winter that I used to go sit outside on the steps just to get a break from the tropical atmosphere. But this winter has been different for me, and the cold is getting to me; next year, I'll know what's coming and I'll have taken steps to be better prepared to deal with it. However, things are looking up! Starting tomorrow we are promised a "warming trend," with temps on Sunday in the 60s, and the obligatory trailing thunderstorms. I am therefore expecting to be in a much better mood by Monday, as long as nothing important blows away.] Anyway, befrazzlement seems like a good state in which to post again about elders and deconditioning; having done it before (and lost it), I should find it easier than writing something entirely new.

"Deconditioning" is a term that refers to steady and progressive -- and astonishingly rapid -- loss of muscle strength, muscle tone, and similar measures of fitness, caused by inactivity. It happens to astronauts; it happens to people confined to bed, which is the reason caregivers now make patients get up as quickly as possible after surgery. And it happens to elders who aren't active enough. Often the result is a loop: The elderly person is inactive because of physical problems that make activity uncomfortable, the inactivity causes physical deterioration that makes the physical problems worse, and there you go ... round and round the loop, and always downward.

My mother was a classic example of this phenomenon. When she was roughly my age, she would get up in the morning, sit down with her knitting or reading in front of the television set, alternate that with knitting or reading while lying on a chaise longue on her screened porch (when it wasn't cold out there), and do nothing else except for meals and bathroom breaks until it was time to go to bed. She had a lot of friends; when they stopped by, they would all sit and talk. She enjoyed herself enormously, and a good time was had by all. And her position on the matter, when we tried to get her to do some kind of exercise, was as follows: "I have worked hard my whole life long, and if I want to just sit and enjoy myself all day now that I'm old, I've earned that privilege -- and that is what I am going to do."

She was right. She had worked hard all her life, and she had certainly earned the right to just sit there and read or knit or nap or entertain her friends or whatever else she fancied, many times over. The logic of that claim was unassailable, and she would not budge from her position. But that regime was the worst possible thing for her health and well being. It made her weak and frail, it made her aches and pains progressively worse, and there was not one single thing her doctors could do to keep that from happening. It was a sorry situation, and all of us who loved her were at our wit's end about it, year after year.

The only way anyone knows to keep this from happening is to start a regular regime of exercise, at least half an hour a day and at least five days a week, while you are still young, and keep it up for the rest of your life. If you have physical limitations while you are still young, get some expert advice so that the exercise you choose isn't something that will injure you. If you are no longer young, it's even more important to find a way -- with expert help if necessary -- to stay as active as you possibly can. And I would suggest that research in sports medicine has demonstrated that even when you have the misfortune to be totally unable to do "real" exercise, you can accomplish a great deal of good for yourself by the vivid and detailed "visualization" -- involving all of your sensory systems, not just your sight -- of an exercise of your choice.

The temptation to just sit there will be overwhelming; I suspect that it's even harder to resist today, when you can say to yourself, "Well, all right, I'm just sitting here -- but I'm not just lollygagging around. I'm sitting here at my computer [or desk, or easel, or piano, or... ] working! That's different!" Sadly, where deconditioning is concerned it's not different enough.

The silver lining in this particular cloud is that deconditioning is one of the problems of old age that you can actually do something about.