Which scenario would you prefer?

Scenario one:

Physician: “OK, Mr. Jones, your cholesterol and blood pressure are too high. You need to take these medicines and get some exercise. Come back in a few months. Any questions? Good. Stop at the front desk to get scheduled.”

Patient: “Uh, er, a, yeah I do have a quest … where’d he go?”

Scenario two:

Physician: “OK, Mr. Jones. It seems your cholesterol and blood pressure are high. We’ve done a complete cardiac evaluation so I know that your heart and lungs are capable of handling some exercise and so are your joints. What do you think about walking outdoors or on a treadmill for about 10 minutes at a comfortable pace, three to four times a week? Would you be able to commit to that? You can always increase the intensity or frequency on your own when you feel ready, but please come back in four weeks so that we can reassess your progress and make other recommendations. Do you have any questions or concerns?”

Patient: “I’m ready to get started.”

When I write a prescription for a medication I must include who, what, where, when and how before a pharmacist can dispense it. Prescribing exercise should be no different. From my perspective as a nurse practitioner in primary care, here are five requisites for a happy, safe, painless, injury free, and gratifying exercise experience:

• Discuss with your provider the level of activity appropriate for YOU. If your goal is to finish next year’s Boston Marathon, make sure this is realistic and establish a plan to make it happen.

• Review current medications or conditions that may affect your exercise. Some medications affect heart rate and some antibiotics sensitize the skin to sunshine. Diabetic nerve problems in the feet may require a regimen built around swimming or indoor biking.

• Like a chef gathering ingredients for a masterful meal, make sure you have your ingredients for successful exercise. Proper shoes or other equipment, the appropriate amount of water, a small towel to mop up your sweat, and sun block for outdoor activities, to name a few.

• Again, if you were preparing to bake a delicious dessert, you would need to warm up the oven. So you need to warm up your muscles. Expecting muscles to perform at a higher level of function than that of daily use stresses muscle fibers, risking injury. For example, a brisk walking pace prior to running, gentle stretching, starting a weight training session with light weights before bench pressing a hundred pounds. One last cooking metaphor: Eating something right out of the oven will burn your tongue. It needs to cool first. Muscles need to cool down also. Consider stretching again or ending your run with brisk walking. This helps reduce and eliminate the metabolic by-products of intense muscle activity resulting in less soreness the next day.

• Finally, ask your health care provider what exercise he/she engages in. What would be the point of complying with an exercise prescription if there wasn’t a role model?

Any type of activity beyond your daily routine contributes to health and fitness. The most important thing to focus on is being active and less on what type of exercise you choose to engage in. The more activity you perform and the more variety of activities you perform the fitter and healthier you will become. Engage in exercise that you enjoy and find ways to incorporate more activity into your everyday life. Take the stairs instead of the elevator or park further away from work or stores. You will gain the most benefit from engaging regularly in activities that stimulate the cardiovascular system. The end result will be more muscular tone, more flexibility and a healthier heart.

To increase your metabolism experts recommend engaging in high intensity (to the extent you are able) short duration activities like interval training, sprinting, and heavy resistance training. This approach has been shown to increase lean muscle mass and promote the increase of innate hormones like testosterone and human growth hormone that help stimulate metabolism. Perform high intensity short duration training three times per week with at least one day rest in between sessions.


• Agnes Oblas is an adult nurse practitioner with a private practice and residence in Ahwatukee Foothills. For questions, or if there is a topic you would like her to address, call (602) 405-6320 or email aoblas@newpathshealth.com. Her website is www.newpathshealth.com.

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