Physician: “OK, Mr. Jones, your cholesterol and blood pressures 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?”

Consider a different scenario:

Physician: “OK, Mr. Jones. It seems your cholesterol and blood pressures 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 the pharmacist dispenses it. Recommending exercise should be no different. From my perspective as a nurse practitioner in primary care, there are five requisites for a happy, safe, painless, injury free, and gratifying exercise experience:

1. 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.

2. 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.

3. 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.

4. Again, if you were preparing to bake a delicious dessert, you’d need to warm up the oven. So too you need to warm up your muscles. Expecting muscles to perform at a higher level of function than daily use stresses muscle fibers risking injury. Try a brisk walking pace prior to running, gentle stretching or starting a weight training session with light weights before bench pressing 100 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. This helps relieve and get into circulation the metabolic by-products of intense muscle activity resulting in less soreness the next day.

5. Finally, ask your health care provider what exercise he/she engages in. What would be the point of complying with recommendations without a role model?

Questions regarding specifics to the above are always welcome. Happy exercising!

• 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 Her website is

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