Frustrated with PCP

[smnc2002]

Hi Everyone,

I went to my PCP yesterday for a 3-month checkup for my blood pressure. She noticed that I have gained 11 pounds since October and ask me what has changed. I told her nothing that I can think of. She asked me if I am taking any medicine that could affect my weight. I told her my neuro had started me on Paxil a little while back and I was told that that can make me gain weight (she has had it listed on my computer chart for months that she was reading while asking the questions).

She then said we have to figure out a way for me to lose weight. I asked about any safe diet pills (I knew there are no really safe diet pills before I even asked) and she said there aren't any.

I then told her we are thinking about getting a treadmill and she said don't waste the money unless we are going to run on it, because otherwise it wouldn't do any good.

She then said an elliptical machine is what we would need, because it basically works your whole body at one time. I reminded her that with the MS, my arms and legs get fatigued and heavy very easily. She said even if I do it for like 15 minutes 2 or 3 times a day that would still be about 45 minutes a day.

I left there feeling so depressed and was like that the rest of the day. She just doesn't get it. Once my arms and legs get fatigued and where they feel heavy like that, it doesn't just go away in a few hours.

Is it just me or should I not have gotten upset by this? I have always had the feeling that my PCP doesn't really believe that I have MS. I am seriously considering changing doctors. Not that I wish MS on anyone, but it would be nice if I had doctors who have MS so that they would understand how I feel symptom-wise.

Sorry for the long post, but had to get this off my chest. By the way, I am feeling much better today...not depressed anymore.

Hope everyone has a wonderful and blessed day!

Hugs,

SMNC

[SNOOPY]

Hi smnc2002,

Everyone will have a different opinion, even doctors, about what exercise is best to do. It is important to exercise within your abilities.

I have had an Elliptical for a few years and love it. There are Ellipticals that have stationary hand hold/bars so you are only using your legs.

I had a treadmill for many years and will disagree that they are a waste of money unless running on it. I walked many miles with that treadmill and I loved it.

Unfortunately, when my leg(s) would decide to "lock" and the belt would keep going the treadmill became unsafe for me to use. That was when I went to the Elliptical.

[wkikta]

A Treadmill can be fantastic for walking exercise, you don't have to run. Running can actually be bad for you, lots of stresses on the Legs. One problem with the Treadmill is that it sets your pace, can be dangerous if you suddenly stop, it doesn't. Slow walking outside or swimming can be best for Low Impact Exercise.

[Toomnyhats]

Your PCP doesn't seem to "get" the MonSter at all! If it were me I would consider getting a new PCP.

As for a treadmill, you can set the pace. And the newer ones have a safety "switch" - from the pictures I've seen it is something you clip to your belt. If you fall the cord is pulled, turning off the treadmill. If you get a treadmill make sure it has this safety feature.

It's January now, wait a few weeks & you should be able to pick up a "used" treadmill for a good price

[SNOOPY]

One problem with the Treadmill is that it sets your pace, can be dangerous if you suddenly stop, it doesn't.

That's what would happen when my leg would lock and I considered a treadmill no longer safe for me.

Toomnyhats:

And the newer ones have a safety "switch" - from the pictures I've seen it is something you clip to your belt. If you fall the cord is pulled, turning off the treadmill. If you get a treadmill make sure it has this safety feature.

As far as I know all treadmills have safety keys such as you described. Mine had one and I always used it.

Even with the safety feature I got hurt. I pushed the wrong speed by accident (MS moment) and it was faster than I could handle.

I was trying to hold on for dear life so I would not go down on the moving belt. I was unable to hit the string to dislodge the safety key because if I let go I would not be able to stay up right.

I finally decided to take my chances and with one hand/arm sustaining my entire self on a fast moving belt I knocked the string and the treadmill stopped.

Fortunately, I did not end up down on a moving treadmill but unfortunately, the arm that had to keep me upright got hurt. I had a partial rotator cuff tear.

So, if you don't have problems with your legs doing what you want them to do and you don't have any cognitive problems the Treadmill would more than likely be fine otherwise the treadmill is not a good idea.

[Redwings]

Hi smnc2002:
I have to agree that what your PCP said about walking on a treadmill doing no good is odd. Walking is the one simple exercise that's universally recommended by doctors and healthcare advocates. The assertion that a treadmill somehow undoes all of the healthful things walking does, and that only running on one is worthwhile, is just strange. Even low-key exercise has been found to be good for health and good for alleviating depression.

I also agree that if your PCP doesn't understand MS and gives you grief about it, you should change doctors. I had to change PCPs for the same reason. Heck, I even had to change neurologists for the same reason!

Since some antidepressant meds are more likely or less likely to cause weight gain, it's apparent that the weight gain isn't all due to just the effects of diet and exercise. (Paxil is one that's more likely to cause weight gain.) WebMD has a nice article about the subject:
http://www.webmd.com/depression/feat...ts-weight-gain

The WebMD article says that up to 25% of people who take antidepressants gain weight. But I've also read several other sources that put that figure as high as 50%. Not all of that is because of poor diet or exercise. While the article addresses the effects of diet and exercise on weight gain due to antidepressants, it also recognizes that sometimes the effects of the meds go beyond that: "There are clearly some people for whom certain antidepressants are essential, even though the impact on their weight can be so strong that it simply can't be offset by any amount of calorie restricting or even exercise. It just doesn't work." And: "You have to recognize that the weight gain is not your fault and that what you are doing to help overcome your depression is far more important."

[jumpinjiminy]

At the PT office, they started me on a recumbent cross-trainer. It was a very nice way to work up the endurance in the arms and legs before adding in the elliptical. Maybe there is a PT office or fitness center around where you could try out this type of equipment before making an investment?

Swimming is great cardiovascular exercise and something I love to do in the summertime, but overall doesn't burn as many calories because of the buoyancy factor. Imagine lying on a bed and waving your arms and legs around. That's probably a bigger calorie burner than swimming. Less gravity, less work. It won't be as fast of a weight loss as with other methods.

Interval training is a great calorie burner, if that's your goal. It starts with a good warmup, then a little cardio to get your heart rate in the working zone, followed by a little weight training to build muscle tone. Wash, rinse and repeat between the weight training and cardio until cooling down. The biggest energy burners on our bodies are the gluts and thighs. Building more muscle means a higher resting BMI which means you burn more calories just sitting.

The best helpers I've found for relearning how to exercise without sending myself to slug island for a week of solitary confinement is a good PT and an ice pack to use while exercising. Getting hot while working out does me in. Your mileage may vary.

Good luck to you. I can't believe a GP would discourage ANY form of exercise. Hmmm. My mom used to walk 3 miles a day on a treadmill. It was like her morning meditation. She would crank up her satellite TV, set her pace, close her eyes and just go. It looked like she was floating on air. It may not burn as many calories as running, but it's easier on your joints, helps build bone density, and boosts your mood. What doc wouldn't like that?

[MrsBones]

I'm going to look at this from the other side, just a different twist on it. Your PCP ( formerly known as a general practitioner for a reason) treats the average person for the average conditions. While they know what MS is, unless they have it, too, they are like the general public in really understanding what it means to live with it. I'm not saying the attitude is acceptable, but your dr was giving sound advice in the area of losing the weight. It just needed to be tweaked a bit.

The major concern here was losing the weight. You brought up getting a treadmill. To lose a single pound in a week, you must burn and/or reduce your total caloric intake (for that week) by 3500 calories, 500 per day.

http://exercise.about.com/cs/weightl...isegoals_2.htm

Now look at the following activities on a treadmill and elliptical . See how many calories they burn? Also, look at those same pages and see how many calories are in common foods.

Walking on the treadmill at 2 miles per hr, for a 150 lb person -170 calories per hr:
http://caloriecount.about.com/calori...-pleasure-a495
Running, 12 min mile, for 150 lb person- 544 calories per hour:
http://caloriecount.about.com/calori...d-running-a339
Elliptical, same conditions- 680 calories,per hour:
http://caloriecount.about.com/calori...l-trainer-a613

I suggest that the dr isn't saying that walking as an activity isn't worthwhile for its total health benefits, just that from the standpoint of needing to lose 11 pounds while taking a drug that tends to make you gain weight, it isn't the most effective exercise to go with.

Given that your dr doesn't understand exactly how the MS effects you individually (they should know the broad strokes of what MS is capable of), they can't realistically tell what you, again, as an individual, should do to lose weight, only what would be suitable for the general population.

Tell them that even 15 minutes at a time is likely too much. Give them very specific details of what your limits are. Ask about physical therapy that could help you with some symptoms like spasticity, weakness and fatigue that could be preventing you from doing various activities that would help with weight loss.

Once they have a better grasp of your limitations, they should be able to suggest a combination of diet changes and a suitable exercise plan, possibly some PT,that fit your abilities or refer you to someone who can.

[gomer]

Treadmills

When I was in P/T 5 years ago, They would have me on a treadmill, but, ONLY with a harness. I doubt home units have the proper hardware for a body harness. They can be DANGEROUS for MSers.

Gomer

[Shashi]

Last year, I bought a manual treadmill. The belt turns only when you walk on it, so if you stop, it stops. It would prevent you from being injured on it. I got mine on Amazon.com for about $120, and it even had a computer which kept track of the distance, calories burned, amount of time, speed, etc.

There is also a free exercise and a free yoga DVD you can that is specifically made for people with MS. It has three levels of exercise, depending on your abilities. Do a search for exercise and DVD here and you'll find the link to it.