Need advice for my wife
 

My wife got serious about her health around 2009-2011 she lost 100 pounds. She exercised all the time, and did lots of rides with me, we even did a couple of cycling vacations. in 2012 A combination of health and personal problems caused her to stop the healthy lifestyle. Things just got worse and she gained very bit of the weight back. Since then she's had carpal tunnel surgery, foot surgery, knee issues, and massive back problems.

I feel like she is on a medical industry treadmill, I don't need to go into more detail. Sometimes I feel like people like her are taken advantage of in the American medical system.

Last year I put together an e-bike for my wife as an attempt to get her to ride more. It worked some but summer of last year she had the foot issues and surgery and stopped.

The problem seems to be that every time we try some kind of physical activity the result is days of pain and misery. For example, Last week I talked into doing a pilates workout with me, seemed to go well, the next night we did a light stretching workout. Two days later she thinks she's going to need knee surgery and her knee is popping constantly.

So my question! She's at a loss of what to do, she's thinking of looking into medical weight loss and I don't know what to tell her. She claims that she's stuck in a feedback loop. Exercise = pain = depression = food = weight = excercise to infinity.

I'm sorry to read of your wife's difficulties. I'm not sure that this forum is the place to go for advice. Do you have a medical advocate associated with your insurance carrier? Maybe your GP can help you build a medical team (psychology, neurology, immunology, nutrition, orthopedics, etc.) to review the case. You might be looking at an inpatient program that includes nutrition, counseling therapies, occupational and physical therapies and other forms of treatment. Hers sounds like a fairly extreme case from the standpoint of interactions between her conditions and her lifestyle. I wish you well.

I'd say start Very slowly with the exercise---simple fact if she can't do five minutes of stretching without damaging herself, she should do a three-minute workout. Start with something non-stressful---there are a lot of good qigong styles that demand zero strength and balance and can help the body get back on track with itself.

A lot of this is mental, I suspect---fear and frustration expressed as exaggerated physical reactions. Qigong can help with that, or some counseling, ot even a good online chat room, so long as she can tolerate the rest of the stuff that comes with the rare gem of good advice.

Once she thinks she can exercise without getting hurt, she can try walking---five minutes every other day this week, ten next week, whatever. Do less than possible because a lot of the initial health benefit will be mental.

I understand the depression-food death-spiral, but if you can help her break that ....also a benefit.

Unless she has some whole-body degenerative disease, she can get healthier .... it might start really slowly, but it is simply physiology.

The mental aspect is generally overlooked. She can literally hurt herself due to feat and expectation of injury---tensing up and pushing a little too hard simultaneously, because part of her brain is trying to defend her, part is trying to extend her, and part is trying to convince her that disaster is imminent.

She really needs to get her head together if she wants her body to work. The brain is by far the most powerful organ.

Thats really rough and hate to hear it. The medical treadmill comment sounds like a lot of my wife's clients when she represented people for SSI, SSDI, and workcomp cases. Perpetual health issues...i only have sympathy and cant offer empathy or advise.

Hope someone in the medical field can help though.

I'd agree with Maelochs, here. Exercise shouldn't be so punishing and it sounds like she runs hot and cold. Getting healthy isn't supposed to hurt. It sounds like she is overdoing it and hurting herself, which tells me that a big part of it is mental.

Also, an anti-inflammatory before exercise may help.

I've been where she is, and unfortunately can point to no magic bullet. I can say that I had to get the massive weight loss started by drastically reducing the food I eat, losing a lot of the weight before I could really start a fitness regimen. Prior to the initial weight loss, my feet and ankles simply could not cope with the load when I tried to work out. Riding a bike 150 pounds overweight is no fun at all, and I wouldn't have been able to tolerate enough of it at that weight to actually burn much calories.

Weight loss surgery is a real crap shoot, and I never went that way. I know way too many people who initially lost weight after the surgery, then put on more than they ever had before but now with all kinds of new complications.

Weight loss can be a fickle thing to tackle but she did it once before and can do it again. I find that when my weight pitches up a bit, it comes back off very quickly. It's the fat that has been on me for 20+ years that is a bugger to shed.

We knew a couple and the wife had one of the stomach surgeries performed on her. She had been pretty large before we met them but had lost a lot of weight. Her doctors ended up having to reverse the surgery for some reason and she is right back to where she started. Sadly, she never changed her lifestyle and went back into how it was before so she really had no chance.

Taking vitamins, minerals and the supplements might help. I take a full regimen of vitamins and minerals daily along with MSM and glucosamine. It could be a placebo effect but my joints feel better when I'm taking them. Curcumin and piperine in combination are supposed to be a very good anti inflammatory combination.


Others have given sound advice too. Exercise isn't supposed to be necessarily enjoyable but it shouldn't be painful. Hope that you can find a balance.

I think we have to be careful about giving advice, and I try to limit my discussion of these things to describing what works for me, and maybe warning people off of stuff that I have good reason to believe is dangerous and/or harmful.

The reason for this is that all of the most recent credible research seems to indicate that there is no universal method that works for all or even most people--that it really varies at the individual level.

What worked for me initially was to weigh myself daily, try to keep a steady weight loss of about 3 pounds a week, and make changes to my diet if that rate stopped, slowed or reversed. I learned not to freak out about 1 day fluctuations because that's usually just water, but kept an eye on trends that seemed to be lasting more than a couple days.

I lost an initial 100 pounds doing basically just that, then lost another 50 or so through exercise.

thanks for the advice. I used to think a lot of this was in her head, but her spinal MRI confirmed it was not. Her weight loss system is pretty much the ideal model. She keeps a detailed calorie count, and limits calories and fat intake. But depression about her pain has knocked her off her routine over and over again.

I recently suggest she try a chiropractor for the lower back pain. I don't even believe in it, I just wanted her to try anything.

She is working 2 days a week, and does alot of walking. She has an appointment to try another spinal steriod injection soon. The first one did wonders and that's when she started walking again, around 2 miles a day, the result was the bone spurs and Plantar Fascitis surgery.

She got a referal for counciling from the clinic she goes to but they couldn't see her until late August.

As many of you have said I haven't heard much good from the gastric surgeries and want her to avoid that.

As far as bikes, a recumbent trike can be very low impact. And, perhaps add electric assist if desired.

Unfortunately, as you probably know, being 100+ lbs overweight can contribute to knee problems, foot problems, ankle problems, and probably back problems too. Diabetes?

One can diet with only minimal to moderate exercise. What the exercise likely gains is chewing up a few extra calories should one's diet slip a little. Plus, of course, the exercise helps push one from losing muscle to losing fat & maintaining muscle.

Be strict with calorie counting.

We had a couple locally who bought a tandem Terratrike (3 wheel recumbent) in order to ride across the country. He was fit and capable but she was overweight by a fair deal. They got out and rode, she lost weight and they ended up actually riding across the county. They were tooling around one day and passed the house, I called to them and we chatted for a bit.

The gist is that the recumbent trike was very useful as it takes balance out of the equation and affords ways of padding and adjusting to make the ride more comfortable.

Oh and the Plantar Fascitis. EGAD... I did a ride a few years ago and overdid it. My feet felt hot near the end. I got home, and kicked back for a bit of a nap. When I went to get up, the pain was excruciating. I had to have someone drive me to the local RX to get crutches. I would wish that onto no one.

One thing I think people who haven't experienced chronic pain don't automatically appreciate is just how easily it can lead to clinical depression. I never had the back problems, luckily, but my foot and ankle problems were severe enough that the chronic pain consistently interfered with my sleep. One of the myriad problems was plantar fascitis and another was a Morton's neuroma. It really is a vicious circle when the weight exacerbates the physical problems and the physical problems essentially curtail most physical activity. That's why for me, I had to focus fanatically on controlling my food intake for two years to get the initial 100 pounds off, at which point my body felt liberated enough from the weight burden to allow me to walk around without pain.

I don't know if this will be true for your wife, but I find that if I use platform pedals, my feet don't get messed up from riding no matter how much I do, and I've definitely tested that. I've done three rides of about 150 miles each in the last three weeks. I think being able to move my feet around prevents any particular spot on my feet from getting inflamed. I have every reason to assume clipless would wreak havoc with my Morton's neuroma (which never fully goes away without surgically removing the nerve), and that hasn't flared up in years of riding.

One year after the plantar fiscitis surgery her foot still hurts some.

She has categorically refused tandems, and I don't think she's got any interest in riding a trike or recumbent. We tried a tandem once, she didn't like not being in control and I'm not going to ride behind her LOL.

I think I'm going to try to get her on the ebike more.

Plantar fascia = using flat pedals in many cases

You don’t mention trying a professional trainer. The best ones are great motivators. Seems like a lot of the problem is attitude/psychological issues. Good luck!

Ouch. I've had plantar fasciitis. It went away but I still have foot pain from a turf toe injury that I likely need to go under the knife for. I can understand why your wife wouldn't want to exercise but she HAS to in order for the condition to fully heal, NOT stay off her feet. Stretching the calves is also mandatory otherwise the tendons will calcify again and the bone spurs will come back. Corrective shoes and special socks also help.

As far as exercise goes, something low impact like bicycling is actually ideal. Her not wanting to do it is just the depression talking IMO. She needs to talk to her podiatrist AND a therapist.

As for buying an e-bike, the simple answer is you need to slow down. That's a lot of $$$ for something she's going to refuse to ride and you going all hardcore is causing her to shut down, not be motivated. Baby steps. Take her out on a Saturday afternoon to someplace where there's a walking trail and a LBS that rents hybrids with a comfortable saddle. Keep the lycra shorts home and pack a lunch.

Another idea is to have her join the Y and have her use the elliptical trainer and take a water aerobics course. At the very worst she'll want to take up knitting or babysitting for side income.

Totally not my experience, but feet vary a lot.

In my case, it was definitely from walking while being very heavy.

One of the problems with it, though, is that recovery takes so long, trial and error isn't really practical.

You have to be super careful with this, though. Some of them are downright incompetent in dealing with injured people. Trust me, they can make things worse.

I was going to suggest this but PGHNeil beat me to it. Elliptical trainers are great low-impact exercise devices----recumbent stationary bikes are good to but the trainer works a lot more of the body. Yeah, I wouldn't want to go to a physical trainer. Some kind of counseling would be better indicated.

I am not going to go into the depths of my dark history but trust me, a delicate physical and mental state needs to be handled delicately.

The biggest thing might be knowing she has her husband;''s support, and that he will keep working with her until the downward spiral is reversed.

Another thing might be her knowing that she is not the first person to go through this, and a lot of other people have found a way back to health and fitness. She is looking a downward dip in her life, not a plunge off a cliff. If she and her husband keep making slow, gentle effort, she will bend her trajectory back upward. It is hard to have hope when more things seem to go wrong than well, but having hope is an important step to seeing things differently, which unlocks the brain and body to achieve at higher levels.

It is easy to get depressed and fall back into unhealthy eating habits "IF YOU USE FOOD AS A COPING MECHANIISM OR TO SELF MEDICATE." Somehow, she has to start seeing food as the medicine she needs to get well rather than something to feel better about not being well.

Get the diet right first and many of the other issues may get better or completely go away. As she starts to feel better, she can exercise more. Exercise is not her pathway to health, diet is.

Personally, I would not eat another processed food product. I wouldn't drink a soda or alcohol. I would consume only fresh produce and the healthiest proteins I could get while working up to a time restricted eating schedule.

It isn't easy but the key really is to start thinking of food as what you need to eat to reach your health goals rather than as what would taste good right now.

I say all this from the standpoint of someone who has used food to medicate. 4 years ago at age 50 I changed the way I ate, lost 160 lbs. and I've kept it off.

This OP sounds much like both myself and my wife's situation. Failing health alongside aches, pains, and medical problems go hand in hand. It is easy for someone that is 'otherwise' healthy to project onto others the benefits of cycling and why they should be doing it. If something hurts to do it isn't like you just want to come back again and again to hurt some more (for most folks anyway).

Perhaps consider other methods of getting exercise that are low/no impact. Swimming comes to mind. Tai Chi perhaps?

I will say this. Don't give up on your own cycling because she is not. This was one of my early on mistakes. Once you lose that fitness and ability, add on some quarantine time, more than a few pounds, etc. it is SUPER hard to get the motivation to get back to that prior point, especially after adding some years in between.

Good luck OP.

I would say that the fix is not exercise, it is going to be a psychological fix. There are lots of inactive people who are not 100 pounds overweight because they do not overeat or eat low-quality food. It is probably one of the most common human conditions to latch onto some sort of habit as an escape from emotional distress. Cigarettes, alcohol, eating, shopping, indulging in materialism or the fashionable and trendy. Anything and everything has been used as a mental crutch or as an escape.

One of the other most common traits of the human condition is that hardly anyone ever changes unless they themselves change, unless there is a radical change in the way they see themselves, their world. Heart disease is still I think one of the top killers in the USA, maybe neck and neck with Cancer, both of which have a lot to do with diet. And of course knee, hip and other skeletal problems are weight related too.

At one time I drank enough that I was throwing up old brown blood in the morning from the stomach ulcers that hard-liquor gave me, which I drank most days of the week. Had my stomach pumped once, and should have had it pumped on a few other occasions probably. This aggravated a host of health problems and at one point I saw my choice was dying soon or quitting alcohol. I am sure that as many choose to stick with the booze as quit it, but for whatever reason I chose to quit. I am sure that is the only reason I am still here today 25 or so years after making that choice. I can still have a drink here and there with a meal or for enjoyment, but I do not have to drink anymore, I don't even think about it or crave it.

I am sorry you have to live with this sort of thing, as watching someone deal with it is no better or worse than dealing with it yourself. I don't know why I drank, and I don't know why your wife eats. One prominent doctor, Gabor Mate, who's books and videos can be easily found, says it is all to blame on past trauma that is never resolved. I apparently resolved something myself, but maybe look for this guys books or videos and watch or read them with your wife and it will greatly increase the chance of some resolution being found, it is probably as good a shot as any, and it is one at a new life . Good Luck

Has you wife tried a non-weight bearing exercise like swimming? My sister had to have both her hip replaced and had all sorts of other issues that needed to be addressed prior to the surgery. She start to do light water exercises at first and evolved into light swimming and continued from there. As she had her hip replacements, the water exercises help her tremendously regain some strength, motion, and eventually her motivation. She started walking longer distances, and then eventually started a work out regimen with a personal trainer that brought her along slowly. She has lost over 125 lbs on this journey, and it all started with a some light water exercises.

Zombie thread.