A Guest Post by Dr. Pablo...Swimsuit Season Shudders, Part 2


Pablo, a physical therapist, member of the gym, and Latino dancer in his free time, writes to his fellow members (and anyone else who reads this post) about body image and the importance of health over looks. Make time to read this...it's fantastic.




Pablo has something to say!!!  First, I would like to tell you that you are all amazing people.  I’m proud of everyone that makes it in the gym to sweat and go through pain along side me (even though a lot of you are not physically by me in the 5:30 class, I know we share a spiritual connection).  All the coaches are the best, and I’m very proud of them for keeping us motivated to go through with the pain on a daily/weekly/monthly/yearly basis.


After reading Coach Kayla’s last blog entitled, “Swimsuit Season Shutters,” my initial reaction was, “Yeah! Who cares what you look like!  Be proud of what your body can do!”  Afterwards, with some reflection, I noticed that we really do talk too much about what the outside looks like as a result of exercise.  Frequently, I have heard around the gym (no names will be named) “Hey, I know I have abs under this layer of fat” or “I just have to lose [blank] amount of weight.”


So what am I trying to say?  Well, I’d like to talk about the differences between health and fitness, and why we should focus much more on health over fitness. The definition of the word fitness, according to google dictionary, is the state of being fit….Um, ok.  The definition of the word fit has three forms.  Adjective: suitable quality, standard or meet required purpose.  Verb: be the right shape and size.  Noun: the particular way in which something fits around or into something.  Kind of sort of, all these descriptions of the word fit have to do with the look of something.  Coach Kayla’s article tells us to ignore those that display “fit” bodies with her many great examples.  We are all different shapes/sizes, and we should be proud of how we look.   ESPECIALLY after doing these crazy workouts!!!


 (With the picture above, it's important to note: it's not wrong to want to be in the "fitness" category. But you cannot sustain what the above picture describes as "fitness" without upholding a foundation of "health." Also, when you've gotten older and "fitness" is no longer a priority, you should already have your "health" to fall back on without having to work extra for it.)


Towards the end of Coach Kayla’s article, she touches upon our effort to be healthy.  So what is the definition of health?  It’s a noun, and it is the state of being free from illness or injury.  BOOM!!!  I just got to what I’m trying to tell yous guys!!!  Being of good health should dominate over any reason that we go to the gym.


So why would you want to listen to this crazy Latino with a funny New York accent?  Well…cause I’m a doctor damnit!!!  (That was for you Coach Robert)  For real though, in my undergraduate days, my exercise physiology professor started the semester by saying… “I have a magic pill.  This pill can help prevent: high blood pressure, diabetes, cancer, stroke, falls, injury during functional mobility, heart attack, overall sickness, and depression (there was a lot more than just those).  This pill can increase healthy sleep, mental health, tolerance to stress (and so on and so on).  This pill is called…exercise.”  The interesting thing is in no point of this list was anything mentioned about “exercise will make you look good/fit.”  This opening monologue didn’t mean much to me being in my early twenties.  However, now that I am in my early thirties, it means the difference between a life of health and a life of illness and injury.


Before I started going to the gym, I was very unhealthy.  Looking at myself in the mirror after eating A LOT of food, I remember not looking at my current state and saying, “I look terrible.”  Instead, I looked at my future self, in 10/20/30 even 40 plus years in the future, and said “I have to make a change.”  No, I’m not a psychic, I’m a physical therapist that works with the older population or geriatrics.  


Joshua Richter from time to time likes to ask me “How was it touching old people today?”  After a long day, I really don’t want to talk about the sad things I see.  But, here it is, what taking care of a geriatric population means to me: of all the countless patients I’ve worked with, those that are well off are those that have less than 2 medications in their medicine cabinet.  Also, these patients have really no past medical or surgical histories.  The ones that are not well off are those that have a long list of co-morbidities: CHF, diabetes, heart attack, stroke.  They have a full bag of medicines and can’t go a day without them.  Going out means going to MD appointments that fill their calendars.  I would ask, “What are you doing tomorrow (or next day, or day after)?”  Their response, “Heart doctor/Lung doctor/Diabetes doctor (and a whole bunch of doctors that I didn’t know even exist).”  These patients have one thing in common throughout all my evaluations, sedentary lifestyles. (Note from Coach Kayla: I feel those last two words should look like the old Goosebumps letters and drip with blood...because they're fatal and scary.)


Do not get me wrong, I am not trying to say these patients are bad people.  I have many fond memories of all my patients, and the most important thing my unhealthy patients have taught me is to be healthy myself.  Diabetes causes you to be dependent on insulin and monitoring of blood sugar daily.   You REALLY have to watch what you eat because high blood sugar damages kidneys, eyes, and heart among many other organs.  High blood sugar on an acute level can cause heart attack, stroke, renal failure.  The flip side, take too much insulin, you have low blood sugar.  This can cause fainting and coma.  Over time, people with diabetes may lose toes, feet, or legs.  


CVA, or stroke, causes you, depending on location of the stroke, to lose ability to use half of your body.  Speech, swallowing food/water, understanding conversations can all be affected negatively.  People with strokes have to be taught to do everything we healthy people take for granted.  Going to the bathroom and bathing on your own.  Feeding yourself and dressing yourself have to be re taught.  Not all with CVA are lucky to become fully rehabilitated, and it kills to break the news to family members that this is how your mother/father/sister/brother will be from now on.


Heart attack simply is a blockage of the coronary arteries that cause DYING of the cardiac muscle causing an eventual end of sinus rhythm.  A person experiencing a heart attack, if given medical attention as soon as possible, can continue to live a long life.  But the cardiac muscle that is damaged will not be repaired, and many face a life of insufficient heart beats.  This means not enough oxygen rich blood getting to every part of the body, and not enough oxygen poor blood returning to the heart to get oxygenated again.  Google artery/venous insufficiency, COPD, and CHF.  I can go on forever, and if you ever would like to talk about the patients I’ve seen and the lessons I’ve learned, I’m up for discussion any time.


On the business side of all this, I’d like to touch upon how expensive all these sick people are, and how it affects Medicare for our generation.  Hopefully I don’t sound like a terrible person, but it’s the truth.  A hospital stay as a result of any of these illnesses can cost A LOT of money.  Anywhere in the high 100,000, not including all the medicines, payment to doctors seen, rehab, home care, or outpatient settings.  Medicare is cutting down SO many things that they would normally pay to the older population as we speak.  Quick examples, diabetic supplies, bathroom equipment, even rehab services, are all being cut down to lower how much Medicare can pay.  I’m making it really simplified, but in short, I’m afraid that when our generation gets older, we cannot afford to get sick.  If this trend keeps up, to have an illness means the cost of health will come out of our pockets.  Personally, I’d rather use my money that I’ve saved all my life to buy a Harley Davidson…


I hope I’m not scaring you guys too much, but I hope I’m scaring you guys enough to make health the number one reason to hit the gym.  Whether you know it or not, you are getting older.  The average life expectancy is getting higher and higher.  I want to see all of you in our 100s and have no health problems.  (It’s possible by the way, I’ve met more than a few patients in their 100s that are in better health than I am!  Their secret?  They never stop moving!!!)


I encourage you guys to look at your family health history and understand that genetics make you susceptible to certain diseases.  My family, mother side diabetes and father side heart attack/stroke.  I have made a personal promise to do whatever it takes to prevent from having those terrible diseases.  I am fulfilling that promise by going to the gym and giving it my best.  My hope is to live a long healthy life and to watch all of you live a long healthy life.  I hope to never have to compare surgery scars or medication bottles with any of you.   I wish to be like those older people that the Crossfit (I know we are not a Crossfit) guys like to show in their promotional videos doing cleans, burpees, and push ups.  I want to walk into the gym with you guys doing crazy skills until the bitter end.  One day we will all say, in a old man/woman voice “back in my day, I used to clean and jerk 250lbs 50 times without breaking a sweat!”  


So, pretty pretty please…get to the gym, do your workouts, hit your PRs, achieve many skills, but most of all, be of good health.





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