Anne Riley, MD, FACC, is a cardiologist at the CardioVascular Institute at BIDMC and BID–Needham. She practices predominantly in Needham and lives in Wellesley with her husband and four children. She is an instructor of Medicine at Harvard Medical School and president of the BID–Needham Medical Staff.
One question I ask almost every patient is “So, what are you doing for exercise these days?”
I generally get one of three responses. Sometimes, a patient will respond with, “Well, still walking/running 3-4 miles 4 days a week, doing yoga once a week and doing some weights and resistance training twice a week.”
If that sounds like you, I will say the same thing I say to those patients: Awesome work. Keep it up. See you at the next blog post. More often, I hear “Well, I was walking pretty regularly last spring, but then this summer my mother started having a lot of health problems, and I needed to go home to take care of her.” Or, “My daughter got married and it threw off my whole schedule, and I haven’t really gotten back on track yet.” Or, “I’ve had a really hard time with an ongoing divorce and I just can’t find the time to focus on myself.” The third response that is also pretty common is “Still not exercising. I know I should be, but I’m just lazy.” If any of these sound familiar, read on.
After reading piles of medical articles about the benefits of exercise and hearing my patients talk about what works and what doesn’t, I have come to a few conclusions:
There are times that life throws us curveballs and times when we cannot figure out how we can possibly fit one more thing (like exercise) into our lives. But if your “this is a crazy time” time of life seems to be stretching out for months and then years, it’s time to restructure, rethink, and reinvest in yourself. Exercise is one of the most powerful things you can do to reduce your risk of heart attack and stroke. It is (almost) entirely within your control. And if thinking about health risks in the abstract is not compelling, exercise gives immediate health benefits in terms of stress reduction, improved stamina during the day, and better sleep at night. Patients often ask me how I manage to have four kids and be a cardiologist. I tell them—I work out a lot. My current favorite way to break a sweat includes anything with a 90s hip-hop sound track and an instructor who yells tons of encouragement. My husband and I both work out a lot, alternating who gets up at 5 am to go to the gym, and who stays home to get the kids off to school.
When figuring out how to move that body of yours, do not let perfect be the enemy of good. In fact, do not let good be the enemy of ok. You do not need to be training for a marathon, or going to the intimidating spin class with strobe lights and loud disco music to be helping yourself and your body. You do need to spend some time finding activities that you enjoy and trying to do them consistently. Also, if you have not been moving your body much, start slow! Try 10 minutes a day of exercise, most days of the week and then add another 5 minutes to that each week until you reach 30 minutes at a time. The most important part is making this a regular part of your life. (for a resource on habit change, see below for a book that I have found helpful).
The American Heart Association recommends at least 150 minutes of “moderate” exercise each week. You can do that in 10–15 minute chunks, 30 minutes for 5 days a week, 75 minutes each weekend day, or whatever combination you come up with. Do what works FOR YOU. Exercise does not require a gym membership to the place with the eucalyptus scented towels and marble locker room (although that place does sound amazing). It requires a pair of comfortable shoes and stepping outside. Walking is a fantastic form of exercise, particularly for anybody just starting up a regular program. When the weather is bad, walking at the mall before the stores open up is also essentially free and has the added advantage of being weather protected.
Guess what other activities count as moderate exercise? Gardening?—yup. Doubles tennis, water aerobics, ballroom dancing (as one of my patients loves to do)—all count. In addition, add two days of strength training per week and you can really pat yourself on the back. Women start to lose muscle mass around age 40, and weights and/or resistance training will help add back that lost muscle. Goodbye flabby arms, hello sculpted triceps! And bonus, all of these forms of exercise will help lower your risk of heart attack and stroke when done regularly.
Whether you want to call it evolution or God’s divine plan for womankind, the fact is, we were born to move. Modern day life has brought us further away from movement with our computers and our desk jobs and our sitting-in-car-line-at-school-pickup for 30 minutes. But the “I don’t have time/everyone else comes first/I’m not good at exercise” mentality is not helping you. So leave that nonsense behind. I promise you: your body WANTS to move. Most of us have the great privilege of being ABLE to move. We GET to jog. We GET to lift. We GET to make ourselves proud. So, hold your head up high, turn up that music, and go break a sweat.
Rubin, Gretchen. Better Than Before: mastering the habits of our everyday lives. Random House Inc, 2015.
In my time as a cardiologist (about seven years and counting), I have seen many women ignore their own health needs because they are too busy taking care of others around them. They have a sick parent, or a sick spouse, whose needs they put before their own. I have literally seen (in the most extreme), women ignore their own heart attacks, or their own worsening heart failure, because they are pushing and pushing to keep the other members of their family going. It is because of this observation that I decided to start writing this blog.
I know what it is like. You have a list. A really, really long list, full of things you have to do. Things for your kids, your spouse, your house, or your parents – or maybe for your spouse’s parents, your dog, your parents’ dog (who you are currently taking care of), just to name a few. But where are you on this list? If you are anywhere, you are most likely somewhere down towards the bottom. More than likely, you are not on your list at all. I get it. I have the same list, and I’m not on my list either. But I should be. And you should be on your own list, too. Here’s what to put on your list this week, and why it’s so important.
I know, this sounds incredibly boring. But here’s the thing: knowing your blood pressure (BP), while boring, is incredibly important. It’s the first thing almost any physician wants to know about you. Why? Because it affects every single part of your body. Heart? Check. Kidneys? Check. Brain? Check. Lungs? Check. (I could go on…) The tricky thing about blood pressure is that you won’t know if it’s abnormal unless you get it checked. Let me say that again. You won’t know if it’s abnormal unless you get it checked. We don’t feel high blood pressure. In fact, unless your BP is severely high, you won’t have any symptoms at all for years and years. But all those organs I just mentioned? They will know. And over time, they won’t work as well because of it.
I am going to guess that most of you don’t know your BP. I’m guessing this because up until 4 weeks ago I didn’t even know mine. I hadn’t had it checked in about two years. To make matters worse, I actually happen to have a risk factor for developing high blood pressure (HBP). During my pregnancy with my twins, I developed pre-eclampsia, which basically means I developed high blood pressure at the end of my pregnancy, and had to deliver a little bit early as a result. Fortunately, after delivering, my BP went back to normal. This condition puts me at risk for developing HBP later in life. So what I’m saying is, I should know better.
The good news? Getting your BP checked is pretty easy these days. (Hint: you don’t even have to go to your doctor). Last week, I was in my local Wegmans and saw a blood pressure cuff set up along the wall by the pharmacy. Without exaggeration, it would take less than 90 seconds of your time. You can pop into a surprisingly convenient number of places that are likely part of your daily travels: the pharmacy, grocery store, fire station, senior center. More advice? Normal BP is less than 120 for the top number (systolic) AND less than 80 for the bottom number (diastolic). If either of those is high, then it is time to go in and see your doctor. I promise it won’t take that long. You deserve to know your BP numbers and understand what they mean. You deserve to be on your list. At the top.
If you want learn more about HBP, this is a great and very readable site published by the American College of Cardiology with more information on high blood pressure: https://www.heart.org/en/health-topics/high-blood-pressure.
The CardioVascular Institute (CVI) at Beth Israel Deaconess Hospital–Needham is staffed by highly trained Harvard Medical Faculty Physicians, each with clinical privileges at both BID–Needham and Beth Israel Deaconess Medical Center in Boston. Each is here to provide you with care for all heart and vascular conditions.
To schedule an appointment at the CVI in Needham, please contact 781-453-5238.