For example, Karen Horowitz, 55, a planned-giving officer with the American Cancer Society, couldn’t sleep during her breast cancer treatment for two reasons: shoulder pain due to complications from her mastectomy, and hot flashes. She was constantly tired and frustrated. It took only a few weeks of physical therapy for her shoulder, and a prescription medication for her hot flashes, to get Karen sleeping through the night. In David’s case, cutting back on coffee and alcohol—which can interfere with restful sleep—made a big difference. If you decide to take an over-the-counter sleep aid, be sure to tell your doctor, because these interact with many prescription drugs.
STEP THREE: GET YOURSELF MOVING
It may seem inconsistent to say that people who desperately need rest also desperately need to move their bodies around, but it’s the truth. If the benefits of exercise could be packaged as a pill, it would be the most popular prescription drug available.
Physical activity has a positive effect on what is called hemostasis: how the chemicals in the blood interrelate and work together. Exercise also improves the healing of muscles, bones, tendons, and ligaments. For example, it spurs the formation of collagen, helping injured tissues heal properly. In addition, it appears to decrease the formation of excessive scar tissue, called fibrosis. Exercise helps us heal better.
Exercise also helps us to heal faster. A 2005 study at Ohio State University in Columbus followed a group of people 55 and older for three months. Each was given a small wound—the kind you’d get from having a mole removed. Then half of the participants were put into an aerobic-exercise program. The results were significant. The average number of days it took the exercisers’ wounds to heal was 29. Among nonexercisers, the average was 39 days.
A soldier I know named Charley, who asked that his last name be withheld, knows just how important exercise is in healing. In May 2007 he went for his annual physical. As a very fit 50-year-old, he was expecting a clean bill of health. Instead, he was diagnosed with prostate cancer. Following multiple surgeries, Charley was having difficulty controlling his bladder and was physically quite weak. He began to get stronger first by walking and then by light jogging. “The first time I ran up the mountain that I lived on, I could only run a block,” he recalls. He would run as far as he could, then walk until he caught his breath. “After about four attempts in the following week or so, I was able to return to my three-mile route,” he says. “It wasn’t good form, but I did it—and recovered in the shower.” Within six months he was back to his usual regimen of running, sit-ups, and pull-ups, and strong enough to accept a one-year assignment to Afghanistan.
There are many ways to begin exercising after an illness or an injury, and it is always a good idea to check with your physician about this. But most people can do what Charley did and begin with walking. A fun and helpful strategy is to buy a pedometer (you can get one for less than ten dollars) and, for one week, tally the number of steps you take each day. The goal for active, healthy adults is 10,000 steps per day. My goal for my patients is simply to increase their level of activity gradually. Keep a log, and each week try to increase the number of steps you take by 500 per day (with your doctor’s permission).
If you have a medical condition such as arthritis, you can still exercise without hurting yourself. For instance, nonweight-bearing cardiovascular exercises such as swimming help to avoid stress on the joints.
You can strengthen the muscles around painful joints with isometric exercises that involve tightening and releasing muscles. Or you can try exercises such as leg lifts, which don’t stress the joints. If you aren’t sure how to start exercising, ask your doctor about seeing a physical therapist. Most health insurance plans will cover physical therapy that focuses on helping people recover.