Tuesday, December 29, 2009

Walk this way

After 78 years I thought I knew how to walk. Apparently I was mistaken.
This despite the fact that as long as I can remember, walking or hiking has been one of the joys of my life. When Joan and I lived in Calgary, hiking in the Rockies was the great family activity during the summer months when the mountain passes were not plugged with snow. In the four national parks a short drive from Calgary—the Banff, Jasper, Kootenay and Yoho parks—there are some 2,000 miles of hiking trails. Over the years we hiked along a good part of them.
A disability now prevents Joan from joining me on such walks, to my great sorrow. But I still enjoy solitary rambles. In October, I walked 19 miles along the trail of a former railway that stretches almost six miles from our town of Lindsay to Haliburton.
As I grow older, however, my pace seems to be slower. Either that or younger people are walking faster than ever before—if you can believe that.
I occasionally drive to Toronto to research at the University of Toronto’s big Robarts library. I park a few blocks away and walk to the library at what feels to me to be a determinly brisk pace. Young whippersnappers, guys and gals alike, pass by me as if I were dawdling. And they do it so effortlessly, not seeming to hurry at all..
The secret, apparently, is in the length of the step. I had never thought about that. Walking always been as unconsciously performed as breathing.
But when we try to walk faster, most of us go at it the wrong way, according to Deena and David Balboa in their book, Walk for Life: the Lifetime Walking Program for a Healthy Body and Mind. Most of us take longer steps when we try to walk faster, when we should be taking shorter, quicker steps, according to the Balboas. With our lengthen strides, we go at it with grim determination, “wildly and counter-productively pumping” our arms. But walking, they say, can be more natural, graceful, relaxing, pleasurable—and faster than the tensed up military marchers.
I decided to test the theory.
The first couple of miles of the railway trail near our house where I regularly walk are paved, and there is a marked one-kilometre section. I walked the one kilometre with short, quick steps as fast as I could. Ten minutes. On the dot. I walked back with longest, fastest strides I could make. Eleven minutes. And I was starting to feel exhausted, my legs were starting to tire, and I was starting to slow, despite myself. There seems little doubt in my mind that over a longer distance, the difference in speed between long and short strides would be even greater.
So that’s how I learned how to walk quicker.
Does that mean I’ll be able to keep pace with younger folk? Not likely.

Thursday, November 12, 2009

The best health care in the world

The world rages over health care: who has the best and who has the worst?
The United States, say its advocates, has “the best health care system the world has ever known” (Senator Richard Shelby, cited by Nicholas D. Kristoff in New York Times, November 5, 2009). American critics argue to the contrary. They point to their country’s dismal health statistics: 31st in world standing for life expectancy; 37th in infant mortality; 34th in maternal mortality; dead last among 19 countries in avoiding preventable deaths; to cite only a few.
In Canada, nearly 90 percent believe that what we call our health care is better than what Americans have, but critics find incidences of hospital and surgical waiting times, and call it flawed. A medical insurance company promises escape from what it terms “Canada’s broken health care,” and immediate access to the very best medical facilities in the United States. All it takes are payments of healthy premiums.
You would not guess it from the boiling-temperature of the debate, but the best health care in the world is easy to find. It resides in each of us.
The debate supposedly about health care is not about health care at all; it is a debate about medical care. Medical care is about treating you when you are sick. Health care, to my mind, is about things that help keep you from getting sick — exercise, diet, lifestyle choices, and psychological aspects. No one in the misnomered health care debate is talking about diet, exercise, lifestyles, stress or mental attitude. The debate is about hospitals, pharmaceuticals, surgical operations, waiting times, and access. While the medical profession constantly urges us to take better care of our health—too often crying in the wilderness— that is not what is being debated.
Ostensibly both medical care and those other aspects that affect our health fall under the rubric of “health care,” and there is a rationale for that. But lumping both aspects under the same term raises problems. It confuses the debate. It tends to focus too much reliance on fixing ills and not enough on staying healthy. And it obscures responsibilities.
Medical care is primarily a responsibility of medical professionals, but taking care of our health is a responsibility that ultimately falls on each of us. All levels of government have a responsibility in promoting and facilitating good health care, while the medical fraternity; such health organizations as those for heart, lung, diabetes; and physiotherapists, exercise physiologists and fitness trainers, also play crucial roles. Their efforts are in vain if we fail individually to become our own best health caretakers. The most miraculous medical care will not keep us well if we ruin our own health.
The care of our health inescapably starts and sticks with each of us. Advice, assistance and facilities have never been as available or as good. The best health care in the world resides within each of us when we grasp the opportunities and responsibility.
And yet, health care is in sickbay. The data confirm it.
Diabetes is one indicator. Primarily because of obesity and lack of exercise, diabetes is “fast becoming the epidemic of the 21st century,” according to The International Diabetes Federation. Some two million Canadians now have diabetes, and the number is expected to jump to three million by 2020. “The number of people with type 2 diabetes is increasing dramatically because of Canada’s aging population, rising obesity rates, increasing sedentary lifestyle, and higher risk for diabetes for Aboriginal people and new Canadians,” says a report from the Conference Board of Canada http://www.conferenceboard.ca/HCP/Details/Health/mortality-diabetes.aspx .
Kids are a particular concern. The number of overweight and obese kids aged 2 to 17 years jumped from 15 percent in 1979 to 26 percent in 2004, according to Statistics Canada. Some believe it’s worse than that, since the data were collected on a self-reported basis, and no one likes to admit that they are fat. “Extrapolating for self-reported and measured data,” Canada’s Public Health Agency estimated that one-quarter of adult Canadians were obese in 2007 http://www.phac-aspc.gc.ca/publicat/2009/oc/index-eng.php . Add to that those who are overweight, and probably more than half of us carry too much fat.
The reason kids are fat is plain: they don’t eat well, and they don’t exercise enough.
Only half the kids aged 4 to 18 eat enough vegetables and fruit to meet the minimum requirement of Canada’s Food Guide; just one quarter eat enough grain products, and more than one quarter eat French fries two or more times a week (http://www.breakfastforlearning.ca/en/services-a-information/research/report-card
With TV, electronic games and computers, Canadian kids spend much more “screen time” than physically active time. Fewer than one in eight meet the recommended 90 minutes per day of physical activity, according to the 2009 Report Card from Active Healthy Kids Canada. http://www.activehealthykids.ca/ But 90 percent spend more than 120 minutes on screen time, and many spend nearly six hours per day. Two thirds live within a reasonable distance to walk or bicycle to school, but less than half do. At school, the trend, apparently, is to reduce physical education and even recess time so as to increase instruction time.
Even the ancient Greeks—who gave us democracy, the foundations of much of our science and society, and the first Olympic games 2,786 years ago—knew better than that. They knew that active bodies promoted bright minds. At Athens, the school curriculum had three divisions: writing, music, and gymnastics. Every schoolboy learned to swim, run, ride bareback, and played such sports as rowing, handball and lacrosse. The Athenian diet was plain and simple, life was Spartan, and citizens (who were a minority) tended to live long.
For a couple of hundred years or so, every generation of Canadians and Americans has lived longer than its parents, thanks to the never-ending-advances in medical science. But now, improvements in medical science might no longer be able to keep pace with declining health care. A warning has been sounded by Dr. Kellie Leitch, Health Canada Advisor on Healthy Children and Youth:
“Given the prevalence of childhood obesity, and its contribution to many diseases, this is the first generation that may not live as long as their parents. Obesity is now having a huge impact which was not foreseen 10 years ago.” http://www.heartandstroke.on.ca/site/c.pvI3IeNWJwE/b.3581723/k.560C/Report_Cards_on_Health.htm
Well-meaning efforts to promote healthy, active lifestyles too often seem undone by big business — supported by government — with its cornucopia of unhealthy foods and endless profusion of un-active activities. We have become less like athletic Athens and more like decadent Rome, where affluent citizens were growing fatter and flabbier in their unprecedented prosperity.
Such thoughts came to mind on a glorious sunny Sunday in October as I hiked along a mid-section of the Victoria Railway Trail that stretches from my town of Lindsay, Ontario, almost 60 miles north to Haliburton. A volunteer organization, Trails for Health http://trailsforhealth.ca/ actively promotes its beneficial use for walking and bicycling. But hikers and bikers must now controversially share the trail with motor vehicles, specifically all-terrain vehicles (ATVs) and, in winter, snowmobiles.
I hiked along a nine-mile, sandy section of the trail that Sunday, from Burnt River to Kinmount and back. Including time for taking photos, I was on the trail some six-and-half hours during my 18-mile walk. I did not meet one other walker, and only two bikers. I met at least 30 people riding along on their ATVs. The appeal by commercial interests for such un-activities seems to have rolled over the best efforts of Trails for Health and others. It’s an indictment of our commercially-driven, indolent society. We have what in reality, if not in name, is universal medical care, but we lack effective, universal health care.
Medical care continues to make enormous strides, the best health care in the world resides within each of us, but for our society as a whole, health care is sick. The data confirm it.

Saturday, October 31, 2009

My broken heart climbs 1,776 steps up Toronto's CN Tower

Every year, thousands of people, from eight to 85, climb the 1,776 steps up Toronto’s CN Tower in fund-raising events for worthy causes. In April, more than 6,200 climbed for the World Wildlife Fund. On October 24 and 25, Saturday and Sunday, 12,000 climbed for Toronto’s United Way.
People who are blind, who are paraplegics, who have cancer or diabetes, have climbed to the top. Plus at least one person with an impaired heart — me — and undoubtedly many other troubled hearts. In 2002, World Champion Paralympian Jeff Adams climbed the Tower in a wheelchair. (In 1988, two men hauled a stove and a refrigerator to the top; in 1989, a crew from General Motors hauled up a car, piece by piece).
Seventeen athletes from AthletesCAN made the climb on Sunday, each with an inspiring story of courage and grit. Among them:
•Tyler Mosher, who nine years ago broke his back in nine places in a snowboarding fall and was told he would never walk again. He is this year’s world champion for adaptive snowboarding and will represent Canada at next year’s Paralympic Games in his hometown of Whistler, B.C.
•Kyle Miller, who six years ago was diagnosed with the same rare form of bone cancer that hobbled Terry Fox on his historic cross-Canada run. Miller battled through chemotherapy and three years later played goal for Team Canada when it won the world lacrosse championship. He plans to repeat the feat next year.
•Chris Jarvis, a diabetic member of the Canadian Rowing Team since 2002, last year’s silver medalist in Canada and 2007 Pan American Games gold medalist. He is head coach and director of operations with Connected In Motion, an organization that aims “to create a ‘slipstream’ for people living with diabetes.”
My daughter, Carol, signed me up to join her team of 20 climbers from Equifax Canada. Our group was slated as one of the first to go. More than a hundred people were already milling about the Toronto Convention Centre when we arrived to sign in at 5:30 am. It is after six when we start climbing. Carol insists on accompanying me all the way, although she is capable of doing it in a fraction of the time it will take me. That’s good. I enjoy her company.
The grey, treaded steel steps with the iron railings wind up the well, a laced steel curtain hugging the stairs so that no one can fall down the gap between the steps and the bare, concrete wall. The steps are just wide enough for three abreast. At the top of each 12th step there is a landing that can accommodate five or six resting climbers.
My wristwatch/heart monitor governs my time. When exercising, each stroke of my 78-year-old impaired heart pumps out significantly less blood and oxygen for my muscles than a healthy heart. Thus it must work harder, imposing a safety limit. On my semi-annual stress test in May, my heart rate reached 143 beats per minute (bpm), my maximum safe peak heart rate. The manuals say that the heart-training rate during exercise should be between 50 and 85 percent of that brief, maximum rate, or up to 124 bpm in my case. That is my safety limit for sustained exertion.
I set out to climb at a slow pace and hug the outside so that others can pass. Racers ran to the top in a few minutes but most climbers walked. I stopped at every tenth landing — after every 120 steps — to check my pulse. It varied between 120 and 128 bpm. I rested until it slowed to 90, about two minutes. Within those parameters, it was not a difficult climb. There was no pounding in my chest, no gasping for air, no sweating. Because I had trained for almost a year, my legs did not tire.
It took me an hour and 16 minutes to reach the top. I rested 15 times, about half an hour in total. Without my monitor to tell me my heart needed those slow-down rests, I might have made it to the top in less time. Or I might have collapsed, and never reached the top. But it was not a race. It was a personal challenge that gave me satisfaction. And I hope it might provide one small example of how the difficulties of troubled hearts can often be conquered.
I’d like to do the climb next year. Next time, in addition to providing a little money for Toronto’s United Way, I’d like to raise money for a local cause, Lindsay’s Ross Memorial Hospital. Last year Art Wilson made the climb at age 85 and raised $7,000 for the Kitchener-Waterloo United Way.
Now there’s an inspiration!

Me and my daughter Carol, at 5:30 a.m. on Sunday, October 25, as we prepare to climb 1,776 steps up Toronto’s CN Tower.