What Your Doctor Doesn’t Know About Exercise

Sometimes I don’t think the doctors know what to do with me.

I like my health care team, but I just don’t think they know what to do with a patient who actually exercises and eats well.

Here’s an example.

After I got my insulin pump last year, I faithfully sent in my blood sugar readings for review.  At first they would make a little adjustment here or there, but after awhile it became the same response every week, “No change”, the nurse would say.  I still felt I was struggling. While my night time lows were thankfully gone, I was still experiencing highs that I didn’t like.  Especially in the morning, which didn’t make sense since I was working out in the morning.

I started adding my morning workouts to the email I sent, hoping that they would give some insight into why some mornings I would actually be higher after a workout than before I started. Weeks went by before a nurse said “By the way, great job on getting some exercise”. That was it.  I stopped taking the time to report my workouts and decided to take matters into my own hands.

I reread sections of the Diabetic Athlete’s Handbook

and bought another book called Think Like a Pancreas

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. I wanted to use the experience of others like me, along with the doctor’s orders, to take control of how and when I made adjustments to my insulin schedule. I learned how to do fasting tests to determine a more appropriate basal rate for mornings. Apparently my body produces some extra glucose in the morning and I just needed a little more insulin to match it, even with a morning workout.

While my personal experience is with type 1 diabetes, I often hear from others in the same boat.  They ask the doctor about how they can manage their illness or how to continue to exercise with their condition only to get a blank stare or a generic “walking is great” response.

So what’s a person to do?

First, if they tell you not to exercise listen. There are certain conditions, let’s say post surgery for a detached retina, where you SHOULD NOT EXERCISE no matter how much you want to.

Second, if they just don’t know what to do ask to speak to someone else. It could be a sports nutritionist, registered dietician or physical therapist but ask to see someone who specializes in exercise or nutrition. Most general practitioners get little training on either. Keep asking till you get the help and resources you need. Great example for me, I was also struggling with lows on my Sunday bike rides.  I got a chance to pose the question to the diabetes educator who trained me on my pump and she recommended reducing my basal rate about an hour prior to the ride. Problem solved. Sometimes it’s just about getting to the right person with the right knowledge about your condition or treatment.

Third, look outside the doctor’s office. Doctors know a lot but they don’t know everything. Acupuncture is a great example of a treatment that can do wonders for some people, either on its own or as a compliment to other treatments. Or look to others with your illness or condition that are successful in managing it along with their fitness.

Fourth, and perhaps the most important, is to know your own body. Exercise and fitness are not all or nothing pursuits. If you are dealing with a chronic illness, know there are going to be times you can’t do your normal routine. I hate it when I have a low just starting a walk, ride or run but it happens. I have no choice but to stop and do something about it. I accept it and figure out how I can put plan B into action. Always have a plan B. If you can’t do your normal weight routine, can you do yoga for 20 minutes? If you can’t run 3 miles today can you walk instead for 10-20 minutes? Know what your body can and can’t do. Plan for it. Make peace with it.