We NEED phys ed

One day this week, I was driving by an elementary school while the kids were out on recess. All across the schoolyard were children in varying stages of activity. Some were standing around talking. Others were tossing a ball. A group seemed to be chasing each other in some sort of game. I loved it.


I also read this week about the Running Club initiative going on in our local schools. The same article mentioned Geoff Hamm at John Sevier Elementary School. I know Geoff, mostly from soccer, and he is the perfect person to lead this kind of wellness initiative. Enthusiastic. Engaged. Inspiring.


Our kids need more activity. No…they REQUIRE more activity. Physical Education used to be a required component of all secondary education. I know that because before I went to Physical Therapy school, I was a Physical Education teacher.


Let’s look at the big problem. Tennessee is one of the most obese states in America. Current rankings put us at about 44^th in the country.  20% of our children are considered obese. And in Tennessee, that rate for adults is in the area of 60%. In America, over 300,000 people die each year from obesity related health problems.


That’s unreal. You would think that in a state with incredible natural resources like we have here (think lakes, mountains, parks), we would have one of the most active populations around. Throw in winters that aren’t too cold and summers that are generally not too hot, and we have few excuses not to get outdoors.


Maybe, like too many things, we depend on our schools to promote an active lifestyle. But the academic demands that we place on our schools are in large part why we removed a lot of physical activity from our schools. Think about “No Child Left Behind” and testing standards that our teachers must prepare kids to meet. With all they have to teach, there just isn’t time for physical education classes.


I would argue, and have the research to back it up, that physical activity during the school day is essential for not just academic excellence but for producing healthy, happy adults. Keep in mind that my background is in this arena.


I’ve said many times that active adults create active children. I still believe that is largely true but our health issues from obesity may dictate that we can’t leave it up to parents. Historically, physical education classes were not only for providing a time for physical expression but also a place to learn new ways to express ourselves physically.


My first introduction to tumbling and gymnastics-type activities was in physical education class. We learned dance (remember the Virginia Reel?) in junior high as part of our school day was dedicated to being physically active. We have to teach kids things that allow them to find fun in physical activity.
If it isn’t fun, it isn’t sustainable.


It used to be that physical education electives were a required part of the college curriculum. Not anymore. My wife actually took a tennis class in college taught by Pat Head (Summitt). Is lack of physical activity in our schools and colleges the reason our state is obese? It’s more complicated than that but yeah, that’s part of it.


Anyway, thank you teachers and school administrators. Thank you for understanding the value of physical activity. Thank you for providing avenues to our children to develop a lifelong commitment to staying healthy.

What I've Learned from my Patients

I often tell stories about patients and athletes that I have taken care of.  I’ve been doing this a very long time so I have plenty of stories to tell.


Maybe it is about their accomplishments, the things they have done and maybe the hard work that it took to get there. Sports are not easy. Rehab is not easy. It takes diligence and persistence to get the results that you want. Those just happen to be two things that I value the most. So, I like to tell their stories.


Or maybe I’ll talk about a coach or teacher and the influence that they have on their players and students. Those folks have a tough job and always, always get too little thanks for what they do.


But one category of stories seldom shared in this space, is the effect that patients have had on me. In the fabric of my life, that is woven so richly. Yet I never talk about it here. That’s about to change.


I can remember one of my first patients when I was still a student. He was a Memphis State football player that was rendered a quadriplegic from a cervical injury when he ducked his head going to make a tackle. He was a robust, charismatic young man, about my own age, and I knew that he had no idea what turn his life was about to take.


He taught me never to take my health for granted. And that this gift that I was about to be given, a career as a physical therapist, was something to be cherished and nurtured for surely I must be there to take care of those like him.


About that same time, I became responsible for the rehab of a 13 year old boy who had a spinal cord infact, rendering him a paraplegic. He was playing in the yard when he suddenly collapsed. He never walked again. We are friends to this day and he will drop in on me for a chat from time to time.


He taught me that we should always make the best of whatever situation that we are in. Here he was, just a young boy, but he was ready to tackle the world. He’s done so—on his terms, and has become an amazing adult.


From time to time, I will take care of this amazing lady who is an internationally ranked athlete even as she approaches her 80’s. Super competitive, she does all the little things constantly and plays her game like someone less than half her age.


She has taught me that age is just a number. And to not let others decide what is appropriate activity for us, whatever our age might be.


It works the other way too. I had a patient one time (well, several really) that acted 100 and had every ailment known to medicine. When I looked at her birthday, I discovered she was only a slight bit older than me. She taught me that I didn’t want to be 66 going on 96 but, better yet, I might want to be 66 going on 36.


I’ve learned from my children as well. Both of them have had their share of injuries and, of course, I was right there with them to take care of them. They taught me that I have to separate my duties as a father from my duties as the one taking care of them when they’re hurt.


That one hits home when you think about all the young athletes that I’ve taken care of through the years. I’ve been close to a bunch of them.  But when they are injured, I have to put all emotions aside and do the job that I’m trained to do.


Those many loving and gracious parents of my athletes have taught me that I have a responsibility to be the best that I can be, every moment. I can take no days off or phone it in. When someone is hurt, I have to bring my “A” game…always. Those parents expect that of me.


I wouldn’t have it any other way.

Be a Little Kinder

My birthday isn’t until May but it resembles a small bonfire. I actually quit counting a long time ago. It is what it is. But today I'm writing about old age and it has nothing to do with sports.


One day this week, I had a car that stopped in front of me on a busy road. At first, I thought it was car trouble and then I considered the possibility of a medical emergency. So when I got a chance, I pulled up alongside the vehicle to see if it was someone needing help.


When I got even with the car, I could see an older fellow that appeared quite confused. I don’t think he knew where he was going. He then started moving forward and so I dropped behind him and followed him for a bit.


He soon turned into a parking lot, parked, got out of his car and walked into a store. He seemed fine. I drove on.


How many times have you been behind someone that did something similar? How many times have you been behind a vehicle that you thought was moving too slow and then, when you passed them, saw an older person? Did you think to yourself “they’re too old to be driving” as you passed by?


Yeah. Me too. And I’m probably a lot closer to their age than I am to yours. But those thoughts have crossed my mind more than once.


Back when I was in high school, I bagged groceries at the grocery store in my home town. It was mostly Saturdays. I remember vividly these old ladies coming to the grocery store on Saturday morning, usually right after their hair appointment. I can remember great big cars and little tiny women that seemed barely able to look over the steering wheel.


For most of them, that was the only time that they got out of the house. That car and the ability to drive themselves gave them an independence that they didn’t want to let go of. They were at an age when we would consider most of them too old to drive.


I can remember when I had to discuss with my dad that he shouldn’t drive anymore. It didn’t go too bad since he still had my mom to drive around. But when it came time to end my mom’s driving…oh, my goodness. She did not take it well.


I had told her that I would agree to allow her to continue driving until she had her second fender bender. Well, she had that one day but vigorously defended her driving. She argued that they must have moved that light pole in the church parking lot, otherwise she would have never hit it.


Even in her latest days, when dementia stole much of her memory, she would insist that she was perfectly capable of driving. For your safety and mine, it wasn’t happening.


My point today? Show a little kindness. Losing the freedom that comes from being able to drive yourself to appointments, to the grocery store, to visit friends, has got to be devastating. As a son, it was hard for me to take away those privileges.


I am not arguing that someone that isn’t safe should still be driving. I’m encouraging everyone to show a little patience on the road. If they’re going slower than you want them to, be kind. If they aren’t dangerous, let them keep driving.

Back on the Bike

I promised I wouldn’t be back to talk about my knee replacement until I was back on the bicycle. Well…I’m back. On Tuesday of this week, at 6 weeks and 6 days after having had surgery, I was back on the bike.


It was a short ride and mostly flat but it was a gorgeous day and it was glorious to be back on the bike.  My knee is still stiff but it was still a “real” ride instead of the trainer that I’ve been on for the past few weeks.


I’ll get the obvious question out of the way first. How is it that I’m this far along? First, my surgery was stellar. I’ve done everything I’ve been told since surgery. I put myself in the hands of a trusted colleague, Candy Martin, for physical therapy. And I’ve worked harder than I would ever expect my patients to work. I also have the key to the clinic so my weekends have been filled with plenty of extra rehab on my own.


Let me tell you a little bit about what I’ve learned by going through this whole thing. Keep in mind that this is my work--I’ve rehabbed hundreds of people with knee replacements. I understand that creature quite well. And I’ve always been one to be empathetic. I appreciate what my patients are going through.


But I have definitely learned a lot from being on the patient side of the equation. I’ve learned that when they say to “stay ahead of the pain,” they know what they’re talking about.


I thought I was tougher than most. I considered my pain tolerance well above average. I thought that if it hurt, I could take the pain medicine and get the pain under control quickly. Huh-uh. Wrong. Twice I waited too long to take the pain medicine. Twice I was in agony for several hours.


I’m as concerned about addiction as anybody and keenly aware that opioid use in this state is out of control, but when you’re hurting that bad, you will do just about anything. My orthopedist, Dr. Justin Jones, had warned me that the pain was going to be bad. He took one look at my X-Rays and knew that.


If you are truly in pain and taking medication as prescribed, the chances of addiction are slim. You do need to get off pain medicine as soon as you can tolerate the pain without the use of opioids.


And about those X-Rays…my knee was a mess. Dr. Jones told my wife while I was in recovery that I was at least 10 years late for having this knee replaced. The surgery took about an hour longer than normal as Dr. Jones chipped away at all the junk in my knee. I learned it doesn’t pay to put it off. I’ve known for a while that this needed to be done. When I saw those X-Rays, I knew. It was past due.


I learned to take care of the swelling. A few days after surgery, I had some pitting-type edema in my ankle. It’s called lymphedema and our Total Rehab-MEND clinic was built around it. Dr. Andi Heinemann who runs that clinic took personal care of me. I learned that this is hugely important.


I knew that early movement was important. Especially extension. You want to get your knee straight. It is the #1 determinant of good outcomes. I would lay in the hospital bed and push my knee into full extension. They didn’t have to remind me not to put a pillow behind my knee.


I knew not to be afraid of it. Early weightbearing is good for the replaced knee. I did one round on the walker with my hospital physical therapist Kim Tippitt and switched immediately to crutches.


I knew that there was a light at the end of the tunnel—that better days were coming, even when the pain was at its worst. I tell my patients that all the time. But there were times when I doubted that. Like everybody, I wanted to be well immediately.


All in all, I was humbled by it all. I’m not Superman. I’m human like everyone else. Yet while this thing was quite an ordeal, it was totally worth it. Just like my patients have been telling me for years, I wish I’d had it done a long time ago.

The BEST Exercise Program

I don’t run. I don’t aspire to becoming a runner. The only running I plan to do is to run onto the football field to check an injury. Or being chased by a bear.


I saw my favorite running group on Wednesday morning this week. I’m not sure I know any of them but I admire their dedication and tenacity. It was about 4:40 and they were about to pass under the Maryville College pedestrian bridge. They were all brightly lit with (I’m assuming) new neon lights to make sure they are seen.


Why are they my favorites? Because they’re always out there. It was 20⁰ on Wednesday morning and they were still at it. I like that.


I know several groups of bicycle riders that are out there too. I admire their dedication to participating in a healthy, outdoor activity, even at the risk of riding on roads where not every vehicle appreciates their presence. Yeah, I’m one of them and I’ve had my share of episodes where cars or trucks decided to express their anger at me being on the same road. Middle finger salutes are frequent. Swerving to scare me happens too often. But that’s not really what I want to focus on today.


Do you want to know what the absolute BEST exercise program is? It’s the one that you will do. It’s that simple (and I’ve talked about it here before).


Take running for example. Those early morning runners may not run hard, fast, or long, but they’re in the arena. They are MOVING, and that’s the key. (And maybe they are running hard, fast, and long but I don’t slow down to check them out.)


I lift weights 2-3 times a week. Well, actually it is more of a CrossFIt or HIIT (High Intensity Interval Training) program but I’m moving weights. I’m staying within the limits imposed by my age and physical ability but I’m moving constantly in the 30 minutes or so I dedicate to this activity.


Some (most) people lift a lot heavier weights than I do and that’s OK. It isn’t a competition for me. And I do admire that they are out there, working hard, in the arena.


I used to play tennis and maybe this new knee will let me get back into that but I admire those that are out there, staying active. Same for Pickleball. Probably not the game for me it’s awesome that a lot of older athletes have found that game and play almost every day.


My wife does yoga to supplement her walking program and it has been great for her. A lot of people have found their place in the yoga studio.


I don’t know what the per capita numbers are but it does seem like we have a lot of gyms around here. Their parking lots are often full which means a lot of people are doing something. Again, it doesn’t matter what you are doing, as long as you are doing something.


I want to put in a plug for an Accountability Partner. That’s somebody that you exercise with. And on days when maybe you don’t feel like exercising, your Accountability Partner might just be the reason that you get in your exercise anyway. You don’t want to disappoint or inconvenience them.


And let’s just face it…we’re all just a little bit competitive. So with someone to exercise with, you’re probably going to work a little harder.


But whatever you do, what matters most is that you are moving your body. Every day. Hike, swim, row…it matters not what you do. Just that you do it.

Grandchild #7

True story. Early this week, I sat down to write for this space. And I sat there. And sat there. Nothing came. I’ve been doing this thing for 35 years and it seemed I finally had writer’s block.


I finally wrote down “I have nothing” and walked away from the computer. A couple days later, I asked my wife for ideas. My biggest supporter, she is also my quickest (but gentlest) critic. If I’ve wrote about the same topic too many times, she will point that out.

It’s the second or third thing she reads when she sits down on Sunday morning to read The Daily Times. (I’m not sure what’s first.) Her suggestion—"duh, you have a new granddaughter.” The very next morning, I had two people ask me if I was going to write about that new granddaughter. So of course, that’s what I did.

This is grandchild number seven and is likely the last (barring a true miracle). She was premature, born at 34 weeks, weighing 3 pounds, 15 ounces. At the time of this writing, she is still in the NICU (Neonatal Intensive Care Unit) at East Tennessee Children’s Hospital.

A shameless plug for Children’s Hospital—those people are incredible. We had one previous grandchild born premature that spent time in the NICU there almost seven years ago. Back then it was a big ward, with all the babies in the same room.

At that time, we watched a building being built across the street, not knowing at the time what it was to be. As it turns out, it was the South Building for Children’s Hospital. It now houses the NICU.

Seven years ago, the staff was just as awesome, the care delivered just as stellar. But now they have the facility to match all that awesomeness. Every baby is housed in a private room with state-of-the-art equipment.

You have to experience it to appreciate what all that means. To have a wee baby, 2 or 3 pounds or so, small enough to almost fit in your palm fighting for their life but surrounded by the best of the best…it’s transformative.

It makes you realize how fragile and important life is. Just this week, we had funeral services for a 37 year old family member. Taken before his time, leaving two young children. If all this doesn’t serve as a life wake up call, you’re pretty oblivious.

This precious little granddaughter, who is doing great and may be home by today, will grow up surrounded by love and will likely never be hungry or wanting of any of life’s basics. The same can’t be said for too many others. In rooms in the NICU near hers are babies that are going through withdrawal, babies that might not make it. We can hear their constant cries in the hallway. It may be life’s saddest sound.

And just last week a child died in the PICU of Shaken Baby Syndrome. Think about all that. Adults that would shake a baby so hard that they died from it. A pregnant mom that couldn’t stay away from drugs and/or alcohol while carrying life’s most precious gift. Unbelievable.

As I held my newest this week, I promised her that I was going to be there for her. That I would guarantee her unconditional love and support for as long as I lived. That I would cuddle with her as long as I could and then hold her hand as long as she would let me.

Thank You for your Service

A family member had a baby about 3 AM on Christmas morning. Everybody is fine. It was a pretty awesome Christmas present. But it got me to thinking about the Obstetrician and the delivery staff at the hospital (yeah…I know…my brain works in mysterious ways).


That baby didn’t care that it was Christmas. It was ready to come out. And that baby didn’t care that folks at the hospital had families. I suppose the Doctor that delivered this baby long ago decided that it was part of their life, part of their duty, to be there when needed.


What a huge sacrifice! It really doesn’t matter what was going on in their own life, what their own family needs might be, they were there. It still amazes me.


And they’re not alone. Think about all those workers in the hospital. They probably would have preferred to be home, enjoying Christmas, being with their family. But they had a job to do. An essential, important job.


You maybe didn’t choose to be in the hospital during the holidays but you probably took it for granted that it would be fully staffed. I would ask that if you do find yourself in the hospital sometime, please be patient when you push that Nurse Call button. Maybe they’re short staffed that day. Maybe somebody called in sick without time to call in a replacement.


Think about those staffing the Emergency Room. I don’t know for sure but I bet that most of the ER’s were busy all day on Christmas Day. Those working there might miss their families that day but when the next ambulance pulls in, all thoughts go to the patient.


Think about those in law enforcement. I’m sure every young police officer would prefer to be there when their own kids wake up and run to the Christmas tree to see what they might find. Instead, they were out there on duty to protect and defend us. Maybe even putting their own life on the line so that we could be safe.


How about the fireman. If there is a burning building, they don’t stop to think that they would like to be somewhere else. They don’t stop to think about how nice it might be to be home sitting in front of a fire, eating too much, enjoying loved ones.


No, when a fire happens, they rush to the fire, putting themselves in harm’s way. My dad always told me that in the event of a crisis, to seek out those that are running TO the crisis, not those running away from it. I think he was talking more about life but it certainly works when talking about a catastrophe.


And it’s not just to save lives. It’s to save your property. They fight the fire to minimize the damage to your house, to minimize the impact on your life.


It got me to thinking about those that work in Emergency Care, the EMTs and Para-Medics. Probably one of the more underpaid jobs out there, those folks are always ready to save your life. And maybe on Christmas Day.


Then there are the utility workers. If your electricity goes out on Christmas day, you don’t really think about the fact that somebody will be on the job, waiting for the call to go and restore your electricity so that your house stays warm on a cold day.


Look to the soldier, maybe serving us on foreign soil. You know they would love to be home. But instead, they’re serving our country, doing their duty. You don’t have to agree with why they are there to appreciate their sacrifices and dedication to our country.


We take a lot for granted. We too often take for granted the sacrifices that so many people make to create a world that is safer, warmer, easier, better.


For all those that serve others, I thank you.