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Practicing what I preach

Keller, Mary MS, PA-C

Journal of the American Academy of Physician Assistants: April 2014 - Volume 27 - Issue 4 - p 1–2
doi: 10.1097/01.JAA.0000444747.63303.e1
Mindful Practice

Mary Keller practices at the Grace Clinic in Elkin, N.C. The author has disclosed no potential conflicts of interest, financial or otherwise.

Tanya Gregory, PhD, department editor

For the past few years, I have been trying to get into running. Mainly because I work in a free clinic where I make grand claims to patients about the benefits of exercise, day in and day out. Overweight? Depressed? Hypertensive? Diabetic? Have insomnia? Anxiety? Chronic pain? Can't afford a cardiologist, or psychotherapist? Start exercising. Exercise every day. Get moving. Go.

I have always been thin and relatively active and athletic, but through graduate school, parenthood, and a new career, I had lost my motivation for exercise. I was pathetically out of shape. My husband was too, but then he started running. And I started to feel guilty for not practicing what I preach. I would tell my patients, “Physical activity at work and taking care of kids doesn't count. You have to get out and exercise.” I started thinking, “I have to get out and exercise.” I started to try to get into running.

I have never been a runner. Not even as a kid. Not even as a soccer player, a gymnast, or a pole-vaulter. I ran no more than absolutely necessary. At the very most, maybe a quarter of a mile. I just was not a runner. So I started slow. My husband printed off a couch-to-5K training plan. It was too advanced for me. Run every other day? No. Too much. So I started trying to jog once or twice a week. The town park has a very nice gravelly path in a mile loop, so I tried to jog a mile. It felt good when I could jog a quarter mile before stopping to walk. It was a big deal when, after several weeks, I could jog the whole mile. And then life got in the way—maybe the weather, maybe a kid's soccer schedule—and I went a few months without running.



But I was still working. I was still proclaiming the importance of exercise. On a daily basis, I was pushing people who worked harder jobs, cared for more complicated families, and battled more physical ailments to make time for exercise. To start slow, but get out there every day. I promised rewards. Amazingly, once in a great while, I would have a patient who had taken my advice. The patient would admit that he or she had not believed me at first, but felt better after starting a regular exercise routine. It had worked. And now exercise was a priority for the patient. I knew I needed to listen to my own advice.

So I tried again. Jog a mile every other day or so. Get out there, Mary. Meanwhile, my husband had stuck with it. He was running 5Ks and placing in his age group; but then, he had actually been a runner before. More importantly, he felt better and was a happier person. And his cholesterol had improved by leaps and bounds. But I have never been a runner, and I was still not a runner. So I coached my kid's soccer team—and played soccer once a week with a bunch of 5-year-olds. We got a dog, and I walked him around the block three times a day. I still tried to jog that mile periodically, and I would feel pretty good when I did it, but I was not a runner.

But I kept at it. I took longer walks when I had the time. By a miracle in scheduling I was able to start going to yoga once a week for a few consecutive months. Sometimes when I walked the dog, I would run a little ways. And once a week or so, I would try to jog the mile around the park. And every day I would go to work and prescribe exercise: It's free medicine! It's good for everything that could possibly be wrong with you! It will lower your BP, lower your sugar, increase your energy level, and help you sleep better at night! Want to lose weight? Relieve hot flashes? Increase your sex drive? Start exercising!

Then one day last spring, my husband was racing another 5K and a stroke of fate caused me to be there with no kids. I was wearing sweatpants and running shoes, too, like it was meant to be. I suddenly realized I should run this thing too! So I did. I ran a 5K. Well, I ran 1K, keeping up with a wheezing asthmatic and a woman twice my age. Then I walked. Then I jogged a little. Then I stopped to tie my shoe, jogged a little, ran, walked, wondered how long a 5K could possibly be, jogged a little, then my sweet husband (who had long since finished the race) caught up with me and gave me some extra water and encouragement, and I finished the race. And you know what? It was kind of fun. I had accomplished something I had never before accomplished—I ran (jogged, walked) the farthest distance I'd ever run before. And I wasn't in last place, either.

So I tried to maintain that mediocre, half-hearted level of commitment to exercise. I walked the dog, went to yoga when I could, and jogged a mile now and then. About a month later, there was another 5K and this one had a kid's fun run beforehand. The plan was for me and the kids to run the fun run, then watch daddy race. My 6-year-old thought the fun run was so easy; he wanted to run the whole 5K. So I quickly found a neighbor to watch my 3-year-old, registered, and got to the starting line. My 6-year-old took off at a full sprint and disappeared into a crowd of 50-plus people. Fortunately, he did not get trampled, and I was able to catch up with him and keep him at a manageable pace. He got tired and we walked. Then we jogged, then we got some water, then we ran, skipped, raced to the corner, jogged backwards, walked a while, jogged, and finally, the little bugger sprinted to beat me over the finish line. It was great fun. Best of all, they had doughnuts afterward!

So we decided to do more. My son and I. A series of 5K cross-country races were advertised; he decided he would rather race once a month than play soccer. I gladly gave up the soccer mom role for the season—exercise really can make your life better! And we signed up for the whole series. The first race went well; he got bored and hot, and I struggled to motivate him to keep going, and then he sprinted to beat me across the finish line. And then we had doughnuts.

Then summer came, the kids were out of school, and it was hot. I went several weeks without running. We took a family vacation to New England: 15 hours in the car in one day. There was a 4K race 2 days after we arrived. The only 4K in the whole state of New Hampshire. And because it is the only 4K, you can have a 4K state record. The current state record for 6-year-olds was 38 minutes. My son took off running. It was 90 degrees and I was dehydrated and exhausted and out of shape. Again. I had to walk at the first 1K marker. When I got to the water station at the half-way point, I inquired about the 6-year-old. They told me he had passed through and was fine. I tried to catch up. And then I gave up. I came around a corner in time to see him heading for the finish line. I was supposed to turn the other way and make another loop around, but I decided to just drop out and watch my son finish. He killed the state record, but since he's not a New Hampshire resident, he wasn't awarded the record title. He didn't care; he got doughnuts. And cookies. But he was a little outraged when he found out I had not completed the race.

I became motivated. I could not have my son ashamed of me. I printed off another beginner 5K training program, and I actually stuck with it. Soon I could run 2 miles without having to walk. I might let a week get away from me without any real exercise, but then I'd pick back up where I left off. I realized that what I'd been saying was true; the more I exercised, the more energy I had. I might be tired and my legs would feel like dead weight, but I'd get through that first mile. After the second mile, I felt pretty good. And then I could run 3 miles. I had to walk some of it, but I did it. And then, after many weeks, a miracle happened: I ran. I ran and I kept going. I ran 4 miles, and I didn't have to walk at all. I had broken through into aerobic exercise, and I felt fantastic! Literally, when I realized I had passed the 3-mile point and could still run, a huge grin spread across my face. I got giddy excited. It is a feeling I cannot adequately describe. I kept on running. I felt like Forrest Gump. I was just running, and happy, and everything was right with the world. I ran home and shared my excitement with my family. They think I'm pretty silly, but they're happy for me.

I continue to encourage my patients to exercise. I feel less guilty, since I am now following my own advice, but more importantly, I just feel better. I have more energy. I have a great sense of accomplishment. I have never been a runner, but I used to be an athlete and I've missed my athleticism. I run most days now. Now I'm trying to get faster; I'm trying to get stronger. I've always known that exercise is the best medicine, good for whatever ails you, but now I'm excited about it. Now I really know it.



© 2014 American Academy of Physician Assistants.