![]() My rating: 5 of 5 stars About a year ago, I decided that I was done with managed care...well, almost done with managed care. The thing is as much as I enjoy working with patients, I have become increasingly frustrated with the US model of "sick care." With an undergrad in Nutritional Sciences, a Professional Masters in physical therapy, a long list of fitness certifications, and a lifelong passion for physical fitness, I've always believed that the best defense we have against chronic illness is prevention. Yet despite the overwhelming evidence that both diet and exercise are effective strategies in preventing and even curing diseases like diabetes, cancer, obesity, and heart disease, we seem to be losing the battle, forget winning the war. Unfortunately, managed care is so carefully managed that I often times spend more time producing documentation that no one ever reads than actually treating patients, which sometimes leaves insufficient time to actually address the underlying issues. Imagine this. An overweight, overstressed, under-rested man goes to the doctor. His blood work shows he is diabetic (metabolically sick) and has high triglycerides (putting him at an increased risk of heart attack). Thanks to the extra weight he carries, he has sleep apnea. Thanks to his sleep apnea, he doesn't sleep well, which contributes to both weight gain and anxiety/depression. The doctor prescribes medicine for his diabetes, a CPAP machine for his sleep apnea, and an anti-depressant for his anxiety and depression. He also tells his patient he needs to get more exercise and eat a healthy diet. Then he sends the patient home. The patient goes to the pharmacist, gets his meds, contacts a medical supply company about the CPAP machine, and makes a promise to himself to get serious about lifestyle changes. He even joins a gym, hires a personal trainer, and loses 30 lbs in 3 months. Fast forward 6 months. He's still on his meds and using his CPAP but inconsistently, and unfortunately, he has not only gained back the 30 pounds he lost but also an extra 5. He knows what he needs to do, but just can't find the motivation or the time, not to mention the money since personal trainers aren't cheap. At 12 months, he goes back for his yearly physical only to discover the meds he has been taking for his diabetes are no longer effective. Now he needs to actually start injecting himself with insulin. His triglycerides are still high, and while the anti-depressant has helped some with his anxiety, he still isn't sleeping well. Part of the problem is he finds the CPAP machine cumbersome to wear, and has gotten out of the habit of using it, even though he admits that he slept better with it on. And to add insult to injury, he now has high blood pressure. While I am a physical therapist (not a doctor), this is the kind of patient I see all the time. Only I see them for chronic back pain, a torn rotator cuff, or arthritic knees. They have terrible diets, many are overweight and obese, the majority can't or don't exercise, and they all have pain they hope therapy can cure. What I want to tell this patient is that while there are many factors that contribute to their pain, their lifestyle is a major factor. I want to tell them to eat more fruits and veggies which are loaded with phytonutrients that have anti-inflammatory properties. I want them to avoid soda, fast food, and other processed foods which are pro-inflammatory. I want them to exercise. Start slow, doing what they can, and then progress daily as their bodies naturally adapt. I want them to become more attuned to and in balance with their bodies. And I want to help them make those changes through ongoing and intensive support. When they leave my care, I want them to be lighter, healthier, and happier. I want them to have more strength, flexibility, mobility, and less pain. I want them to have the self-efficacy to make better choices. And I want them to be off the insulin and blood pressure meds because their diabetes and high blood pressure have resolved. I want their blood lipid profile to put a smile on their doctor's face, and I want their pain to be a distant memory. Instead, because of our mode of care (ie what insurances pay for, the time and resource constraints of managed care, and the patient's fix-me mentality) I am forced to use temporary band-aids like modalities, generic and often inadequate therapeutic exercise, and manual therapy techniques that provide relief in the short-term and maybe even take their pain away, but that don't substantially leave them significantly healthier than when they walked in. This is why I've started my next journey as a health and wellness coach, and why I bought this book when kindle so kindly recommended it to me based on other books I've read. The titled intrigued me, and I liked the cover art. I'll admit, while reading the intro, I wondered if I'd made a mistake. If you follow my reviews, you've probably noticed that the past 40 or so books I've read have dealt with weight loss, weight loss strategies, health, diet, etc, and this book didn't quite fit with my expectations. In fact, it seemed a little over-the-top. Philosophy major graduates from college and decides to go live in jungle where he sprints with weights on his ankles, jumps out of holes (also with weight on his ankles), meditates (because, hey, what else is there to do when you're alone in the jungle) and generally embraces the life of a monk. But, I'm a dedicated and patient reader, so I persist. Luckily, the first few chapters are well written, and I'm beginning to see some substance, wisdom, and relatable ideas. And though I don't particularly like the writer, who comes off as smarmy at times and a downright ass at others, I agree with a lot of his observations, which are both thoughtful and insightful. By the end of the book, I am feeling as if I've actually gotten not only my $9.99's worth, but a whole lot more. While this is meant to be an instructional book on the benefit of an approach to life (and fitness) that the author calls "Weightlessness," I think its real value is in an underlying message that is present throughout. Weightlessness is really about experiencing life in the moment, moving out of your comfort zone because that is where real change and progress happen, embracing pain (or failure or discomfort) because it will strengthen both our physical and emotional selves (which by the way are intimately interconnected), and expecting for life to throw its punches because that is what life does. In the epilogue, which is basically a Q & A between an interviewer and the author, Fazio uses the analogy of a wilted plant (which is still alive but not thriving) to describe a number of people today who are alive, but not really living. And I think his point is well made. This is really a very different book and one I'd recommend not necessarily as a book on fitness/diet or even meditation (though I suppose it is) but as a book on life and how living, really living, is best accomplished when our physical selves and our spiritual (or emotional selves) are not only well-trained, strong, and fit, but in sync. It's a shame I'm only the 14th person to rate this book on Goodreads and the first to review it as it is a worthwhile read.
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April 2020
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