Why older people talk about their ailments

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The six Taylor sisters being schooled at home during a polio epidemic

Aunt Beulah posed (indirectly) a fascinating question in her latest blog post:

Why, as we grow older, do we feel the urge to discuss our health problems at length, when as children we never did?

So many hypotheses rushed into my head that I was forced to share them immediately. Oh dear. So that means I’m a case in point…

These hypotheses are warped by my early life as a cheerful healthy kid with five healthy sisters in the 1940s. My thoughts are bound to be misguided or outright wrong. Tell me, I can take it!

  1. (Worst first.) Our world has shrunk. We are less interested in the outside world and  more interested in ourselves. So we assume the big world is equally interested in our ailments. Ouch. Please let that not be true!
  2. We were strong healthy children. So most health problems were due to “childhood ailments” which we would, by definition, grow out of. By contrast, after middle age any ailment might be, probably is, a sign that we are getting older, and there’s only one way this can end. So we talk about our ailments to stave off decrepitude and death.
  3. Colds, flu, scarlet fever, chicken pox and measles were infectious and non-selective.  With every epidemic our family got a job-lot, six for the price of one. There was nothing individual about being sick, nothing interesting. If I was sick, so were Jill, Deirdre, Prue, Lesley and Penny. Now we feel alone with each new ailment, and we talk about them for company and reassurance.
  4. We’ve lived beyond Doctor-Knows-Best to the Do-It-Yourself era of health maintenance. For every whiff of an ailment we can instantly get 100 solutions on the internet. There is a heck of a lot more information that can be shared, so we share it.
  5. We have a scientific interest in the state of our body and wish to optimize its efficiency for the years ahead. We love being alive and want to make the most of it. So we talk about how to manage our ailments.
  6. We sympathize with friends who have ailments and want to offer support. So we enable their health-talk.

A friend of mine, Elisabeth, lamented the deterioration of a precious relationship. She and her friend (let’s call her Valerie) used to have exciting spirited passionate wide-ranging intellectual conversations every time they met. Now … each entire outing would be filled by Valerie’s health-talk. Not a single other topic was discussed.

Now that’s bad. Endlessly ruminating over health problems must be one of the worst things you can do for your health. It’s boring, and it throws the relationship out of whack — unfair division of time and topic!

I’m pretty interested in the workings of mind and brain, and I am my only available case study, so I’m at risk of becoming a Valerie. But I do have a private rule: no more than 5 minutes per meeting per person may be spent discussing health problems, whether they be bunions or cancer.

This rough and ready private and flexible rule does not preclude sympathy or empathy. But sometimes a change of topic is as good as a dose of aspirin.

Do read Aunt Beulah’s article which stimulated me to think about this! It’s talk about health talk, very funny and wise.

How I became a born-again walker

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A learner is sometimes the best teacher.

bootcamp2015-small 2Who am I to give advice about walking? Somebody who used to be not a human as we know it but a balloon on a string, that’s who.

I deeply appreciate the joy of walking for that very reason: for years I was virtually unconscious of my body when out for a trot. All my attention was locked inside my brain. And what an astounding machine it was too, by gum.

I was a mindless walker

Think think think. Puzzle puzzle puzzle. Imagine imagine imagine. I was a biological thinking machine, propelled forward horizontally by mysterious means. I was conscious only of my thoughts; I cared only for my thoughts.

I experienced myself as a free-floating brain sailing over footpaths and dangling something vague beneath me. That something vague was… my body. Legs? What legs?

You were right on the button, Vi!

My mother-in-law Vi used to say, often, in fact pretty much daily, “As long as you’ve got your health…” A cliché, and so true. By the time she died, she had 20 serious health conditions—19 that she knew about, plus dementia. She began suffering from arthritis in her thirties; even at that age, the idea of going for a walk for pleasure was completely alien to her.

Well, Vi, I’ve been a hell of a lot luckier than you were. And I’ll carry on walking, which is both a cause and effect of having my health, as you put it.

Walking up and down stairs. Walking to the pool on Tuesdays. Walking over Mt Vic on Fridays. Walking to town for errands and entertainment. Walking the compost bucket to the community gardens. Walking my grandson to the park on Saturdays. Walking to meet friends. And once in a while, most deliciously, walking on a beach or in a forest.

Enjoy your walk! 

You’ll have your own walking routes and reasons. Walking the dog? Hiking in the Solomon Islands, shopping for hot air balloons, touring the estate?

Enjoy your walk. It’s your very own. Your walk is your choice, your walk is you.
Enjoy your walk. Even if you are in a wheelchair or using a walker.
Enjoy your walk. That’s not just a cliché: it’s a prescription.

Image from Chiaroscuro 1910, Senior Class Yearbook, University of Montevallo, via Internet Archive Book Images. Image of cyclists taken by a friend or relative, but I forget who, sorry.

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Doing the Otago Rail Trail with friends: my 70th birthday treat and a celebration of sheer good luck so far

9 tips to self for walking young, safe and happy

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On my boot camp, the aim is to reduce suffering, not increase it

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So, how can we walk more mindfully on our everyday excursions? (Not during a formal walking meditation: that’s a different kettle of fish.) And what can we copy from the best young walkers? And what else makes a walk through town a delicious adventure?

These are tips to myself, and some may appeal to you. Some are not possible if you’re very old, or if you have certain disabilities. But if something I suggest resonates with you, why not experiment a little? Strange to say, some of these tips can be followed even in a wheelchair or a walker.

Walk young

  1. Walk fast, Rachel, at least some of the time.
  2. Bounce along. Lift your feet up.
  3. Raise your breastbone a smidgen. This will automatically improve your posture with no other effort. You will be taller!
  4. Lift up your eyes. Elevate your personal horizon a few degrees.
  5. Look around. Look at sky, trees, traffic lights, graffiti, bicycles, children, lapdogs, posters, gorillas and fuschia buds.

Walk safe

  1. Trust yourself. Be aware of trip hazards in your peripheral vision, but don’t walk along looking at the footpath or your feet. That’s no fun and can upset your balance.
  2. Don’t jaywalk, Rachel. Stop it right now! You know that’s dangerous, especially if you trip over your ball gown or a wheel comes off your shopping trolley. You know you are setting a bad example to your grandchildren. (Trying to retrain myself on this one.)

Walk happy

  1. Enjoy your body, Rachel. Be aware of one part of your body as you move along. One day, feel what’s happening in your arms. Another day, your thighs. Another time, the way your arms swing. Enjoy the warm sun on your face: what a glow! Enjoy the cold wind on your face: you’re alive!
  2. And smile at strangers. Deliberately. Often. With eye contact. This is extremely interesting, not to mention fun. Count the number of smiles you get back in return. (Ed. I know, you don’t have to tell me that.)
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Walk like a child. That’s progress!

Image from “History of the Ninth and Tenth Regiments Rhode Island Volunteers, and the Tenth Rhode Island Battery, in the Union Army in 1862” (1892) Spicer, Wm Arnold. Public domain. Painting by Lesley Evans of four little girls CC BY-NC 3.0. Lesley is my sister!  https://www.facebook.com/LesleyEvansArtist/

These legs were made for walking

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These legs were made for walking too, but I prefer my own.

bootcamp2015-small 2Walking. I’ve been doing it for 74 years but I never want to take this miraculous skill for granted. Many of my friends have crook knees or ankles. Some have cranky hips or ceramic hips or bad backs. Some have MS or asthma or bronchiectasis. I’m humbled by their courage and ingenuity as they continue to get around, one way or the other.

Walking is tangled up with independence and free will as well as health and fun.

Walking style provides cues about health

Walking is also linked to youthfulness. Not-walking is a fear associated with old age.

This obvious fact hit me like a ton of bricks when a friend came to stay recently. A whole bunch of odd problems had me worried. At pedestrian crossings, I had to restrain her from rushing across when the red man said Stop, because her automatic impulse was to jaywalk. She was confused about distances and directions and buses and taxis. She rushed ahead, leaning forwards at an angle, then stopped often to take a breath. I’m pretty slow on the uptake, but after a couple of days, I finally got the message: she was ill.

A few months later we learned that she had a form of motor neuron disease. A year later, she was dead.

Join the non-existent leg-appreciation society

But this blog post is not about the larger topic of my friend’s devastating illness and death. It’s about walking.

Walking is simple, natural, automatic, free, always available day or night—no trainer, gym or special equipment required. And this precious skill can be eroded by illness or accident.

After my friend’s visit, I love my legs more than ever. I plan to love them and use them and learn from them for many more years.  In fact I may start an international leg-appreciation society. When my own legs stop working quite so well one day. I will still appreciate what they used to do, decade after decade, without a job description or vision statement or instruction manual.

They have done so much more than walk. They have negotiated footpaths and steps and mountain trails and forests and beaches and farms. They have carried me up and down hills and cliffs and over ice and snow and sand. They have kept me afloat through surf and rivers and lagoons. They have crawled and skipped and skied and marched and run and kicked and danced and squatted and pranced and lunged  and planked. They have raised me safely out of chairs and baths and pot-holes.

Thank you legs!

Phone apps for walking

Breeze used to be my favourite phone app. Its daily cheerleading made me aware of how far I was walking each day. I wiped the app one day when my phone was overloaded with data. Now I want Breeze back again, but my phone tells me I have to get it through the Romanian app store. Romania? I dunno. Beats me.

With a compatible app, walking becomes a substantial component of the exercise regime instead of a means of getting from A. to B. If at first you take only 400 steps on a typical day, that’s not a tragedy, it’s an opportunity. Such satisfaction lies ahead as you notch up the steps, little by little, day by day.

P.S. I think my daily steps are usually around 7000. I think They want me to buy a Fitbit.

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Mechanical toy via Internet Archive Book Images, from Scientific American March 1903. Shadow legs a selfie by Rachel McAlpine, CC BY 3.0

Learning to breathe all over again

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Bad breathing: like managing a hot air balloon

bootcamp2015-small 2So, the next boot camp task was to practise slow breathing, using the diaphram instead of chest and shoulders. Breathing like a baby. Breathing the way my poor body yearns to breathe. The schedule: breathe in to two counts, breathe out to five. Just for five minutes before sleep. How hard could that be?

Even lying down, it was a struggle to fit my breathing to this pattern. The more I tried, the more I failed. Managing my breathing was like steering a hot air balloon: a little more heat, a bit less puff, go up, now go down, left hand down a bit and hey mind the Eiffel Tower!

Breathing just happens, unless you have a physical problem such as asthma. It’s regulated by the autonomic nervous system and requires no conscious input. Interfering with my breathing was like trying to change my digestion speed or heart rate or blood pressure just by an effort of will. Those things are easy for yogi, I suppose. But for mere mortals, repeated exercises are needed.

That’s what I had faith in: the plasticity of the human brain. Practice makes perfect. Repetition, repetition, repetition.

Changing an old breathing pattern: not easy

But first, get it right. My first attempt to breathe the new way stressed me out, and I rather foolishly announced the fact on Facebook:

“I have just noticed that I am stressed. But who can I tell? My friends will all just say, serve you right!”

Bless them, my friends did not say “serve you right” but offered helpful advice. Sensible, kind, caring advice. And naturally this included the number one classic, authentic tip for stress reduction: deep breathing. Alas, deep breathing cannot be the cure on this occasion because it’s the problem.

I was stressed but not downhearted, because I reckoned I had overcome a comparable breathing challenge not so long ago. Now you mustn’t laugh at this: I know it seems ridiculous, but here goes.

Swim and breathe at the same time? A miracle of coordination!

Until a couple of years ago, I hardly ever swam freestyle. Breast-stroke and back-stroke were a breeze because I could always keep my head above water. Anyway, I mainly swam in the sea, where freestyle seemed somehow inappropriate — too earnest, too intense, too pretentious. And between you and me, in my heart of hearts, I believed that if I swam freestyle, I would drown.

Then I began lane swimming at the Freyberg pool and decided to tackle the breathing problem once and for all. It was a psychic struggle—me against my urge to breathe when my nose was still underwater. It was a challenge of coordination and timing and control. A fight for domination. A fight for life. No approach could be less appropriate for the gentle art of breathing, and yet little by little, week by week, I got over myself. Now I’m comfortable doing freestyle, in my own good time.

So I know I can do this breathing thing! Babies can do it and I will too.

Feldenkrais on breathing: upstairs, downstairs and in my lady’s chamber

My next ploy was to attend a workshop on breathing and voice run by Elke Dunlop, the uncrowned queen of Feldenkrais in Wellington. This was perfect timing.

I’ve been a fan of Feldenkrais practice for some years now but it is extraordinarily hard to describe to other people. In fact, I only began attending in the first place because a friend kept nagging and niggling at me. She couldn’t describe it coherently either:

“Most of the time you’re lying on the floor but it’s quite hard work sometimes. You learn to use your body in unexpected strange movements. The idea is to let go of unnatural habits of moving that take too much effort, and to relearn the natural, effortless way of moving, the way we moved as babies. I think you might like it.”

Well! That wasn’t a great pitch, was it? And my friend is a communications professional! I can’t describe it any better, either. All I know is that Feldenkrais practice is a physical game-changer and most of the time, it makes sense.

So I spent a day lying on the floor moving my chest and diaphram and belly and other bits in strange unfamiliar contradictory ways while breathing in and out in equally strange unfamiliar contradictory ways. This experience succeeded in disrupting my bad breathing habits so profoundly that I’m now doing the exercise that Peter prescribed without stress.

Oh, and I got a breathing app for my iPhone. It’s called Breathe & Relax, and it helps.

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If I can swim underwater, I can breathe. I reckon.

Image from “Airships past and present, together with chapters on the use of balloons in connection with meteorology, photography and the carrier pigeon” (1908) Hildebrandt, A. Public domain. Photo of underwater swimmer by Rachel McAlpine. CC BY 2.0

Unloading the larynx: not for sissies

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Physiotherapist digs into muscles that affect the voice. 1906

bootcamp2015-small 2It’s boot camp year. I don’t say no to anything that could help me achieve my prep-for-old-age goals. I’m on stage three of working on my voice. So, off I went to Peter Chum, specialist voice-and-breathing physiotherapist for performers. I do perform (in more ways than one) and I want to give every performance my best whether singing or speaking.

During our initial conversation Peter sussed out my needs, all the while sneakily observing my voice and my breathing. Luckily I didn’t realise he had pointed his mental CCTV camera at me, or I would have tried harder … which would have been counterproductive.

That endless throat clearing: sorted in seconds

Ahem ahem ahem is such a common human problem, given a badly designed valve between stomach and oesophagus. In one minute Peter told me how to abolish gastric reflux. Take a little apple cider vinegar in hot water before dinner, digest your dinner and go to bed. But the vinegar must be the good stuff, cloudy with threads of fermentation bug or “mother”.

Oh. That simple, huh? Ladies and gentlemen, this remedy has worked for me from day one. Awesome.

Getting strangled in a good cause

Then it was hands on time. Have you ever had your throat massaged? Thought not. You wouldn’t choose to be strangled, either, and it’s not so different in the initial stages, I dare say.

A pair of ultra-strong physiotherapeutic hands grasped and pressed and pushed not only the muscles of my cheeks and neck and shoulders and jaw, but even my larynx (yes really!) and tongue (from the outside).You know how a therapeutic masseur digs in extra deep and hard to the very parts that hold the most tension or pain? Now imagine someone doing that to your throat. That’s called unloading the larynx.

It was both scary and intensely wonderful. Amazing. Only after the tension was released did I realise how tense those parts of me had been. After the session I floated away, pretty much spaced out. Migraine eye patterns came and went. Unloading the larynx is powerful stuff. But hey, I could take it.

And now what? No point in softening all those muscles if I go back to my bad old habits and screw them up again. I’ve learned a lot about relaxation from Natasha the speech therapist, but that is not enough.

Next on Peter’s list: slow belly breathing

Breathing is voice. Breathing is life itself. My inner smart-ass Smugilla had something to say on the topic.

Smugilla: You’re a shoo-in. You’ve been breathing all your life. There couldn’t possibly be anything wrong with your breathing. Look at you, you meditate, you do tai chi, you sleep like a log, you know all about breathing. As a breathing machine you’re perfect.

Oh yeah? According to Peter I am breathing fast and shallow.

What? This cannot be! Yet Peter was only stating something that was obvious to him. The numbers do not lie.

To my credit, I instantly saw the truth of his diagnosis. I do constantly raise my chest or even shoulders to suck in air. I often feel as if I’m drowning for lack of air. I breathe as if my lungs need a Sergeant Major to make them do their job.

Fast and shallow breathing ties in with tension around the neck and throat and jaw and shoulders. Everything’s connected, and you can’t have a good voice without good breathing.

Peter gave me a breathing exercise to practise each night before sleep. I’m to do it lying down, so that there’s no contest with gravity, no need to use any muscles to hold myself vertical. Just count 1-2 on in-breath, 3-4-5-6-7 on out-breath. Easy peasy? Well, no.

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Image from The manual on barbering, hairdressing, manicuring, facial massage, electrolysis and chiropody as taught in the Moler system of colleges” (1906). Public domain.

Photo of Capital Choir singers after a thrilling performance of Shaky Places, a song cycle of New Zealand poems. Capital Choir, Wellington, New Zealand shares this photo.

The aging voice: therapy and gym programme

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1912 therapy for stuttering has some similarity to today’s therapy for muscular tension dysphonia

bootcamp2015-small 2Speech therapist Natasha Curham has a positive approach to the common voice disorder, muscular tension dysphonia (MTD). She assured me that it can be successfully treated. Why? Because muscles are involved. With practice, muscles can be strengthened, better coordinated and used more efficiently. Brain has learned to overuse these muscles: brain can learn a better way. I summoned the wisdom of Elke Dunlop, Feldenkrais teacher: “Do less, make less effort.”

The voice review: Rachel could do better

First Natasha gathered my case history and tested the current state of my voice. She found “roughness, breathiness and mild aesthenia (weakness) … creak quality in conversational and reading voice … breath support slightly lower than expected … reduced pitch range with increased gravelly quality at low pitch … reduction in control of volume at times …” In other words, “Rachel could do better.”

I learned a lot about anatomy in the speech therapy sessions and I learned and practised exercises of three different types.

Gym programme for the voice

  1. First I learned ways to decrease muscle tension, any time any place. New ways to take a breath, sigh, yawn, and clear the throat.
  2. Secondly, I practised the “gold standard” fix-it exercises for times when my voice is scratchy or creaky. These involve controlling the amount of air you breathe out while making certain sounds through a straw in water.
  3. And thirdly, I was given vocal function exercises to do twice a day, every day, regardless. This is tried and true practice backed up by solid research. A daily programme has been shown to strengthen and balance all the laryngeal muscles, increase resonance, and improve muscular control and flexibility. This is a gym programme for the voice, with a physiological schedule and shape: “ee” (warm-up) “whoop” (stretching), “boom” (contracting), “knoll” (power).

As with any gym programme, knowledge is not enough. You have to actually do the time. And I do. I care that much.

Altogether I spent four sessions with Natasha, and since then I’ve become much more confident about my voice. It does get tired sometimes, and old-lady-voice reappears. But it’s not an unpredictable enemy waiting to destroy me; it’s a reminder to drink water, take a silent little breath, yawn and sigh, and keep up the exercise regime.

I have evidence already that the regime is working, and every confidence that it will continue to do. I know my brain has to unlearn bad habits, just as my body does. But it all depends on me, now.

How do you do, body

Perhaps the greatest benefit has been an immediate growth of awareness. Before visiting Peter the ENT specialist, I had no idea how much tension I was holding in my jaw and throat. After a simple diagnosis and brief therapy, I could actually see muscles twitching in my cheeks and neck. I never attained the Deirdre Barlow level of neck tension, but we were sisters under the crêpy old skin. Now I consciously relax not only cheeks, jaws, neck and shoulders, but my larynx. I can pop my vocal chords open and shut at will. I can tell my larynx to lie down like a good dog, and it does.

Nevertheless, Natasha had more to offer. She suggested I get in touch with Peter Chum, a physiotherapist specialising in performers with voice problems. “I’ve worked on the inside. He’ll work on the outside,” she said.

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Fifty shades of green. Tea, kiwifruit, griselinia, rata. And a white straw for voice exercises.
 Images: 1912 stuttering therapy from Internet Archive Book Images. 50 shades of green by Rachel McAlpine