Colorado Bariatric Surgery Institute

Some of you may know that I practice martial arts. I practice them for exercise, as means of self-defense, and as a way to nurture my mind. In turn, I ran across this article and found it quite stimulating. Perhaps it will have the same effect on you.

Pure Water: By Dave Lowry


"In Hawaii, aikido is much tougher than here on the mainland". So said a college sophomore from Honolulu who, along with his friend, was visiting an aikido club at a univer­sity in the Midwest back in the 1960s. While being interviewed by the campus newspaper, they expounded their opinions liberally. If you've spent much time around Hawaiians, especially Hawaiian of Japanese ancestry who are budoka, you know that some of them can be a bit ethnocentric. I was around a lot of them in my youth and am accustomed to it—and I must admit that I share some of their perspective. There was a much stronger flavor of "old Japan" in Hawaii back in the '50s and '60s. That led to the belief that the level of their martial arts was pretty high. Indeed, when I was younger, we tended to look at Hawaii, from the point of view of the budo, as a distant prefecture of Japan.

That's all well and good, but it can lead to arrogance and cockiness. And those two guys had near-terminal cases of both afflictions. One of my sempai, Fujii-san, seemed to feel the same way. She wasn't much taller than 5 feet and weighed scarcely more than 90 pounds but her aikido was phenomenal—and on occasion rough. She'd been leaning quietly against the wall while the interview went on, but finally she'd had enough.

"Too much talk," she said. "Let's train".What followed could best be de­scribed as a painful, protracted example of the Japanese maxim about kugi wa tsukidashi, or "pounding the nail back down". Very convincingly, the visiting students had a major attitude adjustment applied through a process of throws and joint locks. Fujii seemed to be whirling just over the surface of the mat. Before the guys could completely get to their feet or really launch a good attack, they got slammed down again. It was interest­ing to watch and probably less so to have experienced, but our two friends left the dojo that day not nearly as impressed with themselves.

It was under the instruction of a sempai like her that I was introduced to aikido and karate-do and, earlier, to judo. They were never cruel. But they made it clear that these were martial arts, and so they demanded rigorous effort and a willingness to accept aches and pains and an inherent element of danger. For that reason, I've been perplexed over the past decade to see the proliferation of arts calling themselves "aikido" that don't look anything like what I learned from Fujii and people like her. These arts feature a lot of theory and philosophy. They involve long discussions about the nature of ki and so forth. They emphasize all kinds of exercises and techniques purported to boost ethereal qualities like "harmonization with the universe". That's fine, but it's hardly the stuff of Fujii's practice sessions.

In my own training in aikido, I occasionally heard the word "ki" spoken. After practice, some teachers would start talking, and I'd get the idea they were trying to tell me about the applications of aikido or another budo to daily life. But the majority of training time was taken up with endless repetitions of techniques, with making our own bod­ies more supple and less resistant to discomfort.

Last summer, I was in another city and stopped by an aikido dojo where the teacher was a former student of Morihei Uyeshiba. The teacher was respected in the aikido world, and when I had a chance to talk with him after practice, I asked about all those people who are "doing aikido" without ever seeming to perspire or ache or even move very much at all. His reply should be of inter­est to anyone who follows the budo.

"Imagine a couple of glasses, both filled with dirty water," the sensei said. "One of them you place on a shelf and allow to sit undisturbed. You pour the contents of the other glass into a pan on a stove with the flame turned up. If you allow the first glass to sit for a couple of days, the water will settle and clear. Likewise, if you heat the water on the stove for a time, its impurities will be boiled out. The glasses, after these two treatments, will both be clear. That is, they will both look clear. But if you want to tell them apart, all you have to do is shake them up a bit. When you shake the glasses, the first will immediately muddy back up. After all, the dirt hasn't left the water. It's only settled to the bottom, out of sight. The glass that's been purified through the boiling process, however, will stay clear no matter how hard it's shaken".

The sensei pointed out that a number of would-be aikidoka—and budoka of all sorts, for that matter—take up their art because they wish to find a path of puri­fication, mentally and spiritually. They're seeking a way that will clarify them, a path through life that will "unmuddy" things, cleanse them of their fears and other limitations. Unfortunately, he noted, they can be tempted to attain that purification through intellect. They sit and discuss aikido philosophy. They employ long lectures and books that engage them mentally. They immerse themselves in parlor tricks and other stunts to try to understand the process of purification.

These people, the sense) observed, have confused the settled water for the purified. Intellectually, they've grasped the process. But life cannot be lived in a wholly intellectual way. When the out-of-control auto careens across the street into your path, when a street punk with a knife lunges unexpectedly, there's no time to become "settled". You must respond purely, instantly, without cognitive thought. And that kind of reaction can be achieved only one way, the sense! told me. You must boil yourself, training and training, heating your spirit until it glows and burns away the muddiness of your doubt and hesitation. In the budo, you can never be content with merely being settled. You must constantly try to be­come like the pure water.

Exercise after Lap-Band®

Before starting any exercise program please consult with your doctor.

You already know that surgery is not a miracle. Along with dietary and behavioral changes, exercise is an important component to your weight loss success. Exercise not only helps you lose and maintain weight, it provides many physical, emotional and health benefits.

According to the American College of Sports Medicine (ACSM) and the American Heart Association (AHA) it is recommended that:
-Healthy adults aged 18-65 years participate in
1. Aerobic activity: A minimum of 30 minutes of moderate-intensity activity 5 days per week
or 20 minutes of vigorous-intensity activity 3 days per week.
2. Muscular strength and endurance: A minimum of 8-10 exercises performed on two or
more nonconsecutive days each week using the major muscle groups. Resistance should
allow for 8-12 repetitions of each exercise.
-Adults 65 years of age and over and adults aged 50-64 with chronic conditions or physical function limitations that affect mobility or physical fitness participate in
1. Aerobic activity: A minimum of 30 minutes of moderate intensity activity 5 days per week
or 20 minutes of vigorous activity 3 days per week.
2. Muscular strength and endurance (resistance training): A minimum of 8-10 exercises
performed on two or more nonconsecutive days per week using the major muscle groups.
Resistance should allow for 10-15 repetitions of each exercise.
3. Flexibility: Perform flexibility exercises for at least 10 minutes two days per week.

Everyone will be starting out at a different fitness level. One may not initially be able to meet these recommendations. From your current abilities gradually increase as tolerated until you meet or exceed these recommendations. Exercise sessions can be broken down into 10-15 minute segments. You do not have to accumulate the entire 30 minutes in one bout. For example you could walk for 10 minutes three times per day to meet your recommendations. Also remember to incorporate more activity into your leisure time and activities of daily living such as: parking farther from your destination, using the stairs instead of the elevator, walking instead of using a cart while golfing, or going bowling instead of to a movie with your family.
There are a variety of activities one can do to meet their exercise guidelines, the key is to find something you enjoy doing. Try walking, biking, yoga, pilates, swimming, aerobics classes, dancing, skiing, or hiking

As stated in the recommendations, exercise needs to be of moderate to vigorous activity. This means that one needs to be working at an above normal intensity. For example while doing aerobic activities you should feel your heart rate increase, it should become more difficult to breathe, and you should break a sweat. You can use your heart rate or the rate of perceived (RPE) scale to assess the intensity of your exercise.

To figure out your individualized heart rate use the following formula:
1. 220 – your age = Max Heart Rate (MHR)
2. MHR – Resting Heart Rate (RHR) = Heart Rate Reserve (HRR)
*To figure out your RHR take your pulse while you are sitting quietly for 30 seconds then
multiply that number by two
3. HRR x % desired intensity (50-85%) = percent of HRR
4. Percent of HRR + RHR = Target Heart Rate

Example:
220 – 40 years of age = 180 (MHR) Your heart rate should not exceed this number
180 – 85 beats per minute (RHR) = 95 (HRR)
95 x 0.50 = 47; 95 x 0.85 = 80 (Percent of HRR)
47+85 = 132; 80 + 85 = 165
Therefore your target heart rate during exercise is 132 to 165 beats per minute. If your heart rate is below these numbers during exercise you need to increase your intensity.

One can also use the Rate of Perceived Exertion Scale (RPE). The RPE scale allows you to assess how hard you are working.
RPE 1-2
No exertion, takes no effort to talk
RPE 3
Easy, talking with almost no effort
RPE 4
Somewhat easy, can talk with little effort
RPE 5
Moderately easy, can talk with moderate effort
RPE 6
Moderately hard, takes some effort to talk
RPE 7
Difficult, requires effort to talk
RPE 8
Very difficult, requires maximal effort to talk
RPE 9 - 10
Maximum effort, not able to talk

For moderate intensity activity you should be between a 4 and 6 on the RPE scale. Vigorous activity would be above a 6 on the scale. Remember the scale allows you to assess your intensity. Everyone is unique an activity you feel is a 6 may be a 3 or 8 to someone else.

As you become more fit, activities that once seemed difficult will become easier. Use the FIT principle to improve your fitness level.
F (Frequency): Increase the number of times you do an activity. For example if you walk 3 times a week, increase to 5 times per week
I (Intensity): Increase how hard you are working. For example if you walk 3 miles in 45 minutes, increase how fast you are walking and walk 3 miles in 40 minutes.
T (Time): Increase the amount of time you are active. For example if you walk 30 minutes, increase to 45 minutes.
By changing any or all of these factors you improve your fitness. It is important to change your routine so that your body is continually challenged.

In addition to promoting weight loss, physical activity has numerous benefits:
-Improves cardiovascular fitness and health: decreases blood pressure, triglycerides, and
cholesterol; reduces risk of heart attack, high blood pressure, and stroke; improves circulation;
stronger heart
-Preserves and increases lean muscle mass
-Promotes fat loss
-Reduces the decline in resting metabolic rate that accompanies calorie restriction
-Decreases intra-abdominal fat
-Improves muscular strength and endurance
-Reduces risk of injury
-Improves endurance and ability to do activities of daily living
-Builds and maintains healthy bones, muscles and joints, reduces risk for osteoporosis and hip
fractures
-Reduces risk of diabetes/ Improves blood glucose control, decreases insulin resistance,
decreases blood sugar levels during and after exercise
-Improves mood, relieves symptoms of depression and anxiety, decreases stress
-Improves sleep
-Improves self-esteem and psychological well being
-Improves quality of life
-Increases energy and endurance
-Improves overall health
-Burns calories
-Slows the effects of aging
-Extends life
-Improves immune system function

Tips:
Start out slow and increase as tolerated
Use proper form to avoid injury
Exercise at the same time daily to create a habit
Make an exercise appointment and honor it as you would any other appointment
Find activities that you enjoy doing
Find an excuse to exercise instead of not to exercise
Vary workouts to alleviate boredom
Set realistic and achievable goals
Find a workout buddy to keep you motivated
Put yourself and your health first!