Radical Perseverance

"Radical perseverance" is truly a great ideal to put into practice in this time. I have been trying to get to the pool every day to swim, and have only missed a few days, so that finally I am managing to have a habit of exercise. When people would say "you have to take care of yourself," I never could make myself do it before. It is interesting to have the bite-size pieces, and to see what it takes to motivate myself to do it. I have started telling patients that they should buy themselves some gold stars, just like you got in kindergarten, and give yourself one every day you do the half-hour walk for heart health. After 10 gold stars, you get a present, and after another 10 gold stars, another present; and each of the presents have to be something which supports and nurtures healthy lifestyle choices. If it works for kindergartners, it should work for us, too! And it helps to stop self-critical voices, replacing them with positive feedback and rewards. My favorite present for the 10 gold stars is a massage. Second favorite is a pedicure. Meanwhile, it is bolstering the cardiac fitness, and bone health.
For bone health, the second level is to do 10k steps a day, which is about 5 miles. But start with a pedometer (you can get it at Big 5 sports) and check what is your average day like. Most women have about 3,000 steps. So you are going to try to go up to 3,500. Every day you do it, you get a gold star. And after a couple of months, giving yourself rewards for every 10 gold stars, you can go up to 4,000. The goal is to prevent osteoporosis, and to be healthy and dancing when you are 90!
Most people who lose weight gain it back. But doing the exercise first, and as a basic platform, helps you be one of the people who can keep it off. For weight loss, I now tell patients to aim for 25 lbs in 50 weeks. That way, you never trigger the famine response, which is to put 10 extra pounds on, after you diet. And you get increasingly fit, and feeling stronger the whole time.
Swimming is helping my back get stronger, so that I can do more, and now I started increasing my surgery load again. For awhile I kept thinking I was going to just have to quit operating, but last week I did two good laparoscopic-assisted vaginal hysterectomies, and it made me feel great that my patients were so happy, had so little pain, and went home soon, feeling good. Part of getting older is still trying to have enough "productivity" to be happy with myself and my work.
To persevere in the face of all that binds us down is a core part of aging gracefully. I really like the Vaclav Havel post about hope. Hope is for the not yet, and the "yeasty" things in life. I am trying to live with radical perseverance, and in joyful hope.