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David Stallings's avatar

Dr. S,

I believe strongly in what you note here, and work out daily. Unfortunately, I must rely on hormone therapy to (very well) control metastasized prostate cancer. Thus, by design, my testosterone is barely measurable, leaving me weak despite regular walking and exercise. It's all I can do. Is it likely to offset some of the negatives you discuss re: low muscle?

David S.

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Tanmeet Sethi, MD's avatar

David, such a good question. Many people are in your situation on therapy to keep cancer in remission, which is critical, but then left with the side consequences. There are more and more studies underway to give us answers about how and what you would need to do to offset that. But in the meantime, the studies we have and the clinical experience I have is that all is helpful. I love that you are walking and exercising. Are you doing any bodyweight or other resistance work as well? I would add that very slowly if you can. And getting a trainer is always a good idea, even if it's just to learn how to do some exercises safely for 1-3 sessions.

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Amba Gale's avatar

I loved your article. I love your Grace, and your making Grace avialable to me to make to myself, in this area. I give myself grace all the time, but not in this area. I am 80 years old and very vibrant and pretty damn healthy. When I am not leading courses (in which I stand for 8 hours at a time, pretty much, and I am able to do that though my body is really tired at the end of the day, I am working at my desk in front of my computer, writing, creating stuff. I sit. I don't stand. My integrative cardiologist suggested I get a standing desk. I got the equipment for it, but I don't use it. I am going to hold myself to account by telling you this shit. I am going to start by walking, right now, on my treadmill in the next room.

My husband and I will be going to Ireland in three weeks on a pilgrimage of sorts with a group. That lovely opportunity will involve walking about three miles a day. I am not in shape, so I am starting now.

Thank you.

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Tanmeet Sethi, MD's avatar

Amba, starting now is always the right place to start. That sounds like an amazing trip and great for your health and connection with others! I love that you have the equipment you need also and I hear you, even having it doesn't make it easy to start. Always give yourself grace that if you didn't start yesterday, today is the best time to try again. Can you let me know how it goes??

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Amba Gale's avatar

It's going well, Tanmeet. Thank you for asking. I am so glad I wrote to you. Today I doubled down and did two sessions. They are still short (6 minutes each) but I am expanding the time each day. Thank you for asking.

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Tanmeet Sethi, MD's avatar

That's amazing, happy to be your accountability buddy anytime. Starting is the hardest part!

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Fran Mason's avatar

I'm glad you've been lifting weights! Some of your readers might enjoy the new book about women and strength training, which is also a fun memoir: "A Physical Education" by Casey Johnston.

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Tanmeet Sethi, MD's avatar

Fran, I forgot to give you a shout out!! Anyone reading here, Fran is exactly how I started lifting and she taught me so much about how to lift safely. I still can hear you in my ear when I do a bench press or deadlift! Although I am now using a hex bar which feels safer for me, if you have any advice on that bar, let me know! And thank you for the book recommendation!

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Fran Mason's avatar

Thanks! I don't know much about the benefits of the hex bar and I wonder about its tendency to swing. But if you like it and feel safe, that's great! I've rarely tried one.

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Tanmeet Sethi, MD's avatar

Good thought on the swing. I think when there’s a good amount of weight on the bar, that’s less likely. I do love the hex bar now. Feels so much safer for my back!

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Cara L / Agelessly Active's avatar

Love that you are doing this series! Muscle is so important and people have a hard time understanding why as well as how to get started.

My work is around helping get people to the point where they can successfully be more active and do strength training. However, that doesn't mean they are going to.

I love being able to share your insights for the deeper insights. Thank you!

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Tanmeet Sethi, MD's avatar

Cara, I am so grateful for your work. I hope people here in the community can learn from you!

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Tracey Fecher's avatar

I switched from reformer Pilates 1.5 years ago to a functional weight training class to combat osteopenia. (My mother has osteoporosis) I was fortunate to find a functional weight training group class with a coach. There are two reasons this works well for me. 1: The community I’ve built with fellow neighbors working on gaining muscle. We groan and tease our coach when he has us do hard things like burpees followed by mountain climbers - sadistic. 😅 2: I just work harder when there is someone leading the class. I now can bench press 65 lbs. I found what works for me. Wishing the same for others.

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Tanmeet Sethi, MD's avatar

Wow Tracey this is SO inspiring! And I completely agree, I work harder in a class, I miss having someone to guide me in a class including Fran who is here on this thread!

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Regina G Beach's avatar

This is such a helpful post! One thing I repeat over and over to my students is "80% is good enough!" Whether you're just starting out, or like me, live with a chronic, energy limiting condition, there's can be a real internalized pressure to give it all you've got and then be too wiped out to pick up the next day. Small, incremental progress is where it's at.

I also find myself saying, "make it easy," "make sure you're still breathing," and "ask your body what it wants and where it would be most comfortable." I think a lot of people equate exercise with discomfort and even pain, which really is not helpful from a physical or mental health perspective. Thanks for including "movement snacking" it's easy to do a few squats, a few calf raises or even a good stretch when you're brushing your teeth, waiting for the kettle to boil or for a meeting to start.

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Megan Kaun's avatar

I would love it if someone could post some examples of video workouts that demonstrate some of the recommendations of this article. I'm noticing that my nervous system gets triggered when I consider coming back to a strength training regime...and I imagine I'm not alone. I wonder if anyone is pairing nervous system regulation alongside some of these strength training exercises. Thank you!

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