Archive for January, 2016

Pemigewasset’s Free Health Spa

January 28, 2016

Sunday’s bright sun invited me up Mt. Pemigewasset in Franconia Notch for the thrill of One Winter Day at a Free Mountain Health Spa (FMHS.) I grabbed my microspikes and poles, packed my first aid kit, bivy sack, ginger tea and snacks, and headed north for the 1.7 mile hike up the mountain.

Thanks to earlier rain and high temperatures, there is a sneaky layer of ice under what few inches of snow we have, so it is best to keep that in mind with every step you take just about anywhere, but particularly over the variety of rocks and logs, puddles and streams that need to be negotiated on a hike.

An FMHS hike is different than other winter hikes because the object is to pump up a good sweat. On other winter hikes, we must layer our clothes judiciously to avoid any heavy sweating and potential chills. The last thing any winter hiker wants is a mishap needing a wait for help in wet clothes, or even a de-energizing slow cold walk out.

An FMHS hike is all about breathing. On the uphill, I usually pace myself using 2:1 breathing. My exhalations have to be twice as long as my inhalations. For example: exhale for 6 paces, inhale 3 paces and shift gears as necessary. When it becomes difficult for me to exhale for 2 paces and inhale for 1, it’s time to stop and rest a bit. The advantage to this breath is that it keeps me hiking in a relaxed state, yet gives my muscles a good stretch and squeeze. Hiking in tune with your own body is crucial. First, it guarantees that you will work up a good sweat. Think of it as the final spin on a complete wash. You still need the rinse cycle, but that comes later. Especially on the uphill, it is important to maintain a good sweat, not a roast, just a sweat. You may need to pocket your hat and open your jacket a bit.

Sweating clears the toxins and debris from our systems. An FMHS hike necessarily needs a brisk walk up a small, well- traveled mountain, one you have climbed before and know it is reasonable for you to complete the round trip and head home immediately after. Pack an extra layer to stay warm on the hike out. These recommendations are for an intentional FMHS hike only.

Using poles helps to distribute the weight so that our legs AND our arms are pumping us up the mountain without straining our knees. The Pemi trail winds its way around swells and streams, through hardwood forest gradually joined by evergreens that take over the nearer you come to the summit. The Pemi summit is a huge field of granite that wraps around evergreens to the east, looks south through the notch and west to Mt. Mooselauke.

At hike’s end, head right on home, treat yourself to a hot as you can stand mineral or solar salt bath, enjoy a warm meal, a good night’s sleep, and a fresh start on the rest of your life!

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The Challenge of Being Mortal

January 14, 2016

Being Mortal: Medicine and What Matters in the End, by Atul Gawande is a book about how people might live successfully all the way to their very end. Gawande is a practicing surgeon with a gift for putting medical challenges into language that the general public can easily understand. My response to the book’s goal was, “Oh my! Yes! Tell me more!” And he did. He gives us a little US history to put things in perspective.

Stage 1- The country was in extreme poverty, deaths occurred in the home because people did not have access to professional diagnosis and treatment.
Stage 2- US income levels increased. With greater resources for medical care, people turned to health care systems when ill, often died in the hospital instead of at home.
Stage 3- US income climbs to highest levels, people have the means to become concerned about quality of life, even in sickness, and deaths at home rise again.

Gawande takes us through a variety of existing assisted living situations with private living spaces that boast live plants, gardens, animals, birds, visiting children, and a variety of classes and activities. They are more like homes than the double occupancy nursing homes we know. Some have pod arrangements with private rooms for residents surrounding common kitchen and living areas. One includes an auditorium where concerts and lectures draw in the surrounding community as well as residents.

As more assistance is needed, Gawande takes us through several actual scenarios that underscore the need to clearly spell out what is important to us. Gawande leads us gently through palliative care conversations that make satisfying decisions about surgery and other treatment possible, what level of being alive is tolerable, what is most important. One person might be willing to go through a lot of pain to be able to eat all the chocolate ice cream he wants and to watch unlimited football on TV as long as possible. Another may not choose to prolong life if she can no longer be an active participant with others.

Gawande takes us through the way to have palliative care conversations that make dying a successful experience. We meet Hospice, the service that aims to make each day the best possible by managing pain and other symptoms and providing assistance as needed for a manageable steady state.

What could be a morbid book instead opens up the strength of persistence in managing our exit. We are still smoothing out the tangles of US history’s Stage 3. For their own families, even doctors must deal with the same hurdles in our medical/cultural system. Gawande has certainly cleared the road less taken for us.

Being Mortal is available in local libraries and through Inter Library Loan.