I was born with multiple birth defects including curvature of the spine, a dislocated hip, and clubfeet. Fifteen years ago I was diagnosed with type 2 diabetes. I also have congestive lung disease and congestive heart failure. With all this, I cannot walk more than 150 feet without getting out of breath. My legs and feet are constantly swollen. How do I exercise?
Robert L. Runkle
Hazle Township, Pa.
Bret Goodpaster, PhD, responds: The short answer to your question is that, as you have already experienced, traditional exercise will be a major challenge. Your disabilities preclude you from performing some of the most common types of exercises. You definitely should consult with your own doctor and with a physical therapist or exercise physiologist who can assess in person exactly which exercises will work for you.
In general, these might include arm or upper-body exercises, such as light hand weights or weight machines. You might also try swimming or water exercises. If swimming or water aerobics are difficult for you, be sure to exercise in the presence of a lifeguard or swimming instructor who can help you if you need it.
Many patients with diabetes have physical limitations, such as neuropathy, that might keep them from walking for extended periods of time. Still, there are various activities that may be worked into an exercise regimen, even if their duration or intensity must be limited. These exercises might include shorter periods of walking, stationary cycling, rowing, and swimming.
Physicians, nurses, and even most diabetes educators often are not appropriately trained to provide guidance about exercise for special conditions or limitations. So it is particularly important for you to get help from the right professionals. You may need to ask your doctor to refer you to a physical therapist or a good exercise physiologist. Call your insurance company and ask what is covered; don't be surprised if you're told that you'll have to pay for some or all of these services out-of-pocket. But don't hesitate to reach out; exercise is vital to diabetes management, and poor exercise can only exacerbate your physical limitations or, worse, disable you further.