What should a doctor's note say so that I can acheive my morbid obesity fitness goal?

September 27, 2012 5:05 PM

Obese and diabetic is no way to go through life son, so I want/need/have to exercise. Problem: Most entities (exercise programs, gyms, trainers) want a doctor's note from me to prove I won't drop fucking dead while attempting to exercise. I want to get a note (one singular note) from my doctor that will allow me to participate in as many different exercise programs as possible. What should the note say?

You are not my doctor. If you were, this would be costing me $15. You are not giving me medical advice. If you were, I'd be getting an EOB from my insurance company.

I was recently diagnosed with Type 2 Diabetes and it has been suggested to me that exercise might be a good thing. Challenge accepted. When I saw my primary care doctor in July, she said as much, but I didn't think to get a fucking note to that effect to present to the fascists that run exercise programs.

A couple weeks after I saw my primary care doctor I went to use the gym at work because they were offering one month free membership, but (wamp wamp) I couldn't pass the blood pressure test (165/95, 167/98) that the Nazis in charge of the gym require in order to screen out people who need to exercise. I was so mad, I quit fucking smoking to try and bring my BP down into the "let him fucking exercise" range.

I signed up for a class at REI but decided to lie and say I don't have diabetes rather than admit it and potentially be required to get a doctor's note because I'm going to go fucking broke if I have to pay a co-pay to get a note from my doctor every time I want to try a different exercise activity.

I have an appointment with my primary care doctor in early October. I'd like to get one note that would cover participation in any conceivable exercise activity. What words should that note contain?

posted by Rob Rockets to health & fitness (27 answers total)

Call your doctor's office. If your primary is like mine, she'll write the note and mail it to you.
posted by xingcat at 5:15 PM on September 27, 2012 [3 favorites]

RX: exercise to tolerance one (1) hr. q.d. for ninety days, renew indefinitely. Medically cleared for exercise to tolerance. Or do as xingcat suggests.
posted by rmhsinc at 5:17 PM on September 27, 2012

They'll probably even fax it.
posted by bq at 5:17 PM on September 27, 2012 [2 favorites]

When you get the note, xerox it so you can use it multiple times.
posted by BlahLaLa at 5:33 PM on September 27, 2012 [1 favorite]

I agree with xingcat. I doubt this will cost you a copay, especially since your doctor has already said that she thinks you should exercise. Just call the office and tell them what you need.
posted by jaguar at 5:40 PM on September 27, 2012

Not directly an answer but exercise doesn't need to cost money. Walking / running, etc. are free for the doing.
posted by BrooksCooper at 5:45 PM on September 27, 2012 [3 favorites]

I couldn't pass the blood pressure test (165/95, 167/98) that the Nazis in charge of the gym require in order to screen out people who need to exercise.

As a side note, those blood pressure readings are quite high. I don't know if you also have that as a diagnosis but you might want to inform your doctor about it.

I'm sure your doctor will provide the note, but in the meantime, how about considering walking for a short period of time every day? It doesn't have to be a gym or some other official regimen to be beneficial.
posted by Sal and Richard at 5:50 PM on September 27, 2012 [4 favorites]

I have no idea but as a doctor, most of those notes that I've seen/used are pre-printed so that I can just check a box and sign my name at the bottom. So you may not need to worry at all about what it says because there is strong likelihood of some sort of xeroxed form

"___Rob Rockets___ is cleared to [] return to work [] return to school [] exercise with the following restrictions: __none__."
posted by treehorn+bunny at 6:12 PM on September 27, 2012 [3 favorites]

Have you called the office to ask if they have a form? I'll bet there's a form.
posted by Lyn Never at 6:23 PM on September 27, 2012

I own a Crossfit gym and have never require anybody with diabetes to provide a doctors note. YMMV, we ask of you have any health issues and I would definitely talk to you about your diabetes before starting you working out but I can't imagine requiring you to bring a doctors note. Thats what our waiver and insurance coverage is for.
posted by youthenrage at 6:29 PM on September 27, 2012 [1 favorite]

Lots of good advice here, but first of all I'd listen to Sal and Richard.
Get your blood pressure down, dude. You're ticking for a "heart event."
The good news is, walk a little every day and your odds go straight up.
I am not a doc.
posted by LonnieK at 6:49 PM on September 27, 2012 [1 favorite]

I was a morbidly obese diabetic when I started at a local gym, and they didn't ask for anything. Maybe you just need to go to a different gym that isn't part of your work? I am in Massachusetts. Dunno if there are laws in other states that require notes.

I didn't end up going to that gym, really. I got more accomplished by walking every day. Built up to an hour+. Down 85 pounds. Off all but one med for diabetes. Working on the last. Walk. Is fun! Can do it on your lunch break at work.

Now I go to the YMCA. I am still pretty big, but again, no note required. I swim, I weight lift with a class, and I hang out on the treadmill. I understand the anger. But there are solutions, I guarantee it.
posted by clone boulevard at 7:00 PM on September 27, 2012 [7 favorites]

I have asthma. I was annoyed when a gym once requested a doctor's note when I joined. My doctor wrote a note saying, shoesietart is in the best position to decide her ability to exercise.
posted by shoesietart at 7:25 PM on September 27, 2012 [1 favorite]

I think the issue is not the diabetes but the blood pressure. Exercise raises blood pressure further (temporarily for a few hours afterwards) and if someone already has very high blood pressure combined with a sedentary lifestyle jumping into an intense gym routine could cause major issues. A responsible owner who saw risk factors for a stroke in a potential client would try to team with the patient's doctor in planning a program, not throw them into a bunch of burpees and say "welp they signed a waiver!"
posted by schroedinger at 7:30 PM on September 27, 2012

I should have mentioned that my primary care doctor (all the doctors in the practice) have a written policy posted in the office that says they charge for an office visit to fill out a form.
posted by Rob Rockets at 7:31 PM on September 27, 2012

Call anyway. This is something they possibly may make an exception for. You don't know unless you ask. And frankly if it only costs you a copay, go ahead and do it. A copay is cheaper than a heart attack.
posted by St. Alia of the Bunnies at 7:45 PM on September 27, 2012 [2 favorites]

This phrase is telling: "the Nazis in charge of the gym". As several people above have noted, the demands that are being made are quite unusual, unless you live in some crazy place like, say, California.

Virtually every exercise center will require that you sign a form that basically says: Yes, I know I may be out of shape. I know that intensive exercise may do me harm. I accept any of these risks, including death. I won't sue you.

Anyone who demands more should be avoided. As others above have said, like Fleetwood Mac, you can go your own way.
posted by megatherium at 7:46 PM on September 27, 2012

PS. And while you decide what you want to do, start out walking. 8 weeks of walking will build your aerobic base. Starting slow and getting your body used to this will make it much more pleasant later.
posted by St. Alia of the Bunnies at 7:46 PM on September 27, 2012

(My gym used the carrot, not the stick in that they gave you half off the enrollment fee with a doc's note. Check on that, mine might not be the only one.)
posted by St. Alia of the Bunnies at 7:47 PM on September 27, 2012

Well, if you want to skip the $15, on top of the quitting smoking (good job, by the way, it's hard!) you can probably see good reductions in a month if you go for a walk every day, cut out carbs, and use "lite" (i.e. potassium/sodium chloride blend) salt instead of regular. Cutting out the carbs will have positive effects on your blood sugar, thus blood pressure, and likely prompt weight loss which will also lower your blood pressure. Using "lite" salt will compensate for any potassium reductions seen early on in low-carb diets and reduce sodium intake.
posted by schroedinger at 7:50 PM on September 27, 2012

My dr's office has one of those signs too, but I think that's more for workers comp and other formal forms. I bet they'd do a quick note for you if you call.
posted by radioamy at 8:05 PM on September 27, 2012

I am going to be brutally honest here: those BP numbers are very, very high. I can understand the frustration on your part, but the concern on the part of the gym is entirely reasonable. Call your doctor's office, get a note, but if you haven't already discussed your blood pressure with your doctor, please do so.
posted by Tiresias at 8:16 PM on September 27, 2012

I appreciate the concern about my BP. I think I should mention that these two particular readings were the two highest in recent memory, and that I consider them outliers compared to the many other BP readings I have had since my diabetes diagnosis in June. My BP trends a lot more normal than those two readings would indicate.

I appreciate the input about walking, especially from someone like clone boulevard who seems to have been in a similar position to what I am in now. Personally, I'd prefer to do something other than walking.
posted by Rob Rockets at 8:23 PM on September 27, 2012

I'm certain that you know it already, but I'm just jumping in to tell you that smoking is really bad for your blood pressure, so good for you if you've stayed off of them. Back when I was smoking I could get my BP up to like 180 on the systolic side (at the time I was also learning to measure blood pressure, so I fooled around) but, after quitting, it fell to 130 with basically no other changes in lifestyle.

As far as "things other than walking" go, if you understand the positions necessary to work out specific muscle groups you can do a lot around the house with your own bodyweight. And you can learn how to target muscle groups just by trying to target muscle groups and observing what gets worked, for the most part. Go slow. I don't just mean progress slowly in learning, but on the negative lift (when you're letting the weight back down, so to speak) going very slowly will get the maximum benefit for your muscles. The positive lift can be done as quickly as you care to.

For example, if you have a comfy chair or couch that you can lean back in you can approximate the standard crunch while watching tv. It may not be the greatest exercise, but if you work it out you'll certainly feel it, and there'll be time for the decline bench later.

I personally like to lean against a kitchen counter or heavy table and work my arms. If you do something like this be sure to keep your wrists straight. Form is extremely important when working with weight. You could learn a lot from one session with a trainer, but remembering and practicing everything by yourself requires considerable mindfulness (for me, anyhow).

If you want to be more serious around the house you might see what you can do with something like this: http://www.youtube.com/watch?v=WG2N0WKmquE

Also, if you'd like to contact me via memail I could propose a couple more exercises -- including a killer one for building/toning your neck and chin -- but do note that I'm neither a trainer nor doctor nor expert of any kind.
posted by mr. digits at 6:22 AM on September 28, 2012

Oh, and if you buy a set of elastic exercise bands and have a door to anchor them to you can do all sorts of exercises. I don't know much about it, but a lot of people do it.
posted by mr. digits at 6:29 AM on September 28, 2012

The rules are prohibiting you from doing what you need to do; how frustrating. But they exist because many people start a program, overdo it, and have a Bad Result. Call the doctor's office. Get some referrals for exercise programs, both specific places, i..e, the 6th St. Y has a good 'Back in Shape' program Weds at 5, as well as a list of exercises, weights, target heart rates, etc., you should be aiming for. Good on you for starting; diabetes is really bad for you, and getting shape will help.
posted by theora55 at 1:08 PM on September 28, 2012

Just wanted to chime in and say don't let all this bullshit stop you. You've got great motivation - don't let this stupid hassle get you down. Once you get the note you're golden, so just push through!
posted by BlahLaLa at 1:55 PM on September 28, 2012 [1 favorite]