Need mobility issues help, GP isn't helpful

June 6, 2023 2:46 PM

I do not want any weight loss advice or even a hint of it. I am very heavy right now, I am trying to figure out ways to be more mobile in the body I have right now, I don't know who to ask or even what to ask, and my doctor hasn't made any suggestions. Regardless of why I am having mobility issues, I am having them and I deserve to be given information to make my life more livable, I'd welcome suggestions on who to ask and where to go. More inside.

Specifically: first, I'd like exercises I can do while sitting to increase my cardiovascular ability. I do not have access to a gym or a pool, I am pretty much housebound right now. I do have a partner who can drive me places, but I'd rather do most or all of this inside for now.
Second, who do I ask about mobility aids, I just found out about rollators and found one that will fit my high weight but low height. I found a stability cane, it seems a bit unwieldy, I'd like to know where to go to ask about mobility aids I may not know about, and hopefully some that are geared towards heavy people.
Third, when I have my yearly physical, is an occupational therapist something appropriate and useful I should ask my doctor about? Or a patient advocate? I really have no idea. In addition, is the fact that my difficulties are being caused by high weight rather then something else, like a stroke or accident for instance, going to cause issues? I feel like people would just rather I shut up and stay hidden rather than try to at least get out there and move some. No one has said that to me, but no one has encouraged me either, I feel very alone in this, so please be kind and NO WEIGHT LOSS ADVICE, not even a little. Thanks folks.

posted by A Fine Kettle of Socks to Health & Fitness (23 answers total)

I don't know about the other two but for your first request, I used an app called Wakeout last year and I really liked it. It had little exercises you could do while seated and they only last a minute or two at a time. But it was enough movement that it made you feel like you were getting a little bit done throughout the day. I know there are other apps like that out there so maybe trying a few and seeing what you like would be good. I'd also check out stretching and limited mobility exercise videos on youtube and see if there's something you like there.
posted by dawkins_7 at 3:07 PM on June 6, 2023 [2 favorites]

For seated cardio, you could try something like Wii Sports or similar games on the Switch that use hand-held controllers and motion control. My mom was recently unable to stand much, but had fun and was able to get her heart-rate up doing the boxing game on Wii Sports. The consoles can be found pretty cheap now, and the game structure made it easier to stick with than just doing shadow-boxing or something similar on her own. She got good feedback from her doctor on the idea, as well, and he said he'd be recommending it to other patients with limited mobility.
posted by duien at 3:07 PM on June 6, 2023 [1 favorite]

I think physical therapy or occupational therapy would be absolutely appropriate here. You need help figuring how how to gain strength and increase mobility with the resources you have and this is exactly what pt/ot does.
Personally I'd call a local place and ask what they would need for you to be able to come then simply request that from your GP in a simple message that says " I'd ike to try some pt to help get me moving better could you sign xyz thanks!" And leave it there.

Here the local national chain places are Athletico and ATI, ymmv if US based on insurance and location.
posted by AlexiaSky at 3:08 PM on June 6, 2023 [10 favorites]

For exercises you can do while sitting, look at seated tai chi. Here is a DVD for arthritis patients, but it will work for anyone with mobility issues: https://us.taichiproductions.com/dvds/arthritis/seated-tai-chi-for-arthritis/

I'm sure you can find a lot of other seated tai chi resources online.

Darebee also has a lot of seated workouts available: https://darebee.com/collections/seated-workouts-collection.html

As for who to ask your doctor about, I don't have a good answer but just wanted to say that I understand your frustration, at least a little bit. You are not alone in this. I'm overweight, and when I've tried to speak to dietitians or nutritionists they all immediately assume I'm diabetic and then get completely lost when I tell them that I'm not. It's like all their mental scripts are based around "heavy person, must be diabetic, so they need to do..." and that's not what I'm asking for.

I have found that if I'm just direct with my GP and say, "I'm having this issue, I want to do this thing, so who exactly do I need to talk to about that..." that I get better results. If I lead them down the road of "problem -> solution" they can go into problem solving mode and give me an answer or point me in a better direction.
posted by ralan at 3:09 PM on June 6, 2023 [7 favorites]

For cardio you can do while sitting, an exercise bike might work for you, if you can afford to throw some money at this. If you have even more money to throw at this, a VR headset and the program VZfit will make you feel like you’re riding your bike through the streets of Paris, or anywhere that Google Maps goes, and you can go at your own pace. VZfit even has a way to gamify it so that you have fun while you’re exercising. I find that even just 10 minutes a day makes a difference in how I feel, You can DM and if you’d like more info.
posted by MexicanYenta at 3:17 PM on June 6, 2023

For cardio you can do while sitting, an exercise bike might work for you, if you can afford to throw some money at this.

A semi-recumbent is even better for this. You literally just sit there and move your legs in a cycling motion. It's a very easy way to get your heart rate up without having to worry about balance, etc.
posted by praemunire at 3:23 PM on June 6, 2023 [3 favorites]

Justin Agustin has a lot of beginner cardio routines, including seated ones, on his instagram. I haven't dealt with the website, but it has more content if you end up liking it.
posted by platypus of the universe at 3:24 PM on June 6, 2023 [3 favorites]

I am thinking something like an under the desk sitting elliptical machine? Something like this -- this link is at random, I know nothing about this specific brand or model.
posted by virve at 3:26 PM on June 6, 2023

(I don't know your weight, but this relatively inexpensive bike works fine up to 240 lb. They had it in my gym for a while. Nothing fancy but does what you need.)
posted by praemunire at 3:27 PM on June 6, 2023 [1 favorite]

I weigh about 270 lbs, and this last fall, after a long illness, my pain doctor sent me to an occupational therapist, and it was fantastic. I'd done physical therapy in the past, without a lot of success, but the occupational therapist focused on function: what can I do, what can't I do that I wish I could, what are my goals and how can I achieve them. We worked together really well and my fitness improved dramatically. So I highly recommend that. My OT specializes in working with people with chronic pain; she's part of the practice at my pain doctor's office. My doctor feels strongly that her being specialized in that area makes her a more effective OT for people like me, but I don't have other experience with OTs so I don't know how different/special she might be.

One of the problems I had with multiple physical therapists is that every single one of them seemed to have a program they wanted to take me through, without asking me about my own goals and functionality. With at least two of them, they were absolutely flummoxed when they wanted me to do certain exercises I literally could not do because I couldn't stand long enough. Maybe I just had, like, four bad PTs in a row, but I've had good experiences in the past with PTs. It just seems like, in my experience, they're great for recovering from a specific injury but not so great at looking at how your abilities and impairments fit into your whole life.

I use three mobility aids quite regularly: a cane; a manual wheelchair; and a scooter. Which one I use depends on how far I have to go, how is my pain/energy level that day, even, "Is this a thing I could walk to do, like going into a store for a quick errand, but will be too much if there's a delay and I need to stand longer than a couple of minutes." A rollator is great for this—it's a seat you have with you ALL THE TIME. The reason I don't use my rollator regularly is that it doesn't help with the pain I experience from standing and walking, but I know other people for whom rollators are a great choice.

I would say, too, that, while many medical professionals will assume your physical difficulties are due to your weight, that may not be true. More than once in my life I've achieved tremendous gains in functionality without losing an ounce, including during this past 12 months while I've been recovering from a long illness that, among other things, was very deconditioning. You can absolutely get more fit, stronger, and more flexible without weight loss, and you can reduce your pain as well, depending on the source of your pain. Improved muscle tone has really reduced my arthritis knee pain, for instance, again without losing weight.

Oh, a couple of other ideas: orthopedic cushions can make a big difference. I have one I sit on that significantly reduces my low back pain from sitting in a chair. I've had more than one friend who carried their orthopedic cushion with them everywhere. Just one more thing to think about.

Good luck. I hope you start feeling better soon, and get good care from your medical team.
posted by Well I never at 3:41 PM on June 6, 2023 [13 favorites]

You could look at under desk pedals for some low impact activity. A You Tube search for "chair yoga" will bring up many options for gentle stretching and movement. Same for "seated weight lifting" doing something with 1-2 pounds is great start. Seated band workouts could also be something you enjoy.
posted by brookeb at 4:42 PM on June 6, 2023

Also, not sure where you're located, but you might want to look for a list of fat friendly health professionals who will help you focus on your overall health and well being without simply haranguing you about your weight or assuming weight loss will solve all your health issues.
posted by brookeb at 4:45 PM on June 6, 2023 [1 favorite]

You could also ask your doctor for a referral for aquatic therapy.
posted by oceano at 5:25 PM on June 6, 2023

Finding a Health At Every Size provider through ASDAH is likely to be helpful in avoiding weight based discrimination and abuse and getting useful help with movement and mobility aids.
posted by shadygrove at 5:38 PM on June 6, 2023 [2 favorites]

One mobility aid I just found out about is a car handle support to make it easier to get in and out of vehicles. They are pretty affordable and this one is rated up to 500 pounds.
posted by lizard music at 5:58 PM on June 6, 2023 [3 favorites]

It may sound silly but one of the reasons Richard Simmons was so beloved was the positive attitude and also his ability to do lots of modifications for various exercises (including sitting). I’m sure you could find some YouTube videos to “try before you buy” and see if it’s a match for you. I can’t remember specifically if he has “weight loss phrases” in the routines or not, my apologies if he does and I’ve put you on the wrong path!
posted by raccoon409 at 6:00 PM on June 6, 2023 [1 favorite]

Seated physical therapy is a useful youtube search.

Seated physical therapy with fitness bands is another useful one. You can use a simple/cheap set of fitness bands such as the ones you will find here.
posted by flug at 12:55 AM on June 7, 2023

My parents have both had in-home physical therapist and occupational therapy. You can ask your doctor if they will prescribe that and then see how it goes. Those types of providers seem to be a lot more helpful in making progress from where you area, vs a physicial. It is also very helpful that they can see your home, what you are able to do there, what you have trouble with, etc.

The occupational therapist is exactly the person who is an expert in helping you find the equipment & aids you need to accomplish the tasks of daily life.

Another option is physical therapy via telehealth. One example provider here. FYI in some states you can need a prescription from a doctor, in others not. Either way, a chat on the phone with a physical therapy clinic would help you figure out how to get started.
posted by flug at 1:16 AM on June 7, 2023

Well I never's comment gave me an idea: if you look for a physical therapist, maybe try finding one who specializes in chronic pain or chronic conditions. They aren't less likely to be fatphobic than the general population, unfortunately, but they will have more experience with working with mobility limitations, and be better at thinking about slow, long-term gain in function rather than the usual in-and-out, short-term, "return this able-bodied person back to perfect condition" mentality.
posted by fire, water, earth, air at 1:51 AM on June 7, 2023

the professionals who could help would be an exercise physiologist and occupational therapist.
posted by chiquitita at 3:10 AM on June 7, 2023

I do believe that an OT (occupational therapist) would be the right kind of professional to help you. I've been doing a deep dive into EquipMeOT's Instagram and YouTube pages. She's an OT who shows so many great mobility-related devices and hacks to make life easier for folks with all sorts of limitations. She shows them with no stigma attached, and finds things that don't look 'medical.' If you've got some time to dig into her videos, you may find some things that help you. Only caveat is that she doesn't seem to specialize in working with people who are heavier. She includes info about that sometimes in her videos, but it's not her focus.

That being said, many of the tools and tricks can work for a variety of people. I didn't find any others who focus on bariatrics in OT on instagram, but some internet searches show that there are people who are training in and focusing on making life easier for overweight people with mobility issues. Maybe you can find an OT in your area who's already developed some tricks in this area. But even if not, OTs are problem solvers at heart, so they want you to come to them with a list of things you're having difficulty with.

OT is about living your life with what you've got right now. PT is about getting yourself stronger and improving your abilities.
posted by hydra77 at 9:10 AM on June 7, 2023 [4 favorites]

I recently discovered Jessica Valant Pilates on YouTube. Perhaps some of her content might be helpful for you or others: https://jessicavalantpilates.com/about-me
posted by kinddieserzeit at 10:26 PM on June 7, 2023

There are some sitting and lying down exercises in feldenkrais. You might check out this site https://feldenkraisproject.com/collections/, with a large collection of free exercises. I didn't see anything about weight loss on the site, I haven't read more than few pages but the focus is very much on functionality not appearance. They are not aerobic exercises but focus more on moving the body in ways that work for you, reduce pain, etc. So might help in some ways that would make it easier to do exercises that more directly increase your cardiovascular ability.

Occupational therapist is a great person to talk to about mobility aids, can help you choose ones to meet your health goals and help with how to use them as well.
posted by yohko at 8:58 AM on June 8, 2023