OUR HEALTH AS WE AGE
My vision is for a healthier future for all Australians
By Samantha Pillay
Why am I so passionate about looking after our health as we age?
I’m ageing. There is a good chance I am more than halfway, and I’m not too fond of that idea. I hope I live long enough to receive a letter from The King. Of course, I want to stay fit, active and healthy.
As a surgeon, I see health as the greatest determinant of one’s quality of life, not money or possessions.
We can influence many factors: obesity, Type 2 diabetes, heart disease, mental health, mobility, stroke, lung disease, cancers, and more.
A commitment to a healthy diet, regular exercise, avoidance of tobacco and alcohol and looking after our mental health requires effort, akin to having a second job. Even though this commitment can slow down ageing and not reverse it, I would argue it is worth the time and effort when faced with the alternatives.
Not only do I see the impact of health problems on my patients’ daily lives, finances, and happiness, I have experienced restrictions firsthand.
From bilateral congenital hip dysplasia diagnosed late, life was dictated by varying degrees of pain with restricted mobility despite several corrective surgeries. Every decision I made involved a calculation taking into consideration my restrictions and pain tolerance.
Looking after my health has always felt like a full-time job. As a child, it was constant physiotherapy and orthopaedic outpatient visits. In my 20s and 30s, training consisted of regular physiotherapy, pilates, swimming, and gym work, up to 9 sessions a week. This commitment allowed me to work and lead what seemed a somewhat everyday life to the outsider. I felt like it kept me falling off a cliff into disability, unemployment and reliance on pain medication. Yet, at times I was spending hundreds of dollars a week on pilates, physiotherapy and training to keep me capable of working long hours required for my career. This regime left little time for family or friends or other pursuits. The concentration and focus needed at work was the best medicine and one of the few things that could block out the pain.
Since my hip replacement in 2017, life has been something I could never have imagined – relatively pain-free. Most of the intense pain was gone instantly. New pains appeared in the rest of my body as I stood and walked more than I had ever before. I recall standing, the day after surgery. Instead of taking all my weight through my better, left leg, I put weight through my right leg without pain. That was an extraordinary moment in my life, like holding your newborn child for the first time.
Within a few months, my ability was more than it had been as a child or in my twenties. It has taken years to improve beyond what I have ever had before. I am still improving and I don’t know what level I will be able to reach. Everything now is new territory.
I understand the effort required to stop the decline or to make advancements when you have health problems. It is not the same as training for someone who has no restrictions and can play sport or go for a run. The wins are small and can take months. By the time I had a hip replacement at age 48, I had so much muscle wasting I had not been able to lift my leg when lying for years, and I had never been able to lift it more than 45 degrees from the floor.
I started by just looking at my leg for the first few months. I could tighten the muscle but not move it. I focused on first learning to shift it sideways. It started being only a few millimetres on a piece of silk on the bed. Without the silk, the bedsheet offered too much resistance. Eventually, I could move it on the bedsheet. My son would lift my leg slightly off the bed, and I would try to resist the fall. It still felt like he was taking most of the weight, but I could feel my muscles working. Eventually, I could break the fall before my leg hit the bed. I gradually extended the range and could lift my leg a short distance off the bed. I developed the range of movement, then added a shoe, before eventually a 1 kg ankle weight over the next two years. I had to stay focused on the wins, forcing myself not to think about how slow the progress was in those early days; otherwise, it would reduce me to tears. The most challenging work was in the early days where the gains were the smallest. It was three years before I could stand on one leg without letting the other hip drop, let alone start to try to hitch the hip upwards. Something no one else but me believed I would ever be able to do.
Like most things in life, it started to get easier with time, patience, and long hours. Now when I exercise, it looks more like what other people do, and I wonder what those other people in the gym used to think watching me spend hours trying to stand on one leg.
The reality was no one could do the work for me, and the gains were slow.
When educating my patients with incontinence about pelvic floor exercises, I realised that I couldn’t do it for them or be there to remind them every day. They often face life stresses, time-poor, weak muscles, obesity, and require endless effort for incremental improvements. My work is not just to educate but to motivate and inspire my patients to maintain and improve their health as they age. Getting results requires improvements in all aspects of their health, not just pelvic floor exercises. The alternative to effort, is no effort, and a faster decline with ageing.
Yet, I know from my struggles that you can improve your health and make changes. If I can do it, you can do it too. Please believe in your ability as much as I believe in you. One’s self-belief and self-efficacy is the first battle to take the steps required to make the changes you desire and become the best versions of yourself.