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Who's in charge, you or your chronic conditions?

In their book Living a Healthy Life with Chronic Conditions, Stanford University researcher Kate Lorig and her coauthors acknowledge the oxymoronic nature of the book's title. How can you have an illness and live a healthy life?

The answer is, you really can't. At least not in the sense of never experiencing unpleasant symptoms after having been diagnosed with a chronic illness like diabetes, heart disease, cancer, stroke, arthritis or emphysema.

However, you can learn to manage those symptoms to such an extent that the illness doesn't take over your life. That's the point of their book, which offers hundreds of tips and strategies for coping with, if not outright defeating, chronic conditions. It's also the point of a new workshop-style course offered through the University of Nevada, Reno Sanford Center for Aging.

Adding Years to Life: Self-Managing Chronic Conditions teaches the very same strategies developed by Lorig and her colleagues over 25 years at Stanford. The workshops meet once a week, 2 1/2 hours a day for six weeks. The first two workshops will be in July-August and September-October in Reno. For more information or to register, call (775) 784-4774.

What would you learn at these workshops? Here are some examples of tips and strategies taken from the book:

• You may feel sleepy after eating a heavy meal, but don't try eating right before bed as a way to induce sleep. Sleep is meant to allow your body time to rest and recover, and when you eat, this takes valuable time away from this healing process.
• Controlled exercise can give you the flexibility and strength to overcome debilitating illnesses. Here's an exercise of which you may not be aware: Sitting in a straight-back chair, place a rolling pin (or a large dowel or closet rod) under the arch of your foot, and roll it back and forth. It feels great and stretches the ligaments in the arch of the foot.
• Breathe right. Not every adult breathes effectively naturally. It's especially important for people with lung diseases. You can learn ways of breathing that enhance the functioning of your respiratory system. One of the primary reasons people with lung diseases feel short of breath and can't seem to get enough air in is because they don't get the old air out.
  

If mobility or joint pain is a problem, here are some tips:

• Make half of your bed while you are still in it. Pull the top sheet and blanket up on one side and smooth them out. Exit from the unmade side, which is then easy to finish.
• Lead with your stronger leg when going up stairs. Lead with your weaker leg going down.
• If you have difficulty using a knife, try a “rocker” knife or pizza cutter, which requires the use of only one hand.

The Sanford Center for Aging workshops cover not just the physical dimensions of managing a disease but such considerations as communicating with family and health professionals about your illness, how to make treatment decisions, how to manage your medicines, and how to plan for the future.

There's also the psychological dimension, which is often the hardest to manage. With an acute illness, such as a broken bone or appendicitis, you expect to recover fully. But with chronic illnesses, the symptoms - although they will vary in intensity - are likely to be with you for life. Plus they can feed on one another.

For example, lung diseases may cause you to become short of breath very easily and make it difficult for you to get around, work and play. It's depressing and stressful not being able to do what you used to. But as Lorig and colleagues point out, depression causes fatigue, and stress causes tense muscles. These can lead to more pain or shortness of breath, and so on.

If you are 65 or older and don't have any chronic conditions, congratulations, you've beaten the odds. It's also likely that, as the old saying goes, “You've been living right.” That's because most chronic conditions are preventable. If you smoked, ate poorly and didn't exercise in your younger years, odds are excellent that you are now dealing with cancer, diabetes or heart disease, or all three. Statistics show that the average person 65 or older today has 2.2 chronic conditions. One reason, in addition to the prevalence of unhealthy lifestyle choices, is that people are living longer on average in spite of those choices. Diseases like polio and tuberculosis that caused what we now think of as untimely death have all but been eliminated in the developed world. As a result, more of us than ever before are getting to experience old-age conditions like sight-robbing macular degeneration, which most often strikes people past age 80.

If we are going to live longer, we're almost certainly going to experience chronic illnesses. But we have a choice: We can allow these illnesses to manage our lives, or we can learn how to manage them - with medicine, food, exercise, attitude and other resources - so we get as much enjoyment as possible out of those extra years.

Lawrence J. Weiss, Ph.D., is director of the University of Nevada, Reno Sanford Center for Aging and an adjunct associate professor of medicine.