I am not a fitness expert and I'm not trying to sell you on some revolutionary fitness regime.  I am making an observation about EMS that I know to be true and I think should be addressed.  I know quite a few EMTs and Paramedics who have a hypocritical attitude about wellness.  Are you one?  This article is dedicated to the health professional with the intent to inspire, not to criticize.  As an EMT, our job entails teaching prudent heart living and injury prevention to anyone who'll listen, but then we walk out the door and ignore everything we just said.  Why should the public take us seriously if we haven't even bought into it ourselves?  

In a few years, we will be the patients that we complain about now.  If I didn't maintain my car, I wouldn't count on much sympathy from you if it fell apart on me.  If you ever plan to: a) stay on the job, b) see your children graduate, c) enjoy a decent quality of life, or d) insert life goal here, you must consider the effects of poor nutrition, stress, and a sedentary lifestyle upon your body and do something about it.

I am not a perfect physical specimen by any means and I'm not advocating a major fitness overhaul unless of course your physician has advised one.  What I am advocating, however, is subtle lifestyle change until prudent heart living, increased strength and flexibility become a regular part of your life. 

I eat poorly sometimes.  I enjoy an occasional drop of the pure.  A nice cigar is an appropriate accompaniment to a special evening.  The point here (if you haven't picked it up yet) is that things are best done in moderation.  When you allow "the good things" to control your life, they're not so good anymore.  Neither is one expected to simply drop all of the old habits and begin anew.  Change takes time.  A common cause for failure in many wellness programs is trying to change too much too fast.  

Consider the novice who is training for a marathon.  When training for a marathon, runners are well advised to start off slow and get used to running for 30 minutes at just a nice, slow, leisurely pace.  Later, the runner is asked to increase to an hour of constant running.  Then a faster pace for an hour.  Then two hours.  Then three.  I think anyone could safely say that one doesn't just go out and run a marathon, they need to work up to it.  Likewise, your wellness plan should include initial benchmarks and achievable goals which, when successful, measure past performance, reinforce your positive attitude toward the program and encourage future improvement.

What can we do about our fitness situation?  Managing your nutritive goals and being cognizant of your mental state are a great start, along with a physical fitness plan.  These three items will be an excellent foundation for turning your new lifestyle into a habit.

Begin by watching what you put in that pie hole.  Scale back on the fast food and consider eating three squares a day.  Or more.  Recent studies advocate "grazing" (eating five or six smaller meals a day) to minimize spikes in blood glucose which only serve to sap energy.   Try eating and drinking less healthy foods only every other time you desire something to eat or drink. For example, consider substituting an apple or a pear instead of chips, or water instead of sweet tea.  A small bag of chips with 7 grams of fat and 105 calories can be replaced with a comparably sized bag of pretzels (0 grams of fat and 10 calories).  If you ate two bags of chips a day and substituted just one of them, you're already saving 49 grams of fat and 665 calories a week.  Another tip that someone gave me was to broil (grill, bake, whatever) extra meat when cooking dinner and refrigerate the extra in zip-lock bags.  Then when looking for something to snack on, try cutting off a small piece of the meat and eat that instead.  The protein is better for you and more satisfying than a candy bar.  While we're discussing what you're putting into your body, consider cutting back on the cigarettes, if that isn't an obvious suggestion.  If you can't quit, make a game out of holding off for an extra fifteen minutes when the craving comes.  By doing so, a smoker with a pack and a half a day habit (30 cigarettes over 15 hours at one cigarette per half-hour) can cut down to one pack a day (20 cigarettes over 15 hours at one cigarette per forty-five minutes).

Having a healthier attitude contributes significantly toward overall well being.  Try looking in the mirror and saying, "I love my job".  If you can't at least say, "I like my job," then you probably should consider another line of business.  For some of the volunteers out there, a friend of mine (a die-hard volunteer paramedic when not at her high-powered public relations job) realized she wanted to be a full-time paramedic more than she wanted to be in the rat race.  Now she's working on the job and, the last I heard, loves it.  You may be realizing the opposite, that emergency service just isn't satisfying anymore. Your attitude is an important tool for success.  How can you expect to succeed in the plan if you mentally subvert it?  You need to take a hard look and realize that you are capable of positive change and capable of doing whatever it is you want to do.  I'm sure you've heard it said that it's a case of  "mind over matter- if you don't mind, it doesn't matter".

Aside from the effect stress has on mental health, stress affects the body and influences physical fitness.  Stress can result in tension; tense muscles are more susceptible to injury.  Stress can affect sleep; sleep is necessary for healing your body.  Stress can affect your body's ability to fend off illness.  If your organization doesn't have an employee assistance program (EAP), do some research and convince your leaders just how important an EAP really is.  EAPs are not just for fixing the damage after it is done.  A good program will provide help with preventing stress as well.  

Some tips for alleviating stress: Take time to do something OTHER than work at this job.  Whether you're a career or volunteer provider doesn't matter.  Find a hobby that makes you laugh or at least feel good when you do it.  Here's something to try: Use your pulse oximeter as a biofeedback machine.  (If you haven't had a physical in a while and you have a risk of heart attack, consider getting one before going into any fitness program or performing this maneuver).  Put on the oximeter.  Look at your pulse.  Close your eyes and take a deep breath.  Blow out against pursed lips and while watching the read-out and controlling your breathing, watch as the pulse starts to lower.  Deep, controlled breathing is one of the easiest ways to minimize stress.  Exercise also minimizes stress and helps not only to make you stronger, but minimizes injury and to helps to build a strong foundation in case you do injure yourself.

Currently I'm trying to get statistics on EMS injuries.  I'm amazed that no significant studies pop up in my searches.  One government workplace study I was relying on lumps injuries and fatalities in EMS personnel into the health professional category.  I have read often which injuries account for the majority of EMS-related Worker's Compensation claims though; back injury.  Proper lifting sometimes isn't even enough.  I suffered my very own lower back injury myself last year.  Fortunately I was in halfway decent shape and I was able to get good rehabilitative treatment.  Within a few months I was close to normal again.  Again let me emphasize, you aren't just going to be able to jump right back in there unless you already have a foundation to build on.  If you've got other surrounding muscles that can take up some of the slack, the healing process will be a little easier.  If you're one of those belt-bustin', donut-eatin', EMTs whose idea of physical fitness is the walk from the bunk to the rig, well, the outcome probably won't be as good.  Accept some personal responsibility for your situation and do something to change it.  We all know someone who has blown out a back or a knee.  Cases like these are all the more reason to lose some weight, put on some muscle, and increase flexibility.

Exercise, my therapist reminded me, can't be stressed enough.  Your best bet is to make a plan.  A good plan will incorporate cardiovascular work as well as flexibility and resistance training.  Check with gyms, schools, or fitness clubs like the Leukemia Society's Team in Training to get help with your plan.  Our Safety Officer was able to get fitness professionals from local gyms to speak with us about different subjects like nutrition, proper lifting, stretching, and developing programs.  Most of these people are more than happy to help emergency service personnel for little or no charge.  Regardless, here are keys to a successful program.

1. Start gradually.  Set achievable goals and ease your way into the program.  Make your program fun and convenient.  Add variety.

2. Listen to your body.  You may need more rest at first.  You may actually sleep soundly for the first time in months.  Learn the difference between good pain and bad pain.

3. Keep a record.  One of the most satisfying things for me is completing that record of what I achieved.  When I ran my first marathon, one of the things that kept me inspired was looking back on all the mileage I was racking up.

4. Build a support network.  Hang out with friends who are motivated to go to the gym or walk or run.  Don't discount programs like Team in Training- you can train and raise money for a good cause and they not only help you with training tips but they keep you motivated.

5. Reward yourself.  My next reward is to return to Breckinridge for some serious skiing.  Reward yourself with some new clothes or tickets to a sports event, or even a steak dinner- if you've been good all week, one nice steak won't throw you over the edge, and it may even be the thing you look forward to each week.

6. Avoid negativity.  Like reminding yourself that you're 12 years older than your smart-ass rookie.  Instead remind yourself how good you feel and how much easier it is to fall asleep and how much easier it is to climb the stairs.  

7. Use prompts and cues.  Posters with the appropriate fitness technique or perhaps a picture of yourself when you were in better shape.  Finish each workout by making that journal entry and enjoying your progress.

As mentioned earlier, the successful plan requires being realistic and setting achievable goals. The early stages of your regime will be the hardest.  After the initial excitement, you may experience doubts.  The program may be too ambitious.  Your progress may be slower than anticipated.  Don't give up; re-evaluate your goals and adjust accordingly. Whatever you do, if you miss a day, or grab one of those donuts without thinking, don't beat yourself up over it.  Just resolve to do better the next day. 

Start slowly and get into some basic fitness training.  Take your time.  It's not all about running.  Try walking at the local mall, or at a school gym or track.  Make a game out of it.  For an on-duty workout with my crew, I picked out a different high-rise each shift and while wearing SCBA and cylinder, we walked the building looking for the electrical rooms, standpipes, etc.  Your pace should be such that you can hold a conversation, but singing would be difficult.  Remember to do an adequate warm-up and cool-down.

By taking a constructive approach to a fitness regimen, you can extend your life, extend your career, and even enjoy an occasional lard-covered sugar pill without too much guilt.  After all, muscle burns calories.  Fat burns nothing.  Reduce your risks.  Eat well, get proper rest, minimize stress, quit (or at least cut back on) smoking, get annual medical checkups and control your weight.  This business is already hazardous enough without your personal fitness making it worse.
 

About the author: Capt. Michael “Mick” Mayers has been a firefighter and paramedic, as well as a HAZMAT and rescue technician for 22 years. He is the Special Operations Coordinator for the Town of Hilton Head Island (SC) Division of Fire and Rescue.  Capt. Mayers is a member of NFPA 1006, Professional Qualifications for Rescue Technicians and has a degree in Fire Science Technology from Savannah Technical Institute.