A word on Stuart Scott, and training sick people

Posted on January 14, 2015

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I’ve sparsely watched Sports Center the last decade, as the show has slowly morphed into the same extremist, repeat the same segments every night, media that so much else is. Tom Brady is about to go to yet another AFC championship game, yet three months ago ESPN, because of one game, would have had you thinking he was so over the hill that he should be more concerned with osteoporosis than throwing a football.

But much like any male between the ages of maybe 20 to 50, I was a fan of Stuart Scott. This is the best testament to his memory I’ve come across:

While I appreciate what Scott represents to many, I believe his death is a poignant opportunity to discuss how we view “fighting” cancer and illness, particularly with regards to exercise. Because while much of the adoration displayed for him since his death makes sense, such as his professional career, the adoration for how he handled his cancer is, in certain regards, to be questioned.

I think it was about a year ago I discovered he was sick, when The New York Times ran this. Much like every other story on Scott’s cancer, it could not be completed without significant attention to his exercise routine while undergoing treatment. As well as his persistence in continuing to work for ESPN.

While many were mesmerized upon seeing photos like this,

Stuart Scott MMA

I, and anyone who has a hint of the physiology of exercise and the immune system, goes “Umm.” I’m not going to make this some essay on the physiology of cancer. Never mind the fact I’m not an oncologist, or whenever I look into cancer in any capacity I seem to come away with a billion more questions than answers, I don’t think it’s necessary. Long story short, when you have cancer, and practically any time you’re sick, your immune system has been compromised. It’s working on overdrive, or it’s not working as it should, or it’s suppressed, etc.

If you’re really tired, you don’t go thinking, “Fuck you fatigued brain. I’m going to win this battle.” No, we all realize in the big picture, you need to rest, sleep, take it easy. You may take some caffeine, you may splash water in your face, you may roll the window down while driving…but eventually you’re losing that battle. Not to mention it’s a physiologically implausible battle to be taking part in. We get this.

We should also understand when we’re sick, when we have cancer or whatever else, that is not the time to be taking part in intense exercise.

Exercise has an endless list of benefits. Strengthening the immune system is one of them. Just like exercise can strengthen our bones, on the flip side, if it’s done too much or too intensely, it can also break our bones.

This is why you need to be extremely careful when you exercise someone who is sick. They’re probably already immunosuppressed, SIGNIFICANTLY IF THEY ARE ON CHEMOTHERAPY, and exercising them intensely is going to be severely hard to come back from due to their already taxed reserves. It’s like breaking a bone and immediately going, “Alright, time to lift some weights.” No. Yes, you want to try to get things moving. But dosage is crucial.

During chemotherapy, some people’s immune system might as well not exist. This is why visitors are sometimes not allowed in their hospital room, especially if there is any hint the visitor is immunologically compromised. The risk of transferring even a basic cold is too great to the fragile immune system.

Meaning going into a gym, a place where more germs exist than in hell, is probably not the best idea. (Good idea if you’re healthy, much like a kid putting dirt in their mouth, maybe it can help strengthen things. But not when you’re already suppressed.) Particularly a gym where people are rolling all over the floor in sweat -like a martial arts facility.

Exercising to exhaustion is almost assuredly a bad idea. Any more activity which further tires you is also probably not a good idea. Maybe some light work, a walk, moving around a bit, yes, you definitely don’t want to be bed ridden. Exercising during chemotherapy can even give one some more energy. That doesn’t mean you go training for a marathon though.

To be fair to Scott, I did seem him mention a few times his workouts had been lessened in intensity compared to before he was sick. Yet what he was doing was still intense. See jumping kick picture above. While his workouts may not have been as difficult as they once were, difficulty -how something feels, is not the same as intensity -how much you’re working relative to your max (for that exercise).

With people who are of the gym rat vein, a workout or exercise at 90, 95, hell, sometimes even 99% intensity may feel like nothing to them (they’ll say), but it’s still 90+% of what they can do. You just have some people who need to be flat on floor before they consider what they’ve done “intense” (difficult). I knew one woman who needed to vomit multiple times before she considered her long runs adequate. This is very common in the athletic world.

From The Courant:

“He worked out like a demon, kickboxing cancer as if it were some small-time punk. Those who worked with him said he refused to complain. He took the chemo like a man, barfed, walked out of the bathroom and insisted that he was good to go on the set. All he wanted to talk about was his two daughters. That is the definition of being as cool as the other side of the pillow.”

He was doing p90x, something notoriously intense, and he mentioned taking part in football games because he missed the physicality.

“It’s amazing how much emotional strength you can develop just by reminding yourself what your body is capable of. This past winter, on a Sunday, the day before chemo, a friend of mine was playing in a pickup football game, and he invited me to join in. Now, football has always been my heart and my soul. As much as I’ve grown to love golfing and working out at a gym, I miss the hit. And I miss getting hit.

After it was over, I remember thinking, This must’ve pissed off cancer. Cancer doesn’t want a 47-year-old guy playing football and catching half a dozen passes, making touchdowns and holding his own with 25-year-old guys. That was a good day.”

I can’t see this as an approach to emulate. This is an approach to question. The point here is Scott was taking his activities to the point they were further tiring him. It’s an approach that, due to Scott’s celebrity, I fear may hurt current and future cancer patients, or athletes who become sick. Much like The Biggest Loser makes woman after woman terrified of their first training session with me, because they think I’m going to scream at them and insure they can’t walk for a week.

For someone like Scott, who was used to very intense forms of exercise pre-cancer, doing some of these things at a reduced intensity may have been perfectly fine. (I doubt it.) But for most, I can’t see this level of activity being something you want to replicate. We know in a population like endurance runners, that training too intensely for too long can make runners more likely to experience infections. The body becomes perpetually non-recovered, making it more likely to become sick.

If you’re already sick -you’re already not recovered- you need to be careful about increasing your susceptibility to more illness. It may not even be the cancer getting worse, but other infections. The mantra of the sports world, “No pain, no gain” does not hold true when training sick people. It’s more like, “More pain, more pain.”

“But what about emotional strength, a positive outlook. If him working out like this helps with these things, then isn’t that good? Isn’t there something to be said for quality of life while undergoing treatment?”

Of course. Especially for terminal patients. But there are other ways to generate quality of life, and we all know people who take exercise to a place where it becomes detrimental. To where the subjectively perceived benefits clearly don’t match the objectively perceived detriments.

Scott has now famously declared,

“When you die, that does not mean that you lose to cancer. You beat cancer by how you live, why you live, and the manner in which you live,” he said. “So live. Live. Fight like hell.”

But I disagree. In contrast to Stephen Jay Gould’s words, which I could not agree more with:

“It has become, in my view, a bit too trendy to regard the acceptance of death as something tantamount to intrinsic dignity. Of course I agree with the preacher of Ecclesiastes that there is a time to love and a time to die – and when my skein runs out I hope to face the end calmly and in my own way. For most situations, however, I prefer the more martial view that death is the ultimate enemy – and I find nothing reproachable in those who rage mightily against the dying of the light.”

Take a different lesson from the sports world here: Know your opponent. Getting sick is not a terrorist attack. It’s not the time to stand up and say, “I will continue living the way I have been despite you.” If anything, getting sick is the perfect time to re-evaluate how you’ve been going about your activities, exercise included. Your way of life may be why you’ve become sick! Rage can work in a boxing match, but it’s not so great with the immune system.

Exercising, even during chemotherapy, is a smart thing to be doing. Just don’t think you need to playing contact football or kickboxing to get the benefits.

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Posted in: Miscellaneous, Sports