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Doctors should be able to prescribe exercise like a drug

BMJ 2016; 353 doi: (Published 05 May 2016) Cite this as: BMJ 2016;353:i2468

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Re: Doctors should be able to prescribe exercise like a drug

Readers may be interested to hear that York City Council runs 'HEAL' (Health Exercise Activity Lifestyle) - a course funded by Sport England - which I find hugely beneficial. Through HEAL, people with long term medical conditions can access a variety of activities suitable for their needs for a nominal payment. One of the courses is a group activity involving weekly, individually tailored exercise sessions, supported by a qualified trainer. The sessions are held at a gymnasium outside the city and one of the facilities which is of particular benefit to me, is the extra warm swimming pool.

There must be many older people like me who, through age or infirmity (or both) find the normal temperature of corporation swimming pools far too cold to use. For those of us with multi-morbidities, a really warm pool can provide the only opportunity for exercise. My list of ailments, past and present, includes radical treatments for 2 cancers, radiotherapy-induced midline lymphoedema, cervical spondylosis, osteoarthritis, osteoporosis (with spinal fracture), bursitis, bronchiectasis and allodynia (oversensitivity, especially to pain and temperature, due to cancer treatments ). So my ability to exercise is severely restricted; also one medical condition exacerbates another. I find swimming and exercising in water supported by a long float is possible and, although not weight-bearing, this helps clear my lungs so aids breathing and helps to combat fluid build-up, which in turn means less weight affecting my joints; plus there are benefits to my overall health, including well-being. Lymphoedema, alone, is a distressing, progressive condition and it would be easy to succumb to depression, especially since I have found it impossible to access a repeat of the effective treatment I had in 2005, due to NHS cuts.

Although I am lucky to have access to a pool at the gymnasium, it is a forty-five minute drive away from my home (sitting has a negative impact on my lymphoedema – compressed lymph nodes). There are two corporation swimming pools nearby which are far too cold for me, but though both are trying to encourage people to join another scheme to get everyone active, neither offers even one session per week when the pool temperature is raised especially for older/infirm people. Why not? There must be many people like me who would like to keep active, who could benefit from access to a really warm swimming pool close to home. The potential gains for the NHS could be immeasureable. Time for some joined-up thinking?

“HEAL aims to help people overcome barriers to exercise by making it easier for them to get started.”

Competing interests: No competing interests

11 May 2016
Mitzi A J Blennerhassett
medical writer/author
Slingsby, York