Conserve to Preserve - What Does it Mean?
Question: I had “Bulbar Polio” in 1942 when I was 10 years old. My throat was paralyzed as was the right side of my face. I was hospitalized for a month and made a good recovery.
In the past 10 years I have again experienced choking and swallowing difficulties. A swallowing study showed that 25-50% of what I swallow remains in my throat. I was given exercises by a speech pathologist (swallowing, and vocalization) which I have done fairly faithfully for the past year. I feel that my swallowing has improved.
Most of the literature on PPS deals with other symptoms with only a passing reference to swallowing problems. My main concern is the idea to “conserve to preserve”. I just want to make sure I am not causing myself future problems by doing exercises.
Answer: I believe that all physical activity, including swallowing should be adjusted to specific tolerance of the individual.
Just as one individual should not walk a distance past their tolerance and be over fatigued, swallowing exercises are fine as long as they do not produce over fatigue. If swallowing is worse after exercises then one should back off. Otherwise continue without concern.
This question brings up a much larger issue of a phrase that, I believe, is misused by many individuals with Post-Polio Syndrome. When it’s used as a mantra, many Polio Survivors say “Conserve to Preserve” as a phrase that means: “I have to stop everything; I have to stop living so that I can preserve what strength I have left”, rather than what it can mean - Work with a PPS knowledgeable physician and PT to determine exactly what YOUR limitations are. Limitations are different for everyone. If one then sticks to not exceeding their limitations and avoids overuse injury, they can “preserve” and still maximize their activity potential. Chronic overuse not activity is the culprit to avoid.
The PA Network posted an interesting Q & A on Facebook. “Conserve to Preserve – What does it mean to you?” I plan to write articles in the future breaking down some of the words in the responses. For example, one contributor wrote they thought it means - "Not doing the things you want to do so that you can do the things you need to do". I would suggest it would be healthier to say "Deciding what you really Want to do and holding off of the things that you want to do (w = impulse or desire, but not a decision)." I believe that words that we use in our head have power over us and so deciding what we Want vs what we want can be an important factor in changing our decisions. Many people do this already with their finances and purchases but have not thought to apply the same language to their activity and health. Another set of similar words that can have power in influencing our behavior and health include: "need to", "have to", and "should". These are all disabling words that give us no choices. Using "Want to" (as a decision, after weighing pros and cons") in place of these words is always much more enabling and positive. I often say “The only thing we ‘Have To’ do in life is die, everything else is a choice. Once we acknowledge this truth, we can make progressively healthier choices.
The holidays are a particularly difficult time when it comes to these activity decisions. In order to avoid chronic overuse activities, some helpful questions to consider this holiday season may include:
Do I want to continue to push myself to prepare the big family dinner (and risk creating pain and exhaustion) or do I Want to put my relationships with family first and preserve my energy by asking for help?
Do I need to climb that ladder to put up decorations despite the obvious risk?
Do I have to bake 12 dozen cookies or do I Want to avoid overdoing it and dial it back a bit and ask for help?
Should “shop ‘til I drop” or do I Want to be a better example to my kids and grandkids by purchasing or even making one special gift.
All these questions center around individual values, desires, and goals. It is my hope, especially during active seasons like the holidays, that we can all focus on our real Wants and be less driven by passing desires/wants, “have to”, “need to”, and a “should” mentality.