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Tuesday, December 13, 2011

Week 7

When Briana arrives, I am a bit nervous. Today is a weigh-in day and I have not seen her for five days. She tells me about the foods she ate on Thanksgiving and asks if they were okay.

"You ate a lot of vegetables and some good foods. You also had some treats. It's okay as long as you don't have too much and as long as it was just one day," I tell her.

"Okay, good!" she replies and seems pleased that I am not upset. I have come to realize how important my opinion is to her. She tries to do what will please me and worries if she thinks she may have made a bad choice.

As we head down the stairs, she reminds me that today is weigh day. She tells me how excited she is to see how much weight she has lost. I feel encouraged, because if she believes she has lost weight, I'm believing it, too!

She gets on the scale and I bend down to see the numbers. I am pleased to see 216 pounds.

"Briana, you have lost three pounds! That means you have lost 11 pounds so far!"

"Oh my goodness! Did I do good?" she asks.

"You did awesome! I am so proud of you! Are you ready to get to work?" I ask.

"Let's do it," she says.

She starts her workout with enthusiasm. She gets frustrated along the way, but she keeps going. I notice how much more we are doing at this point. I tell her that she is getting stronger and healthier every time I see her. "Yep. I know it," she replies.

As we finish the workout, I tell her that I am going to teach her new exercises soon. I also tell her that next week she is going to do a quarter mile on the treadmill. She agrees and says she can do it. I know that if she says she can, she will.

Wednesday, December 7, 2011

Week 6

This week is Thanksgiving week, and I have so much to be thankful for. My work with Briana is more rewarding than I could ever have imagined. Her enthusiasm and loving spirit are contagious. I find myself looking forward to her visits, and our time together seems to fly by.

This week, we only have two sessions together. My plan is to make the most of our workouts. Unfortunately, Briana arrives and is not feeling well. Her stomach is really bothering her and her energy is low. She seems agitated, but is determined to make it through her workout.

"I'm sorry," she says. "I'm sorry for not feeling good."

"Briana, there is no need to be sorry. We all have days when we don't feel our best. We will just take it easy today and do the best we can. If your body needs to rest, then that's what we'll do."

"No, that's okay. I can do this," she tells me, although I can tell by the look in her eyes that she really isn't feeling well.

Slowly, we work through the exercises. I take her through the entire routine but use lighter weights and fewer repetitions. I try to talk her out of the treadmill, but she won't hear it. I compromise and tell her she can do five minutes. She agrees and gets going. I stay with her the whole time, holding her back and letting her know that she can stop if she needs to, which she doesn't. When she finishes, I tell her how I proud I am that she worked as hard as she could. I send her home with several types of herbal tea and firm instructions to rest.

I am now grateful for the short week. I hope it will give her time to rest up and feel better. I look forward to next week when she comes back.

Friday, November 18, 2011

Week 5

I have decided to weigh Briana every two weeks. When she arrives on Tuesday, I tell her it's time to get weighed and she is actually excited. "Let's do this!" she exclaims. She easily steps onto the scale. I check the numbers, walk to the other side and check them again. "Step down for one minute," I say. She steps off, then I ask her to step back up. I look at the numbers one more time.

"Briana, you have lost five pounds!" I exclaim.

"Oh my God! Oh my God! My mom is going to be so proud!" she yells.

"How do you feel, Briana?"

"I'm so excited! I love it!" she says.

"I love it, too. I am so proud of you. Are you ready to get to work?"

"Let's do it!" she says, clapping her hands together.

The workout is great. She has energy and is excited. I notice that she is moving easier and getting stronger each time I see her. We start with Pilates tower exercises, move to weights and intervals, then finish with the treadmill and stretching. Today, Briana has come ready to do nine minutes on the treadmill after completing seven minutes the week before. By this time, she is able to get onto the treadmill without my help. She likes me to stand next to her with my hand on her back. When she gets tired, she says "Don't touch me." Then when I take my hand away she says, "Hold my back, please."

I sympathize with Briana because I hate cardio and have to motivate myself to do it, so whatever she needs (hand on her back or hand off her back) I will indulge her. I stand close to make sure she is safe and try to stay quiet unless she talks to me. If I offer encouragement or comment too much on her progress, she gets agitated and says "Will you stop that please?"

Briana hits the seven minute mark and says "Oh my God! I'm doing it. I'm doing it." She is tired and frustrated, but wants to make the nine minutes. "I want to quit. I can't do it."

"Briana, you ARE doing it. Don't give up."

"I hate this!"

"I know it's hard, but you can do it. Don't give up now," I say. Then the treadmill hits eight minutes.

"Oh my God! Oh my God! Wow!"

"Can you believe it Briana? What do you think?"

"I can do it," she says, and she does. She is ecstatic when the time finally turns to nine minutes. She can't wait to tell her mom this news. I help her off the treadmill and sit down with her to stretch. When we finish, I take her up to meet her mom. She shares the news of her weightloss and her success on the treadmill. Her mom is so happy that we have all been successful. It has been up to her to make sure Briana sticks to the nutrition plan. I tell her that she is doing a great job and that I appreciate her hard work. I am truly grateful, because we couldn't make progress without her support.

As I walk back to my front door, I feel happy. I am happy for the opportunity to do this work. I am happy for Briana for making such great progress, not only on the scale but with her physical ability to move and do the work. I am also happy for having such great support from Briana's mom. I have a feeling that I will be learning so much through this process and feel nothing but gratitude and joy for that.

Week 3-4

Briana and I began our work together on October 18. I am trying to get caught up on previous weeks now so that I can give accurate weekly updates.

Week three was Halloween week. I received a text from Briana's mom that day with a picture of Briana in her Halloween costume. She was dressed as a nun and looked angelic. I was looking forward to seeing her the next day to see how she had done since I last saw her. We had missed two lessons the previous week due to snow. I was a little worried that this might be a setback for us, but Briana had called me several times to let me know she had done her exercises. I loved getting her calls, and it boosted my confidence to know that she was inspired to do things on her own.

I weighed Briana on November 1. It was easier for her to maneuver onto the scale this time. Once she got on, I checked the numbers, then asked her to step off and do it again just to be sure. She weighed in at 224 pounds - a three pound weight loss after two weeks! I had estimated one to two pounds per week for her goal, and she was right there in the middle. I couldn't be happier and she was so proud and excited!

Her energy was up that day for our workout. It seemed like the positive news fueled her. She didn't get tired as quickly and didn't seem as frustrated. She did the treadmill again and we stretched our time to three minutes. Each time a minute passed on the clock, she said "Wow!" When she finished, she could barely contain her enthusiasm for making it to three minutes. I felt encouraged and looked forward to our next session together.

In week four, I decided to add more exercises into Briana's routine. I could tell that she was gaining stamina and endurance, and I wanted to challenge her. By this time, I knew when to push and when to back off. I was already seeing an improvement in her range of motion. I knew that we needed to add weight bearing exercises to stimulate her muscles and encourage the weight loss. So our training had evolved to include basic hand weights and larger movements in addition to the Pilates exercises. We had progressed from doing a handful of exercises in 45 minutes to doing 15 different exercises in 45 minutes, then ending with the treadmill and stretching. Briana was remembering the routine and liked to tell me what came next.

The three most important things I had learned by week four: Briana has a remarkable memory; she gets frustrated when she gets tired and when her muscles are sore; she will always do what she says she will do. These three things are my keys to her success. If I develop a routine that she can remember, she will do the work on her own. If I can help her get through those moments of frustration, she will push on and be happy with herself. If I set up a plan at the end of one session for what we will do on the next session, she will come ready to do it. Overall, we are definitely on the right track!

Tuesday, November 8, 2011

Week 2

"Hi Honey! How are you?" This is how Briana greets me as she gets out of the car. I love her joyful attitude and I love that she calls me Honey. She is excited and enthusiastic to see me and says she is ready to work.

Today I notice that Briana is having an easier time maneuvering the stairs. She is more familiar with my house and seems more comfortable. Once we descend the final step, she knows exactly where to go. She sits down on the Tower mat and asks for help with her shoes. I am surprised by her memory of everything and feel encouraged.

As a certified Pilates instructor, Pilates training is the method of exercise I have chosen for Briana. Classical Pilates exercises are generally done in the same order with a limited number of repetitions. The goal for each exercise is quality of movement rather than quantity. Muscles are worked in eccentric extension rather than concentric contraction, and as an instructor it is my job to make sure that a student is not working to failure. By repeating the same order of exercises and eventually adding exercises into the repertoire, a student will gain strength, stamina and endurance as well as increased body awareness and quality of movement. This is the foundation and inspiration for my work with Briana. The question I have asked myself in regards to her training: Is it possible to teach a woman with Down Syndrome to articulate movement, develop coordination and control, and increase strength and stamina?

Briana has a great memory. She knows exactly which exercise we start with and is excited to show me how she does it. She lays down on her back and begins to pull the rollback bar towards her stomach. Right away, I notice that her range of motion is already greater than it was last week. "You are getting stronger already!" I say to her. "Yes, I know it," she replies, then proceeds to tell me how she has been practicing everything at home. "I do it just by myself. I don't have the bar at home but I do the exercise," she says. I let her know how proud I am that she is exercising at home and we continue to go through our exercises.

At the end of our session, Briana is eager to try the treadmill. I showed it to her on our first session and demonstrated how it works. She asks me to do it and my heart drops to my stomach. Right away, I know that this could be an amazing experience and accomplishment for her or a complete catastrophe. I worry about her balance. I worry about her getting startled when the belt starts to move. I worry about her falling and hurting herself and never wanting to get back on. I worry about every possible thing that could go wrong, then find myself saying "are you sure you're ready?" "Let's do it!" she says and claps her hands together.

Once Briana is situated on the treadmill, I start explaining everything that will happen when the treadmill starts moving. "I know. You showed me last time. Let's do it." I quit stalling, put my hand on her back, set the treadmill to one mile per hour and press start. The belt begins to move and she yells out and tightens her grip on the hand rails. She seems scared, but I tell her she's doing great and to keep going. "I don't want to," she replies. I look at the time on the treadmill and show her that she has been on for 30 seconds. "Lets stop when this number turns into a one," I say. I point to the time for her and she agrees. When one minute appears on the clock, I stop the treadmill and she says "Wow! I can't believe it!" She is proud of her accomplishment and can't wait to tell her mom the good news. She leaves feeling excited and encouraged and I feel exactly the same. I can't wait to see what next week brings!

Tuesday, November 1, 2011

Week 1

Briana and I got off to a rocky start this week. On Tuesday, she came for her first session. She was very happy to be here and I was excited to see her. First off, I wanted to get her starting weight and measurements. Briana weighed in at 227 pounds. Her waist measured 48.25 inches and her neck measured 20 inches. None of this worried me. In fact, her weight was a bit less than I anticipated.

My first challenge came when I realized that Briana does not have a good sense of spatial awareness. She had a difficult time getting on the scale, so I moved it close to the wall. With my help, she was able to step up on the scale then use the wall to help her feel secure. As a result, it was difficult to get a completely accurate weight, but after three times up and down on the scale, 227 seemed to be the number.

After weighing in, I took Briana downstairs to my Pilates and yoga studio. The stairway to my basement is steep, so we came upon our second challenge. Briana was nervous and a bit shaky. I was concerned about her losing her balance and falling down the stairs. I figured out that if I stood on the side opposite the rail, with my back to the wall, I could hold her right hand and she could use the rail with her left. I could also get support and leverage for her weight against the wall. Step by step, we made it downstairs: no slips, no injuries, success!

Prior to our first training session, I had only spent a little time with Briana. I knew that our sessions would be more trial and error to begin with as I got to know her and her capabilities better. I decided to start her with Pilates Cadillac work. By choosing this, she had stability from the mat beneath her and I could assess her capability with different forms of movement and equipment. This was a good choice. Once Briana got situated, I decided to start with an exercise called breathing using the roll back bar. In this exercise, you lie on your back and hold the bar with both both hands. On the inhale, you press the bar towards your legs, on the exhale, you bring the bar back to neutral. For Briana, I was watching for her ability to perform the general movement. Once I told her what to do, she pressed the bar and it barely went anywhere. I cheered her on and asked her to make it bigger. "I am. Leave me alone!". This was her first outburst of frustration. I quickly realized that too much correction at this point was frustrating for her, so I let her continue to perform the movement to the best of her ability while I observed.

Each exercise I introduced after breathing went pretty much the same. I told her what to do, she did it as best she could, and I tried not to over correct or interfere with her concentration. Feeling confident, I decided to put Briana on the reformer. Unlike the Cadillac, the reformer is not a stable surface. Since she had done so well getting on and off the Cadillac, I felt confident that she could handle it. So, here comes my third, and probably greatest challenge of the day. The reformer can be stabilized by adding springs to hold it in place. I engaged all of the springs to help Briana get on. It was difficult for her to maneuver her body onto the short carriage. She didn't like the way the shoulder blocks felt against her neck, and I had to help her place her feet on the foot bar. I could tell that she was unhappy and uncomfortable, but I encouraged her to try a few exercises and she agreed. I took off a few springs to lighten the tension and asked her try pushing the carriage out with her legs. She was successful! Again, her form was far from textbook, but my idea of textbook work had changed drastically within the last half hour. So I celebrated the success of the movement and gave her a high five. Briana was proud.

By the time our session ended, I was feeling slightly defeated. "What makes you think you're qualified to do this?" my mind kept asking me. "I don't know," was my only reply. As we went upstairs to wait for her mom, Briana seemed tired but okay overall. I realized that unlike me, she had already released those challenging moments. She seemed at peace. This gave me encouragement and reminded me not to be so critical or over analyze myself as her teacher.

I saw Briana twice more that week. By Friday, I felt more comfortable reading signs of frustration. I knew when to encourage her, when to be persistent, and when to step back and be quiet. She was focused, determined, and sometimes frustrated and angry. Isn't this true of anyone trying to lose weight and get in shape? So again, my mind asked "what makes you think you're qualified to do this?". This time I answered, " because I believe in her and I believe me and I believe in the possibility that we can do it."

Sunday, October 9, 2011

Welcome!

Thank you for visiting Briana's Quest. Please like our site and visit often. My first posting will be on Tuesday, October 18. Join me as Briana and I launch our journey into wellness together.