This Is Why Proactive Approach Preventing metabolic syndrome, 1 patient at a time. By Gary Parker Jr, PT, DPT | February 2014 Podcast: Listen to 'This Is Why' "I want to help the average person feel better." That was my simple answer to why I wanted to become a physical therapist (PT), when I was asked by my "Introduction to Physical Therapy" professor during my first semester in PT school. The stated goals of my classmates varied-to work in sports physical therapy, or perhaps acute care, or cardiovascular and pulmonary rehabilitation. All the ways in which PTs serve patients and clients serve a societal good, and over the years I've helped my share of individuals post-operatively. But my true passion is helping people become proactive in their approach to health and wellness. No single patient better illustrates the path I've followed and why I embarked on it than Nancy. Sixty-six years old when I first met her, she had a litany of health issues that added up to metabolic syndrome-defined by the National Heart, Lung, and Blood Institute as "a group of factors that raise one's risk for heart disease and other health problems." She was obese, had cardiac issues, high cholesterol, high blood pressure, diabetes, and orthopedic issues such as knee, low back, and cervical pain. She'd been referred to physical therapy after what had been diagnosed as a mild stroke. What I found upon examination and differential diagnosis, however, was that her symptoms only mimicked a stroke. This opened my eyes and led me to develop a health and wellness program for preventing the development of metabolic syndrome. When I started seeing Nancy, she was unable to walk more than 200 feet without needing to sit and rest. She wanted to be able to walk for exercise and shop with her sister. She was highly motivated to change her life. Together, we embarked on a structured 12-week program of weight loss and body composition alteration. I began by measuring her body composition via bioelectric impedance analysis. My program was designed to quantify and seek changes in her body mass index (BMI), intracellular and extracellular fluid percentages, and muscle and fat percentages. I was certain I could help Nancy achieve her goals. She met my explanation with enthusiasm. We started by treating her symptoms and controlling her pain with therapeutic modalities. Next, we initiated an exercise program. At first, Nancy was tearful and discouraged. She was unable to make it past 30 seconds on the elliptical trainer. Her heart rate skyrocketed to nearly 170 beats per minute. She wanted to stop and not return. But I told her we were at the beginning of a long road that would be marked by gradual but steady progress. I assured her that together we'd get to where she wanted to be. Nancy's optimism grew as she began seeing the results of her efforts. By 60 days into the program she was doing 20 minutes on a stationary bike, 20 minutes on a treadmill, and 20 minutes on the elliptical trainer without resting in between. Her body composition was changing, her weight was decreasing, and her mobility was increasing. She told me she felt as if she was embarking on a new life. At the conclusion of 12 weeks, Nancy had lost 60 pounds and her BMI had decreased by 3%. She could follow an hour of cardiovascular exercise with an additional half-hour of weight training. To her own and her sister's delight, she had achieved her original goals and had started setting new ones. She was discharged from physical therapy, joined a fitness center, and came back to visit periodically-reporting happily on her continued progress and thanking me for my role in helping her reclaim an active life. When I look back on what I said 20 years ago about why I was entering this profession, I think of Nancy and feel good about what I've been able to accomplish as a PT. I've helped a lot of average people feel better and live the life they desire. Gary Parker Jr, PT, DPT, owns Elite Gym & Family Fitness Center in Kingston, Pennsylvania, and owns or is a partner in 4 physical therapy practices in New York state.