Chronic Illness, Aging, and the Power of Physical Therapy: Loretta Donovan Returns

In this returning episode of Beyond the Diagnosis, Michele welcomes back Loretta Donovan, leadership coach and healthcare strategist, for a deeper conversation on physical therapy as a powerful and often underutilized tool for chronic wellness.

In her previous appearance, Loretta and Michele explored the role mindset, personal responsibility, and proactive engagement play in shaping health outcomes. That conversation centered on the idea that while doctors treat disease, patients must actively participate in their own well-being. This episode builds directly on that foundation.

Together, they focus on physical therapy not just as a short term solution after injury or surgery, but as a long term strategy for maintaining strength, mobility, independence, and quality of life, especially for people living with chronic conditions.

In this conversation, Michele and Loretta discuss:

• Why physical therapy is valuable even without a recent injury
• How aging naturally changes muscle tone, balance, and mobility
• The role of physical therapy in managing chronic illness
• How surgery, accidents, and long term conditions affect the body over time
• Why home based exercises are just as important as clinical sessions
• The emotional and mental health benefits of staying physically active
• How physical therapy supports independence, dignity, and daily function
• Why patients must take an active role in their care to improve outcomes

This episode offers practical insight, relatable examples, and empowering reminders that movement, strength, and intentional self care are essential at every stage of life. Whether you are navigating chronic illness, recovering from surgery, or simply aging, this conversation reframes physical therapy as a foundational wellness practice rather than a last resort.

About Loretta:
 Loretta Donovan is the President of iAttain and a Professional Fellow with the Institute of Coaching at McLean Hospital, Harvard Medical School. She is a former Chief Learning Officer in healthcare and an educator who has guided leaders and clinicians for more than a decade. As a patient, mother, caregiver, and lifelong learner, Loretta brings deep empathy and perspective to conversations about healing, mindset, and resilience.

Loretta’s Links:
 🌐 iAttain: https://about.me/iAttain
🌐 Appreciative Inquiry Consulting: https://www.linkedin.com/groups/48345/
🌐 ReInvive Coaching & Leadership: https://www.linkedin.com/groups/13322073/

Transcript

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(Soft Music) Hello, this is Michelle Weston, once again with a podcast on living with a chronic condition. Now, you can thrive beyond a diagnosis. You may need a chronic wellness blueprint to be able to maneuver through our healthcare landscape. You may even wanna be an empowered patient. And those are some of the things that I wanted to make sure that my podcast included. And that means that I'm going to be interviewing experts and some of us are experts and also the audience and a lot of women, sometimes men. But I think that when you have chronic diagnosis or diagnoses, what you're looking for, what we're all looking for with that is the best quality of life, the best lifestyle that we can create. And that means lifestyle shifts. That means looking for tools and strategies and solutions on how to help yourself. Because once again, I sound like a broken record like I had the past couple of years, but I'm gonna say it again. Patients have a job. And today I'm going to talk with Loretta Donovan again. She's actually married to a doctor, a retired doctor, but married to a doctor for many decades. And me being a doctor's daughter, both of us feel strongly we have an active role in our health and wellness, okay? And our wellbeing. Doctors do medicine. They don't go home with you. They can talk to you about nutrition. I can talk about physical activity and all of those things. But you, the patient, the person living with that diagnosis needs to take action in order to change, in order to shift. And that's a mindset and behavior. And it ain't easy, right Loretta? Almost certainly is. Thanks, Michelle. You know, everyone of us talks about feeling good and how hard it is to have that happen every day. And part of that is wellness. Feeling good is because everything is going great. But wellness isn't the same for everybody. We have to understand our individuality. Yes. Each one of us does a package where we are born with certain physical capabilities, mental abilities, emotional abilities, talents. When it comes to wellness, everyone isn't blessed with wellness 100% on day one. Wouldn't it be nice? It would be terrific. Can you imagine what would happen if you started off with good muscle tone, eight that was strong, ability to be able to lift the weights you want, all those kinds of things. And great metabolism, right? I'd love to have great metabolism. A lot of us weren't. I mean, I laugh when people say, what kinds of sports do I engage in? Very, very few. I have always had a difficulty with spatial coordination. My eyes just don't work that well. So throw all of the I may or may not catch it. And I am not really coordinated well. You wouldn't want me to be doing any kind of dancing with you. Okay. It doesn't matter. Because wellness for me does not include those kinds of things. They include a lot of other kinds of things, being able to keep up with things I like to do every day. And so one of the things I think of in terms of what helps me to do that is physical therapy. And I want to go track back a little bit. Let's talk a little bit about what physical therapy is and why you might be interested in it, especially in relation to chronic illnesses. Well, there's a lot of reasons that you might be interested in physical therapy. And one of the ones that we are all going to experience is aging. Unfortunately, yes. As we get older, our bodies are going to change. Yep. And- We just talked about this. I mean, both of us are health and wellness. We work in health and wellness and we're both coaches a little different. She works more with doctors and researchers, but both of us look at the healthcare landscape and go, how can we utilize our skills in health, wellness, and wellbeing to make a difference? So physical therapy, most people are like, "Ugh, I don't need to do that." So Loretta and I have a different take on that. And that's why I asked her to talk about this. So physical therapy, getting older, you actually need it more, right? You actually need it more. I mean, it is a given. It doesn't matter whether you were born with that perfect date that I don't have, or whether you have muscular strength, there will come a time that things are going to shift. We know about gravity, things will go down, but things also, our chest tends to get wider as we get older because the muscles tend to loosen up and our rib cage widens. Interesting. We wind up as we're getting older, some of the muscles and joints that we use over time are going to get a certain amount of wear and tear. So there's all kinds of things that are related to aging. We can go from the top of our head to the tip of our toes and take a look at all of the things that are not necessarily going to stay the same, particularly after the age of 50. Although that isn't always the dividing line. It's a more individual way. Okay. One reason we might need physical therapy is we've had an accident. So you may be in your prime, everything is working great, you fall. Yep. And you break your wrist. Sure. You know, you pull a muscle in your back. All of those things can happen, or unfortunately some people are car accidents, okay? I think I mentioned accidents is because accidents can lead to a chronic problem. Yes. Everything is not healable. Everything is not fixable. You may, somebody who has had a hip problem, has had surgery successfully, they still find that there's a deficit that they will continue to have. So it becomes a chronic issue. Yeah, and I've talked about that. I have dropped foot from MS for 24 years. But with physical therapy, and I'm very fortunate, one of my physical therapists who's a professor here at Hunter College in New York, has me in research studies. And I wanna tell you something, without him and PT and his students, my gait would not be, it is the best I've seen it in 24 years in the past year and a half because of physical therapy and utilizing that and going, okay, this makes a difference in my gait and how I stride. And you think to yourself, what are you talking about? I'm talking about that they have ideas and ways to strengthen what we have and not like play to the negative, right? Exactly, exactly. And see, these are the things that we as individuals can do. It takes a professional to know what to measure, how to measure it, and what the extremes are from poor to excellent and where we should sit as a person. So accident-wise, I had a bad fall quite a few years ago, skiing, I put that on ice right on my fanny and wound up with some pain for a couple of days. It went away, unfortunately, I fell at home about six weeks later. Right. And that caused some of the discs in my back to start to shift. So when I say accident, there's all kinds of accidents and the changes that took place in my spine as a result of those two falls have not been repaired surgically, which has not been advised, you know, that-- That's not been needed. They don't feel it's needed, right? Yeah, so that means I have a chronic problem with my back. So we're talking about all kinds of accidents that can lead to all kinds of sequelae. Okay, the third thing that might cause you to have a need for some kind of physical therapy is surgery. Okay. Different kinds of surgery. Strangel, not always the ones you think, obviously people always think, well, if I'm gonna have a problem as a result of surgery, maybe it's orthopedic surgery. Not always. For the women who are the listeners, if you have had a mastectomy, you may wind up with some chronic problems. Because of the skin, because of the tightness and-- Well, a whole bunch of things are going to happen. We don't have total mastectomies anymore. That took place in the fifties and sixties, maybe into the seventies. The mastectomies we have now retain the chest muscle wall. Thank God. But you may wind up with some of the tendons on your chest wall wanting to pull back, because the weight of the breast is no longer there. You may wind up with some issues with your armpit, because the incisions often in an attempt to be able to find the lymph nodes may extend that far. So that means that even though you may recover from the mastectomy and you may hopefully be cancer-free for the rest of your life, you may still have a follow-up problem with your chest wall. Wow, okay. Physical therapy could potentially help with that. Now, one thing I will hop back on, when I talk about physical therapy, I'm not always talking about going to a physical therapist's office or having a physical therapist come into your home. This may be something that you will do on your own with their direction. Yeah, once they teach you the knee stuff, like I had meniscus tears in my knee. I still need to, even though I don't think I need to, do some of those exercises, even though it was 30 years ago that I had this, it still counts. Absolutely, now the other kinds of things can happen in surgery, people who have had abdominal surgery. Yeah. Okay. Like me, yep. Bariatric counts under this. Appendectomy, hysterectomy. Gallbladder. Okay, it's a gallbladder, you name it. Even if you have had laparoscopic surgery, it's still an intrusion into the abdomen and the stages that are going to go on. Well, very often in recuperating from surgery, people lessen their day-to-day routine. They are not using their bodies the same way, and therefore they lose muscle tone. And that means that their core is not as used to be. And if the core isn't strong, that means number one, your clothes aren't gonna fit as well. And number two, you may wind up with poor muscle tone not supporting your back anymore. Interesting. And I'm speaking from experience, unfortunately. Well, me too. You know, I've had hernias when you lose a lot of weight. Most of us have had hernias, some of them very, very deep. And so when I get, you know, I just, for the first time in my adult life, got bronchitis and the coughing old muscles. And I had to go back and do some exercises to help those muscles so we didn't have a new tear or that I didn't do any more damage, you know, because pulley muscles is pulley muscles. Exactly. And see, this is what's so ironic. And everybody says,"Well, you had a cold." That's not a big deal. You'll get over cold in a week or so. That's a lot. And if you've had very cold, if you've had any, those people who unfortunately had COVID or have had it now, a few, all of those kinds of things that you do, the stress of the coughing, coupled with the lack of day-to-day activity, it's going to make you more prone to be open to additional damage to your body. And so physical therapy can help. A couple of other things to be aware of. And talking to one of my physical therapists not too long ago, I talked about certain kinds of medication and whether or not they could have had an effect on muscle loss. Oh, interesting. Okay. Whether or not violence could be affected. And his reaction to me was people don't realize practically every medication we take does that. Now it depends upon what it is. Okay. Men who have had prostate treatment. In blocking their testosterone, lose a lot of muscle tone. In losing muscle tone, you wind up with your balance way off because remember, we have muscle memory in our bodies. We depend upon using what we think we have as equipment. And what that equipment is going with consistently being reduced over weeks and months because of testosterone blocking medication. People can trip, they can fall on the stairs, they can hurt themselves because they didn't realize that they didn't have the ability to be able to do something they used to do before. That's another thing to be aware of. Now, we talked, touched a little bit about the chronic things that can happen to people, but we have to be aware of the fact that chronic disease can also include the kinds of things that most people have come to understand is not great health conditions. Such as? Have heart disease. Okay. Chronic problem. High cholesterol. High cholesterol, absolutely. COPD, lung disease, people who have emphysema, right? Okay, sure. People who have diabetes. Diabetes. Diabetes, I was right at the top of my list. Especially, people who have juvenile diabetes, type one diabetes are very, very concerned and aware of their feet and their hands and whether or not their circulation is good. They may wind up with loss of nerve tissue. And when you can't feel the floor the same way, guess what? You're more up to fall and hurt yourself anyway. Diabetes can tend in that direction as well. So when we talk about what's happening with people, people who have these diseases, Michelle has talked to you about her long-term health issues. That's something she has learned to live with. She has accepted it. She's worked very, could I say, devotedly to understanding what she can and can't do. I'm a tough cookie. Exactly. There's one last category, and it's not the happiest category, but I want you to think about this too. I'm involved with Medivivor, which is an organization that fundraises through volunteers, very tiny staff, to raise money for research of metastatic breast cancer. People who have medicine. Can I say something? For you, this is reality for your daughter who you lost, and then you have had to come across breast cancer. So this is close to home. It is, but I want to talk about it in terms of terminal disease, okay? All kinds of cancer. Even though we know that overall, the medical field has been far more successful over the last two decades in curing people of cancer. There are some people who are diagnosed late. Okay, yeah, like my brother. There are some people whose type of cancer I happen to have lost relative by marriage to sarcoma. There is no cure for it, okay? Wow. So different kinds of cancer discovered too late or currently incurable for the list. The other kinds of things that fall on the list are unfortunately things like ALS. A member of my lead-off, ALS. So when we talk about certain diseases that are not going to go away, physical therapy also plays a role because quality of life can be maintained for a longer time if you are able to keep on moving, keep caring for yourself. Remember, as you lose your ability and get sicker and sicker, being able to bathe yourself, feed yourself. Get up from a seated position, right? All of those kinds of things are going to get harder if you don't maintain your muscle tone. So that's a full spectrum. We've gone from tiny little things like, I was coughing too hard with bronchitis, up to I have terminal illness. So physical therapy, all of kinds of things. So why even think about physical therapy? And this is what it can do to help people who have chronic disease. People who have osteoarthritis, which again is one of the aging diseases or heart disease or type two diabetes or any of these kinds of things. Number one, your exercise capacity. Your muscle strength will get better if you exercise and it doesn't need to be hours and hours and hours at the gym. No. And we'll talk about quantity in a little while, but that's the first thing that physical therapy can help with. The second thing it can do, it can reduce pain. Yeah, hello. You know, I discovered when I had a bad shoulder, I discovered I had a bad shoulder, I should say, when the pain in my upper arm, just above my elbow, driving me crazy, I went to my physical medicine doctor. She referred me back to my physical therapist. And I kept on saying, but I don't understand, what did I do to my upper arm? And the answer was you did nothing. The nerve in your shoulder is referring the pain back into your upper arm, okay? So I was in pain, it was a good reason for me to want to go for physical therapy. Right. It does, if you can reduce your pain symptoms, you're increasing the quality of life. Thank you, absolutely. Okay, the third thing is why do we want to do it? Well, exercise will increase our mortality, reduce, excuse me, all cause mortality. So people with heart disease and heart failure, people who have heart problems, who become more sedentary are not going to get better. They need to be able to move, but they may be reluctant to because it's scary. You may be having some chest pain or other symptoms, maybe your legs are swollen with fluid, you can't figure out on your own, you need somebody to help you to figure out what to do, so that you will feel better and not hurt yourself. The other things, physical therapy can help with people who have metabolic issues, and there's all sorts of them. Everybody's familiar with the questions of hypothyroidism or hypothyroidism or whether or not you have other kinds of diseases that are related to your metabolism. But overall, your metabolism is going to stabilize if your body has a way to be able to use all of the enzymes properly. Right time in the right way. And of course, the last we mentioned before, type two diabetes, okay? People who significantly improve in treating their type two diabetes if they move, that is because their body does not know how to deal with the sugars that come from a well-balanced diet. We're not talking about people who are sitting around eating Hershey Kisses all day. No, no we're not, we're really not. You could be having a vegetarian dinner and still wind up with problems from type two diabetes. Yeah. You need to figure out how to help your body to be able to use up the sugars that it cannot metabolize because of your deficiencies and insulin, okay? So how can you use physical therapy? Well, the first thing is you go to your physical therapist and they can prescribe what needs to be done within their facilities. Many of us have a limitation on physical therapy with our health insurance. It might be six visits or six weeks, whatever it is, you could use that to the maximum in two ways. Number one, participate well when you are in the presence of your physical therapist, communicate with them well, let them know what's working, what isn't working well. Number two, from the very beginning, they should be giving you a set of instructions for home exercise because most people don't see a physical therapist more than three times a week. You say five, okay. So it could be as many as that, but remember, you could go home and you could do another 10, 15 minutes. I guess I'm saying five days a week because you've been giving these exercises. So when I came home from PT at NYU, I have a program in my phone and I do this 15 minute program five days a week. Yeah. And it doesn't take much. One of the things I did for a bad shoulder was to a child's ball that was about 12 inches in diameter and the physical therapist showed me how to roll it back and forth across the kitchen counter. This is not a big deal. Those balls are the most supermarkets. It's not like I had to go something back. Exactly, and if you pay tennis, you have a ball. Yeah, well, they wanted a larger one, but you could, not so, I mean, the other things, exercise bands. Yeah. The red ones are the ones that have the greatest amounts of stretchiness, so you're not gonna hurt yourself, but you could advance to a more strenuous one, but those are amazing. You could do lots of things with the instructions from your physical therapist, okay? The simplest things, walking up and down stairs. Lifting something, I mean, if you have nothing else to lift, a couple of bottles of water, you know? Absolutely, eight ounces, 12 ounces, 16 ounces, perfect. Yeah, so that physical therapy can be used for chronic disease by going to the physical therapist, as we said, as well as home exercise. It can also help you to be able to figure out how to be able to deal with the risk factors for diabetes or diabetes-related complications, like we mentioned neuropathy. So if you happen to have had a family where people from more than one generation or multiple people in a generation who are your ancestors have come down with certain diseases, guess what? Yeah. Don't be surprised if you wind up with some of the same problems, and if you're seeing your primary care physician, you might say, "This is what happened to my uncle or my mom or my dad." And I'm a little concerned, I'm getting to the age where they were starting to have these problems. What can I do to start having the same issues, okay? Yeah. And then your physical therapist can also evaluate you in relation to a combination of conditions. One of the things we talk about is holistically treating a patient. So it's wonderful if you go to the eye doctor and all they're doing is treating your eye, but the fact of the matter is the rest of the body really needs to work in coordination. Your digestive system, the way in which you walk, the way in which you sit, all of those kinds of things, kind of relationship with one another. But we're going to try to be able to deal with all of those kinds of things. Guess what? There's also a benefit emotionally and mentally. So we're talking about whether or not this is a good thing for you to do, you should know. It's winter time right now, hearing about scenarios. Right. But guess what? You're going to get a serotonin push if you're out there walking around, even in the house. You don't have to go outside. But it's a good thing because what you're doing is raising your spirits. And even yourself, give yourself a pat on the back when what you're doing is giving yourself a little bit more credit to the fact that yesterday I was able to do something 10 times and now I can do it 12. So as we go through all of these phases, we're going to be able to place ourselves in a position where we are taking control. Remember, Michelle has said to you, and I believe this wholeheartedly, we are the ones who have to make the decisions and direct the health outcomes we're going to get. If we are not driving that process, we are missing opportunities because the doctors, nurses, therapists, all the people who see us are well-intentioned people, but they are going to deal with you as a generic individual until you show them how unique and different you are. Yeah. You know, I think this is a beginning of a conversation. Loretta, I'm so glad I had you on today and we were able to talk about this and introduce the idea of really using and, you know, tapping into using physical therapy, not just because you had knee surgery, not because, you know, you got like, you know, using your phone all the time and you suddenly have issues in your arms. This is about your life. And if you take this seriously, living with a chronic condition, you will probably have a better, easier, nicer quality of life. I think both of us are testament to that, whether you're, you know, 50, 60, 70, 80, you know what? This is something that's worth you. And I, for one, I'm glad that you talked about so many things, not just, oh, you know, I have to go to physical therapy. You know what? You're taking it with you and this should be an opportunity for you to strengthen your body because our bones are our bones. They carry us around and you need to make sure that when you're carrying your groceries, make sure they're even, make sure that you're doing some weights, because you are. So utilize those little things like a ball on a counter or using water bottles to take a walk if you don't have weights around. These are the things that can make your body of life change. And I'm gonna revisit with Loretta on some other conversations, but you know what? In this new year, new you, and all of the healthcare landscape challenges we have, we both felt it was important to talk about something that was basic, that everyone could do. And I think both of us feel like, you know what? When you're the patient, take on your responsibility. And that's not me being flippant. That's me trying it and not trying it and falling down and getting up. And all of us are in this together. Loretta, thank you so much. And we'll revisit some things because she's my mentor and she's just a wealth of information and inspiration. And I feel very lucky to have her in my life and in my career. That's terrific, Michelle. Everybody be well, you take care. See you on the next time. Thanks for tuning in to this episode of Beyond the Diagnosis. If something we talked about today resonated with you, if you're craving deeper understanding, better support, we just wanna know you're not alone on this journey. Make sure to subscribe to my free sub stack at michelleweston.substack.com. M-I-C-H-E-L-E-W-E-S-T-O-N.substack.com. That's where I share personal insights, expert takeaways, and extra resources to help you stay informed, empowered, and one step closer to the clarity you deserve. And if you found this episode helpful, leave a review or share it with someone who needs to hear it. Your voice helps this message go further. Until next time, keep asking questions, keep trusting yourself, and keep going beyond the diagnosis.