My job is pretty sedentary.  Possibly not quite as bad as a full-on office job but not far off it.  I park the car in the car park, walk into the hospital and that’s all the exercise I get until I leave the hospital and walk back to the car at the end of the day.  The most physically active I am during the working day is when I walk up the hill to the diabetes centre where all my clinics are.  It’s about 5 minutes from my office and includes a couple of flights of steps. But once I’m actually in clinic, that’s me – sitting on my backside for the best part of 4 hours, other than a 5 second walk every so often to pick up a set of case notes or call in a patient.

Ward rounds are slightly more active – very slightly.  I potter back and forwards between patients and the computer desk for a few hours and if there are patients in other wards I may even have to incorporate a flight of stairs.  Definitely not enough to get my heart rate up or make me feel short of breath.  Office based sessions and meetings are scary.  I don’t move my backside at all.

I know that calorie counters and heart rate monitors are not that accurate and definitely not the be-all-and-end-all but it’s useful to see how one activity compares to another.  I now know that sitting at my desk uses about 1 calorie a minute.  Walking quickly round the hospital takes about 10 minutes and uses 45 calories or thereabouts.

We’ve all heard the mantra that we should be aiming for 10 000 steps a day.  As with anything in life it’s not that simple and not all steps are the same.  A gentle amble from one end of the ward to the other is not going to increase your heart rate in the same way as a sprint of the same distance.  The government’s guideline is that we should be aiming for 30 minutes of moderate exercise most days which can be done all at once, or split into different sessions.

It’s all interesting information though and I wanted to see what my step count was.  I bought myself a pedometer much to everyone’s amusement – apparently they are ridiculously old fashioned.  I should have a fit-bit or an apple watch or at the very least my iPhone should be collecting the data.  However I’m not allowed to wear a watch at work (infection risk), and often I don’t carry my phone around with me as I don’t usually have a pocket.  Additionally, lots of my patients don’t have smart phones and if I’m recommending something to help them increase their activity levels I would like it to be something I’ve tried myself.

So I did a couple of base-line days – park the car in the usual place, wards in the morning, clinic in the afternoon, a bit of office-based activity in the middle.  My step count for a day like that was around 3500.

My plan to increase my activity was very simple and was as follows:

  • Park the car in the furthest away car-park from the hospital and then walk briskly to my office the long way
  • Walk briskly round the hospital site at lunch-time
  • Walk briskly back to my car the long way at the end of the day

I was pretty much scuppered from the outset.  Day one I dropped the kids at school and headed to work.  I quickly discovered my usual commuting route was closed as resurfacing works had over-run.  I thought I’d be clever and take a back road, but after winding my way round various single track roads I discovered my Plan B road was also closed as a stolen car had been abandoned and burnt out there.  I then had to do a 20 point turn in my massively long estate car (the next car will have parking sensors, I swear), and drive into various ditches to squeeze past all the other cars and vans that were also “cleverly” attempting my detour.  By the time I got to work, I was tearing my hair out and my 40 minute commute had become 70 minutes.  There was no way I could justify parking as far away as possible and taking a head-clearing, prolonged, brisk walk around the hospital.

On day 2 I was asked to come to a short notice meeting at lunch-time, so missed my lunch-time walk around the building.  The meeting over-ran and I forgot I’d asked an extra patient to come and see me at the start of clinic.  By then my clinic was running late and at the end of the day I had to dash to my car to make sure I got back in time to pick up the kids from afterschool club.

The rest of the week and the following week went a bit better and generally speaking I managed two out of the three walks which increased my average daily steps significantly from 3500 to over 6000 and sometimes higher if I managed all three.  I was definitely achieving 15-20 minutes of brisk walking a day.  Then on days I wasn’t doing any other exercise, after the kids were in bed I could go for a quick 15 minute walk round the block and get in the rest of my activity.

Though I don’t think I could ever get in 30 minutes of moderate physical activity during the working day, those extra minutes of walking and using the pedometer to see my step count were enough to make me feel that it wasn’t a big deal to go out again in the evening to get to my target activity levels.



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