“Look at a patient lying long in bed.

What a pathetic picture he makes.

The blood clotting in his veins,

The lime draining from his bones,

The scybala* stacking up in his colon,

The flesh rotting from his seat,

The urine leaking from his distended bladder,

And the spirit evaporating from his soul.” 

This blunt but enlightening poem was written by Dr. Richard Asher (1912-1969), a renowned British endocrinologist who is remembered today for his articles that challenged the medical establishment, such as The Dangers of Going to Bed which he wrote in 1947.  Maybe he was inspired by the revelations during World War II that the sick and injured (who were released early from hospitals due to lack of beds) actually fared better than those who remained bedridden.

In recent years you have probably heard the claim that “sitting is the new smoking.” This is often asserted in the context of selling some product to keep you moving. In fact, the doctor who coined the phrase, James A. Levine, MD, PhD. also invented the treadmill desk for the purpose of helping office workers be more physically active and thereby avoiding health risks linked to long-term sitting.

While inactivity is linked to health problems, comparing the effects of sitting with those of smoking is probably a stretch. However, the fact that physical activity is important to overall better health is affirmed by research and medical professionals.  

Throughout history, bed rest has been considered the proper treatment for many ailments and is still necessary in some cases today. Modern doctors are realizing that since our bodies are made to move, there are many negative side effects to remaining inactive for long periods of time. These consequences are referred to as “deconditioning.” The theory “use it or lose it” certainly applies to body function. Caregivers should be mindful of this and encourage activity on a daily basis – after checking with the recipient’s health care provider for any recommended limitations. Here is an overview of common effects of extended bed rest.

• The cardiovascular system (heart, blood vessels and blood) shows many effects even after only a few days: blood pools in the legs (which can lead to dizziness and falls upon standing); the heart beats faster but pumps less blood; the blood becomes more viscous which may lead to the formation of a blood clot.
• Muscles begin to atrophy (deteriorate). After a week of complete bed rest, muscle strength may decline by as much as 30% – and the time to regain that strength is much longer. Balance and co-ordination are affected which increases fall risk.
• Bones, especially the long bones of the leg, decrease in density when they do not perform their weight-bearing function. In turn, the risk that even a minor fall will result in a fracture increases.
• If joints – especially shoulder, knee and hip – are not used, the surrounding cartilage weakens, resulting in limited movement.
• Due to additional pressure on body parts against the bed surface, decubitus ulcers (bedsores) may occur.
• As appetite is often suppressed, dehydration or even malnutrition may result.  Diminished mobility and peristalsis (involuntary movement of the muscles of the intestines) often leads to constipation.
• Urination may become less effective. Inability to empty the bladder often leads to infection. Incontinence frequently occurs. 
• Mental health and cognitive concerns such as depression, irritability, confusion and anxiety have been linked to the combination of illness and prolonged bed rest.

It is interesting to compare these findings of modern medical professionals with the poem Dr. Asher wrote almost seventy-five ago. He seems to have been a man ahead of his time. While doing research for this column, I found another version of his poem which included these last two lines:

“Teach us to live that we may dread unnecessary time in bed.

Get people up and we may save patients from an early grave.”

Note: scybala* is a medical term that means “hardened masses of feces” – thought you might want to know.