Terry, I'm 50 years old and an avid bowler with 20 lbs. to lose. I have blood clots in my legs from taking hormones for menopause. Even though I have stopped taking the hormones I have a really hard time walking for exercise. I used to walk all the time and now it's very hard to get any speed without pain. I have tried weight training and again my legs behind my knees hurt so much it's hard to continue. Any suggestions?

-- Daurene

First Daurene, I want you to make sure that your doctor thinks it's safe for you to exercise with the blood clots. If he or she says it's OK, why not try using your upper body rather than your legs? Swimming is the first activity that comes to mind. There are a couple of reasons why swimming may be the best way for you to get exercise.

First, since swimming makes more use of your upper body muscles than your legs, it keeps blood circulating throughout your entire body. This lessens the chance of blood pooling in your legs, which could cause discomfort because of the clots. Swimming also keeps your body horizontal, so your blood pressure is lower than when exercising upright. Your heart doesn't have to fight gravity to pump your blood back out of your legs.

If a pool isn't available, there's a machine called the U.B.E. (Upper Body Ergometer) that's like a bicycle for the arms. You sit at it and turn cranks with your arms. This apparatus gives you a cardiovascular workout using only upper body muscles. For general cardiovascular health, as well as calorie burning, you need to get to the point where you're getting some form of aerobic exercise three or five times per week, for 30-45 minutes a session.

If using weights with your legs is painful now, try just doing upper body resistance work. You want to increase your overall lean muscle mass to help reduce body fat and to raise your resting metabolism. Training upper body muscles should also help your bowling. Do chest presses, lat pull downs for your back, lateral deltoid raises (flies) for your shoulders, biceps curls and triceps extensions for your arms.

Daurene, in order to lose weight you need to cut calories as well as exercise. Since you may be limited in how much exercise you can perform, monitoring what you eat is crucial. Multiply your current body weight by 11. The figure you get is approximately the number of calories you need per day to maintain your current weight. Try cutting that number by 20% and make sure no more than 20% of your calories come from fat each day.

My master plan for you, Daurene, is to begin with upper body forms of exercise that don't send blood down to your legs. I hope that after a few weeks you can incorporate a little cycling into the plan and eventually resume walking. (Cycling brings blood to the legs, but then pumps it back out.) Try using a U.B.E. or doing free weights with your arms, interspersed with five minute sessions on a stationary bike, which will prevent blood from pooling in your legs.

Roll some strikes for me, Daurene!

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