Membership in these health clubs and spas involves more than 16 million persons. Of these 16 million persons, more than 9 million engage in aerobics and/or body-conditioning classes at least three times per week.

These numbers do not include hospital- or corporate-based health clubs and spas, or other private clubs.

The latter clubs bring an additional 4 million persons to the total.

Indeed, the sheer number of persons engaging in aerobics and body-conditioning classes is staggering.

And, the potential number of persons who may experience permanent damage to their residual hearing as a result of exposure to high-intensity levels of music is likewise significant.

The truth is that, without technology, you’d be hard-pressed to run your business effectively. Therefore, next month, Fitness Management will publish a survey conducted by the Fitness Industry Suppliers Association­North American (FISA­NA), in which I encourage you to participate.

The goal of thissurvey, says David Dinerman, executive director for FISA­NA, based in San Diego, Calif.,

Is to “develop a baseline understanding on the use and perception of technology in the health and fitness industry.

For example, what’s being used by whom, and whether clubs aregetting what they need.”

Of course, in this quintessential service economy there’s relief for that parental problem, too, provided you can afford it. Several organizations have cropped up in the Valley to shuttle kids to school and to Chinese-language, violin, karate, and other classes throughout the day — for about $9 per ride. At one such service, Kids Kabs in leafy Saratoga, Calif., interest is high. “We get 30 phone calls a day,” says founder Coreen Fujinami. “They’re often very stressed-out parents. They’re multitasking…. They’re well educated and they want the best opportunities for their kids.” Often overscheduled kids, she adds. “Sometimes kids just need to play, they need some down time too, though classes do keep them out of trouble.”

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Upon joining FitClub, members have the option to buy a “key tag” for $10. This key tag allows members to purchase products and services at a discount at participating businesses. Businesses are identified by FitClub stickers, which are applied to their doors in the same manner that credit card stickers are displayed, explains Program Coordinator Lisa Godfrey. More than 50 businesses participate in the program, including restaurants, travel companies, car dealerships and carpet cleaning companies. “Surveys of membership indicate high levels of satisfaction with the Added Value Program,” says Godfrey.

And it’s not only the members who are satisfied. FitClub receives free promotional products from these companies for events. Explains Godfrey, “Vendors participate in club events, providing free products and services while promoting their business [to our members.]” Twice a year, each vendor provides gift certificates valued at $50 or more to be used in club events, retention programs and contest giveaways. “These donations help offset the cost of promotion,” says Godfrey. Each vendor also participates in open houses and community service events, and provides free gift drawings, food or demonstrations. This “decreases costs for the club, and enhances each event’s entertainment value,” Godfrey explains.

Another benefit to the club, which is a bit more subtle, is branding. Members use the keytag outside the club, which “increases name recognition and validation at no cost to the club,” says Godfrey. Finally, FitClub also makes a profit, to the tune of $21,000 annually, from the sale of the key tags.

In addition to members and the fitness center, participating vendors also have something to gain from FitClub’s Added Value Program. As a benefit to vendors, FitClub provides low-cost advertising within the club and its publications. Vendors have also reported increased sales due to the program.

Says Godfrey, “The program has reached a level whereby local businesses now solicit the club for participation.”

The biggest concern with this program was making sure vendors delivered the services advertised, and communicated any changes, Godfrey says. To keep the program running smoothly, a contract was signed that specified the business arrangement between the club, its members and participating vendors. “The use of the contract greatly eliminates any miscommunication or misunderstanding,” Godfrey explains. “Vendors are contacted regularly to monitor program satisfaction levels, and to ensure participation in future years.”

FitClub’s Added Value Program not only benefits the club, but it also serves the community as a whole by bringing customers to local businesses, and it serves its members with an “added value” to their memberships.

“Arthritic joints take more effort to move than normal joints,” said Ginny Keely, P.T., M.S., of Southwest Texas State University’s Department of Physical Therapy in San Marcos, Texas. “Learning to protect joints reduces pain and saves energy. Adaptive devices and techniques can improve the mechanics of a task, allowing it to be accomplished with less strength or movement,” Keely explained.

The Benefits of Assistive Devices
The benefits of assistive devices are many, says Dr. Thao Tran, of The Institute for Rehabilitation and Research (TIRR) and the University of Texas-Houston Medical School. Safety should be the No. 1 factor, but quality of life also is very important. Many easy-to-use medical aids are available to help with function and independence, but individuals should receive instructions on how to use them from their physician or therapist, Tran cautions.

Many assistive devices are available at your nearest drugstore or medical supply store. According to Tran, there are three categories:
Mobility aids — Canes, crutches and walkers help your balance, compensate for weakness on one side and prevent falls while taking the weight off sore joints. They can also prevent additional stress to other areas of your body. For example, overcompensating for a sore left knee, in the long run, could cause deterioration in your right knee.

Daily living items — These include bath bars, jar grippers and other household gadgets. Hundreds of adaptive devices are available that can help with personal care and household tasks.

High-tech help — This can range from voice recognition systems for computers to inexpensive timers for clocks, alarms, lights and heating/air conditioning systems.

Home Sweet Home
Discovering helpful tools and making some simple changes to your home can make a big difference. Home health occupational therapists can help you identify ways to make your home safer and easier to navigate. Or try these small changes, recommended by a number of sources, including Tran and Keely:
Use adaptive devices, such as jar openers, that will help you function with less pain.

Ask your pharmacist for easy-open caps rather than childproof lids for your medications without prescriptions if there are no children in your house.

Place a waterproof chair or stool in the tub or shower to help you get in and out more easily.

Adjust the height of the toilet seat with risers.

Use electric can openers and knives.

Invest in large-handled eating and cooking utensils. Many have special easy-to-hold grips.

Use long-handled reaching devices or tongs for grasping hard-to-get items.

Count on shoehorns and use Velcro instead of shoelaces.

With just a few accommodations like these, arthritis patients can protect their fragile joints from further injury.

“If you’re going to have clean locker rooms, it means you’re going to have to police them,” Lavoie says. This means having one staff member inspect and straighten the locker area every hour. Trash should be emptied, counters should be wiped down, mirrors should be cleaned and there should be no water or towels on the floor.

Everything should also be in good working order, meaning there are no jammed lockers, dripping faucets, stopped toilets, broken shower heads or burned-out bulbs.

Any maintenance problems should be fixed as soon as possible, and proper signage should be posted to let members know you are aware of the problem.

The area should also be disinfected daily and vacuumed at least once a day, depending on use.

In the 1950s, Ringgold focused on painting and addressed issues of racism and politics. Over time she became intrigued by character development and experimented with a mix of painting and traditional quilt design elements. Gradually, she added storytelling with words to her visual works, creating a novel hybrid of mural paintings with traditional album or story quilts. To date, Ringgold has made more than 95 quilts and hundreds of other artworks.

Mother and Daughter Create Fabric Frames Together
In the 1970s, Ringgold collaborated with her mother, Willi Posey Jones. Jones worked as a fashion designer and a dressmaker and helped Ringgold fashion fabric borders as frames for her painted canvas. The fabric frames were more flexible and less expensive than traditional wood or metal frames.

Ringgold had found it doubly challenging — as a black artist and as a woman artist — to find galleries willing to show her work. Without an audience, Ringgold could not get her messages across to the community. The fabric frames made it more economical and easier to roll Ringgold’s artwork to ship pieces to interested galleries around the country.

Sharing a Multi-Generation Tradition
Ringgold had a rich family heritage of fabric arts. In addition to her mother, Ringgold’s maternal great-grandmother, Betsy Bingham, had worked in fabric and made quilts. Bingham’s mother, Susie Shannon, had made quilts as a slave in antebellum Florida. In her work, Ringgold appears both to contain the spirit of these women and to set their spirits free once again. In 1997 Ringgold made “Cotton Fields, Sunflowers, Blackbirds and Quilting Bees,” which depicts a traditional circle of women quilting in the midst of a sunflower field — a very nontraditional location, but one which symbolizes the strength and joy in women working together.

Children’s Books
Written in 1991, “Tar Beach,” (Crown Publishers, Inc., 1991, $18.00; paperback 1996, $6.99), a children’s book, was the first of many successful translations of Ringgold’s fabric work to a medium where they could reach more people.

In “Tar Beach,” Cassie Louise Lightfoot, an 8-year-old third grader, lies beside her brother on the flat asphalt roof of their apartment building. Cassie looks up at the stars while her parents and neighbors play cards. She sees herself flying up and over the George Washington Bridge and, magically, it becomes hers. In her vision, she is liberated and free to rescue herself and her family from the oppression of racism and poverty in their lives.

Exuberant from her spiritual flight, Cassie inspires readers with the message that anyone can fly. Ringgold makes a unique contribution through her children’s books by creating many heroic and inspiring girls, in addition to Cassie. The fact that the girls are black — or African-American — fills a void in children’s literature and enriches all her readers.

Holding Ringgold’s book is almost as delicious as being allowed to touch original artwork. Ringgold repainted scenes from her original “Tar Beach” story quilt, made in 1988, and added new images. The translation into print permits the sensation of getting in closer to Ringgold’s vision.

“Tar Beach” was her first book and was both a Caldecott Honor Book and winner of the Coretta Scott King Award for Illustration.

Also, “Faith Ringgold” by Robyn Montana Turner (Little Brown & Co., Boston, 1993, $15.95) is an inspiring life story with wonderful illustrations of Ringgold and her artwork.

Quilts to Capture the Experience of Black Women in America
Ringgold developed a rich and complex story about a black American woman and carried the narrative through a series titled “The American Collection.” Several of these works travel together. Seen together, they are soul-stirring. Ringgold can inspire adults through her imaginative works as readily as she can paint a child in flight. She says that she gets ideas from reflecting on those who have inspired her. She grew up in Harlem and feels that she was surrounded by positive role models, including Thurgood Marshall, Dinah Washington, Mary McLeod Bethune and Duke Ellington.

Treat Yourself to a View of New Masterpieces
Faith Ringgold’s work is included in the permanent collections of several museums, including The Metropolitan Museum of Art, The Museum of Modern Art, The Solomon R. Guggenheim Museum and the Studio Museum in Harlem.

During Kwanzaa, treat yourself to your own virtual tour of her Web site and, in the new year, look forward to getting to know her work more. Don’t forget to inspire friends by passing along new names or sharing ideas with them. It is a wonderful way to spread a woman’s touch.

You talk about quality of life. Are there cases where, even if the surgeon says to have surgery, I can look at my life and say, “I don’t need to do this?”
Sure. Let’s say you’re someone whose major enjoyments in life come from a rather sedentary existence. You enjoy reading, puttering around the garden. And you do not particularly enjoy activities like tennis or running. You may have a knee condition and when you do engage in vigorous activities, you have pain, and that pain would best be relieved by surgery, a ligament repair in your knee. If in your lifestyle, that pain is infrequent and it keeps you from the activities that are unimportant to you, then by no means should you even consider having an operation. Conversely, if you play singles tennis three times a week and the pain is keeping you from doing what is a very important part of your life, by all means do it. The question is: how important is the pain in your knee in the context of what’s important to you?

What if it’s not me who’s considering surgery, but a close family member or friend, is there a role for me, or should I stay out of the way?
I think you can be an enormous help. First and foremost you can help them focus on the fundamental questions. You can be a sounding board for their concerns. If it’s someone to whom you’re very close, I think it can be helpful to you to join them at the time of the surgical consultation so that they have essentially a second set of ears, or second antenna, to recall the enormous amount of information that’s usually being exchanged in such an encounter.

I hear a lot of stories about surgeries done in the past from older people. Is surgery a lot different these days?
It’s a completely transformed world compared to 20 or 30 years ago. It is a much safer world. Many of the operations we did then have become obsolete. And the things we do now weren’t even considered then.

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What happens if I hear my surgeon’s very good, but when I try to talk to him, he’s rushing me and is on to the next patient before I’ve finished my sheet of questions? Should I go elsewhere?
Hopefully, even before you ask, he will have volunteered additional resources in his office or institution to help answer your questions. If that’s not available, I think it is right to feel uncomfortable, and you ought to seek more information elsewhere.

It’s OK then to expect that your surgeon may not be the source of all the information you need?
In fact, the surgeon should not be the only source of information because there are many aspects of the process of having an operation that I think are better communicated by nurses, physicians assistants, anesthesiologists, and others that will be involved in your care.

You mentioned the surgeon does the calculating and I take the risk. What about the risk, especially with anesthesia?
There’s an enormous spectrum of risk that’s associated with surgery. For patients who are otherwise healthy, the risks of anesthesia are extremely low. And they should be weighed against the benefit that you anticipate getting from the operation. If it’s an operation that’s designed to make your life longer, with convincing statistical evidence that the operation will do that, the risk of anesthesia is generally trivial in comparison. And with regard to issues of quality of life, we take chances all the time to improve our quality of life. We travel in airplanes, cars, boats…we walk around on streets crowded with traffic…we eat in restaurants…all have risk and, obviously, a quality of life benefit. I think anesthesia ought to be considered in the same context.

What about pain? I’m concerned that being cut into is going to cause a lot of pain, especially after the operation.
Post-operative pain now is generally very well controlled with medication, and with some relaxation therapies. Some people would argue that hypnosis can be helpful here as well. But the mainstay of post-operative pain management is certainly the use of medication. It’s most important that you be given adequate doses. The medications themselves are well-established and quite safe.

You mentioned relaxation and hypnosis. Is it realistic to expect that some kinds of alternative or complementary medicine could be part of the surgical experience?
It’s very variable. There are some patients who are very receptive to these techniques, which are most valuable in my opinion for the subjective benefit they provide. They simply make you feel better. That’s just not true of everybody. If it works for you, by all means do it, provided that what’s being proposed is safe and compatible with the surgery or the medicines that you’re taking.

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Are there certain questions I should always ask if I’m trying to decide whether or not to have surgery?
Absolutely. First and foremost, does the proposed operation have explainable, definable benefits to you, both with regard to survival and to quality of life? And unless you feel that it is going to benefit you in at least one of those areas — namely, to increase your likelihood of survival, or increase the quality of your life in a way that’s meaningful to you — you shouldn’t do it.

How can I tell if I’ve gotten a good surgeon?
I believe reputation is important. You should ask your surgeon how often he or she has done the operation that’s proposed for you, and what the results have been. You should expect a level of comfort in the explanations you get from the surgeon, in both the reasons for having the operation and in the experience and knowledge that he has in doing that procedure.

Should I always get a second opinion?
Most often, I don’t think you need a second opinion if the answers you’ve been getting to the fundamental questions provide you with comfort. If you feel you need an operation, based either on its ability to prolong your life or make it better, then I think you should feel very comfortable in the decision. If you have any discomfort in that regard, then you should seek more information through a second opinion.

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