prevention

Wellness Wednesday: A Thousand Small Cures

Not a day goes by that I am not asked about one “cure all” or another. Wellness Wednesday has been a column devoted to just the opposite- the many, sometimes small things, which done repeatedly, amount to the “cure”. The “cure” offered by longstanding attention to wellness is none other than prevention. 

Even when unpreventable illness or injury happens, wellness behaviors can make the difference between a good outcome and a bad one. We have so much power over our health but people scarcely realize it. Some realize it but are not up to taking that responsibility. It feels better to ascribe their poor health to genes, “toxins” in the environment, or something else. Strangely, empathy rather than blame is in order here. Why ? Because empathy is empowering and empowerment works. Once people get the message (though empathy) that they are not alone, they have the courage to begin improving their health related behaviors. 

Taking charge of your health is easy and empowering from day one. That is the secret that popular media and medical professionals alike keep obscuring. It is not so much a matter of discipline as it is of planning. It need not take place all at once. Once people get the message that wellness behaviors are easy, and need not be hard to be helpful, they are more apt to do them. 

How do people get these messages ? There is of course the popular media. To find this material about health maintenance you must be seeking it. These people are already on the right track. But what about others ? Here is where I believe the responsibility falls on all doctors to talk to patients about their health maintenance. Even before that, I believe it behooves all physicians to set a good example in this regard, and keep themselves as healthy and fit as possible. Nobody is perfect, and nobody should be held to an unrealistic or extreme standard. Yet, doctors should practice what they preach and lead by example. 

Physicians offices should be set up to refer liberally to nutritionists, physical therapists, counselors and others who can specifically teach and monitor health maintenance behaviors. Physicians themselves should learn how to discuss sensitive matters like weight. They should ask about life at home and work to screen for interpersonal issues or abuse. 

It is my hope that popular culture will increasingly embrace legitimate ideas about nutrition, fitness, mental health, and health care.  By now, most people know how ideas travel though communities and social media. Good ideas are sticky, and should be circulated. For example, food and workout posts which we love to hate actually bring these ideas to the fore. 

My website is a repository for health information related to Obstetrics, Gynecology and Health Maintenance. However, it has a limited readership. My plan to curtail blogging to Medical Mondays only is an attempt to get "more bang for the buck” and try another format for distributing this information. There are a couple decent books out there in this subject area, but mainly the field is lacking. I will be looking at the possibility of an ebook versus apps to serve as resources for women looking to improve their health. I hope you stay with me along the way. 

 

Structure Sunday: The Structure of Prevention 

Here’s a simple question: Is it hard or easy to stay well ? 

Staying well is two things: avoiding disease and optimizing health. I’ll be the first to tell you that there are some diseases you simply can’t avoid. I’ll also be the first to tell you that most diseases are a preventable. 

What is prevention ? Is prevention hard or easy ? Prevention is not one thing. It is collection of different actions. Most importantly, these are done over time, on a meaningful schedule, and so we call them habits. I find that lots of people do certain few healthy things once in a while. Oftentimes these same people wonder why they do not see gains in health or fitness. What they are missing is the element of time. Taking one, two or ten habits and performing them in perpetuity over time is what makes the changes. If I could change just a few ideas in my patient’s minds, this would be one of them. 

Prevention requires you to harness the element of time. Time gives your actions power. Most prevention habits are simple easy acts in and of themselves. By themselves they don’t so much. Multiply them by months and they make significant and long lasting changes. 

Here are some super simple acts which you can multiply over time. 

Mind: 

Record three things for which you are grateful before you go to bed. 

Read them upon arising. 

In a conversation, listen first then respond with “I” statements. 

Think and take two full breaths before responding during a conflict. 

Meditate for 10 minutes per day. 

Have about 6 close friends. 

Consider having a partner. 

Have a pet of whom you take good care. 

Ensure your work is meaningful. 

Don’t overspend. 

Take your allotted vacations. 

 

Body: 

Wash your hands at work and when you get home. 

Get your required vaccinations. 

Sleep at least 7-8 hours a night. 

Wear seat belts. 

Use sunscreen.

Eat three meals and three snacks each with protein and produce. 

Avoid simple refined carbohydrates. 

Use olive oil and green tea. 

Ban soda, smokes and drugs. 

Limit to one wine or beer per day. 

Drink 3 liters water per day. 

Brush twice a day, floss and use a peroxide mouthwash before bed. 

Exercise for half hour 5-6 times per week combining cardio and light resistance. 

Incorporate yoga every week. 

 

Super basic, right ?

Super powerful.

That’s what these habits are when repeated over time. 

Prevention doesn’t hurt, it’s not expensive, and you can do it anywhere. It does take a plan to carve out the small slots in the day to do these things, but it really isn’t hard. Just keep the list handy, do the items, and you will wake up in a few months and notice some pleasant changes. 

 

 

 

 

 

 

 

 

 

 

MEDICAL MONDAY: The medical facts behind helmets and skiing.

This article is written in honor of my brave niece who is recovering from a ski accident. 

She is very athletic and very experienced. She is not reckless, and was wearing a helmet. Nonetheless, she caught an edge, lost a ski,  flew out of bounds, hit a tree, lost consciousness and went down a tree well. Luckily, a patrol just happened to be skiing right behind her and dashed down after her. She and my sister in law, who nearly passed by the single ski on the trail, hauled her out, and our awesome Alert Helicopter evacuated her. Her helmet suffered a big gash. She got a concussion and some hairline spine fractures. People keep saying she is so lucky that that she was wearing a helmet. 

It wasn't luck. The data and recommendations are crystal clear and their family follows them. I have summarized them here for you. They come from a review article which was published in the Journal of Trauma and Acute Care Surgery in April of 2014. This review combined the findings of 16 prior well designed studies which examined the effects of helmet wearing on both skiers and boarders. Here are some of their key findings: 

  • Injuries in boarders are more numerous and more serious.
  • Incidence of injuries are higher in males, and those under 17 years of age. 
  • A 1996 study showed the average inpatient cost of a skiing or boarding injury to be $22,000.
  • There are 600,000 ski and snow boarding related injuries per year in North America.
  • About a fifth of these are head injuries.
  • About a fifth of these head injuries are severe enough to cause loss of consciousness of concussion.
  • That's about 24,000 people per year losing consciousness or having a concussion with their head injury.
  • The 16 studies collectively showed anywhere between a 30%-60 % reduced incidence of head injury while wearing a helmet. 
  • They also showed decreased incidence of loss of consciousness upon striking a fixed object while wearing a helmet. 
  • Wearing a helmet is not associated with increased rates of other injuries, poorer responses to stimuli, or riskier behaviors. 

The authors concluded that helmets should be strongly recommended and that policies should be put into place to promote their usage. 

My niece is going to be fine. But she has a few challenging weeks ahead of her. She will miss her finals, miss her sports, and end up with lots of physical therapy and doctor visits instead. We are just grateful she is with us and, and still moving and smiling.