mind body

Wellness Wednesday: Dealing with Disappointment

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The other day, I inadvertently backed up into my husband's truck, for the second time in one month.  Both times it was parked in an atypical location, but both times I should've seen it. Both times I was going about 1 mile an hour. I have incurred enough damage to pay for two round-trip airfares to Europe. This was a disappointment.

 

My initial reaction was that I was sad and dismayed. However I was on my way to a delivery, so I knew I had to be sharp. I knew it was nobody's fault really and that there was nothing to be done about it at that moment. The necessity to get out of my funk in short order was actually a really positive exercise. It caused me to think about the best way to deal with disappointment.

All the sources that I consulted on the subject indicated the same basic set of recommendations. Here is my personal redux on the matter. 

  • Pause and breathe before reacting. Take a couple of minutes if need be.
  • Acknowledge your own feelings of disappointment or anger, but do not act out.
  • Accept the present state of affairs.
  • Deliberately avoid blame and invoke an attitude of neutrality.
  • Take responsibility for what you can.
  • Remind yourself that all problems have solutions or at least strategies.
  • Deal constructively with what you have to and postpone the rest until the initial shock wears off.
  • After the initial shock wears off, reach out to others who you know will be helpful and supportive.
  • After any big disappointment, stay in your basic routine. Observe a good sleep schedule and stick to your three meals and three snacks every day as well as your workout.
  • Go out of your way to remind yourself about all the good things in your life. 

 

Keeping this routine will help keep your stress levels down and help you recover from disappointments. 

 

 

Structure Sunday: The Structure of Childhood Memories

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Childhood memories are an important part of who we are. It is up to parents to engineer varied and happy memories into their children's lives. This weekend we went down memory lane by virtue of hosting a wedding reception for the son of some of our closet friends. You would not think a wedding would focus a great deal on childhood memories. And yet, this weekend, it was a veritable memory fest. Of course there was the requisite slideshow of the childhood pictures of both bride and groom. But more than that, at the reception, clusters of conversations ensued, conversations between people who had done much together as children but little recently as adults. 

My extended family is large and we ourselves have three grown children. But, and this is one major point of this post, we have so many friends who are like family. These are families we have known for 20 to 30 years, and whose children have grown up with ours. Back in the day, we gravitated toward them because they were good and interesting people. More than that, they were creative and adventurous, and despite the fact that we were college students of modest means, we had adventures: us, our kids, our friends and their kids. These people have stayed our good friends all this long while. It feels like a tribe, or the proverbial village, the village it takes to raise a child. 

These adventures we had took time, planning and some wherewithal, but it all paid off in ways which we did not then entirely anticipate. Today we have grown kids who sit around the table and marvel at all they got to do as children. We look at old pictures and tell tales of glory. They know their experiences have shaped them. These children have grown to be inventive and resilient from their experiences. These are two of the greatest gifts a child can have. And now they are taking their kids out too.

It is fewer and fewer kids who have these experiences of rafting, camping, hiking or traveling for the sake of seeing a new place. I am writing to encourage you to find good people for your village. Find them and set off on adventures. You will have to take time off work, plan, get some gear, and maybe even learn a few new things. But that's all part of it. Go make some great memories for yourself and your children. You will get more out of it than you realize. 

Food Friday: Treats

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This is a health oriented blog. And yet, I hope for all my readers to experience a wide range of culinary delights. Food is for celebration and rich sweet treats are served at celebrations. How can you participate without feeling like you’ve eaten poorly ? Here are ten tips to turn nutrition buffs into connoisseurs too. 

 

 

 

 

  1. Eat properly on all regular days. 
  2. Get your workout done before attending your party. 
  3. Fill up on healthy foods before the dessert treats arrive. Savor them as much as the treats to come. 
  4. Fill up on healthy beverages like water, soda water and herb tea before dessert arrives. 
  5. Skip dessert if its not really well done. 
  6. Skip alcohol if you chose a rich dessert. 
  7. Be discriminating. Chose only the best for yourself, e.g. choose chocolate mousse over a cheap candy bar. 
  8. Take a small portion. 
  9. Savor your portion; Eat slowly and mindfully. 
  10. Enjoy ! 

Wellness Wednesday: Physical Methods

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Not uncommonly I have patients with pain issues, mood issues or both. Now, I suppose I write as many prescriptions for these conditions as the average doctor, but such a thing is hard to know. And yet, I am an advocate of what I like to call "physical methods" to control these problems.  

Since I practice evidence based medicine, I am committed to sticking to methods that have evidence supporting them. Believe it or not, the following methods are all evidence based. 

Let’s tackle pain first.

It’s pretty simple. If you have pain when stationery, you need to move. If you have pain when moving, you need to reduce movement or get help to find a better way to move. Physical therapy can provide this. 

Use heat and cold. Heat is to increase circulation which helps tight muscles or cramps. Cold is best for anything inflammatory or injury related in the first 24 hours. 

Massage is helpful in many cases of muscle pain. 

Abdominal binders, support hose, and wrist braces can be helpful in certain circumstances like pregnancy related pain. 

For the open-minded, I advise yoga for all sorts of pain: migraines, rheumatologic conditions like lupus, and for back pain pending approval of the back doctor.

Meditation takes a little more commitment, but it too, is evidence based and has been shown to favorably impact pain. 

Of course actual exercise is well known to improve resilience and to make people more resistant to pain. 

I consider music a physical method. Post operative patients have lower pain medication requirements when exposed to music they consider pleasant. The applications go way beyond that. 

Physical Methods for Mood 

All of the above also improve and stabilize mood. But did you know that the smell of natural citrus elevates the mood ? That’s why we have atomizers for natural essential citrus oils in our office. 

Simple adequate sleep is a proven method to improve the mood and increase the pain threshold. 

And if you haven’t heard this term before, you need to: Hangry. It is the combination of angry and hungry, which pretty much makes the connection between mood and blood sugar. Yes, something as simple as three meals and three snacks rich in protein can improve the mood immensely. 

All of these interventions and their effects are quite measurable and act via the nervous system and the circulatory system. Take the time to incorporate them into your life. They work. They’re cheap, and they’re fun. Because we all need to feel better sometime. 

 

 

To learn more see our pages: 

 

Meditation 

Yoga

Music and Health

Wellness Wednesday: My Specific Workouts

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Do you understand the power of being specific ? Have you ever tried to give someone instructions and found that it didn't work?  It may have been because you weren't specific. 

Everything from parenting to counseling patients about fitness is easier when you are specific. Case in point: I have recently changed the way I counsel about nutrition. I used to tell people about protein, carbohydrates and fats. I told them about meals and snacks. Then I let them run with it. Not much changed. They would come back in, with no change in weight or inches. They were frustrated and disappointed, since they had made concerted efforts. 

Then I started asking people to do simple food journals over a couple weeks time. Most people used a paper journal. When they would return, I reviewed it page by page, which took surprisingly little time. I took a red pen to each page, and marked it like a paper for a class, with comments. Most particularly, I wrote in the changes I wanted to see. I even gave a grade, which everyone found amusing. After that feedback, they would go home with a very specific idea of the changes needed. This made changing very easy to accomplish. And it got great results every time, in terms of blood sugar, weight and inches. 

So today's Wellness Wednesday is devoted to some very specific fitness strategies. I have suggested cardiovascular exercise to people as long as I have been a doctor, but only a small percent actually keep a consistent workout regimen. But I have found that when I suggest specific workouts, adoption rates are greater. 

A workout is a very personal thing. A workout regimen is even more tailored. But to give you an idea of what one should look like for a healthy adult, I will present my favorite DVD workout which I use on a regular basis. 

As I indicated in a prior post, I think it is important to take one day off per week. Mine is Monday, since Monday is the beginning of my workweek and is generally challenging. Beyond that, I like to alternate harder workouts with moderate workouts. I like each workout to be for the whole body, but I like to vary them through the week, to be well rounded literally and figuratively. Finally all my workouts qualify as high intensity intervals since research shows they yield the best results in the shortest period of time. I go from 20 to 40 minutes a session, depending on the workout. That's not much time out of the day ! 

My current favorite workouts are from Beach Body. And while this series has a somewhat comical name, it is extremely well crafted, arduous, fun and comprehensive. It is, (drum roll please) the Brazilian Butt Lift Workout series. Among those, Sculpt and Rio Extreme are the Hardest, with Cardio Axe being the most fun. Tummy tuck is the most time efficient at 20 minutes. 

Jillian Michaels does a great job at crafting a balanced workout which is hard and fun. She is also very encouraging in a drill sergeant kind of way. I like her workout series Ripped in 30 (days) and the sequences are only 24 minutes long. Her cardio yoga DVDs like Yoga Inferno are very cool but not for the faint of heart. 

Zumba is fantastic if you like a dance type workout. Zumba is generally of lesser intensity, but Rush and Ripped can give you a respectable workout. 

Chalean Extreme is for those who want to increase their resistance part of their workout. Hip Hop Abs is for those who can dance hip hop. 

Cardio Burn Sculpt by Gaiam is one of the best for getting back into exercise. It can be done at any intensity and is very well rounded, with a warm up, a cool down and attention to both upper and lower body. There is even an express version. The teacher Tanja Djelevic, is very soothing and encouraging. 

Finally on those days when yoga is required, the GAIAM DVD Am and Pm Yoga is the best. It is relaxing, thorough and quite brief at 15 minutes per session. For a really creative and moderately hard yoga exercise, try any DVDs by Shiva Rea. I do the Daily Energy and Vinyasa Flow Yoga. 

I pick from these like a smorgasbord. It keeps all kinds of things going well, like my mood, joints, muscle mass, bone density, and energy. If you check with your doctor, and carve out some time 6 days per week, you too will be rewarded when you do appropriate and consistent exercise. 

To learn more, see our sections below : 

Fitness

The Quantified Self 

 

 

 

Structure Sunday:The Structure of Back to School Preparation

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I loved school. But I always hated those back to school signs in the stores. I still do. It always made summer seem shorter than it really was. And yet, now that I am a seasoned parent, I think there are real benefits to preparing for back to school. 

Just about now, it’s time to check in with your kids about any summer assignments they might have had. Don’t be that parent who declines to ask since they want their child to “ do it on their own”. Ask and get involved. Yes, it is nice when kids are self starters, but each kid is different, and you should at least know what is going on. 

It’s time to get together with your munchkin and deep clean their room. Give them some advance notice so that it is not a shock and so it does not interfere with their remaining summer plans. Let them know you might be willing to make some improvements if a good job gets done. Great examples would be a new bulletin or marker board, or perhaps a cool shelf.

Make sure that once their room is clean that everything truly has a place. Sometimes kid get blamed for having messy rooms when in fact there really is nowhere to put anything. Make sure there are enough hangers, shelves, baskets, boxes, or whatever it takes to fulfill the maxim “ A place for everything and everything in its place. “ And of course, most importantly, set a good example and keep your house clean, tidy and organized. People, especially kids, get used to whatever they’re in. You do your kids a big favor to model organization to them in this way. Being spatially organized does so much to lower stress in the house. 

Make sure to supply what they need for school. Make sure the basics are there, but also try to show you value education by going the extra mile for them with their school supplies. Make sure they have an excellent backpack to carry it all. Allow them to express their personal style. 

Make sure you know about the lunch and PE situation to come. Consider a well done home made packed lunch if school lunch quality is marginal. You can even teach your child to make her lunch eventually. Food is a great place to show kids values in action. Make sure your child has a chance to choose how they carry their lunch. 

Attend any orientations or registrations with your child, all the way through twelfth grade if you ask me. 

Finally, survey the back to school clothing situation. Assuming the room cleanup went well, ill fitting, damaged, or unwanted clothing has been given, donated, or recycled. Introduce the idea of starting your school shopping at a good thrift store such as Goodwill. Offer to take some of your child’s friends along. It is a truly fun treasure hunt. It is hip, green, and cheap.Then after that, check online for any swaps or sales, then get what you must new. 

You are the parent and you have a lot of influence. You can have this influence better by what you do, compared to what you say. Your day to day choices about how you interact with your kids convey your values. These back to school  tips will help you your convey your interest in their education, life habits, and health. They help you convey that you care about them. 

Food Friday: Summer Guests

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Summer should be full of guests. Where there are guests there should be great food and drink. And yet, it is important that the work of food preparation not get in the way of entertaining. Here are simple, easy ideas for summer entertaining. 

 

 

1. Give at least a week of notice, so the gathering is informal but not too informal. Be open to drop ins. 

2. Be aware of any food intolerances or limitations. Have at least three dishes everyone can eat. 

3. Incorporate the out of doors somehow. 

4. Invite guests to contribute a dish but let them know to come even if they are too busy to prepare something. You may also simply ask them to bring soda water if you suspect they are busy. It is a good idea to invite guests to bring what they are good at cooking, within the constraints of your theme. 

5. Favor foods which can be prepared in advance, especially the main dish. An example would be meatballs in a slow cooker. 

6. Favor food which are presented, more than actually prepared, i.e. fruit and vegetable platters with dips. Similarly, favor foods which are assembled by the guest, i.e. a taco or fajita bar. 

7. Serve buffet style. 

8. Have a great selection of drinks, especially in hot weather. People love a big punch bowl. We make ours with 2 parts club soda with one part 100% fruit juice such as apple raspberry juice from frozen concentrate. We cool it with ice, but also frozen berry mix. We may also float some citrus slices. The variations on this punch can be endless, and it the flavors can morph as the bowl needs refilling. 

9. Don’t be afraid to decorate a little. You can be fun, festive or sophisticated at your whim. 

10. Finally, don’t forget the most important part of entertaining: Making your guests feel welcome. 

Wellness Wednesday: Healthy Communication Skills

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Communication skills are intrinsic to our wellness. They are central to our relationships and our effectiveness in life. I have distilled a list of six main steps in healthy communication. I discovered I have lots of room for improvement. Hopefully you will find something helpful too. 

1. Attitude adjust.

  • Consider your purpose in the conversation. 
  • Assume the best intentions in everyone. 
  • Stay positive - honest, patient, optimistic,  sincere. 
  • Value everyone equally. 

2. Check physical factors.

  • Put away distractions like phones. 
  • Make comfortable eye contact.
  • Watch your body language.  
  • Watch your tone. 

3. Listen actively.

  • Listen first.
  • Ask open ended questions.
  • Set aside judgement while listening. 
  • Listen actively -  Don’t interrupt; read back, aka clarify and reflect. 

4. Guide your reaction. 

  • Use empathy; Try to see the other person’s point of view.
  • Practice self awareness -recognize emotions and stresses as they arise and rather than react to them, handle them appropriately. 

5. Say your piece. 

  • Pause and ponder. Think before making a point.
  • Understand how your message might be received.
  • Tailor your message to your listener.
  • Use empathetic assertiveness. 
  • State needs, express feelings; Value your own point of view as well. 
  • Be direct; Be BRIEF - Give the "b"ackround, "r"eason,"i"nformation, "e"nd, and "f"ollow-up.

6. Connect and conclude. 

  • Connect personally.
  • Encourage the other.
  • Focus on the result.
  • Ask for input and feedback. 
  • Follow up with a plan. Close the loop. 
  • Show appreciation for the person and the conversation.  

 

Awesome references that expand on these tips: 

http://lifehacker.com/top-10-ways-to-improve-your-communication-skills-1590488550

http://www.lifehack.org/articles/communication/9-tips-to-improve-communication-skills.html

http://www.wikihow.com/Develop-Good-Communication-Skills

http://www.skillsyouneed.com/ips/improving-communication.html

http://www.skillsyouneed.com/general/emotional-intelligence.html

http://www.skillsyouneed.com/ips/improving-communication.html

http://www.inc.com/kevin-daum/8-ways-to-improve-your-communication-right-now.html

http://www.citehr.com/11334-6-good-tips-increase-your-communication-skills.html

http://advancedlifeskills.com/blog/14-very-effective-communication-skills/

http://www.wfm.noaa.gov/workplace/Comp_Conf_Handout_1.pdf

http://www.helpguide.org/articles/relationships/effective-communication.htm

Structure Sunday: What I do to stay healthy

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I am 53 and I have lupus. But I am pretty darn healthy, thank goodness. People often ask me what I do to stay healthy. It's really no mystery. So today's structure Sunday is about the structure of my week. 

Sunday- the beginning of my week

  • Breakfast with family
  • Team clean - ( Housecleaning) especially laundry
  • Clean desk, pay bills ( which I have recently mostly automated yay ! ) a big stress reducer
  • Grocery shopping 
  • small scale recreation 
  • longer workout 
  • family dinner 
  • Prep for the workday per usual routine- down to packing lunch and snacks, and picking morning outfit ! ( a stress reducer and time saver ) 

 

Monday -workday

  • The usual routine of am protein drink, midmorning snack, second breakfast, lunch and midafternoon snack. Daytime intake must include one large glass of water, one large bowl of ground green tea, and one small cup of kefir, a probiotic.
  • pm- break from workout 
  • family dinner per usual routine 

Tuesday- workday 

  • usual routine 
  • longer workout 

Wednesday - surgery and chores

  • grocery shopping 
  • shorter workout 
  • entertain if possible 

Thursday workday 

  • longer workout 

Friday - workday 

  • shorter workout 
  • special family dinner
  • evening outing 

Saturday - 

  • family breakfast 
  • longer workout 
  • larger scale recreation 
  • entertain 

 

Everyone thrives on routine, from adults to children.  It gives your system signals of peace and plenty. With a reasonable routine, stress hormones decrease and everything from thinking to healing improves. 

You can also use routine help with taking medications and supplements, and to regulate your sleep schedule. If you are having a tough time meeting your health goals, just build a routine. Routine can make hard things easy. 

People say they do not have the willpower to eat well and exercise regularly. Here's the newsflash: It's not so much a matter of willpower as it is engineering. You simply schedule your healthy habits and stick to the schedule, no questions asked. 

Wellness Wednesday: Curing Procrastination

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Is procrastination an illness ? No. But it can affect your health. Let’s take a look at what it is, why it happens, and how to cure it. 

What is procrastination? 

Procrastination is putting off things that need to be done. How big is the problem ? About 20 % of people are chronic procrastinators and these percentages increase significantly during college. People who are chronic procrastinators perform more poorly in their family, in high school, in college, in jobs, and in relationships. This sounds like an unfortunate nuisance, but it is actually a health problem. According to many sources, procrastination creates stress which interferes with sleep, weakens the immune system and makes heart disease more likely. It is also very hard on mental health. 

To understand why procrastination happens, we have to look deeply into issues like self control, self image, inner honesty, fear of failure and distress tolerance. 

1. Procrastination may start as a form of silent rebellion against parents. This becomes a vicious cycle as adolescents avoid parents in favor of friends, who do not hold them accountable as parents would. 

2. Certain necessary tasks or even the idea of the tasks make people uncomfortable (distressed) , either because they dislike doing them or they are perceived as difficult or overwhelming. Those who cope with their feeling of dread or discomfort (distress) by avoidance may procrastinate, only making matters worse. Those who have poor coping skills or distress tolerance are likely to do other dysfunctional things to cope with life’s daily challenges and discomforts, such as abuse substances. 

3. When people do not want to risk failure, they will subconsciously "arrange" to have insufficient time for a task, thereby providing themselves with a ready excuse for their suboptimal performance.

4. Procrastination is self sabotage. People procrastinate to fail in order to show others they have been mistreated, to “get back at them” or to acquire victim status. ( This is, by the way, passive aggressive behavior.) 

5. Some people who procrastinate simply want others to pull up the slack in whatever it is that needs doing. 

6. Some people who really want to succeed procrastinate. They deceive themselves about several things: 

  •      They will be more motivated tomorrow.
  •      They have plenty of time left. 
  •      Their task will not be that challenging nor take that much time. 
  •      They will do better when they are feeing more motivated or inspired. 
  •      They think they do better under pressure. 
  •      They are talented enough to pull it off. 

     These are white lies we tell ourselves. 

 

What can be done about procrastination ? 

 

1. Procrastination is hard to overcome but it requires honesty with oneself and usually firm persistent guidance from others. 

2. Strong feelings of interpersonal conflict should be evaluated by a qualified counselor. 

3. Problems with procrastination in the setting of substance abuse should also be evaluated by a qualified counselor. 

4. Simple methods to beat procrastination are as follows: 

  •      Fortify your will power and your distress tolerance with adequate sleep, healthy meals, snacks and regular exercise.      
  •      Become a list maker. Get a system which is either digital, paper or both and include reminders such as sticky notes or alarms. 
  •      Use SMART goals criteria for your list items. See more about SMART goals HERE. Nutshell version: SMART goals are specific,measurable,attainable, relevant and time-bound.
  •      Overestimate the time it will take you to get something done. 
  •      Ditch perfection as a goal. It gets in the way of progress and accomplishment. 
  •      Divide large tasks into a series of small manageable tasks. 
  •      Practice mental “ time travel” to see how you will really feel tomorrow. 

5. All of this requires self regulation. Practicing self regulation with small tasks has been proven to improve self regulation with big tasks. 

  •      Realize that self regulation is critical to healthy relationships and success in life. That should be plenty of motivation. 
  •      Pick several easy small tasks, and stick to them. Larger tasks WILL get easier as a result. 
  •       Yoga or meditation is especially good training for the nervous system where self regulation is concerned. 
  •      Be easy on yourself for lapses. 
  •      Pat yourself on the back for all successes. 

   

References: 

 

Cal Poly’s Procrastination PDF - WOW amazing document ! http://sas.calpoly.edu/asc/ssl/procrastination.html

Psychology Today: 

https://www.psychologytoday.com/blog/dont-delay/200903/self-regulation-failure-part-4-8-tips-strengthen-willpower

https://www.psychologytoday.com/articles/200308/procrastination-ten-things-know

https://www.psychologytoday.com/articles/200909/ending-procrastination-right-now

https://www.psychologytoday.com/articles/201109/procrastination-oops-where-did-the-day-go

https://www.psychologytoday.com/articles/200308/procrastination-ten-things-know

 

Mindtools: 

http://www.mindtools.com/pages/article/newHTE_96.htm

 

The Procrastination DOOM LOOP 

http://www.theatlantic.com/business/archive/2014/08/the-procrastination-loop-and-how-to-break-it/379142/

 

Procrastination and the great Stanford Marshmallow experiment 

http://youarenotsosmart.com/2010/10/27/procrastination/

 

University of Cambridge 

http://www.counselling.cam.ac.uk/selfhelp/leaflets/procrastination

 

Princeton

http://www.princeton.edu/mcgraw/library/for-students/avoiding-procrastination/procrastination.pdf

 

Procrastination and Your Heart

http://nymag.com/scienceofus/2015/03/procrastination-is-not-great-for-your-heart.html

 

 

 

 

Structure Sunday: The Structure of a Hobby

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Who could have imagined that the love of horses could lead to so many good things. 

When I was a child, I was enamored of horses. I always asked my parents to let me have a pony ride at the fair. When my family moved into the beautiful Palos Verdes Peninsula in Southern California, horses became a major part of my world. You see, all the homes were situated around a network of riding trails and riding rings that were maintained by the city. Every house had a stable, and every family a rider or two. I got some riding lessons locally and really liked it. My parents and I decided this would be my sport and that we would pursue it as a family. 

I was accepted by an established trainer and he obtained a proper quarter horse. We trained until we were ready to show. It required about an hour and half drive out of town each way, and we did it at least four days per week. I did my homework in the car. When I arrived, I would train for several hours each time. It was dusty, intense and stressful, but I liked it nonetheless. Eventually I showed with my stable, all up and down the Pacific Coast in what was then called the Pacific Coast Hunter Jumper Stock Horse Association circuit.  It required a lot of time away from school which was hard. 

Riding has a way of building you up, no matter how hard it is. You learn tolerance: tolerance for your trainer, tolerance for your parents, and tolerance for your horse. You learn tolerance for the invariably bad weather, like intractable rain making muddy arenas, or broiling dusty heat in the Indio sun. You learn to control your fear and steel yourself as you wait to enter the competitors ring. Nowadays we call this distress tolerance. 

You learn to win, and you learn to lose. You are being trained, but at the same time you are training yourself. You have a chance to meet a great goal by meeting lesser ones along the way and you learn right away the winning takes a long long time and more work than you imagined.

I truly believe everybody should have a chance to pursue something seriously. I think all children especially should be raised knowing that they will be taught many things, and that when they find one that is special to them that they will be encouraged and even expected to learn it well. When young children attend classes for hobbies like ballet, music, riding or marital arts, or when they play sports like soccer or football, they learn that success requires practice over time. 

These traits of distress tolerance, perseverance, courage, and ability to work on a goal are key for success in life. I believe hobbies right from childhood foster these priceless traits. 

When I attended the horse show at Rebecca Farm today, I thought a lot about my horse show days. I was full of pride for all the riders and all they had accomplished. I hope you will go out and attend such sporting and arts events in your community. More than that, I hope parents will introduce their children to something inspiring they can pursue. 

For more information, see rebeccafarm.org. 

 

 
 

Wellness Wednesday: Exercise Statistics

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Most people who come into my office for an annual exam report that they live an active lifestyle. Of course this means different things to everyone, but it is an interesting starting point of discussion. 

Our impressions of our exercise patterns are rarely accurate unless we take the time to chart them. I am going to devote this post to a reality check for us collectively. Number lovers are in for a treat. 

Children: 

  • Only 1 in 3 children is physically active every day. 
  • Only 6 of the 50 states require PE in each grade. 
  • The CDC recommends children be physically active for one hour each day. 
  • One third of high school students plays video games for more than 3 hours per day. 
  • In 2013 only 27 % of all high school students had 1 hour of physical activity in each of the preceding 7 days. Fully 15% of high school students reported NO physical activity in any of the prior 7 days. 
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Adults: 

  • Less than 5 % of adults get 30 minutes of physical activity each day. 
  • Only 1 in 3 adults gets the recommended amount of physical activity in a week. 
  • The 4 states where adults have the highest incidence of exercising 3 or more times per week are: Vermont, Montana, Alaska and Hawaii. In these states about 60 % of adults meet this criteria. 

Appropriate physical exercise comprising both cardio and weight bearing exercise has numerous mental and physical benefits for children, adults, and seniors. Exercise these days has become more evidence based. We know more than ever about how to tailor it to a patient's specific health needs. Exercise certainly does not need to be onerous or miserable. Without exception, people who exercise regularly derive great satisfaction from it.

Check with your local health club or YWCA. Get some exercise DVDs for home use. Find my DVD recommendations in the RETAIL THERAPY section. Learn more in our section on FITNESS. 

Structure Sunday: The Structure of Your Home Office

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Today's women have to do it all. Homemakers and professionals alike need a home office to do all that they need to do. Here are my tips for what goes into a home office, and what should take place there. 

I have also included some great resources about home offices. 

 

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Three setups tailored to your budget:

The Essentials:

  • A place to write and store your life management things. 
  • Day runner with addresses, calendar, and notes or smartphone with same features. 
  • Backup for your smartphone if you have one. ( ? cloud) 
  • Writing implements, pens, pencils, highlighters, markers 
  • Spiral notebook to centralize and keep notes ( instead of sticky notes everywhere)
  • A few sticky notes even so 
  • Filing box and files 

Nice to have: 

  • Laptop with internet access 
  • Software 
  • Spreadsheet like Excel for Windows or Numbers for Apple  
  • Word processor like Word for Window
  • Photo storage and processing software. 
  • Bulletin or marker board for ideas, art and planning 
  • Bookshelves 
  • File cabinet 
  • A decent camera

Deluxe: 

  • Printer/fax/scanner
  • Nice speakers
  • Nice headphones 
  • IOS device like ipad 
  • an extra monitor 
  • A good camera

 

Ideas for your home office schedule

 

At the beginning of your day...

  • Leave your home office alone. Get your health related things done first, like working out, bathing, and eating a healthy breakfast. 

 

 In your home office work time… 

  • Check your email twice per day. Don’t do it reflexively. 
  • Leave social media closed until tasks are finished. 
  • Add every new contact into your address book AS THEY COME IN.
  • Keep a spread sheet of your budget. 
  • Use accounting software like Mint, which is free, ibank, which is cheap, or Quicken, to keep your bank, loan and credit card accounts in order. 
  • Set up bills to pay automatically or put reminder notices in your calendar program. 
  • Store your photos digitally, and backup those and your other documents two ways, the cloud, and a cheap external hard drive. 
  • Work on your projects in sessions about 45-90 minutes long. Then get up and stretch and drink some fluids. 
  • Develop a system of file keeping. You may like Evernote which is free. You can organize anything into albums. In side the albums are notes where you can put text, documents, picture, sound, movies, links, or anything. 

 

At the end of the day

  • Review your calendar and plans for the next day. 
  • Chart any nutrition or fitness data that you are working with on a daily basis. Make sure the method is simple and fast. 

At the end of the week

  • Review your calendar and plans for the next week. 

 

Home offices can be a lot of fun. They are ground zero for domestic creativity. Think recipes, projects with kids, projects for the house, tracking that workout and budgeting for that vacation. Knowledge is power and organization will put it to work. 

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Wellness Wednesday: Beyond Relaxation to Renewal 

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Most of us are familiar with the recommendation to relax on a regular basis. We are all familiar with the ravages of stress and the problems associated with insufficient sleep. We generally think of relaxation as the antidote. To most people this means to physically rest or sleep , and to be quiet and still. There is no doubt that some of this kind of time is good on a daily basis, especially if it is done in a mindful fashion such as in meditation.

But sometimes we need more than relaxation. We need renewal. Renewal goes beyond relaxation. It is similar to relaxation in that it is a break from the usual work routine. However, after that, the similarities end. Renewal is more planned. It may involve physical activity, such as exercise, or an outdoor adventure. It may even involve a challenge. It often involves other people, especially people who are new to you. It involves unfamiliarity, learning and even getting outside of one’s comfort zone. 

Productivity experts are extolling such “ strategic renewal” as the newest productivity tool in the success toolbox. This concept can be utilized on different time schedules: daily, weekly , monthly, quarterly. 

Daily Renewals 

  • exercise 
  • meditation 
  • reading 
  • connect with close family and friends 

Weekend Renewals: 

  • connect with farther flung family and friends, socialize and entertain
  • patronizing the arts 
  • sports 
  • spiritual observance
  • volunteer
  • outdoors 
  • reading 
  • exercise 
  • creative pursuits outside of work 

Monthly or Quarterly renewal: 

  • adventures 
  • conferences 
  • different kinds of work projects 
  • travel

See to the basics first: adequate sleep, regular exercise, and good nutrition. Ensure some relaxation on a daily basis. But go beyond all this and try to start thinking about renewal as well. 

To learn more :

See our sections on Sleep Yoga and Meditation 

LIfehacker

Huffington Post 

New York Times 

Stanford University Cafe Science

What Most Successful People Do On the Weekend, by Lauren Vanderkam 


Structure Sunday: The Structure of Your Media Consumption

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IMG_0083.jpg

Omigosh I must be so easily amused. I have flown planes, climbed mountains, and swam with sea lions, but today, I got the biggest rush from organizing cookbooks in their new shelves. I just adore their beautiful pages full of recipes like magic spells waiting to be cast. A beautiful recipe transforms you as you make it, and your family as they see what has been prepared for them. 

I am reading a riveting book right now. It is called Seveneves. I found myself reading it at a stop light. Not good. I chose it based on the genre, sci fi, but also because of the reviews on Amazon, and finally because of what I was able to learn about the author, for instance that he double majored in Physics and Geography. I learned all this on the internet.

Seveneves: A Novel
$21.00
By Neal Stephenson
Buy on Amazon

 

 I did all that research because I wasn't going to devote several hours of my life to something less than totally worthwhile. You see, I get absorbed in my books, fiction and non-fiction alike. They transport me. I don't hear things around me when I am reading. If something is going to affect me like this, it better be quality and it better have redeeming value. I want to finish the book a better person. 

I feel the same way about film, but there are far fewer good films than there are good books. Still, the depths of Netflix and Apple TV are unplumbed, and I look forward to it whenever I have time to dive deep. I don't know if my approach is correct; I save film like candy or ice cream, and cannot watch it until I eat all my vegetables, i.e. work, housekeeping, bills, and exercise. 

Music, however, is like water to me. I have to have it all the time. Patients know it plays all day long in all our clinic rooms, and we try to make it wonderful. We try to make people enjoy their time with us. I want to turn more people on to fine music.

I believe music puts you in touch with yourself. If a song makes you melancholy and wistful, it is touching something within. You may gain from this awareness, and perhaps be able to give the issue more attention. Likewise, if you hear something that makes you feel like dancing, it's because that dance is already in you; the song merely helps release it. 

When I was growing up, all this was so expensive. Books were bought in bookstores, and records required expensive equipment to play well. Regarding films, well, you had to make arrangements to go to a theater, providing you were old enough. But nowadays, the widespread availability of all this media is astonishing. I believe it is world changing. 

I have a great personal interest in the lives of those with low income and high aspirations. I respect these people. I want to understand how they can realize their dreams. I think one big piece of this puzzle is widespread high quality media: books, film, and music. These are not just      niceties in life. They nurture the soul and enlighten the mind. 

Media like music, film and books are not about living vicariously or being passive. They are about learning and getting inspired to go out and live life to the fullest. That is why I think everyone should have access to all the good stuff all of the time. 

So I wondered how much it would cost to have unlimited access to all this media all the time. Here is a rough calculation: 

 

  • Amazon Prime costs $99 per year. You get access to 41,000 movies and TV episodes, and 350,000 Kindle books. Of course the Kindle app is free for any platform. Just be aware these are like Netflix titles, not necessarily the hot new releases, but still very good. 
  • Netflix has a somewhat different set of movies, all for $7.99 per month,  all released several months after they hit theaters. 
  • Apple Music, is $9.99 per person  or $14.99 per family per month. For this you may stream the entire Apple music catalog. Or, you could get Pandora with ads, for free, or without ads, for $4.99 per month. 
  • Let's say you actually want to buy a few physical books because, like me, you think cookbooks should be physical, or because you want to have a paper book to pass around, then you must budget a few dollars for that. Let's say you, like me, buy used books on Amazon, and you decide your budget is one book per month, at $5 per book used, plus $3.99 per book shipping.

If you have a smartphone and internet already, then we can ignore those costs. If we say, for purposes of argument that you "want it all" , the tally is as follows: 

Amazon Prime = $99/yr

Netflix annually = $95.88/yr

Apple Music for one = $119.88/yr

Paper books one year, as detailed above = $107.88

Total = $422.64 per year or $35.22 per month. Aren't numbers interesting ? 

Let's say you are really on a tight budget. You pick only Amazon Prime for Kindle books and streaming video, together with free Pandora for music. Your cost is only $99/year or $8.32 per month. Honestly, that is two lattes. What an amazing time we live in. 

 

Food Friday: Drink !

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I am absolutely compelled to write again about hydration in this, our week of three digit temperatures. I had one reasonable and well intentioned patient who came in with symptoms and was FIVE LITERS short on her hydration ! 

Let us review. Normally, a non pregnant woman needs 2 liters of fluid per day. A pregnant woman needs three. Add another liter for temperatures over 85 degrees, and yet another liter for activity such as hiking. So if you are pregnant and hiking on a hot day, your fluid requirement is easily 5 liters, and that is assuming you are coming to the day adequately hydrated in the first place. 

The human body is about 60 % water. Let's say you weigh 154#. That means you weigh 70 kg. That means you contain 42 kg of liquid or 4.2 liters. Getting short on fluid percentage wise is easier than you think. 

How can you lose so much fluid ? Well there are the obvious ways, but then there is also respiration, sweat, and something short of sweat which is still fluid loss through your skin called insensible loss. It all adds up. Heat and activity increase insensible losses like crazy. 

Here is the interesting stuff: 

" ...fluid loss of 1% impairs thermoregulation (the ability to regulate your temperature), and thirst occurs at this level of dehydration......Vague discomfort and lack of appetite appear at 2 % . Dry mouth appears at 3%. At 4% work capacity is decreased. Difficulty concentrating, headache, and sleepiness are observed at 5%. Tingling and numbness of extremities can be seen at 6%, and collapse can occur at 7% dehydration. " ( reference from the World Health organization) 

Here is the fun stuff: 

Summer is a great time for cold drinks. Try to take the traditional summer cooler and put a healthy spin on it. Here are some examples that will provide you with much needed electrolytes as well as fluid and taste. 

  • Club soda with a splash of 100% fruit juice. 
  • Mocktails like Virgin Mary, Virgin Daquiris
  • Herbal iced tea or sun tea on ice with lemon and mint leaves, sweetened with a little fruit juice 
  • Healthy fruit frappes made with fresh fruit, ice, and plain yogurt or kefir. 
  • Decaf mocha frappes made with ice, one pump of chocolate, and your milk of choice. 
  • Stay hydrated and enjoy ! 

For more information see : 

Drinks in Nutrition 

Weathering the Heat 




Wellness Wednesday: Bathing

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Did you know the in the Middle Ages, bathing was considered unhealthy? Indeed, they were not called the Dark Ages for nothing. 

Bathing has had a long history, dating back to ancient India, where it was done more than once per day for ritual reasons.  Elsewhere in the ancient world, Greece developed the ritual of bathing into a way of life, where it was integrated with the tradition of athletics and the life of the the gymnasium. Roman baths are famous as a social institution, where gossip and politics took place amidst the steam and the towels. Later as Christianity took hold, public baths went out of favor as being immoral, since they were associated with debauchery and hedonism. Bathing itself fell out of favor during the time of the plagues, as Medieval physicians felt it opened the pores and let in disease. Farther north, the Nordic people maintained a tradition of saunas, and unlike the other public bathing environments around the world, theirs bore no association with immorality or disease. 

During these dark times others kept the practice of bathing alive. European explorers marveled at the cleanliness of the Mesoamerican people. Across the sea, Japan had a rich bathing culture, using rock pools, furnace baths, and heated rocks with seawater to make steam. In later years the Japanese would refine the art of the public and the private bath, requiring separate cleansing beforehand, then a clean soak to establish tranquility before family dinner time. 

Today we use baths for cleanliness, relaxation and therapy. It is a simple intervention with pleasant results. With only a few precautions, baths are a great strategy. The precautions are these: 

Pregnant women in the first trimester should not take hot baths. This is because there is an association between elevation of core body temperature with failure of the neural tube to close, and conditions like spina bifida. 

No bath should be very hot, since this increases risk of heart attack and fainting in the susceptible. Very hot baths also dry the skin and can precipitate headaches. 

Bathing in warm plain water is best. However a tiny bit of scented essential oil or salt may be used. Bubble baths are hard on our tissues as is the use of soap, which should be restricted to the shower only for truly dirty or greasy skin, and never the perineum. The face should be cleansed twice a day with cleanser, not soap, and should be moisturized before fully dry. 

Enjoy bathing as a stress reliever. As Sylvia Path once said, 

"There must be quite a few things that a hot bath won't cure, but I don't know many of them."

 

References: 

http://www.history.org/foundation/journal/autumn00/bathe.cfm

http://www.brainyquote.com/quotes/quotes/s/sylviaplat107968.html

https://www.aad.org/dermatology-a-to-z/for-kids/about-skin/taking-care-of-your-skin/washing

 

Structure Sunday: The "Capsule Wardrobe"

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Bon Chic, Bon Genre. (BCBG!) This is the French idea that if you present yourself well in dress, that your mindset will be better. 

This is the week that both Americans and the French celebrate their independence. Why not celebrate a little independence from fashion trends, from self consciousness, or from spending too much? Marveilleuse! 

What is this French concept of "the capsule wardrobe"? It means a wardrobe of restricted size with precisely chosen components. It is a useful concept today when women need to do more with less, and when they would like to be valued for who they are and what they do, rather than how they keep up with trends. It is important too, since the capsule wardrobe is part of the minimalism movement, which, together with the environmental movement,  highlights the benefits of having less  "stuff", but more space and more time. 

But wait? Aren't French women all about the fashion? But of course! It is really that they are all about style. In this way of thinking, the clothing highlights the woman, not the other way around. The clothing should not get in the way of her looks or her life. 

The first step in creating a capsule wardrobe is to tune up your nutrition and exercise! Mais Oui! You want to be trending gently but persistently toward your healthiest weight and body composition. As you do this, your clothes will look and feel better, and you will feel better in them. Check out our sections on Nutrition and Fitness to learn how. 

What is the first step in tuning up your exercise and nutrition? It sounds counterintuitive, but it is to accept your present state. Be kind to yourself. Allow yourself to take sustainable baby steps toward your goals. Let it take the time it needs to take, as long as you are moving in the right direction. For some great tips on making sustainable changes, check out our section on Motivation. 

Developing a capsule wardrobe requires a good mindset. It is not, as you might imagine, a mindset of scarcity; rather it is a mindset of abundance. Developing a capsule wardrobe also requires a closet cleanout. This is a good exercise. You will see that you have more than you thought, oftentimes more than you need. You will find there is much to get rid of and pass on to someone else. Strangely, when you get rid of the unneeded items, the closet contents are somehow “better”, like you have spent money on your wardrobe, but you haven’t. 

Here is how to decide whether to get rid of something: 

  • You don’t feel comfortable or at ease when you wear it 
  • You wouldn’t buy it now 
  •  It looks better on the hanger than on you 
  •  You haven’t worn it in one to two years. 
  •  It is unrepairable

A word about size. We all know that weight can fluctuate. So if you have beautiful flattering pieces that just don’t fit now but will when you are at a better weight, keep them, but take them out of the closet and store them elsewhere until you have met your weight and body goals.

Here are the key elements to a capsule wardrobe: 

  • Pieces that are tried and true
  • Pieces must fit well, be flattering and make you feel good. 
  • Emphasis on simplicity
  • Emphasis on high quality 
  • Color scheme focuses on neutrals with certain pops of color depending on the season.
  • Neutrals are whites, beiges, blacks, grays, navy and denim. 
  • All elements work together and may layer. 

Here are the consistently observed effects of working toward a capsule wardrobe: 

  • Makes you feel more confident
  • Lets you think less about what you are wearing and more about what you are doing. 
  • Streamlines dressing in the morning and at other times. 
  • Costs less
  • Frees up time for things other than shopping 
  • Frees up room in the closet

 

The French Version of the Capsule Wardrobe:

  • relies heavily on neutrals 
  • requires flawless fit regardless of body type
  • favors natural fibers
  • allows no visible brand names 
  • almost uniform like in simplicity
  • does not over accessorize
  • excludes extremely high heels or platforms, flats and medium heels are ok. 
  • allows nothing which makes you feel physically or psychologically  uncomfortable, i.e. too tight or too risqué  
  • involves le “no makeup” look, which simply highlights and clarifies the face, rather than decorating it. 

I have provided you with many entertaining references, since the capsule wardrobe is best appreciated in pictures. I could never have a truly tiny wardrobe such as the ones that some of these bloggers propose. For one, where I live, we have four very distinct seasons, each requiring its own wardrobe. However, moving toward simplicity, quality, and feeling good inside is always a good thing. 

 

References: 

http://www.whowhatwear.com/same-outfit-every-day/

http://www.whowhatwear.com/how-to-capsule-wardrobe/

http://www.un-fancy.com/capsule-wardrobe-101/my-capsule-wardrobe-summer-2014/

http://theproject333.com/solution/

http://www.lightbycoco.com

http://www.minimalistbeauty.com/my-springsummer-2015-capsule-wardrobe/

http://www.wardrobeoxygen.com/2015/03/ask-allie-an-active-casual-capsule-wardrobe.html

http://www.wardrobeoxygen.com/2013/04/capsule-wardrobe-no-fashion-victim-no-frump.html

http://theeverygirl.com/how-to-create-a-capsule-wardrobe

 

French Version: 

http://www.paris-to-go.com/2014/08/10-pieces-1-year-project-333-zero-waste.html

http://www.savespendsplurge.com/how-to-get-a-parisian-fashion-wardrobe-bon-chic-bon-genre-part-one/

http://www.tonpetitlook.com/fr/2015/05/25/la-capsule-wardrobe-lart-de-reduire-sa-garde-robe-intelligemment

Wellness Wednesday: Music and Health

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Yesterday Apple debuted its all encompassing music service. With a subscription, one can listen to the entire contents of the iTunes music store 24/7/365. There are infinite permutations and possibilities for creating playlists and stations. It is the music service to end all music services. 

The association of Apple Computer with music has been long and fundamental. Much of their product inventory has been about consuming and even creating music, and other forms of art such as as film. There is a belief within Apple and indeed, within many decades of California Bay area culture that music is essential to the good life. I believe modern science is beginning to substantiate that belief. 

Listen to music.jpg

 

 

Since I have been totally immersing myself in music since the services inception 18 hours ago, I decided to learn more about what is happening to me when I listen to music. What follows is a characteristically nerdy report on the relationship between music and health. It's amazing and stirs hope. 

A rather casual Google search promptly unearthed a plethora of research and commercial articles on the subject. I will give you the "digest" form and, of course, the references. The oldest work I evaluated was from 2009. Study designs varied, but many were randomized and controlled. Many of the studies were done in the setting of assessing benefit to peri-operative or hospitalized patients. 

 

 

 

In short, exposure to "pleasant" music, self chosen or otherwise, was associated with the following: 

  • decreased preop anxiety,
  • decreased post op cortisol levels, blood pressure, heart rate, pain level, thus decreased requirements for post op sedation and pain medications 
  • decreased pain and depression in fibromyalgia patients 
  • decreased heart rate and pain in hospitalized pediatric patients 
  • improvements in both branches of the immune system, cellular and humoral, in the elderly 
  • improvements in athletic performance 
  • improved sleep 
  • improved cognitive function 

 

 

How does our body and mind produce all these responses through music? The precise science is not entirely worked out. However, studies using measurements of hormones and neurotransmitters by blood tests and targeted neuroimaging reveal the involvement of the dopamine, serotonin, and adrenal pituitary axis systems, among others. 

The cardinal work on this matter seems to be an article produced by one of my old college housemates, Dan Levitan, and his colleague Mona Lisa Chanda. (See reference below.) They evaluate and ultimately support the claims that music produces its effects through the bodies systems for reward, motivation, pleasure stress, arousal, immunity and social affiliation. And these responses, of course, work through various brain centers which produce the aforementioned hormones and neurotransmitters. 

So how you feel on music is very very real. So I suggest you indulge yourself. Find your music and bring it into your life. Better yet, make your music. And if you have small children, do everything you can to get them into music education as early as possible. It helps develop the brain and enhances the power of all the good things music can do for us. 

 

 

Wellness Wednesday: Generativity 101

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I must have missed a day during my Psychology rotation. If I could have planned it, I would have missed the part about Freud and psychoanalysis. Give me a social or a cognitive psychologist any day and I will be much happier. These types of psychologists study the development of personality and cognition, or the thinking process throughout the lifetime. One of the great social psychologists, Erick Erickson, viewed our lifespan as occurring in stages, eight to be precise. They are depicted in the graphic taken from the pages of simplepsychology.org. ( See reference below.) 

I am writing tonight to introduce a new concept: generativity. It is the eighth stage in Erickson’s concept, and this seems to indicate it pertains only to people who are middle aged. I think it pertains to all adults, young or old, and maybe even certain adolescents. In a prior post I highlighted the evidence behind the importance of creativity to health. In this post I would like to highlight the importance of generativity to health and wellness.

Generativity is a term created by Professor Erickson to denote "a concern for establishing and guiding the next-generation." It has to do with creating something beneficial for those who come after you. It has to do with making the world a better place. In both Japanese and western culture it has to do with making your mark. Steve Jobs famously use the phrase "put a dent in the world". 

I have a hard time seeing that this kind of altruism is restricted to middle-aged people. The literature says that this personality trait does not have to be there initially to manifest itself later in life. But what if we were to hold it up as a desirable value? What if we were to make it trendy? Would more people embrace it and do so sooner in life? In Jewish thinking there is a phrase which I think relates to this. It is “Tikkun Olam”. This means to repair the world. It is something we are taught from early on.  It is one of the highest Jewish values.

In the field of psychology, there is actually a scale to measure generativity in a person. It is called the Loyola Generativity Scale or LGS. It is a point system in which the subject answers the following six questions:

  1. I tried to pass along knowledge I gained through my experiences.
  2. I have made and created things that have had an impact on other people.
  3. I have important skills that I try to teach others.
  4. If I were unable to have children of my own, I would adopt children.
  5. I have have a responsibility to improve the neighborhood in which I live.
  6. I feel that my contributions will exist after I die.

You get a zero if the statement does not apply to you, a 1 if it sometimes applies, 2 if the statement often applies, and 3 if  the statement always applies. The higher the score, the more generative you are. And not surprisingly, the happier you are. There is real research that indicates that a high score on the Loyola Generativity Scale is positively associated with life satisfaction.

Generativity is a new term for me. However it is an old and very useful concept. I am writing today to do my part to put it a little more on the map, and to encourage a conversation.

 

References:

What's generativity and why it's good for you at HuffingtonPost

Kristensargsyan’s Blog

Simplepsychology.org

Foley Center for the Study of Lives at Northwestern University

Psychology.about.com

Generativity in the Young, Midlife, and Older Adults. McAdams, et alia. Psychol Aging 1993;8(2):221-230.