mind body

Wellness Wednesday: Holiday Wellness

Here are just a few tips to make this most intense part of the holiday season less stressful, more relaxing and more celebratory. 

1. Take a look at your calendar from now until New Years. Make sure you are neither overbooked, nor forgetting about events that are meaningful to you. Make sure the schedule is realistic and that your family members are all on board with the plan. 

2. Take a hard look at your budget and stick with it for your Holiday expenditures. A great source of holiday stress is financial. Reduce costs by decorating with natural elements, entertaining pot luck, and by making or baking homemade gifts. Consider also gifts of outings. For example, give a certificate good for “one Sunday afternoon walk in the park with me”. 

3. Ramp up the consistency of your workouts. You will feel better about yourself and avoid the Holiday weight gain. 

4. Be choosy about your indulgences. Eat slowly and savor your treats. Drink ample water through the day, and be sure to consume the sights and sounds of the season, not just the tastes. Consider being the amateur event photographer of the family. It takes your appreciation of the season far beyond the food. 

5. Relatives coming from out of town ? Make a sound plan for their accommodations. A little advance planing can save a lot of stress. 

6. Anticipating stressful interpersonal encounters ? Plan ahead and adjust your attitude. Try to see the good in everyone. Blessed are the peacemakers. 

7. Bon chic, bon genre - This is a French saying meaning that if you dress well, you bring your best self forward. Dress to present yourself thoughtfully, and to indicate your respect, enthusiasm and cheer. Never dress to impress. Dress to delight and to put others at ease. 

8. Consider the deeper meaning of the season. This is, of course, the best way to put the shine on the season. 

 

Happy Holidays from Dr. Gina 

 

 

 

A very nice reference for more reading : 

 

http://www.clevelandclinicwellness.com/Features/HealthyHolidayCelebrations/Pages/introduction.aspx#

Wellness Wednesday: Nature and Health 

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Tonight I attended the Banff Mountain Film Festival as I have done almost every year for the last 20 years. This film festival is a celebration of mountain culture and the outdoor lifestyle.

Mountain culture means a certain thing to me, my family and my friends. Understanding what this means can shed some light on what it means to be healthy. 

I could say it means high adventure like ice climbing, parasailing, and extreme skiing. I could say it means having a community where fitness is highly valued. I could say it means being outdoorsy. I could say it means being active in the environmental community. But it is not exactly just these things. 

It is a little but of each of these things. But mostly it is this: it is connecting WITH  people IN nature. We know from the social sciences that being connected to others is critical to health and wellness. We also know that immersion in nature is critical to our well being. Numerous studies have demonstrated that exposure to or immersion in nature improves the following: 

 

  • mental health

  • immune system resistance

  • reduced stress

  • reduced anxiety 

  • reduced anger

  • reduced fear

  • increased positive mood

  • increased feelings of unity with others, more sense of community

  • more concern over helping others 

  • enhanced social interactions 

 

For children, exposure to nature has been associated with the following:

 

  • reduced stress levels, increased fitness 
  • reduction in ADHD symptoms 
  • enhanced student performance on tests of critical thinking 

 

The data on the subject of nature and health are fascinating, overwhelming and encouraging. Check some out for yourself: 

University of Minnesota

Health Promotion International

National Wildlife Federation

American Public Health Association

Stanford University via Science Alert

The Lancet

University of Washington

Norwegian University of Life Sciences

 

No matter where you live, be it city or country, this is important for you to know. You and your family need your time in nature, no matter the season, no matter whether you live in the mountains. coast, desert or plain.

You should keep an eye out for any outdoor film festivals in your area as they are sure to inspire. Our local festival out of Banff is sponsored in part by National Geographic. I was intrigued by their stated interest which was the intersection of “science, adventure and storytelling” . Go out and get some for yourself. 

Wellness Wednesday: Gratitude is at the Center of Wellness 

Most people think of gratitude as a feeling. Actually, it is a practice. Did you know that there is a science of gratitude?

Major academic centers the world are investing in gratitude. Gratitude is studied as a part of a relatively new branch of Psychology called Positive Psychology. A landmark study in the Journal of Personality and Social Psychology, 2003, volume 84 number 2, entitled “Counting Blessings versus Burdens: an experimental investigation of gratitude and subjective well-being in daily life." This research suggested that”...a conscious focus on blessings may have emotional and interpersonal benefits”.

Much more recent research since then has also underscored the physical health benefits of gratitude. Most of us understand by now that the mind and body are connected on a neurophysiologic level, and while it is fascinating, it is no surprise that a mental practice such as gratitude could go on to have concrete benefits to physical health. 

What is gratitude, the practice?

Prof. Robert Emmons, the author of”Gratitude Works !" recommends establishing a full on gratitude ritual. These can include the following:

  • Make a resolution or vow to practice gratitude. 
  • Make a plan to practice gratitude. 
  • Have a morning gratitude ritual. Examples would be glancing over your gratitude journal or meditating for a few minutes about what you are grateful for. 
  • Adopt the physical habits of gratitude such as smiling and making eye contact, saying hello,, saying please and thank you, and making a physical gesture such as handshaking if appropriate.
  • Send written expressions of gratitude such as emails and thank you notes in paper.
  • Place objects or other visual cues in your house, office, or where you can see them to remind you of something for which you are grateful.
  • Keep a gratitude journal. Make it brief but make it regular. If you keep it by your bed you can glance at it first thing in the morning.
  • Go out of your way to remember good times.

 

What will a practice of gratitude do for you?

There is an enormous body of science from a variety of sources that indicate the following effects of gratitude:

  • Stress reduction
  • Improvement of a immune function as measured in the bloodstream.
  • Better recovery from loss, i.e. Better resilience
  • Higher levels of life satisfaction.
  • For students,better grades.
  • It makes you a better friend to others.
  • Improved sleep.
  • Strengthens interpersonal relationships
  • Improves team functioning 
  • Greater alertness
  • Greater enthusiasm
  • Greater goal attainment.
  • Lower levels of depression
  • Enhanced capacity for empathy
  • Improved self esteem
  • Reduced aggression
  • Decreased loneliness
  • Greater tendency to act with generosity and compassion
  • Increased energy.
Gratitude
$11.27
By Oliver Sacks
Buy on Amazon

This is not just new age foo foo nonsense. Institutions such as Stanford, Harvard, and Penn, not to mention Google have thrown serious money, time, and entire departments into the pursuit of the evidence based effects of gratitude.

So this Thanksgiving, capitalize on this most important of national holidays. Find your gratitude, and keep it going. 


References and Additional Reading: 

Pass the Gratitude: Recipe for a happy Thanksgiving, From Huff Post Los Angeles

In praise of gratitude, from the Harvard Mental Health Letter

Seven scientifically proven benefits of gratitude that will Motivate you to Give Thanks Year-round from Forbes

Expanding the Science and Practice of Gratitude, From the Greater Good Science Center at the University of California, Berkeley

Why gratitude is Good for You, From the Stanford Social Innovation Review

Wellness Wednesday: How to Start Your Fitness Routine 

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There are people out there who experience lasting fitness breakthroughs. They all have to start somewhere. This week's post is about how you can start your fitness regimen. 

How do you break out of your rut? By creating a new rut. A lot of people have good intentions and a lot of people have brute force discipline. But that's not really what it takes.

What does it really take? It takes a good set up. You have to set yourself up for success.

 

As with any goal, your goal of starting fitness needs to be SMART.  

SMART means: 

  • SPECIFIC
  • MEASURABLE
  • ATTAINABLE 
  • RELEVANT
  • TIME BOUND 

 

1. Specific- Decide what you are going to do. I suggest beginners either go to a class at an accredited health center, gym or, as a lower cost alternative get a selection of appropriate fitness DVDs for home use. One great regimen is every other day at the gym interspersed with every other day at home with a DVD. Always take at least one or two days off a week. On those off days you may do gentle yoga to perpetuate your habit and stay limber. 

Being specific also means that you know exactly what you are going to wear and exactly what you are going to do to start the workout. For me, this means coming home from work, changing into my exercise clothes, turning on my DVD player, grabbing a glass of ice water, and then putting on my workout shoes. By then, the workout is as good as done. I do it the same way every time to create and reinforce a habit loop.

2. Measurable-Consult with your doctor about how many days a week you should work out. I suggest no less than three and no more than six, preferably 5 to 6 days per week. When you are a beginner the duration of your exercise should be no more than 30 minutes and possibly closer to 20.

Very importantly decide on a method of recording your exercise episodes. This can be as simple as making a mark on the calendar or as complicated as using a fitness tracker on your smart phone. Don't make a big deal out of the recording, just do something simple and quick. Then your exercise becomes measurable.

3. Attainable-Make sure the first three months of your workout are easy. Your workouts should be so easy that they provoke nothing more than some light breathing. They should not hurt, burn, or exhaust you. The first three months of what you do is simply to let your body and your mind adjust to the idea of regular exercise. You are building a habit. You will almost certainly want to modify the routines you see in the easiest of your DVDs, but this is perfectly okay. 

4 Relevant-The first three months of your fitness workout should focus on light cardio and light resistance combined. This is the most relevant form of exercise according to current Sports Medicine evidence. You do not want to undertake long distance running or powerlifting or anything so specialized or extreme.

5 Time bound-You know your schedule. Carve out precisely 30 minutes for a 40 minute work out getting yourself five minutes on either side to change clothes. Know exactly where the workout is going to be placed in your day for the entire next week. Be realistic… you have 30 minutes. Everyone does, but this might mean you need to be more efficient overall, and there is nothing wrong with that. It also might mean that you have to cut things out, Such as Facebook, Pinterest or even Big Bang Theory.

 

You really want it. You know it will make you feel good. You know it will enhance your health. You know it will set a good example for your family. I'm here to tell you that fitness is not hard. In fact, it's fun and satisfying. Take these SMART steps today and start your fitness routine.

 

 

 

 

 

Wellness Wednesday: The Wellness of Being Yourself

My new T shirt 

My new T shirt 

As most of you know I recently returned from my alma mater, nerd nation, the mothership, Stanford University. Here is a group of misfits so diverse and enthusiastic that they just might save the world.

Wikipedia defines nerds as follows:

Nerd (adjective: nerdy) is a descriptive term, often used pejoratively, indicating that a person is overly intellectual, obsessive, or lacking social skills. They may spend inordinate amounts of time on unpopular, obscure, or non-mainstream activities, which are generally either highly technical or relating to topics of fiction or fantasy, to the exclusion of more mainstream activities.[1][2][3]

The Wiki goes on further to add the following:

"Nerdy" interests[edit]

Some interests and activities that are likely to be described as nerdy[by whom?] are:

Jane McGonigal writes convincingly in her book “Reality is Broken" that the gaming community is full of people with great capacity to focus, as well as a passion for adventure and righting wrongs. She proposes to harness this energy for good and not just for gaming. This nerdy passion for adventure and justice combined with an intense capacity for focus was just what I saw at Stanford.

I returned from nerd nation inspired and encouraged. However I also found myself with a number of questions. Have I had enough faith in myself and the world? Have I tried enough new things ? Have I developed myself to my fullest potential? Have I done enough to make the world a better place ?

There is the temptation for these questions to become very heavy. However, in nerd nation, there is the acknowledgment that everyone is unique and that everyone has something unique to contribute. It was provocative nonetheless to meet a considerable selection of people who are doing things that could actually change the world, and by change the world I mean things like discover life on other planets or cure cancer. It is even more provocative to consider that most of these nascent accomplishments were not that hard. Rather than coming from brute force of mind, they came from unencumbered creative thinking, an environment supportive of trial and error, and steady efforts in a collegial team environment. 

On balance the visit was more empowering than daunting. This is where the connection to wellness becomes evident. I have written before about the connection between wellness and creativity. I have also written about the connection between learning and wellness. There is clearly a connection between wellness and altruism. I write now to encourage all of us to have a little more faith, a little more creativity, maybe some continuing education, maybe a little travel to get us out of our own heads, and more drive to make the world a better place.

Get your nerd on people.

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. 

 

 

 

 

 

 

 

 

 

 

Structures Sunday: the Structure of Studying

I'm a perpetual student. You may not realize it but in certain circles this was considered an insult. I now realize it is good thing. Indeed life long learning is the only way to go.

I have already blogged about the importance of reading and creativity. Those of you who know me realize I have a number of serious creative pursuits, Since we are approaching Halloween, I am deep in preparation to sew a detailed costume. For these sorts of things as well as my work, I have to study. That's right, study.

For my costume I have had to research everything from specialized sewing machine feet to the thermal properties of craft foam. For my amateur photography I have had to research telescope eyepieces and how to connect a old school serial port to a USB port.

Tonight for example I am deep into my annual board review preparation. Every year we have to review research articles and take tests, But every 10 years or so we have to take a big test and that is what I am preparing for this week.

Additionally, I am aware of many of my friends and their adjustment to the new school year. Bottom line: all parents home school, even those parents whose kids go to public or private school. That's how I felt anyway when my kids were in grade school and high school. Every day when I would come home from work I would simply change hats and I would turn from OB/GYN to homeschool teacher. I would check in with each of my kids to see what they had to do for homework and upcoming tests. I would check in on how their classes were going. I might take a some time and give them a little supplemental information on a topic if I happened to know something about it. Finally I would monitor their study habits. As much as I think they found it irksome, I think even they would admit it has served them well. 

So what are good study habits? There are numerous books written on the subject which are beyond the scope of this blog post and well worth reading. I just want to emphasize that you should stay intellectually and creatively active as a part of your overall good health. I also want to empower you to get involved in your children's academic life. So here are a few basic tips for studying that will serve you as a parent coaching children, a student, or simply as an adult keeping her intellectual and creative life healthy.

  • Get an overview of the task at hand. Even grade school children should know that school goes in semesters or quarters. They should know when the tests and quizzes are given, and when their assignments are due. Both children and adults should have a simple clear system for writing this down. It can be either digital or paper. Their should be a daily and weekly routine for referring back to this schedule. That makes for no surprises and less procrastination. 
  • Prepare. It does not matter whether you are preparing for a book report in seventh grade or a board exam when you are a doctor, preparation is key. Learn to channel your anxiety and concern into an early jump start on your project. This is imperative because it alleviates stress and gets the job done.
  • Know how to study. Here is a general method for low stress, effective preparation. 
  1. Scan the material for an overview.
  2. Read the material thoroughly.
  3. Highlight the material thoroughly.
  4. Make your own handwritten notes from your highlights.
  5. Make index cards from your handwritten notes, using a brief description on one side and more complete details on the other.
  6. Quiz yourself on your index cards. Do it out loud. When you do, put the ones you know well in one pile and the ones you need to review in another pile. Repeat your index card quiz, this time only with the pile that you need to review. Again, put the ones you fully understand in the good pile and the ones you need to review in the bad pile. Repeat the process until there is nothing in your bad pile.

It turns out that getting as many senses involved in your learning helps. The technique described above involves several senses, sight, touch, and hearing. Reading, writing with your own hand, and seeing what your own hand has written or hearing yourself read what you're own hand has written reinforces the learning of information on multiple levels, indeed in multiple areas of brain.

This is all well and good if you simply need to learn facts. However, if you need to know how to work problems, that comes next. Work on all the problems you can two or three days before they are due. That way you have a chance to go in and ask questions well before the problems need to be turned in. If you are a parent supervising children with homework like this, be sure that they do their assignments at least two days before they are due. You will ingrain this kind of habit in them for the rest of their life, and that will serve them well. And don't forget to lead by example.

If you're working with older children who will be taking tests, coach them a little bit in test preparation. Emphasize early and repeated contact with material as well as working of every problem that the teacher has handed out. Encourage students to use practice tests that have been provided to them and that are available on the Internet. Encourage them to fill in their understanding with information they find on reputable Internet sites such as Khan Academy. Have them try finishing the test preparation the day before the test is given so that they can spend that day asking the remaining questions. Tell them not to be afraid of being like Hermione Granger and having their hand in the air all the time. 

Make sure you and your children have a good night’s rest before any tests. I realize this is easier said than done but it is sound advice. In fact, make sure they are well rested before any school day. This will maximize their ability to learn. Equally important is a good protein rich breakfast, especially before tests.

It is important that if you are parents supervising children in their studying or their homework that you be supportive not harsh. Regardless of what you may think of their teachers, encourage courtesy toward the teacher. To do otherwise is a disservice to your child. 

Is very important to remember that if you are helping someone with their work, you're principally helping them to understand how to do the work themself. Under no circumstances do you do the work for them. You may work a similar problem for them to see, since that is different.

A healthy creative and intellectual life has been proven to benefit health. This is true for both adults and children. I hope these tips help make your studies easy and fun.

 

Food Friday: Soup is Soul Food

Every cook should know how to make homemade soup, especially those on a budget and those interested in eating healthy.

Two weeks ago I wrote an unusual post about how to make soup stock. It might seem like an unusual post for blog on Obstetrics, Gynecology, and healthy lifestyle, but not when you take a closer look.

One pillar of healthy lifestyle is healthy eating and another pillar is a healthy home life. Home cooked food can help with both. Soup is one of the most comforting and potentially healthy home cooked foods. It is also one of the easiest, of course once you know how. Homemade soup is also one of the thriftiest things to make since you can utilize leftovers and assorted ingredients from the refrigerator, garden, or pantry.

How to start? As always, start by cleaning up any stray dishes in the kitchen, organizing, and assembling your ingredients. Thaw any broth you have frozen. If you have not made frozen broth you can obtain good organic broth in three different flavors at any natural food store. You can also get a jarred  broth concentrate, also organic, at most grocery stores and at Costco as well.

Determine the vegetables you want to include. I'm a fan of great variety, But you can also make a vegetable flavored soup and emphasize one or two flavors such as red pepper. Prepare all of the vegetables by washing trimming and cutting them to the appropriate size.

I try to ask my patients to emphasize the protein in their diet. Decide what the protein in your soup will be. Consider chicken, red meat, fish, seafood,or even eggs. Cut your choice into bite-size pieces.  If you can tolerate legumes like beans and peas and can handle the carbohydrate that they bring, those can be included as well. Prepare all these ingredients so that they are ready to put in the pot.

I like to try to make my soup with only one pot. Choose your pot based on the volume that you want to make. Make sure it is extra large so that when you stir it with a long wooden spoon nothing will spill out.

Use a good cooking olive oil to sauté your first ingredients.These would include garlic, onions, or chilies if they are in your recipe. You will do them first so that they will flavor the oil. Make sure to use enough olive oil on the bottom of the pan. After this, Add your meat, chicken, or fish. Sauté until golden brown, but not fully done. I like to add fairly heavy spices to the cooking meat at this point since the flavor seems to penetrate better than adding it later. Then add your vegetables one by one and cook them until partially done, going from the hardest such as carrots to the softest such as spinach at the last.

When everything seems partially and evenly done, add liquid. I usually add a a half a cup of either red or white wine first. This adds to the depth of flavor. Then I add my broth, at least enough to cover all the hard ingredients, and usually more. I may or may not add a can of diced or stewed tomatoes, depending on the flavor I want to achieve. All you have to do at that point is bring it to a boil briefly, then simmer until the hardest vegetables are fork tender. If you intend for your meats to get very tender, they will have to simmer at least a couple hours. 

This is a good general recipe for a variety of different kinds of soup. You can make it with a large variety of different vegetables and if you add beans and a little pasta it turns out like a minestrone. If you add only a few vegetables and a lot of beans, tomato paste as well as onions and chilies, you have chili. You can pick a vegetable theme such as green vegetables and limit yourself to just a few onions, leeks, spinach, and kale. If you make a broth-y chicken soup with napa cabbage, ginger and green onions, you can drop whisked eggs into it and have egg drop soup. You can do the classic pumpkin soup especially at this time of year. Or you can go with the popular roasted red pepper soup.

If you have athletes, children or adolescents in the home, you can afford to serve this soup with a good whole-grain bread. Otherwise, it should stand on its own. You can always add a side salad and cold glasses of milk, to round it out.

Have fun with your soup and add some garnish. Garnishes can be anything from grated cheese or sour cream to minced green onions, parsley, crumbled hard-boiled eggs, sliced almonds or Siracha sauce. 

You will find that people tend to gather around a kitchen table with a good homemade soup. Having a sitdown family dinner with soup is good for health and good for the soul. 

Wellness Wednesday: When NOT to work out

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Last week I “exercised” poor judgement. I knew it right away, since my natural consequences were swift and sure. 

I had an exhausting week at work. I had kept up on my regular workouts, and got a moderate amount of sleep. Then one morning very early, really in the wee hours of the night, I had to go do an emergency delivery. This dovetailed right into the day. As I worked into the afternoon, not surprisingly, I felt off, a little ill. However, it was the night of the big Zumba Master class, with the awesome teacher from out of town. It was not to be missed. 

I felt like it was all I could do to get my zumba clothes on. Maybe that was a sign. If you can’t get your sports bra on you should not work out. Anyhow, I got there, and it was packed. A nurse friend of mine told me I looked tired. She told me I’d feel better after the workout. Then the new instructor started  in and she was dynamite. It was great dancing; stuff I had not seen before. I did feel better. 

Somehow I had gotten into a little clutch of instructor types in my section of the crowd and everybody could actually dance. That made it even more fun, but you had to really put out. And put out I did. By the end I was drenched, which is unusual for me. My face was red as a beet, also unusual. And then I stepped into the cold night air and felt sick. Weird sick. I was pretty sure I had whacked my electrolytes. 

When I got home I felt strangely weak, and super thirsty. I drank slowly, ate some chips and salsa for salt, and soaked in a tub. I got better, but it took until the next afternoon for me to feel ok. 

Moral of the story ? Remember that working out is for health. If doing it will not be good for you then don’t. Other moral ? Listen to your body. 

So I thought I would take this occasion to give you ( and me) some reasonable criteria for postponing your workout. 

  • The neck rule: You may do a light or “ recovery “ workout if you have the simple sniffles or head cold (cold above the neck) and you are otherwise healthy. 
  • You should pass if your respiratory infection is below your neck in your chest or you feel systemic symptoms such as body aches and fever. 
  • If you have actual Influenza, do not work out. 
  • Do not work out if you are having an asthma flare. Consult with your physician on how to treat your flare and when to return to exercise. 
  • Do not work out after a concussion until your doctor releases you. 
  • If an old injury is acting up don’t just tough it out. Perhaps do a workout where it is not involved at all, or just get in to be treated. 
  • If you went without sleep, i.e. less than 5 hours… then just do a light session, eat, shower, then hit the hay. 
  • If you are really sore from a prior workout, go light on some different type of workout. 
  • If you are dehydrated, then hydrate up, wait a couple hours, then you should be ok. 
  • If you are pregnant without complications, you should be able to continue to exercise, but you will have to modify in later weeks. Consult with your physician about this. 

If you work out in a gym it is particularly important to stay away when you are sick, to prevent the spread of your illness. Likewise it is prudent to wash hands, use sanitizer and avoid touching your face so you don’t get what others have brought. Consult with your doctor about this season’s immunizations. 

Regular moderate exercise stimulates the immune system in a good way. But hard exercise to “ get you to the next level” can actually temporarily suppress immune function. During mild illness, a light workout or yoga session will not result in you losing fitness. When you are under the weather, switch your emphasis from training to self care. You’ll be glad you did. 

References: 

WebMD

Greatist

MayoClinic 

Structure Sunday: The Structure of Family

What is family and what does it do for us ? I have had a family focused type of weekend and I wanted to share some numbers and thoughts about the issue of family. 

 

 

 

  • The nuclear family: Two parents and their children.
  • The blended family: which is remarried or re-partnered parents each with their own children under one roof.
  • The extended family: such as sisters, uncles, grandparents, and non relatives either living in the home or elsewhere.
  • The single parent family
  • The childless family.

Consider all these and more. Add in non married partners, good friends and neighbors. All these people bear on how we live, our health and our happiness. 

Here are some illuminating data from census.gov.

About 50 years ago, 80 % of households included a married couple. Now this is down to 50 %. Some households are made up of non family members, and these are up from 10 % to about 33% in the same last 50 years. 

Two parents households with children have decreased about 15%in the last 50 years to 70% of all households with children. About 25% of all household with children only have a mother. Father only households are up to about 4% of all households with children. 

Among all households with or without children, a steady 30 % are childless. 10% of all households are single parent households with children. Households which are traditional, meaning married with children are half of what they were over about the last 50 years, going from 40 to 20 % . 

Everyone knows the saying “ It takes a village.” I would like to point out that this is not just for kids. Adults, married, single or partnered, are happier and healthier if they have strong familial and friendship ties.

Through history, we have developed families, clans and tribes for surviving and thriving. We are wired for it. But in modern times, we are more likely to reach out to friends or coworkers. People sometimes forget to reach out to those closest to them, even those with whom they live. 

I am writing to suggest that people look around and renew ties to those most near. I suggest that this include spouses and partners, children and others in the household, as well as old friends and even neighbors. These relations may not have the cachet of accomplished coworkers, but keeping these relationships healthy has deep benefits. 

It helps us with continuity, and to know our personal history. It helps with feelings of stability, especially for children. Getting along with those closest to us is not really glamourous. But it make us flexible and empathetic. It grounds us. 

Try starting with a phone call, email, or a card in the mail. Then, by all means, plan some sort of get together. The most important thing to remember is that it doesn’t have to be perfect. You don’t have to be perfect, and they don’t have to be perfect. The most important thing to do it to connect. 

 

 

 

 

 

 

 

Food Friday: Fasting and What To Do Instead

Fasting and cleansing make headlines. They are dramatic trendy measures taken by those seeking improved health. But do they work ? Are they safe ? 

Fasting is generally regarded as going off food for at least a day. Cleansing involves the same but with some sort of liquids and juices added back. Sometimes enemas are part of the “cleanses”.

Proponents state that they get past their hunger, and that they eventually feel good, even high. They state their bowel movements show they are getting cleaned out. Their stomachs flatten and they feel light. Who wouldn’t want all this ? 

Unfortunately, it doesn’t last. Our physical and mental vitality depends on a flux of matter and energy through our body. It is true that our body is designed to weather the temporary hardship of relative drought or famine, but under these conditions it cannot thrive. 

So many people participating in cleanses or fasts are doing so to achieve optimal health and high performance. However, to really thrive, we need optimal nutrition and optimal activity as much of the time as possible. Fasting and cleanses are not compatible with this. 

What do fasting and cleanses really do ? In many cases, they are dehydrating. This can be dangerous, especially if subjects are very young, old, or unwell. The body does burn fat and glycogen for energy, but in more prolonged fasts, muscle mass is lost. This types of metabolism actually produces more “ toxins”. It does not detoxify. 

All this provides a substantial stress on the body. Stress hormones are activated. Neurotransmitters  which help us cope with stress are activated as well, accounting for the feeling of elation and capability. 

Weight does indeed get lost, but mostly in the form of water, stool, fat and and muscle. When a normal dietary and fluid intake is resumed, most of the weight is regained. Muscle of course can be rebuilt, but this requires exercise and surplus protein in the diet. 

Colon cleanses can be dangerous. The colon has a normal bacterial flora. The importance of the balance of this flora is becoming better understood these days. Colon cleanses disturb this balance and can lead to problems with digestion, dehydration and serious electrolyte abnormalities. 

I have noticed that purveyors of these unproven and dangerous methods charge high prices. I have also noticed that they advertise to vulnerable populations, including those undergoing cancer therapy. I find this very concerning. 

The answer to all of this is very simple. It is common sense evidence based medicine and health maintenance. It is Friday, and I am thinking about the weekend. So instead of going on about this downer topic, I would like to tell you my alternative version of a quick health boost. 

I call it a “spa weekend". To me, this means I will arrange to do several key things this weekend in a concerted spirit of boosting wellness. They are as follows: 

 

  • Get the ideal amount of sleep all weekend. 
  • Do morning yoga. 
  • Drink green tea each day. 
  • Drink 3 liters of water each day. 
  • Do longer afternoon workouts each day. 
  • Have 3 ideal meals and 3 ideal snacks each day all weekend, heavy on protein, veggies and fruit. 
  • Soak in the tub each day. 

I might even do my own pedicure. 

That is my idea of a plan to boost wellness. I hope you can take a spa weekend sometime soon. 

 

 

 

 

 

 

 

 

 

Wellness Wednesday: Getting Real about Wellness Coaches

"Are health coaches a real thing? What do they actually do? Something like that sounds really expensive.” In our survey two weeks ago you said the most helpful thing for your health improvement would be a health coach. Here is the lowdown on this very real and up-and-coming service.

There are a lot of coaches out there. There are a lot of health and wellness coaches out there too. As you know, I have hung out my shingle as an "evidence based" practitioner. Accordingly, if I were to get a wellness coach, I would want one that practiced evidence based coaching. 

I have done a little homework on our behalf, and found that the American College of Sports Medicine certifies only one coaching program in the country at this time, wellcoachesschool.com. Lucky for me, the medical fitness center (health club) associated with my hospital utilizes wellness coaches certified by this school.

However, I too assumed this would be on the expensive side. Here's what I found out. First of all all, prices are cheaper if you are a member of the health club, which stands to reason. Secondly, they offered different packages. The cheapest package without membership was $200 and consisted of eight sessions over eight weeks. This would provide personal training in a small group. This sort of thing would be an out of pocket expense.

On the other hand, I was pleasantly surprised to find out that the more extensive packages involving weight management and wellness coaching for those with serious or chronic medical conditions might be covered by insurance. These programs range from $250-$750 and take place over several months time. Of course any coverage by insurance would have to be determined beforehand and would have to be based on documentation in the patient's medical record by a patient’s physician, someone like me. 

Although I was encouraged by all of this, I did come away from my fact-finding with the impression that my patients who need this most are simply not going to be able to have access to this, afford it or obtain coverage for it. 

This led me to the idea of being your own coach. This is not my idea or a new idea. A simple Google search revealed several reputable sites which deal with this topic. I will share them with you now.  

How to become your own life coach with 14 simple strategies

10 ways to be your own life coach

How to be your own life coach in four easy steps

And my favorite,

Tips from the pros: how to be your own life coach

 

I am thinking about getting wellness coach certification from wellcoachesschool.com. So much of what I do in the course of the day with my patients is wellness coaching. While it is true that I deliver babies and perform female pelvic surgery, I spend a lot of time and energy trying to get my patients to be well. I would like to be as good as this as possible.

I looked into the course curriculum, and I noticed they had two key textbooks, one you get when you register for the classes, and is rather costly. The other is available on Amazon.com for a modest amount of money ( At this time a used one is $0.43 plus $3.99 for shipping. ) It is called "Organize your Mind, Organize your Life” with the subtitle,”Train your brain to get more done in less time”, by Margaret Moore and Paul Hammerness. I think this is a great place to start for people who want to be their own life coach. I know I am going to crack open this book as soon as possible. 

Beyond that I am still going to be giving continued thought to what, in practical every day terms, could help people meet their basic health goals in nutrition, fitness, and stress management.

Stay tuned for more tips on achieving wellness on next weeks Wellness Wednesday. 

Structure Sunday: The Structure of My Reading List

Isn’t reading for kids in school ? Who has time for reading ? I hear these types of things all the time. Reading is immensely important to me. Stacks of books and magazines line my home office.

I have already blogged about the scientific evidence on the effect of reading on health in the following post: http://drginanelson.com/drginablogs/2015/2/28/structure-sunday-structure-your-mind?rq=reading

Now I am going to share how I divide my reading pie. 

  • Reading the news
  • Reading to indulge certain interests 
    •      Things that just pique my interest 
    •      Things I’m trying to do
  • Reading for self improvement 
  • Reading for Medicine
    •      To deal with a patient problem 
    •      To accomplish my annual board review 
  • Reading for business 
  • Reading for inspiration 
  • Reading for fun

 

Here are my current examples: 

 

Reading for News: 

I use Flipboard, a popular customizable news app, my Yahoo homepage which I have tailored to my interests, and News, the new Apple app included in the latest IOS operating system. I also sometimes look at two local paper newspapers. 

Interest Based Reading; 

I am always reading cookbooks, or on cooking sites. I love foodnetwork.com, and epicurious.com. My favorite cookbooks right now are” Paleo”  cookbooks like NomNom Paleo. Pinterest is the best pictorial cookbook in the universe.

I am working on a sewing project and have had to reread some stuff about free motion machine quilting. I am also reading about the work of Natalie Chanin, a designer who revitalized an Alabama community with her handmade heirloom pieces of organic cotton jersey. See alabamachanin.com. I am trying to use one of her beautiful instruction books to make a tunic out of old black t-shirts. 

I am doing quite a bit of reading about small smart energy efficient homes. My family is considering a project with these. On my desk right now is a small beautiful book called “ Convertible Homes”, by Amanda Lam and Amy Thomas. 

Reading for Self Improvement: 

I am about to dig into “ Superbetter”, by Jane McGonigal, a scientist and game designer interested in harnassing the power of gaming for self improvement and medical recovery. I am also excited to ready the giant book on my desk written by my old dorm mate Dan Levitan, The Organized Mind. Good on you, Dan. 

Reading for Medicine: 

The large stack of research articles for American Board of Obstetrics and Gynecology annual board review. I have to have them done by December 15th, but prefer to have them done by October 20th, when I go on vacation. 

Reading for Business: 

I am currently reading “Ask” by Bryan Levesque as an ebook on my Kindle app on my IOS devices. I regularly read Inc. and Entrepreneur magazines. 

Reading for Inspiration: 

I am still working my way through “ Becoming Steve Jobs”, by Brent Schlender and Rick Tetzeli. Wired magazine is a constant reliable source of inspiration. 

Reading for Fun: 

I just finished a new favorite, “ Seveneves”, by Neal Stephenson. I have ordered "Trigger Warning", a short story collection by Neal Gaiman, and just bought  paper copy of “The Martian” by Andy Weir, since I have a feeling I will want to share it. Finally I am savoring “ The Magician’s Land” by Lev Grossman, and author who I was pleased to once meet at a reading.  And yes, my favorite fiction genre is sci-fi. 

You might ask how I learn what’s out there to read. I live in an area THAT HAS NO BOOKSTORE ! I go to Amazon.com and check the recommendations. I also am a member of the online community Goodreads, where I get all kinds of ideas. I read book reviews such as the regular columns in my favorite magazines. I check the NYTIMES review of books, and the books award lists such as the Nebula Awards. Plus, I simply google things like “ The 10 best new cookbooks of 2015” or “ The ten best sci-fi novels of 2015”. 

How can I read so much ? Here’s the secret: I do it all kinds of ways. I read my paper books in the day, books on devices at night, and use Audible.com to listen to books when I drive, jog, cook, sew or do housework. Each method has a different effect and that is ok. Try them all and see what you think. 

Reading stokes the fire in my soul. So take page from this playbook and harness the power and joy of reading for yourself. And don’t be afraid to have a few things going at once. 

 

Food Friday: Soup Stock 

Our evening temperatures are beginning to dip into the 30s and yet, our outdoor activities continue unabated. This weekend I'm sure we will be out either observing the lunar eclipse or the Northern lights. This means we're going to get chilly. This means we will want soup. 

Soup season is here again. While I love summer with its fruit platters and salads, I adore the soups of fall. A beautiful soup makes a great centerpiece for a meal, and if made well, soups are healthy and appeal to everyone.

What does it take to make a delicious soup? It takes a well-made soup base. Some people call this broth and some people call it stock. I think when you see how it is made you will understand why it tastes so good.

The first thing you should do is roast some chicken. I realize this sounds daunting to some, but it is actually one of the simplest things you can do in the kitchen. Moreover, whole chickens are one of the most inexpensive healthy foods you can buy. Around here, we can get them from our local farmers or you can get a good whole organic chicken at Costco. You will need a roasting pan, but it need not be fancy. It should have a roasting rack. You can usually get these at secondhand stores. You will also need a meat thermometer and these are available for just a few dollars at any grocery store. This is a small price to pay for food safety. Before you start to unpack your chicken, adjust the shelf in your oven and preheat it to 425°. Read through all the instructions first, and assemble everything you need before you start. In French, this is called “ Mise en Place”, or to put in place. 

Start by reviewing food safety. Recall that raw chicken and its juices are a culture medium for bacteria. Keep everything confined to the sink or nonporous cutting boards. Open the packages in your area and do not reuse any of the utensils or surfaces for anything else without thoroughly cleaning them in hot soapy water. Once you get your chickens unpackaged, remove the giblets and rinse them. Set your hollow chickens onto the roasting rack in the roasting pan. Then, discard the packaging, wash the utensils and surfaces and finally wash your hands with hot soap and water.

Brush the surface of both chickens thoroughly with olive oil. Sprinkle them liberally with good kosher salt and freshly ground pepper. Encrust them with whatever other herbs you like. Add about an inch of liquid to the bottom of the pan. This can be water or white wine. Cover the birds loosely with foil. Roast at 425°until their internal temperature is 165 degrees deep in the flesh. For the last 10 minutes or so, take off the foil and brown the tops of the chicken until they are nice and crispy but not burned. This will serve about 10 people or a  small family for several days. 

To make broth, take all of the chicken meat of all of the bones and serve or store it. You can use it to make sandwiches, chicken salad, main dishes, and pasta. Keep all of the drippings in the pan unless they are burned black. Compress the carcasses down in the pan and place back in the oven and either bake them at high temperature or broil them until they are golden brown and dried but not burned. Take the roasting pan out and add several ingredients which will flavor the broth. Here are some choices:

  • Garlic cloves, and onion with their skin
  • Chopped carrots, Chopped celery
  • Older apples that are still good
  • Any fresh herbs and peppercorns

Cover all the ingredients with water and bring to a boil on the stove top. Boil for 10 minutes, then simmer for at least two hours.. When finished, strain and transfer to a clean cool container or containers, preparing either to use, refrigerate, or freeze. Consider adding salt at this time.

If the weather is cold, I like to cool my broth outside. This way I don't have to put hot containers of broth into a freezer or refrigerator, compromising the temperature of other items. Either hot broth or cold broth is safe, but warm broth spoils quickly, and should be stored or used promptly. 

I freeze our broth in quart containers being careful to leave about three quarters of an inch of head space at the top. Now I have a delicious base for any number of different kinds of soups or sauces. We have used this to make soups with chicken, red meat and all kinds of vegetables.

Mostly we just make soup with what is on hand. The general principle is this: Pick a soup pot of adequate size. Saute your meats, garlic, onions, and hard vegetables one by one in olive oil and spices. Once they are cooked, cover with broth and add the softer vegetables such as tomatoes and greens. Bring to a boil, then simmer until done. Season to taste. To your health ! 

Wellness Wednesday: Survey Results for your Biggest Health Challenges

Don't you like getting survey results? It's like getting the punchline to a joke or solving a puzzle. Basically you get to compare your anticipation of the results with the actual results. It's even more fun when the results you get are unexpected. 

Many thanks to those who took the time to complete the survey. The number is small, but it is more than last survey I ran.

Here are the key results:

Personal trainer and fitness women.jpg
  • Approximately three quarters of respondents felt that their health was only somewhat where they wanted it to be.
  • The biggest health challenges were divided almost equally across nutrition, fitness, weight, and stress.
  • Most everyone who took the survey took the time to write a bit about the biggest obstacle to health maintenance. Time was the most common theme expressed in a variety of different ways. Some people referred to the time demands of their job, partner, kids, house and pets. I doubt very much that these things are ever going to go away. In fact, I hope all of us always have jobs, partners, kids,  houses and pets. It sounds to me that concerted improvements in time management would be helpful across the board.
  • Respondents were uncertain and vague when asked open ended questions about what would help them the most with there health. However when given a choice of specific set of health related products, they were able to clearly choose what would help them the most. This is where the surprise came. It wasn't a product at all. Far and away the most often chosen product was a "health coach." 

Fairly recently I ran into a physician friend of mine who I thought had retired. It turns out she had actually gotten certified as a health coach. She is loving it and and really feels like she's making a difference in her patients' lives. So after I saw the results of my survey I called her up to find out a little bit more. It turns out that health coaches are probably the next big thing in preventive medical care. 

It turns out that there quite a few health coaches out there and it turns out there are a lot of courses you can take in person and online by a great many certifying organizations to become one. However, only one organization is approved by the American College of Sports Medicine, the Wellcoaches School of Coaching. (wellcoachesschool.com) It is an evidence based program which uses up to date behavioral, exercise and fitness science to help people improve their life and their health. Luckily for us, my friend was certified in this manner. She works at out local fitness center. 

All well and good. But I called her later and grilled her about insurance coverage for such services. It turns out that, yes, many insurances do cover some health coaching, which struck me as a pleasant surprise. So I am going to start utilizing her and her team for my patients. I and many other doctors do a lot of office based health coaching, but in the setting of providing specialized medical care I can only give health coaching a limited focus. 

I wonder about those without insurance, those with high deductibles, and those with insurance that does not cover health coaching. I still would like to know what resources would be helpful to people who wish to, in effect, be their own health coach. What do you think ? 

 

 

 

Wellness Wednesday : Your Wellness Challenges

This Wednesday I am reaching out to understand your health challenges and what could potentially help you meet them. I work with patients nearly every day and give them information about what can improve their health. Sometimes they are able to work successfully with it and sometimes not. I am fascinated with what separates the two groups. 

I have always tried to make the process of becoming healthy accessible to everyone. I am striving to learn the pertinent behavioral science behind health habits that will enable me to help you actually make those positive health changes. 

I myself am motivated by a variety of things: healthy cookbooks, exercise videos, stories of success, and even inspirational cards that sit on my desk. 

I invite you to take my survey and let me know about your challenges and what you think could help. I am most interested in your response. Click on yoga girl below to access the survey. I promise to publish results next week on Wellness Wednesday. 


Best,

Dr. Gina 

Structure Sunday: The Structure of Your Process

How can we get done all that we want so that we can truly free up personal and family time ? The answer lies in our process. Here is a rough and simple set of guidelines that should help you improve any process that you do, from shopping for groceries, to generating a report, to buying a horse. 

Read More

Wellness Wednesday: The Benefit of Trying New Things 

Nutrition, fitness and good relationships can keep us healthy. But... trying new things ? Yes, being adventurous has physical as well as psychological benefits to our health. (1) 

Adventure is a relative thing. For one person it might mean trying a new cookbook (me) while another may need to paraglide to 5000 feet above sea level (my son). But in all cases it means doing something different than your usual, and, for best results, it means getting out of your comfort zone. Comfort zones vary considerably in size.  

Does adventure have to be dangerous ? Of course not. But it should expose you to a new environment and require you to do things you have not done before. So why does it have to be all that? 

Before I explain, lets take a look at the American vacation. It is an endangered species. We are one of the few developing countries without a national policy of paid leave. Those companies who do provide paid leave do not always encourage its use, even though research shows it greatly improves employee productivity and satisfaction. When the companies do provide leave AND encourage its use, employees are reluctant to take it. Why ? Forty percent are afraid of coming back to " a mountain of work" , a third feel no one can do their work but them, a third feel they cannot afford it, and about a fifth feel guilty.  Forty-three percent of adults do not remember the last time they tried to have an adventure. Reasons for avoiding adventure range from lack of money to embarrassment. (2) Fear of one thing or another plays a role in skipping vacations. Ironically, it should be the opposite, since skipping vacations is associated with a measurable and significantly increased risk of heart disease in men and women, according to the Framingham study. (3)

And yet, we bemoan our lack of time off and we make bucket lists all of the things we don't and won't do. We execute what Tim Ferris calls the " deferred life plan". (4) Moreover, we note how every year seems to pass more quickly. 

Enter adventure. If we do get around to it, here is what happens. First, our narrow view of the world opens back up. We experience different ways of living, and see ourselves and others in a new light. Novelty and some degree of challenge have to be a part of it. This way, our confidence and competence is enhanced. A 2015 Study on newly graduated nurses found that a nontraditional outdoors adventure leadership program increased feeings of competence and confidence. When they returned to work, their transformation was felt to have impacted their entire work culture. (5) 

Adventure may even be an antidote for the accelerated passage of time. Dave Engelmann, a neuroscientist, notes that the more familiar the world becomes, the less we remember, and thus the faster times seems to pass. (3). I deduce that novelty and adventure may help us savor the time we have. 

Check out these fun resources: 

30 New Things to Try by Lifehack.com

The Beginner's Guide to Trying New Things

Staying on Top of Your Game

References: 

  1. http://www.huffingtonpost.com/laurie-gerber/are-we-having-fun-yet_b_7948588.html
  2. http://www.huffingtonpost.com/2014/08/19/americans-vacation-days_n_5682576.html
  3. http://www.newyorker.com/magazine/2011/04/25/the-possibilian
  4. http://www.bothsidesofthetable.com/2010/01/10/what-can-you-learn-from-the-4-hour-workweek/
  5. http://www.ncbi.nlm.nih.gov/pubmed/25608096

 

Wellness Wednesday: Workouts for your Mind and Soul

Have you ever heard of TED talks ? If I had to think of the SINGLE BEST USE of media, TED talks would be it. Now aren’t you curious ? 

TED talks are short (usually less than 18 minutes) powerful talks by people with important and timely insights. Originally they were by just the very best and the brightest, people such as Bill Gates, Steve Jobs and Steven Hawking. To this day, they are still given by those who have a deep special interest and expertise in a subject. 

The TED talks were originally conceived in California. They have close ties with the California University system, Stanford, and all major universities the world round. They are international in scope. To be invited to speak is a rare privilege. To attend in person is enormously expensive, but all talks are provided free to everyone over the internet.  TED talk conferences have branched into all major cities, and TEDx has been developed to give smaller communities the chance to participate. 

Oftentimes Ted speakers are researchers, or high level thought leaders, heads of state, or industry innovators. Commonly they are scientists or extreme athletes. Occasionally they are artists of note. They are always fascinating, and always worth watching.

And while you can listen to TED talks on iTunes radio, podcasts, and elsewhere, they are best watched. There is nothing like seeing these sorts of people give these usually intense distillations of human wisdom and brilliance. If you want to see a great example, check out the Talk by Jill Bolte Taylor. In video format, it brings it so much more down to earth. The speakers seem more accessible, as though you might run into them in the grocery store. 

I can tell you why a TED talk is so potent. This is because I was asked to to do one at the first TEDx conference in our area. I had done public speaking before, so I thought it would be straightforward. Wow did I have a lot to learn. A TED talk is not like an academic lecture. For our conference in northwestern Montana, I had several coaches, starting weeks in advance. One came all the way from Southern California to coach us. The coaches had to tear my style apart and put it back together again. I was lecturing, whereas they needed me to actually connect on a personal level over my material. I had to explain myself in clear ordinary nonmedical language.  I had to connect, which was my biggest challenge, and I had to end with a call to action. Plus I had to get it all done in 18 minutes or less.  

 

There are so many stories you and your family NEED to watch at TED.org and TEDx.org. I have been showing them to my kids, family and friends for years, and they are an endless source of inspiration. The TED.org website is great in that you can chose a talk by speaker, topic, or even rating. You can get an app on any platform or you can use a computer and a browser to go to TED.org. I cannot recommend then any more highly.