Improvements

I wrote a while back about making some improvements in my life. Out of shape, not eating well, not sleeping well, not getting much exercise, stress at a fairly high level. Seeing as it's the new year, I think it's worth reflecting on those improvements.

I made a few changes in my habits in the hopes of improving that situation. Started running, monitored my eating habits, tried to focus on maintaining a more regular sleep schedule. It went well for a while, kept it up for a month or two. Lost the 10 lbs I put on during clerkship, was able to fit back into a few clothes that had gotten a bit too tight, and was generally feeling in better spirits overall.

Running unfortunately stopped with the cold weather. I'll need to find a way to keep up my exercise habits in colder weather, because unless global warming kicks it into high gear, I'm only going to be able to run outside for about half the year, at least using the gear I have. Eating habits kept up a bit longer, though I stopped keeping track of my calories after a month or so. The holidays are not the greatest for avoidance of sugar... I put on 5 lbs, pretty much entirely in the last 2-3 weeks, cutting my gains over the last 4 months in half. If nothing else, this is a great reminder about how hard weight loss. Persistence is necessary, but hard. Managed to successfully transition my morning glass of juice to tea though, so that's a win.

Continuing with the positives, my stress levels have definitely fallen, despite it being CaRMS time. Consistent sleep, even though I'm still lacking a little in the total amount, has helped. I've been a bit more social lately, something that fell off a cliff in clerkship and in medical school in general (though a series of restaurant dinners haven't exactly helped the waistline either). I've also started prioritizing some things I enjoy, like watching the hockey game or doing some reading. I've had some luck in cutting down on screen time as well - getting a subscription to a weekly newspaper has helped a lot, letting me get a bit of a different perspective and taking some of my online reading offline.

So, what are the next steps? First is getting back to exercise and eating well. I did it before, it worked, I can do it again. Getting back to good sleep habits in the next step - in general, I've had good sleep hygiene, just not starting the process early enough. That can change. Lastly, in continuation with general stress reduction strategies, I'm cleaning out my apartment. That's been an on-going holiday project. I have a large amount of minimally functional space, as well as many possessions that I'm not using and will likely never use. Getting organized has been cathartic in a way.

Anyway, this post is mostly just a reminder that in medicine, no one will look out for your well being unless you make it your own priority. I've enjoyed the last couple months, despite the hiccups and mixed results. Having the luxury of call-free electives hasn't hurt, and going into the remainder of fourth year, where I'm back in the classroom with ample free time, should give plenty of opportunity to continue good habits. The next challenge will be to solidify these habits and make them adaptable to the busy schedule of residency - when wellness will matter all that much more!

Lifestyle Modifications

One of the things I've enjoyed about Family Medicine is that it's really the one area of medicine - aside from perhaps Pediatrics - that can get patients to start living healthy lifestyles before they develop disease. It's not a common occurrence - I've really only had a few patients come in where they were truly in a pre-disease state and could have their risk profiles change with lifestyle modifications - but in a medical system that is still primarily reactive, it's a valued opportunity.

For all our medical advances, nothing beats a healthy lifestyle to ensuring continued well-being. A balanced diet, sufficient exercise, adequate sleep, stress control, elimination of smoking, and moderation of drinking. For most patients, these six habits will do more to provide a long, happy life than anything any physician can provide.

These interactions have also been a great reminder to put the emphasis on my own health. Over the past two years, my health habits have fallen to pieces. I went from getting regular high-intensity exercise to getting virtually none. My diet went from reasonable-to-good to consisting of a lot of sugar-heavy foods. I started getting less and less sleep, of poorer and poorer quality (call and 5:30 am shifts didn't help much with this). Stress was naturally through the roof during clerkship. On the plus side, I fortunately didn't start smoking and my drinking stayed fairly moderate, so we'll count those as wins.

As I move out of the craziness of clerkship and onto the regular craziness of what will hopefully be the rest of my life, I'm trying to get some of those healthy habits back. I got a FitBit recently as a present and it's proved to be pretty good motivation (even though research shows it might be detrimental, at least to weight loss). I'm trying to push my daily steps a bit higher and I've started running again. On the sleep front, I'm now more aware of what helps me sleep soundly and what doesn't, thanks for FitBit's helpful - albeit somewhat unreliable - sleep tracker. It's also making me chart what I eat, which if nothing else is making me a bit more mindful of what goes in my stomach. It's led to some specific changes - since I was a kid, I'd have a glass of juice in the morning with breakfast. Every morning. While it gets presented as a healthy serving of fruit, juice is pretty much pure sugar with very little nutrition. I'm drinking tea now instead - never was a coffee drinker - and appreciating the change. Cutting it out eliminates a fair number of empty calories and tons of sugar from my diet.

I never want to be that hypocritical doctor lecturing my patients about good health when I'm not willing to make those changes myself. If only to understand the difficulty that can go along with making these positive lifestyle changes, I'm finding these new efforts worthwhile - and hopefully my own health improves as a result!

Get Some Exercise!

I put on a good 20 lbs this year, mostly due to declining activity and a worsening diet. I've started (slowly) reversing that trend, getting a bit more exercise and definitely eating better, but to keep that going, here's friendly reminder (mostly to myself) that exercise is really good for you!

Healthcare Triage. It's awesome. You should watch it.

Research on lifestyle and its effect on health is often fairly tricky. Nutrition research in particular is fraught with challenges that make a simple interpretation of available evidence very difficult. But exercise has some fairly clear-cut and wide-ranging benefits, for both physical and mental health.

Something the video (and available literature) don't support is the notion that basic exercise causes weight loss - though more extreme body-sculpting regimes may be better on that front. So, while I'm increasing my activity in part because of an increasing waistline, my dietary changes are likely to matter more on that front. The flip side is that even when exercise doesn't lead to weight loss, it still leads to better health. So get some exercise!