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Archive for the ‘Health’ Category

Poor Miranda Kerr

Tuesday, July 9th, 2013

It’s true.  I’m feeling sorry for Miranda Kerr these days.  Not because I think her life is especially hard.  But because she’s out there doing the best she can – just like all the rest of us – and she’s getting dumped on left and right these days.  She’s a short blog post away from Gwyneth Paltrow-level hatred, and I think that’s too bad.

The backdrop is this:  Kerr (a Victoria’s Secret lingerie and swimsuit model) was recently signed by Net-a-Porter to star in a series of web videos titled The Body Beautiful discussing her diet and exercise regimen.  The first video was just released and in it she gives the recipe for her morning smoothie.  And I will level with you on this one – it’s a little over the top.  The recipe includes the following: water from a fresh coconut, cold pressed coconut milk, acai powder, goji berries, spirulina, cacao powder, maca powder, chia seeds, and vegan rice protein powder.  Not exactly things most of us have lying around the kitchen.  Actually, they’re not exactly things that many of us could track down if we wanted to.  So of course the media have jumped all over Kerr for being out of touch.

I have to cry foul, though.  Miranda Kerr is supposed to be aspirational.  Her whole job is to look like most of us will never look so that we will buy the products she models/endorses in the hopes of inching our way closer to that ideal.  She won the genetic lottery, and she’s making the most of it.  I don’t blame her a bit.

Further, and more importantly, it wasn’t that long ago that supermodels were more likely to be known for their drug habits than their health habits.  As someone who clearly remembers idolizing the figure of Kate Moss, I would much rather today’s young women follow the example set by Miranda Kerr.  Perhaps her example is an unattainable one for most people, but it is still a good one.  Smoothies and yoga are far from the worst advice she could give.

It’s easy poking fun at people like Kerr and Paltrow.  And I will be the first to admit that they bring it on themselves a bit.  It wouldn’t kill their aspirational vibe to throw in a few mainstream recommendations.  (“And if you don’t have access to acai powder, blueberries are also a great source of antioxidants.”)  Nevertheless, I’m here to take up for them.  There are far worse ways to leverage your celebrity than by sharing your (freakishly healthy) smoothie recipe, or writing a blog with your favorite lifestyle tips.

We have to remember that these people live in a bubble of privilege.* We can’t expect them to share such personal details of their lives as their diet and exercise habits and come across as relatable.  Of course Miranda Kerr isn’t going to spill the secrets of her amazing physique and disclose a freezer full of Lean Cuisines and a punch card for the spin class at the Y.  And that’s okay!  I’m thrilled to know what Kerr eats for breakfast every day.  Perhaps she has some ideas that will help me up my own game, even if I don’t have the time, money, or inclination to adopt her regimen in its entirety.

I applaud anyone who has a public and aspirational life and is willing to be candid about what she does to achieve her health, beauty, or life balance.  Many of her suggestions may be out of my grasp, but if I take that personally then it’s on me.  If her best is better than my best I have to accept that.  And besides, of course Miranda Kerr and Gwyneth Paltrow have set a bar that is higher than I can reach – they’ve both got at least four inches on me.

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*That is their own doing to a certain extent – there are certainly ways to remain more connected to the mainstream.  But I also understand the desire to stay in that bubble.  We live in a celebrity-obsessed culture and if I lived a life that required a body guard for me to step out the door with my son I might limit myself to the upper echelons as well.

Frankie Say Relax

Tuesday, December 11th, 2012

My laziness was an end in itself: to relax.

I’ve had stress on the brain a lot lately.*  (See posts here and here.)  Work has been crazy for the past few weeks.  The holidays are wonderful, but they don’t exactly create an abundance of spare time.  And various other aspects of daily life don’t suddenly evaporate just because work and holidays have made grand entrances.  I’ve been feeling the stress of it all pretty acutely these days, and not always doing a bang up job of managing it.  I could feel it in my upper back.  I could sense it in the hateful thoughts that silently passed through my mind when someone “stole” the elliptical machine I’d been planning to use at the gym.  I could hear it in my tone of voice when the dogs got underfoot.  Something needed to change.

In the past I believed that genuine, productive relaxation could only be mine once the final item on the day’s To-Do list was crossed off; that any attempts to unwind while chores and errands awaited me would always be undermined by the stress of things left undone.  And up until this past weekend that belief had proven true.  But something in me reached a breaking point.  That list, at least for now, is not getting any shorter.  For every item that I check off I add another one or two.  I could sense that this likely isn’t going to change until at least mid-January, and I wasn’t willing to go through the next four weeks feeling tense and acerbic.

On Saturday morning GAP did what he always does on the weekends – he told me to relax, and for the first time maybe ever, I did it.  He took IEP with him to the gym just as SSP went down for his morning nap.  And I, still jammie-clad, curled up under a blanket on the sofa and watched two Tivo’d episodes of Parenthood. Our fondue pot sat in the kitchen sink with cheese still scorched to the bottom of it from the prior night’s holiday party with my girlfriends.  Dog hair billowed around my baseboards.  The beds were left unmade.  And I successfully ignored all of it!  It was the best decision I’ve made in weeks.

By the end of two episodes of my show SSP was starting to wake up.  After the credits rolled I walked upstairs to collect him, feeling as refreshed as if I’d gone for a two-hour massage.  I felt relaxed.  I felt on top of things.  I felt HAPPY!  Starting the day with my batteries charged made it infinitely easier to face the items on my list.  SSP pitter-pattered around while I got dressed, made the bed, and tackled the fondue pot.  My other guys returned home as I was cheerily sweeping the baseboards.  I almost didn’t recognize myself.

I don’ t want to go back to the level of unreleased stress I felt prior to Saturday.  At some level, though, I’m glad that I found myself there once.  It triggered a change in me that I’m not sure I could have made otherwise.  It forced me to experience for myself that sometimes relaxation best preceeds productivity.  It smooths down our splintered edges.  It buoys us against choppy waters.  It fuels our tanks for the work that lies ahead.

As of Monday morning the sheets hadn’t been changed and the laundry hadn’t been done.  I had, however, gone out for pizza with my boys, taken a nap on the couch,  walked the dogs and gazed at Christmas lights, and  gone out to dinner with good friends and seen a movie with GAP.  In some way, it was absolutely the most valuable use of my time.

*Yes, I realize that thinking repeatedly about stress likely does nothing to lower my feelings of it.  I like to be ironic.

Stress Test

Tuesday, October 30th, 2012

I had to fill out a questionnaire about my health for work.  Do I smoke?  Do I exercise?  Do I get regular check-ups?  That sort of thing.  These types of questions usually leave me feeling a smidge proud because my truthful answers are almost always the “right” ones.  When it comes to matters of health, I play it pretty much by the book.

The end of the survey threw me for a loop, though.  It asked you to indicate within what timeframe (one month, three months, etc.) you intend to make a change in various aspects of your life.  The lifestyle issues in question were to quit smoking, exercise more, eat better, get more sleep, and handle stress better.  For the first four I was able to happily mark the “I already do this” box.  But for stress… I did a double take.  I don’t remember which box I ended up checking, but in my heart of hearts I know I have some work to do there.

Lots of fellow bloggers have written lately about Gretchen Rubin’s new book “Happier at Home.”  I’m also in the middle of it, and have found myself doing some good but hard thinking in response.  Rubin’s aim with this most recent happiness project was to make her home into a place that fosters her happiness.  This effort speaks to me because it is my home that I find to be my biggest source of stress.

It is not my home itself that causes me stress.  Yes, it is an old house with a handful of ongoing maintenance to-dos, but nothing too significant (last spring’s pipe replacement nightmare notwithstanding).  Rather, it is the rotation of weekly chores and obligations that wear on me the most.  For the past two consecutive weekends I have literally sat down to relax only for as long as it takes me to eat a meal.  By Sunday evening I’ve found myself satisfied with my level of industry, but utterly and completely spent.  And while I crave a hyper-productive weekend every now and then, the prospect of gearing up for one every single week leaves me cold.  I’m not sure how to get the equation of my weekend back into balance, though.  The tactical elements of it are not interesting enough to discuss here – I’ll get it figured out – but the existential elements are.

Why is the impact of these stressors at home so much greater than stressors in other areas of my life?  When my job leaves me feeling unraveled I don’t take it to heart nearly as much.  When I get stuck in traffic I don’t assume that it’s a personal failing.  Yet when I feel stressed out at home the stress itself is compounded by the belief that I’m to blame for it.  It’s not a happy feeling.

In a recent post over at Motherese Kristen cited a NYT blog article about how American’s pursuit of happiness has left us statistically more anxiety-riddled than any other nation.  The piece was interesting from a cultural point of view, written by a recent British transplant who noted that Brits find discussion of happiness to be a bit crude and desperate.  The numbers about our rates of anxiety are compelling, and I understand how idealism about happiness can leave us comparatively disappointed, but somehow I still find myself opposed to the implicit premise that this means we should stop seeking it.

I know what I want.  I want each weekend to be filled with a balance of productivity and pleasure.  When Sunday evening rolls around I want to feel that I have been fortified by two days off and am ready to face the week.  Knowing what I want – and acknowledging it – is the only way to make any sort of progress toward it.  Keeping myself blissfully unaware of my desires may prevent disappointment, but it is also a sure path to continued frustration and stress.

Reading “Happier at Home” has been a wake up call, of sorts.  I want to be happier at home.  Specifically, I want to be happier on weekends.  Unlike getting stuck in traffic or being handed a monster project at work, this one is completely within my control.  That makes it both worse (because only I am to blame for any unhappiness I feel) and better (because in the long run I believe in my ability to change things).  I will not hold up some fictitious ideal and compare myself to it until I have no choice but sheer misery.  But neither will I avoid the topic altogether just to keep myself out of the emotional muck.

I will take it one task at a time until I’ve shuffled the deck of my life at home into a configuration that is better suited to support my happiness.  My first task?  Keeping it all in perspective.  This will work itself out in time.  Stressing over stress is not the first step in any happiness solution.

In Defense of the Rut

Thursday, October 25th, 2012

I eat the same thing for breakfast every morning: whole wheat toast, yogurt, fruit, and hot chocolate.  This is partly because it is healthy, partly because I like it, and partly because eating the same breakfast every day makes morning logistics much smoother.  I’d been thinking that maybe I need to mix things up a bit, that I was stuck in a rut that I ought to climb out of.  But a few things I’ve read recently have me second guessing that idea.

First I read Big Little Wolf’s post about the thousands of decisions we make in a day.  She starts out with a rundown of the decisions she makes in the first five minutes of her day, and it exhausted me just reading it.  I hadn’t thought about the sheer number of decisions we make, as so many of them are made in a split second, and have few lasting consequences.  Shower first or breakfast first?  Neither one is going to make or break the day.  But as BLW’s post continues she discusses the virtues of routine, of making a decision once, and implementing it over and over so that each time we take the action the thought behind it is minimal.  (Another example, I decided once which was the best route to work.  I don’t decide every single morning how I want to get there.)

Then, in Gretchen Rubin’s new book, “Happier at Home” she mentions the issue of willpower.   For her a component of increasing her happiness is to abstain from things she will later regret – Christmas candy being the indulgence in question on page 120.  Alongside her discussion of her own desires to curb holiday candy munching she writes,

Researcher Roy Baumeister has shown that we start each day with a limited amount of self-control, and as we use it – when we resist saying something inappropriate, wrench our thoughts away from a topic, … or make tough decisions – we gradually deplete it.  As our self-control gets used up, we find it harder to resist new temptations.  If I use self-control to respond nicely to a nasty e-mail, it’s harder to me to refrain from speaking sharply to my daughters.  If I resist eating from the restaurant’s bread basket, I may end up eating half of [my husband's] dessert.

In reflecting on this passage, and juxtaposing it with BLW’s post, I’ve come to a convenient conclusion: When it comes to healthy habits, ruts – or less pejoratively, routines – are a wonderful thing.  They free us from the drain of tiny decisions and they prevent us from depleting our cache of self-control too quickly.

Having routines can facilitate all sorts of good behavior.  Not eating bacon for breakfast every morning takes no self-control because it offers no temptation since it isn’t part of my routine.  I don’t have to decide to floss at bedtime each night, I just do it as part of my routine.  I don’t have to haul myself out the door to walk the dogs each morning because it’s just part of my day.  Not surprisingly, areas of my life that are less routinized are more subject to decisions I may regret.  I’m only sort-of diligent about packing my lunch each day.  My stomach starts growling at 11:15 almost every day, which means that by the time noon rolls around I’m much more likely to give in to a buffalo chicken wrap and fries in the company cafeteria.  Also, despite my best intentions my observation of a bedtime is weak, which means that when a ballgame is tied or a blog post isn’t yet written (ahem…) I end up getting to bed much later than I’d like.

I’m not here to say that our lives should be completely programmed.  Diversion from such routines is, I think, what brings surprise and delight into our lives.  The inability to stray from our routines ends up making us slaves to them, which is no way to improve any aspect of your life.  But most of us live our day-to-day lives in a lather, rinse, repeat mode – at least to some extent.  This means that whatever decisions become routinized may be small within the confines of each specific day, but are magnified significantly when extrapolated out over weeks or months or years.  So if I make a good decision once, and then implement it every day I get the benefit of that good decision without the stress of making it over and over and charging against my “bank” of self-control.

All of a sudden my toast and yogurt aren’t looking so bad.  Now if I could just get past the fries.

I Want To Be 100 Years Old

Tuesday, September 25th, 2012

I should clarify that. 

I want to be 100 years old… eventually.  For the moment I’m quite happy at 35. 

I’ve been thinking about age a lot lately, though.  Last week* I celebrated my birthday.  At the same time I started sort of digging into Dr. Joel Fuhrman’s work which promotes wellness and longevity achieved by adhering to a nutrient-rich diet.  Then yesterday (with birthdays still on the brain) as I was out for a bit of a walk after lunch I decided that I want to live to be 100 years old. 
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I’m not sure when it started, but for a very long time I’ve cared a great deal about my health.  I suppose it goes back to high school and a fixation on my weight.  But since then I’ve come to a consistent happy place on the scales (I still weigh myself at least three times a week…) and now my concerns are more tied to my actual well-being.  I’ve always been a regular exerciser.  I eat a reasonably balanced diet.  I get regular checkups.  And I usually get plenty of sleep.  But if I’m going to play the long game – and what game is longer than 100 years? – then I need to do more. 

Lately I’ve been reading more and more about how the American approach to disease – treatment, rather than prevention – is all backwards.  This isn’t to say that everyone who has cancer or diabetes is at fault for their illness.  It is to say that scientific research has shown us how to dramatically reduce our risk factors, and I intend to do just that.  I have some sense of how I’ll go about it.  The sweeping majority of it will be dietary – increased consumption of things like beans, lentils, Swiss chard, and blueberries, and decreased consumption of things like white starch, meat, and soda.  Changes to my nutritional profile won’t be the sum total, though.

I want to relax more.  I want to smile more.  I want to feel more purposeful.  I want to read more books and take more baths.  I’ve felt static lately, as though my life – while abudantly happy – isn’t being cultivated as it should.  I want to be happy and thriving on my hundredth birthday, not merely hanging on.  For that to be the case I need more than phytonutrients.  I need a not just a balanced diet, but a balanced life. 

In all honesty, I may not be that far off.  But I think a few thoughtful changes might go a long way.  I don’t yet know what they’ll be, but I plan to write about some of them here.  Perhaps you’d like to see your hundredth too.  Perhaps we should celebrate together! 

*During an unplanned week-long blogging hiatus - the juices just weren’t flowing…

With Freedom Comes Responsibility

Tuesday, June 5th, 2012

They were the words I heard along with nearly every major rite of passage.  When I got my first bike.  When I was first dropped off at the mall without an adult.  When I got a curfew.  When I got a car.  You name it and I heard some version of, “With freedom comes responsibility.”

You probably heard it too.  And if you are a parent whose child has been granted a longer leash at some point then you’ve likely said it yourself.  It is a parent’s way of reminding a child that while he has earned the right to wander farther from the nest, in some literal or metaphorical capacity, he must hold up his end of the deal.  He must not squander that freedom.  He must enjoy and use it wisely.  And the most important implication, of course, is that he must use good judgment or the freedom will be taken away.

Perhaps someone should have told the American public the same thing when we were given the freedom to buy fountain sodas in 44 ounce portions.

I’m sure you’ve caught wind of the new legislation proposed by New York City mayor Michael Bloomberg.  The basic premise is that sugary drinks (sodas are the primary target here) could not be sold in portions larger than 16 ounces.*  Beware, Big Gulp – this means you.  Not surprisingly, consumers and beverage industry insiders alike are, well, freaking out.

There are so many ways to look at a ban like this.  Some people will believe (as I intimated at the start of this post) that as a society we have not managed our dietary freedoms responsibly and that the loss of such freedoms is a logical and appropriate consequence.  Other people will believe that our country was founded on a basic premise of freedom and that legislating something as seemingly benign as soda consumption strikes at the very heart of who we are as a nation.

While I have my own opinions, I can understand both perspectives.

This Huffington Post editorial makes some fair points against the ban.  Author Adam Geller addresses the “slippery slope” argument by commenting that,

If government is within its right to restrict behavior to protect health, then why wouldn’t a mayor or other official ban risky sexual conduct or dangerous sports like skydiving? What’s to stop a mayor from requiring people to wear a certain type of sunscreen or limit the amount of time they can spend on the beach, to protect them from skin cancer?

My response to him?  Sky diving accidents are not costing our country $174 billion dollars per year.  Even skin cancer doesn’t hit that tally.  And it’s that dollar figure that causes me to lean into Mr. Bloomberg’s territory.

Let’s consider the tobacco industry as an analogy.  If you think about tobacco legislation, things got really serious at two key moments.  One was when we discovered that the tobacco companies knew their products were addictive and took steps to increase their addictiveness.  The other was when it was proven that the damage done by smoking was not limited to the smokers themselves, but also to those around them.  Once we knew with certainty that second-hand smoke was having an adverse effect on non-smokers we began taking things much more seriously.

Now, if I alone am obese, my obesity doesn’t affect your health.  It doesn’t give you Type 2 diabetes or hypertension.  It doesn’t raise your prescription costs or require you to have a foot amputated.  The immediate adverse effects of my own obesity lie with me alone (and perhaps loved ones in my life who must also deal with it).  But if 63% of Americans are overweight or obese, that does ultimately affect you.  When two thirds of Americans are overweight it affects patient volumes and wait times in emergency rooms.  It raises insurance premiums across the board.  It creates massive amounts of chronic disease that will burden our healthcare system for generations.

So while my obesity may not affect your health, it absolutely affects your life.  And this is what brings us to the conundrum of the soda ban.  That is, how much are we willing to allow our government to intervene in this issue?

In this vein, an LA Times editorial comments,

Almost everything government does restricts the freedom of the governed in some way. People tend to accept these limits without complaint when there’s a clear connection to public safety and civil order, or a clear benefit from the spending that’s proportionate to the cost. … The support weakens when the connection to public safety isn’t so clear or the benefits are more abstract. … [T]he public accepts some governmental intrusion into what people eat and drink. There is an assortment of restrictions on alcoholic beverages, including a minimum drinking age, drunk-driving laws and regulations governing when and where liquor may be advertised. There are food safety standards and nutritional mandates on school lunch programs. …  But telling the average person that he has to eat X or cannot eat Y goes a step further. It intrudes on personal decisions that consumers make with their own dollars that affect just their own bodies.”

Ahhh, yes.  But as we’ve already discussed, the effect eventually reaches much further than the individual’s own body.  So what do we do next?  Mr. Bloomberg, being a politician, has chosen to pursue the legislative route.  (When you are a hammer, everything looks like a nail.)  However, marketing experts believe that such restrictions will cause people to resist their intent, potentially causing them to backfire altogether.**

The next problem, then, is figuring out how to make an issue of this issue without hurting the feelings of more than half the country.  There is such stigma attached to obesity.  It brings with it a whole cargo ship’s worth of baggage including feelings of insecurity, weakness, inadequacy, failure, judgment, and so on.  These are valid sensitivities, and ones that should be handled with kid gloves.  That doesn’t mean, though, that they shouldn’t be handled at all.  Ignoring this problem won’t make it go away.

The most important point in this entire issue, though, is to acknowledge that Mr. Bloomberg isn’t wrong in his assessment of the problem.  American rates of obesity (and all its related conditions) must be lowered.  I’m not the right person to say whether or not his legislative tack is the right one.  But his strategy – reducing consumption of countless empty calories – certainly is.

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*The ban would not apply to juices, diet sodas, alcoholic drinks, dairy drinks such as milk shakes, or sodas sold in grocery stores.

**From my vantage point, I wonder what a well-executed public service campaign would do.  (When you are a marketing professional, everything looks like a campaign opportunity…)  In the spirit of the “This is your brain on drugs” commercials from the 1980s, I can imagine a series of ads that would highlight the horrors of obesity and all of its medical side effects that might be quite compelling.  They would cast a pall on excessive consumption while still leaving the ultimate decision in the hands of the consumer.  But I don’t  know if they would ultimately be effective or not.  It’s an idea, I suppose.

Mental Muscle

Tuesday, May 15th, 2012

It’s demoralizing, really, the way that I try and try and still fail and fail.  Anyone with even a smidgen of pride would walk away, but not me.  I keep going back for more, no matter how embarrassed I may be, always with the hope that I will improve.  Nevertheless, the fact remains… I am incredibly bad at Scrabble.

Actually, that’s only mostly true.  What I’m really bad at is Words with Friends, the mobile phone app version of Scrabble that I’ve started playing.  (Sidebar: I finally ditched the BlackBerry and got and iPhone!!)  I had such high hopes.  I have a great vocabulary and I really thought I would be good at this silly game.  Alas, I am not.  Nor am I any good at Scramble, another game that is basically a digital word find puzzle.  I’ve been playing Words with Friends for about three weeks and Scramble for about one.  I haven’t yet won a single game against anyone.  It pains me to say it but it’s true.  But perhaps you can understand why I keep going back for more.

You’ve probably read the studies.  They are mentioned more and more lately, especially as the incidence of Alzheimer’s and other forms for dementia are on the rise as the baby boomer generation nears retirement. They discuss how the brain is a muscle that atrophies without use.  It must be exercised.  It must be challenged and stretched.

I try to challenge and stretch my mind as often as possible.  Frankly, that desire was the genesis of this blog.  I usually use reading as my primary means of mental calisthenics.  But lately my usual zeal for reading has taken a hit.  And while I hope that I’m close to seeing the light at the end of the sleep-deprived tunnel I’ve been in for the past year, for the moment curling up with a book is still an express train to sleepy town for me.  So I was happy to find little nugget-sized opportunities to challenge myself via these interactive online word games.  Little did I know they’d have me hanging my head in shame.

And that is exactly why I’ve decided that I must keep playing.

I’ve decided that if I’m so woefully bad at these word games* then they must be calling upon a part of my brain that is weaker than the rest.  They must be forcing me to flex my mental muscle in ways that it isn’t used to – like kickboxing for the mind.  If I am this bad at them, then I must really need them.

I work hard to make sure that my body will go the distance.  But I want to make sure that my mind can keep up too.  So as I run, lift weights, and eat my whole grains, lean protein, and veggies, so will I continue to humiliate myself in word game match-ups against friends and family.  I will keep playing until I start winning.  Because my brain clearly needs the workout.

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*My only solace in this whole deal is that I recognize that these games are about visualization as much as they are about vocabulary.  Yes, you have to know the words, but you also have to see them in a jumble of letters and without any context.

My Unsolicited Medical Advice

Tuesday, May 8th, 2012

I suppose I have an unusually large portion of my identity staked in being healthy.  I sort of pride myself on it – on not missing checkups, never having had a cavity, exercising regularly, having a cholesterol ratio of 2:1, eating lots of broccoli, and drinking lots of water.  I’m in this thing for the long haul and I want my body to go the distance.  When it comes to being healthy, I think I’m reasonably good at it.

In addition to my healthy lifestyle obsession I have a bit of knowledge about the healthcare industry.  I used to work for a healthcare company, and still have many friends and former colleagues in that industry.  I am also fascinated by the writings of people like Atul Gawande and their insights into how we practice and consume medical care in this country.

Given these two little truths about me, I was particularly struck by an article I read in a magazine at the gym last weekend.  It was Glamour, or Elle, or something along those lines – something decidedly non-medical.  (It was whichever rag had Rachel McAdams on the cover of its February issue…)  At any rate, the article contained letters from doctors.  The letters were to anonymous patients and said what these doctors “really wanted to say” to their patients.  Apparently – and I suppose this shouldn’t surprise me although I wish it did – many doctors withhold the full scope of their concerns about the health ramifications of patients’ lifestyle choices for fear of appearing judgmental.  So in these letters they let it all spill forth.  And it was heartbreaking.

Why don’t doctors tell us the truth?  For those of us in good health, we are lucky that there aren’t many painful truths to be told.  But for people who need to be confronted, are doctors not holding up their end of the bargain when they soft-pedal their concerns?  I’m all for physician diplomacy and happy patient relationships.  But I’m also fairly sure that there’s some interpretation of the Hippocratic oath that is violated when our doctors are legitimately worried about us and keep it to themselves.

With that – and my moderate knowledge of the healthcare industry – in mind, I thought I might offer my own perspective on what I look for in a doctor.

Asking Questions

Does your doctor ask you questions about how you maintain your health?  Are they open-ended?  Does she ask, “Do you exercise regularly?”  Or does she ask, “What is your current exercise routine?”  For starters, the Yes/No version makes it a lot easier to lie.  Secondly, the open-ended version starts a dialog.  This is true of discussions of diet and exercise, but also medications, pain points, stress levels, and myriad other concerns.  Doctors who hear you out will be operating from a place of much more complete information, and their advice and guidance will likely in turn be much more complete.

Basic History

What does your doctor know about you?  Does he know more than what you entered on the health history checklist at your first appointment?  If you have switched doctors get your records released from your old doctor and have them sent to your new one in advance of your first visit.  When you go to your first appointment ask your doctor if he’s read the records you sent over.  If not, find out why and determine if you’re in the right person’s care.

Touching

Does your doctor touch you when you go in for a checkup?  Or is he just looking at lab results and other statistics on paper.  Does he feel your lymph nodes and listen to your heart?  Does he ask questions when he checks you?  Is he paying close attention to his exam or is he just going through the motions?

Incentives

This is a big one.  And, honestly, it’s not one that you have much control over.  Nevertheless, it’s good to be aware of your physician’s incentives.  Most doctors are still paid by hospitals and insurance companies on a fee-for-service basis.  This means that they are paid a fixed amount for each exam/procedure that they perform.  In short, it’s volume-based and more patients seen means more money earned.  Internists are paid the same amount of money for a thorough checkup as a slapdash one.  Surgeons are paid the same amount for a smooth and precise surgery as one riddled with complications and errors.  I’m sure you can imagine (or have likely experienced for yourself) what this looks like in practice.  The good news is that there is a slowly-emerging trend in healthcare toward “accountable care.”  This means that physicians are in some way held accountable for their performance, whether via taking on financial risk for the health of their patients, or via bonus payments for providing high quality care.  My advice on this one?  Ask your doctor how she gets paid. Even if she’s still on a fee-for-service model merely asking the question will alert her to the fact that you are an informed patient and will be paying attention to the attention she pays to you.

So there you have it.  Gale’s guide to health and wellness.  I have no idea what any actual medical professional would think about it, but it works for me.  And maybe it will work for you.

Keeping it Simple

Tuesday, April 24th, 2012

My sister-in-law eats an apple every day.  She’s religious about it.  Ive never really understood why she is so steadfast about it, but I’ve recently learned that it doesn’t matter.  I should follow suit regardless because she’s onto something.

I was a bit shocked last week when I read this article about all of the health benefits of apples.  Of course I’ma accustomed to hearing the praises of blueberries and grapefruit sung.  But apples?  I had no idea they were much more than convenient additions to a brown bag lunch.  Nevertheless, they are apparently all of the following: beneficial for weight loss, beneficial for digestive health, antioxidants, and agents in preventing oral, breast, colon, and kidney cancers.

Bits of information like this inspire me in some strange way.  I think it’s because of their simplicity.  In a world where we are constantly inundated with copious – and often conflicting – information about our health, it is such a relief to learn that for once that the advice is easy.  We give up carbs and gluten but we aren’t sure why.*  We read about the evils of sugar and then try to figure out whether or not sugar substitutes count.  We hear from one source that we should take a multi-vitamin and from another that we shouldn’t.  It becomes overwhelming quickly.

But this?  This I can get behind.  So instead of waxing philosophical about the beauty of simple advice, I’m going to let the advice stand alone.  Eat an apple today.  In fact, eat two.  And if you need more convincing, go read the article.  Then go eat your apple.  Your body will thank you.

*I really don’t understand the current gluten free craze.  For anyone who doesn’t have celiac disease, what’s the problem with gluten?

Sugar High

Tuesday, April 10th, 2012

I’ve been living it up lately.

Every day at work I eat my lunch.  And every day when I finish eating I walk up to the check-out line of the company cafeteria and pay for a chocolate chip cookie that is about four inches in diameter and a fountain soda.  And it always hits the spot.  This daily treat probably runs me about 600 calories.  Under normal circumstances such a delightful sin might be a once-a-month occasion, if that.  But lately I’m doing it every day.  Why?  Simple. …  Because I can.

Nursing a baby is a huge commitment and a lot of work.  The bonuses are two-fold.  Most importantly, it’s good for my baby.  Secondarily, the calories it burns afford me the opportunity to eat more or less whatever I want.  This doesn’t mean that I eat junk food every day.  On the contrary, I’m aware that whatever I eat so does SSP.  So I take care to eat a balanced diet that is good for both of us.  But I justify my “cookie and a Coke” habit with the premise that I can take such liberties with my diet only for a limited time, so I had better take advantage while I can.  Hooray, I thought.  Bring it on!

Then 60 Minutes had to go and rain on my parade.

Their recent piece on the toxic nature of sugar was a total buzzkill for me.  The net of it is this: “When a person consumes too much sweet stuff, the liver gets overloaded with fructose and converts some of it into fat. Some of that fat ends up in the bloodstream and helps generate a dangerous kind of cholesterol called small dense LDL. These particles are known to lodge in blood vessels, form plaque and are associated with heart attacks.”  In addition to the heart disease risks, sugar is associated with increased cancer risks and has been shown on fMRI to be as addictive as cocaine.

Then The Huffington Post doubled down with a pair of articles (here and here) endorsing the 60 Minutes piece and echoing the evils of sugar.

Ugh.

So what’s a girl to do?  What is any of us to do?

Should we heed this doomsday – and scientifically substantiated (grrrrr) – news?  Or should we take it with a grain of salt?  All of this new research on sugar is depressing at best, foreboding at worst.  Are we to believe that sugar is like tobacco, and any amount of consumption is to be avoided at all costs?  Or is it more like alcohol, something that can be damaging and addictive when consumed irresponsibly and in excess, but which can also be enjoyed in moderation without any real harm?

If I were overweight, or diagnosed with diabetes or hypertension then I would not sit here wondering whether or not I should ditch my daily sugar high.  But I’m really healthy.  My cholesterol level are great.  I exercise daily.  I drink lots of water and eat lots of vegetables.  At my most recent physical my doctor told me that I am “built to last.”  Given all this, can I afford to to continue my sugar-laden indulgences?  Or is the fact that I can afford the calories irrelevant?

I can tell you this: as soon as SSP is weaned I will drop this habit.  My soda consumption will drop back to about one a week.  And my dessert proclivities will be substantially adjusted as well.  But can I afford to throw caution to the winds for the next seven months?  Or do I need to dial it back now?  Given what I’m learning about sugar I’m inclined to modify my habits sooner than my baby’s first birthday.  (Also, the novelty of my cookie/Coke habit is slowly fading.)  But at the same time I want to believe that in the context of an otherwise completely healthy lifestyle, it’s not that big a deal.

It’s my one vice and it’s temporary.  But I care a great deal about my health.  Truly, I’m torn.