The diet and lifestyle for Sean (a 26 year old professional football player) wont work for me (a 49 year old physician/yoga practitioner)------------------------>
"You have to start exercising!" I caught myself saying to a patient. Then I asked, have you ever exercised before? No....well, there was badminton in high school. Now if I didnt ask, I would assume she would just go back to her "Bally's" membership and start her old routine again. I imagine some people leaving with suggestions I made and getting home but not knowing how to begin. Maybe going out and starting to jog with 2 year old pair of tennis shoes with no arch support. (That would eventually lead to shin splints, pain for days with walking down the stairs and having to indulge in a few advils, get reflux symptoms then curse me for having made the darn suggestion to begin with.) Or the 40 year old that buys a treadmill again only to use it for hanging laundry after 3 months because its boring to run in the house. The word "exercise" can actually connotate fear and embarassment in some that didnt like gym class in highschool. In 2005-6, only 53% of students in the US participated in athletics. That can be translated to 47% didnt like gym or have great experience with finding a sport or just arent aware of healthy forms of exercise short of running and calisthenics (-Arnold Schartzneggars attempt at the presidential physical fitness awards). Zooming to the CDC's statistics, if 2/3rds of the population is overweight, then dare I say more than 1/2 of that group may not have any experience/knowledge of activity that could save their lives short of running that will probably hurt their knees. Oh.... "pre-habilitiation exercise education" is not covered by insurance but a below the knee amputation for diabetes pays "good money" to the surgeon and hospital.
I have coined the phrase "Heart Healthy Activity" to be spoken instead of "exercise". It doesnt conger up experiences from highschool for some and it opens ideas up for the ex-athletes that are stuck on one kind of routine. Andy Weil professes in his book "Optimum Health"....act your age. To prevent injury in activity not designed for the decade of life you are in. Heart Healthy Activity for a 20 year old differs from that for a 40 year old. The HHA for an obese 20 year old differs from that for a lean 20 y/o. A 40 year old on high blood pressure medications cant measure heart rate like a diabetic on sugar medicine. A 49 year old ex-bodybuilding, high school sprinter (booya) usually will be against starting yoga with the typical preconceived notion that "I'm not flexible so don't think its right for me". Bottom line is just like some medicines cause back side effects in one person but lifesaving results in another, HHA has to be "tailor-made" to the persons age, loves, goals, economic status, physical disability, sex, family responsibility and free time. I believe if this basic lifestyle change is to be sustainable, then thought, design, and a good intention to make the patient successful in changing has to be invested. This is why I work with chiropractors, a physical therapist, a registered dietician/personal trainer, exercise physiologists and counselors. A well rounded team can provide several different "in-roads" to attempt with each patient in order to design a HHA that they will be able to embrace to initiate a change. The more you change with HHA, the more you improve the chronic medical disease: the more you improve the chronic medical disease, the better you feel: the better you feel, the more empowered you are to make the next change.......
As a patient, you have to be willing to try new things outside normal comfort zone....essentially trust that the person designing the program has the best intentions and desires for your success. As a provider of healthcare (doctor trainer, yoga teacher...), we have to keep in mind, not every prescription for lifestyle change is the same for a given patient.
Monday, August 22, 2011
Wednesday, August 17, 2011
Went to the "2011 Veggie Fest" in Naperville because a trip to downtown was cancelled by a "Half-Marathon" occuring at the same time. I remember reading about it and wondering if it would be like a glorified sunday farmers market or smaller. As we approached from the highway, I could see major road barricades and a mass of people being controlled with police direction across a major off ramp. First I thought, must be an accident or concert....then a realized they were all headed to the "Veggie Fest". According to one of the vendors, (a cosmetic dentist and previous patient of mine) 10,000 people were expected for this 4th annual get together. I was amazed to see a cross generations, not just the tail end of the baby boomer generation (booyaaa!!) but young college kids, young families, a few retirement age folks; Indian, Asian, African Americans and "other" all walking around really taking advantage and interest in open tent lectures, vendor stands, food sampling tents, yoga (booyaa again!) Chiropractor tents......there was one MD tent. The Md/doc had a sign over this table reading "Ask the Expert" ....no other pamphlets, give aways, hand outs....pretty drab compared to the flashy and informative tables of alternative medicine counterparts at the next tables. And he wasnt busy...kinda looked bored.
All this is a statement that the call for better health is being asked by the community and answered by the community (at least a small percentage). In my opinion, healthcare reform will not be able to move anything faster than snails pace. I appreciate that "Obama Care" has made some initial steps to change the paradigm. But with the polarity of the government, it will take a heathcare catastrophy to make a significant inroad to change. (Just like the automotive industry bailout!...rescue at the last minute and socialize it). Nothing wrong with socialized medicine: it is working for Europe while our way is failing-along with our health) People have placed too much reliance on govenment to "get them healthy" .....like the guy who comes in after 40 years and says "fix me doc...just dont make me change my hours, diet or free time.....and by the way, I am not a pill taker and dont believe in psychiatry".
What prompted me to discuss?... Chicago Mayor Rahm Emanuel announced this morning new plans to "Incentivise" (......actually-Penalize) city workers to lose weight, lower cholesterol and lower blood pressure. An article in the Sun-Times called it -"Carrot and Stick approach".
Just so happens my partners at First Health Associates and I have been working on a sustainable plan for lifestyle change just because of the way our weight loss graduates over the last 3 years are still maintaining a hunger to seek out more change even with the great gains they have made. All have been able to lose weight, most have been able to get off medicines, some have been able to change their family members and friends......every single one has been empowered to understand the concept that the power for successful change was inside all this time, just took education/guidance to plan a way to bring it out. The "incentive" we give people in the current program is/are the graduates from the previous programs. We have a growing "wall" of success stories to our program "The Largest Losers". I believe in what Dean Ornish said at my AZCIM fellowships conference......"Fear based medicine that uses the threat of future heart attack or cancer is not a sustainable motivator for change......its about the Joy of Living"....when our team is able to help in making a single change....our patients feel better, it empowers them to embrace the next opportunity to make another change. Small, high value, "daisy-chained" steps to lifestyle change are more sustainable than the "all in" decision to change everything at once. (although some of my Vata patients need this)....either way, we are ready to support all with conventional, alternative and ancillary healthcare.
A small percentage of Chicago's city employees drive 2/3rds the total healthcare costs around 5 chronic illnesses that could be managed with lifestyle change. The US population is the same way, an average of 6000 dollars spent per citizen per year and we are ranked close to the bottom of the list of world countries for being healthy. The good news is that with what I witnessed at The Naperville Veggie Fest, a small percentage of the population is taking their health into their own hands and showing great success at initiating a lifestyle change that is sustainable. I believe in the next decade, we will incentivize the rest of the community to break free of the status quo and instead of Dying Longer-experience the true Joy of Living. I feel in my heart we can grow this from a club, to a culture to a Wellness Generation....just takes the one step at a time.
Thursday, August 4, 2011
We have incorporated summer vacation into our family ritual. Its so easy to say, lets just stay in Chicago....theres so much to do here and its a hassle to plan an outing. Many more excuses can be created in the depth of my mind but its so fulfilling when the vacation is over and the memories of time spent away from the normal ritual are permanently burning into the temporal lobe of my brain. I have to praise collective thinking as to how great ideas are creatively morphed and then carried out. If it wasnt for the sharing of the initial intention and desire between me and my beloved, then her and her siblings, I dont think the idea of "where should we take the kids before school starts" would have blossomed just because- I'm to busy with promoting my clinic, giving lectures and growing my practice. I love the way a small spark of an idea can be shared with like-minded people and especially with the speed of communication now-a-days, a well planned concept can be effortlessly developed. People all have dormant talents that sometimes go unrecognized until a spark ignites that center in the heart chakra. Once ignition happens, its like this inborn desire continues to drive the individual to creatively expound on what they feel is the right way to "celebrate" the idea that was initiated. Usually in giving group, this inspires others to contribute to the growing idea in their own way. ( ie...one person is great at shouting out the idea to the group, one person is great at searching for flights and houses, one person is great at cooking meals, one person is great for planning events, one person is great at packing the whole kitchen to make sure we dont forget anything.....) When everyone contributes their individual talents, no matter how small, the "universal idea" that was started with a thought...takes off with all details being covered and in the end....almost no effort being recalled as to how did we launch this massive plan into reality.
I feel this speaks to the concept of surrounding yourself with like minded individuals. Equally important is to "shed" the relationships that seem to foster alot of energy just to end up with a feeling of I didnt feel good about spending time with that person. Some people have not matured to the point of realizing the universe isnt here for YOU; you are created to contribute to IT. Those people who pollute, eat without guilt, cheat taxes, cut in line, disturb the peace, spread rumors, insult others....all have an agenda to be self serving. When your intentions and desires are geared to just bring energy to you and not to grow or contribute to the good of all, you become an "enery drain" to your family, your friends, your coworkers, your community, your race.....and yeah, even the planet.
In the end, something that started as an idea and blossomed into an experience that my kids, neices and nephews will remember as "I remember feeling good about myself when we all participated in that trip way back in 2011", makes it worthwhile to share ideas with other likeminded individuals.