This has been a gift and a challenge. I’ve spent so much more time with my littles. They have grown so much. Our family unit has strengthened tremendously. Their bond has tightened. It has been amazing to see.
The toddler has become so talkative and bright and grown into his little personality. He’s learning sight words, using the potty, building with blocks, learning some Mandarin, and so much more. He’s super loving—not really something I expected. And I think the pandemic has affected him the least, likely because he’s the youngest, and has so little to compare to, and he has his big brother, who he adores.
The third grader—boy have we gone through some things. He’s fluent for his age in Mandarin, learning division, starting to have big boy feelings. And he has definitely let it be known a few times that he is sick of COVID—because he would have been able to meet his summer friends in person if it weren’t for COVID, he would have been able to spend holidays with his family if it weren’t for COVID—oh, he gets it. He wanted to go to school in person, but then realized he could catch COVID even with a mask, and decided that maybe he didn’t want to go. He’s struggling a little to pay attention with remote learning, and we’re struggling with how to help him meet his full potential.
Mostly, I worry about what my kids are missing—with the younger, I think about all the things the older was doing—swimming lessons, taekwondo, and the older is not getting to continue these lessons currently—well taekwondo, but virtually, and it’s really not nearly as stimulating that way.
I think about everything they are missing. I pray that we are doing the right things for them daily. I’m praying as they begin to assimilate a little more—or don’t.
There’s no way to know if you’re doing the right thing for your kids. My husband looks at me because I’m the doctor. But really, I know the medicine, but I’m just as clueless about what the right thing to do for my kids is. I’m human. This parenting thing is hard. I’m just praying.
Good thing God made them resilient. Good thing God’s in control more than I am.
I miss my husband. I mean, he lives with me and all, but because I am a physician and I’ve been exposed to so many people, I don’t necessarily trust my exposures around our normal childcare. I would feel horrible if I exposed my mother or father in-law to COVID. And we don’t necessarily trust alternative childcare—you never can be sure if other people share your values when it comes to social distancing—I don’t want to expose my family any more than they are already exposed.
And so date night is…nonexistent. Because kids are around ALL. THE. TIME.
I miss my husband.
I miss feeling like a woman, getting dressed up for him, and being able to just sit and talk to him in a restaurant or ride in the car with him. And sure, we talked about the kids—but they weren’t there.
If there’s anything I’m hoping this vaccine brings, I’m hoping it brings some grown up play time. My marriage needs it.
So many losses. So many still sick. So many recovered. So many still in denial. So many moving around like it doesn’t exist. Still. So many misinformed. So many giving the wrong information—even colleagues. It has been a roller-coaster of a year. And at the end of it—a light. A vaccine. A vaccine that so many don’t trust, but that I took because I am exposed to too many, and I expose too many vulnerable people. A vaccine I will ask many people to take because without herd immunity we will never be able to move around anywhere close to normal again, and herd immunity takes mass vaccination—or mass infection, which means mass death, and that shouldn’t be an option. Yes, there is the absence of post-market research, but at this point, it seems benefits outweigh risks for most, and when you weigh the mental, emotional, economic turmoil this pandemic has caused, it seems worth the risk of a vaccine that is around 95% effective at preventing infection and thus far has no major side effects.
I’m excited about the prospect of having something to offer my patients when it comes to outpatient treatment. We have monoclonal antibodies to try to keep patients who are at high risk for poor outcomes out of the hospital. But I wouldn’t be honest if I didn’t admit I want more. I want an oral therapy to be able to give patients. I want answers for the ongoing symptoms some of my patients are having. I want to be able to give my patients a hug.
Where are we moving into 2020? Many promising things on the horizon, but in the middle of numbers ballooning, national leadership that has completely ignored the pandemic for the past month, and those of us in health care—we are tired. Mentally, emotionally, physically—tired. But we keep giving ourselves pep talks and pressing forward, for our patients, for society. Despite being paid less, despite many of our colleagues having to close their practices or becoming unemployed—we continue to fight. We continue to educate; we continue to care for the patients we can. We fight.
There’s a light at the end of the tunnel. There is. Hopefully everyone will help us walk into it.
Soulful Sundays: Once a week I will have an installment that speaks to my spirituality, because, as I’ve said, to me, spiritual wellness, is essential to complete wellness. Because I am Christian, my spirituality is heavily based on my relationship with the Trinity and the Christian Bible. If reading about God, Jesus, or the Spirit will offend your sensibilities, these posts aren’t for you–be advised
It’s been a while, but it’s past time.
I’ve been reading and growing, just quietly. But I definitely want to get more active on the blog again, and what better way to start than with a Soulful Sunday?
Last year was migraines. This year? Well, I won’t go into the details–I think it would be embarrassing to people who aren’t me, and this blog isn’t about that. What I’ll say is that I have always found it so interesting how the strength you gain from one trial is definitely intended to carry you through the next one. This past year has been hard, humbling, disheartening–but full of growth and love. I have seen the worst in people and the best in people. I have learned to pray for people who have the worst intentions for me. I have remembered to forgive people who never asked for it. I have seen what true friendship means. And in the midst of going through this, I did a devotional on my Bible app call 41 will come with my brother. It wasn’t what I thought it would be, but it was exactly what it should be.
It reminded us of the significance of the number 40 in the Bible, 40 days of flood, Moses hid for 40 years after committing murder, 40 years the Israelites wondered in the wilderness, and 40 days Goliath bullied Israel. It’s the latter that the author chose to focus on to remind us of our personal responsibility in bringing our 41.
I think people should do the devotional, so I’m going to try not to steal the thunder, but this is what I want to say–I walked away from the 7 day plan with a renewed sense of walking into the purpose has for me, despite those that will try to derail me from that path. One thing I have seen in watching others with great purpose is that the devil will get very busy in trying to derail them. People will discourage you, he’ll let that inner voice of yours tell you that your mistakes are too big, and you could never be the person God is telling you you’re supposed to be. That book you are supposed to write, that business you are supposed to start, that presentation you are supposed to give, that promotion you want, the life you are supposed to touch just by being the best version of you possible–the devil is trying to convince you you’re too small. He’s allowing people to tell you that you are too something: too inexperienced, too old, too mean, too new, too cute, too ugly, too uneducated, too poor–and all of it is a lie.
Understand that if God means it for you, no one can take it from you. If God means it for you, there are people who will never be touched in the way they should be if you don’t live up to the purpose God intends for you. And understand that with God’s power behind you, if you believe, you can not fail if you are walking in your path. One of the verses that touched me most was Romans 8:11:
“But if the Spirit of Him that raised up Jesus from the dead dwell in you, He that raised up Christ from the dead shall also quicken your mortal bodies by His Spirit that dwelleth in you.”
Y’all–the Holy Spirit dwells in me. That makes me powerful beyond my imagination–I just have to tap into it, I have to believe in it. I have to face whatever adversary is between me and my purpose knowing that the victory was won before the battle began, because I am meant to touch the lives I will touch by living to my greatest potential. I am doing no one any good by shrinking, by letting those voices, those naysayers, those agents of the enemy get in my head. I am a child of the Most High, He has given me the gift of His Spirit, and my purpose is to glorify Him by living to my greatest and fullest potential. I dare not shrink into the shadows. YOU dare not shrink into the shadows. Not because of people, not because of COVID, not because of anything.
It reminds me one of my favorite quotes–and on it I will end.
“Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness that most frightens us. We ask ourselves, ‘Who am I to be brilliant, gorgeous, talented, fabulous?’ Actually, who are you not to be? You are a child of God. Your playing small does not serve the world. There is nothing enlightened about shrinking so that other people won’t feel insecure around you. We are all meant to shine, as children do. We were born to make manifest the glory of God that is within us. It’s not just in some of us; it’s in everyone. And as we let our own light shine, we unconsciously give other people permission to do the same. As we are liberated from our own fear, our presence automatically liberates others.”
Sleep is so important to our health, and according to the CDC, about 1/3 of Americans aren’t getting enough. Adults need between 7 and 9 hours of sleep nightly, and while you can try for an average, what we’ve actually seen in some studies is that some of the negative effects aren’t necessarily outweighed by making up for sleep debt at the end of the week.
So why is sleep so important?
Adequate sleep supports a healthy immune system.
It supports a healthy memory and sharp thinking
It keeps stress hormones in check
It helps stabilize our mood
It supports a healthy weight
It decreases inflammation
It decreases our sensitivity to pain
It helps our body repair and heal
So, what happens when we don’t get enough sleep?
We can be more at risk for infections.
We are more likely to have health problems like diabetes, hypertension and heart disease
We are more likely to have mood symptoms
We are more likely to overeat
We are more likely to age faster
We have decreased concentration and memory
So, what’s the first step? Committing to getting enough sleep. Set a bedtime and stick to it. It’s important to reduce blue light exposure about 1 hour before you want to go to bed, and ideally you’ll have a routine that relaxes your mind. You want to have a room that’s as dark as possible, and it’s best to have a cool environment.
Typically it’s not recommended to lie in bed for more than 20-30 minutes trying to sleep as this teaches your brain that bed is a place to try to sleep rather than to sleep. If you’re lying there trying to sleep, it’s best to get up and do something relaxing that doesn’t involve blue light and return to bed when you begin to feel yourself become very tired or nodding off.
There are many things that can interfere with sleep, including certain health conditions like sleep apnea. If you are truly having trouble with sleep, see your physician.
I’m super excited to join Karla J. Aghedo for another wellness weekend to Refocus as we continue this marathon inside of the COVID-19 pandemic. So much has gone on the backburner in 2020 due to this pandemic, and I’ve been tasked with reminding us all of some important things to add back to the checklist to ensure our physical health.
I’d like to start with a couple of important concepts. First, you get out of your body what you put into it. Keep that in mind as we move throughout each concept. Things do not necessarily come easily, but you get what you give. Equally, if not more importantly, I’m about to lay out a bunch of information. It can seem overwhelming–like I’m telling you you have to be perfect. The truth is there are tons of ways we could be taking better care of ourselves, but perfectionism is not something I want to encourage. Remember, in our journey of self improvement, imperfection is okay, giving up is not.
I do like a good pneumonic–so here goes–let’s REFOCUS!
R: Rest enough.
E: Exercise consistently.
F: Feed our bodies well.
O: stay One step ahead.
C: Control chronic illnesses.
US: We are just as important as everyone else.
Rest Enough
We live in a society that doesn’t value rest enough–we brag about how much we don’t sleep, how little vacation we take, all while we have more diabetes, hypertension, heart attacks and mental health problems. We need rest. And contrary to popular opinion, it actually makes us more productive. In the book Rest: Why You Get More Done When You Work Less, Alex Soojung-Kim Pang explores many different types of rest and their importance. He gives a very brief summary in this article where he discusses concepts like starting an early morning routine, walking–particularly outdoors, napping, stopping work at the right time, and of course, sleep. I also like to include mindfulness and meditation in this area. All of these things are important foundations on which to build our physical health.
Exercise Consistently
There are soooo many benefits to exercise discussed here and here.
I always encourage my patients to do something that they find enjoyable–it doesn’t have to be the gym or running or weight lifting. It can be turning on youtube and learning the latest line dance! Just do something to get your heart pumping. Ideally, if you are doing something that would be considered moderate intensity cardio (that is, something that keeps your heart rate at 50-70% of your maximum heart rate for the duration of your work out), then you want to get about 150 minutes of exercise in weekly. If you are getting your heart rate between 70-85% of your maxiumum heart rate, or performing vigorous cardio exercise, you don’t have to do as much. You should also be incorporating strength and stretch into this program.
Eating when you are hungry and stopping when you are satisfied, not full
Decreasing your sugars significantly
Try not to drink your sugars (smoothie exception, but be careful!)
Food is medicine. Eating well helps support our immune system, keep us at healthier weights, prevent and reverse metabolic syndrome and insulin resistance which causes diabetes mellitus type 2, prevents and reverses hypertension, prevents cardiovascular disease–the list keeps going.
(Stay) One Step Ahead
By this, I mean make sure you do your preventative care!
This year it is of utmost importance to get your flu vaccine. I did a previous blog post here about the safety and importance of this vaccine. However in the midst of COVID, it is even more important to make sure we are protected. Why? Because the flu typically fills up our hospitals and ICUs during flu season. They are already more full than usual due to COVID patients. The same thing that cause widespread lock downs at the beginning of the year will cause widespread lockdowns again if we can’t contain hospital admissions. Also, I truly believe if we ever see influenza and COVID infect the same person, it will be unequivocally deadly–this is not something I want to see. Get vaccinated.
Depending on your age, you should be getting cervical cancer screening, breast cancer screening, colon cancer screening, osteoporosis screening. You may need lung cancer screening. You also should consider continuing to get your eye and dental exams depending on your health status.
Control Chronic Illness
One thing we have seen many people do is put off regular physicians appointment out of fear of contracting COVID-19. It is important that if you have chronic health problems such as hypertension, diabetes, and heart disease, that you are scheduling your follow up appointments with your physician. You want to stay ahead of these health problems since poor control can have you end up in the hospital and possibly with infections. Consider a virtual visit if this is being offered, but also, many offices have come up with procedures to make in person visits safer for their patients. Make sure you are completing your blood work, taking your medications as prescribed, and doing all the lifestyle pieces above to optimize your health.
US: So important, I had to make it plain
We need to be on this list. While all these things are about us, I find it needs to be said that we are a priority. So many times my patients “can’t” do the things above because they are too busy prioritizing someone else over themselves. Our health is just as important. We are just as important. I sometimes say that you can’t take care of X if you aren’t taking care of yourself, but truthfully, God made you in the same special way He made everyone else. You deserve. Put yourself on the list–high up on it.
So I’ve found myself in a season of being smacked in the face with the need to push myself into change and growth. It’s very uncomfortable, but who grows when they are comfortable?
I was doing an amazing devotional with my brother, and was reminded of something:
What that means is I am extremely powerful because of Whose I am and Who dwells in me–the Spirit of the one who can do more than I can ask or think–more than I can imagine. And I started asking myself–then why would I think so small? How insulting to my God! When He can do so much, why would I ask so little? Why would I dream so small?
I am asking you the same–challenging you to dream bigger. Whose life can you change or touch if you dream just a little bigger, answer more challenges that maybe you’ve been shying away from. Remember, you are God’s instrument. He has endowed us with talents that we are responsible to use.
I am reminded of one of my favorite poems by Marianne Williamson, “Our Deepest Fear”, likely one of my favorites, because I need the constant reminder.
“Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness That most frightens us.
We ask ourselves Who am I to be brilliant, gorgeous, talented, fabulous? Actually, who are you not to be? You are a child of God.
Your playing small Does not serve the world. There’s nothing enlightened about shrinking So that other people won’t feel insecure around you.
We are all meant to shine, As children do. We were born to make manifest The glory of God that is within us.
It’s not just in some of us; It’s in everyone.
And as we let our own light shine, We unconsciously give other people permission to do the same. As we’re liberated from our own fear, Our presence automatically liberates others.”
Go answer your call–fulfill your purpose of bringing glory to God by living his purpose for your life and meeting your full potential.
Metabolic syndrome is a term that has come up quite a bit in some of my blogs, and I thought that it may be prudent to take some time to fully explain what this really is.
The National Cholesterol Education Program’s Adult Treatment Panel III report (ATP III) defines the metabolic syndrome a multifactorial risk factor for cardivascular disease that includes 6 components:
Abdominal obesity–the tendency to carry more weight in your midsection than other areas of your body
Atherogenic dyslipidemia–unhealthy proportions of lipids. It can be too many, or too few of the “good” lipids to the proportion of “bad” lipids
Insulin resistence +/- glucose intolerance–this doesn’t necessarily have to be the classification of diabetes mellitus type 2, but this is what causes diabetes mellitus type 2
Proinflammatory state–a state caused by a number of things, including increased adiposity (too many fat cells). This can be checked by a CRP value.
Prothrobotic state–this is the state of a body wanting to clot too readily. It’s why people are told to take aspirin.
Definitions for each of these vary, depending on the source you are using. The main thing is in recent years, you are seeing more and more people talk about insulin resistance and adiposity as being major drivers in metabolic syndrome.
Metabolic syndrome is beginning to be connected to many different health problems. I recently gave a talk connecting it to gynecologic health issues, in addition to it’s cardiovascular implications.
Medicine is looking for drug targets to help prevent morbidity and mortality from metabolic syndrome. However, many of these risk factors can be modified through a healthy lifestyle.
Eat well: remember the healthy plate! Healthful diets are the cornerstone of health! Good nutrition and appropriate nutrient balance are ways we try to keep our bodies at a healthy weight and prevent the maladaptive hormone balance that happens when our bodies have excess adipose tissue–the changes that lead to metabolic syndrome. You can consider a plant-based diet, which is one of the most evidence based diets, or if you are at the other end of the spectrum, low-carb, or keto may be reasonable options. Just do something!
Move as much as possible: exercise of at least 150 minutes of moderate cardio weekly, plus strength and flexibility training, is considered an active lifestyle. I say start where you start! If that’s a 10 minute walk daily or 30 minutes once weekly, its better than 0. You want to move as much as possible,because, in addition to all the other benefits, it helps maintain a healthy body weight, reduces insulin resistance, lowers blood pressure, reduces inflammation (any one noticing a theme)–it basically reverses metabolic syndrome!! So get moving people–dance in your living room, go for a walk with your family, ride your bike, go for a swim–just move! And remember, your change doesn’t have to be perfect, it just has to be changing. That’s it.
Plant-based zuccini lasagna, courtesy of Chef Julia, The JuJu Products
YES! You can!
I started moving towards a more plant-based diet earlier this year. In full disclosure, I’m not fully plant-based today, I’ve had periods of being more plant based than others.
I made my decision because I was trying to see if moving to a less inflammatory diet would help my headaches. I truly believe it was helpful in decreasing the frequency and debility I was experiencing.
There are many other reasons to consider switching to a plant based diet.
A plant-based diet has been shown to:
Improve nutrient intake
Decrease mortality from all causes
May reduce the risk of coronary heart disease by estimated 40% and cerebral vascular disease by 29%
Reduce the risk of developing type 2 diabetes and metabolic syndrome by 1/2
Reverse atherosclerosis (hardening of the arteries)
Decrease blood lipids
Decrease blood pressure
What is it?
A plant-based diet is a diet based in nothing from animal products. A vegetarian diet is slightly less rigid and typically allows eggs and dairy.
So, how do you start? Like anything, you start
There are sooooo many resources for beginning a plant based journey, and it does require research. If you are going to be strictly plant-based, and not vegetarian, you will need a vitamin B12 supplementation.
If you click the link, there are several other links to information on how to get started on your own. It takes a good deal of research on nutrition and matching nutrients. You want to make sure you are getting enough essential amino acids per day, and enough nutrients–you can’t just eat rice and potatoes–not healthful!
One thing I have done is invested in meal prep. It let’s me try different flavors and takes some of the stress off as I transition. My meal prep person is AMAZING!! If you’re in the Houston area and reading this, consider contacting Julia of The JuJuProducts for amazing vegan meals. You can also look for a healthy vegan meal prep in your area as you continue to try your own vegan recipes.
You can start with Meatless Mondays and transition to more meatless days, or rip the bandaid off and go for it. The goal is to make a change in the right direction. Honestly, the right way, is the way that works for you and your lifestyle!
All Plant-based “shrimp” poke bowl, Courtesy of Chef Julia, The JuJu Products
I was very honored to be asked to answer some questions for some ladies to discuss their Healthy Future Marriage–and I thought, let’s do a blog post!
I’m not a gynecologist, but guess what? Your metabolic health can affect EVERY ORGAN SYSTEM!!
For women, it’s important to remember that a healthy lifestyle isn’t just about fitting into that perfect outfit, it’s also about a healthy heart, healthy ovaries, and a healthy uterus!
Many gynecological problems are related to metabolic syndrome and unhealthy BMI, in particular, PCOS, endometrial polyps and cancer, and uterine fibroids (honestly, these are some I was asked specifically to touch on—there may be others).
PCOS
PCOS is polycystic ovarian syndrome. Many women present because of irregular periods. They may have more hair in places we like to pluck and wax. What I would find on my evaluation is hormone imbalances, sometimes I see the cysts on the ovaries, many times the BMI is increased, and many times there is some insulin resistance. See the last two—we are touching on metabolic syndrome here. PCOS is much more likely to be associated with metabolic syndrome, and women who lose significant weight (which tends to reverse metabolic syndrome) can see improvement or reversal on their PCOS. Additionally, one of the treatments for PCOS is metformin, a medication used in diabetes management. It normally helps control the periods and improve fertility.
Fibroids
Uterine leiomyoma (fibroid) benign masses that grow on the uterus. A couple of studies have shown that there is may be an association between fibroid developing metabolic syndrome.
Endometrial Polyps
Endometrial polyps and cancer are tumors of the lining of the uterus. They have a known association with BMI>30, diabetes, and hypertension (things that make up metabolic syndrome). They are so frequently associated that they are known as the “metabolic triad” of endometrial cancer.
Adipose tissue is an endocrine organ. In excess it secretes hormones that may promote cancer growth
Hyperglycemia promotes an environment for cancer cell growth
Insulin resistance promotes cancer growth by promoting IGF-1 (a growth factor). (Metformin has a role here as well)
So, what do we do about it?
Eat well. I always say that a healthy diet begins with a healthy plate. Plant based diets are extremely evidence based, but if you are sticking to a healthy plate, you are on your way!
Move as much as possible! Cardiovascular exercise if at least 150 minutes weekly, plus strength and stretch is recommended.
I tend to believe that if you focus your efforts in these two things, the health follows. (You can also find other tips about decreasing stress through meditation and getting enough sleep in the Wellness tab). If you are having problems after trying these, then discuss with a healthcare professional who can help you further!
