#ThankfulThursdays 8/18/2022

Gratitude is important for wellness–it can improve mood, tolerance to pain, improve blood pressure, improve sleep, reduce inflammation, and the benefits go on. I have devoted Thursdays to publicly showing gratitude, because no matter what is going on in life, if you’re alive, there is something you can give thanks for.

This week, I’m grateful for the quiet time I had to be with my thoughts looking at the view in my hotel room,

the support of friends, some who drove a good distance just to support me, some who shipped flowers just to show how proud they were, many who bought books, and who listen to me and always are there when I need them—I have amazing friends.

For the successes I’ve seen,

for my babies—who often remind me I’m the “best mom ever” (for now at least 😊), for safe travels and the rain that came at the close of my drive, for confirmations, for new beginnings, I give thanks.

What are you grateful for this week?

Healthcare as Selfcare: A Bold Plan for 2021

I have never been a fan of New Year’s Resolutions. Why? Because people tend to come up with these grand plans that they only stick to for 1-2 months and then gloriously fall off the wagon. However, what I do tend to notice is that at the end of each year, I naturally tend to reflect on the year, seeing if I’ve grown as person. Have I improved on the human I was the previous year. How do I want to improve in the next year? I think it’s a natural closing of a chapter.

This year has been like no other in most of our lifetimes–it has brought about a different kind of stress, a different kind of reset. And so, at the end of this year, it does bring about a different kind of reflection.

My friend has given me the honor of being a part of her wellness retreats and speaking on physical health. We began just trying to pick up the pieces that COVID had shattered. Next was a REFOCUS, as we shifted our vision back to those things that could keep us healthy in mind, body and spirit (I, of course, focus on body in my sessions, but fully agree in the whole approach). This time, we REBUILD, as we plan for how we will enter 2021, in a new head space.

I want to caution everyone from thinking that 2021 will be perfect–because we all entered 2020 thinking it had to get better than 2019, and look what we got…lol! So I think the first lesson is to be prepared for ANYTHING, and GRATEFUL in EVERYTHING!

As we prepare to rebuild in whatever 2021 has to offer I want to remind us that healthcare IS selfcare, and if we’re going to achieve it, we must plan for it. Here’s the first steps.

Get Your Mind Right

A few important principles:

Be realistic about your preferences and your lifestyle. If you don’t, you are setting yourself up for failure. If you already wake up at 4:30 for work, you likely aren’t going to get up earlier to do anything. If you don’t eat green foods, you likely aren’t jumping straight into plant-based. Don’t set yourself up for failure. Set small, realistic goals, and celebrate every small win.

You want a schedule, and not a to do list. A to do list tends to make you feel a little like you have a never-ending list of things you didn’t get done, and reinforces a failure mind set.

We have to start by believing that it can happen. “Fake it til you make it.” “Speak it into existance.” “Believe it and you can achieve it.” For me, it all came together when I read the book Psycho-cybernetics and was confronted with science and real world examples of the self-fulfilling prophecies and self-limiting beliefs that everything came together. It made the practice of affirmations make sense. So part of what I want everyone to do is assign an affirmation to each piece of what you plan to accomplish as you move through your plan of self improvement, because whether you believe you will or you won’t, you’re right!

Remember, imperfection is okay, giving up is not. Plan for imperfection. Know that you will not be perfect, and there will be moments you’re going to have to pick yourself up from falling off the proverbial wagon or horse or whatever. Plan to fall AND GET UP EVERY TIME.

Rest

I always start here because if you aren’t resting well, nothing else in your life will go well. You must get enough sleep (7-9 hours nightly for adults) in order for good mental clarity. However, it also regulates weight, blood pressure, blood sugar, appetite, cardiovascular health….you get it, it regulates a great deal. You need sleep. Additionally, you need other types of rest: meditation, mindfulness, and play. Don’t forget that we are not designed to be on all the times. Studies show that we are more productive and healthier when we incorporate the right types of rest into our lifestyle.

Rest Plan

Example: Set your reminder on your phone for when your evening ritual should begin. Commit to having this relaxing time and going to bed at a relatively regular time.

Exercise

Exercise is beneficial for so many things. It helps control weight, improve cardiovascular health, decrease joint pains, strengthen muscles, improve cognitive function, control depression and anxiety, strengthen our immune system–again, I can go on and on. I like to think of exercise as the fountain of youth. If you don’t have an exercise plan, this should be high on your priority list. Jogging as little as 7 minutes daily can make a difference in cardiovascular health, and 150 minutes of moderate intensity cardiovascular exercise weekly is what is considered an active lifestyle (75 minutes of high intensity)–that’s just 30 minutes daily. Truly, being sedentary is one of the greatest risk factors for an early death, and we are all doing much more sitting with working from home, zoom meetings, etc.

Exercise Plan

Examples: 1. Commit to walking 30 minutes daily during a meeting that can be off camera. 2. Commit to waking 30 minutes earlier to zoom a zumba class. 3. Commit to walking 10 minutes on breaks three times a day. *Hint* You can multitask and watch videos for a class, watch taped shows, or be in a meeting while being on a treadmill, bike or elliptical

Feeding our Bodies Well

The old adage says “You are what you eat” and it’s proving more and more to be true. I like to say, “You get out what you put in,” and I think of food as the ultimate medicine. It’s so important to choose foods well, because our diet plays an important role in our over all health. Your choice of diet should really depend on your personal risk factors and natural tendencies, but generally sticking to a healthy plate won’t steer you wrong, and I like to teach this often. When you are picking which diet you’d like to go with, please remember that it’s important to consider your preferences, your lifestyle–be realistic, because consistence is key. The important think is that plants are your friend, whole foods are your friend, and it’s important to watch your portions. To learn more about the individual diets, select the links: Plant-based, Keto, Intermittent fasting, Mediterranean

Food Plan

Examples: 1. Have a grocery day and a cooking day *Hint* It only takes about 30 extra minutes to cook several sides and prep proteins for the week. 2. Commit and budget to purchase meal prep. 3. Consider grocery delivery if not already participating.

stay One Step Ahead

We have to stay one step ahead of our health by being on top of our screenings preventative health. This means going to our doctor’s visits, knowing what our numbers (cholesterol, blood sugars, blood pressures, BMIs) look like, and having a long term plan for our health. We need to make sure we are on top of screenings such as colon cancer screening, cervical cancer screening, breast cancer screening, osteoporosis screening, and cardiovascular screening, lung cancer screening and prostate cancer screening (age, gender, and risk specific). We also need to get our eye and dental exams. Don’t let these things fall to the back burner–prevention is care–I have saved lives through early detection.

Prevention Plan

Example: 1. Look at your schedule now to begin booking your healthcare appointments and scheduling that time. 2. Budget for the money you may have to spend on additional tests. Healthcare unfortunately does cost money in the United States.

Chronic Illness Control

This year has really thrown us for a loop, and it may be time to refocus on getting some chronic illnesses under control. The things above are important factors in controlling chronic illness, but if you have hypertension (high blood pressure), it’s also important that you be monitoring those numbers. If you have diabetes (high blood sugars), you need to be checking these numbers as well. It’s important that you have the supplies needed and that you make the time to monitor your health status. It’s also important that you take the time to make sure you are taking any prescribed medications that help keep your chronic illness in check. With my migraines, I have a few pharmaceuticals that help me manage my headaches–one is daily, one is monthly, and one I have to go in for quarterly to for injections. I will confess, I struggled for while with that daily medication–but I had to come up with some schedule to help me remember to get it in. I also have to make sure I make my quarterly appointments–and not just that–my weekly to biweekly physical therapy appointments, and as much as I hate working that into my schedule, it must be done. Make sure you are planning ahead and making the time to take care of your health.

Chronic Illness Control Plan

Example: 1. Attach taking your medications to an action that you do daily. Don’t do it until you’ve taken your medication. 2. Commit to taking your health measurements whatever prescribed frequency. Come up with a similar adherence plan.

US

Remember: this whole thing has been about us being on the schedule–us being a priority on our list. Don’t let the excuse for not accomplishing the above be because you were too busy doing something for the other people (husband, kids, employer) on your list. You are important. You matter. You are first on the list. Make it happen.

So remember, you need to book you me time. Sit with a work calendar and pick some days or afternoons off in advance–plan for those preventative care visits. Plan for your rest time. Plan for your exercise. You deserve it.

Example Affirmations

  1. My body is a temple and deserves proper maintenance and care.
  2. I prioritize rest and my health because I am important.
  3. I have presence of mind and choose my response to stress. I eat when I’m hungry–not emotional, and stop when I’m satisfied.

I invite you to share some of yours that you will use to help you on your journey to better health in the coming year!

Meditation

There are many types of meditation, but mindfulness meditation is the type that has been most studied in scientific literature.

I was first introduced to the concept in college, and I wasn’t a fan. Though I’ve always been incredibly introspective, and thought myself open-minded, I didn’t get it. Meditation first became a tool that was extremely useful for me when I was working in a position that wasn’t suited to my personality, and was driving me a little crazy/depressed. I went through formal mindfulness training at that time that really helped me to survive my last few months in that job.

Now, I use mindfulness and meditation to help me with my migraines. I have become a true believer–through practice–that my migraines must be controlled through a balance of all of the interventions that I have thrown at them: pharmacology (meds), diet, exercise, physical therapy, and mindfulness. If one is out of balance, it doesn’t work.

So what does the literature say?

Well, this 2017 Journal of American Heart Association article, discusses in detail hypertension, insulin resistance, heart disease, and finds that possible benefit on cardiovascular risk although the overall quality and in some cases, quantity of study data is modest. They go on to say that Meditation should be considered as a complementary therapy to help reduce cardiovascular risk for those who are interested in this practice, with the understanding that further research should be pursued.

The mind is a powerful tool, and one I believe should be utilized fully on our wellness journey.

Wellness is…

My happy place

I’ve had this page now for about 10 months, and it’s about wellness. I sat down to try to come up with my definition of wellness, and I realized it was still quite nebulous.

One concept that resonated with me was a concept that I believe I got from one of the books I read in the time before my migraines–its the concept that true self care isn’t bubble baths, facials, massages–I mean, it can include those things, those are nice. True self care is the concept of creating a life from which you don’t need escape.

I also decided to look up some formal definitions of wellness.

UC Davis defines wellness as “an active process of becoming aware of and making choices towards a healthy and fulfilling life…more than being free from illness, it is a dynamic process of change and growth.”

The World Health Organization defines it as “…a state of complete physical, mental and social well-being and not merely the abscence of disease or infirmity.”

The National Wellness Institute defines it as “a conscious, self-directed and evolving process of achieving full potential.”

Where I have always acknowledged that one has to be aware of the mental, physical and spiritual aspects to be completely well, the National Wellness Institute sites 6 dimensions of wellness, and UC Davis has as many as eight: occupational, emotional, spiritual, environmental, financial, physical, social, and intellectual.

It makes me chuckle to have arrived here after all this time–that wellness is a journey, not so much a destination. Something so obvious–something I have seen play out in my life and in my struggles to do this. Something I have seen play out in this blog. It took seeing it written in black and white, by scientific minds to really get it. I feel a little basic…lol.

A thought that is reinforced by this definition: Imperfection is okay, but giving up is not.

Live well, friends.

I *HEART* My Exercise

One of my fave shots of me and bestie1 getting it in.

But I’ve been exercising every day for the past X months, and I still haven’t lost weight…

I can’t tell you how many times I’ve heard that line in my office.

Or the response to the question “What are you doing for exercise?” that for some reason is immediately answered with their weight loss efforts, or how they know they should lose weight.


PEOPLE!! Exercise has lots of benefits—some of them have to do with weight, BUT that’s not all of it.

First, let’s talk about what exercise does for weight. Weight loss is 80% diet, 20% exercise. So, you can expect a small amount of weight loss from exercise if you have been completely sedentary, but don’t expect a great deal. What you can expect is weight stabilization. What we find in patients who have been successful in weight loss and kept that weight off for a substantial amount of time (years) is that they are exercising regularly. In addition, I tell my patients, the exercise is COSMETIC. It’s what’s going to help your body look like you want it to look, regardless of whether the scale changes. But for me, these are all extremely superficial to why I am asking people to exercise. Below are just some of the many reasons I like to encourage my patients to GET MOVING!!

  1. Exercise improves memory and thinking skills.
  2. Exercise improves symptoms of depression and anxiety.
  3. Exercise improves insulin resistance.
  4. Exercise improves blood pressure.

In fact, this infographic highlights many of the benefits, from improving bone health to improving sexual health, including some of the things mentioned above.

My active and youthful octogenarians swear by exercise, and swear it helps keep them youthful, active, and they have less achyness when they are exercising regularly.

I encourage exercise at every age. I prescribe it first for almost every chronic ailment. You will hear me mention it often. And it doesn’t have to be much depending on what benefit you are going for.

I actually recently read this article that cited a study that showed that only 7 minutes of jogging daily can cut your risk of heart attack and stroke nearly in half, and adds to your life. I’m huge on circuit training and HIIT training to maximize your time when it comes to burning fat and building muscle—and these workout generally can provide major results in minimal time. But honestly, I encourage people to move in ways they enjoy, swimming, dancing, biking—whatever makes you happy, and is something you will sustain, is something you should do. If you hate walking on a treadmill—don’t buy one. Stop using the heat of the Houston summer as the reason you don’t work out—it’s hot EVERY SUMMER! Come up with a work around.

MOVE! Not to lose weight either. Just because it’s good for you.

The Giving Tree

I read the article in The New York Times Parenting column and thought it was quite interesting. The Giving Tree was one of my son’s favorite books because he was particularly fond of trees. But I hated this book. And I felt he was too young for me to fully articulate why. The most I said was, “the boy isn’t a very good friend to the tree, and it makes me sad.” He was 4 or 5 at the time.

We don’t read it very often anymore for that reason, but now, I don’t think I’ll mind. This article, entitled “We Need to Talk About ‘The Giving Tree'” has given me some very good discussion points, and quite honestly, they’re good for young and old alike, and it inspired a train of thought PERFECT for my first post on wellness.

In The Giving Tree, a little boy befriends a tree. The tree loves the little boy and gives him whatever he asks, just for the boy to leave for long periods, grow, and return downtrodden, looking for his “friend” to give him something to fix his next problem.

The tree had no healthy boundaries, and gave him whatever he asked, only to be left at the end, with nothing, but a stump to show for this “friendship.”

I saw a parallel in life, right in my office. I have people in front of me all the time, not following their health care regimen, not finding time to eat right, exercise, check their blood sugar or blood pressure because they are taking care of a family member, over too many church ministries, bogged down at work…you name it, I’ve heard it.

My “patient non-adherence” problem is generally filled with a story about how this person has put themselves on the back burner for so many others. NO. BOUNDARIES. It’s what the giving tree did. And she gave until she was only a stump, with nothing left to give, and the boy had everything.

Many times we talk about self-care, we think, spa day, massage, etc. I read this piece a while back that shared my opinion that self-care is so much more and defined true self-care as building a life from which you don’t need escape. That requires excellent skill in setting boundaries.

Here are some wonderful quotes from the article that are great take-aways:

“Self-sacrifice is not sustainable, and it isn’t healthy either. Research shows that people who care about others and neglect themselves are more likely to become anxious and depressed.”

Adam Grant and Allison Sweet Grant

“Generosity is not about sacrificing yourself for others — it’s about helping others without harming yourself. It’s not about giving to takers — it is giving in ways that nurture more givers. It’s not about dropping everything any time someone needs you — it is prioritizing your needs along with theirs.”

–Adam Grant and Allison Sweet Grant

I thought I was very good at boundaries. And I was okay at it, but I’ve learned that for people I really care about, I have a hard time sticking to my guns. I really rely on their respect for me, and that’s a mistake—we must be comfortable with requiring that respect regardless of whether it is offered.

And actually, let’s take it a step further. Not only did this tree give everything, but it asked for nothing. This is where I have the MOST room for growth: asking for, and receiving, help from others. It’s essential to wellness. Not only does it allow others to express love for you, it allows your tank to be filled in ways you truly need but can’t provide yourself. It is also a practice in humility. It strengthens relationships, because, when we’re honest, there’s a bit of power that comes from always being the helper, never the helped. The closeness that comes from the vulnerability of you allowing someone to help you can really strengthen the bond of friendship (I think I learned this from Brene Brown).

But it’s not just me. These same patients, horrible at boundaries, tend to be givers who need to be convinced to accept help from others. Who either have a hard time humbling themselves enough to receive, a hard time realizing their worthy of the very same help they are wasting away giving others—or some combination of the two.

So, in my inaugural wellness blog post, I choose not to necessarily focus on exercise, or healthy eating, or meditation. But to focus on boundaries and vulnerability. Because the balance between these two things are essential to formulating the inner peace that is required to live well, and I always say, true health starts with mental and spiritual health.

P.S. For more information on these topics, I highly recommend Brene Brown, who is the vulnerability guru. See links to her books on amazon below (I am making NO MONEY FROM THIS—I JUST LOVE HER STUFF):

The Gifts of Imperfection

The Power of Vulnerability

Rising Strong

My Responsibility

https://jm-aq.com/wp-content/uploads/2013/10/stop-domestic-violence-logo.png?fbclid=IwAR1Y6SH03oI5U4QIpjKFIJtZZmdPYjJXe-kZhqMkgdo1E1tlGxuZhyAZQPc

October is Domestic Violence Awareness Month. I have a church member-friend-inspiration who has a non-profit organization that is all about Domestic Violence, and last year I had the opportunity to attend the organization’s annual brunch for the first time.

Her Voice is a mentorship program that supports victims of domestic violence in the first 2 years after they leave their abuser, since this is when they are most vulnerable to return to the situation.

My eyes were truly opened, and I realized that as a physician, I felt unprepared to handle this incredibly important topic. Sure, I knew I was supposed to be asking if my patients felt safe in their homes, but what was I supposed to do if they said no? So I’m sad to say hadn’t been doing my part.

I promised myself I was going to do better, in part because Dr. Shana made is very aware that ending Domestic Violence was each of our personal responsibilities. But I’m ashamed to say after a few failed attempts at trying to put a tool kit of resources together, and a few struggles of my own, I let this important topic fall to the back burner.

Well, here we are again, a year later, and I am at this fantastic event again. The transparency was unparalleled as the emcee shared that she, too was a victim of domestic violence and was having to work through some of her feeling surrounding being central in the event.

Dr. Shana defined domestic violence as “a systematic way of destroying a [person] from the inside out.” She also hit us with some very troubling statistics. Every 9 seconds a woman is abused. One out of every 3 women (and one out of every 4 men) will experience domestic violence in their lifetime. And Harris county, the county in which we reside, leads Texas in domestic violence homicides. I actually had to look this up , guys. And what I found troubling is that this has been a pattern since at least 2015—and as she said, this is NOT where you want to be #1.

We later heard from one of Her Voice’s mentors, a domestic violence survivor, who shared her story of survival. Truly touching she shares how she “wanted and needed to be loved.” How she “thought she’d found Mr. Perfect”, and he had a broken past, and “she wanted to help him” but he flipped the script on her. His mom was even in on it, and tried to tell her how she could be have to try to avoid the abuse. It finally ended, but she almost lost her life. As she says, she finally realized that “Love does not hurt you, degrade you, mistreat you, or isolate you.” She is now in a loving relationship, and her husband was there to support her, beaming with pride as she shared her story, a perfect example of the theme of the the event: Shattered, but silent no more.

So the beginnings of a tool kit:

What is Domestic Violence?

Houston Hotlines

713-528-2121—Domestic Violence

Houston Area Women’s Center Shelter

Houston Area Women’s Center Counseling

List of Houston Area Resources

Also, I don’t want to forget to tell my Houston area people that there is a concert hosted by Men Against Domestic Violence later this month. For more information click here.

 Domestic Violence is a silent killer. 1 in 3 women, guys. That means if you don’t know anyone, it’s just because she hasn’t told you. So if you’re worried about your friend, ask some questions, without judgment. Let her know you’re there for her. Share some resources.

Whose responsibility is it to stop domestic violence?

MINE!!

Plant-Based Diets

If we’re looking at diets that cut one particular type of food, plant-based diets may just have the most data to support its benefit to health. I do find that people, for some reason, are the most resistant to this thought, but it could have something to do with the fact that I’m located in the great and interesting state of TEXAS!

Truth is, Americans eat WAY more than their share of protein, and we really don’t need animal protein to meet this requirement if we eat a wide variety of plants to fill this need. You do have to do your research and make sure that you get all your essential amino acids daily, and generally will need to supplement with vitamin B12 since we do get the bulk of this from animal products.

Plant based diets tout benefits such as reducing risk of cardiovascular disease and cholesterol, reducing insulin resistance, and reducing body weight, in addition to other health benefits including reduction in some gastrointestinal cancers. I will likely go further into some of the benefits in later blogs, but we’ll stop here as an introduction.

Physicians Committee for Responsible Medicine is an organization that is passionate about plant based diets. Please find some of their excellent links below to get you started if you are interested in this lifestyle!

A 21 Day Quickstart Program

More guidance on Nutrition

A Vegan Starter Kit

Recipes

Vegan for Atheletes

Vegan in Pregnancy

Nutrition for Kids

(Update 1/5/2020: Houston Vegan Chef with Great Food)

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