rx4living

Hello! It’s been a while since I have posted. My apologies, I have been suffering from imposter syndrome. Here's the back story: I often tell my patients, especially my weight loss ones, that if you fail to plan, you plan to fail. And for the last two years, I have failed to plan. All my life I have set goals and reached them by planning….. need to ace an exam? plan my study sessions, unexpected expenses? plan the repayment, want to go to medical school when you majored in English? plan your personal post-bac strategy. My confidence as well as success in achieving my goals, started to falter as my family planning ran into major roadblocks, but really started to unravel during pregnancy with my youngest son. He had a rocky start from day 1 when my bHCG levels didn't meet goals and my self-preservation plan with another predicted fetal loss was that I stopped planning on expecting a live child as the end result. I started living in the moment, letting life happen to me, including an emergency delivery and NICU stay. Totally unprepared to have a live child, especially at 28 weeks, I rallied and was able to focus on short-term goals of getting him home, financial recovery (since I had not planned a maternity leave), helping him meet his milestones, etc., but I was still faltering in my planning capacity. Then my mom almost died from flu and I rallied a plan for convincing her to get appropriate medical care and she lived, then COVID-19 happened and I rallied as part of multiple efforts to help save the world, but then in early 2021, I stopped even rallying. To be honest, I could barely stay awake and go to work, but I brushed it off to anxiety and pandemic life, busy working mom life, not taking enough vacation, burnout, etc. Then my husband almost died due to a complex aortic dissection. I rallied yet again -- didn't sleep for days between visiting him in the hospital, taking care of my family and keeping up my regular work schedule -- but a week later, I went into shock due to profound anemia and accompanying lack of iron.
What is the point of this somewhat sad story and series of unfortunate events?

The point is that I could not figure out a way out of my new pattern of thinking, climb out of grief for what I had lost and build hope again. Life was still happening as I went through treatment and recovered, my children grew, I started two new jobs all the while helping my husband navigate his new life fraught with setbacks and limitations. But I was unable to rally for myself and plan how to reach my goal, as much as I wanted it to happen. And to be frank, quite a complex goal. The life that I once recognized with fondness and pride in what I had planned and worked towards had been replaced by a painful uncertainty with little that was predictable or foreseen. Time was passing and my cyclical thinking of "what's the point?" -- as I kept a side eye out for the next disaster to hit me -- kept rounding the corner. With a new year and a birthday in January, the time was ripe to apply something I say almost every day in work and at home -- a plan can be simple or a small change, but the important part is consistency and accountability to make it happen, thus creating big changes.

Every day, I planned to focus on completing one task, ideally a very discrete yet proactive choice (e.g. planting bulbs, completing a set of pushups, etc.). I posted on social media for the first 28 days to hold myself accountable; for it takes about 28 days to set a pattern, 100 days to make it a habit, and another several months to have the habit stick and feel natural. So today, being the 100th day of the year, my self- assigned task was to write about my own journey to start planning again. Has it felt natural? Not always, but it is getting easier. Have I set a 6 month plan or set a long-term goal yet? Nope. But it is a start: I now have pretty flowers and am able to do 100 pushups as well as 100 choices that have broken my cycle of passivity. What do you want to change in your life? Start to gain traction by setting small and specific tasks, but be consistent and accountable to yourself. You will start to see bigger changes and reach your goal.

Data has shown again and again that doctors who have an understanding of lifestyle medicine and make it part of their own lives are more successful at motivating their patients to change. It has also been said that the best physicians take care of their own health first and not just tell others what to do. This month has been just that for me.

Many of my patients ask me to tell them how to be healthy — often with that wishful light in their eyes that I will pull my unicorn wand out and make it happen by the end of our meeting. Good health is such a complex issue that I try to break it down into things we have to acknowledge and accommodate because we cannot change them and those things we can change by the choices we make, which I help them form.

I don’t like being the patient or getting tests done, but a little knowledge goes a long way when it comes to assessing risk. Here I am pictured in front a CT scanner for my recent coronary artery calcium score assessment. This is not a routine test (not covered by insurance, unfortunately) but after discussion with my own physician, we made a shared decision about the best way to evaluate my risk of heart attack, stroke or death from heart disease. This test is considered the best measure — comparing risks and benefits as well as cost (only $99!) — of the extent of asymptomatic heart disease for adults at risk.

I can’t change my age or gender or family history or my past medical history but I can make the best choices for me today with the right knowledge. Knowledge of risk and what to do about that is the key to health but remember it is still a tool not a destiny.