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How to jump-start a new healthy habit

I did not have the ideal workout space during my recent trip to Costa Rica, but I have promised myself to exercise every morning, no matter what. I'm proud that I made it happen.

I'm honored that this article has been published on BookTrib. Please see this linke to read the article. https://booktrib.com/2018/10/how-to-jump-start-a-new-healthy-habit/  I'd welcome any comments below. What are your suggestions on the best ways to start a new health habit?

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Admitting Defeat, and Moving On

Biking over the Brooklyn Bridge with Don

I am finally admitting defeat. My foot pain, stemming from self-diagnosed plantar fasciitis, is not going to just "go away" on its own. I've been mostly ignoring it for over seven months. I ran all winter and spring, dutifully taking Naprosyn after my runs and stretching briefly but otherwise brushing it aside. I ran a half-marathon in January and kept up with eight-to-ten-mile long runs on weekends. Now I have to stop.

 

I usually try to practice what I preach as a physician. I embrace a healthy lifestyle, including daily exercise. I'm an ideal MS patient too. I take my medication regularly, and I never miss a test, a doctor's visit, or an infusion.

 

But cutting back my mileage on runs to appease my sore foot has felt wimpy, even as I limped around the rest of the day.

 

Now I've resolved to change. I am officially taking a break from running and getting serious about healing this injury. I'm going to be a good patient.

 

The timing is not quite coincidental. With Austin's high humidity and LOW temperatures in the mid- to-upper 70s, summer runs are usually pretty miserable. Still, the lake beckons, my dog gets antsy, and we have to hit the trail. Just not this summer.

 

I have to be adaptable – not my strongest skill. In doing so, I will search for the unexpected benefits, the silver lining.

 

I found one already during our recent trip to New York City. After a long stroll on the first day, through Central Park and the Upper East Side, I realized that my foot would not permit another day of endless walking. I was disappointed: unrestricted wandering is my preferred activity on most vacations.

 

But our Plan B was even better. Don and I discovered CitiBikeNYC. For $13 each, we bought day passes for unlimited 30-minute bike rentals from any of the hundreds of CitiBike docking stations scattered around the city. We biked through lower Manhattan, over the Brooklyn Bridge (where the bike lanes were much less crowded than the walking lanes), and made our way to Brooklyn Heights, a part of New York City we had never visited. Throughout the day, we alternated biking and walking, logging roughly 12 miles on the bike and much less on foot. We saw far more than we would have without the bikes, and though my feet were still aching at the end of the day, I know the bikes reduced my discomfort.

 

These last few days, my feet got a real break with my return to work. I am creating a physical therapy plan for myself, and I have revised my daily exercise plan to avoid running or walking. Now I go to spin class, do a 21-minute circuit work-out,  hop on the trusty Stairmaster, or swim at Deep Eddy Pool.

 

I had dinner last night with Jess – my most consistent and much-loved running partner – and her family. It didn't quite replace our therapeutic talks on long runs together, but it was wonderful nonetheless (with the distinct advantage of Jess's terrific cooking and cherry pie for dessert).  I just wish I had a treadmill for the dog…

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Self Care: Part 2

This Mother's Day, I got back on my bike for the first time since the MS150 for a morning ride my mom and daughter.

A trip with my 10-year-old, Clara, to Laguna Gloria Art Museum to make robots for Family Day; a stop by the community garden to pick carrots; dinner at a favorite neighborhood restaurant; a good movie with Don; and a morning Mother's Day bike right with my 13-year-old, Ella, and my mom have resulted in a pretty ideal weekend. Busy, but not overly so. Productive, but fun. Quality time with many of my favorite people. Now I'm ready for my afternoon Texas Physicians for Social Responsibility board meeting and a low-key family dinner. 

 

This all ties into self-care, and below is Part 2 of my blog about my recommendations and personal self-care strategy. These questions came from a reporter who was writing an article for the New York Times. She did not end up using my answers, but I wanted to share them anyway, in case they are helpful.

 

What dietary behaviors do you believe protect your health – do you practice what you preach to your patients?

I feel strongly that I can't advocate for good health habits effectively if I don't follow them myself. I am a long-time vegetarian except I occasionally eat fish. I also am one of few Americans who actually eat more than five servings a day of fruits and veggies. Having MS has made me even more careful with my diet. I also try to set a good example for my kids, though it's led to few heated discussions about why I won't buy them Doritos.

What do you advise patients to do?

I tell patients that there is no magic to a healthy diet or to weight loss, which is often the goal. To lose weight, cut calories and exercise. For everyone, I suggest avoiding sugar-sweetened beverages, making sure that each meal contains at least one serving of fruits and/or vegetables (aiming for at least five servings a day – and even more is better), and avoiding fried and highly-processed foods. Keeping salt intake to a minimum (less than two teaspoons) is another good rule of thumb. Limiting alcohol, too, is important.

Do you take vitamins or supplements?

I don't take vitamins or supplements, except for calcium (for bone health) and vitamin D (only because I have MS). Evidence supporting most vitamins and supplements is pretty poor for those with a well-balanced diet. 

What about exercise?

I'm obsessed with exercise. I started exercising nearly every day over twenty years ago as a medical student. Exercise in my stress-reliever, my antidepressant, and helps prevent anxiety. I run or do another aerobic activity every morning just after I get up. I think exercise if the most important thing I do for my health – by far.

What are your thoughts about elective medical procedures - eg.back surgery, knee/hip/shoulder replacements?
I really try to practice evidence-based medicine. Some procedures – such as knee surgery for meniscal tears – have not been shown to be better than nonsurgical care. I do not advocate these procedures that only add to soaring health care costs and subject patients to unnecessary risks.


Tell me your thoughts about incidentalomas?

Incidentalomas are extremely common and are one driver behind escalating health care costs. Patients – and even some health care providers – often think that more screening, more testing is better. The problem, of course, is that we find things we aren't expecting, that often will never become a problem, but also can't – with 100% certainty – be safely ignored. I experienced a scare years ago as a patient when my doctor thought she detected an ovarian mass on a bimanual pelvic exam (a type of exam that is no longer recommended by many authorities in those without symptoms). I ended up needing an uncomfortable pelvic ultrasound – to the tune of hundreds of dollars and significant personal anxiety – to prove that it was nothing.


Do you watch your weight?

Yes. I have been fortunate that I've always had a healthy weight, and I've never been on a diet (except for a couple weird ones that I tried to alleviate MS symptoms), but I still work to maintain my weight through healthy nutritional choices and daily exercise. I keep a scale in my closet and check my weight regularly.

What do you do in general to keep healthy?

I strive for a healthy diet, daily exercise, daily (short) meditation, and seven to eight hours of sleep each night – usually I can do this!

What do you think are the most important things people can do?

Exercise and a healthy diet are more important than any pills or tests that a doctor can offer. However, people can still get sick (I got MS!). Having a trusted physician who can help when symptoms develop and getting screening tests and immunizations as recommended are critical as well.  

What are your hopes for medical care in the future?

I hope that as a society we can take steps to better support healthy habits and to offer truly universal, affordable health care.

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