physician, heal thyself

i have to do some sort of project for my community rotation. this may sound like a big deal, but it’s not — the project can be anything from designing a handout about some aspect of pediatric care to give to patients, or figuring out a small-scale way to make the clinic run just a tiny bit smoother. while i was ellipticating yesterday, i came up with a fun idea: healthy lifestyles for residents!

as i mentioned before, healthy lifestyles is our program for overweight kids and teens designed to enable them to change some bad habits and gain a sense of empowerment, helping them to avoid eventual diabetes, hypertension, high cholesterol, and other health problems. during this nice relaxed month, i’ve gotten to work in this clinic a few times already. i think it’s a good program and i’ve enjoyed my time there thus far, although there the data on efficacy is still being collected.

look, there’s even a commercial!

i’d love to say that we (the residents) are always 100% compassionate and empathetic to these patients and their families, but i have to admit that sometimes it’s more natural to look at the most obese children and think, “omg, just STOP going to golden corral!!”. like it or not, we may place negative value judgments on their choices (supersizing at mcdonalds, drinking large amounts of mountain dew, plopping the little ones in front of the tv) without considering the family’s background and health education level, economic circumstances, or time constraints.

we also sometimes give our patients guidelines to follow and act like it’s easy. obviously, judging from the continually worsening pediatric obesity epidemic, it’s not! the healthy lifestyles program emphasizes making changes just a little at a time, and i am learning to appreciate that this is the way to go rather than to overload your patient (and parents) with a prescription for an instant life overhaul. we do let them know what the ultimate goals are — but still have them pick just one or two minor issues to work on before each successive visit.

5-3-2-1-almost none is the mnemonic we use for healthy lifestyle guidelines for kids:

all of these tenets have research to back them up showing that kids who follow them are healthier. it sounds fairly simple. but i have heard residents often make off-handed comments that their lifestyles don’t even come close to this ideal! i think that it would be a really valuable experience for us to try meeting these guidelines at least for a month, so that we might gain some empathy for our patients. as a bonus, each resident would likely learn some healthy tips from our own experiences about fitting in activity when busy that we could pass on to families.

so, i’m designing a community challenge for residents, designed to be completed during this (cushy) rotation! i think that most of us will like getting the chance to take a step back and think about our own health (for a change). i am going to base it on following the above guidelines, but also add some other challenges (calculating sodium and saturated fat intake for a day, maybe, or looking at stress-management/relaxation time). any ideas would be welcome!

as for me — to be honest, i already meet most of these guidelines, although i do take rest days sometimes (with no activity) and i know that i sometimes exceed screen time of 2 hours when i count minutes spent on my precious macbook! but i’ll work on meeting these for the rest of the month, and report back, of course.

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4.1.09

workout: 36 minutes (4 ‘miles’) on the elliptical at levels 10-12, then level 2 of the 30-day shred. i am sore today! i’m not sure it was that much harder than level 1, but it worked difference muscles. some of the plank and jumping exercises are really just plyometrics in disguise, which i think is great — plyo workouts are really supposed to be beneficial for running!

doin’ time: no cooking — as mentioned yesterday, i went out to tonali in durham. i had a yummy glass of white rioja, but i’d give my meal about a B or B+. i started with a soup that was described as ‘chicken with fresh local vegetables’ and was surprised to be served a cream-based light green soup with just a bit of chicken in it and no vegetable chunks. it was good, but just not what i had been craving. i then had cactus soft tacos with queso fresca — and i think that as much as i want to like cactus, i am just not a huge fan. on the plus side, they were very light (with minimal cheese) and summery-tasting, but the tortillas seemed a little rubbery and it just wasn’t that satisfying. i would go back again at least once to try some other dishes (my interest was piqued by a mexican paella dish) but i wouldn’t call it a favorite. service was good and attentive although my server didn’t quite speak enough english to answer any questions.