Monday, May 25, 2009
When we talk about healthy living, choosing foods or actions that serve us well often means that we are faced with making a life change that to give up a habit for a new choice or behavior. Do we go from smoking two packs a day to being a non-smoker just because we think we should? When faced with diabetes how many people do you know who walked easily away from eating sweets to follow the recommended diet? Granted, fear or iron self-discipline can serve people in making big changes, but most often humans go through a pretty predictable process. Maybe you’re like me in that when you have some understanding of WHY you may react as you do, it can make it easier to be kind to self and make different choices. Try this out.
Notice this is not a one time event or a single decision made, but a PROCESS which means as many times as is needed over time to make a true change in habit. Researchers call this Transtheoretical Model or Stages of Change.
FORMAL NAME //SIMPLE NAME
Precontemplation // Unaware, Unwilling
PRECONTEMPLATION describes any of us prior to awareness that what we’re doing may not be a very good choice for us. Example: “I eat all my food fried –what’s the big deal about that? I like it that way and it’s how Mom fixed meals.”
FORMAL NAME //SIMPLE NAME
Contemplation //Listen, consider, inform self
CONTEMPLATION comes when the fried food lover finds out his older brother has had a heart attack and almost died. He hears that eating fried foods can contribute to heart problems, but hey, it’s not HIM who had the heart trouble – it’s his brother. “ Couldn’t happen to me!” Stage two is when our fellow finds out his own cholesterol levels are sky high - a major risk factor for heart attack. NOW he’s more willing to listen to all this talk about diet…he’ll think about it. Can’t hurt to find out what he could do instead.
FORMAL NAME //SIMPLE NAME
Preparation // Making a plan, letting go, grieving the changes
PREPARATION to change a habit includes things like wondering “CAN I change? Do I have what it takes to do something so challenging?” Or “Who can help me – take a cooking class or date that cute little gal who’s such a health freak! She’ll cook for me and show me how.” Selling the deep fryer, getting olive oil to replace the corn oil…grieving the changes, feeling mad that you ‘have to,’ realizing you’re kind of scared and don’t really want to die in your 40’s.
FORMAL NAME //SIMPLE NAME
Action //Starting again, taking small experimental steps
ACTION – making behavior changes, repeated choices to enact the new behavior, wrestle with the longings for the habitual, “Hey! I like baked fish!”
FORMAL NAME //SIMPLE NAME
MAINTENANCE includes staying with the new program to make better choices and can include “slips” when you backslide, ie eating Fish and Chips but not every meal. Slips always are followed by a choice to begin again or to give up, but hopefully there is internal motivation and outward support to keep going.
QUESTIONS FOR YOU……
1. What is it you know in your heart that you do (or not do), right now, that is not good for you?
2. What do you like most about your unhealthy choice?
3. What do you like less well about it?
4. What stage listed above are you in if you were to consider making a change in behavior?
5. What’s one tiny little step you might be willing to take to turn around this habitual action or lack of action?
If you’re contemplating a change in your life style behaviors, you’ll notice that part of that phase is “making a plan.” Most human beings I know and love are fallible, ie they make mistakes, back-slide, and have slips in their new behaviors. Planning can help you to identify who in your world would be supportive of you in making a plan to change how you live. Consider someone from inside your family, friends who may be more objective, adults or “grandparent” types who will respect and nurture you as you tackle the hard stuff, and maybe even young people who have unfailing confidence in you. Getting a number of those folks alerted to become your “pit crew” can make a huge difference in succeeding with your plan for change. Trust me, none of us needs more failure!
Another suggestion is to connect with a health professional who can be your health coach during change process. Ask Nurse Deb! Leave me a comment here if you’d like to arrange for private conversation via phone or email, and see my web page for details of how this process can work for you. http://www.asknursedeb.com/
Sunday, May 24, 2009
Tibetan Medicine and Indian Ayurveda tell us that "food is our first medicine." It implies that food choices can soothe what ails you, or by eating what is in harmony with your body type, you can maintain your good health and skip altogether the experience of getting sick. Perenial wisdom of the 80's assured us "You are what you eat." Feed lot fattened beef filled with chemicals? Chickens so top heavy they cannot walk even if they had room to try? I would suggest that our culture of fast foods, highly processed foods, and allegedly 'fresh' produce that travels >1,500 miles to reach us is not exactly what makes for healthy strong bodies. Small wonder diabetes and immune dysfunction are skyrocketing - we've forgotten what life giving food looks and tastes like and are losing the tribal knowledge of how to prepare food from scratch! (Definition: 'Scratch' means having meat or other protein source, veggies, carbohydrate, beverage, perhaps fruit or desert that you put together and cook to create a meal - not thawing or heating up a pre-packaged item or warming soup from a can!)
How many young people launching into adulthood know how to cook for themselves? Unfortunately that issue is not new to this generation - how many middle aged to elder men know how to cook for themselves? A family tale tells of a young woman whose mother wouldn't allow her to enter "her" kitchen, and upon her marriage in the 1940's, the young couple survived on BLT's until the husband couldn't bear it any longer and offered to teach his bride a few more meal menus. How many times a week do you or someone in your household cook a meal from scratch?
GARDENING & FARMING?
How many people know about gardening? How many people know how to raise a food animal and care for its needs now that family farms have been consumed by agribusiness? I read a disturbing report last year about a survey of both urban and rural students who were asked to identify where common foods come from, answering questions like "Do beans grow on trees, plants, or are they part of a root?" "Does bacon come from a plant or animal source?" Respondants didn't do so well...I guess our young people believe that beans come in cans or frozen in plastic bags from the grocery store and never think more about it. That is, if they eat green things at all! I cringe remembering how my son would assert that "Vegetables are what FOOD (ie cows, chickens, deer etc) eat!" even though he was raised eating salads and fresh veggies from our garden. I'm not sure I want to know what his dinners look like in his bachelor pad.
In my grandparents' generation, gardening and home canning of food to last through the winter was a way of life. The whole family participated from little kids to elders. Victory gardens sprouted in urban yards in response to World War II's food shortages. We began to lose our knowing as refrigeration, transportation and manufacturing boomed and made available to us food from all over the country and now, from all over the globe. But despair not - organic farmers teaching us about healthy soil and are showing us the delightful outcome of preparing food without the petro-chemicals of fertilizers, herbicides and pesticides. Farmers' Markets are thriving and popping up in many communities to provide life-filled, truly fresh produce. We have universities teaching adult learners to be Master Gardeners as we realize just how wonderful a process it is to produce flavorful food from our healthy soil, sunshine, fresh water, seeds, and sweat.
Author Barbara Kingsolver and her family have gifted the world a wonderful book, Animal, Vegetable, Miracle: A Year of Food Life that chronicles their year of exploration of what it means to "eat local" - food that has been produced within 100 miles of their home, and to eat in harmony with the season, foregoing summer fruit from South America in the dark of winter here in the states. The book includes recipes, political and social commentary, web resources, and helpful informational "how to" for things like making your own cheese, mingled with narrative of the successes, frustrations, challenges and satisfaction that accompanied this family's growth. There is also a web site on which people from all over the globe have contributed stories and ideas for furthering the work begun in Animal, Vegetable, Miracle...a down-loadable index to the book's topics and resources, updates and photos. It is an inspiring site to browse! My hunch is that this book will either scare you into finding the nearest Big Mac super-sized meal to hide from the truths told, or it will inspire you to never look at food in quite the same way again. It may even become part of your personal eating evolution! Enjoy, and let me know what you think about all this new/old information and ways of living. May our food be our medicine and may we be healthy and happy!
Tuesday, May 19, 2009
I had never dreamed I would have this experience - and I am so very grateful. I hold the presence of the current class who left for India on Sunday, in my heart and thoughts, wishing them a life-altering experience on their adventure. Enjoy a photo of the Tibetan flag flying over the institute.
In the quest for personal wellness and health, this dog-run program has identified some basic yet essential components of what ensures healthy happy living - exercise, play, good company, time spent outdoors in nature, regularly scheduled mealtimes and adequate restlful sleep. (I am grateful they leave the cooking to us however as I don't think our interpretation of what is a gastronomic delicacy has much in common. )
Here are some questions for you to ponder:
- Who paces YOUR day if you don't have doggy trainers?
- How often are you skipping meals because you're too busy?
- When's the last time you cooked a meal and ate it with your family or housemates?
- How well are you sleeping and do you wake feeling refreshed and rested?
In the next few blog posts, I will comment about ideas for healthy living choices and invite readers to challenge my assertions, be challenged in turn to 'own' the ways they may fall into not so healthy habits, and offer up hard learned suggestions to readers of this thread. I'll also give you something to chew on that describes how we humans dance around with the notion of change, and changing our behaviors.
My doggy health coaches have just rushed in from tussling outside followed by a quick dip in the pond, wagging their soggy tails and smiling widely! When's the last time I felt that kind of exuberant delight with my life? When's the last time I skinny dipped in the neighbor's pond?!
The two of them have taken up positions on the floor recognizing that "She's doing that computer thing again..." followed by deep contented sighs. As I think about it, dogs are pretty adept at patience and quiet meditative 'being-ness' too. Pretty masterful companionship, isn't it?
Thursday, May 14, 2009
Clear, effective communicating is not done easily when one is a patient in a busy clinic setting or when you feel awful and are an in-patient of the local hospital. The following have been noted to contribute to physician/client communication glitches:
- Being undressed ( a bare foot doesn't compare to the GYN exam outfit!)
- Sitting either above or below the physician
- Competing with the computer for the doctor's eye contact and attention
- 15 minute appointment allocations
- Fear about diagnosis (the patient or the doc's distress or both...)
- Stress (I'm late, you've waited a long time, I have someone in the ER that needs me...)
- Topics I don't want to hear or talk about (sex, impotence, mental illness, addiction, etc)
As a client you are pretty powerless to change how your doc is feeling about his/her day, but asking for the first appointment of the morning or afternoon can be one way to find your doc on time and refreshed from a good night's sleep or lunch break - theoretically. (Keep in mind that emergencies have no respect for either sleep or meals so your doc may have slept little or "lunched" with a bag of peanuts thrown down his throat in the elevator.) However, there are things YOU can do for yourself to increase the odds of holding up your end of the communication skills.
- Don't ever go to an appointment alone. The buddy system works well - two sets of ears and two brains can be a bonus. (Keep in mind this person needs to be trusted with your personal medical information and identified in the doc's records as a trusted insider.)
- Talk with your buddy before the visit to fill them in on your concerns, what you want to accomplish in the visit with the doctor, and get their ideas.
- MAKE A LIST of questions you'd like addressed, or of symptoms or changes in your well-being. Prioritize what is most important as you may not get all the way through your list.
- When possible, put your clothes back on and sit in a chair facing your doc at eye level for the "talking" part of your visit. It evens the power.
- Ask your visit buddy to write notes during the visit, or use a tape recorder to track lab data, instructions for medicine changes, words you need to look up later.
- If you know ahead of time that you have many questions or will need time to talk about treatment choices, ask the scheduling person to make it a 30 minute appointment. If you need time to absorb a diagnosis before making a treatment choice, schedule a return visit in a few days. Go home and process, talk it over, feel, react, breathe deeply.
- Consider expressing what you appreciate about the visit with your doc - gratitude is a powerful shifter of moods and enlists your provider in appreciating YOU!
- When you are an in-patient, find out when your doc will likely make 'rounds' so your buddy can be present and advocate for your needs. Be sure to share with this buddy your concerns, questions, changing physical status so they can speak in an informed way if you are unable to speak for yourself. Consider making a copy of your "today notes" and give it to your nurses - they often can advocate/facilitate order changes far more quickly than waiting for a doc to arrive.
Finally, know that we are all imperfect humans living in an often challenging and scary world. There is plenty of room for forgiving foibles, finding humor to lighten instense times, and recognizing we're all doing our best. It may seem evident that your doc is far from a god and oh, so human......but maybe we're all God and just don't remember. So let's practice, shall we?