Monday, February 18, 2013

"From a fellow physician that needs your advice"

I just want to say that I am appreciative of all of my readers and hopeful that you are finding All Is Well That Eats Well a helpful and informative resource for healthy living.  I receive emails from many of you and although I am very busy seeing patients and with various projects, reading through your letters is one of the highlights of my week.  Below, you will find one email in particular from one of my readers.  I feel that her concerns are shared by many of you with busy, fast-paced and often stressful lifestyles and I wanted to share our correspondence.

Dear Dr. Amirnazmi,

My name is Sabrina Q.  I'm a third year Internal Medicine Resident in Michigan and I have been following your Facebook page for the last few months.  I really enjoy reading your articles and love the various food recipes you post.  You inspire me to make delicious and healthy meals.  After your current post "Why Doctors Need Training in Nutrition"  I really thought hard about my current situation.  This article really resonated with me because it described everything that I go through on a daily basis, especially since I am the senior resident in the ICU this month.  Since starting residency, I have gained 50 lbs.  I can't fit into my nice clothes, I don't look like how I use to, I am chronically tired (I am sure you know all about that), my exercise endurance has decreased. I could go on.  I need help. I just don't know where to start and how.  I want to go back to the old me. I'm more grouchy, I fight with staff and other residents.  And I know no one deserves that. The one good thing is that I am going to be a Rheumatology Fellow next year so I know my schedule will improve but where do I begin.  If you have the time, I would really appreciate some heartfelt advice.

Thank you,

Dear Sabrina,

Thank you for your letter.  First of all, you shouldn't be so hard on yourself.  Residency is the most challenging part of medical training both professionally and personally.  Maintaining a healthy equilibrium in our lives is hard enough on its own...add to that the stressors of residency with erratic sleep and eating schedules, the stress associated with the responsibility of caring for the lives of others and having little to no time to de-stress via meditation and exercise and it's infinitesimally more challenging to strike that healthy balance in your life.  I remember what it was like to be in residency- often times there wasn't even a chance to use the bathroom!  The exhaustion and stress is no doubt unhealthy and very ironic since we as health care providers are supposed to be models of health.  That being said there are simple things you can do to take a step in the right direction and put you on the path to a healthier lifestyle even while under all the duress of residency.

1.       Stairs over elevator

        I remember during residency although I was on my feet what seemed to be virtually all day, admitting patients, rounding on them, doing blood draws, counseling patients or discharging patients, lots of these activities don’t involve too much cardiovascular stress…other than perhaps running to a code blue which hopefully isn’t too often.  Making the decision to use the stairs, both down AND up, is a small step that can lead to huge results.  It’s a great workout that you don’t actually need to set aside time for…it just works its way into your daily routine, exactly the convenience you need during residency!  That being said, I highly recommend setting aside 30 minutes on 3 days of the week (post-call days or routine days when you can actually get home by say 6 pm) to get your heart rate moving and break a sweat.  It doesn’t have to be complicated either.  Pick something you actually enjoy doing- power walking with a friend or to some good tunes, your favorite zumba or pilates video, a class at the gym or even blasting your favorite playlist in your apartment/home and dancing around.  Anything to get your body moving! 

2.       Eat Breakfast

        Lots of residents skip breakfast either because they “don’t have time” or because “it’s too difficult” or because they somehow think they are eating so much unhealthy food during the day that this deprivation will result in some sort of weight loss or at least not as much weight gain.  Instead, with some planning, why not eat healthier all day long AND enjoy a simple breakfast at the same time.  Eating a well-balanced breakfast boosts metabolism, preventing fat deposition.  Again, this doesn’t need to be complicated either.  When you are at the store, stock up on fruits like bananas and apples, whole grain toast and nonfat yogurt.  And make sure you have some peanut butter at home so you can quickly throw a spoon on your fruit or toast as you run out the door.

3.       Prep on your off day!  

        This is by far the most valuable piece of advice I can give you. With just a little bit of motivation, you can use part of your days off to prepare for healthy eating the rest of the week!  At the grocery store, make sure you stock up on all the essentials—see my piece Grocery Shopping 101.  Wash and cut up all those fruits and veggies and place some into individualized bags for a grab and go snack.  One of my all-time FAVORITE snacks- super healthy and tasty- are my Bananarama Bars.  They are so easy to make and once you do the preparation you have an awesome breakfast/snack for the rest of the week.  You can also refer to my Healthy Snacking 101 piece for more ideas.  Just shove these snacks into your white coat pocket and when those patient rounds are getting a bit too long and you’re starting to feel hypoglycemic, have a bite!  Definitely beats all those caloric snacks void of nutritional value trying to entice you from the vending machine!  The rest of the fruits and veggies you can use for salads, smoothies, pasta dishes or on sandwiches.  Eggs are another excellent ingredient to have on hand.  Just hard-boil a bunch on your day off and you have a delicious and nutritious, breakfast, snack or lunch for the week (Egg and Gruyere with Tarragon on Whole-grain Baguette)!  Enjoy alone or in sandwiches and salads (my favorites: Get in my Belly Tabouleh, Arugula, Avocado and Cilantro Bliss, Gratifying Greek Salad.)  And finally, one of my favorite ideas is pick your favorite soup recipe for the week (my favorites: Simple and Delicious Lentil and Spinach Soup, Feel Good Homemade Chicken Soup, Hearty Persian Barley Soup) and prepare on your off day.  That way you will have a nutritious and tasty dinner all ready for the rest of the week.  All you need to do is heat it up and you’re golden :-)

Hope these ideas help!  Not only will they improve your body with respect to fitness and disease prevention but also how you feel about yourself, your exercise endurance, energy level and your overall mood in general.   And they are not just for the busy medical resident but for any busy student or professional on the go who wants to eat delicious food, stay healthy and look sexy!   

All the best,

Solmaz Amirnazmi MD

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