The 5 Elements of Physician Self-Care

by Rebekah Bernard MD

Studies show that medical students have a precipitous drop in empathy levels within just months of starting their third-year clinical rotations. While there are a variety of proposed explanations for the transition from naïve pre-med idealist to world-weary cynic, one likely culprit is the de-emphasis on self-care which occurs during these rotations.

Virtually overnight, medical students transition from a routine of regularly scheduled lectures and study periods to a brave new world of 4 AM rounds, overnight shifts, and wolfed-down meals in between operating room cases.  And if students dare to express feelings of hunger or fatigue, their senior resident or attending is likely to tell them to “suck it up!” or remind them that “you can sleep when you’re dead.”  By the fourth year of medical school, jaded senior medical students are passing on the same ‘words of wisdom’ to the juniors behind them.

The message: Patient needs come first. Doctors’ needs (and much less those of medical students!) are a mere inconvenience, something to be ignored and overcome. Or worse, something to be proud of.  (“You worked with a 103-degree fever?  Well, one time I went back to work after giving myself intravenous fluids in the call room from for a stomach flu!”)

While it’s possible to continue this superhuman behavior for a few days, weeks, months, or even years, it’s not good and it’s certainly not healthy.  Moreover, doctors develop dangerous habits that are hard to break, following them even after their student and resident days are long gone.  Case in point:  Unless there is another doctor present, I’m always the first person done eating at the table, as if some invisible code pager is going to pull me away from my meal at any second.

By continuously deferring our own physiological needs, physicians harm not only ourselves, but also provide a disserve to our patients.

Geni Abraham, MD, an internist and wellness expert, notes that when physicians don’t take care of their own needs, they can’t be “good medicine” to their patients.  Abraham compares physicians treating patients while they are physically depleted to “trying to fit a twin-sized sheet onto a king-sized bed”—a futile and impossible task. 

“Do as I say, not as I do”                                                                                                                                                

In order to provide the type of care that patients deserve, physicians must prioritize their own needs. “We’ve got to get back to the fundamentals of personal health care,” says Abraham.  “We need to be doing exactly the things that we are telling our patients.”

She recommends that doctors start by focusing on the following aspects of self-care:

1.      Nutrition.  “I don’t care if you want to follow a vegan or a keto-diet, as long as you are eating whole foods and a balance of nutrients,” says Abraham.  It’s also important for physicians to practice mindful eating—actually tasting and enjoying our food, rather than gulping it down as if we are on 24/7 duty and expecting to be called to a patient’s bedside at any moment. 

Abraham notes that eating is a social activity, and great enjoyment can be gained from eating in the company of others.  Take the time to schedule and plan meals with family and friends, rather than eating over the sink or in your car (guilty on both counts).

2.     Exercise.  “Exercise is the cheapest drug for anxiety and mild to moderate depression,” says Abraham.  “It’s also one of the best ways to help students and residents learn, as movement has been shown to promote learning.”  While physicians certainly understand the benefits of exercise, the challenge is often finding the time to exercise. 

“You have to find the time,” advises Abraham.  Even if you can only do 10 or 15 minutes, schedule that time into your week and make it non-negotiable.  Consider an app like the “7-Minute Workout,” which gets your heart pounding and can be done in the comfort of your living room.  It may also help to find something active that you might enjoy like a sport or dance class.

3.     Sleep.  “Lack of sleep causes memory loss, irritability, and chaotic thinking,” says Abraham.  “And chaotic thinking doesn’t help our patients or ourselves.”  Abraham recommends getting enough hours of sleep at night and practicing good sleep hygiene.  “Put your phone upside down to avoid the blue light that it emits and avoid watching intense television shows before bedtime.”  Instead of looking at screens before bed, Abraham recommends practicing mindful meditation or deep breathing exercises.

If you still feel sleepy even after getting enough hours of sleep, consider getting tested for sleep apnea.  Robyn Alley-Hay, MD, a retired obstetrician-gynecologist who is now a physician coach notes that starting CPAP for her previously undiagnosed sleep apnea was a life-changer.  “I wish I had been tested for sleep apnea years ago,” says Alley-Hay.  “I no longer have to start my day exhausted, slow, muddled, and generally grumpy.”  Alley-Hay recommends that doctors get tested and treated.  “It is hard enough to recover from call nights, irregular shifts, and short nights as a physician.  Add sleep apnea on top of that and it’s a recipe for exhaustion, burnout, irritability, and even depression.”

4.     Nontoxic relationships.  Physicians need support from family members, friends, and colleagues.  We need to take the time to nurture those relationships by scheduling activities, like date-night with your spouse and lunch with a colleague.  Show up for medical society meetings and physician socials.  Knowing that we are all dealing with similar issues can provide a great deal of support. 

On the flip side, extricate yourself from relationships that are toxic or emotionally draining.   Say ‘no’ to people, employers, committees, or memberships that fail to add value to your life. 

5.     Mindful self-compassion.  Abraham suggests that physicians pay attention to how they talk to themselves.  She reminds us that humans are wired to pay more attention to negative thoughts than to positive ones, and that we need to practice and work to counteract negativity in our lives.  “It takes five positive thoughts to overcome one negative thought,” says Abraham.  One way to achieve mindful self-compassion is to keep a journal of your emotions, and to take a moment at the end of each day to focus on the things that went well. 

When one of my patients is being hard on themselves (“I’m stupid, I’m a failure”), I take a cue from Martha Beck and ask them if they would speak to a child the way they are speaking to themselves.  The answer is usually: “Of course not!”  In the same way, physicians need to be kind to ourselves and forgive ourselves when we make a mistake.

Achieving self-care

As overachievers, physicians often try to take on too many tasks at the same time.  That’s especially risky when it comes to self-care.  “If you try to make 19 different changes at the same time you won’t succeed – it will be too overwhelming,” says Abraham.

Instead, she advises executing one idea at a time.  “It can be as simple as increasing your water intake or eating two fruits per day to begin.” 

Abraham also advises us to think of ourselves like a boat.  “If you want to turn a boat, you have to do it slowly by degrees, not as a pirouette.  If we turn the wheel too fast, we will just end up at the same point where we began.”  Instead, she advises that we focus on change idea by idea, degree by degree.

By making slow and intentional positive change towards self-care, physicians can function better and more effectively—and that will pay off in patient care.  As Abraham says, “Eat right, move right, sleep right, and think right, so that you can feel right.”

Rebekah Bernard MD is a family physician in Fort Myers, FL and the author of Physician Wellness:  The Rock Star Doctor’s Guide

https://www.medicaleconomics.com/news/5-elements-physician-self-care

Practicing Gratitude

Thanksgiving is an opportunity to give thanks for what we have, for the relationships we cherish with our friends and family, for our health – a time to celebrate all life’s blessings. This is a powerful time of the year for taking time to reflect upon those things we are most grateful for. Gratitude has been consistently associated with greater happiness. But gratitude doesn’t have to be saved for special occasions. The habit of being grateful starts with appreciating even the smallest things in life. Start incorporating gratitude into your life on a daily basis and you will quickly notice your life filling with more things to be grateful for. Here are 5 ways to practice gratitude daily:

Develop the habit of being grateful.  One of our greatest gifts is the ability to choose what to focus on. The best way you can begin your day is by counting your blessings. Take time daily to write down five things that you are grateful for. Fill up with the feeling of gratitude in your body. There is nothing too small to be grateful for, count things such as being able to start your day with a warm shower or receiving a note from a friend. You can also try writing things you are grateful for that you may not yet have in your life. What are you working toward or believing for – feel grateful for that now.  As you develop the daily habit of gratitude you will notice that you are naturally more grateful and have more empathy and happiness in your life.

Share your gratitude with others.  When you express gratitude to others not only does it make their day a little brighter, but it will increase your own level of gratitude and happiness. Show your appreciation through a smile, a text, thank you note or a phone call.

Spend time with friends and family.  Practice the art of listening and support your friends and family. Find ways to build others up and find positive ways to share genuine compliments with them. Connecting with others improves physical health and psychological well-being.

Focus on positive thoughts and solutions.  No matter where you are and what your situation is, your focus can be shifted to something positive. Finding fault and complaining drain our energy. It is important to combat negative thinking. Dwelling on the negative will keep us stuck in an unhealthy place. Make sure to focus on the good things that happen in a day and not the one bad thing that didn’t go well. Sometimes we have to practice objectivity – what would you say to a friend who had that problem? As you focus on gratitude and positive outcomes, this type of thinking will become like second nature over time. Take a moment at the end of each day to focus on the things that went well. This is a positive way to end your day and will improve rest by promoting contentment – no matter how your day was, you will sleep a bit better than you would have.

Give back.  Volunteering is a powerful way to share your gratitude with others. Even small acts of kindness can symbolize your appreciation of others and their situations. Feel grateful for the capacity to volunteer your time – this can include things such as helping in a soup kitchen while knowing you are so grateful for the healthy food you have at home lining your pantry and refrigerator shelves.

It’s easy to take all of our blessings for granted. Stop and be grateful, even if just for a simple glass of clean water, we maintain our lives because of water. Research shows us that practicing gratitude boosts our emotional well-being as well as physical health. Every day is a good day to enhance our lives through giving thanks.

-Diane Duvall, Life Coach and Certified Health Coach for the Lifestyle Medicine Practice of Dr. Geni Abraham, Board Certified, American Board of Internal Medicine.  Our Internal Medicine Practice is an integrated medical practice with a focus on Lifestyle Medicine. We offer health coaching sessions to help you reach your personal goals. Dr. Geni Abraham, Medical Specialists of the Palm Beaches, Inc., 205 JFK Drive, Atlantis FL 33462.  Phone: (561) 432-8935, Visit DrGeniAbraham.com and Follow us on Facebook: Dr. Geni Abraham

Top 10 Myths About Cardiovascular Disease

How much do you really know about your heart’s health? It’s easy to be fooled by misconceptions. After all, heart disease only happens to your elderly neighbor or to your fried food-loving uncle, right? Or do you know the real truth – that heart disease can affect people of any age, even those who eat right?

Relying on false assumptions can be dangerous to your heart. Cardiovascular disease kills more Americans each year than any other disease. But you can boost your heart smarts by separating fact from fiction. Let’s set the record straight on some common myths.

  1. “I’m too young to worry about heart disease.” How you live now affects your risk for cardiovascular diseases later in life. As early as childhood and adolescence, plaque can start accumulating in the arteries and later lead to clogged arteries. One in three Americans has cardiovascular disease, but not all of them are senior citizens. Even young and middle-aged people can develop heart problems – especially now that obesity, type 2 diabetes and other risk factors are becoming more common at a younger age.
  2. “I’d know if I had high blood pressure because there would be warning signs.” High blood pressure is called the “silent killer” because you don’t usually know you have it. You may never experience symptoms, so don’t wait for your body to alert you that there’s a problem. The way to know if you have high blood pressure is to check your numbers with a simple blood pressure test. Early treatment of high blood pressure is critical because, if left untreated, it can cause heart attack, stroke, kidney damage and other serious health problems. Learn how high blood pressure is diagnosed.
  3. “I’ll know when I’m having a heart attack because I’ll have chest pain.” Not necessarily. Although it’s common to have chest pain or discomfort, a heart attack may cause subtle symptoms. These include shortness of breath, nausea, feeling lightheaded, and pain or discomfort in one or both arms, the jaw, neck or back. Even if you’re not sure it’s a heart attack, call 9-1-1 immediately. Learn you risk of heart attack today!
  4. “Diabetes won’t threaten my heart as long as I take my medication.” Treating diabetes can help reduce your risk for or delay the development of cardiovascular diseases. But even when blood sugar levels are under control, you’re still at increased risk for heart disease and stroke. That’s because the risk factors that contribute to diabetes onset also make you more likely to develop cardiovascular disease. These overlapping risk factors include high blood pressure, overweight and obesity, physical inactivity and smoking.
  5. “Heart disease runs in my family, so there’s nothing I can do to prevent it.” Although people with a family history of heart disease are at higher risk, you can take steps to dramatically reduce your risk. Create an action plan to keep your heart healthy by tackling these to-dos: get active; control cholesterol; eat better; manage blood pressure; maintain a healthy weight; control blood sugar; and stop smoking.
  6. “I don’t need to have my cholesterol checked until I’m middle-aged.” The American Heart Association recommends you start getting your cholesterol checked every 5 years starting at age 20. It’s a good idea to start having a cholesterol test even earlier if your family has a history of heart disease. Children in these families can have high cholesterol levels, putting them at increased risk for developing heart disease as adults. You can help yourself and your family by eating a healthy diet and exercising regularly.
  7. “Heart failure means the heart stops beating.” The heart suddenly stops beating during cardiac arrest, not heart failure. With heart failure, the heart keeps working, but it doesn’t pump blood as well as it should. It can cause shortness of breath, swelling in the feet and ankles or persistent coughing and wheezing. During cardiac arrest, a person loses consciousness and stops normal breathing.
  8. “This pain in my legs must be a sign of aging. I’m sure it has nothing to do with my heart.” Leg pain felt in the muscles could be a sign of a condition called peripheral artery disease. PAD results from blocked arteries in the legs caused by plaque buildup. The risk for heart attack or stroke increases for people with PAD.
  9. “My heart is beating really fast. I must be having a heart attack.” Some variation in your heart rate is normal. Your heart rate speeds up during exercise or when you get excited, and slows down when you’re sleeping. Most of the time, a change in your heartbeat is nothing to worry about. But sometimes, it can be a sign of arrhythmia, an abnormal or irregular heartbeat. Most arrhythmias are harmless, but some can last long enough to impact how well the heart works and require treatment.
  10. “I should avoid exercise after having a heart attack.” No! As soon as possible, get moving with a plan approved for you! Research shows that heart attack survivors who are regularly physically active and make other heart-healthy changes live longer than those who don’t. People with chronic conditions typically find that moderate-intensity activity is safe and beneficial. The American Heart Association recommends at least two and a half hours of moderate intensity physical activity each week For Overall Cardiovascular Health. Find the help you need by joining a cardiac rehabilitation program, but first consult your healthcare provider for advice on developing a physical activity plan tailored to your needs.

https://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease/top-10-myths-about-cardiovascular-disease?fbclid=IwAR2YFYM5vDBShgH9ToZGHGBUif3FtEujiHvikkIcB118KJTM8cPNQyLEVfk

Finish this Year Strong

At the first of the year many of us create a list of health and wellness goals that we want to accomplish. We often feel that this will be the perfect time to get things started. But imagine what it would be like to start your New Year feeling and looking your best. Due to the busyness of the season, the last few months of the year are usually when we make the worst decisions regarding our health. Imagine building momentum toward your goals now with an intentional plan to overcome the various stresses and unhealthy lifestyle habits that distract so many during this time of year.

Become intentional and make good choices through the end of the year.

This is about more than just healthy eating; it’s about creating healthy habits and consciously creating the life you desire. Do you feel that your schedule gets out of control this time of year with too many responsibilities and obligations? How many gifts do you really have to buy and how many functions do you need to attend? Does your house really need to look like the pictures in Pinterest – do not let this overwhelm the joy of the season. Reserve some time over the next few months for personal self-care. Choose self-care activities that reenergize you. Find joy in the season and in positive change. It’s not about the end goal, it’s always about the journey. Discover different types of exercises that you like and focus on eating whole foods, enjoying the flavors of the fall harvest.  

Enjoy the Season.

There is no need to deprive ourselves during this holiday season, but we should be choosy and budget our holiday eating wisely. When faced with large buffets and feasts at holiday gatherings don’t feel obligated to eat something just because it’s there. Focus on eating the foods you really love and be sure to make room for veggies. Enjoy your food and pace yourself, take your time and stop eating when you feel full. If you are going to drink alcohol, try alternating between water and alcohol to minimize intake and stay hydrated. If you know that you will be indulging in a few extra calories this time of year be sure to increase daily physical activity. In addition to walking, consider adding activities the whole family can enjoy.

Focus on high quality, nutrient-dense foods. Imagine what your health and body would look like if you multiplied the nutrient-density of your diet. Think roasted vegetables vs French fries. Eating whole foods vs refined, processed or fast foods. Increase healthy fat intake (such as avocados, nuts and seeds, and olive oil) and get away from sugar and refined carbohydrates. Incorporate intermittent fasting – start by not eating after 7 pm. Don’t skip breakfast – starting your day with a balanced meal focused on protein and healthy fats will set your healthy metabolism for the day and put the brakes on cravings and overeating later in the day. Incorporate vegetable omelets, avocados, crustless quiche or protein smoothies.

Invited to a party and need to bring a dish? Consider bringing a dish of non-starchy vegetables or a low-carb Mediterranean-style platter. Fill your low-carb snack tray with cooked meats such as sliced roast beef, turkey and pepperoni (choose the best quality you can, with minimal processing and minimal added ingredients). Add fresh ingredients such as a variety of cheeses, olives, avocado, stuffed mini peppers, mixed nuts, vegetables, fruits and low carb crackers. At least you know there will be a variety of low-carb snacks (brought by you) that you can enjoy.

Let this season be a time of celebration and also relaxation.

Enjoy your family and friends and if you do fall overboard and lose sight of your goals just try to get back to your healthy habits as soon as possible. Incorporate these Healthy Habits to Finish This Year Strong:

  • Stay hydrated with 6-8 cups of water daily.  
  • Stay energized: exercise 3 times per week.
  • Pace yourself during this season to avoid overscheduling or overspending.
  • Make time for self-care and find balance and joy in the season.
  • Make adequate sleep a priority.    
  • Find ways to walk more.
  • Add more vegetables and fruit.
  • Snack on whole foods like nuts and seeds.
  • Commit to a daily gratitude practice.
  • Get connected with friends & family.
  • Balance meals with protein and healthy fat to prevent cravings. 
  • Reserve sweet treats for special occasions.
  • Bookend healthy eating around parties and never go to a party hungry.
  • Have small daily goals to help you achieve success.

-Diane Duvall, Life Coach and Certified Health Coach for the Lifestyle Medicine Practice of Dr. Geni Abraham, Board Certified, American Board of Internal Medicine.  Our Internal Medicine Practice is an integrated medical practice with a focus on Lifestyle Medicine. We offer health coaching sessions to help you reach your personal goals. Dr. Geni Abraham, Medical Specialists of the Palm Beaches, Inc., 205 JFK Drive, Atlantis FL 33462.  Phone: (561) 432-8935, Visit DrGeniAbraham.com and Follow us on Facebook: Dr. Geni Abraham

10 Traits of Emotionally Resilient People

If specific types of challenges tend to “undo” you, or you often feel frustrated, impatient or drained, there may be some gaps in your resilience strategies. Learning and developing the traits of emotionally resilient people is a great way to even out your reactions and consistently take a more balanced approach to life.

1

They practice the art of care and self-care. They have discovered what their personal needs are and they provide for themselves. They have taken the time to discover and incorporate whatever it is that makes them feel cared for; creating a baseline and individual strategy.


2

They understand that stressful situations don’t define them. They have relegated circumstances to their rightful place: as short-term conditions that have no power or influence over whom they are in the moment or who they will be when the situation has changed.


3

They are compassionate. They know that everyone deserves respect, good will and love ― including others who may not be handling situations or circumstances in ways they would prefer. Judgment and condemnation do not contribute to nurturing resilience.


4

They know life isn’t perfect and they’ve learned to practice acceptance. Instead of resisting what is happening, even if it’s not their preference, they accept circumstances they can’t change and expect that things will get better.


5

They know when to ask for help. We’re taught to be self-reliant and independent with our problem-solving and much of the time this approach is entirely appropriate. Yet sometimes the best way to the downhill side of a challenge is to enlist the help of friends, family or colleagues. Resilient people have learned discernment in making this choice.


6

They know when to listen, when it’s time to be supportive, and when to allow space. These are also judgment calls. Holding the awareness that there is a right time and circumstance for each of these strategies is the first step to learning which one is applicable in any given situation.


7

They have positive supportive circles. Making a conscious choice to interact with people who are willing and able to offer the support they need is vital in building resilience. Negativity and criticism drain resources and impact the ability to put things in perspective.


8

They know who to go to for honest advice and who’s more likely to add drama to a situation. Loving or caring for someone doesn’t necessarily mean that person will provide the guidance you need. Each person has their own strengths, so taking relevant personality traits into consideration before asking for advice is important.


9

They are self-aware and often engage in practices that provide self-reflection. The adage of “know thy self” is important in building and living with resilience. It can often make the difference between feeling confidence about the ability to handle adversity and feeling hopeless or overwhelmed.


10

They are grateful. They often have a gratitude practice that they do daily ― such as keeping a gratitude journal. Gratitude broadens perceptions about life and helps to increase feelings of hope and openness towards new possibilities.

It’s common to have developed several of these traits, yet have little experience or comfort with others on the list. Zero in on which areas you feel can assist you in boosting your reservoir of resilience. You’ll find it’s worth the effort and focus so you can achieve the results you are looking for.

Stay tuned for more resilience tools and tips.

https://www.heartmath.com/blog/tools-tips-articles/10-traits-of-emotionally-resilient-people/?fbclid=IwAR3ygWicmDd9q9vZHgKmQcO8fmaurZqIN54TZKuUi8mzFtWkfZjnJZ7ixog

Lower Stress: How does stress affect the body?

Feeling stressed out? It can have lasting effects on your health and wellbeing. But there are ways to manage stress and its symptoms that can help you feel better.

Stress Stinks! What Can You Do About It?

Stress is a fact of life. A 2017 American Psychological Association survey found that a whopping 80% of respondents reported experiencing at least one symptom of stress over the past month.1 Does this describe you?

Sometimes we stress over good things, like a long line at a brunch spot, a new job, an upcoming wedding, or a new baby. And other times it’s over not-so-good things like being sick, working too much, or family drama. 

Stress can affect your mental and physical health in so many ways.

Long-term activation of your body’s stress response system, along with prolonged exposure to cortisol and other stress hormones, may put you at risk for health troubles like:2,3

  • digestive problems
  • anxiety
  • headaches
  • depression
  • sleep problems
  • weight gain
  • memory and concentration issues
  • high blood pressure
  • heart disease and stroke

So what can we DO about stress?

You want to avoid all these, right? Us too! Luckily, small changes are easy to try. We even have a nifty list! Let’s get started:

Get giggling. Make silly faces with the family, have a staring contest, watch videos of babies and puppies – whatever gets your belly moving, try blowing off some steam with some laughs! Bonus points if you laugh till you cry.

Let’s list. Making a list can help you decide what’s actually important to do today so you don’t feel buried all the time. Added bonus? You’ll feel a sense of accomplishment when you cross things off as “done.” We can practically hear you saying “aaaahhhhh” already.

  • Find a friend. Take a 60-second social break to message someone with a “Hello!” And hey, if it turns into a longer chat, we won’t tell!
  • Move more. Movement is good for your heart and your mind. Dance like crazy to get the funk out, try hula hooping, briskly walk around the block and listen to the birds, or take that hip-hop class you’ve always wanted to try. Bonus points if you laugh while you’re moving! 
  • Get your butt in bed. Getting enough sleep can help you feel less cranky and overwhelmed, and more productive and creative. If you want all that, you gotta get to bed earlier! Turn off the screen(s), you can binge-watch your show and earn more XP tomorrow. Sleep experts suggest aiming for about 7 to 9 hours of sleep a night.4 See you in the morning, sunshine!
  • Be with your breath. You’ve been breathing your whole life, but learning to focus on your breath can actually trigger your body’s relaxation response. According to Dr. Herbert Benson, a cardiologist and Harvard Medical School professor of Mind Body Medicine, diaphragmatic (deep) breathing is one of several ways to elicit the relaxation response.5 Try it! You’ll be getting your Zen on in no time.
    • Get comfy and take a normal breath.
    • Next take a deep breath slowly through your nose, filling up your chest and belly. Let your belly really puff out – we promise, you don’t look fat!
    • Now breathe out slowly through your mouth (or nose, whichever) and repeat.

De-stressing shouldn’t stress you out. Which one are you going to try now: giggling, socializing or moving?

Let’s do this, and be Healthy For Good!

Last reviewed 7/2017 https://www.heart.org/en/healthy-living/healthy-lifestyle/stress-management/lower-stress-how-does-stress-affect-the-body

1American Psychological Association 2017 Survey Report, Stress in America: Coping with Change http://www.apa.org/news/press/releases/stress/2016/coping-with-change.PDF.

2U.S. Department of Health and Human Services, Office on Women’s Health, Stress and your health https://www.womenshealth.gov/a-z-topics/stress-and-your-health

3Centers for Disease Control and Prevention, Coping with Stress https://www.cdc.gov/Features/CopingWithStress/index.html.

4National Sleep Foundation, How Much Sleep Do We Really Need? https://sleepfoundation.org/how-sleep-works/how-much-sleep-do-we-really-need

5Harvard Health Publications, Harvard Medical School, Relaxation techniques: Breath control helps quell errant stress response http://www.health.harvard.edu/mind-and-mood/relaxation-techniques-breath-control-helps-quell-errant-stress-response.

7 ways to reduce stress and keep blood pressure down

When it comes to preventing and treating high blood pressure, one often-overlooked strategy is managing stress. If you often find yourself tense and on-edge, try these seven ways to reduce stress.

  1. Get enough sleep. Inadequate or poor-quality sleep can negatively affect your mood, mental alertness, energy level, and physical health.
  2. Learn relaxation techniques. Meditation, progressive muscle relaxation, guided imagery, deep breathing exercises, and yoga are powerful relaxation techniques and stress-busters.
  3. Strengthen your social network. Connect with others by taking a class, joining an organization, or participating in a support group.
  4. Hone your time-management skills. The more efficiently you can juggle work and family demands, the lower your stress level.
  5. Try to resolve stressful situations if you can. Don’t let stressful situations fester. Hold family problem-solving sessions and use negotiation skills at home and at work.
  6. Nurture yourself. Treat yourself to a massage. Truly savor an experience: for example, eat slowly and really focus on the taste and sensations of each bite. Take a walk or a nap, or listen to your favorite music.
  7. Ask for help. Don’t be afraid to ask for help from your spouse, friends, and neighbors. If stress and anxiety persist, talk to your doctor.

Along with these ways to reduce stress, add in a healthy lifestyle — maintaining a healthy weight, not smoking, regular exercise, and a diet that includes fruits, vegetables, whole grains, lean protein, and healthful fats — and high blood pressure could be a thing of the past.

For more information on lifestyle changes to treat high blood pressure and how to choose the right medication if needed, read Controlling Your Blood Pressure, a Special Health Report from Harvard Medical School.

Building Foundations to Survive the Stressful Seasons of Life

Through all the seasons of life it is important to nurture our emotional and physical health. It is natural to become reactive or default to bad habits during a busy or trying time. Staying healthy does not need to be complicated. When life gets difficult with work stress, a family member not being well or overwhelming deadlines to meet, use these four foundations as a blueprint to enable you to build resilience or to help get you back on track.

1. Nutrition  When we are busy it is easy to grab processed foods or fast foods that lack the nutrients that we need to thrive. It is important to eat real food. Food is information for our body, and we need to fuel our body and mind so that we can accomplish more. Make sure most of your diet includes nutrient-dense foods that let you accomplish more with less.  Make sure each meal and snack packs as much benefit as possible. It is very important to stay hydrated. To keep it simple, always have a bottle of water with you and aim for 8 glasses of water per day.

Unhealthy convenience foods contribute to additional stress. Unstable blood sugar levels caused by processed, high carbohydrate foods increase stress hormones in our body and can also cause changes in our mood. It is important to incorporate healthy fats and lean protein into each meal and snack to keep our blood sugar in balance.  Aim for five different vegetables per day. Try to incorporate the different colors of the rainbow into your fruit and vegetable choices.

One of the best things you can do is prepare snacks and meals for the day. Grocery shop wisely and focus on the whole, natural foods in the outer sections of the store. Have healthy snacks available such as berries and walnuts, celery and almond butter or baby carrots and hummus. Purchase snack size packets of nuts and seeds. There are also many companies that deliver home-cooked meal kits or meals ready to eat. When only fast-food or restaurant food will do choose healthy options. To play it safe, stick to grilled instead of fried food and choose side dishes such as fruits, soups and salads. Whether you are dining out or eating in, it is important to maintain a balanced diet. Make sure you are getting a good mix of lean protein, healthy fats, fruits and vegetables, and whole grains.

2. Stress Management  Stress has been proven to have serious effects on our bodies and minds. Some seasons of life bring us more stress than others. It is important to practice self-care regularly. If you take care of your mind and body, you’ll find you are more productive and have more energy throughout the day. We can’t always change our commutes, deadlines, and pressures but there are actionable strategies that we can put into practice.

  • We can turn on the stress response and create the hormones of stress just by thinking about our problems. Trade emotions like fear, worry, or overwhelm for elevated, heart-centered emotions like gratitude, appreciation, or joy to create a cascade of healing hormones.  
  • Keep a gratitude journal or start your day with a mental list of five things you are grateful for. If you can only think of one thing to be thankful for – begin with that – and repeat.
  • Incorporate a daily practice of stillness. Calm your mind and body and reconnect with the present moment with focused breathing. Focus on a soothing image, a positive word or prayer. Find even five minutes a day to meditate or to listen to your favorite music.
  • Carve out 15 minutes of “me time” each day. No phones, emails, or deadlines. This time is just for you.
  • Learn to say ‘no’. Having too much to do and too little time is a common cause of stress. Are there things that can be delegated to others or completed at a later date?
  • Spend time with friends and family. If you want to be happy and healthy, relationships are very important.

3. Sleep  Actively prioritize sleep. There are too many distractions and things competing for our attention that keep us awake. When we do not sleep well, we crave comfort foods and lack the energy to exercise. When we are sleep deprived our mood is affected and we are more reactive. Incorporating a relaxing bedtime routine can be transformative. Dim the lights and quiet your mood. Turn off all technology and the television at least 30-minutes (90-minutes would be best) before sleep. The blue-light emitted from these devises can suppress your melatonin production and affect your sleep and health. Try to maintain a consistent bed-time schedule.

4. Movement  Build movement into your everyday life. Rather than let stress build up, incorporate 10-minute or 15-minute walks into your day to buffer the effects of stress. Physical activity will increase your energy levels, improve your health and boost your mood.  If a trip to the gym doesn’t work with your schedule, fit stretches and muscle-building exercises into 5 or 10-minute intervals during your day. You can fit in a “kitchen workout” while your dinner is baking or an “office workout” for the first few minutes of your lunch break.  Make a habit of doing little things throughout the day that build up to 30 minutes of exercise. Keep your body strong and build resilience so that you will have the reserve to handle unexpected challenges and they will not deplete you.

Finding balance in these four foundational areas can make a huge difference for your mood, energy, outlook on life and how well you can handle stress. Develop good habits and when you lose your focus just get back on track. When you start to feel drained, irritable and less focused, it’s time to listen to yourself and your body. Maybe you need to go to bed an hour earlier next week and that will do it. Maybe you need more protein in your breakfast meal for sustained energy in your day. Perhaps you will find that a one-hour yoga class per week could restore and rejuvenate you. It’s the little things you do in your life day by day that can make a master change in your health and happiness.

-Diane Duvall, Life Coach and Certified Health Coach for the Lifestyle Medicine Practice of Dr. Geni Abraham, Board Certified, American Board of Internal Medicine.  Our Internal Medicine Practice is an integrated medical practice with a focus on Lifestyle Medicine. We offer health coaching sessions to help you reach your personal goals. Dr. Geni Abraham, Medical Specialists of the Palm Beaches, Inc., 205 JFK Drive, Suite A, Atlantis FL 33462. Phone: (561) 432-8935, Visit DrGeniAbraham.com and Follow us on Facebook                                                     

Taking Care of Your Heart

February is American Heart Month. This is a great time to focus on steps we can take to keep our heart healthy and prevent heart disease. Heart disease is the leading cause of death in the United States, but a heart-healthy lifestyle can go a long way to prevent heart disease. Medical conditions such as high blood pressure, high cholesterol and diabetes can increase your risk of heart disease. Make sure you are working with your doctor and incorporating healthy lifestyle practices to treat these conditions.  Our day to day lifestyle choices directly impact our heart’s health. Research shows that making healthy lifestyle changes, even later in life, may stop and actually reverse heart damage.

A healthy diet is one of the best weapons you have to fight heart disease.  The food you eat (and the amount) can affect other risk factors such as cholesterol, blood pressure, diabetes and being overweight. Choose nutrient-rich foods instead of nutrient-poor foods. The Mediterranean diet is a heart-healthy eating plan that is high in fresh fruits and vegetables (variety of color), lean protein, healthy oils (Extra virgin olive oil), whole grains, beans, nuts and seeds.  Research has shown that the traditional Mediterranean diet reduces the risk of heart disease.

This healthy diet includes:

  • Eating fish and poultry at least twice per week and limiting red meat to no more than a few times per month.
  • Using herbs and spices instead of salt to flavor foods.
  • Avoiding hydrogenated oils (trans fats) which are found in fried foods and processed foods such as pies, cookies, pastries, donuts and frozen food.
  • Limiting refined sugars and carbohydrates such as white bread and white rice.
  • Sticking with water as your beverage of choice is best, as there is no benefit to adding sugary drinks.
  • Focusing on whole, natural foods and eating lots of vegetables.
  • For dessert, eating fresh fruit and saving sweets for a special treat or celebration.
  • Taking time to savor your food and enjoy your meals with family and friends.  

Regular exercise is one of the most effective tools to strengthen the heart muscle and reduce the risk of heart disease. Your heart will get stronger and healthier if you lead an active life. Regular exercise has many benefits including: burning calories, lowering blood pressure, reducing “bad” cholesterol and boosting “good” cholesterol. Aim to do aerobic exercise (“cardio”) for thirty minutes, five to six times per week.  Some examples include walking, jogging, biking, swimming or dancing. To check your intensity and make sure you are not pushing too hard, you should be able to talk but you shouldn’t be able to sing a full song. Find activities that you enjoy and start small. You can even break up your exercise sessions into 10-minute intervals. In addition, you should include strength training twice per week to build muscle and reduce body fat. To maintain flexibility, be sure to include stretching exercises (such as yoga) weekly as well. For ongoing encouragement, use an app on your phone or a wrist band that provides input on how many daily steps you have taken. Talk with your doctor before making any changes to your current exercise routine.

Focus on rest and relaxation. The effects of stress can have a direct impact on your body and can harm your heart. It’s important to have healthy habits in place to help in preventing and managing stress. When we feel stressed, we often reach for unhealthy habits to find relief, such as drinking alcohol, smoking cigarettes or overeating. These unhealthy habits lead to other factors that may contribute to damaging your heart by increasing blood pressure, cholesterol, triglycerides and blood sugar.  Find hobbies and activities you enjoy, stay social and engage with friends and family. Stay positive and ponder uplifting thoughts about the future, as optimism is good for your heart. Dedicate a certain time each day to focus on your body and relaxing. Practice stress reduction techniques and exercises such as deep breathing, meditation, yoga and tai chi. Getting a good night’s sleep is important for a healthy heart. Aim for seven to nine hours of quality sleep per night. Create a nightly routine to unwind and relax before bed and stick with the same sleep schedule, even on the weekends.

Working with your doctor is essential to managing your health effectively. Staying proactive with your lifestyle choices will have a positive impact on your heart and overall health.

-Diane Duvall, CLC, CHHC, CPT

Diane Duvall is a Life Coach and Certified Health Coach for the Lifestyle Medicine Practice of Dr. Geni Abraham, Board Certified, American Board of Internal Medicine.  Our Internal Medicine Practice is an integrated medical practice with a focus on Lifestyle Medicine to prevent chronic disease and promote health and wellness. We offer health coaching sessions to help you reach your personal goals. Dr. Geni Abraham, Medical Specialists of the Palm Beaches, Inc., 205 JFK Drive, Suite A, Atlantis FL 33462.  Phone: (561) 432-8935 Visit DrGeniAbraham.com and Follow us on Facebook

Simple Daily Habits for Reducing Stress

Stressors, good and bad, are a part of everyday living. Extreme stressors, such as the loss of a loved one, can obviously impact our health. But the ongoing, daily stressors that we face on a regular basis also put a strain on the body’s ability to function properly. According to the American Institute of Stress, up to 90 percent of all visits to primary care physicians are due to stress related problems. While we cannot completely avoid stress, there are effective ways to manage how much we are affected by stress. 

Incorporate these simple daily habits to start living a lower-stress lifestyle.

Practice Positive Thinking 

It’s not the event or circumstance that determines whether we are stressed, but how we respond to those events. It’s how we feel or think about the event that determines our stress levels.  It is important to choose a positive mindset and challenge negative thoughts. It can be helpful to practice relaxation techniques while focusing on positive emotions such as appreciation and gratitude.  This can be as simple as breathing deeply while you focus on things that you are grateful for.  Emotions, or feelings have a powerful impact on our bodies. Practice maintaining a positive focus to reduce the effects of stress. Make sure to stay connected with friends and family and engage in activities that inspire you to smile, laugh and think positively.

Exercise

Incorporate 10-30 minutes of moderate activity into your daily schedule to reduce stress. Exercise reduces the levels of our body’s stress hormones, and it increases production of chemicals that elevate mood. Medical studies show that exercise dramatically reduces depression and anxiety.  Even one session of exercise can improve your mood.  Find an activity that you enjoy. Include walking in nature, swimming, group fitness, biking, tennis, etc. Regularly practicing yoga can be a great way to reduce stress and restore your sense of well-being.  Yoga can increase strength, flexibility and your ability to relax.

Get Quality Sleep

Sleep restores health and vitality to your mind and body.  Inadequate sleep can cause irritability and stress. Getting 7 to 9 hours of sleep each night not only leaves you more energized and better prepared to deal with stress, but it also lowers your risk for many diseases. Consistently maintain regular bedtime and wake-up hours. If you have trouble relaxing, try herbal aids such as valerian, passionflower, lavender oil, lemon balm or chamomile.  Avoid caffeine consumption (tea, cola, coffee, chocolate) within 4 to 8 hours of bedtime.  Reduce stress and prepare for a great night’s sleep with a relaxing bedtime routine (book, meditative music, bath, relaxation technique).

Mind/Body Relaxation Techniques

The state of relaxation is linked to higher levels of feel-good chemicals such as serotonin and the growth hormone which repairs cells and tissue. Relaxation is a state of rest, enjoyment and physical renewal.  Harvard researchers have found that yoga, meditation, prayer and guided imagery all induce the relaxation effect.  Meditation can be as simple as letting tension go as you focus on your breathing.  If your mind wanders, return to your breath. Guided imagery is a type of meditation utilizing your imagination to visualize yourself in a peaceful setting where tension is washed away from your body and mind.  Practice one or more of these techniques even 5 to 10 minutes a day to offset the stress response with the healing power of relaxation.  Do you ever find yourself in the midst of a stressful situation? Deep breathing, where you fill your abdomen and expand your diaphragm downward, is one of the most powerful exercises you can do to quickly de-stress. Breathe long, slow and deep in a mindful-state as often as possible. As a powerful daily practice, deep breathing will advance your health and well-being. You can also unwind by enjoying a massage or practicing progressive muscle relaxation (an exercise that involves tensing and relaxing muscle groups throughout your entire body) to relieve stress and release muscular tension.

Eat a Balanced Diet

A good diet will help prepare your body for daily stress. An unhealthy diet will only make you feel sluggish and less able to deal with life’s everyday demands. Reduce processed foods containing high sugar, saturated fat and salt. Enjoy a variety of fruits, vegetables, quality fats, nuts, whole grains, legumes, and lean protein. Take time to enjoy your food and eat without rushing.

You don’t need to devote hours to stress relief every day. Just practice these simple habits on a regular basis and enjoy a more positive, fulfilling life.

-Diane Duvall, CLC, CHHC, CPT

Diane Duvall is a Life Coach and Certified Health Coach for the Lifestyle Medicine Practice of Dr. Geni Abraham, Board Certified, American Board of Internal Medicine.  Our Internal Medicine Practice is an integrated medical practice with a focus on Lifestyle Medicine to prevent chronic disease and promote health and wellness. We offer health coaching sessions to help you reach your personal goals. Dr. Geni Abraham, Medical Specialists of the Palm Beaches, Inc., 205 JFK Drive, Suite A, Atlantis FL 33462.  Phone: (561) 432-8935 Visit DrGeniAbraham.com and Follow us on Facebook