Wednesday, March 22, 2017

Hello Spring

Hello Spring
Here in Miami there isn’t much of a shift in the seasons.  The joke is that it’s always hot and sometimes just a little less humid.  This winter we’ve had the warmest winter on record (my brother is a meteorologist, I should know.)  But when you take a walk outside there’s no denying the sound of birds chirping or seeing blooms all over the trees

It gets us all excited for mango season – and when you see a tree that loaded with blooms, all the possibilities of what’s to come.  Maybe I’m reading too much into it, but we know whether it’s going to be a good season or a great season just from looking at the blooms.

To quote my yoga teacher, Marianne Wells Yoga School, “what does the promise of spring mean for you? Is there a thaw that needs to happen in your heart?  A pain, a loss that you’ve been hanging on to that you could release to the love and warmth of spring?  We owe it to ourselves to let go.  After all, nothing lasts forever.  That’s what the renewal of the seasons teaches us.”
And that got me thinking.  Sure I know my blog is normally about food and nutrition.  But I also write about well-being and the whole body-mind connection.  So I’m going to write about what’s been going on in my life.  It’s mainly been work as of recent.  I’m constantly trying to find a better balance between work and my personal life.  My previous job I had a 75 mile one-way commute.  Let that sink in.  75 miles one-way.  It was a 3-hour commute.  While the commute was a far distance I did at least drive against traffic – I know people that drive 10 miles and it takes them an hour in traffic – I’m not sure I could’ve survived that and often wonder how people do it.  Regardless it was 3-hours of my life spent driving daily.  When I would return home at night I’d be soooooo tired it felt like the life had been sucked out of me.  It’s hard to describe, but ask anyone that’s been so focused on the road, it’s draining.  Flash forward to my new job.  I have a 5 mile commute that takes about 20 minutes, some days 30 minutes.  But my days are long – from seeing patients and then charting on patient notes.  I always have the best of intentions of leaving at 4 – but I’d say in the last year that’s only happened a handful of times.  Most days I’m there at least until 6 pm (I start my day at 8) and then some days I’m there even later.  I’m not saying these things to complain, I’m simply using my life as an example from what we can learn from, what I can learn from. 

I love what I do and I love teaching people about diabetes.  I don’t love weight loss counseling – truth, there I said it – I like teaching people about eating healthy and with diabetes you’re able to show them how to manage their blood sugar levels with the food that they eat, the exercise that they do and an adjustment sometimes of their medication (and with insulin it’s even more exciting for me to teach someone about as it’s even better managed from the day to day checking of their blood sugar levels).  In these past two weeks I’ve had 2 patients with gestational diabetes and believe me when I tell you that their numbers are dependent on what they eat and we’re trying to completely manage their blood sugar levels with food and avoid using the insulin if we can.  The picture isn't the greatest, but you'll see below almost all of the patient's levels are at target - and the one that was above target two days in a row, so we switched her food at that meal and the next day it was within normal limits.  That to me is rewarding.
That’s the kind of counseling I enjoy.  The weight loss counseling is tough because it’s never about the food and so I don’t feel like I’m actually teaching patients rather I’m counseling them and let’s be honest I don’t have a psychology degree.  All of this background insight to simply say, I’m working too many hours in the day and I’m giving my patients beyond 100% and I’ve not been giving back to myself. 
My yoga teacher’s words really resonated with me the other day and had me really reflecting.  I always talk about ways to give yourself self-love – one of my recent blogs, Self-Care Sunday – was even on that very theme.  But I’ve been failing myself and not following through and actually giving myself my own self-love.  And because of this I’ve been feeling drained all over again.  It’s a repeat performance of my last job all over again.  And that’s why I started reflecting.  How am I going to change this?  How can I make this better?  It’s definitely time for a change and I know it cannot continue this way.
So yesterday I did all the things that I love and enjoy.  Probably should've spaced them out and not crammed them all in one day.  But I figured go big or go home!

-I meal prepped for just a couple of hours.  Setting up the staples for the week helps me (because I am getting home so late at night) that at least I can eat a good, hearty meal - because I am definitely not cooking once I get home.  Some people don't like cooking, but I find it can be relaxing.  I enjoy cooking healthy food that tastes good.  Nothing makes me happier - well, maybe grabbing a perfect picture of the meal I just prepared.  I styled a few pics of the food I'm eating this week.  Gotta document the healthy eats.

- I spent time with my family.  My mom shares a love of cooking, so we headed south to a fruit farm she knows of.  Great little find down south, Granddaddy's Farm Fresh Market, a small, local farm.  It's always rewarding being able to buy fresh food and support the farmer behind that food.  If I had to grow my own food I'd be doomed - I kill everything.  Thankful for the farmers that do grow the food.  The BEST strawberries I've ever had.

-I wrote a part of this blog.  I love writing when I have a theme and something I feel that people can learn from.  This week it wasn’t about nutrition but it was about a current theme in my life –and to be honest many of my most recent patients have complained of this very same thing.  Perfect timing and the writing just flows – welcoming Spring with open arms.  Things are going to change. 
-Yoga & meditation– I’m still nursing a rib injury.  I don’t have an interesting story to tell, I’m just a clutz.  Daily I’m doing something to myself, most times without harm, but this time I didn’t fair so well.  So I didn’t have any asanas (physical poses) except good old savasana – corpse pose.  But it was just what I needed to do – focus on my breath (that is hard to do with an injured rib) and just be still and present.
-HEAT game.  I LOVE sports.  Have I told you recently that I LOVE sports?!  My HEAT are pushing for the playoffs and they needed my support!!  Sure we got a L and not the W that I was hoping for, but there’s no other feeling that you get when you’re at the game cheering your favorite team on.    #HEATison   

-Reading.  I haven’t read an actual book in I don’t know how long.  Someone recommended Judy Blume’s latest book – "In The Unlikely Event"– and 75 pages in, I’m hooked.  I have to see how all the characters are connected and how this story unfolds.  I loved Judy Blume from her "Tales of Fourth Grade Nothing" days and she’s not disappointing me again.  Books are a great way to create an adventure.  This adventure keeps getting better page by page.  Can’t wait to see how it all plays out.

Immediately my job is not going to change.  It’s time consuming and at times stressful.  What I can change is how I spend my free time and make sure I’m giving back to myself.  I shouldn’t be cheating myself .  It’s the old adage – “You can’t pour from an empty cup.  Take care of yourself first.”   In order for me to make any impact with my patients I truly do need to start giving back to myself.  Spring is that time for change, growth, and renewal.  It is a time of new beginnings & new possibilities.    And it’s time to give back to myself because things are going to change…

Sunday, March 5, 2017

National Nutrition Month - "Put Your Best Fork Forward"

National Nutrition Month® - 2017

“National Nutrition Month® is a nutrition education and information campaign sponsored annually by the Academy of Nutrition and Dietetics.  The campaign is designed to focus attention on the importance of making informed food choices and developing sound eating and physical activity habits.  “Put Your Best Fork Forward” is the theme this year – encouraging everyone to make small changes over time that eventually will make a big impact on one’s health. 

Last week I had a patient come in to my office and literally wanted a quick fix for weight loss (not the first patient to do this, but just my most recent).  She continued to go on and list every (and I mean EVERY) excuse in the book as to why she couldn’t lose weight.  Today’s theme is not talking about other possible hindrances in one’s weight loss journey (i.e. hypothyroidism, depression, etc), however, she had a response for every suggestion that I was making.  She was a high intense person and was SUPER stressed with work and being a single mom.  I simply stopped and asked her how she was fueling herself with all this work that she was doing.  She had described to me going long periods of time without eating, she was a realtor and was always on the road and didn’t want to eat food out and about as she knows it’s not the healthiest.  She continued with more excuses/responses.  I explained to her that I would make lots of suggestions to her but I only needed her to pick ONE thing to work on to improve upon.  She couldn’t believe that I told her to make just one change.  I explained to her that the way I saw it is that one small change would be the most beneficial to her – it wouldn’t seem out of reach, it wouldn’t stress her out even more, and she was more likely to succeed.  Am I right?!  As the session continued I do believe she began to break down some barriers and realized that she has been putting too much pressure on herself and trying to do it ALL at once, and with no success I might add.  Her trouble area was rushing out the door without breakfast.  I suggested to her to have her son help prep some overnight oats for them both.  That way she could still rush out the door, but at least have breakfast on hand (not go long periods of time without eating, setting the tone for the day, etc).  She liked the idea. 

Here are a few versions of overnight oats that I’ve done recently.  I do prefer a little more milk with each bite, so mine might look a little “soupier” than you might like (I add an extra ½ cup of milk the following morning).  But the recipe is simple: ½ cup rolled oats, ½ cup skim milk (or nut milk alternative of your choosing – aim to look for one that’s had pea protein added in, it ups the protein per cup of milk), 2 tbsp of any nut butter, ~1/2 cup of fruit (natural sweetener – no added sugar), and ~1 tbsp of chia, hemp, or flax seed.  This overnight oats is a game changer.  Not only are you having breakfast (which is important) but you’re also starting the day off with whole grains, healthy plant-based protein (from the nuts/nut butter), and healthy fats (from the nuts/nut butter and the seeds – chia, hemp, and flax) that will fuel and sustain you through the morning!  My patient I described wasn’t having breakfast and she wasn’t having nearly enough whole grains/fiber in her diet.  So little did she know she wasn’t just changing one thing but two. Ha!  All jokes aside, I really want my patients to start making these types of changes and implementing them for life – not just for some quick fix weight-loss diet.  My patient did like this idea and this was the goal of what we started to have her work on in this next week.

The other area that she wanted to focus on after implementing breakfast was dinner.  She knows she needs to cook healthy meals, but the bottom line is that she stated she didn’t even have time to go to the store.  Well, well, well.  Enter meal delivery systems.  They are ALL the rage right now.  I tried Hello Fresh recently.  I wasn’t sponsored to do so and this isn’t an advertisement.  I’m just speaking from experience of what meal delivery system I tried – please do your own research and see which one fits best for you – prices, menus, etc.  I opted for the vegetarian option and all the items were dropped off on a Monday afternoon.  It had 3 boxes of all the ingredients for three meals.  In essence each meal is supposed to make enough for two meals – mine ended up making three meals for two of the meal boxes.  Each meal was ready in less than 30 minutes and the flavor on all three was out of this world! Granted I only tried a week, but the truth is you can check the menus out and see what sounds good to you.  If this patient’s problem is that she can’t get to the store?  Hello!!  All the grocery items are there ready for you to go.  My patient after talking with her more was stopping each night to pick up food from a local eatery close to home, supposedly healthy.  Stopping each night for food?  And she’s pressed for time?  Her other struggle was finding something her son liked each night, walking the store not knowing if what she was eating was healthy (because of that health halo I do believe many patients are confused at the stores and don’t know what to buy).  I suggested to her trying a meal delivery system.  Sure she’s tired at night and doesn’t want to have to come home and cook – who does?  There are even meal delivery places that already deliver the food prepared – I told her that would be a decision she would have to make and then possibly transition to using a food delivery system that had all the ingredients.  I use the recipes I received from Hello Fresh still to this day – they’ve made the repertoire of “keepers” in my house – so as I told my patient the meal delivery system could be a great start for her to build on and then have viable options to keep with in the future.  She did like this idea and said she was going to do her research to see which one she would use.

The last area that my patient really needed to work on was time management/stress management (as she called it).  She doesn’t have enough time in the day and that stresses her out.  She is consumed by work, so much so that it affects her time that she spends with her son, her exercise regimen, and simple downtime (she has none).  I’d say this fits the bill of most Americans, she’s not alone.  The goal for her is to simply find ways in which to improve the situation.  One thing we thought about was having her workout with her son.  She didn’t think this was ideal as she likes to have her alone time working out, but the truth is she needs to work out and so does he.  They’re both not exercising and while she might enjoy the time alone from her son she’s also not been spending enough time with him as it is.  Just me looking in from the outside, easier said than done I told her.  She did like the idea and began to think of a few outdoor activities they could do together as a start.  While National Nutrition Month might be more weighted on nutrition, physical activity is a key, critical component when it comes to overall health.  I know in my own experience when I exercise I’m less stressed.  I believe that incorporating exercise will help this patient release a little bit of the tension/stress that she is feeling.  She might feel pressed for time and think that she can’t fit it in, but that’s the hamster wheel that she’s on – she feels like she can’t get off for even one second, when in reality, exercising will help her overall well-being. 

Small changes make a big impact over time.  Aiming to have breakfast daily, opting for 100% whole rolled oats instead of instant oats, or exercising a few days a week, when implemented, can make a big impact toward improving your overall health.  Drastic changes, like eliminating entire food groups, or adopting a major shift in diet are not necessary to be successful.  In fact, the 2015-2020 Dietary Guidelines for Americans actually suggest “starting with small changes in order to make healthier lasting changes you can enjoy.”
The Academy of Nutrition and Dietetics is promoting this message of starting small this National Nutrition Month.  It’s a reminder to us all that “each bite counts and that making just small adjustments can add up over time.”  One step at a time, “Putting Your Best Fork Forward”, to create healthy habits that last a lifetime.