8 things I want my patients to know

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1. I am human, too

You forgot to take your medications? You picked up fast food on the way home? You skipped your exercise because you were too busy and exhausted? You had one two many drinks when out with your friends? You only get a few hours of reliable sleep a night?
Guess what? Me, too. Being a doctor doesn’t make me immune to messing up and not doing what I’m supposed to do. I personally have struggled with obesity my whole adult life, and I am going through many of the same struggles you are. Don’t be afraid to open up and let me know what you are having a hard time with. I don’t expect you to be perfect because I am most certainly not perfect myself.

 

2. Out of sight does not mean out of mind

When I round to see you in the hospital, you may only see me for 5-10 minutes a day. This is not because you are not important. Before and after I enter your room I will have reviewed your chart, ordered tests and medications, consulted with appropriate specialists, discussed your case with your nurse and our unit staff, and have a plan outlined. You may only see me for a few minutes face to face, but I am constantly working behind the scenes to improve your condition and your care.

 

3.Don’t apologize for your body

Many of us hate going to the doctor and getting examined. Be it just a general physical or a more invasive exam like a breast exam, vaginal or rectal exam. You do not have to be ashamed and apologize for any perceived shortcomings. These exams are routine for me, and I am not here to judge you. And guess what? I hate getting these exams done, too! Sometimes you just have to bite the bullet and power through it.

 

4. I am a physician because I love it, not for money

Doctors are fortunate to make good salaries. This day in age, most physicians like myself are employed by healthcare systems and are on a fixed salary. This means most of the dollars that come out of your pocket don’t make their way to me. I am also bogged down in loans, many hundreds of thousands of dollars of medical school debt, and it will take me a lifetime to be able to pay them off. So while I can live comfortably, I cannot afford a lavish lifestyle. Medicine is a lifelong career, not a quick way to make a buck.

 

5. I stay up at night worrying about you

When you are under my care, I constantly think about how you are doing. If you were having a bad day when I rounded on you in the hospital, I’m likely to be mulling your case over as I try to sleep. Your health and your safety keep me up at night, and I will do everything within my means to help you. Your worries are my worries, too, and I carry the names and faces of my patients with me for years.

 

6. I get stressed out, too

Part of being a physician is learning to leave our personal lives at the door. When I enter your room, I may have just suffered a terrible personal loss, be feeling unwell m, or just stressed with run of the mill life issues. I do my absolute best to make sure that none of those stressors come into the exam room with me, but I’m not perfect. If I seem tired or sad or grouchy, I may be having a bad day, too. If you notice this, try to give me the benefit of the doubt because I’m probably trying my best. If you are worried my stress is affecting your care, let me know. I may not realize just how much my own stressors are coming across to you.

 

7. I am on your side, but we may not always agree

Many times it can feel like patients and doctors have a different opinion on what constitutes the best plan of care. If you have pain, I may not think giving you strong opiate pain medications is the right treatment. You may think you need surgery or a procedure to fix your medical issue, and I may think you need medication treatment or to give it time and see what progresses. I may not be able to offer you a quick fix for your problem, or a fix at all, but I will always prioritize your goals of care. If I don’t think I can meet those goals, I will be direct and tell you.

 

8. I don’t always have the answer

Doctors hate having to say “I don’t know,” but the truth is we often don’t. Saying “I don’t know” does not mean that I haven’t given your concerns full consideration. In medicine, absolute certainty is not the norm. A lot of conditions like abdominal pain, headaches, fatigue, joint aches and pains, viral symptoms cannot be attributed to any one cause, they just get better and go away by themselves. Some chronic conditions, like chronic pain, we may never be able to define well or understand the underlying cause. If I don’t know I will give you my best and honest professional opinion, but I may not always be able to give you a definite answer.

Barre Class

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Tried a new workout today! I like to try new workouts with my friends because we can all laugh at how ridiculous I look trying to get the moves down 😆😆😆 It’s also a great way to make new friends!
We went to our first barre class today at Pure Barre in Centerville OH. Now walking in, as usually is the case, I was the biggest woman by at least 25 pounds. And also as usual, I didn’t let that deter me! Don’t get intimated by other people’s bodies and fitness levels- you do you!
Now this class is a kind of mix between Pilates, yoga, and ballet bar exercises. The whole class is really about using isometric exercises to improve core strength. My core is definitely my weakest area- if you slice me open you won’t find muscles but marshmallow fluff! So this class was really hard for me, to get the right form and then sustain the exercises was a lot of work!!! The class instructor was good about correcting form- but I definitely could have used more information on how to modify the exercises to suit me personally. I will definitely go back and do this again, and I will keep working at it till I can keep up with everyone else!

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Bonus points for music including Kelly Clarkson’s version of It’s Quiet Uptown… definitely won me over with that cause you know I’m a Hamilton freak!!!

What is Even up With Women’s Clothing Sizes?

Can you guess the size of these dresses as we go along? Good luck!

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I recently have had the fortune (or misfortune) of needing to buy new clothes and trying to figure out what size I need in the wake of an 83 pound ongoing weight loss. Well here’s the thing… good luck with that! What I have experienced while trying on and buying new clothes is that the discrepancies in women’s sizes are even worse than I thought.

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This is not a unique problem to regularly sized women’s clothes… plus sizes are guilty of the same behavior. At my heaviest I may have been a size 18W dress from Eloquii, a size medium from City Chic, a size 24W in Democracy Jeans, a size 14W dress in Calvin Klein, and a size 18 regular dress from Loft or Land’s End.

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So why the variability? There are no set standards or rules for clothing makers to use. As time has progressed and beauty standards have changed, so have the sizes on our tags. As the American populace had become heavier, “vanity sizing” has taken over the market.

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From a merchant standpoint this obviously makes good sense- sell women the same size clothes with a smaller label, and they will be happier and come back to you again. The classic example of Marilyn Monroe still holds true today. A postulated size 12 in her time, she could be anywhere from a size 0-8 today.

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When I was shopping just recently I bought dresses in sizes 12 (Calvin Klein), 10 (Calvin Klein), 16 (Adrianna Pappell), and even size 6 (Luxology and Ronni Nicole)! I am still roughly 40 pounds heavier than I was in high school, when size 10-12 was my average size, so the fact I can wear that same size now is baffling. It is confusing and frustrating to have no idea what size clothes you will need until you try on a specific brand. Now anyone who knows me knows I love my dresses, but right now shopping is feeling a little more like work than fun! Thank goodness for online shopping with free shipping and returns! 😉😉😉

A: 14w

B: 16w

C: 14

D: 12

E: 6

Chickpea Taco Mason Jar Salad

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Once again, I started with a base of a Marley Spoon recipe and made it healthier and work for me!

This recipe makes 3 mason jar salad servings

Ingredients

1 can chickpeas, rinsed and drained

2 tomatoes, diced

1/2 white onion, diced

3/4 cup of drained and rinsed black beans

3/8 cup dry farrow, or any other grain cooked per directions

1 carrot sliced into thin ribbons with peeler

1 yellow bell pepper thinly sliced

2 tsp of Mexican spice blend

One small bunch cilantro. Mince leaves and finely chop stems. Keep leaves and stems separate.

Dressing:

Juice of two limes. One clove garlic minced. 1 tablespoon olive oil. 1/2 tsp honey. All minced cilantro leaves. Pinch of salt and pepper. Whisk together.

Directions

Heat up 1 tablespoon olive oil. Cook onion and cilantro stems for 5 minutes, until onions soft.

Add chickpeas, tomatoes, and Mexican spice blend. Cook 5 more minutes.

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Build salad

In each jar, directions from bottom to top. Add 1/3 of each of the rest of ingredients, split evenly between jars.

2 tablespoons dressing

Bell pepper and carrots

Black beans

Farrow or other grain

Top with stewed chickpeas

Enjoy!!!

Nutrition info (if using farrow)

391 calories

63 g carbs, 9 g fat, 15 g protein

 

 

 

 

Portions, Calories, and Nutrition

Let’s talk portions, calories, and nutrients!

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Calorie counting and keeping track of my macronutrients (carbohydrates, fat, protein) has been essential to my weight loss. Eating portions that are too big has always been a problem, but obviously the portion size depends on what type of food I am eating. I have also cut way back on eating restaurant food because the portions are often times 2-3 times the size recommended and there are often hidden calories in the way the food is prepared. At home, eating seconds is a issue that has had to be curtailed as well. I keep track of everything I eat with an app, so I can closely monitor my nutrition.
These photos are of are two meals I eat often, so let’s compare them. The one in the 7 inch wide yellow bowl is homemade cauliflower casserole. My husband Rob makes this for me and it is delicious! It has roasted cauliflower, leeks, spinach, a béchamel (hot yummy cheese) sauce, and is topped with bread crumbs. The meal on the 10.5 inch wide blue plates is my favorite in the world, fajita vegetables. I have given up the tortillas, and just eat the veggies with salsa and cheese. This allows me to cut back on unnecessary carbs as well as lower the total calories by 300. Being vegetarian, carbs are the main component of my diet, making up about 50-60% of my total daily intake, so I am working to try to increase my protein content and cut back on carbs where I can.
The cauliflower casserole has 600 calories per serving with 63 g carbs, 23 g fat, and 31 G protein. As you can see it is in a small bowl, because it is more calorie dense and so the serving size is smaller.
The fajita vegetables are on two large dinner plates. That is because I eat two full plates of these veggies, roughly 6 cups of vegetables, per serving. They have 400 calories for both plates with 58 g carbs, 10 g fat, and 16 g protein.
So this is why I eat so many vegetable fajitas! I can eat huge portions since they are so low calorie, and they are extremely filling. It is a wonderful hearty meal at the end of the day. The downside is that they are lower in protein content, so in my other meals for the day I need to try and compensate for that.

HIIT at The Studio Fitness

HIIT class

 

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Today I went with my beautiful friend Milinda Zabramba to a HIIT class up in Vandalia at The Studio (Zumba) Fitness. I love HIIT because it is an amazing whole body very challenging workout. This was the first time for me going to this class and it was mainly all intervals with a tiny bit of dance like moves thrown in. It was really good! Again this is a high intensity workout, so it isn’t good for beginners.
It being my first time, it took me a bit to get the routine, and it was a little hard to hear the instructor at times, but she was very good at making the moves clear. The workout had a lot of arm toning exercises and planks mixed in also, which I sorely need for these wimpy arms. The last 15 minutes was full of some very challenging core workout- good stuff.i would definitely do this class again.
I did stick around and did part of my first ever true Zumba class as well. This was much more low-moderate in intensity. There were several adorable older ladies there as well, so good for all age groups. I would recommend this class to all levels. It was low impact, you can modify it to make it even less so if you need to. This class had pretty easy dance moves so it wasn’t that hard to follow along. I think I’m going to keep with more of the HIIT style workouts, dancing is absolutely not my thing. Two left feet

Combatting Compassion Fatigue in the Opioid Epidemic

This is the patient’s 8th admission over the course of two weeks. The patient is a heroin abuser and has bacteremia and endocarditis. Their heart valve is failing and they are in and out of congestive heart failure. Everyday dozens of medical professionals converge on the patient to give treatment and advice. And everyday after hearing that advice the patient leaves the hospital against medical advice and goes to use IV drugs. They wind up back in the hospital out of fear or panic, or they are brought back in after overdosing by the police. The cycle continues.
In this common daily scenario, it is very easy as a provider to lose hope. We are everyday doing our absolute best to treat patients who many times, do not want or refuse our help. In the throws of their addiction, these patients are focused only on the next high- regardless if that costs them their lives.
So at the bedside, how do you maintain your own well being and sanity? At our core, we all went into this field to help people. Drug addiction is a challenging disease, but it is a disease. Not a moral failing. Not a choice. Treating addiction just as we would any other disease is the first step in the process. It can be very hard to separate our emotions and personal biases from our work with these patients, but we must. Focusing on what is best for that patient in that moment is the only thing that matters.
Easier said than done, right? Compassion fatigue and burnout are real daily issues at our jobs. We are not going to save every patient, people are going to die. All we can do is our best to treat each patient as an individual with kindness and compassion, as well as excellent medical care. And at the end of the day, that’s it.
Don’t take the stress of treating patients home with you, leave it at the door and know you did everything you could. In order for us to remain excellent providers and not flame out we need to prioritize our own mental and emotional health.
You do not want to let feelings of overwhelming stress keep building up unchecked- so what can you do?
1. Talk it out with your colleagues
2. Delegate- ask for help from your colleagues when you need it
3. Practice meditation and self reflection
4. Do some yoga and exercise- do whatever you love doing that helps you cope with the stress of this job
5. Take time off when you need it
6. Be okay with saying “no”
7. Get more involved- sometimes being part of the solution, in this case like volunteering at a drug rehab center or helping improve access to addiction resources, can restore the meaning to your daily work
But above all know that there are so many of us out there right now going through the same thing- if we are open and honest about our struggles as providers we can get through them together.

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