Habits - December

I spend a lot of time with my patients talking to them about healthy lifestyles.  I talk about good food choices and how much exercise they need and strategies for making positive changes in a world that is pretty much optimized to make people fat.  And then I go home and sit on my couch eating cheese.

I have the misfortune of being someone who both hates exercising and loves eating (I suspect I'm not alone in this), so my natural tendency is to get larger with every passing year.  Over the course of my nine years of medical training, I gained approximately 30 pounds - over 3 pounds per year!  While that doesn't sound too bad, if I keep up the same slow rate of weight gain until retirement, I will be approaching 300 pounds by the time I get there.  Assuming my heart and my liver and my knees don't give out before I make it to retirement.

The other, and perhaps more important part of the healthy lifestyle equation, is that I simply don't feel good when I spend my life on the couch eating cheese.  Well...I must admit...I feel great at the moment when I'm lying horizontally in my favourite pjs and shoveling gooey cheese into my mouth.  It's the moments afterwards when I feel sluggish and tired and anxious and unable to focus that are less pleasant. 

For years, it's been easy to justify my choices, because I've simply felt so overwhelmed by the stress of medical training.  There were many days in medical school and residency when I felt like it took everything I had just to make it to bedtime, so I allowed myself to do (and eat) whatever would help me get through the day.  Now that I'm an attending, though, things are different.  I have much more control over how much I work, even if I sometimes don't make good decisions with that control.  I do far less call than before, and none of it is in-hospital call.  I finally have the time and the energy to start making some of the good choices that I talk to my patients about all the time.

So...how do I do that?  I've written here many, many times about wanting to make changes in my life, yet so far few of them have stuck.  Most recently, there were my four categories of habits that I wanted to adopt as an attending, which were so unsuccessful that I didn't even get around to blogging about the last two categories.  As I've been thinking about how to make the changes that I want to make, I keep coming back to the piece of advice that I give to all of my patients:  make gradual, long-lasting change.  No complete transformations on January 1 that last for less than a week.  No four categories of habits to adopt when you're starting a new job and dealing with all of the stress and adjustment that doing so entails.  Gradual, long-lasting change.

For me, the obvious first step is getting back to the gym.  I have pretty much the best setup for working out that anyone could have, as there is a gym two floors below where I live that costs me nothing, has brand-new exercise equipment, and is rarely used by anyone else.  My goal is to go three times a week:  Tuesdays and Thursdays before work, as I have no morning clinics on those days, and Sundays while my girlfriend is at church.  I'm not setting any specific requirements for myself beyond 1) getting to the gym and 2) spending 30 minutes doing anything that counts as exercise.  If I choose, I can spend the 30 minutes walking very slowly on the treadmill.  I just have to move. 

I've done okay with this the past few weeks, although today was the first day that I made it to the gym on Sunday.  I'm hoping that by making exercise part of my routine, like cleaning the litter boxes or showering, that it'll just become something I do without thinking about it. 

Wish me luck!