New Year Resolutions

The “clean slate” of a new year almost always leads us to think of resolutions … things we could change to make our lives better.  This is a great time for reflection to realize what you have accomplished, where you’d like to be in a year, and what changes you need to arrive at that goal.  I just finished reading Making Habits, Breaking Habits: Why We Do Things, Why We Don’t, and How to Make Any Change Stick by Jeremy Dean which provided some useful ideas about making resolutions.

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Know why you want to make the change

“There has to be an ultimate goal that is really worth achieving or the habit will be almost impossible to ingrain.”  Jeremy Dean

Let’s take one example – losing weight.  It’s fine to say you want to lose weight… but why?  Wanting to fit into your clothes is not a trivial reason, but will it really motivate you when it gets tough as much as these?

  • Being able to “walk the walk” when you talk to patients about losing weight
  • Reduction in your risk for diabetes, heart disease, cancer and a variety of other health problems
  • More energy, better mood, less pain…

What’s important is that you find reasons that resonate for you.  Do a little research and write down why you want to make the change.  Plan to review this, and revise it when needed, on a regular basis.

 

Make the resolution then make a plan.

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To continue the losing weight example, what are the specific new habits you want to develop?  Are they “SMART” changes?   (Specific, Measurable, Attainable, Realistic and Time-Based).  For example…

  • I will eat 8 servings of fruits and vegetables every day.
  • I will set the alarm clock 15 minutes early to do push-ups, crunches and squats before I go to the hospital.
  • I will plan my meals and shop once a week so I can take healthy food with me to work.
  • I will schedule my workouts every weekend so I can attend at least two spin classes a week.
  • I will cook one healthy dish on the weekend that I can eat for at least 4 meals during the week

 

Develop the “what if” plan.

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The next step is to imagine all the things that might derail you and write down a specific plan for each of them.  This will be an ongoing process… as you come up with new excuses to not follow through with your new habit, add it to the list.

Back to the example of losing weight….

  • If I forget to bring fruit/veggies with me to work, I will go to the cafeteria or lounge to get at least 2 servings to eat at work.
  • If I walk by MacDonald’s and feel drawn in by the smell of the fries, I will remember that I’m trying to set a good example for my patients
  • If I hit snooze on my alarm clock, I will move it across the room.
  • If I think I’m too tired to go shopping for the week, I will remember that this is the key to having healthy food at work.

“Making healthy habits should be a voyage of discovery.” Jeremy Dean

 

Keep track.

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Self-monitoring is critically important to maintaining a new habit.   It doesn’t matter if you use an app like My Fitness Pal, a calendar, a spreadsheet or a system like the Bullet Journal… stay accountable by keeping track.

 

As the habit becomes engrained, change it a little to keep it interesting.

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Working out with exactly the same routine quickly becomes boring. It’s one of the reasons people love group classes like spin classes  – the instructors are always changing the routine.  Be mindful and creative… but stay out of ruts!

“Making or breaking a habit is really just the start. To develop a truly fulfilling and satisfying happy habit, it’s about more than just repetition and maintenance; it’s about finding ways to continually adjust and tweak habits to keep them new; to avoid mind wandering and the less pleasurable emotional states that accompany it. There is great enjoyment to be had in these small changes to routines. When life is the same every day, it gets boring.”  Jeremy Deans

 

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Looking for inspiration?  Here’s a list of New Year’s Resolutions for medical students, residents and busy docs.  Pick 1 or 2 and start working on your plan, your what-ifs and how you will monitor them!

  1. Learn to meditate and spend at least 10 minutes every day meditating with HeadSpace. (Here’s the TED talk that introduced me to this great app.)
  2. Eat fruits and veggies with every meal.
  3. Walk 10,000 steps per day.
  4. Take the stairs instead of the elevators.
  5. Learn the names of all the people you work with… the guy who mops the floor, the clerk at the desk, the person who works in the blood bank.
  6. Write down three things you are grateful for every night before you go to bed.
  7. Log all cases (if this applies to you) the same day and finish medical records within 24 hours.
  8. Use a system like the Bullet Journal or Remember The Milk to become more organized and never miss a deadline (including the birthdays of your family and friends)
  9. Cook your own meals at home (take a class if you need to).
  10. Be on time to conferences, rounding, meetings, classes, etc.
  11. Spend at least half a day a week “unplugged” and use it to play.
  12. Keep a journal to remember the important events of the day, vent about things that upset you, and make plans for the future.
  13. Read something that is not medical every day.
  14. Stop eating fast food.
  15. Drink less alcohol or stop all together.
  16. Get at least 7 hours of sleep any night you are not on call. (and have a plan post call to sleep more)
  17. Cut out all added sugar.
  18. Drink more water.
  19. Keep your house neater… or at least a part of your house!
  20. Stop texting while driving.
  21. Learn about motivational interviewing to help your patients.
  22. Read a major textbook in your field in one year.
  23. Learn something new from every patient you see
  24. Try a new way to exercise every month
  25. Set your intention for the day every morning.
  26. Eat breakfast every morning.
  27. Set limits on checking email, Facebook, Twitter, Instagram and other social media sites.
  28. Practice mindfulness.
  29. Plan your meals for the week on the weekend to make sure you have great food on call and at work.
  30. If you have to sit a lot at work, come up with a plan to not be so sedentary.

 

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I Forgot To Tell You About My New Favorite Breakfast!

This morning I was lecturing to the first year medical, PA and DNP students. At the end of my embryology lecture I included some advice on how to eat well as a busy student. I talked to them about how to set a good example for their future patients, how to increase vegetables in their diet by making Mirepoix every weekend, shopping at the farmer’s market, and how to plan for the week. I also talked about why it’s important to eat breakfast. I told them about one of my favorite fast breakfasts, but forgot the second one!

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MLB BREAKFAST TACOS

Here are the ingredients:

FullSizeRenderThis batch had beans, cheese, a red bell pepper, a jalapeño and some cilantro, but you can add anything!  Spread out the tortillas and divide up the ingredients between the tortillas.

IMG_3511-1024x1016Roll them up, put them in the freezer. Two minutes in the microwave and they are ready to eat!

 

OVERNIGHT OATS

This is SO easy and really delicious.  Put ~1/3 cup rolled oats in a bowl and add twice as much (~2/3 cup) liquid. (You may need more of both depending on your caloric needs)

My favorite liquid is kefir (liquid yogurt), but it can be milk, almond milk, soy milk, etc. Leave it in the refrigerator overnight. Eat it in the morning. That’s it!

You can add any variety of fruit, nut or nut butter the evening before or in the morning. My current favorite is blueberries and slivered almonds added in the morning.

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Eating Well at Work

It’s hard for those that haven’t been there to understand how medical school, residency and/or long hours in the hospital changes what and how we eat.  There isn’t time to sit down to eat, there aren’t good choices and often, the only thing to eat is the “free” food at conferences.  But…. Free food isn’t free. There’s a reason it’s cheap (poor ingredients) and that it “tastes good” (lots of fat, sugar and salt)… but it makes us feel terrible after we eat it.  (Beware the middle of the night french fries!) More importantly, we aren’t providing the nutrients we need to take care of other people and ourselves.  So, what’s the answer?

Spend the money and the time to invest in your health! Grabbing donuts or bagels in the surgeons’ lounge in the morning, pizza at noon-day conference and a hamburger at MacDonald’s in the middle of the night is terrible. (You know it’s true).

 

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So what’s the alternative? Here’s a five-step, easy plan that will let you eat better, feel better and avoid gaining weight in medical school and residency.  This is predicated on cooking your own food but you can use this plan if you don’t cook by buying prepackaged foods.  But really…. If you can learn how to take out a gallbladder or care for ill patients in the ICU don’t you think you can learn how to sauté a few vegetables???

 

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  1. Make a plan
  2. Make a shopping list
  3. Shop once for the week and (when you can) prep ahead
  4. Use your day(s) off to cook things that might take a bit more time and freeze some for other days
  5. Keep a few “instant” healthy meals in your pantry

 

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Make a plan

Map out your week’s meals and snacks using the “pizza rule” (nothing you cook should take longer to cook than it takes to order a pizza). Pay special attention to call days. It’s important to have really delicious food which can be grabbed in a minute when you are on call. I use Evernote to make my list for the week so I can share it with my family:

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If you like to cook, you probably already know where to find recipes you’ll like. If you don’t cook regularly, I post recipes on @drmlb with #CallFood that meet the “pizza rule” and would be delicious on call. Here are few other sites I use regularly: Eating Well, Cooking LIght, My Recipes, Food Network, Kayln’s Kitchen, Skinny Taste. If you use Evernote to organize your list, it gives you one other advantage – you can download their add-on and clip recipes from the internet directly to Evernote. Each “note” (i.e. recipe) in Evernote can then be shared with whoever you cook with (i.e. whoever gets home first can start dinner!). It also lets you search all your notes so you can easily find your recipes in the future.

 

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Make a shopping list

I use Grocery IQ for my shopping list. This app lets you organize your grocery list by the aisles in your favorite stores to make shopping faster. It also allows you to share the list with your significant other which means that whoever is able to get to the store first has the updated shopping list!   I don’t really use the “coupon” feature or the barcode scanner, but if you choose to use these functions, please use the FoodEducate app with it to make sure your choices are healthy!

There are other apps for shopping which come recommended by others which, to be fair, I thought I should share: Any List, Pantry Manager, Paprika

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Shop once and (when you can) prep ahead

Planning lets you spend less time in the grocery store and absolutely means less food wasted. When you get home from the store think about the meals you are going to cook later in the week. If your carrot soup on Tuesday calls for sliced carrots, diced fennel and chopped onions, chop them when you get back from the store on Sunday and put your “mise en place” in baggies or containers in the refrigerator. Cooking is not that time consuming…. but prepping is!

mirepoix

One other good trick is to make “mirepoix” on the weekend for the week. Diced onions, carrots, celery, bell peppers, etc can be prepped and put in a bag. It can be an instant stir-fry on nights when you need something fast.  You can also put a handful in soups, omelettes, or wraps to get extra vegetables in your day. Mix it with leftover rice or other grains to make an instant salad (you can add tuna, if you want, too).

 

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Use your day(s) off to cook things that might take a bit more time and freeze some for other days.

You need good “comfort food” when you are working hard, but it can be both comforting and healthy. For example, this recipe for spaghetti squash lasagna. The preparation for this recipe isn’t that hard (you can steam the spaghetti squash in the microwave instead of roasting it in the oven, for example) but it’s a little too long for nights when you get home late and are really tired.

Learning to use a pressure cooker (my favorite) or a slow cooker like a crock pot is a great way to cook up a batch of something when you are home and doing other things without spending a large amount of time in the kitchen

No matter what you make or how you make it, make enough to freeze individual portions and then store them so they will stay fresh. Don’t forget to mark the containers with a Sharpie and eat them within 3-4 months!

 

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Keep a few “instant” healthy meals in your pantry

Despite my best efforts to plan, there are weeks when I’ve miscalculated amounts, don’t have enough time or just don’t want to eat what I had planned. When that happens, it’s great to have a go-to “instant” meal, which usually comes out of the freezer and pantry. Here are some to get your list started!

Moroccan Lentil Stew – (particulary good with harissa and served over couscous)

Quick meals from frozen ravioli

Shrimp fried rice

 

food be your medicine

Fast, Easy Recipes: Naturally Ella

I’m always looking for websites with great recipes that meet the “pizza rule” for medical students, residents and busy docs. (Food that takes take less time to prepare than it does to order a pizza).

Naturally Ella is a website by Erin, who “grew up on fast food” but, along with her family, made significant changes when her father had a heart attack at age 45. Her blog has healthy vegetarian recipes that are easy to prepare and make great #callfood*. Even if you aren’t a vegetarian, these recipes will convince you to join the Meatless Monday movement!

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Avocado Chickpea Salad

 hummus grilled cheese sandwich

Hummus and Grilled Cheese Sandwich

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Sweet Potato Sriracha Noodle Soup

 

*Search for #callfood on Twitter for other “pizza rule” recipes that are great to take to the hospital for call!

Fast and Easy Recipes – Protein Bars

The senior class ends their formal education at Baylor with a capstone course called “APEX”. In addition to reviewing critical medical information, communication skills and other important aspects of becoming an intern, there are also wonderful lectures from faculty on “how to be an intern”.

One of the APEX speakers this year was Dr. Sally Raty, who stressed how important it was to take time to care for yourself.. but that you had to look for efficient ways to do it! She promised to share recipes that are easy and take very little time to cook. I’ll share the rest of the recipes on future posts… but here is the first one (which she adapted from this recipe).

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These bars have a ton of ingredients, but they are easy to find, and this bar is way better for you than those processed, chemical blobs you’re spending $2+ on. I keep all of the dry ingredients for these bars in a basket in my pantry. I just pull the basket out and make the bars. The crumbs are amazing on vanilla ice cream….not that I would ever do that, but I’ve heard it is good.

3 cups raw oats
(nothing fancy. Quaker 3 minute (not instant) oats are fine)

1/2 cup whole sesame seeds, or shelled sunflower seeds

1/2 cup shredded coconut (unsweetened is best, but sweetened is easier to find)

1 teaspoon ground cinnamon

1 teaspoon salt

1/4 cup brown sugar

1 cup vanilla Greek yogurt

1/4 cup + 2 tablespoons pure maple syrup or honey

1 cup peanut or almond butter

1 teaspoon vanilla extract

1/4 cup coconut oil, liquefied if solid (or just use canola oil)

1/2 cup chopped chocolate chips (> or = 70% cacao is best)

1/2 cup chopped nuts (almonds, walnuts or pecans)

1/2 cup chopped dates, raisins, figs or other dried fruit–optional (I don’t typically add these)

1 cup vanilla or chocolate whey protein powder– Garden of Life Raw Protein is a good one and is available at Whole Foods Market

2 eggs

½ cup egg whites (or add a 3rd egg)

Heat oven to 350F. Spray an 11 X 7 inch glass baking dish with nonstick stuff. Throw everything in a big bowl. Mix well with your hands. Place in the baking dish, press into the pan to eliminate bubbles and try to get it level. Cook for about 20-25 minutes. Let cool completely to room temp. Refrigerate for a few hours before cutting into bars. Cut into about 48 bars. Refrigerate the cut bars.

 

Healthy Recipes: 101 Cookbooks

It’s been a while since I posted about cooking and the pizza rule”. If you are trying to eat well as a medical student or resident, the key to success is planning, finding simple healthy recipes, and cooking for yourself.

101 Cookbooks has recipes that are healthy and many that are fast… but a few minutes on this beautiful blog will also feel like a “mini-vacation”. Heidi Swanson’s beautiful writing about food and travel, her award winning images plus the wonderful recipes make this time well spent.

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Summer Vegetable Curry

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Kale Market Salad

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Best School Lunch: Sicilian Broccoli and Cauliflower Pasta

 

* The “pizza rule”: Find recipes that let you cook dinner in less time than it takes to order a pizza.

This Year’s @drmlb’s Top 10 Gifts for Medical Students, Residents and Busy Docs.

This time of year, family and friends of docs and/or docs in training are looking for the last minute holiday gifts (if you are trying to have them shipped) or planning the trip to the store(s) for gifts.

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The one thing any busy person doesn’t have enough of is time.  If you think about it in that context, you can find presents to support interests, fitness, studying (or just having fun) in a thoughtful way.

1. Someone to help clean their home.  It is the most amazing present to come one once a week (or even once a month) to a house that has been cleaned by someone else.  If there are family members who are willing (and it’s appropriate) you can put together a gift of cleaning supplies with a certificate for monthly housecleaning.  If not, word of mouth to find the best person is usually the best way, and will often help you find someone who also does laundry and ironing.  (a true gift!).   There are professional services in every city as well that can be found with an easy internet search.
2. Something to help integrate fitness into their every day activities.  If they don’t have a good bike to commute to school or the hospital (and this is something they would like) this is a great present.  Don’t forget the helmet, reflective vest and very bright lights as part of the package!
3. A fast computer.  If they have the same computer they had in college and you are able to do this for them, the time they will save in uploads will be very appreciated!
4. A smart phone or mini iPad (especially the new iPad air).  Like the computer, if the phone they have is more than 3-4 years old, the upgrade will be much appreciated.  The mini iPad (instead of the regular size) fits in a white coat pocket, which is why it’s ideal for anyone who wears a white coat.  If they have an iPad, think about some of the more expensive medical apps. (or a certificate for the App store
5. Kitchen appliances to save time (and promote healthy eating).  My favorites on this list would include a rice maker (which can also be used to steam meat and vegetables), a pressure cooker a slow cooker or the Krups multi-cooker.  A blender is always a good gift (to make smoothies and soups).  If you are feeling particularly generous, a VitaMix instead of a blender is much more versatile (and makes much better smoothies!).
6. Prepared meals. If you have family who love to cook, you can make a “certificate” for homemade food in freezable portions.  If you can afford it, there are personal chefs who do the same thing.  You can also give them a gift certificate for a grocery store like Whole Foods that has healthy prepared food or companies that deliver healthy meals (In Houston, it’s companies like MyFitFoods – but this varies from city to city).
7. Fitness equipment for home.  For medical students who are spending a lot of time studying think about a FitDesk, FitBike or a treadmill desk.  The standard stationary bikes, treadmills, etc are another option, but they are expensive and you have to really know that they are preferred over going to the gym (see #8).  A less expensive but very effective gift would be a “fitness care package” with resistance bands, FitDeck cards, a gift certificate for running shoes, and other small less expensive gifts.

8. A membership in a local gym. You can also consider a certificate for group classes in spinning, yoga, or whatever they enjoy.
9. Time with family and friends.  Think about a “certificate” for time together – maybe with restaurant gift cards or movie gift cards attached.  A “certificate” for a monthly home cooked meal?  If you aren’t in the same town, think about how to make it easy for them to spend time with their friends.  If you know their favorite restaurant or hangout, see if you can get a gift certificate.  If not, go for tickets to the local theater, one of the movie chains (find out which one is closest to where they live), or their favorite restaurant chain. If they have children, babysitting is a wonderful gift.
10. Whatever you can think of that makes gives them more time and/or will support them during times of stressful and busy work!

 

 HAPPY HOLIDAYS TO ALL!!!PEACE_ON_EARTH

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Last year’s suggestions on wellnessrounds.org