Category: Body
What Reminds You of Your Real Goals?

What Reminds You of Your Real Goals?

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I often lose sight of what I really want.  It is easy to get caught up in things that don’t really matter, distractions and avoidances that help dilute the sting of failure when trying to reach a goal.  Sometimes those coping mechanisms are in direct opposition to my true desires.

I can get depressed or bored thinking about my health problems and it makes me want a Monte Cristo sandwich or something fried dipped in ranch dressing.  It is no secret that I have overeating tendencies and I also have what I like to refer to as “blood sugar issues”.   Hyperglycemia can lead to so many poor outcomes.  I am fully aware of how losing one’s eyesight, kidneys, or legs can be devastating to quality of life. I have personally wrapped the stumps of newly amputated legs of diabetic patients. And then watched the patients call their families and friends to sneak them thick stacks of tortillas or a 2 liter of cola. Even when loss is fresh, and literally painful, old habits die hard.

I have considered tattooing the likeness of my kidney or heart on my arm as a reminder that what I eat might take those things from me someday. It is damn hard to keep motivation going, to keep goals and realities at the forefront of my thoughts, intentions, and actions.  Ultimately it is my desire to live a long and healthy life.  To spend as much time as possible with people I love doing things I enjoy.  In order to do those things I need my organs and my ability to walk, to see.  So why can’t I be honest with myself when I binge eat a cake, that I am sorta killing myself in shortened life or functionality?  The ideal would be to preserve my health, not squander it foolishly.

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I Know What it Takes to Be Non-Compliant

I Know What it Takes to Be Non-Compliant

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There is a tumor in my mouth.  It has been there since the end of November, and I have yet to have it biopsied or removed.  There are many factors involved, including:

  • Delay in referral TWICE from my dentist’s office
  • A referral to a provider that’s not accepting my dental AND medical insurance
  • A seemingly lengthy medical review process
  • Limited number of providers who can assist with my problem, creating a scheduling delay

In the meantime my tumor has progressed and what seemed like a simple situation has turned into one where I have tooth bone loss and an uncertain prognosis.  Already I have seen multiple providers and not all of them seem to know what they are talking about.

I happen to work in the healthcare field and know a thing or two about what it takes to get access and follow through with both preventative care and treatment for illness.  I understand the system, have good insurance, and know how to advocate for myself, but yet I feel the pain of trying to use the healthcare system.  There are reasons some people fall through the cracks or don’t do what their providers ask of them.  In healthcare we call these patients “non-compliant”, as in, “Jeff is non-compliant—he hasn’t seen the specialist we referred him to for his abnormal labs.” Or, “Susie hasn’t been taking her asthma inhalers as prescribed and has been non-compliant with the treatment plan.”  Yes, there is judgement involved.

As a nurse it is hard to always objectively see the obstacles to a perfect treatment trajectory.  Once we recommend something to a patient we like to sit and wait for them to do their part, to see the next specialist, take the next medicine, get the next test done.  We like to think we can only lead the horse to water, and can only reasonably convince so many horses under our care at once to drink with the resources we have.

But when I am on the other side of the exam table I get it—I really do know from experience—as a mother and a patient what those obstacles to healthcare are.  In order to improve health we have to have access to people and tools to help us, follow through on testing and interventions, and maintain new habits and routines.  The stars must align in the following ways:

Access

  • Provider Availability
    • Proper providers accepting new patients
    • Specialist referrals happen when needed
  • Affordability
    • Able to pay insurance premiums, deductibles, copays, coinsurance
    • Straightforward billing and payment options
  • Convenience
    • Location
    • Reasonable waiting periods for appointments
    • Appointment time slots available (minimizing lost time at work or school)

Follow Through

  • Open communication between provider and patient
  • Thorough education provided on what is happening and what to do next
  • Continuity in providers
  • Trust and rapport in the care relationship
  • Motivation of the individual—seeing value in therapies

 Maintenance

  • Incorporating new habits and routines
  • Long term monitoring for chronic or high-risk problems
    • Appointment reminders
    • Care coordination between providers, specialists, and therapists

 

When things go right there is a balance of “providing” (done by practitioners) and personal responsibility (of the patient and their caregivers). There is a dance of expectations by both parties, and many times those expectations are not met.  Sometimes it is the nature of the system that creates trouble, especially when it comes to access, but there are ways to help ensure you are getting what you need.

See the best providers available

Get recommendations from friends or screen online reviews. Don’t be afraid to ask for special permission if you are told that a provider isn’t taking new patients.  They may make an exception if you are related to or know a current patient. Find a different provider if you aren’t meshing well with the current one.  If you have a rare or hard-to-manage issue try to find someone who has experience with it.  Use your insurance company as a starting point to find providers in your area who fit your needs.

Understand the workings of your health insurance

What is covered and at what rate? Who do you call if you have questions?  Insurance companies can actually be very helpful in preventing costly mistakes—mine once helped me clear a $1400 charge that a hospital was wrongly trying to collect from me.  Sometimes insurance companies make mistakes too, and if you know your coverage specifics you can argue or appeal items not paid.

Contact billing if you are having trouble paying

Payment plans can keep you out of collections. Providers can end their relationship with you for non-payment, and if you aren’t hiding from your bills you will be more likely to follow through with appointments and tests.  Don’t forget to ask for itemized bills to ensure accuracy.

Maintain the care conversation

Call and call again if you have to. Ask for what you want and be open to negotiating.  Let someone know if you don’t understand or need more information.  Be honest with your providers and expect the same from them.

Keep your promises

To yourself and to others. Do your best to attend recommended appointments and tests.  Take responsibility for your health and the things you can directly control.

Don’t give up even if it seems near impossible to have health care without obstacles and glitches.  I anxiously await my appointment with the oral surgeon for my tumor. And I’m sure this won’t be the last point in a chain of custody for my health that will bounce back and forth between the sides of the medical court, me on one side and “the system” on the other.  (But wait…I’m part of the system.  Does this mean I am playing against myself?  Too deep for me today.)
13 Tips for Getting Over the Hump of the Exercise Hill

13 Tips for Getting Over the Hump of the Exercise Hill

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This week I have started running again after an 8 month hiatus.  Before that hiatus I had been struggling to get my mojo back while recovering from a herniated disc that left me with a dragging leg.  I was slowly adjusting to bearing more and more of my (unfortunately increased) body weight using an antigravity treadmill and twice a week physical therapy.  After I had finally started pounding pavement I was blessed with pregnancy and my best laid plans sunk like a massive stone.  I went from running a 10k every week to rolling around on a chaise lounge like a narwhal.  A narwhal that likes to eat peanut butter with a spoon out of the jar.

Now I am at it again adjusting to running, and I feel the pain of an untrained body, the burn of lactic acid in my quads.  Today I didn’t really want to go on a run since I was up half the night with Baby Boy and my running pants feel like sausage casings.  But my sister (and usual running partner) wanted to go.  She is running a year-long virtual race and I didn’t want to let her down, so I went despite all of the excuses I wanted to come up with.  I was slow and I had to keep stopping to help my 5 year old with his monster scooter.  Altogether I made it a painful mile and I was glad I went—it wasn’t nearly as bad as I thought it would be.

I remember when I first started almost 6 years ago, and how I could barely run around the corner without hyperventilating and stopping tripod style, hands on knees, wishing that I had never left the house.  It took a lot of mental self-prodding and progressive commitment to get to the point where I felt like a “runner” and craved the feeling of hitting the streets, wind in my armpits and endorphins in my veins.

It is hard to get over “the hump” of making an exercise habit.  There is a part of your mind and body that wants to stop the demand of training and take you back to somewhere safe, where yoga pants are comfy for binge-watching Netflix and the only sweat you see is on the outside of your glass of Diet Coke (or the inside of the wrapper of your hot burrito).  You must defy that part of you and keep trying until it becomes who you are and what you do.

Things that have helped me defeat exercise procrastination:

  1. Schedule it in every week.  Hit the frequency and duration you desire by clearing your calendar, booking a class, arranging childcare or a meetup, etc.  Making an external commitment helps keep you from cancelling your date with fitness.
  2. Find secondary wins. The more you get out of your experience the more likely you are to stick with it and look forward to it.  Positive feelings snowball and accumulate.  When I bike to work I save money on gas, improve my mood with sunlight, and save time by combining workout time with commute time.  And when I meet a friend to bike on the way I also get social time!
  3. Keep setting goals. Give yourself a milestone to reach.  And once you’ve reached it set another.
  4. Sabotage the saboteur. Cut your excuses off before you can make them.  Write down all the reasons you might give yourself not to exercise and the workaround you can use when they present.  Here is one of my examples:

Saboteur Me: “It’s too rainy outside.  Might skip the run today.”

Smart Me: “Oh-no-ya-don’t.  You can get out the rain cover for the jogging stroller and wear a hoodie.  Or you can pay the small fee to run indoors on the treadmill at the public pool.”

  1. Set yourself up for success. Give your body and mind a chance to be good at being active.  Get plenty of sleep, eat right, save energy for workout time, and be safe to prevent injury.
  2. Give yourself credit for activity, not just “workouts”. Everyday things like yard work, grocery shopping, and cleaning are exercise.  Get some chores done while you get fit.
  3. Change it up. Cross training is good for your body.  Find different ways to move and different places to do it to keep from workout burnout.
  4. Track it. Keep an exercise journal, spreadsheet, or use an app to see how far you’ve come in your journey.
  5. Share your struggles and successes with others. Talk about it and surround yourself with people who are supportive.
  6. Celebrate your milestones. You deserve to feel good about working hard.
  7. Integrate activity into your identity. If you dance call yourself a dancer.  And if you aren’t quite ready for that yet be okay with telling everyone “I do Zumba.”  Proudly wear your freebie T-shirts and use your water bottles from the events you attend and places you’ve exercised.
  8. Be okay with making mistakes. Don’t let a setback derail your efforts.  Instead use your experience to avoid failure in the future (see #4).
  9. Give yourself permission to give up. Sometimes one type of activity just doesn’t float your boat anymore.  Competitive body building or curling or trick water skiing can’t be for everyone.   It’s okay to break up with your workout routine, although you shouldn’t stay single.  Find another exciting rebound exercise right away!  There are other fish in the sea.

I am trying to take my own advice.  I will be revisiting these mantras over the next few months as I try and reach a goal of running a race by the end of summer.

 

 

 

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