Health Care Reform: Health of All Americans Should Improve

As congress begins to discuss Health Care Reform, we wonder how the health care system can be fixed.

Some of us in the health care profession have some of the answers already: don’t get sick.

It is cheaper for everyone in our society for all of us to stay healthy and well than to be sick. Obviously. Of course, we will get sick or need to see a medical professional, occasionally. A slip of the knife while slicing the apple, a fall from the stool or strep throat are just part of life, no matter how careful or healthy we are.

But there are services that should be included in health care reform that is not part of our health care system now: wellness related services.

We want the health of all American to improve – regardless of their current health status or their current insured status. We currently serve the sick population. We don’t help people in the early stages of disease to keep them from getting sicker. We don’t catch them in the pre-sick stages and help them reverse it. That just isn’t what our system is set up to do.

Registered dietitians, true nutrition experts, can help with this. If only physicians would refer and health care plans would cover the cost. Nutrition plays a role in improving so many disease states, but also preventing many as well. Proper nutrition can improve the health of everyone: children and adults, young and old.

Nutrition services from a registered dietitian and other wellness related needs to be part of the new health care policy in the United States – part of every insurance plan, available for every American.

Heart Health Part V: Manage Stress

This is the final segment on modifiable lifestyle risk factors for heart disease to wrap up “American Hearth Month.” My other blog NewMexicoRD.blogspot.com, discusses foods and heart disease.

Stress management. It seems like a silly thing to some people and downright impossible tp others. Unfortunately the people who are most likely to stress out about things are probably the ones who are at higher risk for heart disease.

People who are “type A” personality, the ones who stress easier than others, are more likely to have the heart disease as a result. I’ve noted before, it isn’t the stressor that causes the stress, but the individual response to the stress that causes it.

There is some research indicating there is a relationship between heart disease risk and the amount of (perceived) stress in ones’ life.

Health behaviors can contribute to stress. Smoking, inactivity, and/or high fat diet can contribute more to the stress. However exercise and a healthy diet can help the body physically deal with stress as well as help us relieve some stress (a walk around the block perhaps).

High stress can lead to high blood pressure. Chronic stress can lead to chronically elevated blood pressure, a risk factor for heart disease.

Find some coping strategies to help when you are stressed. Find a hobby and work on it for an hour or two. Plan to take a day off – tomorrow or in a few weeks. Don’t tell anyone and relax and read a book or see a funny movie or be alone in a bath. Go for a very long, relaxing walk. Even if you can’t take a day off, take an hour or two to read, watch a movie and be distracted from your thoughts for a while.

Develop some coping strategies to deal with intermittent stress that you can’t walk away from such as counting to ten or a mantra such as “a year from now, will this matter?” Sometimes it will, but a lot of times it won’t.


It takes practice, and moving from a high stress person, to lower or even moderate stress person doesn’t happen overnight or even in a couple of weeks-months. It takes time and patience. But keep working on it. I often tell people who say they don’t have time to do these stress management techniques: you will have plenty of time when you are in the ICU following your by-pass surgery. Take time today to relieve your stress.

Heart Health Part IV: Quit Smoking

In part four of the “American Hearth Month” theme for February I continue with heart disease issues on this and my other blog NewMexicoRD.blogspot.com. Here continues the discussion of modifiable risk factors for heart disease.

Cigarette Smoking is the leading cause of preventable death in the United States and a significant independent risk factor for heart disease. Aside from the obvious cancer risk, cigarette smoking also contributes to heart disease, including increasing the risk of developing plaques in the arteries.

Even if you are not overweight and eat healthy, you are at significant risk for heart disease if you smoke.

If you are able to exercise, yet still smoke, you are still at significant risk for heart disease.

Smoking increases blood pressure and increased the risk of a blood clot.

Smoking decreases HDL-cholesterol (the one you want to be HIGH).

If YOU don’t smoke, but live with someone who does: premature deaths from heart disease are still significant even when it comes from other people’s smoke.

Need assistance in quitting? Ask you primary care provided about prescriptions for quitting, or contact 1-800-QUIT-NOW for more assistance on how to quit. Your life or the life of your family may depend on it.

Heart Health Part III: Leisure time Physical Activity

Continuing with the “American Hearth Month” theme for February I continue with heart disease issues on this and my other blog NewMexicoRD.blogspot.com. Here continues the discussion of modifiable risk factors for heart disease.

Physical inactivity is a risk factor for heart disease. If you are not a smoker and eat healthy, but don’t engage in regular physical activity, you are putting yourself at risk. If you choose the parking lot or parking space closest to your office or the entrance to the store, the thought of going for a walk is misery, or riding a bike is a childhood memory, your are putting yourself at risk.

I’ve mentioned it before, and it will likely be mentioned again, your leisure time physical activity:

• needs to be consistent. It should not last for a few days or a few weeks and then be forgotten until next New Years or health scare.
• needs to be moderate-vigorous. It should not be a stroll around the mall or sauntering around the park while your dog is running around sniffing everything. The more vigorous, the better.

Now, this is not saying to go from couch potato to hot potato, but work on becoming a moderate to vigorous exerciser. It does take time, several weeks to several months, to work up to the vigorous activity. If you start out vigorous, you will very likely end up back on the couch and vow to never return to activity again.

Even if you never get to “vigorous” but remain at “moderate” just go at it regularly and forever. Vow to be that person at the assisted living facility who is the first person to sign up for the guided walks and other activities and beat out the other folks on the 1-mile walk, because if you are one of the Americans who starts engaging if leisure time physical activity you can prevent or control your personal risk of high blood cholesterol, diabetes and most likely will lose weight and prevent or reduce your risk of becoming obese.

Don’t want to run or ride a bike? No one said you needed to. Just get outside and walk. Walk for 15 minutes at least 4 days a week. Do this for 2 weeks; the following week work towards 20 minutes on each of those 4 days. As you feel comfortable with it, keep moving up by 5-10 minutes each week or two until you have reached a minimum of 30 minutes, 5 days a week and ideally 60 minutes, 5 days a week. This is consistent with the 2008 Physical Activity Guidelines for Americans that I blogged about back in November 2008.

This is so good for your heart, good for your weight, good for your blood pressure, good for your cholesterol, good for your blood sugar control, good for your bones, good for your joints, good for your stress levels, and great family time or alone time depending on which you choose.

If it is cold, bundle up. If it is hot, go early in the morning or in the evening and wear a hat. Either way, take water if you are going out more than 30 minutes.

NO EXCUSES! Heart disease has painful consequences if you wait too long, so get moving now.

Heart Health Part II: Are You Obese?

Continuing with the “American Hearth Month” theme for February I continue with heart disease issues on this and my other blog NewMexicoRD.blogspot.com. Here continues the discussion of modifiable risk factors for heart disease.

A major independent risk factor for heart disease is obesity. Simply put, obesity is defined as too much body fat, which unfortunately about a third of the country is classified as obese and another third of the country is overweight – making fully two-thirds of the nation with a risk factor for heart disease that they can do something about. And NO most of these people are not big boned or very muscular.

Previously I mentioned that you should know your numbers – blood pressure, cholesterol, and blood glucose – and take some steps to improve those numbers. Being overweight or obese can increase blood pressure, increase total cholesterol, LDL cholesterol, and triglycerides, lower HDL cholesterol, and increase blood glucose. So the first step to improve those numbers: Lose Weight…

Even if these numbers are in “normal” ranges, obesity is still a risk factor for heart disease. The heart has to work harder every minute of every day to circulate the blood to the entire body.

How do you know if you are in the obese or overweight category? Generally speaking people who are in this category can do one of two things: calculate their BMI (aka Body Mass Index) or measure their waist circumference.

BMI measures and calculated a number based on your weight to your height and does not distinguish between men and women or lean body mass (bones, muscle, and water weight for example) and fat mass. It is your weight in kg divided by height in meters squared (kg/m2). There are many places on the web that can calculate it for you and tell you what it means. My favorite is the National Heart Lung and Blood Institute, but you can “google” BMI to find one. A BMI value between 25.0 and 29.9 is overweight, and a BMI value of 30.0 or greater is considered obese.

Waist circumference is another way to measure your risk. Measure at your belly button, just so you know for next time where to measure again. Do not measure where you wear your pants, especially if you are a man, since many people wear their pants way below their fat/waist! IF you measure greater than 35 inches as a woman or greater than 40 inches as a man – you have a fat problem and need to do some work…Oh and if you want to suck it in when you measure, go ahead, but you are only sucking in air, not fat.

Do you need to lose weight? First thing, know you can reduce your risk by losing just 7-10% of your current body weight initially. That may not seem to daunting!

How do you lose the weight? Step 1: Don't do a silly crash diet. Step 2: Cut down on calories – don’t worry about cutting carbs, bread, white foods, blah, blah, blah…You HAVE to cut down on calories, so cut those portions down!

Step 3: Next post…will tell you another big key to help you with your weight/fat loss goal.

Heart Health Part I: Know Your Numbers

As January comes to a close I remind people to review the goals they set earlier this month and remember them as we roll into February, and the sweets begin to make a come-back: heart disease is the number one killer of both men and women in the United States.

Since 1963 congress has required the president to proclaim February as “American Heart Month.”

On both this and my other blog NewMexicoRD.blogspot.com, I will be dedicating the rest of January and all of February to heart disease issues.

From the Wellness perspective, there are modifiable risk factors for heart disease and non-modifiable risk factors. The non-modifiable risk factors, genetic, gender, and age you are just stuck with and as much as you may want to deny them, change them, and/or lie about them you can’t. So let’s discuss the ones you can change or modify.

The first one is your blood. Not your blood type, but the things about you and your risk for heart disease your blood can tell us.

Here is the first thing you need to do to lower you risk for heart disease: Know your numbers – and do something about those numbers.

1. Blood pressure – two numbers – the systolic and diastolic – current recommendations say that you want it to be less than 120/80 mm Hg.
2. Cholesterol numbers (aka lipid panel) taken after a 12 hour fast and you want ALL four numbers – and don’t accept any less than the four! You want to know the values of your:
   a. Total cholesterol – currently less than 200 mg/dl is desirable
   b. LDL (low density lipoprotein) – currently less than 100 mg/dl is optimal
   c. HDL (high density lipoprotein) – less than 40 mg/dl is not good, greater than 60 mg/dl is protective
   d. Triglycerides – less than 150 mg/dl is normal
3. Fasting blood glucose (FBG) taken after a 12 hour fast and you get – one number which should be anywhere between 70 – 100 mg/dl.

Each of these numbers being high, except HDL, is a risk factor for heart disease. A low HDL is a risk. The more numbers that are high, the more you are at risk. High blood glucose is also a risk for diabetes.

When you go to your health care provider for a check up, you should always have your blood pressure checked. When they do that, ask them to tell you or write down the numbers for you!

During your check-up each year or two you should be getting blood work done and it should include the lipid panel/profile and the glucose. About a week to ten days after the test is done, you should get a call from your provider with the results. Ask for the numbers, the results. Or better yet, ask them to mail or fax you a copy of the results or offer to go by and pick them up. These are your results and your records, so there is no reason why you shouldn't have a copy. This way you don’t have to worry about writing the numbers down wrong.

Keep track of these numbers and see how they are changing each year or two. You don’t want them to get worse/higher. You want them to get better (or stay the same if they are already good).

What to do to improve those numbers? Just keep checking in all through February…

What Is Skinny?

It is still the same week of the now historical inauguration of President Obama. Since I was working, I did not see the non-stop coverage on every news channel of the drive to the church a block away, the parade, the crowds, the views of every little this and that to kill time waiting for something to happen, and then the coverage of the drive to the ten inaugural balls that evening. I heard my favorite network had 15 hours of coverage of the whole thing!

Of course this was a fantastic event and not to undermine the day, but the media does like to take a good-great thing and just wring the heck out of it…

One of my co-workers mentioned that one news commentator brought up, again, that President Obama was “too skinny.”

A terrible, and insulting word in my opinion, however, luckily for the President, he is NOT considered “skinny.”

If the reports are to be believed, he is a 6’2” and approximately 190 pounds. With only that to go on, that gives him a body mass index (BMI) of 24.4, placing him in the “normal” weight category.

If our dear president gains a mere five pounds and becomes 195, giving him with a BMI of 25.0 and in the overweight category America! One does not go from skinny to overweight with a five-pound weight gain.

What is wrong with someone that states a man of 6’2” and 190 pounds is “skinny.”

He may be “lean” – with a low body fat percentage for sure, emphasizing one reason that BMI is not the best way to measure a persons “health” or “weight.” However it still indicates that he is in a healthy weight range for now – and should not be concerned about gaining weight.

He does need to keep in mind his smoking habit…and how it affects his health

Stress Part: IV Alcohol and Stress

Many people love to hear when a supposed “vice” has research that supports a benefit to ones health. Alcohol is one of those things that has health benefits, in that it may help reduce your risk of developing heart disease, reduce risk of sudden heart attack, reduce risk of gallstones and perhaps reduce risk of diabetes – IF consumed in moderation.

That is the big one – if consumed in moderation!

Moderation defined: one drink per day for women and two drinks per day for men, and NO carry over from one day to the next.

But what is the ONE drink – that is the key!

• 12 fluid ounces of beer (not 16 or 20 or 24 ounces)
• 5 fluid ounces of wine, any color (not 8 fluid ounces, or half a bottle)
• 1½ ounces spirits (one shot)

While this amount of alcohol can provide health benefits, it can also help relax and relieve some stress in some people as well.

However, it can increase stress among some individuals and to those that surround us when consumed in excess.

Excessive alcohol consumption can increase stress from the social consequences of bad or embarrassing behavior. But there are also the potential health consequences that accompany over-consumption of alcohol, best defined as chronically consuming MORE THAN moderate amounts of alcohol for several weeks, months, or years.

• Increase risk of stroke
• Increase risk of high blood pressure
• Increase risk of cancers of the pancreas, mouth, pharynx, larynx, esophagus and liver
• Increase risk of breast cancer
• Increase risk of heart damage

Of course if you are pregnant, there is no know safe amount. It is suggested/recommended that you not consume alcohol during your pregnancy.

If you have a family history of alcoholism, it is also suggested that you use caution when consuming alcohol and know your risk regarding your family history and alcoholism.

Bottom line: Alcohol can relieve stress in small-moderate amounts, but it can increase stress in greater amounts.

Be Well - and have only that one (or two) drink(s)...

Stress Part III: Time, Time, Time...

People often think the answer to their problems, or at least their stressors, would be more time. If I had more time, I would exercise more, plan healthier meals, read more, etc.

The funny thing is that already nine years into the 21st century and we have more things today that help us save time than our parents did when they were our age.

I the 1970s and 80s we had two phones in the house (and had no idea who was calling). No phone went with us to the store. My mother hand wrote letters, birthday cards, and invitations and my brother and I had to write thank you cards. They generally took a week to get there. We took turns having to open the garage door for the one family car. We didn’t go out to dinner more than once every month or two. And most startling of all: we had one television and NO cable and NO computer. How on earth did we survive without cell phones, email, garage door openers, programs to balance our checkbook and pay our bills?

Now if my mother had time to do all those things, feed us dinner, correspond regularly with family by hand and snail mail, and be present at my school on a unnerving regular basis, and work, then how come she had time to do it all and without the "time savers" we seem to have today.

Unfortunately the “time savers” have increased the stress in our lives, in addition to all those things we “have” to do.

I often tell people, as long as “American Idol” or “Dancing With the Stars” is the number one show on television, trust me, you definitely have time to ______ .

I have suggestions for people to help lower stress levels. First you have to step back a bit and really determine what is important to YOU. For example, I do really like TV, but have decided that I am "allowed" one 60-minute TV show a night in addition to the 60 minutes of local and national news. For example, I used to be a fan of CSI: NY, but when Pushing Daisies came along on the same night I had to choose. Now ABC is moving Life on Mars to Wednesdays, but it looks like Pushing Daisies may be gone. I have to choose a show on Wednesday and I don’t get two hours.

I have other priorities, including maintaining a healthy happy home. It is tough, but I have found by limiting things like television shows that do not enrich my life, have cut down on me being stressed on other things because I have TIME for other things.

Another thing I do around maintaining my home: instead of tackling the cleaning on a Saturday or Sunday in a massive 2-3 hour block, I have split it up into 30 minute bits Monday through Thursday. Usually it comes down to two chores each night that are scheduled for 15 minutes each – such as cleaning the bathroom and dust bedroom. Generally they don’t take 15 minutes anymore, but I can usually to it during the TV show I’m watching (the dusting) or during the commercials (the bathroom). Come the weekend the only thing left is the laundry and that’s a family chore. Since it is the family’s laundry, all three of us are there when it comes out of the dryer to sort, fold and put away.

Major points on time management to ease stress:

1. Prioritize and eliminate the unnecessary – how much reali-tv to you need?
2. Spread it out – it is less tiring to do 20 – 30 minutes of cleaning than 2 – 3 hours!
3. Make sure the whole family helps – especially when it is their stuff.

Think about it - even if you don't act on all of it.
Maybe stop watching that TV show you really aren't interested in anymore?
Or clean dust the living room while you do watch it?
It will be one less thing you have to do later!

Stress Part II: Sleep It Off

This is one of the most difficult strategies surrounding stress – getting proper sleep. It often becomes a vicious cycle – the sleep stress pattern. When many of us are under stress, one of the first things to go is proper sleep. Your mind does not settle, and it keeps you awake, or all the things in your mind that are causing the stress awaken you during the night.

Getting a good night’s sleep is a major component of good health (in partner with healthy eating, exercising, and not smoking). Sleep allows our body to go through two types of restoration: mental and physical. During certain sleep cycles, our body restores itself physically and allowing the body to re-energize (and yes, still burn calories). During other sleep cycles, our body restores itself mentally, allowing the brain to compartmentalize everything from the day and put it into memory. Think of it filing everything from the day. Generally, when we fall short on sleep, it is the mental restoration that is shortened, since the body must physically function to keep going.

So, when we are stressed and we are having trouble sleeping, and wake up even more stressed, what can we do?

Before turning to sleeping pills or alcohol, consider these tips:

1. Set your bedtime: plan what time you are going to go to bed tonight. It could be 10 pm or mid-night or even 2 am. Regardless of when it is, plan on it and set it.
2. Set a time limit: shut yourself off or shut things out after a certain time. Make it your own, and be firm. You need to relax before heading to bed – ideally a couple of hours, but realistically, let’s make it an hour before your bedtime.
3. What are you shutting off? Everything – the computer, phone, Blackberry, television… you are beginning a relaxation time before bed, which will be a ritual for you from now on. The iPod/CD player may remain “on” if it is playing relaxing music.
4. Setting your ritual: This can include your cup of (decaf) tea, washing your face, brushing your teeth, writing down (with a pen and paper) something you need to do tomorrow (do not touch that computer or other electronic gadget), taking a bath, or reading a book.
5. Don’t exercise: Please don’t take this literally, but take it to mean not to exercise within a 2-3 hours before you plan to go to be. Raising the body temperature and the heart rate doesn’t help you be calm for bedtime.
6. Avoid caffeine, food, and alcohol: These disrupt sleep if consumed too close to bedtime. Eating right before bed does not cause weight gain unless you are eating too many calories, but it can cause sleep disturbances if you have too much food in your belly.

Setting the Room:

• Sex and sleep: You’ve heard it before and you have it here. The bedroom should be used for only two things, and blogging or twittering isn’t one of them. Keep it to what it was meant for, and nothing more.
• Dark and cool: The room, not your partner. The room should be dark, and ideally cool. Not too warm – that’s what the covers are for.

While planning these sleep rituals may seem like they are taking away from “important” tasks that you need to accomplish, consider this: will you accomplish those tasks more efficiently after you have a good nights sleep, or just accomplish them and miss out on good sleep? Either way, they will get done, but will they be done better when you are in better mental shape?

Work on these things. It may take time and practice, but it is helpful to have these rituals to get you to bed on time and peacefully.

Sleep well tonight – or very soon.

Stress Part I: Move it to Lose It

Everyone looks for something to relieve his/her stress. Whether it is a massage, a drink, a movie, or a good book, we all have out favorite stress reliever. One of the most beneficial stress relievers however is exercise. I know, how SILLY to think of ADDING something to my life, another think to my schedule to contribute to my stress, but lets look at some of the benefits:

• Exercise can decrease the production of stress hormones.
• Exercise helps build up the immune system.
• Exercise increased endorphins – the feel-good hormones.
• Exercise helps build muscle and strength in your entire body including your heart.
• Exercise helps clear your mind of fatigue and helps you think better.

Whether it is aerobic/cardiovascular, strength training, or flexibility (yoga), any type of exercises you can and will engage in usually will have a benefit for your mind, and almost always on your health.

It takes practice and time to get to the point where you can exercise without your mind going to where you think you should be. For example, going on that walk and thinking about the “to do” list, or “clearing your mind” in yoga class, but eventually it happens. It can take weeks, or months, but you will get there with practice.

You learn to not feel guilty about all those things you should be doing instead of exercise, because when you get back to your task, I promise, it will still be there. If it isn’t…all the better!

How much exercise should you do? Based on the 2008 Physical Activity Guidelines for Americans, here is the reality of it:

• All adults should avoid inactivity. Some physical activity is better than none, and adults who participate in any amount of physical activity gain some health benefits.
• For substantial health benefits, adults should do at least 150 minutes (2 hours and 30 minutes) a week of moderate-intensity, or 75 minutes (1 hour and 15 minutes) a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous intensity aerobic activity. Aerobic activity should be performed in episodes of at least 10 minutes, and preferably, it should be spread throughout the week.
• For additional and more extensive health benefits, adults should increase their aerobic physical activity to 300 minutes (5 hours) a week of moderate intensity, or 150 minutes a week of vigorous intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity activity. Additional health benefits are gained by engaging in physical activity beyond this amount.
• Adults should also do muscle-strengthening activities that are moderate or high intensity and involve all major muscle groups on 2 or more days a week, as these activities provide additional health benefits.

It may seem like a lot, but lets break it down: 150 minutes is 30 minutes five times a week and 300 minutes is 1 hour a day five times a week.

Will exercise prolong your life? Maybe, maybe not. But it will help it be a healthier life while you are here. Trust me – there is time to do this. One day, there will be plenty of time, but by then it could be too late. The stress will have caught up to you and by then the chronic disease will have caught up too, and you will wish you could do some walking on your own. I hope you saved for retirement and got a good long term health care plan.

Stress Is Relative

If you are the least bit like me – you stress out on many things, the littlest things, and anything. As I noted in my October 18th posting prior to my marathon, I had nerves, I had a headache and I had trouble eating. Even the morning of the event I got into a “fight” with my husband (meaning I was irritated and crabbing at him) as he was driving me to the event because I wasn’t going to get there as early as I wanted to. He even said to me – “it’s only a run!” I KNEW that! I wasn’t running for anyone but me. I was stressed about the run, but my stress presented itself in irrational behavior toward him.

Five days after the marathon I was in a meeting in Chicago with about twenty other dietitians. We did an exercise/ice breaker where we stated our most stressful moment in the last five days. I mentioned my marathon – and while it was a personal accomplishment, it had been (one of the) more stressful moments of the past five days. I could have also mentioned trying to make sure I packed all my things for a cold weather five day trip into one suitcase so I wouldn’t be charged a $25 luggage fee by American Airlines, or hoping that my airplane didn’t get delayed since I needed to be at a meeting in downtown Chicago an hour after I landed, or any number of things that I chose to stress about that week, but the marathon was the biggest.

I was the first to go, but once others took their turn mentioning their stressful moment in the past five days, I realized how my stress is so…silly? One person, who owns her own business, was upset by having to lay-off one of her employees due to slower business in the current economy; another had her business partner in her successful community magazine leave her and she was completing what would be her last publication that weekend; a third woman whose husband serves in the special forces in the military, helped another wife bury her husband the days before we were sitting in the room. All this had happened in the five days prior to our meeting!

Two days later as I am speaking to my husband on the phone, he is quite upset over how our son left a crayon in his pants and it “ruined” a pair of his jeans and he had just spend half and hour cleaning the dryer. I almost laughed. “It’s a pair of pants,” I told him. A pair of pants and thirty minutes cleaning a dryer is nothing compared to still having a job, a companion, and a life. He got my point, but was still irritated.

I WILL still stress about “silly things,” I just cannot help it. Unfortunately, it is my personality type and I know it. However, I recognize, and we must all recognize, that most of the time (of course, not all) the stresses in our lives are brought upon ourselves. But most importantly, the way we respond to the stresses in our lives is very important to our health and wellness.

If we choose to blame others for the stresses, then we will be unhealthy and have repercussions of the stresses. If we choose to make changes, adapt, and/or accept the environment we are in, then we may be healthier for it.

Stress is relative. When my son’s car broke down, literally in the middle of the road – that was very stressful AT THAT MOMENT. It was soon over. A new stressor will present itself soon, and so will many others. I can choose to be upset by things, or do my best to take it in stride. I have several mantras for this:

• A year from now, will this matter? (Only once was that the case, and that was when my dog was missing. It turns out he was at the neighbor's house, so it ended up not being the case after all. Most of the time, a week from now, it won’t matter.)
• There is a reason for everything. There is a purpose for this. I just may not know what it is.
• This isn’t the worst that could happen.

Work on realizing what stressors are really YOU choosing to be stressed.

Halloween Tips on Treats

As Halloween is very soon, and the time change to fall back is soon after, here comes the season of food and feasting on treats. Let’s tackle some wellness tips for the first fall food holiday – Halloween.

It does not matter whether you have kids to take through the neighborhood, a local party or other treat gathering event, or they come to your door, you must maintain the control. Here are some tips to help you with that.

Make a Plan: You must decide ahead of time what you are going to do on Halloween night. Are you taking the kids out? Or are you the designated greeter? Even better, turn off the porch light to have a quiet dinner and a movie. You may not be able to get away with the last one, so lets go to the next tip.

Don’t Buy Early: Do NOT buy your treats more than a week ahead. Even a few days prior is sufficient. I bought mine just two days before. (The candy company and the stores are banking on you buying way ahead, cause they just KNOW you will be back for more.) Purchase the treats for the kiddos, not for you, and avoid opening them prior to the big night. Even better buy treats you don’t even like. (Peanut butter taffy anyone?)

Rethink the Treat: Try something different. Ideas: fruit snacks, single-serve microwave popcorn, pretzels, cheese and cracker or peanut butter and cracker packages, packages of trail mix, sugar-free gum, single-serve packages of instant cocoa or cider, sticks of beef jerky, 100 calorie snack packs, rice krispie treats, granola bars, individual servings of dried fruit. Want something completely new and different to give-away? The PLAY-DOH Halloween Trick or Treat Bag (not candy but still edible – though it does contain wheat). It’s 20 cans for $4.00 so not too bad, and I would have loved to get this as a kid! http://www.hasbro.com/playdoh/default.cfm?page=products&product_id=20702

With Your Own Kids: Walk the kids, don’t drive them around the neighborhood; the exercise is good for both of you. Don’t take your kids candy and treats, and after five days get rid of anything that is left; if it is still there, then it really isn’t a favorite.

After it is over: It’s the season for the non-perishable food drives, so take your extra candy and donate it. Some of the children in the shelters or for the families, who can’t afford food, aren’t really able to get out there to trick-or-treat, so let them have the leftovers. You certainly don’t need it and your kids don’t either.

Follow these tips and you will safely get through the Halloween season and on your way to the next Fall Feasting Day...

Sharing a Personal Success

It is done! After training for almost 6 months, this past Sunday I accomplished one of my life goals: to complete a marathon before I was 40.

I ran the Duke City Marathon yesterday with the true goal of completing it, and a hopeful goal of completing it in under 4:30 hours.

I completed it in 4:28.02. Even with training for the last 6 months, it was tough the last 6 miles, just as everyone who has done this had promised. However, I think the worst part I was that my husband, who supported my through most of the race, had parked the truck about 1/3 mile away and I had to walk to it after running for 26.2 miles! Sometimes you feel that you can’t just do anymore, but you do.

A colleague of mine who has run many marathons, including Boston three times and Chicago last week in 3:10 said I looked much better than she did last week. That was nice of her. I feel pretty good today – just a little bit of soreness and glad to have a banister on the stairs at home.

Will there be another? Highly unlikely, but who knows? It was just something to check off the list.

See the full results here: https://www.runraceresults.com/secure/raceresults.cfm?id=rcls2008

Nerves – cause for pain in the stomach, in the head and in the legs…

The day and days before the big day and I’m asked if I’m nervous… I didn’t think so, but three big things are happening.

I’ve been having difficult time eating. Not good, since I should have been loading up on carbs and calories for the last couples of days and especially today. I’ve dropped three pounds in the past few days, which may not seem like much, but this is from my morning weight.

I’ve been having my bout of migraines. I get migraines on a pretty regular basis, but now and then I get a batch of them over the course of three days and even with my meds they are only controlled but never completely go away. Today is day three. Hopefully today is the last day.

I had those terrible night leg cramps in my calves on Thursday night/Friday morning really bad in my left leg, and then one in my right leg about an hour later. They were so bad that today, a day and a half later I’m still sore in my left leg.

So, what can one do?

It is rarely that we dietitians do this, but we do say it: force yourself to eat. I’ve been eating on a schedule today. I’m not hungry, but I’m eating. I set my timer and eat something – high carb – every 3 hours. I had oatmeal for breakfast; yogurt and tortilla for early lunch; cheerios for late lunch; banana and peanut butter for snack; I’m having popcorn now, and making some gnocchi for dinner.

I stay hydrated and take my meds for my migraines and just pray that tomorrow I wake up fine.

Those leg cramps (ouch). Stay hydrated, water and Gatorade (at least this last couple of days), take a calcium supplement, stretch, and take an Advil to take away the pain.

Hopefully, all will go well, and the only pain will be from fatigue at the end, or near the end, tomorrow.

One of My Life Goals - Being Checked Off on Sunday

One of my goals: Run a marathon before I'm 40.

Coming up on Sunday, October 19th, I will run my first marathon - the Duke City Marathon here in Albuquerque. The only goal that day: to finish (before 1:30 since I have a massage scheduled for 2 pm).

My very first race was a 5K at the Duke City events four years ago on October 24th - and it was excrutiating and exhilirating at the same time.

Since then, I have run six official 5K, three official 10K, the La Luz Trail Run twice, and three Half Marathons (all in Albuquerque).

Of course in training, I have run those distances many times and I improve my time most of the time.

I'll decide next week, or maybe later, if I will run another marathon, but for now... I'll be ok with sticking to the half marathons with most of the runners in the U.S.

Live by example.

Oh yes, and I just turned 39 two weeks ago...