Are you in control of your life? You or a pill? You or magical thinking? You or the doctor?
People do not do lifestyle changes because they do not believe in themselves. They don’t believe that they can be in control. I tell you, you are right unless you take care of your sentinel risk factors.
What are the sentinel risk factors? The sentinel risk factors simply are sleeplessness and uncontrolled stress.
After thirty years of practice I found many patients fidelity to me was not because of my store of knowledge and experience, but on the strength of my pen! My ability to give them a drug. A drug as an antihypertensive, an antibiotic, an antilipid agent, an anti-inflammant, all which would not be necessary if they only heeded my advise from my experience and knowledge.
I often pose this question to my patients:
“WHO WOULD YOU LIKE TO BE IN CONTROL? Yourself or me?” Your accountant or your wife or husband, or your parent?
Some people need a drug as an antiepileptic and so, therefore, need that pen of mine, but most do not need any medications, and, in fact, most of their worries would be avoided with a simple lifestyle change.
It is clear today that obesity, hyperlipidemia, much of heart disease and cancer, hypertension could all be avoided if one changed one’s lifestyle. The big question is:
“WHY DON’T YOU TAKE CONTROL?”
The reasons are several:
1. Some don’t want control
2. Some can’t take control
3. Some doubt they even know how to take control.
In a series of 100 patients, 98% said they would like to be in control. However, when confronted with the facts that they were not in control and asked why, 75% blamed it on their environment, stress; 10% said they were just too comfortable having someone else being in control, as a doctor, parent, etc.
“Oh”, I said, “like being in a car without brakes or one in which another one decides when to brake, but you control the gas pedal”.
Excuses for self-indulgence some don’t realize that their behavior, that is not caring for themselves, controls those around them. It maybe that is what they unconsciously want.
There is another group that seemed not able to take control, though they think they are in control. This is the majority; those who maybe executives, businessman, mothers and fathers, doctors, lawyers. People who are in places of responsibility have had an education that required dedication. Those enmeshed it a rat race. They can’t get off the treadmill. One would think, for instance, taking doctors out of all the professions these doctors should have more self-control than anyone else. By far they have the knowledge; they know the consequences of a bad lifestyle. However, the facts are that 67% of the doctors according to the American Medical Association are either overweight or obese; they have one of the highest divorce rates; they have one of the highest suicide rates; they have a high degree of drug dependency and alcoholism.
Well why when it is apparent that these were the young men and women who in their college and high school days were dedicated to their studies, showed incredible motivation and discipline. Why, now that they are out in practice are they unable to control their own passions, their appetite for food, alcohol, and other drugs? The reason is simple, just as a Ferrari or other high functioning car will not go unless there is gasoline in it; the same thing is true with our ability to follow through and to control our own lifestyle. If we do not have enough dopamine and serotonin or tank is on empty and we are unable to show self-control. An example is myself, some 10-15 years ago after having a week of working some 90 hours, being on call on the weekend, coming in at 3:230 in the morning from a night call and waking up at 8 only to look at myself in the mirror to realize how much I had aged and that I had gained over 60 pounds. At that moment, I had remembered the last patient I had seen and individual with a stroke two years younger than myself. That was motivation enough for me to say I was not going to have the same fate. I was then 50 and would make the change now. I marched down to the kitchen, opened up the cupboard only to find the oatmeal just behind a bag of chocolate donuts. I took the donuts and threw them out into the garbage. I then began cooking up the oatmeal at which time I also went over what I would be doing that day, planning out the rest of my meals, the exercise that I would be performing and all the the things to get me on a schedule of self discipline.
At that moment just as I was about to take my first bite of oatmeal my beeper went off. It was the time of the digital beeper, as I read the message it said, “Doctor your patient has been waiting in the emergency room since 4 o’clock”. I must have fallen asleep and gotten the message, but slept right through it. This had never happened to me before. My stress level and my emergency system went in overdrive. This, of course, caused a physiological phenomenon in myself. My adrenal surged, provoking my adrenals to pump out cortisol which rang for fuel, jet fuel, that is the type that comes from carbohydrates. As I ran out the door my arm lunged into the garbage and I took out one donut for my mouth and one for my fist as I drove to the emergency room. What happened to my resolve? What happened to my fear of having a stroke? What had happened to my motivation? Didn’t I as a physician know better? Wasn’t I just seconds before thinking of an entire plan to change my lifestyle. What happened?
What happened is simple. I had low serotonin and dopamine levels because of constant stress and lack of sleep. When one is on empty the car does not run. When dopamine and serotonin are low, we have no self-control.
I call these, that is control of our sleep, adequate sleep 7-8 hours at a minimum, and controlling our uncontrolled stress and that is trying to dismiss or place aside those things that we cannot so something about and do something about those things that are in our control. (If one does this, one can obtain sleep that will restore our dopamine and serotonin and minimize the expenditure of serotonin and dopamine that occurs with frustration and that is uncontrolled stress.
In the Anti-Alzheimer’s Prescription I discuss this. That is sleeplessness, the sentinel risk factors, stress and sleeplessness.
The following blogs will try to have you understand why you do not follow what you know is the right thing for you, what is obvious, what was obvious to me in order to make a lifestyle change. We will go over diet. We will go over the DEAR Program.
Diet
Exercise,
Accentuating the brains reserves (Neurobics), and
Rest and Recovery.
We will take each topic one at a time.
Diet. What are our pit falls? It is different for everyone.
Why don’t we exercise? Is it true that there is a time deficiency?
Neurobics. Why don’t we learn something new as a musical instrument?
Rest and Recovery. The most important of all. Why don’t we take advantage of meditation? Of an early night to bed? Listen to soothing music?
LIFE STYLE EXAM
Each one of these is different for each particular person. It is through examining what causes us to fail that is important. Stop right now and look at your life and take what I call the Life Style exam and that is on a scale from 1-10 how satisfied are you with your diet, with your appearance, with your work, with your sex life, with your sleep, with your spouse or children or other, with your spiritual life. A 5 would be okay, 10 excellent, and 0 extremely bad. Then when one is through, think at how much time a week do you spend in each one of these categories. Get the picture? Now you know where effort is needed.
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