Thursday, May 29, 2008

Making Change

A blogger friend asked me how to get her father-in-law who is undergoing cardiac bypass surgery to make lifestyle changes.

It's not easy. I struggle every day with motivating my patients to change their lives.

If many of my patients with high blood pressure stopped smoking, started exercising, ate better, cut out excess salt, and lost weight, they would be on fewer blood pressure medicines. And, in the long run they would have fewer health problems and live longer.

How do we get people to do these things? To someone who has lived a sedentary lifestyle eating whatever they want, making all these changes at once must be overwhelming.

The best time to get people to make changes is at a life-changing moment, such as when hospitalized with a first heart attack or when needing coronary bypass surgery. People are scared, and as a result they are receptive.

So, to my blogger friend who asked how to get her father-in-law how to live more healthfully, use the resources at your hospital while he's recovering. Ask for someone from the hospital's cardiac rehabilitation program to talk to him. Get the nutritionist to sit down with him and explain what he should and should not be eating. Encourage your father's nurse to educate him also. And, you personally may live a healthy lifestyle, but it's hard to hear these things from a family member. There's too much emotional attachment. It really has to come from someone else, not just you, so try not to sound preachy.

Think back if you've made lifestyle changes. Did you do it overnight? I certainly didn't. In college, I was a vegetarian who ate way too much sugar and dairy and barely exercised. During my sophomore year of college, I decided I should start running -- on that first day, I got halfway around the block before my friends drove by and picked me up.

Be patient, and be supportive, and best of luck.

6 comments:

Urban Vegan said...

I read an article in the NY Times about the Japanese concept of kaizen--making tiny changes to your routine to stretch your mind and internal boundaries (and creativity, too). I think this is the best approach. But who knows?
I went vegan cold turkey and that stuck!

I've been thinking about this a lot myself. I am relatively healthy--a thin vegan who exercises often. My diet is better than most. I eat lots of raw foods, whole grains and fiber--but I also eat loads of sugar and fat. Plus I like my evening glass of wine (or two).

Cancer runs rampant in my family, so my impending changes are more related to staving off that illness--ie, a low-fat diet, less alcohol, less sugar, more fruits and veggies. I'm not doing so well, so far, to be honest! But I get up every morning and keep trying.

seattle said...

I am a 3 1/2 yr MI survivor, and recently received the Lifestyle Change Award at my local AHA HeartWalk. My advice is to enroll in the Cardiac Rehab program with an open mind and heart at your local hospital, and take full advantage of it. They will have dieticians, nurses, exercise physiologists available, along with the support and encouragement from the other patients. I stayed in the program for almost 3 years before I joined a gym at my new employer. I went from 30 yrs of no routine exercise to working out 5-6 days a week, and it is part of my routine life now. I also lost 50 lbs in the first yr, not by dieting, but just changing to healthy eating habits. Get that patient educated and involved in their health! There are many resources available.

Anonymous said...

I made huge lifestyle changes this year. In January, I was obese, sedentary, suffering from terrible pain due to a bulging disc in my back, hip arthritis (I'm only 42 y.o.!), and meralgia paresthetica, which is usually a fairly trivial condition but in my case had me feeling like I was being tasered in my thigh repeatedly throughout the day.

I was in pain all the time -- standing, sitting, lying in bed. There was no position that was confortable. I couldn't even sleep.

All my orthos (three of them) told me I couldn't do weight-bearing exercise because of the arthritis and that swimming was my only option. They also all told me that weight loss would not improve my pain. (I hate swimming. I'd rather have a root canal than go to the pool.)

My PCP, however (God bless him) told me to exercise, even if it hurt. "Don't be afraid of the pain. Exercise is not going to make your arthritis worse."

So -- I started "running" again. Following the instructions that Doctor Mama put on her website, I would "run" (I could walk faster than my "runs") for 30 minutes every other day.

Since January, I've lost 40 pounds. I'm now only mildly overweight.

But the most important change: I have NO pain! Or rather, I should say, almost no pain (my hips do feel tender sometimes). But I have NO meralgia, no back pain AT ALL, and only minor hip twinges.

But to answer the question, How can you get someone to make lifestyle changes? I think the answer is, You can't. No one could MAKE me change. My PCP, and Doctor Mama's website, gave me permission to try "running" (I always feel like a liar when I call it running because it's NOTHING like the running I used to do), but in the end, I made the lifestyle change only because I was desperate.

I was in horrible pain, all the time, at age 42. I felt like an old lady. I was terrified that I would develop the multi infarc dementia that hit my mom at a young age as a result of Type 2 diabetes. I was clearly headed down the same path. I didn't want to lose my mind and turn into a drooling idiot as she did 15 years before she died.

Yet, I was in so much pain, and so overweight, that I felt as though there was nothing I could do. I was hopeless. It was really hard to turn that around.

Would it have helped if someone close to me had scolded me? NO!! I KNEW I was in trouble. I felt horrible about it. Being scolded would only have made me unhappy, it would not have motivated me.

What you eat and how much you exercise are incredibly personal decisions. Your healthcare providers can give you information, but in the end, you have to choose for yourself. -victoria

VeganHeartDoc said...

Seattle and Victoria,
Wow, way to go! You have some absolutely inspiring stories.

Geoff said...

Its sad that people need to reach a crisis before they are prompted to work on a healthier lifestyle. We are trying to help people overcome the barriers to making those changes, by providing the support, motivation, and accountability that are needed for sustained changes in healthy lifestyles. you can see it at wellsphere.com

Geoff said...

Vegan Heart Doc, your blog is great, and I'd like to feature it at wellsphere -- would you drop me an email?
Cheers, Geoff
--
Geoffrey W. Rutledge, MD, PhD
dr.rutledge@wellsphere.com
www.wellsphere.com
medblog.wellsphere.com