Elastic Recoil

recoil /re·coil/ (re´koil) a quick pulling back.

"elastic recoil -- the ability of a stretched object or organ, such as the bladder, to return to its resting position."
Dorland's Medical Dictionary for Health Consumers. © 2007 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

One of the down sides of aging is that your body just doesn’t react the way it used to.  For example, it is a lot harder to get in shape, and to keep a shape. In other words, when we get older, our muffin top becomes a blob. 

When you are 20, your skin happily returns to it’s previous shape and maybe the only tell tale signs are some stretch marks.  Something really awful happens somewhere between 40 and 50.  Your elastic recoil, recoils. 

Suddenly, when you lose weight, instead of your abdomen and legs and arms going back to their usual normal shape, you have chicken wings, and loose wrinkly skin where you used to have a muffin top.  You look in the mirror and scream, “NO ONE TOLD ME ABOUT THIS!!!”   I look like my MOTHER!!!  What happened?

It’s like a pair of jeans getting fitted JUST for you , like a second skin, then suddenly you lose weight and they just don’t fit right.   That said, it’s much better to LOSE weight and get healthy if you’ve become overweight or obese as you’ve aged, and invest in “foundation garments” to hold it all in.  I’m just glad they don’t kill whales anymore for the “whale bone”  in said garments.


BTW, all of those lotions and creams and supplements do nothing for "cellulite" and lumpy skin.  The elastin is deep in the dermis where lotions and creams don't go.  So I guess the only thing to do is to exercise!
Boards are in 3  days.  Wish me luck.  I will start to exercise after the Board exams are done!  I need to banish my chicken wings and firm up my muffin top.  Oh let's face it, it's an entire muffin!

Boredom

Boredom is the enemy of anything worthwhile.

 I’m discovering that.  Beginning a healthy change in one’s diet (or “lifestyle modification” in medical parlance) is exciting, new, and at first, easy.  It’s like falling in love.  At first, every little thing about that person is new and cute and interesting.  You love being with that person, talking, touching, sharing.  Your friends will think you’re over the top because all you do is talk about that new special someone.  They don’t want to hear every single detail, but you tell them anyway because you’re excited!

Then you get married.  Life settles into a predictable routine and suddenly you discover that the cute little snort your partner makes when he laughs is really NOT cute, but annoying.  You feel annoyed sometimes and don’t want to talk.  You discover the WORK of marriage.  You realize it’s worth it (if you’re smart), and you learn to forget the arguments, overlook your loved one’s faults, and love them anyway. 

That’s what getting healthy is like.  At first, all the new habits you’re developing are new and exciting.  In diabetics, we talk about the “honeymoon period” where the diabetes goes from horribly, awfully, controlled, to unbelievably good.  The patient loses weight, eats right, and their labs come back fantastically good.  Three or four months later, the patients’ weight starts to creep up.  “I went on vacation, (a cruise is the worst) and stopped watching, stopped exercising, and when I got back I didn’t get back into my routines.”

Getting healthy is changing your routines.  At first, because they’re new, all your friends know you’re “on a diet” and cheer you on.  You do fabulously at it.  You do all the right things, exercise, eat right, etc. and then.....something messes up your routine. 

I’ve read in multiple places that it takes 30 days of doing some new habit to make it stick.  I belong to a group called “Flylady” who uses this idea to get people to clean their houses and their lives.  She adds a routine a week  and sends out emails of encouragement daily.  It works, but you have to do the routines daily.  She stresses that you need to just START.  She uses a timer.  The enemy is Perfectionism because you think you can’t get things done so you never start.  She encourages you to  just do 15 minutes, or 10 minutes and STOP.  It’s okay if you don’t finish.  Do 15 minutes of a new habit daily.  Clean up a “hot spot” (a messy junk collecting spot) for 10-15 minutes a day.  I plan to eventually use this plan to get off my butt to exercise.  I’m trying to use this also for writing the blog. 

I saw a patient the other day who has been with me for the 16 years I’ve been in Oak Park.  She saw me through both children being born, and all the ups and downs of our practice.  When she first started with me, she was morbidly obese.  She joined Weight Watchers, and started exercising every day.  That was about 13 years ago. She lost probably about 100 lbs, and has kept it off.  I saw her the other day and she was very disappointed because she wanted to work for Weight Watchers and they told her she needed to have a BMI of 25 to work for them.  I think that is so short sited.  She has a BMI of 27, but has KEPT IT OFF.  She is healthy!  Tom Cruise, I read somewhere, has a BMI of 30.  It’s because he’s muscular.  She’s not in Tom Cruise’s shape but she has managed to keep her weight off, keep exercising, keep eating right.  She has so much to offer to those of us who are trying to establish good habits.  The point of this whole thing is to get healthy, not to be a fashion model, after all. 

So, set your timer (thank you Flylady!) and make a menu and grocery list.  Set your timer and start dancing around your house.  Start a daily healthy habit. 
Appreciate the fact that you are alive and have a chance to change and STAY that way!

Weekly Menu and Weigh In

Weigh in and Menu Making Day:
So far I’m doing really well, but I was beginning to feel deprived.  Seems I didn’t pick out enough recipes and make enough food on the weekend for the week.  I was inspired
yesterday by one of my patients though.  She made up her mind in February to change her life.  She changed her diet, and began training for the marathon.  She came in regularly to see me for a weigh in and occasional waist circumference.  I saw her yesterday and found out she had run the  marathon this past weekend and FINISHED IT!!!! WooHOOO! 
I’m not sure I could do that! 
Congratulations to her.  I was so excited I could barely contain myself.  She’s lost a ton of weight, and has lost about 4 inches in her waist circumference.  Isn’t that cool?

Okay, so here’s my weekly weight, before breakfast in my PJ’s. Drumroll please.......
194!  Yea!!!

Menu for the week:

Slow Cooker Southwest Hominy and Turkey Sausage Stew
Slow Cooker Flank Steak
Fish tacos
Bulgar pilaf with pistachios and raisins,
No noodle Vegetable Lasagna

Broccoli, clementines, apples, 4oz nonfat yogurts, and baby carrots for snacks. 
(I’ve discovered snacks are really important so I am not ravenous on the way home from work).

The Poop Report

Doctors are a warped bunch of people.  We talk about poop and get excited about different types of poop.    Well, we call it “stool” and “BM’s” to sound cooler.  But let’s face it, it’s poop.  In the hospital, when someone has a BM after surgery, we all cheer because it means their bowels have woken back up.

I had a professor in residency who was an old GI attending from South Africa.  He had a saying which has stuck with me my entire career.  It’s simple and it’s true.  He said, “Michele, you can divide the world into two types of people.  Those who look, and those who don’t.” 

Of course he was speaking of looking (or not) at your stool.  In my personal experience, about 75% of people look, and 25% are appalled to be even ASKED to look.  That is until they’re 80.  Suddenly, 90% of people look (for their health) and 10% look ALL THE TIME and tell you every single detail about it!

Now I understand this is an uncomfortable subject.  In my husband’s family, no one EVER talks about poop.  I found this out after the kids were born and I would try to give him information about the kids stools.  He started calling it the “Poop Report” and making fun of me for even bringing it up.  You see, in MY family, well, poop had the potential to be something to be very proud of.  We got the poop report every day from my dad.  He had his own classification system too.  There were “Bowl Wrappers”.  These were “healthy” BM’s that looked like a cobra at the bottom of the bowl, ready to strike.  We would gather ‘round the toilet to admire it.  There were “Torpedoes”.  Self explanatory.    I can’t remember the rest, or maybe I’ve blocked it out.  We also had a separate classification for those who had the uncanny ability to sense that someone was just settling in on the john  (or the “throne” as we called it).  Dad would think that it was safe to sit and read the paper and enjoy a good poop.  I would come running in screaming that I “had to go,” and was crowned  a“radar butt”  usually with a few expletives thrown in for good measure. 

I bring this up not to gross you out but to explain that Doctors have a stool system too.
It’s called the “Bristol Stool Scale”.  I thought about putting in a picture, but I’ll let you google it. 

Why in the world am I talking about poop?  Well, anyone who has made a drastic change in their diet knows that your poop changes too.  I figured it was all the fiber I was eating, but MAN!  This was just too much. (I’ll spare you the full poop report).  Anyway, it got me to thinking about fiber.  I’ve been reading labels lately. I noticed that they had fiber broken down into “SOLUBLE Fiber” and “INSOLUBLE fiber.”  It was more confusing than helpful.  I’m embarrassed to say that I didn’t know the difference and figured other people reading this wouldn’t either. 

So here goes.  Soluble fiber is just that.  Soluble.  If you put it in a glass of water, it dissolves.  In your stomach it becomes a big gelatinous mass and soaks up fat and sugar and slows down digestion.  Foods that have lots of soluble fiber include oat bran, barley, apples (not the skin) and similar fruits,  and legumes. They bring down your cholesterol. (Cheerios anyone?)

Insoluble fiber does NOT dissolve in water and goes through your digestive tract unchanged.  (think corn).  (Again with the poop report)
Wheat, corn, oats, barley, nuts, flaxseed and the skins of some fruits (apples and pears for example) are a good source. 

Insoluble fiber is like a broom, and soluble fiber is like a sponge.  Insoluble fiber gives your stool girth and bulk.  It fills you up so you don’t feel as hungry, and helps you lose weight.  Soluble fiber helps reduce your risk for diabetes  and lowers your cholesterol because it slows down the transit of sugars and fats and makes it take longer to absorb. 

So, your poop tells a lot about how much fiber you’re eating.  If you have constipation and rabbit pellet poop, well, start eating more fiber!  If your LDL is high, like mine, eat more soluble fiber.  Apples, oranges, oatmeal (the long cooking or steel cut stuff is best), barley, etc.  Become a "looker"! 

This has been your daily Poop Report. 

Willpower

“The trouble with resisting temptation is it may never come your way again.”  ~Korman’s Law

“Most people want to be delivered from temptation but would like it to keep in touch.”  ~ Robert Orben

“There is a charm about the forbidden than makes it unspeakably desirable.”  ~Mark Twain

Abstainer, n.  A weak person who yields to the temptation of denying himself a pleasure.  ~Ambrose Bierce, The Devil's Dictionary, 1911

I’ve been thinking about willpower today.  Today was a rough day.  There were so many opportunities for me to really mess up. 

What I’ve noticed is that willpower is not intestinal fortitude.  It is not a character trait.  It is a series of choices in which you make in a split second each time.

Think about it.  You find a wallet.  Do you keep the money?  You know the thought crosses your mind.  You end up trying very hard to find the person it belongs to and returning it.  You’ve made a choice. 

Today, it was the choice between the stairs or the elevator.  The elevator was WIDE OPEN!  It was screaming to me, “Come into the bosom of my comfort and muzak.  I will whisk you up to the fifth floor and you won’t experience the discomfort of climbing the stairs.” 
I took the stairs.  The elevator doors closed in disgust.

There was a birthday at our office today.  There was some really delicious looking cake sitting on the counter all afternoon.  “You know you want me.  Look at me all dressed up in this slinky sugar glaze, filled with pudding so creamy that your very being will transcend into light!”

I walked away.  Like 5 times.  It was like a siren call in the kitchen.  I lashed myself to my chair in my office using the phone to drown out the sweet siren song and answered phone calls and filled prescriptions.

I have figured out that willpower  is just a series of daily choices.  Willpower isn’t  a moral compass which tells you what is good and bad.  Not having willpower isn’t a lack of character.  Think about it.  What if you followed the credo to live each day as if it were your last.  Would you give in to the chocolate shake’s frothy call, or would you say, “Oh no, I’m hoping to have a great body for the casket later today.” (Probably not the best example, hm?)
It’s just making choices. 

I’ve discovered that it is a lot more difficult to make the choices which are harder when you’re tired.  I almost succumbed to ordering Chinese tonight.  “C’mon Mom, Let’s order Chinese! or Pizza!  You know you want it!” 

I did.  I really did.  I was very tired and didn’t want to cook. 

I was close.  Hand on the receiver....looking up the phone number....AGGGHH!  NOOOOOOO!!!!!

I found a quick shrimp stir-fry with zucchini and I added some other vegetables and made some Israeli whole wheat couscous.  It took 30 minutes, and the kids cleaned up.  More importantly, they liked it and stopped clamoring for take out. 

I will leave you with this quote:

“I generally avoid temptation unless I can’t resist it”  ~Mae West

The Art of Cooking Part II

Part II Learning How to Cook in the 1970’s and ‘80s and Beyond


I learned from TV that cooking could be fun.  “The Galloping Gourmet” was always a hoot to watch.  He would be plastered by the end of the show because he drank wine while preparing the food.  To his credit, he made a 180 degree turn around and became an advocate for alcohol restraint.  His food always looked great.   Then there was Julia Child, but her voice was a turn off.  And her recipes were too complicated. 

When I went to college, I learned to cook in self defense.  We had an apartment on campus during Junior and Senior year.  I became adept at creating masterpieces out of really inexpensive foods.  (Macaroni and cheese in the box became a tuna noodle and pea casserole).  My roommates and I would occasionally pool our meager resources and put together a real sit-down dinner.  Anything was better than the cafeteria. 

Medical school was another place where I expanded my repertoire.  I was a poor starving medical student on a shoe-string budget.  I lived around the block from a Wonder Bread Outlet and ate peanut butter and jelly sandwiches for lunch every single day.  (I still love them and make my own jam now.) My roommates and I cooked all the time!  It was cheaper than eating out. It was challenging as one of my roommates didn’t eat any vegetables at all.  I really never understood that, but we accommodated her and made veggies for ourselves on the side.

So how is it that young men and women cannot learn how to cook now, in this age of the great international brain called the INTERNET?  There are zillions of cookbooks at the library, at second hand stores, at other peoples houses too, in the case of not having access to the internet. 

I would love to have the resources to pull a “Jamie Oliver” and open up a big “learning” kitchen.  I also would love to go into people’s homes and get rid of all of  the “crap” in the cupboards.  When I tell people that they cannot, under any circumstances, drink soda, they look askance at me as though I’ve asked them to amputate a finger or something.  It’s the same with chips and such, the same with asking them to stop eating at fast food emporiums.  I get this look of abject horror, followed by terror, followed by the, “I’m listening but you’re out of your mind” look. 

Yes, I know that look well.   Usually about then, I say, “So, honestly, I can see from the look in your eye that you think I’m nuts. Are you going to stop drinking soda?”  Usually they hesitate, hem and haw, and eventually respond that they’ll try.
Is soda so bad?  Well, it has no nutritional benefit to it.  It is extra calories you can use for other things which are better for you, like fruit, or vegetables. 

So back to cooking.  How hard is it to fire up the George Foreman, throw some spices on a chicken breast and cook it, zap some broccoli in the microwave and zap a small potato?  Put some salsa on the chicken and Voila! Dinner.  You’ve completely avoided the stove!

Look on line for cooking techniques and recipes.  Try out new grains and spices.  We have the “Green Eggs and Ham” rule in our house.  We all try new stuff.  If we don’t like it, we don’t repeat it and we don’t have to finish it.  Guess what?  We usually like it and finish it. 

Sometimes we cook real stinkers.  In fact, we did last night.  Into the garbage it went.  Oh well, live and learn.  Then there was the time I made the "Inedible Thai Chicken Curry".  It was EPICALLY BAD.  We put on a brave face and really tried to eat it.  Unfortunately,  there was so much pepper in it that we both started to sweat bullets and get chest pain, and laughed at ourselves for even trying to eat it as we threw it out.  It lives in the Annals of Bad Food History in our family. 

My Dad has a saying for foods he doesn’t like. It’s an attempt  to not insult my Mother.  You know never to repeat that recipe when he utters the phrase.  When asked if he wants more, he says, “Oh no. You shouldn’t have too much of a good thing.”  Out in the garbage go the leftovers!  Game over.  Failure.

The Art of Cooking, Part I

The Art of Cooking Part I

I was corresponding with a friend of mine and we hit upon one of the problems of eating healthily.  Many people do not know how to cook. 

Every day I will see a young man (or woman) who weighs a great deal more than he/she should.  I will take a diet history and inevitably find out that he/she eats out for almost every single meal.  Not only does he eat out,  but he eats at  McDonalds or other fast food restaurants.  When asked why, he inevitably tells me that he doesn’t know how to cook. 

This always blows my mind.  I grew up in a house where my mother cooked but also put Stouffers frozen sides up on a pedestal.  She made Stouffers sides all the time.  Most of them were not bad.  She did know HOW to cook, but often she was too busy to REALLY cook every night.  I remember at 14 years of age asking permission over the phone while she was at work, to make stuffed pork chops. Now, I had never cooked an entire meal before this. I wanted to learn how to cook, so I went to, (what else?) the Joy Of Cooking!   We had an ancient copy that was dog eared and stuffed with papers with hand written recipes in it from my grandmother.  My SOUTHERN Grandmother.  My NORTHERN (Irish) grandmother was not a fabulous cook.  She boiled things to death and always left an ingredient out of the recipe for the  few things she made well.  They were never quite as good as hers.  Infuriating.

Unfortunately, stuffed pork chops were a bit above my level as a novice cook.  I used twine to sew them closed.  I think my father was picking twine out of his teeth for a week after that.  I didn’t get too discouraged though, and kept trying. 

My Mother taught me the basics of chopping and slicing and sauteing and frying and broiling.  She was the QUEEN of broiling.  She was known to remind us daily that we needed a meat, a starch, and a vegetable with every dinner.  She also served up a quarter of a head of iceberg lettuce with tomatoes as our salad every night.  I still hate iceberg lettuce.  We also had milk with every meal. 

 I can still make a mean southern fried chicken and fried pork chops with white gravy.  I only do that once every couple of years because you can actually FEEL your coronary arteries close as you eat it.  Yum. 

I digress.

There is so much on the internet now.   There are even VIDEOS showing you how to saute, broil, fry, chop, etc. You don’t even NEED a mother to teach you how to cook!  I once found  a cookbook called, “Help, My Apartment Has a Kitchen In It!”  It was hilarious but had some pretty good recipes and taught techniques in it.  There was a lot of motherly advice in it.

I’m not quite sure what is causing this phenomenon of not cooking.  When I was a kid, there weren’t restaurants on every corner, and foreign food was Italian or Chinese.   You HAD to eat at home because there weren’t that many restaurants.  Fast food was a big treat. Is this why people don’t cook now?  Is it because they can walk around the corner and get good tasting cheap food? (Note:  I didn't say that it was good FOR you)  Is it the “food deserts” where there are no big chain grocery stores?   Is it that we are working longer hours and are exhausted?  Is it that Moms and Dads and their spouses are both working full time?  I think it is not a simple question.  I’m sure people smarter than I am are looking at this very question.  I hope they solve it.