Team S.J.G.R. Belated Thursday Huddle: Think about it.

Zachary checks for errors

"Tried, you cried, you shouted, you pouted
But I told ya - you should thought about it

Think about it."

~ Special Ed

__________________________________________

The huddle for this week is very simple:

Think about the things you eat. Or better yet. Think before you eat it. 

This photo above is of Zachary who was demonstrating something his Grandpa taught him when it comes to eating chicken. He calls it "checking for errors." Ha. Well. This chicken wing that Zack was eating was at a North Carolina barbecue spot. And as far as wings (which are tremendously fattening) go, this particular place was deliciously worth every single calorie and fat gram.

Now.

Sometimes--or rather many times--food gets placed in front of us that isn't good enough for the damage it will do. Like, pizza for example. Really, really good pizza? It's actually kind of rare. Decent pizza? Quite common. My take on pizza (unless I'm just famished or being unkind to myself) is that it has to be superior pizza for me to eat it. Or at least eat it without a trace of guilt.

So I guess my point is. . . . do away with the mindless chomping. Make sure that you consider, if only for a few seconds, every single morsel that goes into your mouth. For example, I just ate half of a bagel with some crunchy peanut butter on top. I know that a bagel is high in calories and that the peanut butter is high in fat. I also know that both are great fuel before a run which, in a few moments, I will be doing. I thought about that before doing it. Oh, and did I want a whole bagel? You bet I did.

Would it have been the end of the world to eat a whole bagel? Naaah. But the bagels I have are just aiight and not worth it. Plus I might go out to dinner with friends tonight so would much rather save my calories and fat grams for something legitimately delicious. You get my drift?

I don't believe in oppressive diets. I don't. I think that you should treat yourself to really delicious things sometimes. But I also know for sure that most of the things that add junk to our trunks are "pretty yummy" or "good" but not seriously, legitimately delicious. And I'm just saying--why not push those things away instead? How about you allow yourself really rich and delicious things in moderation and then focus on nourishment the rest of the time?

In other words: Every now and then, allow yourself the chance to LIVE to EAT. But all the rest of the time? Instead just EAT to LIVE. You feel me?

Even if that's hard for you, though, just don't let yourself eat without thinking. Say to yourself, "What's this I'm eating? Am I even hungry? Is this super fattening? And if so, is it worth it?" Then as you get through your meal ask yourself, "Am I satisfied? Can I just stop eating right here and be fine?"

I will throw out a couple of disclaimers, though:

Let's say you are at a restaurant that has a legendary meal. Let yourself enjoy it, man. Don't be such a wet blanket to yourself that you miss out on the experience--because we all know that food can be an experience. One of my biggest regrets was when our good friends Shannon and Michelle, who then lived in New York City, took Harry and me to the incomparable Peter Luger Steakhouse during a visit. Out comes this marbly, piping hot, bone-in t-bone steak for four people. And me? I was on a health kick and didn't eat it. I had one bite and that's it. And that? That was just plain stupid if you ask me. Who goes to PETER LUGER STEAKHOUSE and doesn't have damn steak? Ugggh.

And no, I wasn't a pescatarian or vegetarian or vegan or anything. And I get it if you're one of those things, but I wasn't.  So, as the BHE says, "I tripped" when I didn't allow myself that experience.

But this? This piece of Key Lime Pie that I had while visiting the FLORIDA KEYS last December? Chile, please. I tore it up and licked the plate. Felt zero guilt and knew I wouldn't. Because who in the hell goes to the Florida Keys, eats at a restaurant serving Key Lime Pie and doesn't allow themselves the chance to enjoy it? I mean, besides somebody who doesn't like Key Lime pie? And what carnivore goes to a North Carolina Barbecue dive and doesn't eat the barbecue?

A wet ass blanket, that's who. So don't be that. Don't get so crazy with this that it makes you no fun to ever eat around. But also don't let the pendulum swing too far the other way. See, I guess it all goes back to the list of NOs. You just HAVE to have some things that you make a NO under nearly all circumstances. Do it in a subtle way, too. Once you have a NO list, it's easy to keep it moving.

Oh yeah. And before I forget--here's a sidebar comment: You CAN do things with your friends and celebrate their birthdays, etc. over things other than FOOD. Stop agreeing to only "meet for drinks" or "take so-and-so to dinner for her birthday." I mean, you can, but you don't HAVE to. Suggest a hike like JoLai and some friends did for someone's birthday. Meet up at Stone Mountain for a run or even a walk. Challenge your friends to come up with non-food socializing to counter every food-related one.

Just a thought.

socializing over a MEAL with my friend JJM

Someone commented on this blog that their brother said, "I'm allergic to that. If I eat it I break out in fat all over." Bwwaaah ha ha ha. I think about that and chuckle sometimes. Especially when reheating a rubbery piece of day old pizza from Papa John's. I say, "Girl, you are SO allergic to this. Do you wish to break out in fat?" Ha.

Lastly this:

Counter your food allowances with food subtractions. Not extra laps. I mean that. We LOSE WEIGHT IN THE KITCHEN. We GET FIT IN THE GYM. Stop drinking mojitos and swearing that you'll run two extra miles on the treadmill. Stop eating chips and guac and saying you'll hit an extra cross fit class. Cut. It. Out. Push the plate back. Kind of like that whole versus half of a bagel. Pay now or pay later--plate and fork wise.

Oh, but if it's worth it? I mean, legit and deliciously worth it? Eat it, man. And then go back like Zack and check your work for errors. I'm just sayin'.

That's all I got.

****
Happy Belated Huddle.

Now playing on my mental iPod. . . . .

Alls well that ends well.

This is a feel good story here:

A mother takes her child across town to camp. After taking her other child across town to where he needed to be first. And also while trying to get her own ass to work where she has to take care of sick human beings.

Wait. This isn't me, so like, sick. . . . um. . . marine life. Yeah. That's it. Marine life. Ah hem.

Okay. So said mom pulls up at across town camp and camp kid says, "Hey mom! I don't see my lunch box with my snack and lunch! Is it up there?" At which point said mom looks around her passenger seat knowing FULL WELL that it is likely sitting back across town where she sat it on the table. Just before saying, "ZACHARY! MAKE SURE YOU GET YOUR LUNCH BOX AND YOUR WATER BOTTLE!"

Whoops. I mean. . .errr. . .SMACHARY. I mean, since this is like, not even about me. Not even.

But Smachary totally didn't have his belongings and said mom was already late for work. After she mouthed the F-BOMB three times in rapid succession, she tried to call husband, also known as Smachary's dad. Well. Smachary's dad had worked late so he was knocked out and not answering his crappy cell phone. Smachary starts crying and stuff and lamenting about how he is LITERALLY going to STARVE TO DEATH and become DEHYDRATED. Which is actually what he said and only partially untrue if you know how hard these kids play in this camp.

So said mom frets. And frets some more. She calls in the heavy artillery. Grandma. And Grandma being Grandma, that is, mad helpful and such, agrees to come even further from across town and across counties even to bring Smachary a lunch. But as for a snack, he'd be in a bad way.

Mmm hmmm.

Then said mom starts feeling all bad about Grandma driving over the river and through the woods. She then remembers that one of the members of Team S.J.G.R. lives right, right, right by the camp. And since the team is more than just work out motivators, they are a true team, said mom said, "What is there to lose?" and sent a text to Jill Joyner. Whoops. I mean, SMILL SMOYNER. Yeah.

So SMILL SMOYNER, who is cooler than the other side of the pillow with the AC up on high, says, "Of course I'll bring Smachary some vittles." And that is what she did.

Let me just say this:  Said mom met SMILL SMOYNER originally as a reader of her blog. (Yes, said mom blogs, too.) And from there--like two years after they'd only known each other through the comments section--they became real life friends. In fact, they even have kids at the same school. But that doesn't mean Smill had to have said mom's back or anything. But she did. And how cool is it that said mom has increased her village in this awesome, awesome way? Through a blog of all things?

So shout out to SMILL SMOYNER who saved SMACHARY SMANNING from DYING OF STARVATION AND DEHYDRATION at his camp. And also shout out to every person who has ever had somebody's back and who gives of themselves without making it seem like you owe something.

*ting*

(That was my feel good smile.)

'Preciate you, Smill Smoyner.

Smimberly Smanning aka Said Mom

***
Happy Friday.

Team S.J.G.R. Thursday Huddle: Brave.

You can be amazing

You can turn a phrase into a weapon or a drug

You can be the outcast

Or be the backlash of somebody’s lack of love

Or you can start speaking up. . . .

Honestly. . . I want to see you be brave.

~ Sara Bareilles

I saw a patient recently that deeply disturbed me.  She was upset about the weight she'd picked up over the last five years and was frustrated with the slowing of her metabolism. But that wasn't the part that bothered me. What dug under my skin was the absolutely horrific way she spoke about herself and the way that no amount of positivity or encouragement could get her to stop.

"I'm a fat ass cow," she said. "I'm never going to meet anybody because I'm undatable. And who would want to date anybody who looked like this?" She grabbed her waistline and shook the excess skin.

What's worse is that there wasn't really too much excess to grab. But even if there was, this was still awfully harsh. Damn, it was. I mean, sure, she could stand to lose a few pounds but no person deserved to be talked about like that. I don't give a damn what size they are.

"I am just wondering," I said carefully. "Why do you speak this way about yourself? Like, if someone spoke this way about your sister or your best friend, what would you say?"

She laughed. "I'd kick their ass. But neither of them is a fat ass slob. I look horrible. I hate how I look. And no matter what I do, nothing works to lose weight."

That's when I gently pointed out that she'd told me that she skips breakfast and eats like a bird at lunch. I tried to encourage her by letting her know that modifying this could improve her metabolism. I showed her some cool smartphone apps like My Fitness Pal and Fooducate. And pulled out all the stops to get her believing that trying a little of this just might help.

But none of that was working. NONE of it. She was caught in a do-loop of self-hate.

Ugh.

My resident had already screened her for depression. And that screen was strongly positive. But when we tried to broach the subject of managing her mood disorder, she shut that down.

"It might make me gain weight," she said.

"But feeling this way can make your energy low. This could actually help."

"I'm scared of that stuff."

"I understand," I replied. "Would you be willing to let us have you see our mental health specialists?"

"You mean a psychiatrist? Oh hells no."

Then she called herself "double wide" and described herself as "nasty-looking." I'd never heard anything more awful said about another person straight to their face. Unless you count those horrid reality shows.

I wondered what would happen if she used all of that same energy to say positive things about herself. To list those "what I love about me" things instead of decimating herself like this. But I realized quickly that this wasn't even in her control. The self-hatred was squashing her and suffocating her from any flicker of daylight.

As I looked back through her chart, I saw that others had explored the diagnosis of a mood disorder with her before. She had shut down depression management over and over again, calling it "voodoo" and "make believe." In her chart you could see that with every year that she went untreated for depression, she gained more weight.

Yep.

So I could go on and on about that unfortunate encounter. Fortunately she wasn't suicidal or homicidal. And we did at least convince her to see a provider in mental health but beyond that she wasn't trying to hear much else.

She also went off on me for not wanting to give her a diet pill by prescription. And even accused me of plotting to keep her looking like a "fat ass cow."

Sigh.

Look--I'm not even sure what my point is of telling you about this. I think it's mostly me wanting to implore everyone who is a member of this team to NOT speak negatively about themselves. But also, I hope anyone who feels depressed will be brave enough to get some help.

Depression impairs so much. And I know for sure that mental health issues are very, very complicated sometimes. But I left that visit thinking about how, how, HOW can I do better as a provider next time? How can I be more helpful, more encouraging, more empowering? Was this totally beyond my level of expertise? I still don't know the answer to any of that.

But let me just say this:

If you are reading this and you are feeling depressed? Or anxious? Or like your only outlet is to mistreat yourself? Please. Do whatever it takes to get some help. Because you deserve to be happy. To be well. To thrive. And to see yourself as worthy of the fat of the land.

The last thing I said to that patient was this:

"You are NOT a cow. Or a double wide. Or nasty looking."

And you know what? I feel certain that, as of the end of that visit, she didn't believe me. Especially because she said she deserved to be on the side of a Chick fil A highway billboard.

So no. She didn't believe me. But you know? I am praying that someday she will.

Yeah.

No matter how grey the clouds, there is still some beauty underneath just waiting to get out.

***
Happy Huddle Day.

Now playing on my mental iPod. . . . I love this video because of the self love and bravery it took for these participants to dance like no one was watching. Even though everyone was. Honestly Team S.J.G.R.? I want to see us be brave.

On each other's team.

image taken (by Ms. Turks) and shared with patient's permission

"And you know we're on each other's team."

~ Lorde

________________________________________________________

I saw him today in clinic. A resident physician had just signed him out to me and I was just popping in for a supervisory visit. All of it simple enough.

As soon as I walked in, I thought, I've seen this patient before. And that must have shown on my face because right as I thought that he spoke.

"Remember me?" he said.

I had to do a double take because I wasn't so sure. I cocked my head sideways and bit the inside of my cheek. For a moment, he looked a bit hurt by that. But then, in a snap, it all came back to me. I widened my eyes in disbelief. "No way."

"You remember now?"

"You were. . .wait. . .Team Better? Yes! Team Better!"

"Team BETTER!" he exclaimed. And literally we both jumped up and danced in that room.

"And look at you! You're better! You are!"

"I am! I am!"

I clapped my hands and squealed with delight. And honestly, right after that, I immediately felt like crying.

"I can tell you have a testimony." That's what the nurse, Ms. Turks, said when she saw our interaction. And he looked at me and smiled when she said that. I smiled back.

And so. Together we told Ms. Turks the story of "Team Better." I even pulled out my phone, loaded up my blog and read him an excerpt of the story he gave me permission to write about that experience. The very story he allowed me to share with all of you of Team Better. 

I surely did.

"You guys saved my life," he said.

And I said back, "No, you saved your life. We just agreed to join you in believing that you could."

"That made a big difference."

"It did for me, too." And I said that because it was true.

So this? This was simply a story of what can happen when someone looks at you and treats you with an expectation that you can and will win. Win over whatever it is holding you back. For him, it was a serious illness that threatened to keep him bed bound and disabled for the rest of his young life. For someone else, it might be something altogether different. That expectation led him to fight for his life which, in a way, we all are doing every single day.

So here is what I want to know:

Who's Team Better are you on? Who's Team Better should you be on? And tell me, who is on your Team Better? The one rooting for you? Are you on it? Are you? Remember--my patient was the most important member of that team during his hospitalization--but it all started with someone speaking life into him. Life. Not death. Not disability. Not despair. Not dead ends. Life. 

Man. We search and search for the panacea to what ails us when sometimes it just comes down to the energy we draw and receive. What life we speak into ourselves and others. And a lot of that is a choice. Our choice, yes. But also the choice of those around us. And those choices can be life or death. They can. If this man taught me nothing else, he showed me the power of intention. When there is intention, that energy is greater, more powerful.

Yes, it is.

We wrapped up the visit and I headed to the door. The mood was light and you could tell that everyone felt happy inside. That feel-good energy was filling every crevice of the room.

"Still Team Better, right?" I held out my balled up hand to give him a celebratory fist bump.

He smiled big, wide and genuine. Then he leaned forward to let his knuckles touch mine. "No doubt, Miss Manning," he said. "No doubt."

I cried the minute I got on the other side of the door. I surely did.

Because this? This is the real Grady. Humanity and hope woven tightly into fleeting moments and unforgettable testimonies day after day after day. . . . and grace personified.

Yeah.


***
Happy Thursday. (This serves as your Thursday huddle, Team S.J.G.R.)

Now playing on my mental iPod. . . . .and now yours.

Team S.J.G.R. Thursday Huddle: Say something--I'm giving up on you.

Isn't it funny how easy it is for us to pay compliments to other people but not ourselves? I was listening to the radio the other day and someone posed this question. It was simple enough, but wow, did people have a tough time answering it. Then they asked a second question. That one was equal in its simplicity yet for that one, those answers came fast and furious. And honestly? Short of one word, the questions were identical.

Yup.

So I'm sure you're wondering. . . .what, pray tell, were these questions? Let me tell you. Or better yet--let me ask you.

Quick--tell me the answers to these questions:

1.  What are five things that you really, really like about your body?

2.  What are five things that you really, really *don't* like about your body?

Now. If you're anything like me, that second question was easy-peasy lemon-squeezy. But that first one? Hmmm. Even if you have a great self image, it's hard to hit five without having to think hard. But doesn't it suck that it isn't even remotely difficult to point out even ten things you don't like or that you'd change or that you want to work on?

Yeah.

So, here's the deal. Today's huddle is going to require you to speak up--and speak up publicly. Since I already know that you can (and probably have) told someone of the things you aren't so keen on when it comes to your body, I won't ask you to do that. Instead, I need you to take a moment to answer that first question.

What are five things that you really, really like about your body?

Jill and I were most likely affirming each other at this moment

Now. Before you respond by telling me that you can't do this, imagine YOU as a friend to yourself. As your own BFF or girlfriend sitting across from you in a coffee shop saying that same thing. How would you affirm that friend? Because I know that surely you would. You'd quickly find twenty beautiful things about her (or him) and list them right then and there. You know you would.

And.

Let me also challenge you to not just name those things like hair, lips, and earlobes. Push yourself to see beauty in the parts of your body that work hard for you every day. And, sure, it's fine to name those aforementioned things, but I want you to do for YOU what you'd do for a friend. Tell YOU what you'd tell her. Or him. Or them. See it. Find it. And then tell it.

My point is that we need to be friends to ourselves. Like really, really good friends. One day I was feeling particularly crummy about a few things and that song "Say Something, I'm Giving Up on You" came on the radio. And for whatever reason, that day I heard it as me talking to me. Me saying that I need to chuck myself under my chin and look myself in the eye to say, "You're really kind of amazing, actually."

Yeah. That.

Maaaaan, I wish I had time to talk to somebody about how it doesn't matter what somebody ELSE is telling you about you if YOU don't believe it yourself. Yeah, I know that "you yourself" thing was kind of redundant--sort of like this dude I knew who always used to preface things by saying  "me, myself, personally. . . . " Ha. The take home message is that everyone can be saying something about you--but if your opinion differs from it, what difference does it make? That goes for the good and the bad, man. Or like that other songwriter said, "No one can tell you what you know." Mmmm hmmm. Wish I could talk to somebody about all that, but I don't even have time.

So tell me. What do you know about you? What do you really, really like about your BODY? No, not your personality or your spirit--your BODY. Come on. Say something. . . I'm giving up on you, man.

Alright. Deep breath. Here goes. And like the radio personality said, "Don't overthink it. Just spit it out."

What are five things that I really, really like about my body?

#1

I like my nose. It's kind of biggish, actually but it's such a . . . well. . .huge part of me and my face. It's super distinct, covered with freckles like JoLai's, and is the thing that I think makes me look like my dad. It's very "Draper" that nose. Which connects me to them.

#2

I like how my legs look in skirts and high heels. I feel feminine and beautiful when I put on a heel of three inches or more. I like how my husband looks at me when I do and how strong and agile I feel when I walk across a floor in them.

#3

I like my arms, including my wrists and hands. This took a while for me to embrace. Yes, I know that my wrists are skinny and that my triceps are a far cry from Mrs. Obama's. But over time, I've come to like that my wrists are kind of delicate. My hands are veiny like my mother's and my grandmother's. Sure, I'll never be a hand model (unless it's an old lady hands model) but so what. My hands are their hands. Which makes me feel like we are one whenever I look at them. My upper arms tone up pretty well when I exercise which I like.

#4

I really like how my back looks in a backless dress. It looks strong. And I can see that, even with my narrow shoulders and generally small build up top, all that running and also those occasional lat pulls and dead rows show there before anywhere else. I like that.

A friend took a photo of me dancing at an outdoor concert last weekend. I was in a halter dress my hands were in the air waving to the music. And when I looked at that candid snapshot, I said, "Hmmm. I like the way my back looks on this picture."

 And I was proud of myself because I said it out loud to my friend. About myself.

#5

I like my. . .errr. . .  seat cushion. I can't say I had a full appreciation for it before marrying the BHE. He's definitely in cahoots with Sir Mix-a-Lot and is far less concerned about high letter alphabet brassieres. In jeans, in skirts, in dresses, I like it. In pajamas, too. I'm working on liking it in swimsuits but it's funny . . .Harry always comments (positively) whenever I walk by him in a swimsuit. And it ain't my delicate wrists he's talking about. Ha.

"We flawless!"

Okay. There's my five. Now it's your turn.

You know? Affirming my body in this way just made me keep thinking of things I like about the one I have. Just like dogging yourself (and others)  can become a habit that rolls off of your tongue without you even thinking about it, loving yourself can be the same way. I was surprised to see that I could think of five more things I liked once I allowed myself. I think I'll do this with my boys tonight, too.

Alright. Delurk and give me five. Five things that you really, really like about YOUR BODY. Say something. . . . before you give up on you.

Go!

***
Happy Thursday, beautiful ones.

Now playing on my mental iPod. . . . .as sung to myself.


. . .and Sir Mix-a-Lot. . .as sung by the BHE. Ha. Go on and dance. You know you want to because even as misogynistic as this song is, it's impossible to not shake your donk to it. Ha ha ha. Now pardon me. . . . .

Team S.J.G.R. Thursday Huddle: Do the right thing.

I saw this patient today who was smart. Far too smart for what he was doing and, in addition, asking his doctor to do as well. I was seeing this gentleman with a resident physician and before going into the room his provider reviewed the plan of care with me.

"His hemoglobin A1C is over ten and his blood sugar today is in the 400 range. That said, he's not too keen on insulin so I guess we'll try to up is pills. And then as far as his cholesterol goes, he's said he doesn't want anything and that he'd watch what he eats."

"Wow. What about the blood pressure?" I asked.

"It's almost controlled but not perfect. He would likely benefit from a second agent since he smokes but he's not having it. So I guess I will just work with what I have. Maybe refer him to nutrition to lower his salt and give the quit line number to quit smoking."

"That's it? This plan sounds kind of bootleg, man." (Yes, this is how I speak to my residents sometimes. #dontjudgeme)

"I mean. . . what can you do? He doesn't want what I'm recommending. So I guess I just have to work around that, you know?"

Now. Let me just unpack on this for a second. Would that be okay? Don't mind if I do.


But before I do, let me tell you a little more about what happened when I met this patient. Honestly, I was expecting some overweight dude who would appear older than his age. Thick middle, thinning hair, and a defiant attitude. What I found was nothing like that.

This man wasn't too overweight at all. Sure, he smoked but he didn't look very old. And that's good because he was actually a little younger than me. And really, he wasn't difficult to interact with or any such thing. Matter of fact, he was a pretty cool dude.

I asked him some questions and he gave me answers. I explored his family situation (married with high school and adult kids and five grandkids) and his siblings, parents, and upbringing. Part of a big family. Lots of love and support. Used to be an athlete. Works a good job with benefits. And seemed to have plenty to live for.

But then, upon further questioning, he reveals to me that not only his father but recently his brother passed away from a heart attack. Both of whom were under the age of fifty.

Yes.

Now. Despite all that, he was refusing insulin ("I don't do needles!"), pushing back about blood pressure pills ("Those things is 'dick killers.'"), shutting down cholesterol management ("I'll just skip eggs") and still smoking ("I try to quit but my nerves get too bad.") And this? This right here--when coupled with his family history--wasn't just unfortunate. It was stupid.

Yeah, I said it. Stupid.

We all do stupid things. Like, I remember my first year of medical school when I was madly in love with this guy for like six very intense months almost to the point of messing up in school. Oh, and I also racked up a ridiculously high phone bill despite zero income coming in. And even with my phone about to be disconnected, I kept accruing more charges. Plus I kept catching him in tall tale lies which were red flags, but I ignored all that. And that? That was unfortunate, yes. But mostly, it was stupid. You know what, though? That shit wasn't life or death. And it wasn't threatening to rob a family of their patriarch.

It's the same with people shaking salt and drinking sugar and never exercising and then either avoiding their doctor or blaming them for confronting them about it all. Not just unfortunate--but stupid. Especially when the person KNOWS the right thing to do.

This man knew what he needed to do. But he was resisting. And yes, we talked about his feelings and trepidations and excavated why he felt the way he did. We uncovered some things and got at a few things but he still threw up road blocks to allowing us to offer him the standard of medical care. Instead he wanted us to come up with some cockamamie plan B.

"You know? This is like somebody asking you to paint their house and giving you a tiny paint brush and some first grade tempera paint. It doesn't make sense. At all."

That's what I said. And I said it because it was true. Because this man knew better. He did. So I flat out told him that we will make recommendations that do right by him and that he is grown and can decide how he'd like to proceed. But as far as this play-play regimen he was asking his resident doctor to piece together for him? Like the Grady elders say: "That dog don't hunt."

Now the good news is that the patient came around. We had a good talk and we connected and he agreed to do the right thing. But really that isn't the point. The point is that this--this knowledge of the right thing to do but a refusal to do it-- is so, so common and is probably responsible more than anything else for killing us softly when it doesn't have to. I do give this brother credit for at least coming to the doctor. Turns out that for his job, they check blood pressure so the necessity of being signed off forces him in to see us. So he tries to go for the minimum. A la carte medical management, if you will.

I will jump on my primary care physician soap box and say that it's not fair to your doctor when this happens. Asking us to offer you substandard care because you aren't ready to accept what is tried and true. Or what will work. And I swear that I am also guilty. My doctor tells me to get certain lab tests or exams and I factor whether or not it is worth getting socked in the pocket for. Sometimes I'm a good egg and sometimes not. Now I have a great PCP that holds my feet to the fire. She ignores my BS and nudges me to do the right things.

And so I do. (Mostly.)

We need to cut this shit OUT. This practice of highly, highly intelligent people making stupid choices when they know better. Like knowing that your family history is effed up but eating high fat, salty things every day anyway. Or having high ass blood pressure and other risk factors for heart disease yet operating as if you don't. No, that's not just unfortunate. That's stupid.

And doing all of those things AND not being under a doctor's care? That makes you more than stupid. It makes you an assassin. Yes. THAT. An assassin of yourSELF. Which is a damn shame.

Sigh.

In the movie Forrest Gump (one of my favorites, along with Do the Right Thing) Tom Hanks' character Forrest was a simple guy. There was a lot of stuff he just didn't know or get. So if, say, Forrest Gump decided to drink sweet tea and full sugar sodas and eat french fries and not exercise in the face of crappy genetics, a spare tire, and cardiovascular risk factors at least we could chalk that up to him not knowing better. So here is my question: What is our excuse?

If you are savvy enough to read a blog or be on Facebook or click on Twitter or whatever techie things you do, then surely--SURELY--you are among those who are learned enough to know the right things to do. And see, at some point when we keep ignoring what we know to be right, something unfortunate happens.

With that boy, I failed a biochem midterm and got called into the Dean's office. I also got confronted by the ("Oh, I forgot to tell you that I sort of have a"-)girlfriend. Yes. The one that he'd had the entire time we'd been together (unbeknownst to me) which was as awkwardly bad as it sounds. And yeah, all of that was unfortunate. But it wasn't life threatening. It wasn't.

This? This avoidance, denial stuff when it comes to cardiovascular risk? That's not awkwardly bad. Instead, it's just sad. Or least, it will become that way eventually.

Damn. I'm all up in your faces, aren't I? But I guess I'm just frustrated with this crazy do loop we get into. And this do loop becomes a death spiral if we don't grab the handles by both hands and right the plane back upward.

Yup.

I broke up with the boy, got a tutor and ended up doing just fine in Biochemistry. I became a doctor, I got to marry Harry and, allegedly, that girlfriend became that boy's wife at some point. So hallelujah that all of that worked out. For everybody. And hallelujah that nobody got really, truly, severely, irreversibly hurt in the process.

I wish heart disease was that simple. It isn't though.

Ask yourself: Do you know what "the right thing" is when it comes to your health? Or at least sort of, do you? If not, find out. If so, ask yourself this out loud:

"Am I an assassin?"

If you aren't raging against this machine called heart disease with all of our might? That answer is YES.

Sorry to unpack. And yes, my toes hurt after this one, too.

Shit Just Got Real, y'all. Let's do the right thing, a'ight?

***
Happy Huddle Day.

A reminder from da mayor. . . . 


Love and hate. . . . . often how we feel about the balance between doing right and doing not-right. Right?


Remember Radio Raheem's good word about how love wins: "Left hand hate K.O.'d by love."  Say word! We can DO this.

Team S.J.G.R. Thursday Huddle: Food Fight!

Okay. So yeah, yeah, you can say it. I've been a little bit inconsistent with the Thursday S.J.G.R. huddles here lately. But everyone knows how annoying it is when people blog about not blogging enough, so I'll just leave it at that.

Ah hem.

Okay. So for some reason when I sat down to write a Thursday huddle for our team, this kept coming into my head:



FOOD FIGHT!

Why? Because when it comes to us getting to healthier weights to protect our hearts from CORONARY HEART DISEASE, food seems to be the source of an ongoing fight. You want it, so you eat it. You promise yourself that you'll run a little further or work out a little longer. All in an effort to counteract the crap-ton of calories you consumed.

Go ahead. Admit it--you do it.

Alright, so check it. I constantly have these daily epiphanies or rather re-epiphanies when it comes to this whole business of food and weight management. The latest is one you've heard over and over and over again: Lose weight in the kitchen, get fit in the gym.

Period. End of story.

Here's why that has become a re-epiphany. . .

For the last several weeks, I've been super busy. Between travel and work and kids and more, I've not been super consistent about running. Specifically, I haven't been getting in my long runs on the weekends and the ones I am getting are super short ones. Yup.

Now. I knew I had this dream of getting into my original wedding dress for my tenth wedding anniversary party. I didn't want it to be ridiculously tight and I wanted to feel good in it. So that meant I'd need to allow zero fluctuation in my weight. But I wasn't really exercising so much, so what's a girl to do?

Thanks to our team, I knew exactly what to do. It's called fork management. And especially carb management. Careful consideration of everything I ate and drank--even more than normal--which allowed me to shimmy into that dress with no problem. And I knew that it had mostly to do with Team S.J.G.R. and the attentiveness that it has forced me to have to what goes into my mouth. WE on this team all know that nobody can outrun a big butt if they aren't managing the food. We also know how ridiculous it is to tether poor dietary choices to individual workouts.

At least, I hope we all do.

Honestly? I felt better and fitter ten years after my wedding day than I did in 2004. And in 2004, I was working out like a crazy fiend, denying myself just about everything, and obsessing over the step aerobics schedule in my gym. All so I could look fierce when I came down the aisle. But this time? I simply thought about my portions, adhered to my "no list", and watched out for those pesky saboteurs that I affectionately call B.L.T.s (bites, licks and tastes.) That proved to be far better than some wretched diet.

What does this mean? It means that all of this is about lifestyle management. It's about unsweetened tea instead of sweetened tea, "no, thank you" to that sugar-laden mojito, and passing on dessert since the dinner was rich in calories. It's about moving 150 minutes or more on most weeks but on others simply doing the best I can. And then it's about not having to overhaul my life just to fit into a dress.

But it's a fight. That is, for some people it is. We give food the power when really, we should have all of the power. Food can't jump off of the shelf, out of the wrapper, and into our mouths. We make a decision. We do.

Now. Forget about fitting into a dress or a suit or whatever it is for right now. Instead, just think about the person or people that you love the most.

Then think about THEM--not an outfit--when you decide to give food the power. Think about these facts that I will now shove squarely into your faces just as it is constantly smashed into my own:

• The leading cause of death and disability in the U.S. (and WORLDWIDE) is CORONARY HEART DISEASE.
• All forms of cancer PUT TOGETHER do not add up to CORONARY HEART DISEASE when it comes to mortality causes. 
• YES, ALL FORMS of cancer PUT TOGETHER.
• BUT exercise and weight management helps nearly all forms of CANCER.
• Liking who you are but ignoring obvious risk factors for CORONARY HEART DISEASE doesn't make them go away.
• Hating who you are but ignoring obvious risk factors for CORONARY HEART DISEASE doesn't make them go away.
• CORONARY HEART DISEASE is the number one cause of DISABILITY, too.
• DISABILITY means that you can't do something that you want to do because of the problem you have that is stopping you from doing it. 
• The kinds of DISABILITIES that people with CORONARY HEART DISEASE face include things like not being able to walk without being out of breath, not being able to sleep flat, and not being able to do any PHYSICAL ACTIVITY without having to stop.
• SEXUAL INTERCOURSE counts as a PHYSICAL ACTIVITY.
• The more weight you carry around your midsection, the higher your risk of CORONARY HEART DISEASE.
• Skinny people die of CORONARY HEART DISEASE every single day.
• Smoking and living with somebody who smokes increase your chance of CORONARY HEART DISEASE.
• Being depressed and not getting treated for it or pretending like you aren't depressed greatly increases your chances of getting CORONARY HEART DISEASE.
• Too much alcohol can cause you HEART DISEASE.
• Too much alcohol is defined as 4 or more drinks on any given day, 7 or more drinks in a week if you're a woman, and 14 or more drinks in a week if you're a man.
• Most people drink TWO DRINKS when they think they're having only ONE DRINK.
• The older you get, the greater chance you have of getting CORONARY HEART DISEASE.
• The older you get, the harder you need to go to prevent CORONARY HEART DISEASE.
• Family history of CORONARY HEART DISEASE should be taken very seriously.
• People who don't have a doctor or refuse to see doctors miss opportunities to reduce their risk of developing CORONARY HEART DISEASE.
• Ignoring the significance of CORONARY HEART DISEASE is really, really, really not smart.
• People ignore CORONARY HEART DISEASE risk every single day and then act surprised or shocked when it comes after them or their family.

Think it through. Get out of la-la land. Stop thinking that a hearty laugh and some cute shoes will prevent you from getting heart disease. Guess what? It won't. Let's go hard together. Let's stop fighting with food because food doesn't have arms, legs or any ability to climb up your shoulder, around your neck, under your chin and into your mouth.

It's all on you. So what YOU gonna do?

SHIT. JUST. GOT. REAL.

What do the people you love deserve? What do you deserve? If you scared, say you scared. But after that, quit bullshitting and change your lifestyle. Before it gets changed for you. Hell yeah.

Believe that.

Tough love? Yep. For all of us. Because this morning I cried hard as hell over my coffee because I missed my sister Deanna. I was re-watching the video from our Delta Centennial Celebration and straight up ugly crying. I thought about the fact that earlier this week I had some good news to share and I wanted to tell her but couldn't. Because of CORONARY EFFING HEART DISEASE. And that? That shit is as real as it gets. It IS.

Cut. It. Out.

Forget a bikini bootcamp. Bump that vacation. Look at the photos of the people you LOVE and go hard for THEM. Not any of THAT. Get in a doctor's care and stop frontin' like you are somehow immune from the prickly grasp of the thing more likely to kill every single person reading this than anything else. Newsflash: YOU AREN'T. And I'M NOT. And you are NOT "JUST A BIG GIRL" or "MEANT TO BE A BIG GUY."

Bull. Shit.

No. You. Are. Not. Your bones are no bigger than anyone else' and "thick" is NOT a defining characteristic that you must continue to embrace.

NOPE.

And you know? There's no guarantee that you won't still have an early heart attack or something like that. But why on earth would you avoid doing things clearly shown to slash the chances of you getting the thing that you ALREADY KNOW is most likely to take you down or take you out? Like. . .why? What could possibly taste better than the salty kiss on the forehead of your child after his first touchdown? What high calorie drink could possibly quench you more than the ocean waves you'll frolic on on vacations with your family? What late night pizza could even remotely bring you more joy than the love of your life? And what nap could come anywhere close to having a heart strong enough to chase your current or future children and grandchildren? Seriously? WHAT? Because that is what you allow to win when you don't fight back. That is the message you send to your family. And that's not fair to them. Or YOU.

Come on, team. Let's GO. Let's TRY. Or at least die trying.

Food fight? HELLS no. We got this!

***
Happy Thursday.

What I watched this morning and cried about. . . . because my family was robbed by CORONARY HEART DISEASE.   
Centennial - A song for love from Kimberly Manning on Vimeo.
                                                                                                                                                                 

Team S.J.G.R. Thursday Huddle: Ten Random Observations

 

Well. Look who got her act together and posted a Thursday huddle? 

*hand raised high in air*

What's up, team?  Checking in with everyone and gathering all you good people around for the world's most random Thursday huddle. Matter of fact, I even wrote a little top ten about it! Like to hear it? Here it go!

I bring you:

THE TOP TEN SUPER RANDOM FLIGHT OF IDEAS THAT I AM HAVING RIGHT NOW THAT MAY OR MAY NOT RELATE TO YOUR HEALTH AND WELLNESS.

Let's go!

#10  Stop hiding, yo!

This was sitting RIGHT NEXT to my patient one day while I was talking to him. And I'm just sayin'. You've just GOT to respect somebody who keeps it THIS real.  None of that "No, Doctor, I don't smoke or drink" from this guy. Nope! Lighters and looseys all wrapped up in a rubber band. What? What!

*pumping fist*

Yesssss!

Look. My point is this: Lying does you no good when you're dealing with your doctor. Keep it real about what you're doing or not doing. Don't hide that lump you felt or front like you are cutting carbs when you aren't. And especially don't lie about your medications. Imagine us doubling the blood pressure medication because we think you're taking it. . . .uhh. . .yeah. 

This picture? It MADE. MY. WEEK. Why? Because my patient said, "Me? I just keep thangs real, nah mean?" Ha!

Loosey = "one loose cigarette"

#9  Siri-iously?

Why does Siri's voice always seem to come in on the exact favorite part of any song you're listening to on your phone?  I was running one day and rocking out to Beyonce's "Flawless." Every single time she got to the best parts, that damn computerized-lady voice would come in telling me how fast I was running or what my split pace was or whatever. I kept rewinding but Siri would find something else to tell me. 

I decided I didn't like her anymore.

#8  Food versus Fitting

Can I just say this? There aren't too many foods that I like more than I like fitting my clothes. Well. Except Key Lime pie. 

Anyways. Case in point: I was in the hair salon and this woman walked in eating some Popeye's chicken. Now. I am the first to admit that I, like most folks, love that chicken from Popeye's, too. But. Not enough to sabotage fitting my clothes. Or feeling heart healthy. 

Popeye's? Yeah, that's on my "no" list. Remember--at a certain point in your grown up life you need a NO list. Foods that are just going to be a nuh-no. 

#croissants #cheesecake #mojitos #anydrinkwithsimplesyrup #potpies

#7  Master Cleansing.

Drink liquid only! Get all of the poop out of you that's making you heavy! Jump start your weight loss! Yes, do it! You'll look and feel great!

*insert eyeroll*

Cut. It. Out.

#6  Speaking of Beyonce. . . . 

"I ain't worried doing me tonight! A little sweat ain't never hurt nobody! Why y'all standing on the wall? I'm the one tonight gettin' bodied. . . "

You can burn a lot of calories by just pretending that you're her when no one is looking. I was listening to "Get Me Bodied" the other day and feel certain that I lost seven pounds in the six minutes that song was on. 

"Drop down low and sweep the floor with it. . . . " and my favorite "Do the Naomi Campbell walk! Naomi Campbell walk! Walk across the room like Naomi Campbell walk!"  

Ha. I was SOOOO fierce, y'all. Tell the truth. How many of you morph into someone else when certain songs come on? Come on. You can tell me.

Oh, and don't even get me started on my "Flawless" routine. . .. 

"I woke up li' dissssss. . . "

Beyoncé - ***Flawless (feat. Chimamanda Ngozi... by beyoncehq

#5  Flat runs.

I mentioned this to some friends recently but it bears repeating. . . . 

I had this epiphany in Florida while running on the path near the beach. Flat runs suck. I mean royally. I ran literally 3 and a half miles and it felt like 3 million because it was such a flat course. Talk about MINDNUMBING. 

This is problematic. One, because I'm running a race in Chicago this summer which is SUPER flat. And second, because I'm running a race in Miami in the winter which is also FLAT. 

Uggh.

I need variation. How do y'all feel about that?

#4  Spinning? No, thank you.

Have I ever told you about the day I went to a spin class and came out with my hair completely soaking wet? Dude. Not cool.

Let me explain. First--I'm not a person who sweats in my scalp. I also turn into Kid from Kid 'n' Play when I unexpectedly get my hair wet. Yeah, so a long time ago I hit a spin class with a friend and agreed that it was the best workout ever. The class was at 6am and I had to go to work after.

Nothin' against Kid but that just wasn't the look I was going for. I haven't done a spin class since. 

#3  Change your shoes.

Hey runners, listen up! Have you been keeping track of your miles on your running shoes? If not, you should. Even if your runners look good, after like 300 - 400 miles, you'll start getting all 'flicted if you keep running in them. 

Yes. 'flicted. Not to be confused with AFFLICTED.

#2  Health care bills.

Here's a question: Why must we receive the scary "this is not bill" bill before getting the real bill? The lady at Aetna told me that it's just "the explanation of benefits." Look, people. Just tell me what I owe.

#cutitout

#1 Feeder-friends

Watch out for your friends who eat whatever they want whenever they want. And who like to go drink all the time. They can jack you for an easy 1,000 calories on one evening of socializing. 

Yup.

You can also counter this by selecting the activity. A walk or coffee is a good alternative. Or just make sure you meet up somewhere that allows you to order something that won't destroy your waistline. 

"Let's go to Fellini's Pizza!"

"Girlfriend, I love Fellini's but Fellini's don't love me. How about (insert suggestion that has healthy selections)?"

Oh, and before I forget. Mojitos, though chic looking, are FULL O' SUGAR. Which means they are fattening. So. . . . me and mojitos are not friends. Nope.

Shut those feeder-friends down before you need a new wardrobe. 

Okay. That's all I got for now. Hollaaaaaaaaa!

***

Happy Thursday.

Team S.J.G.R. Thursday Huddle: Game Plan.

What's up, Team?  I hope this finds all of you well--literally and figuratively. This will be short and sweet, but I hope it will make us all think.

I was just thinking this morning about all of the things that we do in our lives and how, for the most important things, we generally have a game plan. That is, there is some bar we seek to get over or at least up to. For work, that might be one thing. As parents even we nudge our children to work hard in school because a goal has been set. And the bottom line is this: Goals require game plans.

What is your goal? I mean, specifically when it comes to all of this stuff we've been doing and talking about? That's the million dollar question.

Now. Of course our goals can be broken into little mini-bite sized ones but usually there should be some overarching big one. At least, that's what I think.

Here is what I mostly hope every person reading this aspires to have as either their main goal or at least one of their big two:

To personally reduce my modifiable risks of HEART DISEASE and CANCER.

Yes. That.

Okay. So let's just get real again since that's what we do on this team, shall we?

Let's imagine the photo above as all of us standing in a ginormously long line. All of us different people with different stories and builds and everything. Despite all those differences, the reality is the same. Hands down, the thing most likely to cause any of us DEATH or DISABILITY is heart disease. Period, period, period--end of story.

When I say "heart disease" let's also include all forms of atherosclerotic disease like strokes, etc. Because that counts, too. Yeah, that.

So anyways. Let's draw all of our attention to that second word "DISABILITY." I've been thinking about this a lot lately. I think since Deanna left us, DEATH has always seemed like the worse possible thing that could happen with heart disease, but recognized that the aftermath of can devastate families just as much from what I've seen.

Imagine if suddenly you couldn't walk more than a foot without being severely short of breath. What would that mean to your family and wall that you do? What if a stroke left you unable to speak or move the dominant side of your body? How would that affect everything you do? Well? Because THIS? This is as real a possibility as the whole DEATH part.

Sometimes I imagine if Deanna had been left unable to talk or move. Like if her cardiac arrest had ended not in a sudden death but instead severe anoxic (lack of oxygen and blood) brain injury. It's so hard for me to picture us rolling her over and propping her up or cleaning off her tracheostomy tube. And please--let me be clear--I am not making light of the many reasons that people become or are born with disabilities. I'm not. But I am making sure that we are going at everything with our eyes wide open to heart disease as a cause of acquired disability. Even in the younger of us. And yes, I know this sounds super grim, but I need our team to recognize that we are running from more than just death. We are. 

Sigh.

So let's regroup. Let's look at our goals and come up with real game plans. I know it's time for me to look at mine again.

Are you getting at least 150 minutes or more of cardiovascular activity?
Do you know your BMI?
Are you realistic about trying to get it lower?
What are you eating? 
Are you thinking when you eat?
What example are you setting for your family?
Will you be the catalyst for a generational tradition of fitness or a generational curse of inactivity?
How much are you drinking?
Are you separating weight loss from exercise and tying it to what you eat? 
How do you feel? If you feel bad, what are you doing about that?
Who is your doctor?
When did you last see her or him?
What is your blood pressure?
What is your cholesterol level?
Are you up to date on your age-appropriate cancer screenings?
What is your family medical history? Do you know it? Does it affect your health risks?
What excuses are you making?
What foods are in your house that you KNOW should not be?
What do you want? For you, for your family, for your peace of mind?

What?

Because this is stuff we have to KEEP ON ASKING ourselves. Over and over and over and over again. These realities DO NOT go away when we ignore them. They don't. So we have to go at them head on. We do. We DO!

Remember: Anything I say here is a word for ME too. Every word. I need to hear it and read it and digest it all right along with you. But at the end of the day, only you will be accountable for these questions. You can talk about it all you want but a lot of it is visible.

And let me just say again--this IS NOT all about weight loss. It isn't. But the reality is that being overweight dramatically increases your chances of DEATH or DISABILITY from heart disease--and also increases your risk for A LOT of cancers, too. So no matter how you look at it, it is what it is. We just have to acknowledge that fact even if we don't like it.

And slim folks? Don't think we don't see heart attacks and strokes in the slight ones. We DO. So know that you still need to be doing all of these things. You DO, too.

Yep.

So there. That's the deal. Let's get on board with our game plans and get vicious with them. And let's rage against this machine called heart disease.

You feel me?

***
Happy Thursday.

Team S.J.G.R. Huddle: Chastening.

When I get busy, I fall off. Specifically, I wait until the eleventh hour to eat so when I do, I'm famished. I eat whatever is in front of me all the while inwardly pledging to do better with the next meal. The next meal comes and the cycle repeats itself.

Yeah.

My guess is that some version of this happens to you, too. But, see, for me what compounds it is that busy-busy times in my life also make it hard for me to exercise in the meaningful and consistent ways that make me feel good. I look for ways to balance childcare with hospital responsibilities and once I figure that part out? I'm exhausted.

And sure. I know that these are really all excuses. And I also can't help but hear the "excuses" quote in my head that many of us have been forced to memorize and recite at some point or another.

"Excuses are tools of the weak and incompetent and build monuments to nothingness. Those who master them seldom master anything else."

Or something like that. (I know that between my husband, me and a few other folks who pledged fraternities or sororities, we all learned slightly different versions of this--but you get the picture.)

Anyways. I recognize that with some chutzpah I could lunge all over my house or do some work out videos on my computer. But for whatever reason that hasn't been happening.

And so.

What happens next? Well. If nothing changes, I'll look up and have a few extra pounds on me. But see, this is where the philosophy of Team S.J.G.R. is so helpful to me. I know that we get FIT in the gym and we LOSE WEIGHT in the kitchen. So if my schedule is crazy on the hospital service and I feel like there are too many moving parts? My first step is to modify what goes into my mouth.

Yup.

So, for me, that means I have to set an "absolute." In other words, I give up a specific item (or items) for a designated period of time. Although I am willing to make an excuse or two, generally when I make a promise to fast off of something, I stick to it. Right now, those things are bread, sweets and fried treats. I make it black and white. Nothing gray about it.

Some folks give things up for lent. Admittedly, I'm not Catholic though I've always dug the idea of how fasting off of certain things can get your mind refocused. That said, I am the first to admit that what I've given up for these next two weeks is simply meant to counter the imbalance of my dietary life right now. It sets limits which helps a lot. So, nope. No 40 days in the wilderness for me with all of this. I'm thinking about 14 days or so.

Yup.

You know? It's already working. Last night I had dinner with my friend and fellow Grady doctor Stacy H. The bread basket hit the table and normally I would have been all up on it. But I wasn't. And I know that it was because of my "absolutes" or rather this decision to chasten myself with the fork. Or the bread. You get the picture.

And this? This works for me. This has helped me maintain a certain weight for quite some time. I do this periodically and find it helpful. I used to step up the exercise but, again, I now know that weight management happens in the kitchen.

Mostly.

So that's the huddle. Me raising my hand and saying that I needed some chastening. And sharing with you something that has worked for me when life is crazy.

Tell me. What tricks to you have up your sleeve? Are you good at keeping promises to yourself?

***
Happy Huddle.