Promoting Healthy Change: Physical Activity

PHYSICAL ACTIVITY

The bottom line is we all need to get moving!  There are so many benefits to exercise.  Everyone probably already knows this but the evidence is so compelling that I’m recommitted to stress this more with my patients.  In fact, I’ve grown complacent and lazy myself and plan to start becoming more intentional about exercise myself.

Now when I use the word “exercise” everyone is probably imagining going to the gym to use the machines or treadmill or join an organized sport.  Those are all great but physical activity does not necessarily need to be time consuming or expensive.  Simple things we can do during the day can increase the amount of physical activity or “steps” we take in a day.  For example:

·      Park farther out to increase walking distance to a building

·      Take the stairs instead of the elevator

·      Take a 10 min break during lunch and just walk

·      Try walking meetings instead of just sitting and talking meetings with friends

·      Get up and walk to the tv instead of flipping with the remote

·      Etc!

Goal is 10,000 steps a day.  Get a pedometer and start keeping track.  In fact, the fitbit is gaining popularity.  The nice thing about it is you can do this with a bunch of friends and keep one another accountable.

So what are the specific benefits?

Physical activity will affect:

·      Strength and power

·      Cardiorespiratory fitness

·      Balance

·      Flexibility

·      Agility

Here are a few medical conditions exercise will help:

·      Decreases heart attacks

·      Decreases strokes

·      Decreases high blood pressure

·      Decreases diabetes

·      Decreases osteoporosis

·      Helps with sexual functioning

·      Helps with depression and anxiety

·      Decreases total morbidity and mortality

Now here is a sobering fact for us, physicians:

·      1/3 of patients with high blood pressure received counseling to engage in physical activity

·      71% of those patients who were counseled to exercise actually followed the recommendation and lowered their blood pressure

So what is the amount of physical activity we are to aim for?

·      150 minutes of moderate intensity physical activity per week

or

·      75 minutes of vigorous physical activity (in bouts of at least 10 min)

For more extensive health benefits aim for:

·      300 minutes of moderate intensity physical activity

or

·      150 minutes of vigorous physical activity

and

·      resistance (muscle strengthening) at least twice per week

Here is how you can differentiate how intensely you are exercising:

·      Light = can talk and sing while exercising

·      Moderate = can talk but cannot sing while exercising

·      Vigorous = cannot sing and cannot talk for prolonged time

Couple more important facts:

·      Cannot really lose weight by exercise alone but it is important to maintain weight loss achieved

·      Need to fuel appropriately before and after exercise

·      Hydrate!  Hydrate!  Hydrate!

Promoting Healthy Change

I attended a conference in Boston this weekend called Lifestyle Medicine: Tools for Promoting Healthy Change.  Here is a short summary of some of the stats shared with us that I want to share with you.

• our country now spends $2.92 trillion on health care costs
• 78% of healthcare expenditures are for management of chronic disease
• 2/3 of all diseases are lifestyle related

Take home points which we all know intuitively... but have lots of stats and research to back it up include:

• modifying lifestyle choices can prevent/alleviate disease, death, and health care cost
• it makes a difference for physicians to counsel on lifestyle changes

Therefore, I plan to make be more intentional in counseling my patients on these lifestyle changes.  The challenge will be to do so in the time constraints of the clinic model we are currently under.  It is stressful enough trying to stay on time and minimize patient wait time while delivering empathetic and thorough medical care.  I can only imagine the volume of patients we have to see per work day increasing as more folks get access to health care insurance with "ObamaCare".  Nevertheless... try we shall.

So the three key areas to modify one's lifestyle for positive health outcomes are:

• Physical Activity
• Nutrtion
• Stress Management

I'll expound on these in the next few posts.

Happy Fathers Day

Happy Father's Day to all you dads out there!  

I want to dedicate this post to my husband and to my dad.  I was commenting the other day about how my dad is so much more mellow now than when I remember him to be growing up.  My husband made a comment that made me pause and think that maybe my dad was so stressed during those early child rearing years because those are stressful times.  And perhaps... I wasn't an easy kid.

Special kudos especially during this physically and emotionally challenging time when our kids are all so little (five and under!)... AND we're going to add another.  Yep.  Looks like it will be a boy so our little man will have a brother to tumble with.   Now we're even... and now we're done!  So according to this new survey... we're about to decrease the stress level in our life!

So... here's a little father's day tribute.  Thanks, hubby for partnering with me during all the momentous moments.  I especially appreciate it when you...

• change and wash throw up on bedsheets in the middle of the night
• change and wash throw up on bedsheets in the middle of the night after already doing so once
• change and wash throw up on bedsheets in the middle of the night after already doing so twice (this truly happened with our first daughter... hard to forget that exhausting night.  So special kudos to hubby because he usually gets the job of cleaning up the gunk while I bathe and soothe my little one)
• change poopey diapers (hard for me during the nausea period of 1st trimester... though the nausea improves 2nd trimester, certain strong smells can trigger my gag reflex... so again... thanks hubby)
• take the glorious job of wiping poopey bottoms  (same goes here... gag reflex...)
• cut up all sorts of fruits so there's plenty for all to eat (I'm dangerous with a knife so daddy does most of the fruit cutting whether it is mangoes or watermelon or honeydew... you name it, he cuts it!)
• put up the pack n play if we ever have to bring it somewhere (it always takes me longer to figure out how to put all the sides up before pushing that bottom down...)
• pull out and swap carseats if we need to (those darn straps that hook the seat to the car are a pain to figure out and remove... hubby just does it so much better and faster)
• show the kid cool reptiles and bugs to help them learn to not fear them (was a turtle one day, a frog the next... just don't bring home a snake...I could never do this...)
• bathe the kids, brush their teeth and read to them at night before bed (especially during the late nights I work or when I just need a break...)
• act like "robot daddy" to bring a smile to their faces..
• 
  

Comparing Royal Carribean vs Disney for Small Kids

Well, it may be hard to compare because we went on one of Disney's smaller ships... but at the same time we also went on Royal Carribean's smaller older vessels.  So here are some comparings between the Disney Magic and Grandeur of the Seas:  

Kid Program
So here you have Disney themed characters roaming the ship vs no characters on the Grandeur.  I believe some of Royal's larger ships will have Dreamwork characters but we weren't on that boat and my kids aren't as familiar with those characters (like Shrek).  So from my daughters point of view... princesses win.  

The actual kid program on both ships are very good in my opinion.  I was pleasantly surprised at how organized Royal Carribean's kid program was.  They had plenty of activities and crafts and my kids seemed to have lots of fun every time they went.  The actual play area where the activities were held was much smaller on Royal.

Going off season was a plus for both ships since the programs were less crowded.

Rooms
Our family of five had to squeeze into one small room with a balcony for both ships.  Royal's room was slightly larger as there was slightly more walking room once all the beds were pulled out.  However, since my girls were not used to sleeping in the same bed and kept kicking each other and keeping each other up, we ended up having to split them up and each slept with a different parent instead.  Whereas on Disney Magic, they had two separate pull out type beds so each child had their own space.  Plus Disney had a curtain to divide the kid section from the adult bed section, so it almost felt like two rooms.  

The other plus on the Disney ship is they have tiny bathtubs in the bathroom so you can bathe little ones.  Based on that, I can tell they definitely cater more to families with small children.

I loved the wave phone on the Disney ship.  Since you can't really use your mobile phone once out to sea if in international waters (unless you want to pay a fortune), it was super convenient to be able to call one another on the wave phones provided in each stateroom.  I used it to communicate to my husband as well as other family in other staterooms that we were travelling with.   You get two phones per room... so huge huge plus!  I'm not sure if any of Royal's other ships have this feature.

Food
I think Royal wins in this category overall but only by a slight margin.  Royal had more options in the buffet dining.  However, overall quality of the food during the regular sit down meals were probably about the same on both ships in my opinion.  Disney's Magic did have more variety in ambience since they rotate you through three different sit down dinings which had different themes.  That made things more interesting/entertaining.

Other Ship Activities
Both ships have pools for kids as well as for adults only.  The kid pool on the Disney ship had more fun elements like a slide and fountains for little ones etc.  Royal has a climbing wall which my husband loves.  Now Grandeur was one of the smaller and older ships in the Royal Carribbean line and they did not have a movie theater which is usually where I go after the kids are asleep.  So I was disappointed at that.  Disney Magic did have a theater and they were playing fairly new movies like Brave and Avengers on there back in Sept 2012 and you can watch it in 3D.  No casinos on Disney which in our opinion is a plus...  don't have to walk through a really smoky area just to get to another part of the ship.

Shows
My kids loved the Disney shows.  I don't think we let them watch any of the Royal shows since they seemed more interested in just going to the kids clubs for the activities they had there.  Personally, I also really enjoyed the Disney shows and found only some of the Royal Carribbean shows very entertaining but I suppose it depends on your taste.

Cost
Disney costs a whole lot more.

So overall??  Both were good experiences... when I ask  my kids, they liked the Disney cruise better. However... for the value and and the difference of price.... is it worth it?  Would we cruise with Disney again?  Maybe just to try one of their bigger ships... but will have to plan and save for it... and will likely be a while...

Cruising with Kids

So my husband and I first went on a cruise for our honeymoon back in 2002.  Since then we were hooked.  It was a 4 night cruise to the Bahamas on the Majesty of the Seas.  We picked Royal Carribbean over the other cruise lines because of the more active entertainment they offer on board, such as rock climbing and ice skating.  Cruising is fun if you love the ocean.  It is convenient to not have to worry about food literally 24/7 and to be able to walk downstairs for broadway-like shows.  Plus, you get to visit a variety of different places.  Here's a picture of our ship, Grandeur of the Seas:

Why we pick cruising with kids over other type of vacations:

·       Meals!  We don’t have to worry about cooking or what restaurant to go to... or what time to eat even.   With the buffet menu, they can try a little of this and a little of that.  When our toddler wakes up an hour earlier than everyone else, I can take him upstairs and have breakfast with him before his sisters wake up.  We can even order room service at no extra charge any time of day which is super convenient.

·       Childcare.  Our two girls were able to enjoy crafts and games and entertainment while the adults get a short break.  We can drop them off and pick them up anytime and for as long as we wish as long as they are open.  They have childcare for younger children less than 3 as well but you have to pay.  We did use it one night when we had an adult-only dinner with my mother-in-law to celebrate her 70^th birthday.  It was $8/hr which is not bad considering normal childcare costs.

·       Entertainment.  What other venue can you walk a little ways from your bedroom and go watch broadway like shows?  In other settings, once our kids are asleep at night, we pretty much are stuck with watching a movie on our computer or just entertaining ourselves on our laptops.  However, on a ship we have the option to take turns going out even after they are down.  Without driving anywhere we can go watch live entertainment, go for a midnight snack or just relax somewhere on deck gazing at the moon and watching the waves crash.  They even have in room babysitting which you have to pay for.  We didn’t use it but I suppose it is always an option for those who want to explore the ship as a couple.  In the past, we go with enough folks that we can rotate who watches the kids at night.  When they are older they can stay up and do activities in the kid programs as well.

·       Destination.  It is a much more fun way to get to the Bahamas or Alaska or whatever other destination then just flying with the kids.  And once we get there… more fun activities to do on land!  It is a little bit of this and a little bit of that… but with my personality… it is much less work than trying to plan a whole vacation in one spot for a whole week.

What would we do differently next time?

·       Book earlier so we can get a family stateroom .  They ran out for this trip so we all stayed in one room.   It was painful since our youngest would wake up the others sometimes in the middle of the night.  The family staterooms have a separate room for the kids and just more room so we’re not stepping on each other.

·       Wait until the youngest is 3 years old.  The kid program on our ship was called Adventure Ocean.  It is free but the youngest age is 3.  I was a little worried initially because the kid area looked small and my kids’ last cruise experience was with Disney Cruise, however, I was pleasantly surprised with the program.  It was great to be able to drop off our two oldest for a couple of hours and know that they are having fun.  They have a different theme each session and the kids usually come back with neat souvenirs and crafts that they made.   Highlights this trip include: dressing up like pirates one night dancing to gangnam style & a talent show that they put together for the parents on the last day.

·       Go on a bigger ship.  Bigger ship means more activities and newer facilities.  However, it would also mean we would have to fly to Ft Lauderdale since that is the closest port where the large Oasis of the Seas or some of the Freedom of the Seas ships sail out of.  It was nice this time around to not have to pay for airfare and just drive to Baltimore to board our ship.  Other ports we can drive to include New York and New Jersey, however, none of the bigger ships leave out of those ports at this time.

Alright... next post will compare our Disney vs Royal Carribean cruise experience =)

Boston

Wow.  It's hard to find any words to say regarding the whole Boston marathon bombing.  Boston will always have a special place in my heart as I spent seven years living there... I really grew in my relationship with my Lord and Savior there... I met my husband there... in fact, he ran the Boston marathon as a "bandit" the year I met him (it was a college thing to do).

It's been surreal reading all the updates on all the happenings up there.  Instead of google or cnn I've just been reading friends' updates on facebook.  I am glad for the safety of my friends up there.  However, my heart does break for the those who lost their lives and those seriously injured.

Hats off to the MIT cop.  Crazy... he was shot at my old college campus near building 32! (All MIT buildings are numbered... we never called them by names)

As a mom, the story of the eight year old boy especially tugged at my heart.  It reminded me of all those other children who lost their lives not too long ago... also due to violence.  Life is fragile and unpredictable.  I would be a very nervous and anxious mom if it weren't for the hope and faith I have in my Savior.

One of my favorite verses that reminds me of what's to come is from Revelations 21, promising no more crying or pain.

 Then I saw “a new heaven and a new earth,”^[a] for the first heaven and the first earth had passed away, and there was no longer any sea. ² I saw the Holy City, the new Jerusalem, coming down out of heaven from God, prepared as a bride beautifully dressed for her husband. ³ And I heard a loud voice from the throne saying, “Look! God’s dwelling place is now among the people, and he will dwell with them. They will be his people, and God himself will be with them and be their God. ⁴ ‘He will wipe every tear from their eyes. There will be no more death’^[b] or mourning or crying or pain, for the old order of things has passed away.”

⁵ He who was seated on the throne said, “I am making everything new!” Then he said, “Write this down, for these words are trustworthy and true.”

I also really like this Keith Green quote:

“You know, I look around at the world and I see all the beauty that God made. I see the forest and the trees and all the things. And it says in the Bible that He made them in six days, and I don’t know if they’re a literal six days or not. Scientists would say no; some theologians would say yes; it doesn’t matter to me. But I know that Jesus Christ has been preparing a home for me, and for some of you, for two thousand years. And if this world took six days, and that home took two thousand years, … this is living in a garbage can compared to what’s going up there.” 

And I truly believe... as Stephen Curtis Chapman's song says, there's "More to this Life"

Work/Home Balance for Mom

Today's post is actually a guest post from Summer Blackhurst.  It is that time of year again where we are looking for a new match with another au pair for the next year.  So far we've had two chinese au pairs and have had two years of overall very positive experiences.  I'll share more about this in a later post.

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Some days I am up until 1 a.m. tying up loose ends in the home and with my job. Often by the time I lay my head down to sleep, I am promptly visited with my baby’s first cry to be nursed or my toddler’s call for comforting

Finding the right work/home balance has brought me to the brink at times (and as much as a 36-hour day would be just the right fit - extending out the solar system to make this possible just isn’t in the cards). With all the demands on moms in the 21^st century, kids are getting caught in the middle of the madness. They don’t have to suffer though. With a little ingenuity moms can have kids, and if they choose to, pursue career dreams.

In these cases get creative and look for more flexibility at work, telecommuting or working less than 40 hours if possible.  Talk to your hubby about stepping it up as much as possible. Train him to give you a night off from the little ones whenever he sees that “crazed” look in your eyes.

What about childcare? Have you ever thought about bringing in an Au Pair for a little extra help at home? I know with live in childcare it’s scary trying the find the right fit for the family. Finding childcare that doesn’t break the bank is also nerve racking. Au Pair childcare might not fit your needs, but it might. The State department set up this program for “foreign nannies” to come here and receive an invaluable cultural experience. Their job will create opportunities back in their own country for them, and US families leverage the live-in help and culture exchange to restore stability at home. Au Pair care is real time - live in help. An Au Pair keeps the family from being tied down to specific day care schedules and is typically a lot more affordable than using a local nanny.

In the swaying winds of home and family culture, our children need a steady hand more than ever. The more time I spend as a working mom the more I’m convinced too much is on my plate, it isn’t possible to do it all without help. So while we can have it all, we don’t necessarily have to do it all! Finally, I’ve found no matter what I might be going through at the time, I’ve never regretted pushing my little peoples needs the front of the line.

Summer Blackhurst writes content for Go Au Pair. She is the mother of two beautiful boys under three-years-old. She’s been writing for more than 15 years and worked in the childcare field for 20 years.