What Works

I'm interested in what works. In my journey toward becoming healthy two things that work for me are Lose It! and Fitbit.

Lose It! is a web site and app for your phone or tablet. It helps you set and track goals, gives individualized target information for calories and exercise, and I think most importantly, hosts a support community that is really terrific. The psychological research is very clear that working towards a difficult goal - like losing weight - is much more doable when you're doing it with others. Lose It has been very valuable to me.

Lose It!

Fitbit is an activity tracker and much more. It tracks steps, miles traveled, floors climbed, and calories burned and will also give you a target calorie limit based on your stated goals. I have found it to be very motivating in getting the extra activity in that, a little at a time, really adds up. Fitbit will sync with Lose It! You can also develop a support community on Fitbit and enter challenges to keep you moving.

Fitbit

Lose It! led me to a blog that has been very helpful to me: Make Your Someday Today. The blog is the creation of Trevor LaRene and has great articles and terrific recipes, some of which I've blogged about. Trevor is a very active Lose It! member and has lost 85 pounds so far. Right now, he's running a giveaway for a subscription to Eating Well magazine, a periodical he has found quite helpful. Check it out!

Make Your Someday Today

Is Therapy Dead?

Psychotherapy is very effective in treating many problems that afflict us in the 21st century, including those conditions that underlie physical illnesses and contribute to our ever increasing health care costs (see first links below.) Why? Because many problems are the result of how we think, act, choose, and relate - all areas addressed in psychological health care. I've also written about the problems associated with the marketing of every human difficulty as a disease with  a corresponding (expensive) medication to treat it (see second set of links below.)

Despite the evidence for its effectiveness, psychotherapy is less and less available. Why? The simple answer is money, marketing, and comfort. There's much more money to be made in medicalizing everything, especially for the mangled care insurance companies, BigPharma, and the psychiatric establishment. 

People have also been convinced that there is (or should be) a pill for everything including what I've taken to calling Sucky Life Syndrome. Life is difficult for reasons within and sometimes beyond our control. We make choices every day that either worsen the difficulty or just fail to solve it. We feel bad about that. So, we look for something to take the bad feeling away without, of course, actually requiring any change on our part or in our circumstances. And BigPharma has just the answer we and they want. So, psychotherapy as a viable treatment option may be dying out. Not a good thing.....

Evidence for Effective Treatment

Preventing Relapse of Major Depression

Mindfulness, Meditation, and Health
Another Good Reason to Walk the Damn Dog

Psychotherapy Effective in Treating Depression

Hypnosis Helpful in Breast Cancer Treatment and Re...                 

Brief and Effective Insomnia Treatment 

The Dis-easing of Life

Prevention Rather Than Medication??? 

 Childhood a "Brain Disease"?

Unintended Consequences: Do Antidepressants Increa...,

Johnson & Johnson, one of the largest and most pr...

Meds Ineffective and Harmful in Treating Combat PT...

Hammering Our Kids

Epidemic or Marketing?

Shameless

This link - What Brand Is Your Therapist? - describes what therapists must do to survive in our current health care system. It's pretty sad. 

Salmon Baked in Foil with Broccoli and Pesto

Here's a very healthy dish that takes about 20 minutes to make. I am not a huge broccoli fan but I have to say it goes extremely well with salmon prepared this way. Have just this - it's quite filling - or add a salad. If you want carbs with it, go for a baked potato or brown rice. Trust me, though, this is enough by itself. This is my wife Cindy's adaptation of a Jamie Oliver recipe. The Oliver version uses green beans but I suspect you can use just about any vegetable you'd like.

Ingredients

2 handfuls of cut up broccoli

2 lemons 

2 (7-8 oz) chunky salmon fillets, skin on

2 heaped tbsp of green pesto - store bought is fine! 

2 tsp olive oil

sea salt and freshly ground black pepper

1. Preheat your oven to 400. Trim and cut up the broccoli. Halve both the lemons.
2. Pull out a sheet of aluminum foil about a yard long and fold in half to create a double layer. Place a handful of broccoli in the middle to create a bed for the salmon. 
3. Lay a salmon filet, skin side down, across the broccoli and spoon over a heaping tablespoon of green pesto.
4. Drizzle with 1 tbsp of olive oil, squeeze juice from one of the lemons over the fillet, and season to taste with sea salt and pepper.
5. Pull the aluminum foil edges together and scrunch them to seal the parcel. 
6. Repeat these steps to make the second parcel. (This recipe serves two. Do the math to feed more.)
7. Put both parcels on a baking sheet and bake for 15 minutes. Remove from the oven and let it stand for one minute before carefully unsealing one of the parcels and testing for doneness. Bake a few minutes more if needed.

Bon appétit!

Happy Thanksgiving!

What to say about Thanksgiving? I’m not given to easy sentiment or expression of emotion. I usually gag in reaction to much of flowery fluff I see posted on line. It rises to the level of the “peace and love for all mankind” responses elicited from beauty pageant contestants when asked their fondest wish. So, I’ve been thinking about what I’m grateful for and trying to be as honest, real, and down to earth about it as I can. Here’s my shortlist. What’s yours?

  

 I’m thankful for:

• My wife, Cindy Day, whose courage and love uphold me now as they have for so many years. I am particularly pleased with her recent gift of encouraging me to learn how to cook and challenging my fear of “not doing it right.” I am eternally grateful to her for reminding me at crucial times that “You don’t know.” That reminder of my lack of omniscience has saved me much grief and brought me much serenity.

• My son and daughter in law, Jim and Amy, for the privilege of knowing them as a strong and loving couple, admiring their great resilience over the last few years, and joyfully anticipating the birth of their first child Stella Noel right around Christmas Day.

• My stepdaughter Kate and her wife Maggie, two of the brightest and funniest (even more important!) people I know. Their energy, drive, intellect, character, love, and toughness simply astound me. Check out their new blog: http://kateandmaggie.wordpress.com/

• My granddaughter, Amelia, who is – objectively speaking, of course – the brightest, funniest, most beautiful grandchild in the world, a title she will soon co-own with Stella Noel. Sometimes, I look into Amelia’s eyes and I honestly see a very old soul who is destined to do great things (that will have to wait at least until she finishes first grade!)

• My friends, old and new, just for being there and for being themselves in all their glory, irascibility, honesty, brokenness, tolerance, humor, and redemption. A special thanks to my oldest friends (you know who you are!) and to the Geezer’s Breakfast Bunch for all the reasons you know.

• The opportunity in the last couple of years to take real ownership of my life, my serenity, and my health through the help of some incredible people who encourage, inspire, and hold me accountable to my own journey.

Have a Great Thanksgiving!

Night Eating - A Solution

Night time eating is a major problem for anyone dieting or just trying to eat healthy. Including me. (See: Ruminations - Night Eating.)  In analyzing the last month it became very clear that snacking at night - which I call the Midnight Munchies - was the major contributor to my plateau. So, I've done a ton (you should pardon the pun) of research and made an effort to address the problem. The real obstacle for me is at bedtime. I got in the habit of taking a cereal and nuts combo to munch on while I read. That can add up, especially when you get a refill!  I've learned to keep things simple and frame them positively (I will, not I won't.) So, here's what I did:

• Made a decision to eat only in the kitchen and dining room and a committment to do whatever it took to stick to it. For example, if I absolutely, positively had to have a snack, I  committed to having it at the kitchen table. I know myself well enough to know I am highly unlikely to drag my ass out of bed for a snack if I have to go to all that trouble!)
• Resolved to act on what I knew, not on what I felt, on what I needed, not what I wanted. I knew the snacking was a compulsion that would require total abstinence to break. I also knew the urge would go away if I let it. So, my need was to go through minor discomfort for a few minutes until the urge abated. I knew getting into my reading would facilitate that process so I committed to reading for at least ten minutes before acting on any urge. That ten minutes is enough for the desire to dissipate. 
• Made an effort to be mindful of the midnight munchies, i.e., to observe and understand the urge and what was driving it - boredom, comfort, restlessness, entitilement, whatever. The key was accepting the urge (without judgement) for what it was, simply my momentary experience that would pass. Judging the urge or myself for having it would only reinforce the unhealthy behavior and prolong the struggle.

The results? So far, so good. Five consecutive days with decreasing urges and difficulty each night. I know that after a month or so, this will become the "new normal" and no longer a struggle at all.  

Here's a link to a wikiHow article that outlines some more steps you can take to stop the Midnight Munchies yourself.

How To Stop Eating at Night

Night Eating

Ever hear the 'fridge call your name at night, even when you're not particularly hungry? Eat at night more from habit than hunger? Find yourself cruising cupboards, drawers, and pantry shelves looking for something crunchy or sweet to pound down? Eaten stuff that you didn't particularly want, just to eat something? Reproached yourself afterwards for being "bad" when you had been "good" all day and resolved not to do it again. And promptly did the same thing the next night? If so, you are definitely not alone!

The evening hours are a very difficult time for anyone trying to eat healthy and/or lose weight. The inhibiting structure and responsibilities of the day are gone. Simply put, you don't have to go out of your way or wait for a break to indulge. You can eat what you want when you want it. Your options are greater. You have a house full of food that you yourself have purchased or had a hand in selecting. Your guard may be down and you may consciously or unconsciously believe  that you are "entitled to a little reward" for all your efforts throughout the day. If you have problems with relationships, children, work, depression, anxiety, insomnia, or any of our modern ills, eating may be seen as a quick fix — or at least an easy distraction —  for what distresses you.

Nighttime temptations are a common problem for anyone trying to be healthy. It's an even greater problem for those who have a significant weight problem. About 27% of obese Americans manifest what is called Nighttime Eating Syndrome. (See the links below.) It's estimated that 1.5% of all Americans (you do the math) qualify for this diagnosis. Whether this is a syndrome or very unhealthy habit doesn't matter much; it's a real problem for a lot of people.  Me, included. 

I've been surprised by the intensity of my nighttime cravings. I always did a lot of secret eating at night. Yet my urges were no greater at night than any other time. In the process of losing 150 pounds over the last four years I thought my cravings might disappear. For the most part, as I have learned to eat healthy and exercise, the cravings  have diminished or simply gone away. Not at night, though. Along with a sweet tooth that is far more intense than ever in the past, night urges are the most stubborn remaining obstacle in my path. I have some ideas as to why this is so and will write about it in future posts. I'll also explore ways to stop the nighttime eating. For now, check out these links about Night Eating Syndrome. (To be very clear, not everyone who eats at night or struggles with the mindless munchies has an eating disorder! Most do not. Not every human foible is a disease!) In any case, I'd be very curious as to your experiences with this problem!

Night Eating Syndrome

Night Eating Syndrome - II

Turkey Sausage, White Bean and Butternut Squash Soup

This is a hearty and healthy soup great for fall and winter evenings. I made it this morning, we had it for lunch, and we'll have it for dinner as well. It's a Weight Watchers recipe (they've got some really good ones, check them out). A couple of suggestions, though: Use reduced sodium broth and don't add salt; even the reduced sodium broth is quite salty. Use more squash, maybe another half pound, a little less chopped onion, and a tad more garlic. You could throw in some more cannellini beans if you'd like. Serve with a really good bread (we had a hearty multigrain from Wegman's.) Cubing the butternut squash requires some time and effort. Use pre-cut squash to save on both. You can also use regular Italian sausage if the extra calories (not many, really) are not an issue. Enjoy!

Turkey Sausage, Butternut Squash, and White Bean Soup

Get Behind Yourself and Push!

I've been exercising for over a year now. When I started, I had a strong desire to establish an exercise program. Desire is, after all, just a feeling and all feelings pass. To have a shot at success I knew I needed to be and stay motivated. Motivation is not a feeling. It's a decision plus a commitment. The decision is not "I want to." The decision is "I will." The commitment is "I will whether I feel like it or not!"  There are many mornings when I don't feel like going to the gym. I would just as soon stay in bed, reset the alarm, and pull the covers over my head.

Yesterday was that kind of morning. Mornings like that are good teachers. The alarm went off, as usual, at 0500. I hit the snooze button and must have hit it twice as the next thing I know it's buzzing at 5:20. I tell myself "It's too late to go to the gym and you won't be able to do your routine anyway so you might as well get some extra sleep." Didn't work. Two minutes later I tell myself to get my ass out of bed, go to the gym, and do what I can. Once at the gym I decided to skip the weight training and do an extra 15 minutes of aerobics. I learned two things: First, no matter what, exercise as planned and second, don't insist on doing things exactly one way. Be flexible rather than rigid in implementing your plans because rigidity can easily become an excuse for doing nothing at all. Ah, well.... sometimes you have to get behind yourself and push and sometimes you have to be creative.

Here are three links with helpful tips for staying motivated to exercise.

Staying Motivated

Maintaining Exercise Motivation

Exercise Motivation Secrets

Quick Beef With Greek Yogurt Sauce

This is a quick and easy dish for election night - or any night when you're busy! It takes about 15 minutes total and is delicious and low in calories. It's made with ground sirloin, cumin, salt and pepper, and (but of course) garlic. The sauce is a mixture of low fat plain yogurt and diced cucumber. Top the beef with the sauce, sprinkle some fresh, chopped mint on your creation, and serve on a pita. 

This is a Weight Watchers recipe and is five points. The reviews on WW offer some ideas for spicing it up if you're so inclined!

Quick Beef With Yogurt Sauce

Irrational Choices

 Health care reform is vital but complicated. Republicans and free marketers advocate for greater consumer (what the hell ever happened to patients?) choice and more responsibility in choosing and paying for insurance plans. So, Romney/Ryan proposes Medicare vouchers that cover some of the cost (leaving a considerable premium for seniors to pay on their own) on the theory that consumers will have more skin in the game and make wiser choices that meet their needs but keep down costs. A lovely theory! It just doesn't work out in practice.

The link below describes the harrowing and complicated journey of a woman who needed neurosurgery. This woman is also a health economist and knows far more than most people about the intricacies of insurance and health care.

Now imagine an average senior citizen - your 85 year old grandmother perhaps - trying to navigate this very complicated, sometimes deliberately obtuse maze. Trying to anticipate, for example, all the illnesses she is likely to have, procedures she might need, drugs she might be prescribed and matching all that to the managed care plans presently available in her area, at the same time predicting how those plans are likely to change and, oh by the way, where she is going to come up with the difference in premium left after the voucher. Most people will choose the cheapest plan or perhaps the best they can afford at the time. They will not be in a position to figure it all out. Granny loses, insurance company wins. Is that what you want for your parents or grandparents? How about for yourself?

Facing Neurosurgery

Cindy’s Famous Red Sauce

    

My wife, Cindy Day, is an excellent cook. One of the things I've enjoyed over the years is her red sauce. We do a lot of pasta dishes and the foundation is always the sauce. 

Today, for the first time since taking on much of the cooking duties in our home, I had a hankering for red sauce and tried making it. Turned out pretty well, I think. The beauty of the recipe is that a novice like me can make it, it's very simple, and takes little time. You can add to it in any way you'd like, sausage, meatballs, whatever. This recipe makes enough sauce for at least a couple of meals, if not three. Enjoy!

2 - 28 oz cans crushed tomatoes

1 28 0z can whole tomatoes, peeled                                 

3 cloves chopped garlic

3 tbs olive oil

1 cup beef bouillon

2 tbsp brown sugar

1 tsp oregano

2 shakes red pepper

2 tbs dried parsley

Use dutch oven

Cut bouillon cube in half and add one cup of boiling 

water in measuring cup

Heat olive oil on medium heat (4-5)

Add garlic and simmer until soft, not brown                                

Add tomatoes, breaking up, and stir

Add oregano and red pepper

Add 2 - 3 oz of bouillon and brown sugar

Add parsley

Cook 10-20 minutes, adding bouillon as you go, and stirring frequently from the bottom up.

Add to your favorite pasta and enjoy!

Routine Screenings: Blessing or Curse?

The link below addresses the value of illness screening, in this instance breast cancer. The essential questions are these: Are all of the routine screenings (e.g., mammograms, colonoscopies, prostate) really necessary? Are they effective in saving lives? Are they cost efficient? Do they contribute to over-diagnosis with its associated costs, both human and financial?

The answers are complex, critical, complicated, and full of surprises. The issue, though, is far greater than just the worth of routine screenings. If we don't reform our "healthcare" system, we are going to go broke. It's as simple as that.

I put healthcare in quotes because our system actually has little to do with health. At its best, it provides treatment for disease (interesting word, dis-ease) and does almost nothing to promote health. Most illnesses that require costly treatment are related to lifestyle and can be prevented, delayed, or minimized by good health. Yet what we call the health care system simply does not focus on health. Why? The short answer is money. The long answer is comfort. I'll explore this at some length in future posts.

For now, let me just say that health care providers of all types are currently rewarded for the procedures they perform. The more procedures, the more complex the procedure, the greater the reward. So the incentive is to do more discrete, billable procedures. There is no incentive - really, there is a disincentive - for promoting health. No physician can maintain a practice by taking the time to explore with a patient the variables that influence their health, exactly what they can do about it, and exactly how to do it. Six ten minute visits/procedures generate far more revenue than one or two consults with patients designed to help them take charge of their health. That's the reality. Medical people are not being greedy here; they are just working the way the system is designed.

Frankly, most patients like it that way. They would rather have doctors be responsible for fixing them than take responsibility for their own health. Why? It's easier. It's easier to take a pill and expect it to fix you than it is to take responsibility for your health and do what is necessary. More to come.....

Cancer Screening: Blessing or Curse?