Missing in Action

February 27, 2011 § 1 Comment

(a beautiful platter I made for a visiting friend…pieced together some medjool dates, brie, manchego, smoked gouda, marinated and roasted garlic, and olives)

I can’t even remember the last time I posted, but I can almost guarantee that I was closer to my weightloss goal than I am right now.

Residency –

Residency has been pretty hectic/bizarre.  I’ve been at the VA for the past two months so it’s been relatively easy going, but if you’ve ever worked at a VA medical center (God help you if you have or currently work there) you’ll understand why I’m having a hard time describing it.  It’s the most inefficient medical system, hires rather inadequate performers (at least this one does) and stresses DOCUMENTATION rather than sound patient care.  There are hazing rituals that occur here which would never occur at my home-base training site, namely abusive M&M’s (morbidity and mortalities – where you talk about flaws in patient  care), VA CPRS documentation “police”, and harassment (luckily I haven’t been the abusee of any of these wretched people yet but my time is coming shortly as I advance to second-year) by completely incompetent attending physicians.

Monday afternoons are likely the most stressful periods for my senior residents who have to present our morbidity and mortality cases; luckily in the ICU we’re pretty damn strong, but some of the other residents REALLY get the mental pummeling of a lifetime for their so-called “piss poor care”.  It’s a hairy and malignant system, abusive, abrasive and quite frankly I can’t stand it.  It really wears you down to hear your seniors get beaten down for simple oversights made by their supervisors but such is malignant medicine – if your supervisor practices poor medicine, you’re bound to be treated and trained  poorly, taking the brunt of the consequences from both the families and peers.  Because of the intense nature (and unfortunately minimal patient care superseded by endless hours spent SITTING and DOCUMENTING your “patient care” at a computer all day) I haven’t left work on time for the past few weeks…leaving very little time for me-time, and most importantly…catching my much needed sleep.

All of that being said, I’ve been doing my best to maintain a sense of calm and the only ways I know how are to

1) partake in as much outdoor activity as I can; i.e. snow-shoe-ing with my very out-doorsy amiga, Laura

2) dancing around my kitchen with my itunes and a wooden spoon, revamping some of my favorite recipes, and

3) working out when i have the time which has been hard as HELL this month.

4) meeting up with my tight knit group of incredible co-interns (which, surprise – none of them are internal medicine interns…if that tells you anything about my personality. PS – this will also be the focus of a future post – how I’m itching and scratching to switch residency programs because i’ve grown very weary towards internal medicine)

5) shopping – as pathetic as it sounds, I’ve been meeting my sister for many-a-shopping sprees lately b/c it’s been such a wonderful release.  Mind you, I haven’t purchased much and most of these meet-ups are at the local Fresh Market, but the thought of buying FRESH produce to cook with or a brand new cast iron is very exciting and brings me peace.

Residency and my Gut –

I haven’t been to a weightwatchers meeting in months or a weigh-in for a few weeks. my weight has increased by about six lbs and it’s not muscle and I’ve been pretty down about this. Just last month I was about five pounds from meeting goal and thats when my second VA month started and that’s when the real fatigue set in.  I had been incredibly successful combining P90x LEAN with a few classes at the gym (body pump and Spin), as well as cross training – but lately I’m just dead by the time I leave work at 10pm  and barely even have the energy to throw my gym clothes on.

My appetite has also been CRAZY.  I know that the new PointsPlus system allows you to eat most fruits without the weight of extra daily points, but I’ve been eating fruit galore (waaaay more than I had been on the old plan) and my weight is just compounding.  On the average day I’ll have 1-2 bananas, 1 pack of raspberries or blueberries, and at least one cup of grapes in between meals.  My meals, on the other hand, have been upsetting as I’ve been craving salts and of all things, pulled pork.  Being that I can’t have pulled pork for every meal I’ve been gorging on other salty and usually fattening meals, such as frozen lean cuisine and SmartOnes – check out the sodium in those bad boys!  They’re quick and fuss-less so they work well for the VA.  If I don’t take a frozen brick, I typically take some left over small portion of the previous night’s dinner which usually consists of bulgar or soup.  The weekends can be messy though – I typically use my weekly points here or I even go overboard and have EXTRA points, which make way into my exercise points. Hence, I’ve been over points each week for the past month, thus making my weekly at-home weigh-in very stressful.

Luckily I recently found out that a fellow local foodie also goes to the same location for weekly WW meetings so this has been a motivator.  Food PLUS weightloss PLUS friends is usually a win-win game.  I’m hoping to get to more meetings for some real motivation, and get back on my exercise regimen….wish me luck!!

How does you all deal with a period of weight gain and legitimate lack of exercise time?

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Here goes nothin’…first post on a shiny new blog!

June 14, 2010 § 9 Comments

Welcome to my brand spankin’ new blog and thank you for reading

Here’s a little lot of insight into what my goals are and why I chose to start throwing my ideas out to the masses. There’s a long-ish story. If you know me, you know there always is a story.

Here’s the gist: MEDICAL SCHOOL -> stress ->eating like I was hibernating->no exercise + super unhealthy BAD relationship -> more stress->self esteem in the crapper->more stress->more eating +energy drinks and coffee = 30 pound weight gain in 2 yrs.  If you’re bored or I’ve piqued an interest, read on…

Now here’s the sort of full exciting story:

I’ll preface this by telling you, interested reader, that I have dreamed of being a physician since I was 12 years old.  I worked my ass off trying to get there.  Words cannot ever express the euphoria I felt when I opened up my acceptance letter – I was finally in.  It was very easy for me (and probably most of  my classmates) to forget that feeling upon being, pardon the cliche, thrown to the wolves, and expected to learn everything on our own from day one.  DAY ONE.   I never once in my first two years took the time to reflect on how lucky I was to be given the opportunity to become a doctor.  Oddly enough, it was literally the night before I took my STEP 1 boards- two years after school started – that I stopped myself to think that my constant worrying and misery was selfish.  There were hundreds if not thousands of kids out there who would have done anything to be in my shoes – taking the boards to progress to third year. But I was stuck feeling miserable.  I stopped “hating” medical school.  That very day I made a valiant effort to stop wishing I never went or wanting to drop out of medical school.  Who drops out of their dreams? Not this fool. I learned to appreciate being a medical student (an appreciation that heightened after my first rotation with my cardiology mentor – the man who moved me to choose his field…tear).  After all, I was going to be able to help bring someone’s beloved mother/grandmother/daughter/son back to health with whatever skill set I develop.  Why should I be miserable….

The dirty deets

After four (two, really) years of diligently paying full attention to my well being hell in medical school I finally graduated last week and entered the realm of “Physician”.  The dream was finally fulfilled after much emotional torture that is something that I can only describe as sadistic and seriously masochistic to the nth degree, minus the sexual pleasure that typically results from such practices (I wouldn’t know..really).  I was taking out a $200,000 loan (OK, pick your jaws up off of the floor) to pay for torture and to be devalued.  Seriously? I could have found more exciting ways to spend $200,000 AND I could have gotten that happy ending at the end of the session….

The first two years were the worst emotional roller coaster I’ve ever ridden and it was as if the damn breaks failed.  After heart break, tears, non-stop diarrhea, sugar-free Red Bull which-PS false advertising – I STILL DON’T have WINGS, multiple uni-ball pen purchases, dead highlighters, practically non-existent sex life,12 plus hours a day studying at Starbucks, USF, and Barney’s, multiple appointments with my gastroenterologist after developing ulcerations from about four-16 oz coffees daily (with the devil Siamese twins I call CREAM and SPLENDA), horrendous back pain from poor reading posture, tears, tears, and more tears, losing friends, sacrificing a social life, feeling alone, developing a nasty sense of competitiveness, driving my family crazy with worry, missing my best friend, wanting to drop out, thinking I made a mistake….and ultimately falling into a pretty bad depression, I can finally say I made it. Yay.  Was I alive? Let’s check some vitals.  Barely there.  But, I’ll tell you, there was nothing like the smile on my little sister’s face after I walked off that stage with my diploma and hood – that ONE look – that made it all worth it.  She was glowing for me and I had NEVER felt so proud of myself.

The events:

It was during these few years that I also lost myself for the sake of feeling smart-compared to my supposedly much smarter and talented classmates/roommates.  I really wanted to know my stuff inside and out, and excel, but excel I did not (at least for the first year).  I was unhappy.  I missed my family.  I missed having free time.  I missed my best friend.  I missed celebrating holidays with my family.  I missed feeling happy.

It was a mixing pot of fear of failure, a terribly unhealthy romantic relationship with a narcissist (that lasted a horrendous 2.5 or so years and killed my sense of self, worth, happiness, zeal for life), and zero physical/emotional health efforts.   I wanted to be the best, but that was at the expense of my well being.  I stopped exercising, ate every meal of every day at a fast food restaurant because I simply felt it was a waste of time to cook.  Exercise took a back seat to everything.  I didn’t even remember what the inside of a gym looked like or what it felt like to take a fun group workout class.  The sad part was that I didn’t even miss it but I knew I needed it for the sanity that I probably lost.

The nutrition was an utter mess.  I would devour anything that was covered in sugar, mayonnaise and, well, I loved anything that was of ZERO substance.  The more fattening the better.  Slather it on, bitches.  (Speaking of slather, a fun fact about my developing one-woman obesity epidemic was that I developed a love for Mexican food, so much so that my cell phone actually accidentally drowned in a heap of tomatillo sauce and had to be relplaced.) I digress. It was my vice.  It was to the point where the awesome husband and wife duo (two of my best cheerleaders) who ran the cafe at school knew how I liked my poached eggs and buttered toast, cashiers at Panera knew my first name and knew what I was going to order before I even walked in, the Starbucks baristas at three different stores knew my drinks based on the season and would prep them the very minute I walked in – and would add my extra caramel.  My favorite sushi restaurant even made up an interesting special order avacado roll for me…ironic…roll.  Here’s the worst, the creepy Pakistani man who managed the gas station near our study spot actually knew my name (luckily I never found his out).  He knew I’d be likely to wander in about 3 days per week and buy some  sour patch kids, teriyaki beef jerky, cajun mix, Rockstar, a sprite zero (duh, I was watching my caloric intake), or a banana.  There was even a point when I looked so nervous about a test with my beautiful dark under eye circles and acne, that he kindly offered me pot.  I should probably have taken it but here’s an interesting side fact: I’ve actually never smoked (or otherwise consumed) the shit.

Food was the ONLY thing that wouldn’t make me feel like an idiot in medical school and made me feel happy  for about 10 minutes.   I devoured it.  Fat=happiness and ultimate sadness.  Tell me you’ve seen Supersize Me; you know how Morgan feels like death? Yes, well that’s how I would feel about an hour after I ate the sugary and fattening poisons – except the feeling never went away…ever.  I grew to despise the way I looked.  Never wanted my ex to see me naked and quite frankly he never wanted to once I gained my weight (because, and I quote from his mouth, that he started to hate my “fat, wide ass, huge gut, enormous saggy tits, and double chin” – charming, right? – trust me, I finally realized the low/no self-esteem I had to have had to date him – and honestly, he was no model of health himself), and avoided fun social situations because (a) that meant less study time and (b) I looked like crap in everything I wore.  All of this fast food added up pretty fast and depleted my student loan account at the end of each semester and I was almost 30 pounds heavier than when I started school.  It was all over my ass, gut, and chin.  My clothes looked terrible, I looked terrible.  Needless to say, I felt it, too.  My vice has destroyed me. Was this all worth it???? (to be answered in subsequent posts)

The stare-down that changed my bad behavior:

Welcome fourth year.  I had been out with my adorable sister having lunch.  She casually happened to ask if I decided what I thought I wanted to ultimately practice.  I dropped it – “EFF yeah, obviously I love interventional cardiology”.  The look I got when I said this felt like a round-house to the heart.  All she did was look me up and down and say “Seriously? YOUUUU want to be a cardiologist? How are you gonna convince your patients that they need to lose weight?” and yes, it sounded just that bitchy.  That was it, folks. I was crushed.  For days I was uneasy.  I thought, well, maybe patients will listen, who cares if I’m obese?  Then it hit me like a ton of cheeseburgers – I need to stop my cycle.  I need to be my patients’ advocate and model.  I was being a hypocrite.  How selfish could I be? How could I say I wanted to be a cardiologist and treat heart disease if I was sitting at Starbucks drinking a grande caramel macchiato with extra caramel with an apple fritter? How could I dare not exercise then turn to a patient and with genuine love tell them they needed to make better choices? I have to start making better choices.  Let me get on that STAT.  we all know what stat means – it means when I feel like it = never.

I was also getting so tired of getting crooked- brow stares from truly concerned family members whenever I ordered that nastiness that is takeout.  I will NEVER forget my dad’s (who might very well be my favorite person on earth and he knows it) birthday dinner about two years ago.  After we had all finished our dinners, mine, of course, was an alfredo-laden pasta, 8000 calorie , total shit fest that curiously left me craving for more…shit.  When the waitress came around donning a charming smile and full dessert menu…who the hell was I to deny that SMILE and additional tip out of my dad’s wallet? Of course I’d take the menu off her hands.  Salivating like a rabid dog and scouring the menu with an appetite that could put sumo wrestlers to shame, I chose my dessert…and if you know me, you’re likely to correctly guess that it involved the trilogy: booze, fat and sugar…YES, TIRAMISU!  I patiently waited for the waitress to come back and when she did, I reciprocated with that friendly smile and nearly screamed my gluttonous desire for tiramisu…and that’s what I looked at my dad’s face.   He was wearing his “angry face”.  $#*^ !  The one where he looks me dead in the eye, head slightly titled as to look at me from the corner of his eyes, lips pursed as if about to spew profanities, and nares flared.  This was not the look I’d hope for.  I shamefully asked what everyone else was ordering and my father blurted out, “NOTHING! We already ate!”  in his little accent, but theu this teeth as if he just wanted to scream.  I shut my mouth and almost cried.  Yikes. I knew why he was so upset.  I knew that every time I came home and he saw the new weight I’d put on he was becoming more and more fearful of the threat of diabetes which two of his sisters died from, which he is also victim of (although he’s a Type 1).  I should also add that he is by far THE HEALTHIEST person I have ever met.  First off, he is rail thin but well built, works out twice daily – both cardio and weight training, eats extremely regimented meals (possibly stemming from his obsessive compulsive -mindset as a hardcore nerdy engineer).  The fact that this specimen of health looked at me like this…MAN I was defeated.  Embarrassed. I felt like the universe had shat on me…great, now I would never hear the end of it.  I had ruined dinner.  But did that stop me from making that tiramisu my bitch? Nope.  That was THE Worst stare-down in the history of stare-downs. Dad-1,Dessert-0

I dragged this out. It was time to find the tools that I thought I would be best able to eventually recommend to my patients. I researched several diets, plans, fads, gyms.  You name it, I read about it.  But that was the problem…I dragged my feet for weeks researching.  In the meantime I started waking up at 5am to head to the hospital’s free gym.  I finally picked the most practical one I knew; WeightWatchers.  This was one, I knew, would be the most sound weight loss tool I could follow and hoped I would be successful.  After all, now I had graduation to look forward to.  Had to show my stuff off on the beach!

I have felt fabulous on WW.  I have lost a total of 28 pounds thus far (8 on my own and 20 with WW) and I feel like a million bucks – unfortunately this million won’t pay off all of my school debt. Bummer. Not only did I start meticulously watching what I was shoving down my gullet, I also began working out about 5 days per week.  I developed a liking (GASP!) for the gym and bought several work out videos for the days I couldn’t make it to the fitness center.  My favorite routine (and bank-buster) thus far has been HOT YOGA!  I started this to teach myself how to focus and outlast a grueling workout.  I am in some serious love.  I will blog more about that later.  I also found myself popping my AM/PM Yoga in the DVD player right before bed every night.  May I just tell you that this was magic.  Magic sprinkles all over.  I found such stress relief with this practice that I may have reversed the lunacy I developed during my first two years of med school. The jury’s still out.

Finally, the reasons I chose to start blogging were many, but most importantly, during my health journey I have found it immensely helpful connecting with fitness and health bloggers via Twitter.  I’ve been introduced to helpful books, websites, more bloggers and even that intro to Bikram Hot Yoga that so enlivened me.  Ergo, I thought I might jump on that band wagon while it’s hot!  Pop it like it’s hot? Getting my fitness goals out to people who are reading my progress  helps me stay focused and accountable.  That’s my reason…love it or leave it.

So that’s where my story begins.  Hopefully it set the tone, giving you and idea of where I’m coming from and events that lead me to blog.

My subsequent posts will focus primarily on:

  • residency- the ups, downs and all arounds *(I will never divulge the name of my training program, fellow residents, or my patients.  I will also NEVER describe details of their intimate stories – trust and faith in character are traits of utmost importance to me (most importantly in medicine) so I take this responsibility with honor and hold it in extremely high regard)*
  • continued weight loss
  • how my first few months on WeightWatchers panned out
  • my weight loss journey
  • pearls of wisdom I learn along the way, both in terms of weight loss and becoming the physician I am destined to be
  • motivational quotes
  • exercise goals I set for myself and tips that I learn along the way
  • pointing out my healthfulness struggles and obstacles along the way
  • finding balance between work, family, and health (both emotional and physical)
  • continuing to develop healthier habits
  • I LOVE FOOD! recipe posts and photos (yes, I’m one of those people)

These blogging goals are important to me but I am more than likely to add some random fun stories in just to shake things up a bit.  I’m also using this as a way to document my personal growth and development over the next three years.  I’m hoping I can inspire, help and motivate a few while doing the same for myself.

And being that I’ve been trained in a world where lawyers set the tone for medical practice, I should add a disclaimer that none of my posts should be taken as medical advice.  Ever. I post and practice only what helps me and what I’ve learned from fellow bloggers or interesting articles.  I also won’t/can’t give specific medical advice. Trust me, at this stage in my training and the nerves built up over impending internship, you wouldn’t want me giving you any advice on anything other than menu recommendations at local restaurants.

I hope I’ve intrigued you to continue following me in my little journey.  Feel free to add comments and pass this on 🙂

happy blogging!

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