Author: Dr. Julie

Happy New Year!

I wanted to introduce you to Rachelle Mathios, our health coach at Oregon Weight and Wellness and one of the ways we are WAY DIFFERENT from other programs. ( To find out what a health coach does, click here).

Rachelle has invited OWW clients to BUILD THEIR BEST YEAR EVER and I wanted to extend that invitation to you.

Here’s what Rachelle has to say:

“Today is the first day of 2021! Yes, we have finally left 2020 behind us. It’s done. Another one for the books as they say. There are a lot of ways one might describe last year. Some people use the word “unprecedented” while others are calling it a “dumpster fire.” Most of were left speechless. We couldn’t put words to our experience but just couldn’t wait for it to be over. It was certainly one of the strangest years I can remember.

But here’s the thing. With all the ups and downs, difficulties, sorrows, and losses, it was just another year after all. And today is just another day, like yesterday. You are most likely the same person you were yesterday. This life you are living, it did not change overnight just because the number on the calendar changed. Contrary to popular belief, there is nothing magical that happens on January 1^st.

And yet, there is a feeling. We all seem to get that same feeling. Something new is coming. There’s a shift in the air, There is hope. All of humanity seems to breathe a collective sigh, wash its hands of what was, and look ahead to what can be. How beautiful!

I imagine all people across the globe feeling a new sense of energy and positivity for what te new year might hold and I feel connected to it. I’m game! I want in! I want to grab ahold of whatever it is every one else is grabbing onto and yell “Giddy up, let’s do this!”

Typically, this excitement and readiness for change translates into New Year’s resolutions. We all make promises to do better in many areas of our lives: nutrition, exercise, mental health, career, stress, family, relationships. We tell ourselves, “I will always do this and I will never do that” but this usually does not work out the way we intend. We set our sights and our goals BIG. We go BIG but the restrictive ultimatums and contracts feel suffocating, unsustainable, and not at all connected to who we are or what we actually want. And then, as expected, we crash and burn BIG.

According to research conducted by Strava using over 800 million user-logged activities in 2019, it was predicted that most people are likely to give up on their New Year’s resolution around January 19.

What’s wrong with us? Why can’t we stick to our resolutions and why is it so hard to get health?
I’d like to suggest that YOU are not the problem. There is nothing wrong with you and the sooner you stop beating yourself up, shaming yourself, and allowing those inner voices to keep you trapped in a negative thought pattern, the sooner you can take control of your today and begin to build tomorrow.

There’s a better way and that’s what this series is all about. Let’s approach 2021 together and let’s do it differently. If you want a different life in 2021, you have to make moves to make it happen and we can help!”

Check for tomorrow’s blog post for Rachelle’s 2020 Review.

To find out what a health coach is and how health coaching can help you in your journey click here.

I stepped out of the office into 5pm darkness and pouring down rain. Even though I had a great day full of productive and positive interactions, my mood sunk. Winter is here, I thought to myself. And I pulled my coat around my neck a little tighter, locked the office door, and dashed to the car for the dreary drive home.

Every year I fight to make it to December 21 when the days get longer again. If I can just make it until December21, I reason to myself, I will be ok.  And from Thanksgiving on, I fill my calendar with busyness, holiday parties, get togethers, church events, bazaars, bell ringing, etc. This strategy works for me. Time passes and I breathe a sigh of relief come December 21. It’s still dark and cold and wet, but in my head, I know the days are getting longer even if it’s just a few minutes longer. And for whatever reason, that keeps me going.

But not this year. Covid has seen to that.

Because of Covid, there probably won’t be the usual social gatherings. Already my family did not get together for Thanksgiving as planned. It’s not fair and I hate it.

The only useful consequence I foresee is that I won’t be tempted by all the goodies and overabundance of food at parties. But then again, will the isolation of being homebound drive me to old habits of consoling myself with comfort food?

How can I avoid overfeeding my December to not feel regret and reflexively starve my January?

Many of us struggle with SAD, Seasonal Affective Disorder. During the winter months, we don’t get as much sunlight which affects the pineal gland and the body’s clock, increasing melatonin production making us sleepy, and decreasing serotonin production making us sad.

A new strategy I am implementing this year is full spectrum bright light therapy. A growing body of research shows that 10000 lux, about 20 min a day, can be greatly beneficial for mood and energy.

I will take an additional 5000IU of Vitamin D3 and eat happy foods. What are happy foods? Berries, leafy greens, grass fed, free range or wild protein, especially wild caught salmon, avocados, and nuts and seeds. Whole, real food has the building blocks for serotonin and melatonin for optimal mood and energy.

I will challenge the inevitable negative self-talk replacing it with truth.  Yes, this winter is different, but different does not have to be bad. Maybe I can even improve my health and learn new things. Maybe I could finish out 2020 stronger.  I can try new recipes and tackle projects around the home. There is that quilt I want to finish and the books I want to organize and the blog I want to write more often. I can read uplifting books and listen to upbeat music rather than watch the news. I can be creative about how I connect with family and friends.

I can look to the creator of winters and seasons, the creator of lights in whom there is no turning. And if I can embrace this winter knowing it is but a season and spring always follows, this year will end weigh different.

I hate to admit it, but.. for the majority of my adult life…I did not eat a healthy diet. I ate what I now affectionately refer to as crap: Carbs Refined, Artificial and Processed.  And while I am confessing, I might as well add that I did not really eat. I wolfed. I gulped. I shoveled.  I guess I hardly even chewed because according to some, I was the fastest eater both sides of the Mississippi. While I no longer eat fast food, I still eat food fast.

My name is Julie Gilbert and I inhale food.

I had good reason.  In medical school and residency, if I did not eat fast, my beeper would go off and I would not be able to eat at all. I had no time to cook; so, yes, I grabbed quick, convenient, processed food. On my cardiology rotation, I would eat two of those Little Debbie Nutty Buddy chocolate wafer bars with peanut butter. All 330calories, 20g of fat 33 g of carb and 4 g of protein vanished in seconds as I rushed down the hall of the hospital to my next patient’s room leaving a trail of crumbs behind.

During a dermatology rotation, I recall stealing away to McDonald’s drive through on my 20min lunch break and grabbing a large chocolate milk shake every day. All 22 oz of the gummy corn syrup flavored skimmed milk disappeared in the few panicked minutes it took to get back to the office.

White rice and pace picante sauce were staples on my medical student budget. And I foraged free food from noon “lunch and learn” lectures sponsored by pharmaceutical companies.  Needless to say, they did not deliver health food fare. I could usually scrounge remnants of soggy subway sandwiches with processed meat and plastic cheese, maybe a wilted lettuce leaf and half slice of bland hot house tomato if I was lucky.  

Non-nutritious food eaten in the worst way possible.  I probably did not even taste it.

I came by this honestly as many of us do. Time is our constant constraint. And so we learn to eat fast in school, as working moms, as busy dads, rushing out the door, driving down the road.  Or we “skip” breakfast altogether. I hear patients say they prepare a meal for their family, but they don’t sit down to eat the meal with their family. Patients admit they are so busy at work they work right through lunch. Oregon requires employers to give a lunch break, at least 30min, but many times we don’t take it and we end up scarfing our lunch in front of a computer.

When did we start believing that we do not have time for our body’s essential requirement of eating? Or that sacrificing meal time is ok.  Our culture is not like other countries who have a two-hour break in the middle of the day (These countries have lower BMI’s than ours…hmmm).

But gulping food does not give our brains the pleasure of enjoying the food. Consequently, we are not satisfied and then we get hungry or crave more food in an hour or two. Eating while rushed promotes indigestion because our sympathetic (fight or flight) nervous system is in play and what we really need is the parasympathetic (rest and digest) system working in order to digest and absorb nutrients well.

So I am working on slowing down my eating. Telling myself the truth. I need time to eat. I have time to eat. I am not in residency anymore. The food is going to be there in five minutes. I am not going to starve. I won’t be paged away. My work will still be there. The world will not come to an end if I take the time necessary to eat a real meal. I am giving myself permission to take notice of the various colors and textures and smell and taste and savor every bite of food before I swallow.

Mindful eating instead of mindless eating.

And I don’t need to chew the bite of food 100 times like all dieters are trained to do.  I do need to chew thoroughly, yes, but what I am focusing on more is breathing.  Take a deep breath or two in between bites and just relax and enjoy. Allow my body to digest and absorb. Without the distraction of phones or TVs or computers. When you eat, just eat.

It takes twenty minutes for satiety hormones to be released from the small intestine to tell the brain the body had food. If I rush through my meal, I most likely will overeat and be fuller than I am comfortable feeling.

For the last few meals I have eaten, I set my timer in front of me to make sure I spend at least ten minutes eating. I timed myself without the breathing and I can scarf a meal down in three minutes flat. With the breathing, I have stretched it to ten. My goal for dinner is twenty minutes and maybe even thirty on the weekend.

Taking longer to eat on the weekend may decrease my tendency to roam about the kitchen all day in search of what my brain did not get at the meal: enjoyment, satisfaction, pleasure.

These are the different principles we talk about and put into practice at Oregon Weight and Wellness. Because it is not just about what you eat. It is about how you eat.

So join me, won’t you? And slow down to weigh different.

We recently held a virtual meeting with a local company pitching a wellness program we would love to create for their employees and their specific needs.  As I spoke, passion welled up inside me and overflowed, the passion that we at Oregon Weight and Wellness have for empowering people in their own health journeys.

At OWW our care for you is personal.

Obesity is a disease, and it carries with it much dis- ease.  We recognize the gamut of emotions that come with carrying excess weight and we meet our patients with compassion and empathy.  We individualize care to our patients’ needs in holistic and collaborative ways which includes the team members who will serve the patient best. We practice direct care bypassing the barriers of insurance and institutionalized medicine. We practice patient centered care with shared decision-making valuing your input, so you becomes your own health expert.

At OWW we value professional integrity.

We practice the lifestyle that we preach. For example, when we ask our patients to cut out sugary beverages, you can know that we don’t drink sugary beverages ourselves. We understand the struggle because we share the struggle.  We endeavor to eat, sleep, move, and manage stress to maintain the highest level of health so we can show up and be present with you. We maintain healthy boundaries with ourselves and others. We desire open communication. We respect you and your time and want that to be mutual.

At OWW we get results!

We keep up with cutting edge obesity medicine research, continually increasing our knowledge about the treatment of obesity. We incorporate evidenced based obesity medicine practices. We track our outcomes and adjust when needed. Though over 78% of our patients are enjoying at least 10% total body weight loss, we don’t only look at the scale. We look at many different measurements of health. We look at overall wellness.

Especially for such a time as this.

For such a time as this when the state of our well being is directly and inseparably tied to the state of our immune function and our ability to fight diseases including covid-19.

For such a time as this when our individual resilience carries the spirit of our shared humanity.

For such a time as this when “we must, indeed, all hang together, or most assuredly, we shall hang separately.” (Ben Franklin said that.)

Yes, masks. Yes, distancing. Yes, wash hands. And for such a time as this, be more well!!!

Wherever you are on your health journey, Oregon Weight and Wellness is here to come along side and help you be more well.

I lost my covid weight.

Before you cough and sputter about me not having much weight to lose, let me tell you that I had gained 5% of my body weight with all the stresses, changes of routine, having more family around and different eating patterns, food choices, restrictions on where I could and could not go, etc, etc, etc. The Covid-19 (weight gain) is a real thing.

Once people gain 5 % of their body weight, it seems to trigger even more weight gain. That’s why I make this the REACH OUT weight in my Weigh Different program. Reach out and get some help!

To get back down to my pre-covid weight, I chose to fast for five days. Now before you start getting all impressed, I should clarify that it was five days of fasting mimicking. I know, I know, my husband asked me the same thing: if you are eating food, how can it be considered fasting?

I used a Prolon fasting mimicking kit. The food was scientifically designed to provide micronutrients while restricting macronutrients. It came in nicely packaged boxes for each day of the fast. The idea is to get the benefits of fasting without the pain and hunger of fasting. And I did.

I have talked about healthier energy in the form of real food and whole food consisting of plenty of non- starchy veggies, grass-fed, free-range or wild protein, and healthy fats from avocado, olive oil, fish and nuts and seeds. I have talked about the energy that comes from exercise and sleep and drinking water and the sun.

But NOT eating food boosts energy too.

Fasting counteracts energy storage, yes. But it does more a lot more than that. Fasting triggers stem cell production, the brand-new baby cells that keep us feeling young. Fasting stimulates autophagy, the breakdown of old and damaged cells. Fasting improves muscle performance and mental clarity. And fasting can improve metabolic health.

I want to point out there is a difference between fasting and starving.  It is all about choice and your brain and therefore, hormones know the difference. Another word for this is hormesis: the favorable biologic response to a low dose stress, in this case, fasting.

The Prolon kit also came with daily emails to help me know what to expect. That was helpful. But what was even more helpful was having four friends fast with me. That was a game changer. Everyone chimed in via group text about how their day was going and what challenges and successes they were having.

Here are a few excerpts I have been given permission to share:

“My first brave step was to leave the cream out of my coffee today.”

“Black coffee in hand. I am ready. I am worth it.”

“Ordering, possibly for the first time in my coffee drinking history, a Starbucks iced coffee with NOTHING IN IT!!!!”

I can’t tell you how helpful this was for me because as I have proudly proclaim purposely putting butter or cream or and coconut oil in my coffee and blend it to a beautiful creamy frothiness that I look forward to every morning. How was I going to live one day without it?

Knowing that others were challenged by the same thing and overcame helped me to take that first brave step too.

We shared what our expectations from  the fast:

               “positive food habits, food for nutrition and not emotion, decrease visceral fat, realign metabolism.”

We shared pictures of us eating soups from the kit and our families eating big dinners:

“My husband has been eating dinner for ten minutes and it still looks amazing!”

“I am at work and I want to order a burger so bad…..ahhhh!”

               We shared how our strategies and changing self-talk aligned with our goal:

“I am keeping this thought in mind today: ‘if it is important to me, I will find a way. If not, I will find an excuse.’ This is so true for me because it’s easier to talk myself out of (healthy habit) than to stick with it and do the hard things, I am thankful for you all on this 5 day FMD challenge.”

“I just read the statement that made me pause: we change best by feeling good, not by feeling bad.”

“I have to admit I was not sure how day three would go but so far so good. I met up with friends for breakfast and brought along my nut bar (from the kit) and ordered a black coffee. I drank a bit of the L drink (from the kit) before I left. Preparing for what each day holds has been helpful to me.”

“This has been challenging – I can’t believe I am on day 4. My family has been so supportive. (“I am not going to let you fail, Mom.’ ‘You can do this.’) I would usually feel shame about admitting to “dieting” or drastically altering my food intake. But this is for my health and my future and it will benefit all of us. The group has made a big difference for me too. Whew. Almost.There.”

“One more decision. One more meal. One more day.”

Together we completed the five day fast. We felt a sense of accomplishment, a sense we had at least started the process of unchaining our food responses to stressful situations, and a renewed energy to maintain healthier choices going forward.  

We did not starve. We chose to fast. For five days. And it has made a huge difference.

If you have gained Covid-19 weight and are interested in different approaches to weight loss, please contact us at Oregon Weight and Wellness at 971-273-7143

She could not have known when the lily cuttings she brought to the office that day would unfold.  She could not have known what memories and emotions the perfume of the lilies would unfasten. She could not have known the depth of conversation the beauty of the lilies would unfurl. She simply shared the flowers from her garden as an act of kindness and hoped they would be a blessing.

I walked into the office earlier than usual on Thursday morning July 16^th and was struck by a familiar fragrance. “The lilies must have opened,” I thought to myself.  It was a strong fragrance. It caught me off guard at first and I felt uneasy though I couldn’t quite put my finger on why.

We were chatting over coffee in the breakroom before patients arrived when Stephanie commented on the flowers. She noticed their splendor as she walked in the front door of our office. I breathed in their aroma and told her a patient had shared them from her garden. In the next breath I recounted how lilies always reminded me of death.  My son’s death.  I explained without much emotion that we received so many flowers from loving friends and family around that time, and that lilies were invariably among them and tended to overpower any of the other flowers’ fragrances. Funny how the sense of smell is uniquely wired to memory.

“Remind me again when Sammy died,” Stephanie spoke with the empathy of someone who knows the pain and sorrow that motherhood often brings in one form or another. I stared into space just for a second recollecting the day.

“Twenty-three years ago on the 16^th of July,” I answered meekly in utter disbelief that I might have let the day pass without acknowledging my child’s death and therefore his life. If it were not for the lilies.

Guilt taunted me. The guilt of not feeling the pain of grief. As if I should be carrying grief around like a badge of courage and crying on this day represented the pain and not letting go of pain made me a better person, holier, somehow. But I didn’t feel the need to cry right then. Of course, I had not forgotten, and I could never forget. Sammy, my firstborn son, my sweet boy, my treasure in heaven. And the wrestling gave way to wonder. The wonder of God’s love in a fragrance. The wonder of time and space. The wonder of the simplest of gestures, the giving of flowers.

I thanked God for His intimate ways. I thanked him for my patient and her kindness.  She could not have known, I thought again.

God wanted to do more than remind me of Sammy’s day.  “Consider the lilies”, He was saying, “How they grow. They toil not, neither do they spin.” He wanted to remind me how he had grown me through ups and down, sorrows and joys, with His redeeming ways.  I did not have to spin.  I did not have to hold on to pain for the sake of holding on. And it didn’t necessarily mean I had  “worked through it” or “was over it.” As if it had to be either or. It just meant I was where I was. In process.

It was a perfectly balmy day. The sun shone through the neighbor’s scrub oaks which shade the back yard at the office. Stephanie and I shared lunch under clear blue skies at the picnic table that Zeke built.  We talked about the seeming paradoxes that we encounter in life and the black and white/either-or scenarios that did not make sense anymore. “Maybe, with God, there is room for both and…”  

And I gave myself permission to sit there with both and.Both pain and healing. Both sorrow and joy. Both unrest and peace.

Consider the lilies. Consider the both and…

This year I am required to complete a Practice Improvement module. While I can embrace the spirit of the requirements set by the American Board of Family Medicine(that are put in place to help physicians stay proficient since medicine advances at lightning speed) I do resent being told how to do it. As if by completing this task it will make me a better doctor and without it, I would not stay up to date on my own. Can you hear the enthusiasm in my voice as I tell you how excited I am about these obligations?

Negative thoughts plague my mind and keep me stuck: “I don’t want to do a project.”  “ I don’t have time to do one more thing.” Or my all-time favorite: “I can’t want to!” (This is what my grandson says when he gets stuck.)

After five months of procrastinating, I concluded my resistance was not changing the ABFM. And frankly, my resistance was not serving me.  I still had to choose a project.

Could I think about it differently?

I have to do a project to complete the requirement if I want to maintain my certification, which I do.

How can I make it worthwhile for me, so I actually learn and grow?

How can I make it valuable for my patients that they would somehow benefit?

How can I check the box and get this dross off my to do list?

In other words, could this be a win-win-win? The answer was a resounding YES, I reasoned and felt my mind shift from obstinate and contrary to accepting and even excited.

So what was the next actionable step? Hmmmmm…..

We work on behavior change a lot in my medical practice which focuses on lifestyle to improve health. We work with people to figure out how to stop unhealthy habits and form healthy habits. Admittedly, change is hard.

One strategy I had been highlighting lately is habit stacking. Habit stacking is where you add a healthy habit you have had a difficult time implementing to a neutral or healthy habit that you are already doing. Stack the new habit on the old habit and the old habit will serve as a cue for the new habit.

For example, I have a hard time drinking water while at work and wanted to figure out how to drink more.  Every day as I get to the office, I am already in the habit of unlocking the door, turning off the alarm, and putting my bags in the break room. I do this every day without fail.  Putting my bag in its place could serve as a cue to turning on the water for the tea I am going to drink all day to stay hydrated. I was already in the break room where the water and tea lived. It would just take a few more seconds to get the tea set up. I set my mind to it at first, but now I am on autopilot. Put my bag down, turn the tea pot on. As a result, I have been more successful hydrating with water and herbal teas. And the automation of this habit frees me to take care of other things.

Could I use habit stacking as a Practice Improvement project? Why not?

With the advent of electronic medical records, people are used to receiving automatically generated visit summaries to remind them of their diagnosis and treatment plan.  

I see the value of a visit summary and want my patients to understand and follow through on their treatment plan. My current EMR system does not have this feature, so I have to create it manually. It requires intentionality on my part every time. And frequently I forget.

I decided to make this my project.

Create a meaningful treatment plan summary. Figure out how to habit stack it to automate the process. And then follow up with the patient in one week to see if they were implementing or had any questions or ran into any barriers which we could address before time got in the way and nothing was accomplished between visits.

What was something I was already in the habit of doing at the end of every visit which I could stack the visit summary and follow up text or email to? The answer was obvious: the patient’s invoice.

I create an invoice for every patient visit and I was already attaching it to an email. It would only take another 60 seconds to add to that email a summary of the salient points of the visit, what we agreed the patient was going to work on until the next visit. I usually summarize verbally with them anyway. I could write and talk at the same time. And let them know I would follow up with them in a week to see if they had started the medication or got their lab work drawn or implemented the lifestyle change goals.

I was elated with the possibility of this win-win-win situation. A win that patients would receive something meaningful. A win that patients would have additional support in to accomplish their goals. A win that I was modeling the habit stacking I was preaching. And a win that I could cross something off my to-do list.

And I could have been doing this all along.

We all encounter barriers to change. One of the biggest barriers are the negative thoughts we cling to, sometimes without even knowing it.

It took thinking differently about the situation for me to take action. Instead of seeing the ABFM requirement as a chore or albatross, I saw it as an opportunity. My thinking had to change before my behavior changed.

What healthy habits are you putting off implementing that need a fresh perspective? What habits are you already doing that you onto which you can stack another healthy habit? Think different, weigh different.

Can we talk? About Exercise?

It may come as a surprise that I am not one of those people who loves to exercise. When five o’clock rolls around every morning, I have the following conversation with myself:

Me: Julie, ready to run?

Myself: No. It’s too cold.

Me: But you can run inside on the treadmill.

Myself: Well, maybe, if it’s on the treadmill.

Me: You will feel better, energized, and ready for the day, just like you did yesterday after your run.

Myself: Maybe, but I don’t want to run.

Me: That’s ok. How about walking?

Myself: But I don’t want to walk for 30 minutes.

Me: Fine. You can just walk for five minutes.

Myself: Ok I can do five minutes of walking but only walking and just five minutes.

Me:  On your mark, get set, go!

I stepped on my treadmill this morning to walk/run my usual 2+ miles.  With the red magnetic safety button in place, I pressed 3 mph and the green GO square in rapid succession, ready to walk.  Nothing happened.  I pressed everything again, this time slowly and methodically. Still nothing. I checked the power cord. It had a firm connection to the outlet. “Hmmmmm,” I said to myself.

Had my treadmill of 14 years finally given up the ghost? “That would be a bummer,” I thought.

Now I was faced with another decision.  Was I still going to exercise? What was my plan B?

I stared at the control panel remembering when I first got the treadmill. The New Years before I turned forty, I made a goal to run a half marathon and I bought the treadmill as a gift to myself. I was homeschooling three of my four children at the time and my exercise seemed to be a magnet for their mayhem. Every time I even got near the treadmill all hell broke loose.  Eventually I pretended there was an invisible shield around me. Soon my kids learned that unless they were bleeding out, they were not allowed to interrupt me while I was running. I ran every day for one hundred days.  I ran the half marathon I signed up for. Then, like Forrest Gump, I didn’t run any more.

Isn’t it funny (not funny) how hard it is to start a healthy habit and how easy it is to break it?

My treadmill transformed into a kid backpack rack virtually overnight. When my husband noticed it was no longer used for its intended purpose, he dragged it out to the shop with the other exercise equipment I had bought, used, and left for dead. Sort of an exercise equipment graveyard. Sitting in one corner was the Health Rider I got bored with after two pregnancies. Next to it a fancy weight set collected dust. The leg machine I bought to rehab a torn hamstring idled next to the broken, hand-me-down stationary bike my sister-in-law gave me which I never fixed and consequently, never used. Oh, I tried to walk the short distance to the shop to get back into a routine. But the hundred-yard stretch might as well have been a hundred miles some days and if it was raining, forget about it.

Once I had the bright idea to bring an unused elliptical to my office to see if I would be more successful using it there. My plans were foiled when the delivery person (who shall remain nameless) misjudged the height of the parking garage ceiling transforming the metal machine into a mangled mess.

I have tried many things to help make exercise enjoyable: pilates with its promise of toner, leaner muscles, an exercise class at church where I’d meet friends and secretly compete, a gym membership to keep me accountable to the money I was spending. They all helped. For a time. One thing or another got in the way and I got out of exercise.

Then one winter vacation, I started walking on the resort’s fancy treadmill. I walked every day we were there and decided that I may not love walking but it’s what I do best. I am a walker. It’s who I am. I resurrected my old treadmill and made my kids drag it back in the house.

The best time for me to exercise is in the morning. If I don’t get it out of the way first thing, it won’t happen. Sometimes I walk on my lunch hour, but I won’t walk very fast because I don’t want to sweat. And I am not consistent because administrative duties take precedent.  I may not walk on the weekend if outdoor chores prove vigorous enough like push-mowing our acre of lawn or shoveling loads of bark dust or raking leaves. Because I know this about myself, I endeavor to make weekday morning walking a religious routine.

Setting myself up for success is key. I have a pair of well-fitting walking shoes that I only wear inside on the treadmill. I have learned to keep them right by the treadmill so I don’t have to search the house for them and the barrier of “I can’t find my shoes” is removed.

I used to give myself permission to walk on the treadmill in my PJs but found that I never walked fast or long because I never really woke up. I was in my PJs and I associated PJs with sleep and rest, not exercise. So, I found some inexpensive active clothes that I like and removed that barrier.

I listen to music or a book or a sermon or a TED talk so I associate something I like doing with something that I don’t necessarily like doing.

Let me tell you that if at any time during my morning, my well-intentioned husband asks me if I am going to walk that day, the answer is N-O, NO! For the mere reason that he mentioned walking, I will not walk. That’s the Rebel/Questioner in me. I learned this about myself from reading Gretchen Rubin’s book, The Four Tendencies. She sorts out human motivation in four different categories Upholder, Obliger, Questioner, Rebel. I think I could be any one of them, depending on the situation.

The Upholder in me exercises because my patients expect that I exercise, and I have made a commitment to practice what I preach.

The Obliger in me exercises because I want to be around for a long time to play with my grandkids.

The Questioner in me understands all the reasons exercise is good for me; and it’s so much more than just weight regulation.

The Rebel wants to do exercise my way, not the American Heart Association’s prescribed 30min five times a week. I’d rather walk 29 or 31 minutes, not 30 minutes. And I’ll walk when I say, not when my husband suggests.

Before going to my plan B, (my kettle bell routine) I checked one more thing on the treadmill. Turns out  it wasn’t broken. The connection was faulty on the receiving end. A little cord wiggling and it was good as new. The bells and whistles indicated my session started and I finished my five minutes.

That wasn’t so bad. I think I’ll do another five.

What do you like to do that you are willing to do and why? If you are not sure, give us a call at Oregon Weight and Wellness where the exercise conversation will be way different.

PS To find out your tendency, you can take the Four Tendencies Quiz here.

Everything is different during the 2020 Covid Quarantine.  Even Vet Visits.  It is not that I wanted to go, but it’s been one thing after another with my dog Maisie.  And, well, I’m a doctor, not a veterinarian.

In late February Maisie got into something in the yard and developed hot spots. Big ones. In two different places.  Maisie was a hot mess.  I had to shave her beautiful tri-color coat.  She moped around forlorn, like she had leprosy.  She even self-isolated in her kennel.  She never goes in her kennel, at least not without a treat. 

When I first called the vet, they were not offering appointments. They made a few recommendations and told me to call back if things were getting worse.  My kids whose dog had the same issue last year coached me through a treatment plan and soon Maisie was on the mend.  

Before I could get too pleased with my new vet skills, Maisie developed an abscess.  I tried to ignore it, but it grew to the size of a baseball within 24 hours.  Again, the receptionist at the vet’s office could not schedule an appointment.  My son, home from college and bored, took it upon himself to nurse her back to health.  With frequent hot compresses, I am happy to report his treatment worked.  She was back to her playful puppy self.  

All was right in my dog world again. Right as rain.  Until it rained.

Maisie was outside for her usual morning romp last Saturday, happily chasing hapless birds. I was weeding in the garden.  She careened around the backyard fence and slid down the sidewalk, newly wet from the morning’s rain.  Evidently, she clipped her paw on a fence post because she yelped in pain and dropped to the grass, instantly immobilized.  I ditched my garden tools and ran to her aide. She pushed my hand away with her long snout. I spoke in a low, soothing voice.  “Let me look, Maisie.” She cautiously allowed me to palpate each of her limbs.  It was obvious even to me that the third digit of her left hind paw was dislocated.  With gentle pressure it popped back in place, but Maisie would not walk on it.  I waited an hour and when she still would not move, I called the Vet. This time we got right in.

The Vet tech came outside to my car wearing PPE to collect Maisie for her appointment. She dutifully limped behind him; however, it took some coaxing to convince her to cross the threshold of the office.  She looked back at me mournfully.  I felt a little more emotional than usual and big tears welled up in my lower lids. I shoved my arms across my chest. Damn Covid, I muttered.  I swallowed hard, feeling forced by an invisible power to just sit in my car and rebreathe my air.  While I waited, thoughts about Maisie cheered me and helped pass the time.

We had been several years without a dog, but I suddenly felt the need for one when my youngest son graduated from high school and was preparing to go away to college last summer.  Maisie was a gift from my husband for my 54^th birthday, a beautiful Bernese Mountain Dog with gorgeous markings including a white blaze that runs perfectly in the middle of her forehead.  She was little and fluffy and cute, just like a stuffed animal.  But she did not stay little for long and clearly needed training. So, when Maisie was 6 months old, I signed us both up for a dog obedience course which my church offered for free.

Excited for the first lesson, we showed up early and eager.  Nine other dogs of all shapes and sizes meandered into the gym along with their owners.  As it happened Maisie was the youngest and the biggest and apparently the friendliest in her class.  This is a difficult combination when the instructor does not want you getting to know your fellow classmates.  I understood that it was for safety and liability reasons, but Maisie didn’t. Consequently, I spent the entire time yanking on her leash, pulling her away from the other dogs and off their owners.  Maisie spent the entire time choking and spitting and coughing the way dogs do when you are trying to hold them back from sniffing and greeting.  It was exhausting.  By the end of the hour I was drenched in sweat.  My arms were all but pulled from their sockets.  I hated it. I did not learn one thing.  I take that back.  I learned that being the youngest and the biggest and the friendliest was not a good combination in dog obedience school.  Maisie?  She loved it!  She was still smiling and wagging her tail as I dragged her out to the car away from her new best friends.

“You may want to consider a different kind of collar,” mentioned one of the other owners, trying to be helpful.  Her dog was perfectly behaved.

The next week was only a little better.  Even with the different collar.

And for whatever reason, I could not get us to the next two lessons. Either I was super tired, or it was dreary and rainy and cold. When I finally got the gumption to go again, I showed up on the wrong day.  I showed up on the wrong day two weeks in a row.  Where had I put that paper that had the meeting times listed?  

Maisie and I only made it to one other lesson, mind you, so we were way behind all the other dogs.  When the instructor called about the graduation class, I braced myself to be un-invited.  To my surprise, even though we had only been to 3 out of 7 classes, she encouraged us to participate in the final exam that next week.

I did not want to go.  

I did not want to go because I was afraid of failing.  I was afraid of failing because if I failed, I would feel embarrassed and ashamed in front of all the other dogs and their dog owners.  If I could not succeed what was the point of going?   And if I was brutally honest with myself, maybe I even started the downward spiral of self-sabotage after the first two classes, finding any reason not to go.

I could relate to my patients who start a weight loss program highly motivated and then after a few months, drop out.  I can relate to the patients who tell me they sit in their cars outside my office agonizing whether to come in or not, afraid to step on the scale because they know they have not lost weight or worse, they may have gained weight.

And I told myself the same thing I tell my patients:  Imperfect progress is still progress. Everything worthwhile takes time and hard work. 

There is more than one way to measure success.  The most important appointment to keep is the one you are afraid of.  Winston Churchill said it well: “Success is not final.  Failure is not fatal.  It is the courage to continue that counts.”

Maisie and I practiced the exercises every day after work that week and we showed up for the final exam.  We paced nervously along the sidelines carefully studying the way the other dogs and dog owners carried out the exercises one by one.  Finally, it was our turn.  My heart pounded as we waited for the start signal from the instructor who clutched her clipboard ready to critique our performance.  I whispered a few words of encouragement in Maisie’s ear and we began.  

Confidence grew in me with each step as I called out the commands to Maisie, praising her for her obedience, correcting missteps with a gentle tug of the leash.  A few minutes into our performance, I realized we were doing great.  Not perfect.  Not 100%.  But we were doing great.  The other dog owners cheered as we finished.  Maisie earned a third-place ribbon.

My cell phone rang and woke me from my stupor back to the reality of my car and Covid. It was the Vet.  Maisie broke her toe in four pieces and would need a surgery to correct or amputate.  If it’s not one thing it’s another.

 At Oregon Weight and Wellness, we understand weight loss is difficult.  And it is even more difficult during this time of increased distress. Still we encourage you to keep showing up. Keep showing up and you’ll be sure to weigh different.