The Savvy Patient: Translating the science of self-care

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It's All in Your Head


"The future ain't what it used to be."
--Yogi Berra

My life has changed forever. I have lost some weight, and as a member of the 55+ club,  take great pride in being able to comfortably wear the suit I wore at my wedding over 25 years ago. my body composition isperhaps better than it was 30 years ago!  I have gone from very little, if any, structured activity in my life to running twenty miles per week. I’ve been transformed from a sweets and refined-carbohydrate addict to one who craves green, leafy vegetables and whole foods e.g. pasture-raised meats, eggs, butter, and coconut oil. I’ve been transformed from an individual who thought he had control over the tremendous burden of stress in his life to one who actually has more control over the tremendous burden of stress in his life. I meditate daily. I am cultivating a yoga practice and I love it!  I purposefully cultivate as many meaningful relationships in my life as possible. I have transformed the frustration of “not having time” to do the many things that I value to actually doing and experiencing the satisfaction of endeavors that I value the most. I no longer assume as a physician and as a human being that age-related decline in health and quality of life is an inevitability. I “passively accept” less and “consciously choose” more.

My family history is replete with health risks including diabetes, high blood pressure, heart disease, kidney disease, depression, stroke, and premature death. The cards I was born with, in retrospect, were not that great for many of the agerelated morbidities that many people confront. Five years ago, my trajectory of health and wellness was a path largely under the influence of inertia and passivity. My behavioral choices were undermining my health. We now understand through epigenetics that we are not prisoners of our DNA! We can possibly alter our genetic trajectory by choosing more consciously that which our DNA (and it's Stone Age Imperative) was designed to be in relationship with.

I was confronting the need to take medications to control many of the risk factors I was genetically endowed with and behaviorally perpetuating. Currently, my cholesterol and blood pressure have never been better. My mood, emotions, and concentration have never been better and more positive. My marital life has never felt more satisfying. I feel more accepting, trusting, open-minded, and resilient. And the only medications I take are supplements, e.g., fish oils and antioxidants. I have come to appreciate that I have much more control over my life trajectory than I ever thought imaginable! I am more mindful that while alive, it is never too late for meaningful change.

Self-care is in fact a wonderful gift and opportunity! This has also changed the way I care for others. The remarkable life transformation that I’ve experienced and the life transformations that many people I’ve cared for have experienced combined with the scientific research that currently informs the health effects of behavioral and lifestyle change have inspired me to write this book. People who are in more control of their lives experience a lower burden of stress. People who are in more control of their lives are more resilient and better able to transcend setbacks and adversity.

More Control = Less Stress
Less Stress = Effective Aging

Our health is profoundly influenced by our thoughts, perceptions, feelings or emotions, and our behavior. Our brain, the central mediator of these interactions possesses the remarkable capacity for plasticity, the ability to adapt at any time in our lives. Just as an addict is drawn to a substance like nicotine because of the potent biologic basis for reward and motivation, health-promoting behaviors can ignite this same biologic cascade of brain chemistry. The biologic interactions that connect thought, feeling, and behavior can be cultivated to optimize the potential for self-care and successful aging.

Current scientific evidence suggests that these primal mind-body systems are designed to adapt in a manner that rewards positive emotions, thoughts, and reinforces effective behavioral change. These insights suggest that deeply rooted and health undermining habitual thoughts and behaviors can be transformed in a manner that develops and cultivates positively reinforcing addictive motivation and reward that leads to better health and happiness. The “wiring” to promote better health and to reduce the risk of age-related disease is already within you. The good news is that in as little as 4 weeks, these systems can be ignited to more permanently change your attitude, outlook, and life forever.

The catch? This is challenging work. It requires that you dispel the notion that seemingly small and “trivial” magnitudes of behavioral change are insignificant in your life. Life enhancing biologic change deep beneath the surface will be cultivated despite what your long held illusory perceptions have convinced you of. For example, one hour of gardening per week could lower your risk of sudden cardiac death by as much as 66%. Walking one hour a week will significantly lower your risk of coronary artery disease. And while only 4 weeks are necessary to tip your mind-emotion-brain-body momentum in to a positively reinforcing direction, you will be challenged to redefine who you are. It is my intent to share some strategies for how to get there. And while you will begin to experience immediate results, this cannot succeed unless you cultivate a discipline that leads to lifelong change.


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