Cut & Run: April 2015

Available Without a Prescription

Diabetes, hypertension, obesity, arthritis, depression. These are but a handful of the diseases I see every day in my clinic. I am an orthopaedic surgeon—a highly sub-specialized one who mostly treats conditions of the foot and ankle—but when I go in to see a new patient I review the patient’s entire medical history. It amazes me how many medical diagnoses people carry and the amount of prescription medications that they take for them. We live in the richest nation on Earth, with the most advanced medical technology available to us, but we seem to be getting sicker and sicker. I am a firm believer that many, if not most of the diseases I see can be managed, cured, or best of all, prevented. Not with expensive medication. Not with therapy. Not even with surgery. What is this “miracle medical intervention?” As it turns out, it is not a miracle at all. It is lifestyle. Principally, diet and exercise, but stress management, meditation and sleep, are probably just as important.

Let’s start with exercise. I ask all of my patients what they do for a living. Most answer that they sit at a desk all day. It has been said that “sitting is the new smoking.” It is a fact. Our sedentary lifestyle is slowly killing us. Humans are not meant to sit at a computer desk all day. From an evolutionary perspective, we have evolved as hunters and gatherers. Thus, our sedentary lives are at odds with what our bodies are engineered to do. It should come as no surprise then that our bodies are failing. It is imperative that we become more active. Most of us should strive for at least 30-60 minutes of exercise each day. This doesn’t have to be going to the gym and being weirded out by the sweaty guy with the tank top. Find something that you enjoy and JUST DO IT. Walk, run, bike, garden, vacuum the house, anything! As long as you are not sitting on the couch, it is probably exercise. Motion is life, and life is motion.

There is a sign at Good Life Fitness that says, “you will never out-train a bad diet.” It is totally true, and I am living proof of this. I have completed 53 marathons, including 4 double marathons with back-to-back Saturday-Sunday marathons. I qualified for the Boston Marathon and ran it in 2002. However, despite these accomplishments, I have seen my own waistline expand a little bit each year, and have seen my cholesterol, blood sugar, and blood pressure rise a little bit each year, too. How can that be, when I am so very active? The answer is diet. I am from western Nebraska, raised on steak and eggs. Sadly, I was probably also raised on margarine and other sources of partially hydrogenated oils. Over the years, I have become a healthier eater overall, probably, but the stress and hours of my job mean that more often than I should, I reach for a bag of chips and can of soda. Like our sedentary lifestyles, our processed food culture is killing us, too. Again, our bodies evolved as hunters and gatherers. We crave sugar and fat because our bodies know that these mean calories, and calories mean energy and sustenance. Sadly, nearly everything we buy pre-packaged at the store or get in the fast food drive through is laden with salt, sugar, and fat. Perhaps in another thousand years, our bodies will evolve and thrive on the Western Diet, but right now, this diet is killing us. But it’s not too late. I am not vegan (at least not yet), but for 6 weeks this spring, as a sort of experiment of one, I adopted a plant-based, mostly whole foods “diet.” In that very short period of time, my total cholesterol dropped more than 30 points and my blood pressure and blood glucose, once borderline, are once again normal. I am not saying you have to be vegan or vegetarian to be healthy. Michael Pollan said it best. “Eat food. Not too much. Mostly plants.”

We live in a very fast paced, competitive world. Most of us are chronically stressed out and deprived of sleep. Jobs, kids, money, the latest crisis on the news (Ebola, ISIS, etc.) raise our collective level of stress. This, in turn, causes the level of cortisol, a stress hormone, to be increased. This causes physiologic changes in our body that contribute greatly to the diseases I mentioned in my introduction. I have been meditating here and there for several months, and have found it to be a very powerful tool for dealing with stress. It helps me to be more mindful in my everyday life. My wife can probably tell you exactly the days I have and haven’t meditated over the last few months! When I do it, I am a more relaxed, authentic version of myself.

Finally, sleep. Most of us simply don’t get enough. It’s funny how we spend the first 20 or so years of our lives doing anything to avoid sleep (as parents of 3 small kids this is particularly true in our house!) and the rest of our life wishing we could somehow get more sleep. We will spend outrageous sums of money on mattresses and even tech devices to help us sleep better. How little sleep one gets is sometimes seen as a badge of honor among many professionals. There are individual differences in how much sleep we need, but in general, a lack of sleep over time has been linked to lower life expectancy. When we are even mildly sleep deprived, we are the worst versions of ourselves, having short tempers and making poor decisions, like reaching for the caffeinated beverages and fast, unhealthy food. Any wellness program is incomplete without a lot of focus on getting a good, restful night sleep. Eliminate the TV from your bedroom, late night meals, alcohol and caffeine, and you will wake up feeling better than you have in a long time.

As a society, we are starved for health. We spend money on gym memberships, the latest fad diet, and trips to the doctor, all in search of well being. I am by no means a hippy, new age witch doctor. I am a product of western medicine and I know first hand the difference that can be made in people’s lives with a traditional approach to medicine, and this often necessitates pharmaceuticals and even surgery. However, I have become more and more convinced that the solution to many of our problems isn’t the physician’s prescription pad or the surgeon’s knife, but lifestyle modifications that are available without a prescription or even an appointment. Eat your fruits and vegetables, exercise regularly, meditate, and get enough sleep. Doctor’s orders!