RobardUser Robard Corporation | Exercise

How Being a Physician Living with a Chronic Disease Impacts my Work with Bariatric Patients



“You can make $20 per stool sample?” You would have thought I had won the jackpot! I just thought my colleagues and I were getting one over on the “Diarrhea Clinic” in Guadalajara, Mexico. I attended medical school there and was making a habit of “donating” regularly. What I did not realize was that I wasn’t just suffering from “Montezuma’s Revenge.” It wasn’t until I returned home that I learned I had Crohn’s Colitis, an often debilitating inflammatory condition of the GI tract characterized by abdominal pain, diarrhea, and rectal bleeding. It can often result in multiple surgeries to remove diseased colon and worse, colon cancer.

I spent the next several years on different medications including monthly infusions and weekly injections, all of which had many side effects. During my residency, I spent 10 days in the hospital due to a flare that resulted in over 20 abnormal stools per day, anemia, and almost constant pain. Despite this, I returned to my career determined to not let this disease slow me down.

I became a family doctor and practiced in the primary care setting for nine years. During that time, I discovered a passion for bariatric medicine. This evolved out of a desire to keep myself healthy which required changes in my diet. I found that eliminating processed foods and added sugars, except those naturally occurring in fruits and vegetables, helped me to keep my colitis at bay. With the help of an excellent gastroenterologist, I healed and continued to enjoy excellent health for many years. However, this hasn’t always been easy and this is where bariatrics comes back into the picture.

Taking care of myself every moment of every day requires a lot of work. It means pushing myself to exercise even when I am exhausted. It requires eating salads and protein when others are enjoying pizza or ice cream. It requires actively engaging in positive thinking and using tools like meditation, cognitive behavioral therapy and affirmations to manage stress levels. And I don’t always feel like doing these things. These are exactly the same challenges that, on a day to day basis, my bariatric patients experience.

I find that using these tools myself adds an additional layer of empathy and relatability to counseling my patients that otherwise wouldn’t be there. They often greatly appreciate this and find that I am able to help in a very unique way because I “get it.” I share my story with patients because when a doctor is able to be vulnerable, they realize they are not alone and that anything is possible.

Every day, I continue to discover new and powerful ways to care for myself, mind, body, and spirit. As my practice continues to evolve, I incorporate as many of these amazing modalities as possible. I hired a mind-body medicine physician to teach yoga, meditation and other skills who has inspired many of my patients. I have a behavioral counselor who keeps us all on track. But most of all, my patients, staff and I are all just trying to be the best version of ourselves on this human journey. I still struggle regularly — as do my patients — but we all have found better ways to be in this world. And because of that, I have found this work far more gratifying than anything I could have imagined and I believe my patients are better for it.



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Stress and Weight Gain



We all experience stress in our lives. But, did you know that stress could be a contributor to weight gain and preventing you from losing weight? Stress causes our bodies to produce increased amounts of stress hormones. These hormones cause a rush of adrenaline that is sometimes referred to as the “Fight or Flight Response.” When the brain receives a signal that the body is under stress, it releases the stress hormones to help the body endure whatever is upon it. It makes one ready for action and endurance. The human body is made to survive.

However, after the adrenaline rush is over, the body continues to make cortisol. This is the hormone that triggers hunger or the “replenish mode.” For our ancestors, this was necessary. They may have gone long periods of time without eating and endured a harsh physical environment without knowing when they would eat again. Our ancestors needed the cortisol due to high levels of physical stress and activity. Often, they burned double the calories they consumed just looking for their food.

We can hardly say that now. However, despite the decline in physical activity, we are under as much stress today as our ancestors. Much of our stress comes in the form of mental and emotional. Even physical stress, such as chronic illness, brings with it an emotional toll.

Cortisol and the “replenish mode” are designed to allow for survival. Cortisol slows our metabolism to conserve energy and resources. This means we hang on to fat stores. This may not have been a problem for our great-great-great grandparents who hunted and gathered their food supply, however, driving to the nearest drive-through or ordering take-out is not such strenuous work. Add a slow metabolism from cortisol and you get added weight gain.

So, how can you start now to decrease your stress and prevent weight gain? Here are some tips:

1. Take your vitamins. Your B-vitamins and magnesium to be exact. The B-vitamins provide energy and nervous system function and magnesium is known to reduce anxiety. Most of us are not getting enough of these vitamins in our diets.
2. Get protein for breakfast. Breakfast is the most important meal of the day only if it is protein packed. Experts recommend 35 grams or more to get your metabolism cranked, increase your energy level, and keep you satiated longer.
3. Exercise more. Not only are you burning calories and increasing your metabolism, you are reducing your stress level. When you are on the elliptical, bike, treadmill, or in a yoga pose, you can sweat away the day’s concerns and burn off that adrenaline.
4. Get a good night’s sleep. At least 7-9 hours per night to combat cravings. Lack of sleep makes you hungry.
5. No crash diets or starving. When you drastically restrict a food group or reduce your calorie intake, you slow your metabolism further. This will not help when under stress. Instead, find a well-balanced, high protein, low carb diet plan and drink plenty of water. There are plenty of food options for quick, on-the-go nutrition and protein.
6. Eat mindfully. By eating slowly, you give your body time to realize you are full. Mindful eating makes us more aware of emotional eating and combats the cortisol levels our bodies are producing from stress.
7. Seek help. Often stress in life is more than we can handle alone. Seek out a therapist, a health care professional, a support group, or health coach. Do not be ashamed to ask assistance during a difficult time.




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