Change is hard


A common misconception when it comes to dealing with health or medical issues is that if there is a problem, there is also a drug to fix it.  Sure, there are medications out there that help manage a multitude of illnesses.  But there are side effects to each and every one.  There is not one pharmaceutical substance manufactured in the world that is completely risk-free.

A couple of months ago –while on vacation of all things– I found myself feeling fatigued and a little bit queasy.  The first question that popped into my mind, I hate to admit, was: “I wonder what I can take to fix this?”  I actually stewed in my symptoms for a couple of hours before I gathered the wherewithal to grab a bottle of fresh water and drink up.  I felt significantly better in a matter of minutes.  It took at least a day or so to feel completely right, but it was only after I persisted in my effort to increase a steady water intake.  I must have been pretty dehydrated.

What dawned on me was that I started off by asking the wrong question.  When we aren’t feeling quite right, the first question to ask should not be “Is there anything I can take?” but rather “Have I done everything in my power to take care of myself?”

Have you asked this of yourself lately?  What does your diet consist of?  How much do you exercise?  Do you smoke?  Do you bring work to bed?  Do you regularly set aside time to focus on things that make you feel happy and at peace?  Have you even stopped lately to think about what those things would be?

My goal with this blog is to teach you how to need me, and my colleagues, as little as possible.  Consider the principles you read here as your proverbial “apple a day.”  Health care is not fulfilled in taking pills to cure the ailments, but in developing habits that make pills unnecessary.  Which means health care is NOT in the hands of the doctors, but of the patients.  I have said it before, and I will say it a thousand times: Taking care of your health is up to you.

Changing a habit is much harder than taking a pill.  I recently came across a snappy little approach to coming up with a plan for change which surprised me with its common sense.  I credit the National Safety Council for the “SAMRIC Plan” which defines criteria for developing an action plan to make a meaningful change:

S – Simple (clear, understandable)
A – Attainable (within your ability to do it successfully, realistic)
M – Measurable (has a defined outcome, answers the questions: 1. What exactly are you going to do? and 2. How do you know you are doing it correctly?)
R – Repeatable (something you can do regularly, performed often enough to become a habit)
I – Immediate (no need to wait)
C – Controlled by you (your personal responsibility, something you can do on your own)

An excellent example I heard of putting this into practice is contrasting the following two plans:

  • I am going to eat better and lose weight
  • I am going to eat three meals a day with no snacking between, and no eating after 7pm

So let me add here that stopping a habit is actually MUCH harder than starting a new one. That is, unless you make a plan to replace the habit you want to quit with a new habit. It is under the circumstance of seeking to quit something that it is most critical to have a plan. I may as well come right out and say that I am speaking to the smokers out there. If you don’t have a plan to do something positive with the time that you used to spend smoking, you will probably wind up eating bad food. And then you’ll slip back into smoking because it seems like the easiest way to lose the weight you just gained while trying to quit. Thinking ahead will make a difference in your successful outcome, it is at least worth a try.

One final point I would like to make: As a physician, if I see a patient in clinic seeking help with a problem, my first line approach will not be to preach at about whether everything in his/her power has been done in the way of self-care. Changing habits is a long-term effort and targeted towards prevention. If you take the step of coming in to see the doctor (paying a co-pay, waiting in the waiting room, waiting in the exam room…), I believe the stops should be pulled out to evaluate and treat. And of course there are many diseases out there that cannot be effectively managed without medication.  However if we get into multiple visits dealing with the same problem, make sure to assess whether change needs to be made in the prescription or in the execution.

Make a plan, make it happen. But first, make up your mind to do it. Success is in your hands… not in your pill bottles.