Finding the Motivation to Get Motivated

In spite of my best efforts to stay "in the moment" today, my mind keeps wandering to thoughts of summer and - naturally - riding my bike. In Minneapolis, we love to bike and many of us do it in all kinds of weather, but I'll admit that my bike is more of a "fair weather friend." Although I can generally handle the cold, I'm not much for navigating the ice floes that form along our residential streets during the winter.

I'm eager to get back out there to explore my neighborhood on two wheels. I'm also thinking that this is the year I finally tackle some longer rides and get out of the city a bit. I'm excited to start to build up my endurance and get back in shape after this long, long winter hibernation. Admittedly, I haven't been so great about keeping up with my exercise routine this winter, and I'm trying to find the motivation to get up and start being more consistent.

Here are some quick tips - and web resources - that I've found from my own experience and others' advice that will help you build your motivation to whip yourself into shape.

1. Have a goal. Make it as concrete as possible, with a specific deadline. Most people can have the best intentions ("I want to be healthy for my children," "I want to feel better about myself," etc.), but such vague - albeit well-meaning - goals can be tough to measure and it's hard to know when you actually get there! Make it quantifiable: it can be a certain amount of pounds you want to lose by a certain date, or that you want your cholesterol and blood pressure to be down to a healthy range by your next doctor's visit, or that you want to be able to run a 5K. There's a fantastic website called 43things.com that is all about goal-setting. You can create a list of as many as 43 goals, then post entries about your progress and interact with people who are working on the same goal as you. It's awesome!

2. Create accountability. So let's say you want to run a 5K. Find out when there will be a 5K in your area and sign yourself up. Tell everyone you're doing it. Invite friends to come see. By the time you've done so, you'll definitely be motivated not to back out. You can also hire a personal trainer or health coach to help keep you on track - there are a lot of great people out there doing this good work, and you can surely find someone you'll be happy to work with. Here's a website where you can find the top-rated health coaches in your area.

3. Do something you actually enjoy. If someone comes into my clinic and says, "I want to get in shape, but I hate working out," I ask them, "What do you like to do that's active? Anything?" Usually I can draw out at least one thing that the person enjoys doing that also gets their heart pumping. Then I say, "Do more of that!" You don't have to start lifting weights and doing squats to be healthy and do your body a lot of good. You can improve your health and increase your lifespan by doing just 15 minutes of cardio a day! It's unlikely that you'll be shedding pounds quickly or getting six-pack abs at this pace, but everything helps. Just pick what you like to do and do it for a half-hour every day - walk, bike, dance, chase your dog, garden, swim... If you find something you like to do, you'll start to look forward to doing it!

Hiking is better with a few dozen of your best buds!

4. Buddy up. You may notice that while some of your friends are wonderfully supportive of your efforts to get healthy, others seem almost determined to steer you woefully off-course. And with so many of our social gatherings revolving around food and drink, swearing off your vices can make you feel like a social pariah. As a response to this, my friend created an awesome group called Buds of Spring, in which he asked his friends to join him in taking a month-long pledge to exercise for 30 minutes a day and abstain from alcohol, coffee, and smoking for one month. From March 20th to April 20th, he hosted fun events, posted encouraging words and member profiles on social media, and even got sponsors. This year - their 3rd - 150 people took the pledge! Try reaching out to your own friends to join you in taking a similar pledge. Even if it's just two of you sharing recipes and workout tips on Pinterest, at least you won't feel so alone!

A little donut burger action for your "cheat day." Why not, if you've been doing everything else right?

5. Reward yourself. When something is forbidden, it gains a certain power over us. This is why I hate fad diets that are built around the central concept that one food group must be completely avoided. At no point will that food hold such an allure as when you know you can't have it! It's better to teach yourself to enjoy things in moderation. Pick one night a week where you will go out for a glass of wine (or whatever your chosen weakness may be), and a really nice dinner. Or take a walk with the kids to the ice cream store on Saturdays and indulge in the good stuff. Make it a ritual and really enjoy every bite. You will feel so much more satisfied if you eat one chocolate eclair with complete presence of mind rather than sitting in front of the TV snarfing down an entire bag of chips. 

These tips are just the beginning. What have you learned about staying motivated to work out? 

Get your Greens!

Even though, as I write this, we're in the middle of an April blizzard, I know that salad green season is right around the corner. Spring turns every backyard into a salad bar with nettles, dandelion, and my very favorite, lambs' quarters, there for the picking. But I have a confession to make. Even though I'm a (mostly) vegetarian, I don't like salads. Very occasionally, I'll find a salad that speaks to me, but for the most part I always feel unsatisfied after eating what essentially amounts to a big bowl of leaves.

What could be prettier than a whole mess of colorful veggies mingling in a cast iron pan?

I like to justify my salad aversion by saying I'm living in accordance with traditional Chinese medicinal teachings, which assert that all food should always be cooked before eating. I know this concept opposes what so many of us have been taught, which is that raw food has more vitality and cooking destroys vitamins in vegetables. From a TCM point of view however, it is taxing for the digestive system to process cold or raw food, and for those of us whose constitution tends towards energy deficiency, we may not be able to adequately break down and absorb food that hasn't been cooked first. Cooking basically begins the process of digestion in the pan - warming the food to body temperature, breaking it down and unlocking all the goodness so our body can absorb it without expending precious Qi.

This article in Scientific American confirms some of what TCM doctors have been saying for thousands of years: cooking vegetables breaks down their cell walls, making many of the vitamins within them easier for our bodies' to absorb. However, there is a trade-off in some cases; while it tends to boost the bioavailability of some good things, like lycopene in tomatoes and beta carotene in carrots, cooking can lower veggies' levels of some vitamins, like vitamin C. The conclusion? A mixture of cooked and raw fruits and veggies in your diet increases your chances of getting the full spectrum of nutrients from your food.

Well, I know from experience that raw greens - shall we say - "disagree with me," and I've had many patients report the same thing. I also just don't find them palatable, and ultimately the trick to eating more vegetables is to find ways to prepare them that make them appealing to you.

So I've done some experimenting over the years and here are:

Five great ways to sneak greens into every meal without settling for just a salad

Steam them: Kale, chard, and other varieties of greens that are tough or bitter in their raw form become sublime when you steam them just for a minute or two. It's quick and rounds out any fish or meat dish better than potatoes (nutritionally, anyway), or you can serve them with rice and call it a (light) meal. Our favorite way to prepare them is this:

1. In a deep frying pan with a lid, saute a clove of minced garlic in a little sesame oil for about a minute
2.Turn off the heat and add a little water, enough to fill the pan to a depth of about one finger breadth, and bring to a boil
3 Add your greens, broken up into bite-sized pieces of course, and cover. Lower the heat to a simmer and steam for 2-5 minutes, until the leaves are bright green and just wilted.
4. Meanwhile, combine 1 T soy sauce, 1 t brown sugar or honey, 1 t rice or balsamic vinegar, and a good pinch of sesame seeds or any other ground nuts (they're even better toasted)
5.

Strain off any excess water that remains and then toss with the soy sauce mixture

Sunny spinach, almond and lemon pesto

Make a pesto: I don't know what the actual rules are regarding pesto, but as far as I'm concerned "pesto" consists of the following: any green leaves, nuts, and oil blended into a paste. Basil + pine nuts + parmesan and olive oil is most traditional, but any time I have some salad leaves that are getting to be a little past their prime, I make a pesto with whatever's lying around. Then you can add a wallop of concentrated greens to virtually anything - I made this and spread it on frozen pizza last night:

- 2 C spinach leaves
- 1 clove garlic
- 1/2 C almonds
- 2 T parmesan, grated
- 1 t lemon juice
- Approx. 2 T olive oil

Combine the first five ingredients in a blender or food processor, slowly adding olive oil until everything is blended to a fine paste. Add salt to taste.

Add them to pasta: Dandelion greens, arugula, and spinach are fabulous mixed into red sauce - just add to the sauce in the last minute or two of cooking. Beet greens and chard are yummy with cheesy pasta dishes. You can steam them separately and then toss them together with the pasta and sauce.

Don't you feel healthier just looking at it?

Make a soup: There are lots of unexpected soups that either include greens or give them a starring role.  Sweet pea and romaine soup is one of my favorites for spring - it's super elegant and lively. Bok choi, eggs, and green onions come together with soy sauce and other pantry staples to make an easy egg-drop soup. Beans and greens are made for each other - this Italian white bean soup with mustard greens sounds awesome.

Juice 'em: I'm not a big "juicer" (you know, that whole aversion to cold, raw food thing), but I'm coming around on smoothies. You need vitamin C and B12 to absorb iron, which I'm perpetually struggling to get into my body. I like this powdered stuff: Perfect Food Raw Organic. It turns any juice or smoothie into a "Green Superfood" and is the best way I've found to get your greens at breakfast. I know other people love wheatgrass juice, kale juice, etc. It's a great way to supplement your diet and get those vitamins you lose with cooking, but remember you also lose fiber when you make straight-up juice.

The Anemic Healer

Truly, it's been an exciting few months. I doggedly worked my way through my Board Exams, filling out paperwork (a task that I hate like poison!), and creating a home for my new practice on the web, and Monday was the first day that I made myself available to accept patients! The amount of time and effort that has led to this bears reflection - but right now, I'm just excited and focused on looking forward.

As the stress of Board exams dissipated, I was expecting to feel a burden lifted off of me. Once again I could focus on my life beyond my ability to memorize and hold on to a seemingly infinite amount of information. However, I found that some troubling symptoms I had developed (which I assumed were just the result of stress and, as we'd say in TCM, "over-thinking"), were not going away even with rest, good food, and (attempted) exercise. Fatigue - or maybe more accurately, exhaustion - was the number one problem, but what was worrying me most was the fact that I would often wake to the sound of my heart pounding like I'd just run a marathon. My blood pressure seemed to skyrocket when I'd walk up a flight of stairs, or lifted my dog from the floor - I tried making the bed and nearly blacked out! That was my wakeup call. I had to see a doctor.

Coffee, you are no help

I think it's tough for us healer/care-taker types (yes, I'm looking at you moms and dads out there) to admit that we have a problem we can't "doctor" ourselves. Bottom line: I know enough about medicine to suspect what the doctor confirmed: I have iron-deficiency anemia, and probably have for a long time. But going to the doctor meant admitting to myself that I was not well, which made me feel like I was a bad practitioner. I had tried eating better, taking supplements. I had convinced myself that I was just out of shape and stressed, maybe drinking too much coffee. But when I couldn't make a darn bed without nearly falling over, I was convinced there was more going on and I needed a second opinion.

There are those among us healers who stand by the proclamation, "Healers don't get sick!" But I disagree. Once, in the middle of a horrendous migraine (also, I'm told, due to my anemia), I heard the words come as clear as if they'd been spoken to me aloud: "One has to hurt in order to heal." You have to go through your own journey of healing in order to become a healer, to know first-hand a little bit about suffering to empathize with your patients, your children, your loved ones. Because I have walked that path, I am an expert on migraines, on knee pain, allergies, anxiety/depression, and now, on anemia. Everyone's different, but I know how much it sucks to have these problems and I know how much it matters to my patients to take care of them. It makes me that much more serious about going that extra mile to help them find relief. Take it a step further and I know that, having been in pain, I can start to empathize with all kinds of pain. Whenever I hurt, it pulls me off my high horse and reminds me that I too am a human, and even though I now have the skills to help another person find healing, I need to take the same advice I give to others.

Anemic hand on the right. Visiting Arizona recently, my Mom kept saying"you look pale." I thought it was just the fact that I was a Minnesotan visiting Arizona in the middle of winter, but a tell-tale sign is paleness of the palms of the nails and fingers.

So I'll end this post with a little info about anemia. First of all, iron-deficiency anemia is the number one form of nutrient deficiency worldwide, and is estimated to affect 10-20% of all women during their childbearing years. The main symptoms (and I experienced nearly all of them) are: pallor, palpitations, feeling cold, hair loss, brittle nails, breathlessness, exhaustion, mood swings/irritability, blurry vision or "seeing spots," weakness, and "cognitive impairment" - or as I call it, "feeling like an idiot all the time." I also had chest pains. In Chinese medicine, this cluster of symptoms would be attributed to the pathological pattern of "blood deficiency," and in a lot of ways, that's exactly what it is: without iron, your body can't make hemoglobin, which is basically the part of a red blood cell that carries oxygen throughout the body. That means the symptoms associated with this form of anemia come about because the body is basically deprived of oxygen. In TCM terms, this is interesting because we often say that "blood holds Qi" - Qi being translated both as energy and as oxygen. The best way to describe the feeling of anemia is "having no energy" - that's certainly how I'm feeling!

Think that weakness and exhaustion you're feeling is normal? It's never "normal" to feel crappy.

Many women don't know they have anemia because they assume they're being tested as part of their yearly physical, but that's often not the case. And then when all blood tests come back "normal," they assume that their "no energy" feeling is normal as well. Be advised - it's not ever "normal" to feel crappy. If you're experiencing the above symptoms, call the doctor and say specifically "I want to be tested for anemia (and probably hypothyroidism, too - many of the symptoms are the same)."

Chinese Medicine can do a a lot for anemia, through the use of dietary therapy and raw herbs. Acupuncture can help with the symptoms, and it did help me immensely when I was able to get treated regularly. Iron supplements (available over the counter) are arguably the most effective way to treat it, but it's best to see a doc for dosage, and so you can get into the routine of having your blood checked to make sure the supplements are being absorbed.