Making Goals, Keeping Track
Fitness trackers are flooding the markets these days. Some are devices you wear, others are websites. Here’s a small sampling:
- UP, FuelBand and Fitbit—wristbands that sense motion to track both steps and times of no motion to calculate stairs climbed, calories burned, sleep quality and other data
- MyFitnessPal—an app and website for tracking exercise and diet
- EveryMove—a social platform where you enter data from your own fitness devices and receive encouragement and ideas from an online community
With various devices, apps and websites, you can calculate calories burned, measure vital signs, count your steps and even track your sleep habits. You may already have an app: Apple’s Health app is automatically loaded onto iPhones—it may be counting your steps right now!
Pros and Cons
The best part of trackers is that they can aid you in reaching your goals by giving you direct feedback that helps you keep track of your fitness activities. A 2012 study at Fred Hutchinson Cancer Research Center found that people who kept a food journal lost about 6 pounds more than those who didn’t.
An additional motivator embedded in many of these devices, websites or apps is a social context. Your progress can be compared to others discreetly, which helps some people maintain their commitment and push their fitness activities to the next level.
On the down side, most tracking devices and apps aren’t perfectly accurate or don’t work very well for certain activities (for example, cycling or weight training). Just like cardio machines at your typical gym—the elliptical, treadmill, rowing machine and so forth—tracking devices generally provide just a good estimate of your activities. This estimate gives you a comparison point of your progress, which can help you stay active, and that’s a good outcome!
Keeping It Simple
I feel that trackers can be helpful—but they don’t need to be complicated, high tech or expensive. A simple pencil and paper can do the trick. The overall idea is to reinforce your fitness efforts by helping you see your progress, which can help sustain your activities by keeping you accountable.
For fitness goals, whether using a tracking device, app, or pen and paper, use the following guidelines:
- Make a specific fitness goal and record your starting point. Per the American Heart Association, the minimum fitness goal for adults is at least 30 minutes of moderate intensity exercise five days per week. (Moderate intensity means walking and being able to speak in three- to four-word sentences before having to take a breath.)
- Start out easy and slowly increase your exercise gradually. Any exercise is better than none.
- Document each workout: your activity and total minutes. Exercise duration can be broken up into three 10-minute intervals throughout the day.
- Pick activities that you consider fun and change them frequently to prevent boredom.
- Be sure to also add some strength training to your regimen to help improve your bone health and fitness.
Creating a varied regimen and tracking your progress can be a huge motivator! You’ll be able to see how you’re doing. Studies have shown that being fit may help extend your life a little, but more importantly, it can improve the quality of your overall life.
Spread the news
From frontline to quarantine
It is June 12, 2020. Seattle has entered “Modified Phase 1” during the COVID-19 pandemic. Restaurants are reopening with social distancing, and hair stylists are open for appointments with appropriate screening and masks. It all seems like another planet as I enter the nursing home in Queen Anne to see a new patient. Signs posted on the entry door to the COVID wing direct all incoming providers to observe “Droplet Precautions” with masks, eye protection, gowns and gloves prior to entry. Visitors are allowed to see a resident only at the “end of life.”
The facility is even quieter than usual, and I notice a gathering of all staff in the dining room, just concluding a meeting. There are many staff members I know, and I see some with tears in their eyes as they are coming into the hall. As everyone lines up prior to entry to the COVID wing, they help each other tie their gowns from behind. I mention that this is a “very hard time to work in nursing homes.” One assistant turns to me saying, “I wish that it would all just be over.” Only later do I learn that their meeting was to announce the pending withdrawal of life support for a colleague who has been hospitalized with COVID-19 and on a ventilator.
I could not have imagined this change in the world of nursing homes four months ago. I have worked in nursing homes in the Seattle area for 26 years doing skilled nursing care, palliative care and long-term custodial care. This has always been an environment structured to provide care in a social and family-oriented environment. Facilities have recognized holidays and birthdays with parties. Volunteers come to play music for residents, and pets are brought in to provide love and nurturing. Now families can only come to the window and hold up signs or talk on cell phones to their loved ones.
My entry into this new and strange world was abrupt. I remember vividly my visit on February 26 to the Life Care Center in Kirkland. I first noticed concern on the faces of nurses coming down the hall, reporting fevers on several patients. Influenza tests came back negative. When I got back to my office, I commented to my colleagues that it was very strange to see the cluster of fevers without influenza in the nursing home. Two days later, the patients who had been admitted at Evergreen Hospital tested positive for COVID-19, representing the first-identified outbreak of the pandemic in the United States. Forty-three residents of Life Care died within the next month.
I entered quarantine at home beyond the 14 days required following my visit to the Life Care Center in February. I remained well throughout my quarantine and felt increasingly restless just waiting for the time to pass. I gave up a planned evening of live salsa dancing to which I had purchased tickets. I went on walks and bike rides alone and managed a solo cross-country ski outing on empty trails in the Cascades. It seemed odd and difficult to remain away from family members while I felt fairly confident that the precautions I was taking would protect me from becoming ill. Yet, I also sensed the reluctance of close acquaintances to violate the quarantine. It was indeed a time of being alone.
As I enter the final years of my medical career, writing about my experiences caring for patients has become an increasingly important way to articulate my feelings of loss. Isolation in quarantine represented a reversal in my role; now I was the one being shunned for fear of exposure to illness and contagion.
Seeing things from others’ perspective is an underdeveloped skill in our culture. COVID-19 is bringing my colleagues and me to a new depth of feeling and understanding of the social isolation and loss that patients and their families experience regularly. In a similar way, many across our nation are soul-searching around our collective neglect of the injustices suffered by people of color throughout history, in response to the taken lives of George Floyd and others.
Events of this year have broken us open to see realities we’ve always lived close to, but never dared touch. As we come through this time, my hope is that our newfound openness to the pain of others can help us remain more compassionate and fair to those we love, serve and walk alongside in this world.
COVID-19: The new landscape for care
Please continue to Mask Up!
May 13, 2021 – PacMed continues to require that masks be worn at all times on our premises, by staff as well as patients, even for those who are fully vaccinated.
This helps us maintain standards for infection prevention and ensure all our patients can remain safe when they get care, including those with compromised immune systems.
Please note, the new CDC guidance permitting vaccinated people to unmask indoors allows for continued mask requirements per local business and workplace guidance.
Thank you for bringing your mask and helping us keep everyone safe!
New Landscape. Same Commitment.
While living through a pandemic is new to us all, some things are not: We remain wholly committed to your care and safety. Whether you need attention for something major or minor, we’ve put in place additional protocols to make sure you can be comfortable and confident every time you walk through our doors.
You can now pick up with any appointments that were delayed due to COVID through a virtual or in-person visit. Click here or call us at 1.888.4PACMED (1.888.472.2633) to reschedule.
Virtual visits are a great way to keep your commitment to your health from the safety of your home. They also keep our clinics safer for those who need to see us in person.
9 SAFETY STEPS
We’ve put these safety steps in place to protect your health, and ours, when you’re here with us:
- eCheck-in through MyChart to reduce your time and exposure at the front desk. You can check in via MyChart, up to four days in advance.
- Hello Patient can automatically let us know when you arrive, so you only need to do your COVID screening before sitting down. (Add the MyChart app to your phone and enable location services).
- Masks. Our facilities have adopted policies that align with recommendations from the CDC. Currently, all staff and patients are required to wear masks inside. If you have a personal mask at home, please bring it with you and put it on before entering the clinic.
- Screening. We conduct routine coronavirus screenings, including temperature checks, on all patients, visitors and employees. Those showing symptoms will be diverted to another area.
- Social distance. Floor markers help remind you and others maintain a safe distance. We are also limiting the number of people in tight spaces, like elevators.
- Sanitizing. We rigorously wipe down our waiting areas, exam rooms and high-touch surfaces in our clinics. You can help by washing your hands or using our hand sanitizer stations located throughout our clinics.
- Visitors. We are limiting the number of people who come into our clinics, except for those receiving care. This helps maintain appropriate physical distancing and reduces the spread of germs.
- Virtual Visits. For on-demand and routine medical care, we offer virtual visits – a reliable way to see your provider from the comfort of your home.
- Cashless payments. We are no longer accepting cash or checks in our clinics. You can still pay by debit/credit card, through MyChart, or by mailing your check in. (See details.)
If you have questions about what to expect on your return to the clinic, please give us a call at 1.888.4PACMED/1.888.472.2633.
VIRTUAL VISITS
In this new normal, telehealth is one of the new ways we’re delivering on our commitment to your care and safety. If you’re new to virtual visits, we can walk you through it—all you need is an internet connection and a phone or computer enabled for video calls.
Read more about how it works, and how you can try telehealth for your next routine visit:
Learn more about virtual visits and telehealth
Schedule now online, through MyChart or by calling 1.888.472.2633.
LWA: Annual Symposium
LWA Spotlight
Save the date for 2020 LWA Food & Mood Symposium! The Living Well Alliance team is gearing up for our 2020 workplace wellness symposium! Mark your calendars for our event on October 22 at Pacific Tower on Seattle’s Beacon Hill. We will focus on mental health in the workplace this year. You can learn about past events at the LWA Wellness Symposium page.
See what LWA is up to this spring. To accommodate social distancing, LWA is hosting virtual wellness programs for your company. Check out our LWA website for more on webinar topics and virtual yoga classes, including a new class on mindfulness and health.
The Living Well Alliance is run by Pacific Medical Centers. Call us today at 206.621.4419 for more information or email LivingWellAlliance@pacmed.org.
PacMed and Living Well Alliance are trademarks of Pacific Medical Centers.
Nutrition: Why we eat when we’re bored (and what to do about it)
Experiencing boredom is nothing new. However, with stay-at-home orders and socializing frowned upon, we may recently have been feeling more bored than ever! At these times, it’s tempting to turn to our tried and true method for easing boredom: food.
But how did this happen? How did our brains decide that the best way to relieve boredom is to eat?
One reason is dopamine.
Dopamine is a neurotransmitter in our brain that’s strongly tied with feelings of reward and pleasure. When we’re bored, our brains aren’t stimulated, and this causes our dopamine levels to drop. This triggers us to take an action that will bring it back up, such as eating.
Of course, there are other ways to spike dopamine levels—drugs, cigarettes and sex, to name a few—but for a lot of us, food does the trick just fine!
But that’s not all.
Yes dopamine plays a role, but there’s more that goes into our perpetual need for chips when we’re feeling uninspired.
When we experience boredom, we feel the need to participate in behaviors that result in pleasure. However, if we consistently turn to a particular behavior, our brain becomes less able to experience pleasure from other activities.
That means if we frequently rely on food to relieve boredom, our brain becomes rewired to derive the most pleasure from food.
Eventually our brain will crave eating over other activities because that’s how it experiences the most pleasure
However, there are three (obvious) problems with this approach to handling boredom:
- Most of the time, we don’t actually need food. So not only do we mess with our appetite for the next meal, we also end up getting extra calories that our body doesn’t need.
- Those extra calories are also generally empty calories; when bored, we rarely (if ever) choose to eat nutrient-dense foods like fruits, vegetables, lean proteins and healthy fats.
- We rarely feel satisfied when we’re done eating. Instead we’re more likely to experience guilt or frustration with our “lack of willpower.”
Fortunately, we’re not stuck with this habit for life. There are a few things we can do to help break ourselves out of the boredom-food cycle:
1| Notice when you’re eating due to boredom.
Sounds easy enough, right? Become familiar with the times and/or situations you’re most likely to experience boredom, then notice if and when you turn to food for relief. Do you feel bored more often during the day or late at night? While you’re working or while watching TV after dinner? Keep a journal to help with identifying your patterns and trends.
2| Brainstorm other ways to address boredom.
Come up with a list of all the activities you enjoy. Consider hobbies, creative outlets, intellectual pursuits and other activities that get your brain or body engaged. Decide which one(s) you want to try the next time you’re feeling bored.
If your list of activities is looking a little sparse, it may be time to try something new—or return to a soothing hobby from your past. Learn how to knit or take up painting. Sign up for music lessons or become a dog walker. Ask your friends what they like to do and try it out for yourself.
If you still find yourself wanting to eat, even with an arsenal of new activities, have no fear! Remember that the more you use an activity, the more it becomes connected to your brain’s pleasure center. So the more you do it, the more enjoyable it will become.
3| Embrace boredom.
There’s no better time to try this! Instead of reaching for food—or your phone, or a cigarette, or whatever—lean into the feeling of boredom, let your mind wander and be curious. Not only does this give your brain the freedom to think outside the box, it also disrupts the neurological connection between food and pleasure.
A study published in the journal “Academy of Management Discoveries” found that experiencing boredom can actually increase creativity. In the study, one group of participants performed boring tasks, such as copying numbers from an old phone book, while the control group didn’t. Both were then asked to complete creativity tests, such as coming up with uses for a pair of cups.
The study found that those who completed the boring tasks came up with more ideas than those in the control group. It also found that the first group’s ideas were often more creative.
So don’t try to fight off boredom. Ultimately, the more comfortable we are with being bored, the less likely we’ll need food (or anything else) to distract us from it.
Healthy eating!
Recipe: Calming Face Mask for Dry Skin
Here’s a different kind of mask from the ones we are all hearing about and seeing these days! This facial treatment hydrates dry skin … and forces you to take time for yourself.
Add hydration back to rough, dry skin with this moisturizing mask. “The omega fatty acids in avocado and olive oil help seal cracks between skin cells,” says Joshua Zeichner, director of cosmetic and clinical research at Mount Sinai Hospital in New York City. Thanks to soothing ingredients like honey and yogurt, your skin will feel incredibly soft and plump—if a little sticky. Just be sure to rinse well around the hairline.
Recipe: Comforting vegetarian chili
Chili is an excellent “comfort food” that is full of fiber and easy to make. It also delivers an inner warmth while we wait for summer to fully hit the Pacific Northwest. An extra bonus—chili provides about 10% of your daily calcium needs for strengthening the bones. Top with plain yogurt or shredded cheese for an additional dose of calcium.
Have extra avocado and yogurt? Relax after dinner with the hydrating face mask, recipe below!
Outdoor exercise during COVID-19
Are you confused about getting outside for exercise during this trying time of COVID-19? If so, you’re not alone. Like so much about the current situation, the advice about exercise right now can be confusing.
As a sports medicine specialist, I like to think physical activity is an elixir for better health and should be prescribed to most everyone. It’s one of the most effective treatments for multiple health issues (like cardiovascular disease, hypertension, depression, obesity, diabetes and others), and even moderate exercise has been shown to boost the immune system. Exercise is a medical prescription everyone should follow. However, the long-term benefits of exercise need to be pursued while also being smart about the serious risks of exposure to the virus.
As part of our state’s Stay Home, Stay Healthy order, many businesses including gyms are closed. Therefore, exercise needs to be done at home or outside. Yet, many options are unavailable—like parks, beaches and hiking trails that are closed to facilitate social distancing. In addition, the WHO and CDC are now recommending universal wearing of masks when leaving your home, but a mask can make exercise more difficult. All of this information can be hard to sort through.
So how do we exercise—while exercising caution—during the current public health crisis?
Is it safe to exercise outside?
Let’s start with what we know. We know that the virus that causes COVID-19 is spread through droplets released by infected people, such as when they sneeze or cough—and possibly even when talking or breathing. We know these droplets can hang in the air, especially in enclosed spaces. We also know people breathe more deeply during aerobic exercise. A person who is infected may have no symptoms and not know they are contagious. For these reasons, it is of the utmost importance to keep your distance from people you don’t live with—both to protect yourself and to help flatten the curve.
There is also much we do not know yet—but we can apply some common sense. When virus-carrying droplets occur outdoors, it is reasonable to think the concentration will be lower due to the open space. It is possible this would make the “viral dose” you might be exposed to less dangerous. You can lower your risk outdoors even more by maintaining a social distance of greater than 6 feet. One white paper (not yet peer reviewed) recommends staying out of the direct path or lane of people exercising 30-60 feet away, to avoid catching particles in their slipstream.
If you are running, walking or cycling, there is a risk of moving through a coronavirus droplet cloud—however, my assessment is this risk is small overall, so long as you follow the social distancing rules and avoid crowded areas. My recommendation for safety is to maintain a distance greater than 6 feet if you or others are running or cycling outdoors.
Do you need to wear a mask when exercising outside?
If you can use a mask when exercising outdoors, it too would help minimize your overall risk. However, I don’t believe it is absolutely necessary, and it may be difficult to do when exercising heavily. The CDC has information on wearing a cloth mask to slow the spread of COVID-19.
Remember, a cloth or paper mask plays the same role as covering your cough or sneeze: it protects those around you. And since any one of us may be infected with the coronavirus and not have symptoms, wearing a mask when exercising near others can help slow the spread of this disease.
Key takeaways. The risks of exercising outside can be minimized if you follow some guidelines:
- Avoid crowded areas.
- Head outside during slower times. Depending on your area, these may be early morning, during the day when others may be inside working, or in the dinner hour or evening.
- Cover your mouth and nose with a light mask, if feasible, while you exercise.
- For vigorous workouts, try cooler hours, when a mask might be more comfortable (or perhaps unnecessary, if fewer people are out).
- Keep your distance from others. Aim for more than 6 feet if you are walking, running, climbing stairs or cycling, or around others who are pursuing such activities.
- Avoid touching your face during your workout.
- When you return home, take off your gear/clothes and wash your hands thoroughly before touching your face.
- Avoid touching household items (knobs, counters, fridge door, etc.) until you have cleaned your hands.
- If you wear a cloth mask, clean it in a washing machine regularly.
There is risk in life and everyone needs to decide how much they are willing to accept. I think exercise is an important part of life, and while exercising outside has risks, these can be minimized.
I wish you the best in finding ways to maintain your health through exercise, while also taking precautions that make sense.
Chris Maeda, MD, practices sports medicine at Pacific Medical Centers. He sees patients at the PacMed clinics in Beacon Hill, Northgate, Canyon Park (Bothell) and Totem Lake. To schedule an appointment with Dr. Maeda, please call 1.888.472.2633.
Let us know if these tips helped you at StayHealthy@pacmed.org. Read more about PacMed’s response to COVID-19.
Mental health during social distancing
Addressing Mental Health During Social Distancing
As published in 425 Magazine on April 10, 2020
With all the additional stresses associated with the COVID-19 pandemic—financial, relational, and more—building habits and strategies to help mental health is important. Alex Majcher, a member of the Behavioral Medicine team at Pacific Medical Centers at its Federal Way clinic, spoke about how to build some of these strategies: what to include in your routine, what to avoid, and how to try to make the best out of an extremely difficult collective situation.
What are some tips on balancing news intake in a way that doesn’t heighten anxiety?
You should limit the amount of time each day you watch or listen to the news. Don’t leave it on all day as background noise, and don’t watch first thing in the morning or right before bed. If you get your news by reading it on your phone, the same applies; don’t open up your news app as soon as you wake up, and don’t read it in bed trying to fall asleep.
Additionally, if you struggle with anxiety around the news, focus on local outlets. Local news tends to present more succinct information rather than having panels that mix in a lot of emotionally charged opinions. This also helps you to focus on what is happening in your reality and can prevent you from feeling overwhelmed by what is happening all over the world.
What are proactive steps to take to ensure you’re being mindful of your mental health during social distancing?
If you are working from home, it is important to keep a routine similar to what you would have if you were still going to your office. Ensure that you’re maintaining a regular sleep schedule. When you get up in the morning, do all of the things you would have done on a regular day: take a shower, have your morning coffee and/or breakfast, get dressed, etc.
You also can try and find safe ways to help others. As social beings, we have the instinct to contribute to the well-being of the group, which is why it feels good to contribute to others’ well-being. During social distancing, this doesn’t need to go away—there are numerous ways to help others. Reach out to people who may be lonely by phone, or teach someone who doesn’t know how to set up and use social media so they can connect with others as well.
Additional proactive steps include:
- Do things that give you the opportunity to feel like you have achieved something, no matter how small it may seem. Do a project you’ve been meaning to complete at home, finish a puzzle, learn a new hobby or skill. Set a (realistic) goal for each day and work toward it.
- Make a list of things you can do at home that you enjoy, and schedule a time for them throughout your day.
- It doesn’t have to be intense, but get moving: a walk around the block or yoga will do.
- Spend a little bit of time outside each day, no exercise required! This will help prevent feelings of being boxed in or restless, which is common for people to feel these days.
What are the possible impacts of social isolation for those that live alone?
For those who live alone, social isolation can be difficult to experience. When you live alone, you’re already lacking a source of social support. A lot of people have a “work family” and are used to experiencing interaction outside of the home. This change can result in increased loneliness and boredom relative to people who live with roommates or family members.
Everyone’s anxiety is heightened now because of the pandemic and the impacts on their lives due to social distancing. People are concerned about their health and the health of their loved ones, and are afraid for their jobs and financial well-being. There is a lot to be anxious about right now, and being alone can exacerbate the anxiety because it’s easy to get stuck in those thoughts and worries.
All of the things listed above are risk factors for depression. Additionally, financial challenges also are contributing more to this concern for those living alone because they don’t have another person contributing to household expenses. Other symptoms include feeling unmotivated, thoughts of harming yourself or death, feelings of worthlessness or hopelessness, and fatigue. I recommend you seek medical attention right away if you are experiencing any severe symptoms.
What are the ways social distancing might actually be beneficial to mental health?
During this time of social distancing, it gives us time to recharge, and to take time out from our busy and/or regimented lives, allowing us to get the rest we need.
This is an opportunity to form connections with people you may not have known well before because you don’t see them in your everyday life. I have spoken with people I haven’t heard from in years when they reached out because of this. We are being forced to slow down and simplify our lives and it’s an opportunity we didn’t have before.
Along those same lines, I’m sure every one of us has that one thing at home that we have been “meaning to do” but never had the time—that artwork you wanted to create, the cabinet door to fix, that book you wanted to read, or game you wanted to play with your kids: Now you have the time!
What is the importance of unwinding and taking time for yourself?
Your mental health is connected to your physical health. Taking time to relax promotes physical well-being as well as mental and emotional well-being. When you feel high stress for an extended period of time, you are at higher risk for physical illness. It’s important to take care of yourself by getting restful sleep and doing relaxing activities (i.e. reading, yoga, stretching, taking baths).
Any tips on online or remote therapy? Is it as effective/are there ways to try to make it more effective? The benefits of online and remote therapy really depend on the reason for treatment and the personality of the patient. Virtual therapy is a really great tool to reach people who are unable to access in-person therapy because of social distancing, and overall because of living in a rural area, homebound by illness or lack of transportation.
I have also found that remote treatment has been the therapy of choice for those who have high social anxiety, and in my opinion, if that is the only barrier to seeking treatment, this is a fantastic option.
Tips to get the most out of virtual therapy include:
- Video is better than the telephone, and the telephone is better than texting. I know texting for therapy may be an appealing option for people today; in my opinion, text may be good for reminders of learned/practiced skills as a supplement to in-person or virtual therapy, but not a replacement.
- Make sure when you’re talking with your therapist, you’re in a quiet environment with no external distractions. I recommend a bedroom, quiet den, or even a backyard.
Alex Majcher works on the Behavioral Medicine team at Pacific Medical Centers at its Federal Way clinic. She has received her degree from Loma Linda University in Loma Linda, CA. Her medical interests include substance abuse disorders, post traumatic stress disorder, depression, and anxiety. When not in the clinic you can find Alex soaking up live music, reading, horseback riding, and traveling.
Read more about PacMed’s response to COVID-19.