Friday, February 14, 2014

Prism of our own lives


A flicker of annoyance creased my brows.Yes, there was no denying it..as they say, the mirror never lies....there was a little bit more weight around the midriff than I should carry. Didn't like what I was seeing in the mirror and annoyance certainly was the over riding emotion. 
And believe you me,I try my best to ensure I don't put on weight, with good enough cause too. Just crossed 40, family history of diabetes and hypertension, Asian heritage..would tick the box on all counts as a high risk to having problems. But you know what, it's darned hard to make sure the healthy diet and exercise happens on a regular basis...not because I am lazy but mainly because life, work, kids, travelling takes away time from your hands.The health evangelists would tout that as excuses but when most days you leave the house before 7 am to fit everything in and then come back home sometimes around 9 pm, the desire or even energy to exercise somehow seems to be lower down the priority list..I would rather spend the 20 minutes discussing Spider-Man with my son enthusiastically explaining the importance of webs..or trying to tease my daughter about the increasing "noise" from her room which she claims to be music.

And that's reality. And that's life..and in a nutshell why most people find it so difficult...its not that there isn't necessarily the desire but life has a different perspective on it. When the "present" needs sorting, who has time to protect oneself from the ravages of "future"? I have never ever berated or even criticised anyone coming to my clinic , whether type 1 or type 2 diabetes, for inability to lose or even putting on weight....simply because I struggle to do so myself. Recently due to personal ailments, I couldn't exercise...it was frustrating but at least it was temporary...but it certainly put into perspective what pain can do to you and your daily life. 
We all seem to have an amazing ability to preach, amazing innate sense to lecture..but tell you what, behind that desk,its always easy to give a lecture on the importance of healthy food, the relevance of exercise...but after that,we go back to our own lives... don't live the lives of those who go through their daily travails...so an easy way out is always to lecture and then move on to the next patient. if we all knew so much, how come we don't have lithe, toned athletic looking HCPs all over the NHS? I will tell you why...they all have lives and their daily grind where it isn't that simple.

And that is why when I read articles on "how easy it is"...it makes me annoyed. Yes, indeed diet and exercise is all paramount but lets be a bit more realistic about it, shall we? We have issues with food pricing, issues with accessibility, cultural issues....all of which does not help. There is no denying the importance of what a Mediterranean diet provides but don't  make it all sound so simple and more importantly, don't make others feel guilty or bad for not doing something "so simple". Life isn't the same for everyone so using glib terms such as "you should make time for such important interventions" isn't the way ahead.

You want to tackle this..do so properly. We have a long way to go when the biggest event held in the UK over last 10 years- the Olympics- is sponsored by CocaCola and McDonalds...that plastering of their logos make it more acceptable, not less. Food industry is where the battle is..so lets do so properly..and while that's happening, a bit less of the "Oh, Mrs Bloggs, you have put on some weight" followed by a pause.  We must,as healthcare professionals, have a better approach towards the whole weight loss angle..an overarching policy at a public health level, start at schools,,colleges, explain the importance of knowing how to prepare food yourself and perhaps even consider leading the way as regards being fitter individuals. And more importantly, try and appreciate why diet and exercise may not be so easy to do, rather than be judgemental about it. 

Life has a funny way of stacking your priorities.As a healthcare professional, your focus maybe to make Mrs Bloggs use 20 minutes each day for brisk walking and help her reduce her future risk of heart attacks. Her priority maybe to use the only spare 20 minutes in her day to sit with her grandchildren and read them a storybook. 
Lesson to self? Don't judge others by your own life or barometers..we are all different...so are our priorities. A bit more realism, a bit more understanding will probably take us further more than walking ourselves into a state where we view the world only through the prism of our own lives. One can only hope. 

1 comment:

  1. I carry a few more pounds than I should (well, I would prefer it if I were 20Kg lighter) but I did hide a wry smile when the very rotund healthcare assistant at my recent health check at my GP asked me about how much exercise I take. I waved my cycle helmet in response. I think it very unhelpful to categorise people by their BMI, it is far better to look at their wellbeing and relate that to their weight.

    Can you walk up three flights of stairs? Can you walk up three flights while having a conversation? Do you need a rest when you get to the top, or on the landing on the way up? These are much more relevant to people than an abstract formula. It is also clear that ability or desire to take exercise is not directly related to weight and that exercise is not simply about maintaining a "perfect" weight: it is about feeling well.

    Of course, this leads to another question: does the patient actually want to walk up the stairs, since there is usually a lift available. Commercial organisations like Weightwatchers make weight loss a social event where the attraction is the social club atmosphere and the weight loss is a secondary benefit. Exercise for weight loss can be a social event too, I am not talking about the rather trite advice of "join a gym" because gyms are full of individuals exercising (look at the number of people with headphones in a gym). Walking clubs, conservation groups, even a walking tour of a town, these are social events where exercise is a consequence, not a primary aim of the activity.

    So, doctor, when you look at the BMI of a patient (and mentally match the person to the labels of "healthy weight", "overweight" or "obese") look beyond the label and look at what the patient can do, wants to do, and how well they feel. If they want to climb the stairs, but find they have to rest on the landing while everyone else walks past, they have an incentive to lose weight to so that they can climb a whole flight of stairs.

    And do prioritise your kids, they are only this age once and your parenting now is so vital to them (and to you). At the weekend take your son to a comic shop, just make sure that you don't park your car at the nearest car park - you can use the walk to and from the shop to talk about Spiderman.

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