What stage are you?

I had a great day today, despite being super sore. My arms are killing me, especially my triceps. But, on the bright side, the touch of tendinitis I still have in my elbow is hardly noticeable in comparison. Today was good overall. I didn't exercise today except to practice my TKD as I do plan to test again on Friday. The kids are pysched up to see Mom break her first board.

 I ate well today. For breakfast I had egg white on toast sandwich and a pear. For lunch I had a chicken breast with green beans. For dinner I had a small bowl of beef stew Nanny made and fresh veggies on the side-carrots, celery, bell pepers, grape tomatoes.  Sometimes I just don't want an actual "salad".  My calories are 1203. I drank 96 oz of water, my coffee and a diet DP. So plenty of fluids.

 Lately I've run into a lot of patients in the office wanting to make lifestyle changes.  New Year and all that. And then there are those that just aren't ready. These people are smokers, bad eaters, overweight, drinkers, but aren't going to quit anytime soon.  Believe it or not there is a label for this. PRE-contemplation.  These people don't bother me. Some doctors get irritated when the Smoker of 20 years says he's not quitting or when the morbidly obese patient says they hate exercise and they aren't doing it. Not me. I just smile. I remind the patient that it's my job to tell them they could die if they don't, document that I said that and move on.


The next stage of change is Contemplation. These are the people that know they need to change, but aren't ready to commit.  They know smoking causes cancer and it isn't good. They know they need to lose weight and exercise, but they aren't really serious about it. These are the people that are more frustrating for me. It's like I tell them they are standing in a fire and their pants are starting to burn, but they just are so happy being warm, they don't want to move yet. I don't get that.


But people who are constantly stuck in the preparation stage are the saddest ones. These are the people that know they need to lose weight. They make plans about it. Buy a cookbook. Join a gym. Get the newest DVD.  They've tried before. Each time they join a new program or method, but they never REALLY do what they intend to. This was me for a long time.  I joined a gym in college. I joined a gym about 5years ago. I went, like twice and quit. Payed for it though. Lots. I've got cookbooks, DVDs, equipment. And it sat there for years gathering dust.  These people think they are making a change. They think they are doing something, but really they aren't. They're spinning wheels. All talk and planning and lists, no actually doing it.


The really exciting thing as a physician is to see someone make the shift from preparation to action. Sometimes patients DO listen!  When you counsel them to quit smoking, how to do it and next thing you know, they've done it. That's really one of the best parts of my job. Seeing someone succeed in making their health better.  I am so glad to be in the ACTION stage. It doesn't mean I'm perfect. It doesn't mean I don't slip up, but it DOES mean that I am REALLY doing something. I am heading toward my goal which is the final stage- maintenance.


We all think of maintenance as the time when you are in this state of bliss and goal weight heaven. But, the definition of this stage is a time when you work to prevent relapse. In maintenance, you are solidifying the habits you developed in the action stage. You are constantly looking for ways to continue the healthy habits. People in this stage remind themselves on how far they've come, but they know they could relapse into bad habits. They are able to anticipate situations where they might be tempted back to it and make adjustments to avoid their old behaviors.


Wow. Just typing that made me realize how much work maintenance is. It isn't a time when all your problems are "done", but a time that while you are happy with what you've done, you realize you have to be on guard for falling back into your old habits.  So really, it's never over. And talking to people in maintenance I know it to be true. I also know that the longer you do healthy things, the easier it gets. The easier it is to maintain. So while it is discouraging at times to think about always having to be on guard about my weight, it is exciting to know that practice makes perfect. The more I practice my healthy lifestyle, the more natural it will feel to me.


So which stage are you in? Are you in ACTION or are you spinning wheels? Have you reached maintenance?  No matter which stage you're in, what lessons have you learned lately that are helping you?