Showing posts with label David Leopold. Show all posts
Showing posts with label David Leopold. Show all posts

Tuesday, May 1, 2018

You Know What You’re Supposed To Do, So Why Aren’t You Doing It?


By David C. Leopold, M.D.
Medical Director

As a physician, I have long been fascinated by what people do NOT do when it comes to taking care of their health. Why do we not make the choices that we know are best for us? As I have discussed before, healthy living choices in many ways are simple and straightforward, and definitively lead to healthier and higher quality lives. So why do people not do the things that they know they should? Some recent studies and papers have examined this and found some very interesting things.

There are 8 prominent reasons why people do not do the things that they know are better for them, and I will examine a few of them here and some in later blogs.

1) WE WANT IT NOW! As everyone is aware, we are creatures of immediate gratification. To sort of quote the late great Tom Petty (R.I.P Tom!), “Damn the Torpedoes! (full steam ahead)”.  (Well, actually that was Tom quoting U.S. Admiral Farragut , but you get the point).  We want what we want now; we don’t care about what happens in the future. If it is food or that new giant TV and the cost is to our bodies or our bank accounts, we want it now. And none of this makes for very good long term results.

2) GOOD STUFF CAN WAIT, BUT WE FEAR THE BAD. We are concerned with the bad stuff that can happen but not as much when it comes to positive outcomes. This may be because we are wired to be concerned with risk - particularly immediate risk, and avoidance of danger, but we are not really set up to appreciate the benefits of healthy behavior, and certainly not benefits that are in the future. So not making a healthy choice for activity is actually compounded by the immediate gratification of the poor choice (particularly relevant to food choices). The healthy outcome is just too far down the road.  We care a lot if we just had a heart attack, we don’t want another one, but until that big one hits, well, one more cheeseburger sounds pretty good….

3) WE THINK NOTHING IS REALLY GOING TO HAPPEN TO US. This one is particularly interesting to me; we have a false sense of optimism. We think: that won’t happen to ME. Smokers don’t think they will be the ones to get cancer, people who continually make poor dietary choices  don’t think they will be the one to get diabetes or have that heart attack; it will always be someone else. I can tell you right now, I have spent much of my career taking care of people who did not think they were going to be in a doctor’s office suffering from what they are suffering from. And the unfortunate part of this is that so much of our chronic disease is preventable. People have a false sense of their ability to avoid disease. Most don’t realize that they are on their way to an official diagnosis until it is too late, and then it is often very difficult to reverse what has occurred. An ounce of prevention is really better than a pound of cure, but few see it that way.

4) WE ARE ALMOST ALL IN SOME STAGE OF BURNOUT. Being in a constant state of depletion and fatigue often leads to making bad choices. These may be comforting in the moment, but are usually detrimental to our long term prospects. Who does not want to reach for the Ben & Jerry’s or that delicious chocolate scone when we are tired or feeling down? I have yet to meet the person who makes consistently great choices when they are feeling lousy, frustrated, down or hopeless.

So what can we do about all of this? Well, first realize that although the path to good health is clear and should be easy, in the modern world it is not. Temptation is everywhere and making poor choices is supported by industry and advertising all around you. Easily available poor and nonproductive options (e.g. sit around, eat poorly, take the elevator, pretend you are not a ball of stress, etc.)  are the constant devils on your shoulder, encouraging any amount of “bad” behavior you can image.
I was really struck once again by this recently watching the NCAA Basketball Tournament. This event is a paragon of athleticism, which is ironically completely dominated by ad after ad of things to eat that will absolutely wreak havoc on your physiology. How do we stay healthy when we are constantly inundated by things and ideas that want to pull us towards the unhealthy?

So, how to improve when the odds are so stacked against us? Good news, it is not hopeless, although it can be challenging. It can also be liberating and empowering and lead to a better life in our bodies and minds, and the same for those around us. (Here’s an added bonus; study after study shows positive health is contagious. People are healthier when they associate with healthier people. Imagine the implications to your family and friends if you take up the mantle of becoming a shining example of health for yourself and those close to you.) 

Next time, we will talk about the ways to accomplish these goals by focusing on immediate benefits, avoiding too many choices, making commitments to ourselves, being prepared, keeping it simple and believing in ourselves that we can make these positive changes. We will see how we can use the same principles that advertisers use to get us to do detrimental things, to do the good stuff. 
You will soon find that you can actually be feeling better by tomorrow, and soon you can be well down your path to wellness! 

In health and happiness,

David C. Leopold, M.D.

Tuesday, December 26, 2017

The Importance of Integrative Health and Medicine

By David C. Leopold, M.D.
Medical Director

Your health is important to you, but your health is also important to the health of our nation, and even the world. The average person may not think about how their actions directly affect the overall healthcare of the nation, but they do. The lack of prevention of disease results in increased utilization of resources, most directly, time and money. The U.S.A. spent roughly $3.3 trillion last year on healthcare, about 18% of our GDP. The Centers for Disease Control estimates 83% of healthcare dollars (about $2.7 trillion) are spent treating chronic disease and this is expected to increase 42% over the next ten years. Resources spent treating preventable disease takes from resources that could be used for other services such as (fill in whatever condition is important to YOU here). Similar to the concept of everyone chipping in to recycle and minimizing waste, by keeping ourselves healthy, we also contribute to helping with a seemingly insurmountable problem.

Combine all of these issues and you have what everyone in healthcare already knows -- there is a looming American healthcare crisis in the not too distant horizon. But there are two important significant things you can do by keeping yourself as healthy as possible: 1. you can prevent these types of diseases for yourself (and maybe even inspire your friends and family to do the same) and 2. you avoid contributing to the collective burden of treating preventable diseases, thereby freeing up the resources available to be used for (again, fill in whatever is important to YOU here). (Of course, I whole heartedly endorse that you see your health care professionals for regular prevention type services and regular health checkups, or for any issues that are concerning to you!)

At Hackensack Meridian Integrative Health & Medicine we utilize a Five Pillar approach to a person’s health and wellbeing. These Five Pillars of Health & Well-being are: Nutrition, Exercise, Resilience, Sleep and Purpose. By analyzing and addressing strengths and deficits in each of these core components of a patient’s overall health we can develop specific and individual care plans as we to partner with our patients to minimize the risk of developing a preventable disease, and also to improve almost any existing chronic disease. There are extensive interventions that have been shown to improve quality of life, improve disease, and many actually prevent disease. As I noted in a previous blog, many of these interventions are relatively simple to incorporate but some take work and a partnership between patient and practitioner. Lifestyle change is often difficult, but it has been proven time and time again that lifestyle changes work, and have lasting effect. In fact, these changes are often the most effective interventions, particularly in the long run.

Let’s take just a brief look at just a few interventions we have been talking about: Healthy eating and dietary changes are proven to reduce obesity, diabetes, heart disease and cancer. Exercise has been shown to decrease pain, obesity, heart disease, reduce cancer and reduce recurrence of certain cancers. Exercise is also a powerful antidepressant and is an excellent intervention for stress management. Meditation, mindfulness and Mindfulness Based Stress Reduction (MBSR) have been shown to help reduce stress, anxiety and to improve pain (possibly more than medication in the long run). Acupuncture has been shown to help many different disease conditions (e.g., complications from cancer treatments, headaches, anxiety, irritable bowel syndrome, hot flashes, etc.) and a multitude of issues relating to many different types of pain. In fact, based on extensive research and evidence showing safety and efficacy, acupuncture is now recommended by multiple major medical organizations such as the American College of Physicians for the treatment of chronic pain.
The evidence is clear: when applied appropriately (the same goes for any “traditional” medical intervention), lifestyle modification and integrative medical approaches to multiple conditions can be significantly effective. In addition, these interventions can help reduce disease burden and improve suffering and quality of life.

For the reasons above, I believe that integrative medical approaches -- including interventions for sleep, healthy eating, appropriate exercise and reduction of sedentary lifestyles, resiliency teaching and development and cultivation of one’s life purpose -- are not only the Five Pillars for an individual’s health but for the health of this nation. By utilizing the interventions above to improve overall health and reduce disease, we can stem the tide of chronic and preventable disease that is reducing the quality of life for so many people and overpowering our nation’s healthcare system. So you can feel great about taking care of yourself, and also our nation and our planet. You can make a difference! Most importantly, application of these Five Pillars of Health & Well-being can help to keep YOU healthy and in a state of Optimum Wellness. Try making some changes today!

Wednesday, September 6, 2017

Let Me Share a Secret: It’s Not Easy, But It’s Worth It

By David C. Leopold, M.D. 
Medical Director

As our elected leaders continue to struggle with healthcare, we need to remember that all of us directly affect healthcare in our country by the way we approach our own health. As I discussed in my previous blog, we have a tremendous burden in this country for diseases that are largely preventable and modifiable. One of the most powerful things we can do for ourselves and for the healthcare system in general is to become proactive with our own health, to optimize our wellness and to prevent disease conditions from ever establishing.

In this blog, I will continue to discuss ways that anyone can improve their health. But first I want to take a slight detour to talk about some things that directly affect our ability to make healthy life choices.

Here is a secret you may not be aware of--something that healthcare practitioners do not like to discuss or even whisper among ourselves: the reality is most of these interventions are not easy. Most take some work and some actually take a considerable amount of work. Let’s admit it, exercise is hard! Trying to come to terms with what is causing you stress is hard, let alone doing something about it once you actually identify your stressors. Eating right is hard and we are constantly barraged with messages of instant gratification and satisfaction coming from food and food-like substances. Starting a lifestyle that focuses on physical activity, healthy nutrition, and stress management all require work and constant effort in the choices we make. 

I believe we do a disservice to people when we imply that these difficult changes should be easy and simply "flow." There is vast misinformation and messaging that these interventions and these changes should come naturally; that they are simple. Nothing could be further from the truth. These lifestyle changes are decidedly better for you, but they are not easy. This misconception places an undue burden on a person to succeed immediately which is something that is almost always not going to happen. This leads to people ultimately feeling even more frustrated, discouraged and it actually increases their stress. Who needs one more thing to try to do and to fail at it? So most people never even try, or they try and then after not succeeding immediately they go back to their old habits, more entrenched in those bad patterns than before. The reality is doing the right thing is almost always hard, and this is especially true when it comes to taking care of our own health.

I remind my patients all the time that medicine is an art, not a science, and therefore there are really very few guarantees in patient outcomes. I also tell my patients that something I can virtually guarantee is that most, if not all, of these interventions and lifestyle changes will make you feel better and significantly improve your health if you incorporate them into your daily lifestyle.

Are you ready for another secret? Everyone fails at these things before they ultimately find a way to make them work. Failure is the rule, not the exception. We know that almost no one makes changes and sticks to them without many failures along the way. The trick is to recognize that this is normal, it’s not just you and it does not mean you cannot do what you have set out to do! Failure at lifestyle change happens to everyone; in fact it usually takes about 12 weeks of doing something new before it even starts to become something that is incorporated into your "new lifestyle." So when, not if, you fall off the path, don’t be too hard on yourself--it’s totally normal. First and foremost, congratulate yourself for the courage to even try to make changes in the first place, and then really think about and examine why you fell off. Then get yourself back on the path, and try to be just a little bit better, more aware next time. "If at first you don’t succeed, try and try again."

I’ll end my blog today with one of my favorite quotes, one I have relied on since I was an overworked, underpaid, and thoroughly exhausted medical resident. I would often not want to even let it come into my consciousness because it inevitably meant I was going to do more work and probably go home much later. But it never let me down, and because of it I was able to sleep at night knowing I had done what I could.

“The truth of the matter is that you always know the right thing to do. The hard part is doing it.” --- Norman Schwarzkopf

Tuesday, May 30, 2017

Integrative Medicine is Our Best Hope for Healthcare in America (Part 1)

By David C. Leopold, M.D. 
Medical Director

Healthcare in the United States is in serious trouble. Despite spending far more on healthcare than any industrialized nation, we have outcomes that are no better and, in fact, are often worse (the USA recently ranked last out of 11 similar countries) than countries that spend much less. Americans are also much more likely to have more than one chronic disease condition (e.g. heart disease and stroke, type 2 diabetes, cancer, chronic lung diseases, chronic pain, arthritis, etc.), further complicating care and quality of life. The implications of this issue are massive; chronic diseases are the major reasons for sickness, disability, suffering, death and health care costs in the United States.

Perhaps most unfortunate, the majority of Americans still do not make lifestyle changes that are proven to decrease disease and improve health. We still eat too much sugar and processed foods, not enough fruits and vegetables, we are too sedentary, and most people are under chronically high levels of stress and do not have adequate methods to manage this stress. The totality of this problem has direct health impact but also significant economic impact to our healthcare system; we spend an incredible amount of money treating diseases that are preventable. To paraphrase a cartoon, we are mopping up the floor while the sink is overflowing and the faucets are wide open. But what if someone could reach over that overflowing sink and turn off the faucet?

What if we could change this picture, what if we could actually stem the tide by decreasing the ramifications of these chronic diseases and, even better, what if we could actually stop them from occurring in the first place? This is what Integrative Medicine aims to do. Integrative Medicine is probably our best hope to change the current course of healthcare in this country because it focuses on the prevention of disease and a deep and lasting partnership with the individual to work together to improve our health individually and thus collectively as well.

Let’s take just a brief look at just a few interventions we have been talking about. Dietary interventions are proven to reduce obesity, diabetes, heart disease and cancer. Exercise has been shown to decrease pain, obesity, heart disease, reduce cancer and reduce recurrence of certain cancers. Exercise is also a powerful antidepressant and is an excellent intervention for stress management. MBSR (Mindfulness-Based Stress Reduction) has been shown to help stress, anxiety and lower back pain. Acupuncture has been shown to help many different disease conditions and a multitude of issues relating to many different types of pain.

In fact, every major healthcare crisis in this country (e.g. chronic pain and the current opioid overuse epidemic, obesity, diabetes, heart diseases, cancer, anxiety, depression, insomnia, etc.) can be significantly impacted by the implementation of integrative medical approaches.

Look for my upcoming blog posts where I’ll be discussing this issue in more detail.