My most recent interest?…Reading and learning about nutrition and exercise. As a nurse I have had some training in nutrition, which was required for my basic diploma degree, but no training in exercise physiology. The world of nutrition, exercise, and alternative medicine have grown substantially since my white cap days. I am by no means an expert, only scratching the surface of knowledge, but I thought I would share some opinions I have formed from my recent research.
My new found push to be ‘healthier’ (whatever that means) has evolved from several factors. (1 ) I am aging and my mother had open heart surgery for complete blockage of a major artery in her early 40′s (you can’t change genetics). (2) I have been doing some crossfit (*2017 Note here-I gave up crossfit for body pump… cheaper and easier on my joints and much better muscle development as a female… sorry crossfit). (3) Most importantly, I am finding my patient population in primary rural health to be sicker, more obese, and needing more medications, but let me be frank… medications are NOT fixing their health.
All of this has lead me to seek out what can really benefit my patients and not surprisingly the answer is EXERCISE AND DIET! Exercise appears to be the proverbial ‘magic bullet’ for numerous diseases including heart disease, Type 2 diabetes, depression, anxiety, osteoarthritis, fibromyalgia and reduces the risk of a host of other diseases including cancer.
Further, the implications of nutrition in the treatments of such illnesses, while not as widely studied as pharmaceuticals, is impressive. The implications for a vegetable and fruit based diet in preventing and altering heart disease risk is impressive. Good nutrition in itself benefits diseases like diabetes and decreases obesity. The use of nutrition to improve memory, anemia, prevent migraines, improve mood and sleep, and a host of other uses for fruits and vegetables and vitamins, has shown promise and needs more research. So far, this discussion does not even include current problematic treatment of chronic pain in this country and the alternative therapies, diet, and exercise that could benefit such patients (another post perhaps?).
Let’s be honest, medications are dangerous. With current adverse drug reactions and drug overdoses claiming more than 100,000 American lives alone per year, clinicians need to find a safer and more permanent way to improve chronic health in this nation. There has got to be a more adventitious way, a safer way, to improve the health and quality of life of a nation (and to reduce skyrocketing health care costs)! There is…. nutrition and exercise.
Pills, Pills, Pills… do they create more ills? I am beginning to wonder if the toxic nature of long-term pharmaceuticals is an issue for my patients? Seriously, this is a legitimate question. I am not trying to throw the baby out with the bath water. Pharmaceuticals are good. I am thankful for pharmaceuticals and for common life saving drugs, but for the long term treatment of chronic diseases that are all life style related… is our current practice of medical care in this country (acute care hospitalization and primary care medication pushing) working? Look, in a published report on vitamin adverse reactions and deaths in the U.S. in 2007 there were only 8 adverse reactions and 0 deaths. Yet, I would honestly like to know the general health outcomes, quality of life improvements, improvements in mood/sleep/lifestyle, and what patients generally die from who are on long term pharmaceuticals for chronic problems? Longitudinal research anyone?
Further, I have many patients who would benefit from yoga, massage therapy, physical therapy, acupuncture, and the like as supplements to their chronic pain management. The majority of these patients have no health insurance or money, and if they do have health insurance it does not include coverage for such therapies… however, it pays for medications… an issue for another post.
With all of the empirical evidence as to patient improvements in disease through diet and exercise, why don’t we/health care providers (me included) use them more? Wouldn’t we like to wean all of our patients off of their metformin, lisinopril, and lipitor? I know I would!
Several Bottom Lines: Bottom line number one, time constraints within a primary care visit, what ever they may be, and a culture of going to get a prescription for our ailments has lead us here. It is a poor and pitiful excuse and I am not proud to write that I have fallen into the trap of both time and a patient’s desire for a prescription to fix instead of the hard work of lifestyle change. I am confident though that health care providers can lead the charge to change how we practice and how we promote health in the U.S. and around the world! We can do it in conjunction with athletic trainers, dietitians, exercise physiologists, and the like in cooperation.
Bottom line number two, the most common prescription we need to write is for diet and exercise. However, will that make anyone any money? As much as all health care providers hate it, money drives our system. Of course, a patient being sick generally does not bring me personally any more revenue. I would love to see healthy patients all day, or do something else if my patients were so healthy they did not need me (how great would that be!). To cut costs, someone has got to stop making money. Honestly, if I could prescribe only two things to help almost every patient I had in my practice it would be increasing fruits and vegetables in their diets and getting daily exercise. (FYI- I am also going stop encouraging whole grains, because patients interpret this as bread and cereal and then eat processed cereal/bread and think they are being healthy.)
Bottom line number three, we have to help our patients get well through modeling. We have to start with ourselves. No more should we as health care providers say… “well, I am going to eat this candy bar because I take my lipitor for it and I have to die of something anyway.” No more cop outs. No more excuses. We can model the health we want our patients to have.
Now, go exercise or something…