Starting Anew at 49

Image by Getty Images via @daylife
September 17, 2010 was the start of my new life. For the past 15 years, I have been working in Family Practice at the same Clinic, with the same people, and taking care of the same patients. It had become quite comfortable. Last year, my hours were cut due to the economy, though eventually one of our doctors left and I went back to full time hours. However, during the time I was on a reduced schedule, I put some feelers out for a new, or an additional, position.


Since January, I was back to being comfortable. Out of the blue I got a phone call offering me a position with an Urgent Care company. They offered me more money (substantially) for working less days (though still averaging the same total hours). I had several friends with the company who all said they loved what they were doing and encouraged me to make the change.

With some trepidation I submitted my resignation in May, giving my company ample time to find a replacement. The next four months were filled with bittersweet moments, especially my final week. I am so going to  miss many of the friends I have made over the years, but I know we will do our best to keep in touch. I needed to do something to reduce my stress (financial stress as well as the stress that comes with Primary Care, like losing patients and dealing with habitual drug seekers).

I began my new job yesterday with excitement and a bit of nervousness. It couldn't have gone better. The other doctor and the PA I worked with eased me into the routine, taught me how to use the EMR, and were delightful people to chat with and get to know. I can tell I will fit in here without reservation. Time to make new friends! The patients appreciated being taken care of promptly and were not demanding of all the extras the typical patient asks of their PCP. I am looking forward to this new chapter in my life!


My next step is moving. Next month, my son and I will be moving into a new apartment. I am sure that will be another adventure! I am taking the opportunity to pare down our belongings and am going to go for a more Zen approach to our lives. I'm even studying Feng Shui!

Good Carbs, Bad Carbs

Image via Wikipedia

Not all carbohydrates are created equal. Some are much more nutrient-rich than others. These are the carbs any individual who is interested in eating healthily should concentrate on, especially those who are interested in losing weight.

Whole grains, fruits and vegetables are the carbohydrates with the most nutrients and should be the mainstay of a healthy diet. Low-fat dairy products, nuts and legumes also carry some carbs along with their protein. I tell my patients to avoid sugar and "white" starch products as a rule of thumb. This includes white rice, white pasta, white bread, etc. Even white potatoes should be used in moderation. Substitute brown or long-grain rice, whole wheat pasta, and whole grain breads. "White" means stripped of nutrients basically. The best carbs to choose are the ones that contribute plenty of other nutrients, such as protein, fiber, vitamins and antioxidants.

Most Americans take in too much sugar. The highly processed diet we eat as a country is packed with added sugars and syrups, which quickly translate into a whole lot of trouble. Excess sugar has been implicated in the metabolic abnormalities of Metabolic Syndrome or Insulin Resistance Syndrome. It also crowds out more healthful ingredients in one's diet. The American Heart Association suggests that women get no more than 100 calories per day from added sugars, and men no more than 150. Currently, the average daily intake is over 22 teaspoons (355 calories). The major culprits are soda and other sugary beverages, such as fruit juices and sports drinks. However, even seemingly healthful foods like dried, sweetened fruits (cranberries, blueberries, etc.) and reduced-fat or reduced-calorie salad dressings contain high levels of added sugar.

If you make it a habit to avoid sugar and "white" carbs, and you concentrate on eating lots of fresh fruits and vegetables, with some whole grains thrown in for good measure, you can't help but be on your way to a healthy diet!

PrePlan Evaluation

We keep mentioning having a physician clear you for participation in an exercise program, and if you sign up for a personalized diet program, there are several lab tests that are requested. These include your lipid panel, fasting blood sugar, A1C, albumin, and fasting insulin level. Helpful but not required are your hemoglobin, iron level, and B12 level. Before embarking on a weight loss plan it is essential to make sure your thyroid is working normally also, although these levels won't change your plan. However, if your thyroid is underactive, it will be very hard to lose weight until this is corrected with medication.

The results of the labs above will help determine which plan is best for you medically-speaking. Do you need restriction of cholesterol or saturated fats? Are you insulin resistant and needing to limit your carbs? Do you eat enough protein? The results will help us design your custom made plan. We will then take into consideration your likes and dislikes and present to you something that will work especially for YOU.

Do not ignore the need for an evaluation by your physician before embarking on this major lifestyle change. To do it right, this information is essential. In our next post we will discuss the various food groups and the "good" and "bad" in each.

For now, happy new year and good luck achieving your goals. I remain here to help,
MommyDoc