As someone who spends a lot of time talking to people about their own wellbeing, and summarising wellbeing related news for this blog, I thought that this week I would share with you what my week has been like, and how well I’ve been doing when it comes to my own wellbeing. After all, if I don’t practice what I preach, why on earth would you be interested in anything I have to say? I have recently finished reading the Four Pillar Plan by Dr Rangan Chatterjee. It is the best book I have read for some time. Inspiring, insightful and honest, it has been a pleasure to read and genuinely life changing for me. One of the many things that I love about it is the honesty with which Rangan approaches this topic, acknowledging life’s (and his own) imperfections and being pragmatic and gently encouraging. So for my wellbeing confessional, I will break it down into the four pillars: Eat, Move, Sleep and Relax. Here goes…
I try to eat a low carb, high protein breakfast. I have stopped eating cereal (or “breakfast candy” as Dr Mark Hyman refers to it in his book “Food, WTF Should I eat?“. This week I have been practicing my poached egg technique. The best tip I have read for this is to use white wine vinegar in the water, which keeps the egg white together rather than it spreading all over the bottom of the saucepan. With whatever kind of eggs I eat, I tend to also have mushrooms and/or avacado and sometimes bacon. You can do both the mushrooms and the bacon in the microwave. If I want to fry the bacon (because, let’s face it, it’s delicious), then I do it in ghee or coconut oil, which is less likely to burn then vegetable oils. If I’m not in the mood for eggs (which you can eat every day, btw…the old idea that they are bad for you because they make your cholesterol go up has been thoroughly debunked), then I will have some porridge oats, perhaps with some berries in them to sweeten them. I know there are people out there who soak the oats overnight. It sounds very worthy, but I just can’t be bothered. I have managed this breakfast 5 days out of 7 this week. This morning I had a bacon egg and sausage bap in a coffee shop with my best friend after we’d been for a bike ride. Yes, I ate the bap. Yes, I added some ketchup. No, I seriously doubt the sausage came from happy free range pigs. Yes, it tasted pretty damn good and I’m fairly sure I will be able to live with myself and sleep soundly in my bed tonight.
I work at my surgery three days a week. Lunch at the surgery is usually bread, rolls, crackers, crisps, various spreads and some veg. Not great if you are trying to eat fewer carbs. So I try to make my own salad for lunch three times a week. This week I have managed it twice. It is usually chicken with lettuce, peppers, tomatoes and a handful of nuts (which have healthful fats in them. This week I had remembered to make my own salad dressing (balsamic vinegar, extra virgin olive oil, tahini and whole grain mustard with a little honey) but if I don’t have any of that, I’ll just use a shop-bought salad dressing or mayo. Yes, they have sugar and artificial chemicals in them but it is still a salad full of protein and colourful veg, better than half a french stick with some paté (although on some days, I do just want the latter!).
I get in from work fairly late on surgery days. Thankfully my wife is also embracing the lower carb diet (quite a lot more strictly than me, in fact!) and this week our evening meals have included steak or burgers with salad, and fish with roasted vegetables. I had a boys night in with two of my kids towards the end of the week and we got a chinese takeaway. I didn’t have any of the rice. I am grateful to my children for being discreet enough not to mention my eating the prawn crackers and enjoying some pancake rolls with the crispy duck.
A little disclaimer about alcohol
I know, I know….. alcohol should be taken in moderation. There is ongoing debate about whether a little alcohol is good for us, or whether we would be better off without any of it. I won’t get into that in detail today. The perfect storm of both unexpectedly good weather, an even more unexpectedly good world cup performance from the Three Lions and our practice summer party last night means that this week has not been entirely typical, for which my liver is truly grateful. I do normally try to drink moderately and to have two alcohol free days per week. If you are going for the low carb approach, it’s probably better to drink wine than beer. At least my drinking rosé at the practice party was therefore evidence based. Sort of.
I get up 15 to 20 mins earlier than I used to so that I can either ride to work on my bike (if the weather is good) or drive to work but then walk for 20 mins into town and back before starting surgery. Getting out in the fresh air gets the day off to a good start. There is evidence that suggests that outdoor exercise is more beneficial than indoor, gym based exercise (for example, one study showed higher levels of serotonin in the outdoor exercisers). I usually walk rapidly to the town centre to get my heart rate up, and then slow down on the way back , practicing walking mindfully (meditation on the go, basically). I will usually try to get out at 20 mins for a walk at lunchtime too, workload permitting. I tell my reception staff where I am going so they can contact me if needed. I figure that if I’m working an 11-12 hour day, 20 mins break in the middle of it isn’t entirely unreasonable! This week I have managed to do this every day I have been at the surgery. One of the other key things that I have been focussing on whilst in the building is keeping moving. It’s often said nowadays that sitting is the new smoking. Research has been published showing that people working in a sedentary job felt better as a result of just keeping moving in the day, getting up and walking around at regular intervals, rather than being sedentary all day and then doing a higher intensity workout at the end of the day….good news for all of us, particularly those that either hate the very idea of the gym or just can’t face it at the end of the day. On the days I was not in the surgery this week, I either rode to meetings at the clinical commissioning group or got in shorter bursts of exercise e.g. going for a run. One of the things I have not been so good at this week is muscle strengthening exercises (which we should ideally do at least a couple of times a week). Check out Rangan Chatterjee’s Five Minute Kitchen workout , if you think you really don’t have time to be physically active.
It can be difficult to relax in this day and age. Your working day may long and intense. Your mobile device will very likely spend the whole day keeping you on your toes with notifications going left right and centre. When we get home at the end of the day, we still have responsibilities and tasks. Even when these are over with, we often have trouble switching off and calming down. We spend most of our days with our sympathetic nervous system in full flight or fight mood. This can be helpful and appropriate for short periods of time, but the changes to our lives in terms of workplace and culture means that we risk being permanently in this mode, with all the associated health consequences of this. Chronic inflammatory responses raise the risk of all kinds of disease including heart disease, autoimmune disease and cancer.
So what have I done to relax this week? Firsty, I have turned notifications off on my phone. I briefly suffered from FOMO (fear of missing out), before transitioning through to blessed relief. It’s fascinating what a little tweak like this can do for you. Secondly, I use music as self medication every day. This is helpful for so many people. Personally I prefer listening to ambient, electronic music and jazz to chill out. I have lots of playlists I have created on Apple Music, and listen to the radio stations that you can set up based on your favourite music. Frank Lippman recommends Bob Marley in this podcast on How To Be Well with Rangan Chatterjee. This weekend my entire family have been away and whilst I have missed them all, I have taken the opportunity to be selfish and enjoy a lot of me-time. I have spent this afternoon sitting in the garden listening to a Jose Gonzalez album (link here for those of you that have apple music) whilst writing this blog, which I find relaxing , believe it or not! Finally, I need to mention the football. I have traditionally found following England in any international tournament for the last twenty years or more a frustrating, anxiety inducing and thoroughly miserable experience. I have been blown away by the team’s performance this world cup and find myself actually enjoying watching them play. Apparently football may actually be good for dementia and mental health, according to this article in the Independent recently.
I’d like to think I’m not bad at 3 of the 4 Pillars, generally speaking. Sometimes better than others, but better overall than I used to be (and half a stone lighter as a result). However, just as Rangan Chatterjee is honest about his hardest pillar being Relax, mine is Sleep. I think this is because I go to sleep within a minute of two of my head hitting the pillow and sleep solidly through the night. I can also get back to sleep quickly after being woken. This was vital in the years that we had our oldest son Luke living at home with us. He has severe complex epilepsy and I was on call for night time seizures from the age of six through to eighteen, until he left home. His worst ever night was fourteen seizures and the next day spent in resus in A&E. I also had to coped with being a junior doctor, being on call for the practice and doing night shifts for the out of hours GP service. We are all different and I probably don’t need as much sleep as some other people…however, I think this has encouraged an arrogance in me when it comes to sleep, combined with the “sleep is for wimps” culture that many of us find ourselves living in. Also because I get in later than most people from work, I feel that I deserve to have time to relax and unwind. Some days this includes enjoying some online gaming with my xbox live buddies when my family have gone to sleep. Before I know it, it can be the early hours of the morning, with work the next day. There is strong evidence to suggest that people going to work tired are cognitively impaired in the same way as those who are drunk or hungover. So sleep is my biggest challenge because I feel that I can function on what I get, but if I’m honest I know I would probably do better if I had a bit more. I’ve had some really good nights this week, and a couple of less good ones.
For those of you that have a sensible bed time but struggle with your sleep quality, there are lots of things you can do to enjoy good quality sleep including turning off screens for 1-2 hours before bedtime (particularly mobile phones), no caffeine after midday, no exercise within six hours before bed time (but trying to be physically active and getting outside during the day). For me, it’s more a question of behaviour change. This includes telling people that I am going to do it (hence this blog post!) , and having a referee to hold me accountable (my wife may well volunteer for this job) and setting alarms to remind me to go to bed. You can even use an app like IFTT (If This Then That) which will link to a device like a fitbit and give you feedback on how well you slept by messaging or notifications the next day. Or I could just go to bed on time………
So there you have it… my wellbeing week. Better than some weeks, not as good as others. Overall though, I know that I am much more aware of these four pillars and what I can do to achieve them. Some measures are for me, some not. I don’t need to hit perfection in every area every day. I don’t need to beat myself up if this is the case. It’s a question of trying things out, learning from my mistakes, and doing these things consistently enough for them to become helpful habits. Whatever I am doing now, it’s more than I was doing before I started on this journey. That can only be a good thing.
For those of you desperately disappointed at this post not being The Weekly Wellbeing Round Up # 4, fear not…it will be back next week! Until then, look after yourself.
Dr Richard Pile