I’m on day 7 of a week on call today, so will be glad when I can turn my phone off overnight tomorrow! It has been moderately busy, with some very interesting cases. The most worrying of these from a selfish perspective was the patient my age with a heart attack. If they had lots of risk factors that would have been more understandable, but there were none. I’m nearer 50 than 40 now, so I guess it just goes with the territory. Seeing cases like this gives me even more incentive to make good lifestyle choices, as whilst there are things like contracting cancer which are beyond my control, I can certainly stack the odds in my favour for heart disease.
I expect many people’s new year’s resolutions have something to do with health. Whether it’s stopping smoking, doing more exercise, eating more healthily, whatever. I’m fascinated by behaviour change: why do some people appear able to makes changes while others struggle? Why do we desire change in the first place? Are there things we can do to increase the likelihood of success?
I read some interesting work on the subject this week which I wanted to share as it really resonated with me. The starting point is to make the trigger to do ‘the thing’ obvious, available, and visible. For example, a dusty exercise bike in the corner of the garage is unlikely to get used. A dumbbell by the TV might just get picked up. Vegetables nearing their use by date in the back of a cupboard are less likely to make their way to your plate than fruit on the counter.
This however brings me to point 2. Having bananas on your counter won’t get you to eat healthily if you don’t like bananas. ‘The thing’ must be appealing and attractive to you. I think this is easier with food where most people could find some options that are healthy and tasty. Exercise I think is harder, as many people simply don’t like it very much, if at all. If that is you, google ‘types of exercise’ or ‘list of sports and activities’, then go through it until you find something. There are so many options that something hopefully will fit.
Point 3 though, is that ‘the thing’ must be easy, convenient, simple. Picking mountaineering is great, if you live near some mountains. If you live in Dorset, it’s a pretty hard habit to make a permanent, regular part of your life (not withstanding the Purbecks which are pretty hilly!).
Lastly, ‘the thing’ needs to be satisfying and enjoyable. Once you have finished that healthy plant based, home cooked meal, do you look back and feel satisfied? When you’ve had that first jog, do you feel it was worth it?
All of these things are more likely to make ‘the thing’ stick. However, we are human, and we will slip up. When we do, be self forgiving. Beating yourself up will simply make you less likely to try again. I have found this myself with my exercise programme – giving myself a hard time if I miss a workout. The only person that hurts is me, and I’m much better now at saying to myself ‘you’re good most of the time, give yourself a break.’ Something I have found useful here is – don’t miss ‘the thing’ twice. If I’ve skipped a workout, even if I really don’t want to, I’ll force myself to do a mini one the next time it’s due. ‘Mini-anything’ is easy to achieve, and helps add to the sense of identity we feel about something: for example thinking ‘I am a person who works out’ or ‘I am a person who eats healthily’.
The environment we are in also has a huge bearing on how likely we are to follow a good habit. Think of ‘home ground’ vs ‘away ground’ rules. If I’m playing at home, i stick to the rules. If i’m away at a hotel, I’m eating that full English, with croissants to wash it down!
Lastly, be accountable to someone other than yourself. It’s far easier to let ourselves down than someone else. I discussed this with a patient only 2 days ago, who was struggling to commit to any exercise whatsoever. We spoke about arranging to meet his son for a walk outdoors next week. By committing to meet his son, that was something that he admitted he was unlikely to break. My wife and I committed to each other to improve our sleep this year, and so far so good (but still work to be done!).
The most important step however is to have decided to make a change, to have critically appraised the status quo and pledged to do something differently.
My video this week demonstrates the pathological process involved in heart arteries as they get ‘furred up’, what we call atherosclerosis. This has been filmed, and should be up on the website this evening, or latest tomorrow. I hope you enjoy it, and if needed, it serves as a good motivator to make some positive lifestyle changes. If that resonates with you, why not employ these strategies to help you on your way?