Sunday, November 29, 2009

This blog has moved!!

Hi everyone!

Just wanted to let you know that we are still alive and well... we have started a new blog:

http://www.mediatherapyblog.wordpress.com/

This blog will discuss much of the same topics that have been discussed in the Lose Weight For Life blog (which we will not be writing in regularly anymore).

We have finished a movie and published a book and are excited to use the "media" to help with healthy change, i.e. smoking cessation and weight loss!!

Check out: http://www.mediatherapy.ca

Remember that we still have Lunch Club on the third Wednesday of each month at NRGH in room B224. This is a time to discuss anything related to lifestyle and healthy behaviour change.

Take care,
Dr.P

Sunday, August 16, 2009

Lunch Club cancelled for August

Hi all!

Hope your summer goes well!

Just wanted to let you know that there will be NO Lunch Club this month because we are on Vacation (V in CRAVED no more!)...

For health, we all need balance...

Coming next month, we will be releasing our book, First You Smoked, Now You Live, and movie to help hospital inpatients quit smoking. Stay tuned!

Health and happiness.

Dr.P

Wednesday, July 22, 2009

Walk With Your Doc Fridays - Week 4

Hi gang!

My apologies for this late entry...

I was too PRESENT with my holidays and the busyness of returning to work...

I had not been thinking about the FUTURE and this blog, until I saw BH. She reminded me that she was checking the blog!!

She has been implementing a number of the strategies we had discussed over the month!! That's awesome BH!!

On our 4th and final week, we discussed the Time Paradox which is a new book that discusses how we all perceive time so differently. It turns out, those who are caught with problematic behaviours, have too much of a PRESENT orientation. They are not as weighted (pardon the pun!) in FUTURE thinking; the ability to think (and feel) about future consequences or the sweetness of future rewards (delayed gratification). They are stuck in time, in the hedonistic or fatalistic PRESENT and are unable to get free...

Fascinating stuff!

That is why with this program, we have been looking at the past and future in a different light...

In your handy, dandy notebooks we asked you to write out some of your more noteworthy Accomplishments or Powerful Moments (positive past). As well, looking to a Compelling future by envisioning a successful future; looking and feeling fitter, healthier and ______'er... then Chunking each step down on how to get there, i.e. walking 15 to 30 minutes a day, eating breakfast and making healthier choices (you get the idea).

Lastly, we discussed how not to get hooked on cocaine (apparently it's good stuff?)...it's because we see and feel that the future (Creepy) Consequences are so distasteful, that it turns out to be not a great (present) choice...

So if it takes envisioning a future of more disability like more pain from osteoarthritis or the development of full blown diabetes from your current behaviours then there is more fuel in your tank and motivation to stick with some of these new strategies.

We also planned as a group to reconvene on the second Friday in September (the 11th)... this will be a time where you can be Accountable for changes in your measurements. BTW, DH and the team from the IHN would be happy to check in with you over the summer. Let me know by e-mail for contact information.

I wanted to thank the IHN team again for their involvement in this pilot program...I had a lot of fun and hopefully you did too!

Remember CRAVED no more!

Keep me posted on how things are going, my e-mail is d.poteryko@gmail.com

Have a healthy and happy summer everyone!

Dr. P

Monday, June 22, 2009

Walk With Your Doc Fridays - week 3

Hi everyone!

My apologies for the late blog, I was playing ice hockey with my brother and spent Father's Day with my Dad in Vancouver this weekend!!

As you can see, I was doing some of the things I VALUE, like exercise (ice hockey) and family.

This week, we talked about doing the things which we value as a way of helping with lifestyle change.

As it turns out, values are your hot keys and if you honour them while you make lifestyle changes then you are well on your way. Feelings of guilt, shame or regret are usually signs of not valuing your values!

We also talked about how certain eating behaviours can sometimes be viewed as an addiction (thanks for sharing SB!). Many of the same brain pathways and neurochemicals (can you say DOPAMINE!) are involved in both.

As with addiction recovery, it takes a VARIETY of strategies to help with lifelong healing.

We did some DEEP BREATHING (4-6-7 technique).

We talked about cleaning toilets and other things. We know that we have to do some things (i.e. EXERCISE for health), but the fun thing is to ADD something to it to help it

We DETACHED or DISTANCED from food by continuing to use food logs or take pictures of what we are eating (say cheese!)...

Lastly, we started to understand feelings and how important they are and to ACKNOWLEDGE them if one wants good EMOTION management.

HOMEWORK this week included:

1) continue to use a food log or take pictures of your food
2) DEEP BREATHE (use an hourly chime on a watch)
3) walk or do ACTIVITY of 15 minutes a day, and don't forget to ADD something to it to help (i.e. music, a friend, a small REWARD when done!)
4) keep an EMOTION log daily, figure out at any given time how you are feeling...try and identify the feeling (i.e. happy, at peace, sad, anxious, blah, etc.), ACKNOWLEDGE it and move on! Use your spiral notebooks!
5) have FUN!!

Take care,
Dr.P

BTW Here's a good website for organic vs safe foods:
http://www.thedailygreen.com/healthy-eating/eat-safe/Save-on-Sustainable-Gallery-44032808

Friday, June 12, 2009

Walk With Your Doc Fridays - week 2

Hi everyone!

Another great walk!

This week we talked about WHAT to eat. The new (it's 2 years old) Canadian Food guide can help show you the way (including portion sizes)...and it's free!

http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/index-eng.php

Again, choosing more whole fruits (fresh or frozen berries anyone?) and vegetables, whole grains and choosing less meat (more poultry and fish please!) and animal protein helps with healthy weight. We also talked about the importance of calcium and vitamin D.

In terms of resources, the Nutrition Action newsletter is great for healthy food information.

The IHN team has a dietitian (V), who would be happy to answer your questions. Let me know by e-mail if you wish a consult.

Today we also talked about goal setting and CHUNKING down the steps needed to achieve our goals. As said, even though we are in a group, we are all on our own separate journeys and hence we will do different things to achieve success. Thanks to SG for her thoughts and handout on personal goal setting.

With that, I want you to "Detach from the result," much like what BH was asking...we are NOT losing weight here...we are becoming fitter, healthier, slimmer, curvier (you pick the 'er)...forget about the weight loss stuff and concentrate on the steps for health, i.e daily physical activity, better food choices and better emotion management.

We handed out a VALUES list this week, they turn out to be the "hot keys" to behaviour change. There is no such thing as a right or wrong value, but when our behaviours and our values are aligned - nothing can stop us! Try and pick out your top 5 or 10...

HOMEWORK for this week includes:

1) At least 15 minutes of daily physical ACTIVITY, i.e. walking for the week. Go at your own pace.
2) DRINK at least 4 glasses of water (or herbal tea - try out the green/white blend!) a day.
3) Be more mindful of the Canada Food Guide and EAT more fruits, vegetables and whole grains...if you want the weekly checklist, let me know.
4) Value your VALUES and choose the 5 or 10 which are most important to you. Here's a challenge, try and find out what are the values of your partner/friend/family member.
5) Think of and VISUALIZE a COMPELLING FUTURE, ANTICIPATED EVENT or REWARD (VACATION anyone?) where you are healthier and having the time of your life!
6) Don't forget to DEEP BREATHE, a great way to slow down and refocus! 4-6-7 technique rules!
7) Keep on logging your food log or better yet, take pictures of what you are choosing...It's a great way to help DETACH like the "leaving something on your plate" exercise.
8) Don't forget to do the PHQ-9 health questionnaire. More on mood, EMOTIONS and feelings next week!

Make sure you use your spankin' new spiral notebooks for these activities...

Have a healthy week!

Dr.P

Friday, June 5, 2009

Walk With Your Doc Fridays

Hi gang!

It was great seeing and walking with everyone today!

As said, we will use this blog as a resource; a place to see what we covered this week and check the HOMEWORK exercises. Remember with the exercises and this program, it's like a smorgasbord, give something a try and see if you like it!

This program is a pilot and would not be possible without the involvement of our team from the Integrated Health Network (DH, WB and SG)! Also special thanks to SW from the Practice Support Program for helping us with the initial concepts!

You are all pioneers with this new kind of medical practice and we appreciate your time and interest!


Remember, we are not losing weight anymore. We are becoming fitter, healthier and curvier/slimmer/happier (pick any ___er!)...

The program is to be FUN and not fear-based...This week we discussed WHY we eat (besides for survival)…some other reasons included pleasure, stress, social, boredom, low mood, environment, our family...We learned about DOPAMINE, the little neurotransmitter which causes all sorts of "good" things...How it is involved with eating and procreating...How it can be misused and overused in addictions.

HOMEWORK this week includes:

1) write out 1 day food log (everything you eat in a day and why)
2) try and leave something on your plate or glass at 1 meal a day
3) be more mindful of water intake (this includes green/white tea)
4) think of 3 to 5 of your most Accomplished or Powerful Moments (it can be anything, anything that you feel good about like when you learned how to ride a bike, getting your driver's license, graduation, getting your first paycheque, getting married, having children...you get the idea).
5) daily Appreciation (every day think of three moments or people you appreciate and are grateful for)

And don't forget to write them down in your spankin' new notebooks!!

See you next Friday at 1PM at Anchor to walk about to NRGH!

Take care,
Dr.P

Sunday, May 17, 2009

Lunch Club is moving to Wednesdays!!

Hi all,

Hope you are all having a healthy and happy spring!!

I wanted to let everyone know, due to changes in my schedule that Lunch Club will be moving to Wednesdays (i.e. May 20th)... still the third Wednesday of the month at 12:00 noon in room B224 at NRGH...same bat time and same bat room!!

Hope to see you there!

Dr.P

Tuesday, March 17, 2009

Lunch Club March - Positivity anyone?

Hi gang,

It was nice to see everyone today...

There was some good discussion on a great many things.

We talked about how the CRAVED no more mnemonic is a great tool to keep us on track.

We talked about clinical depression and how it can slow your progress.

http://www.bcguidelines.ca/gpac/pdf/depression_full_guideline.pdf

Pages 11 and 12 are the Patient Health Questionnaire (PHQ - 9) which helps identify depression... if you or someone you know may have depression, then one should consult a healthcare professional for further help.

We also asked: "What will prevent me from achieving my goals?" as a great way to uncover the positive aspects of current behaviours...this may also lead to further therapy so that you can do it!

Lastly, we talked about Dr. Barbara Fredrickson's book, Positivity, which covers the tangible tools (ways of thinking and doing) needed to help with positive and fulfilling emotions. Can you say CRAVED no more?

Curiosity, Experimenting and being open will help lead the way. Connecting with others. Contributing, Volunteering and Random acts of kindness. Healthy Distractions (physical Activity, i.e. walking; crafts; reading; journaling) are helpful. Appreciating Nature (20 minutes a day will keep this Doc away!). And lastly, Disputing negative thinking.

On negative thinking, the best way to take another look at what is said is to ask: "What would my best friend say to me in this situation?" I'm sure it will be kinder, gentler and more encouraging!

Today our group made monthly goals: K - will eat more vegetables, PS and RP - will be physically Active 15 minutes a day 3X/week and KM - will become fitter and healthier by 1, and Dispute her negative thinking, by being kinder...

Have a great month!!

See you on the 21st.

Dr.P

Wednesday, February 18, 2009

Lose Weight For Life - week 7

Hi LIFEstylers!

It may be the end of our night program, but it is only the beginning of positive lifestyle change!

Thanks to everyone for their interest, it was an honour and pleasure!!

As said, we are not done...we will reconvene next Tuesday the 24th at noon in room B224 at NRGH in Ambulatory Care to award LIFEstyle keychains to those who complete their 21 day SUCCESS Charts. This is the usual time for our monthly support class called Lunch Club...which meets on the third Tuesday of the month in room B224...it's a time to review and discuss any challenges you may have with "becoming fitter, healthier and _____'er" (you can't get rid of me that easily)...

Tonight, we gave you a primer for the CRAVED mnemonic...things to do or ways of thinking to help shift to a more empowering state of mind.

We talked further about Reverse (R in CRAVED) or paradoxical thinking...terms like "I am such a LOSER!" can be viewed as a negative or a positive...it all depends on your point of view...When it comes to healthy weight change the answer may be more than Eating healthy and regular Activity. It lies in a Variety of things...

We talked about precontemplation, contemplation, preparation, action, maintenance and relapse as ways of looking at any behaviour change...They are called the stages of change made famous by James Prochaska. We are hopeful that we continue in Action phase, but know full well and Acknowledge that relapse can happen...it's important to identify where you are at and then "get back on the bike!"

We supplemented supplements by saying that calcium carbonate and vitamin D are important as well as the fact that probiotics are beginning to show promise with digestion and health...

We also discussed Eating Out and how that it can be a happy and healthful experience...

http://www.webmd.com/cholesterol-management/guide/healthy-choices-when-eating-out

Lastly, we handed out graduation certificates tonight which included a 1 week pass to the pool/gym at Nanaimo Parks and Rec. - special thanks to Damon Johnston for his time and efforts to make this program possible!!

We'll see you at NRGH next Tuesday at noon!! Remember that our class' Day 100 will be Tuesday, May 26th at noon at NRGH...

Take care,
Dr.P

P.S. Some great books to help with behaviour change are Changing for Good by James Prochaska (for EP!), How to Stop Worrying and Start Living by Dale Carnegie and The Power of Positive Thinking by Dr. Norman Peale.

Wednesday, February 11, 2009

Lose Weight For Life - week 6

Hi ho LIFEstylers!

Tonight we did a little Reverse (R in CRAVED no more) or Paradoxical thinking...

We tried our (collective) best to not talk about Eating healthy and Activity.

They are both definitely important for significant change, but they are not the only answer...as we said, it takes a Variety of options to make healthy lifestyle change stick for good!

We talked about Credibilty and how buying a used car can challenge this concept...To help build self-Confidence, it takes making a Commitment and staying on course to become "fitter, healthier and _____'er." Your 21 day SUCCESS Chart is living proof of this change!

We also discussed how to enhance and improve Relationships...understanding the Commonality (of Values), a little Active listening, Eye contact and Acknowledgement/Validation can go a long way to help with this...being able to hug (Embrace) in your more intimate relationships can be a booster!

Lastly, we talked about Accomplishments and Adding as ways to help motivate. When it comes to the things we may not want to do right away, but are important like cleaning the bathroom (or regular Activity like walking)...try rating out of 10 how much you will enjoy/like doing the activity before you do it (i.e. 3 out of 10)...then go ahead (grumble...grumble) and do it...now rate it...invariably the score will be higher! The funny thing about us humans is that we enjoy Accomplishing things...no matter how mundane it may be we get an emotional life when the job is done! Adding to the activity like music or with a friend makes it more FUN!

When it comes to changing the Environment...it's much easier than changing your mind...Your mind will follow gladly! The challenge for the week is to leave every environment (room, outside, etc.) a little more neater/tidier (i.e. Clean the Clutter) than when you first found it. You'll start to feel good doing this!

For HOMEWORK:

1) continue your 21 day SUCCESS Chart, if completed, you will be eligible to pick up a brand spanking new LIFEstyle Clinic keychain on Tuesday, February 24th at noon at NRGH (room B224)...
2) clean your bathroom...rate it out of 10 before and then after...you'll see how easy it is to Accomplish!
3) Change your Environment. Clean the Clutter even if you Chunk it down and clean only one drawer in a messy room...you are on your way!

Have a healthy week.

Take care,
Dr.P

Wednesday, February 4, 2009

Lose Weight For Life - week 5

Hi gang!

Tonight......we talked about Rest and Retire (to bed for sleep that is!)...Both are vital for weight and stress management. In today's fast-paced world, we are sacrificing the zzzzzz's for other things. We also found out that poor sleep can be a factor with weight gain. Can anybody say grehlin? If you or a loved one stops breathing at night or snores excessively then you may want to check with your family physician. Especially if your Epworth score is 10 or more. There are simple and effective treatments available. Good sleep hygiene can go a long way for good health.

Your goal of becoming "fitter, healthier and slimmer/curvier/_______'er" just got easier by using a SUCCESS Chart to plot your Accomplishments. Remember to Chunk it down for lifelong success!!

Your LIFEstyle challenge (for a rare LIFEstyle Clinic keychain) is to do a 21 day SUCCESS Chart with 3 vital behaviour changes (a food choice, environmental/behavioural and Activity)...Remember from last week's Tips #1 sheet...that is the gold standard, if you are hitting all of those behaviour's and food choices you will be maximizing your success...but as said, we want to build your Confidence, so better to choose small and achievable goals before we move on to loftier heights!

As said, this course is for life...if you apply these principles...you will achieve your goals!!

Homework for this weeks includes:

1) design your 21 day SUCCESS Chart with 3 new changes (1 food choice (Eat healthy), 1 environmental/behavioural and 1 Activity, i.e. walk 15 minutes every other day).
2) try Resting for 5 to 10 minutes a day in the middle of the day...you may find your energy and concentration soaring!

Have a wonderful week!

Dr.P

Wednesday, January 28, 2009

Lose Weight For Life - week 4

Hi LIFEstylers!

Tonight we reviewed VALUES (V in CRAVED no more!)...as said, there is no such thing as a right or wrong value...some of the class' VALUES include: HEALTH, FAMILY, CHILDREN, INNER PEACE, (SELF-)ACCEPTANCE, CREATIVITY (which can be in many different forms!), ECOLOGY, GRATITUDE, LEARNING, HUMOUR, RATIONALITY, SELF CONFIDENCE and WEALTH.

As said, now that we know what we value...if we honour our VALUES daily, we will find making positive behaviour changes much easier!

We handed out the "Tips #1" sheet...this is the gold standard for weight change...if all of the behaviours are followed to the letter for the next 21 days then one can get the greatest results (paired with regular Activity)...but as said, "slow and steady will also get you there!"

Remember if you have DIABETES, I want you to check your sugars regularly and stay closer to the Canadian Food Guide as we discussed last week.

As noted, I am not a dietitian, but would be happy to re-refer you to the hospital's clinic.

Lastly, we talked about "SUCCESS Charts" to help give you emotional and physical traction to show how far you have come to build and strengthen your self-Confidence (a CRAVED letter) and self-efficacy.

For this week, 1) pick one food choice which brings you closer to your goal, i.e. eat 1 or 2 more vegetables/fruits, drink more water/green tea, etc., 2) choose one Environmental/Eating behaviour change which can include plate/utensil size, writing out your eating log, eat a breakfast, location, i.e. kitchen only, 20 minute rule, 7PM rule, etc. and lastly choose an Activity each day or every other day...even if it is 5 minutes of walking - it's a good start! Try out your new pedometers (now that's Rewarding!!)! Special thanks to Donna at the IHN!

At the end of each day, check your Accountability...So for this week:

January/February 29 30 31 1 2 3 4 ____________________________________________
Daily walking 5 10 5 15 10 15 10
(minutes)
____________________________________________
Eat something
for breakfast x x x x x x x
____________________________________________
Drink water x x x x x x
(1 glass)
____________________________________________
Eat 3 fruits x x x x x x
per day
____________________________________________

Remember your SUCCESS Chart will not be perfect (who is?).

Also VISUALIZATION can be wonderful tool with motivation and resolve...so making a bulletin board and put your Accomplishments (and SUCCESS Chart!) or inspiring pictures on it to help keep you focused...the fridge door is a great place to put "I'm getting fitter, healthier and curvier!" This visual tool can help show you and Remind (another CRAVED word!) how far you have come!

HOMEWORK this week includes:

1) being mindful and living by your VALUES daily
2) making a 3 behaviour SUCCESS chart for the week which includes one new food choice, one Environmental/eating behaviour and increasing Activity (try out your new pedometers!)
3) continue to Deep breathe daily (even hourly)

Have a wonderful week!

Take care,
Dr.P

Wednesday, January 21, 2009

Lose Weight For Life - week 3

Hi LIFEstyler's,

Tonight, we learned some of the HOW's of eating..."to become fitter, healthier and _____'er."

As said, the term diet is not a good one...increasing one's better food choices is the key. Remember that everyone is on their own journey (it is NOT a race), how fast you go with the changes suggested is up to you.

For behaviour change to stick life long..."slow and steady will win the race!"

There was much discussion tonight about the number of servings suggested for healthy weight change. Interestingly, these are the numbers suggested by the Canada Food Guide with the exception of 2 to 4 grains (half) instead.

http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/index-eng.php

We also discussed how environment plays a key role in our eating behaviour. Changing utensil and plate sizes, eating in the kitchen only, using the 20 minute rule and drinking 6 to 8 glasses/cups (green and white teas are great choices) of fluid a day are helpful.

We also learned about the very useful CRAVED mnemonic tool. It helps us kick our "animal" behaviours to the cortex before we get into trouble...

We did some Deep breathing (D in CRAVED) with some upper body stretching...The shoulder scrunch is great for stress relief when it's in the neck and shoulders!

Tonight we learned about Values (V in CRAVED). They turn out to be the "hot keys" to behaviour change. There is no such thing as a right or wrong value, but when our behaviours and our values are aligned - nothing can stop us!

For HOMEWORK:

1) determining what your top 10 Values are
2) making food choices which are more aligned with the Canada Food Guide with the exception of grains (2 to 4 servings)...just remember that slow and steady will win in the end!
3) write out 2 more days in your food diary
4) try and increase your physical activity; it can be as simple as increasing your walking from 5 minutes a day to 10 minutes or 20 minutes every other day

Have a wonderful week!

Dr.P

P.S. On HOW to eat, Dr. Joey Shulman's book, "the last 15" is another wonderful resource.

Wednesday, January 14, 2009

Lose Weight For Life - week 2

Hi gang!

Tonight we reviewed what the 3 F's (food, fornication and fun) are...and how they help survival and DOPAMINE.

We also discussed that you are no longer going to lose weight anymore, but instead become "fitter, healthier and curvier/slimmer/sexier/happier, etc. (you pick the ____'er)." As it turns out, the unconscious mind (which really runs the show!) only processes positives. So by stating the desired behaviour change in the positive, it is easier to move towards something versus away from it.

We also talked about WHAT to eat. As noted, I am not a dietitian, and if you wish further dietary information the free Dial a Dietitian is available at 1-800-667-3438.

The new Canadian Food Guide is also a good resources.

http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/index-eng.php

We talked about CARBOHYDRATES (simple and complex), PROTEINS and FATS. All are essential for health and wellness. We also showed you a number of food items which may not be as good for you as their label suggests.

We also learned how to do the clinic's DEEP BREATHING technique, the 4-6-7 technique. It can be a wonderful stress reliever and way of becoming more mindful when required.

For HOMEWORK:

1) DEEP BREATHE x 3 daily
2) try and do physical activity on a regular basis; it can be as simple as walking 5 minutes a day or 10 minutes every other day
3) use your new gifts, your eating log, for 2 days this week

Next week, the FUN really begins when we'll talk about HOW to eat!

Have a wonderful week!

Take care,
Dr.P

Wednesday, January 7, 2009

Parks and Rec. Week 1

Greetings LIFEstylers,

It was nice to meet you all!

As promised, we have developed a blog to help with your journey of becoming fitter, healthier and curvier/slimmer (pick any ___er!)...

We will give a brief overview of what we discussed in class as well as review your homework for the week ahead.

The program is to be FUN and not fear-based...

This week we discussed WHY we eat (besides for survival)…some other reasons included pleasure, stress, social, boredom, low mood, environment, our family...

We learned about DOPAMINE, the little neurotransmitter which causes all sorts of "good" things...How it is involved with eating and procreating...How it can be misused and overused in addictions.

Homework for week 1 was:

1) fill out GREEN medical history form
2) do your baseline measurements (waist, height and weight) and put them on the GREEN form
3) 2 day food log
4) leave something on your plate or glass once a day

Have a wonderful week.

Next week, we will discuss WHAT to eat...

Take care,
Dr.P

P.S. On HOW to eat, Dr. Brian Wansink's book, "Mindless Eating," is a wonderful resource.