On Being Healthy: Setting Goals

It is a new year and with new years come resolutions. For many years, the most common NY resolution has been to change to a healthy lifestyle, either by losing weight, improving diet, or exercising. Goals without plans of execution are destined to fail. So no matter what your goal is, whether it is to lose weight, exercise, read more, make new friends, do a daily devotional, or find a new hobby, you must have a plan.

1.) Setting Realistic Goals

Goals must be attainable and realistic. When I counsel patients on obesity, they usually have some unrealistic expectation for weight loss. Women especially! (Women, just face the fact that you will not lose weight as fast as your male counterparts. God designed us to hold on to calories in order to continue the human race in the event of famine. So… if you get marooned on an island, you will out live your husband.)

  • So what is a realistic goal? For weight loss centered on lifestyle change, 2-4 pounds a month averaged over several months, for there will be plateaus and dips. For those wanting to read more, start with 1 book if you read 0 last year. If you read 10 last year, increase it to 12. For those wanting to improve diet, pick one thing you will REMOVE and one thing to ADD to your diet.
  • Start small. Accomplish the small goals. Count the victories. THEN improve upon those results. Did you lose 5 pounds in a month? Great! Lets do it again next month. Did you go 1 month without a soda? Great! Now see if you can go 1 month without soda and dessert. Did you get to your book goal by June? Awesome! Double it by December. No one was ever discouraged by meeting goals early, but I have seen many people set too lofty of goals and get discouraged and quit. You must know yourself. Do you have the will power to push yourself to lofty goals or do you need tiny victories to help encourage you along the way?

2.) Be specific.

Do not be vague with your goals. Don’t say “Lose Weight”, instead say “Lose 15 pounds by June”. Don’t say “Read more”, say “Read 5 books this year.” Don’t say “Exercise more”, say “Walk/run/swim/bike 3 times a week for 30 minutes.” Know exactly what you are striving for so that you can celebrate when you achieve that milestone.

3.) Making a Plan

So you set your goal… Now what? You need to come up with a way to get from point A to point B.

  • So you decided to lose weight. Are you going to do that by exercising? Dieting? Both? See below for further specifics.
  • You want to try to eat healthier. What are you going to do? Weight watchers? A fad diet? Paleo? Keto? Whole 30? South Beach? Does heart disease run in your family? Do you need to think about low fat/cholesterol diet plans? What about osteoporosis? Do you need to increase your dietary calcium?
  • You decided to exercise. What type of exercise do you think you will enjoy? When are you going to exercise? Where are you going to exercise? If it is outside, what is your indoor contingency plan?
  • You want to do a daily devotional or quiet time. Are you going to do a guided devotion plan on the Bible app? Are you going to use a Bible reading plan? Will you journal your findings and prayers? Will you do this in the morning or evening? How are you going to adjust your schedule to make time for this?
  • You want to find a new hobby. What are you going to try first? Do your friends have any hobbies you find appealing? What hobbies fit into your lifestyle- budget and time?

4.) Accomplishing the Goal

Celebrate! Do not be ashamed to tell your friends or family. Be proud of what you accomplished. That 5 pounds is great! That one book is a milestone! Walking 30 minutes 2 times a week is an improvement for you!
Do not compare yourself to others because that will rob you of joy or plant a seed of envy.

5.) In the Event of Failure

If you do not meet your goals, take time to reflect to see why you failed. Then alter your plan and try again!

  • You didn’t meet your weight loss goal… So did you cheat on your diet? Fail to stick to your exercise schedule? Did you have some health problems that hindered your ability to exercise? Did your metabolism come to a screeching halt because of menopause? Are you getting empty calories somewhere that you don’t realize? Are your portion sizes too big? Is your lifestyle to sedentary?
  • You didn’t reach your book goal… Did one book bog you down because it wasn’t enjoyable? Did you have a hard time finding time to sit down and read a physical book? Would it benefit you to start reading on a kindle book since you will always have it with you? (Waiting rooms and car pool lines are great for reading instead of browsing Facebook) or listening to audio books on your commute (mine is only 12 minutes and I listened to 60 audio books last year)?
  • You didn’t find a hobby… Did you make time to try several activities? Did you go with a friend? Did you give each activity more than one try? Sit back and reflect on what you truly enjoy. Do you like to be active, still, creative, indoors, outdoors, interactive, reflective? Have you considered things that are not traditionally considered hobbies? Vacation planning, tutoring, volunteering, meditation, yoga, trivia night, board games, wine/craft beer tasting, cooking, yard work/gardening.

Meet the Family

While being a physician brings me great joy, the greatest joy in my life comes from my family. Being a mother has been the most incredible journey. I could not ask for a better partner to parent these kiddos with than my husband and best friend Nicholas.

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Nick is a lawyer by training and a pastor by choice. Our best friends joke that I save lives and he saves souls. He loves what he does and he lives what he believes. He is the most helpful and amazing man and is an incredible dad to our two rascals. I am so wonderfully blessed to have him beside me. We have been inseparable since we started dating. We don’t usually do “guys nights” and “girls nights” because frankly, things are just not as fun without him around and I am pretty sure he feels the same way about hanging out with me. He and I both love to be active. As we have gotten older and acquired more responsibilities (ahem… kids), we have had to be more creative in combining hobbies and quality time. Most people go on dates to the movies or nice restaurants, but Nick and I wake up at the crack of dawn to bike 30 miles on the back roads of Madison County.

We have two kids, Coy (4) and Kennedy Vale (1). My regular patients always ask how my babies are doing. I love to show pictures of them to my patients.

Coy loves to come to work with me and help me “make patients better”. Several lucky patients have been able to meet him on one of the days that he has been successful with those big brown puppy eyes and convinced me to bring him to the clinic. Coy is named after my grandfather Coy. They are two peas in a pod, just like I was with Big Coy when I was little. Coy is an excellent big brother and loves his little sister so well. Coy is also a big sports fan and you can always find him out in the front yard cheering on the neighborhood joggers and playing baseball with his dad.

Kennedy is named after my other grandfather Kenneth. Her middle name Vale, means from the valley. We had a miscarriage between Coy and Kennedy, so after traveling through that valley, we were blessed with our baby girl. Her initials are KVC, which were my initials before I married. I was so excited when I found out I was having a girl. All my friends that have little girls told me how quiet, gentle girls are. Well, this girl broke the mold.  Kennedy also means “helmeted chief”. This girl is SPUNKY to the max. She is “very aggressive” as her big brother says.

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We have two dogs as well. Uno (10) the rat terrier and Moose (1) the boxer.

Uno is Nick’s dog and was around before I came along. He isn’t a big fan of me since I took Nick’s attention away from him. He tolerates me at best. He is an odd little dog and doesn’t like to play. I think of him more as our “house cat” since he basically perches on the back of the couch to keep away from the kids and Moose.

We got Moose for Coy a couple of months after Kennedy was born (terrible idea, don’t ever get a puppy if you have a newborn). Coy is not a huge fan of Moose’s big boxer tongue and Moose has pretty much “imprinted” on Kennedy. For those who are not familiar with the Twilight series, Imprinting is a phenomenon in which two souls (one of which is a werewolf soul) are inexplicably and unavoidably attracted to one another. Kennedy is his person. Do not get between that dog and his girl.

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Why Should Anyone Listen to Me?

So I’ve explained to you what this blog is about. I’ve explained to you what an internist is and what I went through to get there. But the real question you are asking is: “Why should anyone listen to you?”

I am not the smartest doctor you will ever meet. Not even close. But I’m no dummy either. I went to school for a long time to be able to give the BEST care to my patients, but book smarts are not the whole story when it comes to the making of a competent physician. Your physician needs to be able to empathize and relate to you, especially in primary care.

I believe everything I’ve been through in life has helped me to get where I am. We had a professor in med school tell us, “Prepare well, so that you may serve well.” God has been preparing me for this job my entire life. As I reflect back on my life experiences, the joys and the sorrows and the disappointments, it is evident that God wanted me to experience these things that I might relate to people in order that I may serve them well.

I grew up on a farm in the delta. I was the “best son” my dad never had. I worked hard in our yard and on the farm. I ran a catfish hatchery. I painted classrooms. I went to Mississippi College and took med school level classes in undergrad. I studied in the library while my friends were having a “normal college experience”. I usually always had some sort of job during school as well. I coached basketball. I worked in retail.  I hated asking my parents for money. I was grateful for their sacrifice to send me to MC. I graduated with honors, started medical school. I spent 12-14 hours per day in the library those first two years studying to pass the board exams. Studying so that I would be prepared when I had people’s lives in my hands. 3rd and 4th years of medical school were a blur. I performed menial tasks for the residents. I fetched coffee and gauze and tape. I held clip boards for attendings and retractors for hours on end during thoracic surgery and pressure on bleeding wounds. I did patient presentations on rounds and chest compressions during codes. As a resident, I worked 80 hours a week. Every 4th day I would work almost 30 hours in a row.

I know what it means to work.

I saw both of my grandfathers pray for rain on their crops. I saw them pray for dry weather for harvest. I saw them work until the wee hours of the morning on a combine or cotton picker to get the crops harvested before a tropical storm blew in. I saw my dad worry about catfish being “on flavor” and oxygen levels in the ponds dropping on a hot summer night. I saw crops lost and crops made. I saw lean years and fat years.

I know the look of worry and the weight of concern.

I went to Sharkey-Issaquena Academy growing up. I graduated with 16 people. SIXTEEN. I absolutely loved it. We didn’t get to choose our friends. There were not enough students to have cliques. There were no rich kids and poor kids. There were no haves and have-nots. There were no jocks and nerds. I mean, there were kids in all these categories, but students didn’t walk around with labels. We interacted with everyone, pre-K through 12th grade. It wasn’t perfect and there was conflict ( I mean, c’mon, its high school), but the conflict couldn’t really last very long. Who else were you going to be friends with? Then there were the teachers, who either taught your parents or were related to you some how. You couldn’t be a punk in class because your parents were on speed dial. You couldn’t really avoid people in our small delta town, so you did not have a choice but to get along.  I learned so many valuable things at that school, but growing up in this environment allowed me to learn to relate to everyone.

I know how to talk to people, no matter their age, color, socioeconomic status, or level of education.

While I am a doctor, I have also been the patient and I have been the patient’s family many times. I have broken bones and torn ligaments. I have had surgeries. I have been put on low sugar diets. I have worried about lab results. I have been told I worry too much. I have experienced the annoyance of taking medications on a daily basis.  I have experienced the joy of birthing two babies. I have mourned the loss of an unborn child. I have comforted my best friends during their battles of infertility. I have cried tears of joy with them as they finally entered motherhood. I have slugged through the misery of losing “baby weight”. I have lost weight unintentionally and so fast that it was concerning to those that loved me. I have seen a parent go years without any physician being able to explain what was wrong with her. I remember the relief of finding an answer and the disappointment that there was nothing to be done about it. I have “slept” on the uncomfortable couches in Batson Children’s Hospital as my 2 week old received treatment. I have rushed my husband to the emergency room as he was experiencing anaphylactic shock. I have heard my mom utter the words, “its cancer,” and felt the numbness that takes over your body and then you hear nothing else that is said. I have heard the doctor say, “there is a good chance its curable”.  I have received the phone call,  “my numbers are up again”.  I have met my grandfather on the helipad as he was flown in for an emergent heart cath during a massive heart attack. I have seen family and friends struggle with addiction. I have felt the searing pain of suicide. I have lost a grandmother suddenly. I have watched a grandmother slowly languish away from dementia. I have sat in an exam room with my child and discussed the possibility of a rare disease.

I know the joy, hope, pain, grief, shock, struggle, worry, anxiety, and fear of the medical world.

Most days, it is easier to be the doctor than the patient. God knew what he was doing when he set my feet on this path. He has directed my steps and I know that I have experienced all of these things so that I may better serve my patients.  I may not be the smartest doctor you ever meet, but I know a few things and the learning never ceases. I will work tirelessly for my patients. I can talk with my patients, and listen to them, and recognize their looks of worry and concern. I can empathize with my patients, because I have experienced many things that they have or will experience.  I hope and pray that through this blog, you may find encouragement, motivation, healing, knowledge, and comfort.

“All praise to God, the Father of our Lord Jesus Christ. God is our merciful Father and the source of all comfort. He comforts us in all our troubles so that we can comfort others. When they are troubled, we will be able to give them the same comfort God has given us. For the more we suffer for Christ, the more God will shower us with his comfort through Christ. Even when we are weighed down with troubles, it is for your comfort and salvation! For when we ourselves are comforted, we will certainly comfort you. Then you can patiently endure the same things we suffer.”

2 Corinthians 1:3-6

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What the heck is an Internist anyways?

In short, I take care of adults who do not need surgery (though if you should need surgery, I have several on speed dial and can get you in quickly). I am the one who takes over your primary care when your pediatrician tells you its time to move on. If you want the long version, please continue reading.

If you are an adult and you have any of the following: diabetes, high cholesterol or high blood pressure, depression or anxiety, the flu or a cold, allergies or headaches, then you can come see me! Our office doesn’t generally operate as a walk-in clinic. We prefer you to make appointments. We like to get to know our patients so that we can best help you as you age. We also understand that problems arise acutely and we try to keep slots open to fit in our patients who wake up with a sore throat or need to be seen that day. But that is just what I do. The making of an internist is much more than just “adults who don’t need surgery” and not all internists practice the same way.

The Making of a Physician
First, I need to explain to you the training we go through as physicians. There are so many members of the healthcare team in this age of modern medicine. Many patients do not know the difference between a physician, a nurse practitioner, a physician’s assistant, a nurse, a medical assistant, and a radiology tech. There are so many people that go in and out of the rooms in the clinic and it is even more so that way in the hospital. Each person has a role within the healthcare team. I am writing to highlight the training of a physician, not to belittle any of my other medical team members.

How to become a physician:

  1. Complete 4 years of undergraduate education and you usually need to major in a science based degree since most requirements for medical school entry are in biology, math, and chemistry.
  2. Apply and get accepted to a accredited medical school. You must maintain >3.5 GPA and score well above average on the MCAT. You must also be well rounded and have plenty of extracurricular activities and volunteering on your resume.
  3. Complete 4 years of medical school. You must pass 2 USMLE Step board exams which are 8-12 hours each.
  4. Match into a residency program. Shortest residency programs are 3 years long and the longest, which is neurosurgery, is 7 years long. Residency is very closely supervised practice of medicine. Every decision made by the residents are scrutinized by their attending physicians.
  5. Pass a 3rd USMLE Step exam before completing residency, which is another 8-10 hour test.
  6. After residency is complete, take a board exam the board certified in a specific specialty which is another 8 hour test.
  7. After residency, there is the option to further sub-specialize, which is an additional 1-3 years depending on the fellowship program.

So in case you weren’t keeping count, by the end of residency, physicians have 7 years of post-college education and 20,000 hours (at minimum) of training under their belts. This is what makes physicians the experts in medicine and leaders of the healthcare team.

The Making of an Internist
An internist is a physician who completed a residency in Internal Medicine. We treat non-surgical problems in adults. Cardiology, gastroenterology, rheumatology (specializes in disorders of the joint and autoimmune diseases), infectious disease, endocrinology (specializes in hormonal disorders), pulmonology (lung specialist), geriatrics, allergy and immunology, hematology (specializes in blood disorders and cancers), and oncology (specialist of cancer) are all sub-specialties of internal medicine. As an internal medicine resident, most of the training is focused on very complex patients in an inpatient setting. I did the Primary Care track of our internal medicine program because I fell in love with my weekly primary care clinic when I was an intern, and that allowed me to get a little bit more experience in outpatient settings prior to graduating.

My Journey in Internal Medicine Thus Far
I was very fortunate to be able to stay in the Jackson area and practice with five well established internists in the community. They were excellent mentors and I will be forever grateful for their role in shaping the way I practice medicine.

When I started in 2015, we still were practicing “traditional medicine” where we would admit our patients if needed and round on them in the hospital. With all of the new requirements, electronic medical records, and other various forms of red tape along with an aging patient population, we soon realized that this was not going to be a sustainable way to practice very much longer. We turned our admitted patients over to the hospitalist teams and focused on seeing our patients in clinic. I hope that one day the paperwork and red tape vanishes and I am able to return to a traditional practice. Until then, I will continue to work with my fantastic team to provide the best care possible to my patients in the clinic.

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Welcome to Ask Your Internist!

Ask Your Internest with websiteWhat is the purpose of this blog?

  • I desire to create a place for my patients, friends, and family to access reliable and applicable medical information. There is so much bad information on the web. In a sea of online voices, very few are reliable. I battle against medical myths and bad home remedies that people get from the internet on a daily basis.  I have nothing to sell, and I strive to provide unbiased advice for my patients. Also… the flu shot will not give you the flu. More on that later.
  • I will accept suggestions from readers on topics to write about, but I will not be answering direct questions. If you have a medical concern or question, please seek out advice from your physician.
  • If you are my patient, please respect doctor-patient boundaries and call us during office hours or make an appointment. (I love you all, but this is a hobby and I’m not opening that can of legal worms.)
  • Please use this information to help you in your journey to become healthy, but this is not intended to treat or diagnose conditions. This is in no way an appropriate substitute for an actual visit with your physician.

**This is not a blog intended to diagnose or treat medical conditions, but to be a resource for information. If you have a medical concern, please contact your primary care physician.**

Why would you spend time doing this?

  • See above. I battle bad information on a daily basis. It bothers me to the core when I see my patients getting off track due to bad information that they read online.  (Side note: check your facts before sharing an article on Facebook.)
  • I had a blog in medical school. I enjoyed writing, and I miss it. This is somewhat therapeutic for me.
  • I also love to learn. You can’t make it through medical school without this particular hobby. I hope to learn new things and practice strategies to help me help my patients as I go along.

What type of information can I expect to find here?

  • I plan on posting topics in medicine, recipes, and  tips for living a healthy lifestyle.
  • I also plan to share some of my experiences. You may get a post on an incredible book that had a significant impact on me . You may see me post about a great local coffee I tried. You may get to hear about a workout class I went to try out. You’ll absolutely hear a funny story about my kids! This is supposed to be educational for my readers, but also a bit of therapy for me!
  • I also have friends who are doing some really incredible things across the world. I plan to do several interviews a year so that I may learn about their missions and ministries and I will share them with my readers!

Who will be posting?

  • Naturally, I will be writing the majority of the posts. Usually in a Q&A format. In this world of twitter length attention spans, I will try to keep my answers concise, yet fully informative. That is not always possible, so be patient with me.
  • Occasionally, I will ask a physician colleague to do a guest post in their area of expertise.
  • I am also looking for advice from nutritionists, dietitians, personal trainers, yoga instructors, etc. Anyone who is considered an expert in promoting a (medically proven) healthy lifestyle may wind up posting! I want there to be plenty of variety for my readers.