Healthy Physical Activity . . . One of the 4 Foundations of Self-Care

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In celebration of Burnaby’s Move for Health Day this Wednesday, May 10th, join our family doctors and community members of every age for the Burnaby Division of Family Practice’s 2nd annual Walk With Your Doc.

I’ll be presenting a free talk, “We Were Made to Move” at 6:30 pm at the Confederation Community Centre. This will be followed at 7:15 pm with an easy Walk With Your Doc around the Confederation Park track. You’ll learn about the benefits of exercise, how it can improve your enjoyment of life and your ability to do everyday activities, and how you can make daily physical activity a new healthy habit. All members of the public of any age are welcome to join our team of Burnaby doctors as we walk the talk! Each participant at the walk will also get a free pedometer (while quantities last).

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Most people – including patients and healthcare providers – may think of healthcare as what doctors, nurses and other allied health professionals do for you. Although it is our role to partner with you, giving you the support, knowledge and resources to make informed decisions and achieve your personal health goals, I believe the bulk of your healthcare is self-care: what you do for yourself – when we’re not watching.

The four foundations of healthy self-care are (1) healthy eating (or consumption) – what you put into your body, including alcohol, drugs and tobacco; (2) healthy physical activity, (3) emotional wellbeing and (4) healthy relationships. Think of your self-care as what you eat, what you do, how you feel and how you relate.

Regular physical activity is so essential to health that doctors will be walking the talk during the week of May 10th – the World Health Organization’s Move for Health Day.

The Doctors of BC is supporting doctors for the annual Walk With Your Doc events in communities across the province. Physicians are volunteering their time to walk and talk with their patients and other members of the community of any age.

The message is simple: physical activity is important to your health, and walking is one form of activity that most of us can do.

Over recent years, more doctors are literally writing prescriptions for exercise, and there’s even a global organization called Exercise is Medicine. A typical dose is 30 minutes of moderate exercise (such as walking) in single or divided doses 5 days a week. Of course, every prescription has to be tailored to individual preferences and conditions.

The key message is that regular exercise can be as potent as pills in preventing disease, maintaining your health, managing chronic conditions and extending your life. But some of my patients would rather pop a pill than start exercise to lower their blood pressures.

Yet you don’t have to wear running tights, cycling shorts or a swimsuit, and you don’t have to go to the gym. The variety and range of healthy physical activity is broader than formal exercise alone.

To many, exercise is a dirty word. They associate it with work, pain and the school gym classes of their childhoods.

You can reap the benefits of physical activity doing many of your regular household chores: mowing the lawn, doing the laundry, gardening, raking, mopping, sweeping and vacuuming.

All these activities get your feet moving and use big muscle groups. Watch out for marathon sessions of chores. Mowing the long grass for the first time in the spring, raking and composting can be a grueling triathlon. To avoid injuries warm up, stretch and pace yourself. Break up big jobs into smaller ones. Take breaks and stay well hydrated.

Walk whenever you can – up and down the stairs, around the block, to visit your neighbours, to run errands and get to the park. Dance to your favourite music.

To celebrate Move for Health Day in Burnaby on Wednesday, May 10th, Burnaby’s Healthy Community Partnerships Committee has organized a variety of health-related events. During the day, the school district has planned a community walk with some elementary school students and Moscrop school will have a health fair for its own students.

For all adults, we have a Community Wellness Fair from 2 to 4 pm at the Confederation Seniors Centre at 4585 Albert Street in North Burnaby. There will be great displays, people and resources to help you lead a healthy, active life.

Burnaby Parks and Recreation offers a variety of free activities at our pools and community centres throughout the day and evening. For more information check online at burnaby.ca.

I’ll be presenting a free talk, “We Were Made to Move” at 6:30 pm at the Confederation Community Centre. This will be followed at 7:15 pm with an easy Walk With Your Doc around the Confederation Park track. You’ll learn about the benefits of exercise, how it can improve your enjoyment of life and your ability to do everyday activities, and how you can make daily physical activity a new healthy habit. All members of the public of any age are welcome to join our team of Burnaby doctors as we walk the talk! Each participant at the walk will also get a free pedometer (while quantities last).

To register or learn more about the Doctors of BC’s Walk With Your Doc events in communities across the province, check walkwithyourdoc.ca.

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Dr. Davidicus Wong is a Burnaby family physician.

 

Posted in Burnaby Division of Family Practice, Empowering Healthcare, Exercise, Healthy Living, patient-doctor relationship, Physical Activity, Preventive Health | Tagged , , , | Leave a comment

Your Story and How You See Yourself: Implications for Personal (and Global) Wellbeing

 

Tapestry Talk

On Friday, April 7th, 2017 at 7 pm, I’ll be speaking at the Vancouver Convention Centre East, 999 Canada Place in Vancouver as part of the Tapestry Foundation for Health Care’s public presentation series. My topic: Going Beyond Old Stories – Exploring, Engaging and Evolving into Our Positive Potentials.

I’ll talk about exploring your personal story and the stories of others, engaging in the understanding and unfolding of your life story, and how our understanding of self, others and life can evolve as we transform our selves and our world towards our positive potentials. See more at http://www.tapestryfoundation.ca

One of the key determinants of physical and emotional health – and therefore, happiness itself – is our sense of belonging – our connection with our community.

Yet most of us go through our lives as distinctly separate individuals. Siblings compete with one another (as do spouses). We begin our lives in school focused on individual achievement (or failure). In sports, we compete with an “us versus them” mindset.

Competition spreads to every part of adult life. We compete for jobs to earn more and get ahead. We compete for our homes. We fight traffic in our daily commutes. What is traffic? Other people.

We compete as we compare ourselves with others, and we judge others – just as we know others are judging us – by the clothes we wear, the cars we drive and the symbolic prestige of particular mundane items of utility – phones, shoes, purses and watches.

When we follow this mainstream way of thinking, the natural conclusion is we all lose. By the end of this life, you will lose all you have gained. Everything you have built will one day be gone, and in a few generations, your name will be forgotten. What’s the point of it all?

How you tell your personal story – how you see yourself and how you relate to other people and the rest of the world – impacts your emotional wellbeing and your capacity for enduring happiness.

The inescapable truth is this: you are not a separate, independent individual; you are a global citizen interdependent with every other person on this planet. Your wellbeing is dependent on the wellbeing of others.

The “me against the world” and “us versus them” story disconnects us from others and dehumanizes them; they become objects in the way or objects to be used. In reality, we have more in common with every other being on this planet than we realize.

We each have hopes and dreams, pain and pleasure, joys and sorrows. We experience the same range of emotions and we are all subject to illness, misfortune, aging and death. We can unconsciously adopt maladaptive core beliefs and get stuck in narrowed points of view, yet we each have the capacity to change and grow.

This recognition can awaken compassion. We share our vulnerability, and we share our responsibility.

The big problems of our society and the world will never be solved by people – and countries – looking out for themselves. As long as we see one another as separate and competing individuals, we will continue to see abuse, crime, homelessness, hunger, terrorism and war.

When more of us realize our interdependence and connection with the global community and all life on this planet, we will see the positive evolution of humanity and life on Earth. It begins with you. Together let us be the change we wish to see.

On Friday, April 7th, 2017 at 7 pm, I’ll be speaking at the Vancouver Convention Centre East, 999 Canada Place in Vancouver as part of the Tapestry Foundation for Health Care’s public presentation series. My topic: Going Beyond Old Stories – Exploring, Engaging and Evolving into Our Positive Potentials.

I’ll talk about exploring your personal story and the stories of others, engaging in the understanding and unfolding of your life story, and how our understanding of self, others and life can evolve as we transform our selves and our world towards our positive potentials. See more at http://www.tapestryfoundation.ca

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Caring for the Caregiver

On Saturday, March 25th, 2017 from 10 am to 3:30 pm, I’ll be joining a number of other speakers at the Burnaby Seniors Outreach’s Caregiver Expo at the Bonsor Recreation Complex, 6550 Bonsor Avenue, Burnaby. For more information, call (604) 291-2258 or check the website at www.bsoss.org.

On Friday, April 7th, 2017 at 7 pm, I’ll be speaking at the Vancouver Convention Centre East, 999 Canada Place, Vancouver as part of the Tapestry Foundation for Health Care’s public presentation series. My topic: Going Beyond Old Stories – Exploring, Engaging and Evolving into Our Positive Potentials. I’ll be talking about the challenges of evolving positively in an ever-changing, unpredictable world to achieve our highest potentials and support others in achieving theirs. See more at http://www.tapestryfoundation.ca

Caregivers take on a role on top of their other roles in life. They may need to manage the financial, medical and household affairs of a family member while still attending to their own. They may be sandwiched between caring for their growing children and their aging parents. There is only so much time. You only have so much energy, yet you remain on call 24/7.

Many adult children look after elderly parents, uncles and aunts and see it as paying back for the love and care they received as children. Sometimes our feelings towards our family members are mixed. None of us is perfect as a child or a parent. We all make mistakes and we easily fall into patterns of behavior and rigid ways of relating to our family members.

Sometimes family members may resist the change in roles. In the face of growing disability, they may struggle for their independence and refuse the help they need. They may persist in the role of being in charge though they may lack the capacity to make appropriate decisions.

Caregivers therefore experience a mix of emotions. While still caring deeply, they may feel frustration and resentment with their roles and how they are treated. Outstanding issues in their past relationships may add further conflict to their lives today.

At times, the demands of caregiving can be overwhelming, and as family members’ disability and dependence increase as it always does, there inevitably will be a point when you can reach your limit. You may break down in tears, lose your temper or feel like giving up, and when this happens, you may feel guilty about it.

Caregivers of course are at risk for Caregiver Stress. They need to be aware of the signs and symptoms and know when and how to get the help they need.

Over time, chronic stress can lead to a sense of helplessness, which is associated with anxiety. If this persists, we may acquire a sense of hopelessness, which in turn is associated to depression.

These feelings in turn will shade our thinking, influence our behavior and impact our capacity to help ourselves as well as our family members.

When we are suffering from anxiety, we will be prone to panic. Our thoughts may be more disorganized and we may be preoccupied with worries. We underestimate our resources and abilities. We overestimate our challenges. We will have difficulty sleeping. We may catastrophize – imagining the worst case scenario – everyday.

When we are depressed, we may feel weepy, dejected and hopeless. Physically, we may have changes in our appetite and sleep. We will feel tired, lethargic and unmotivated. We may stop enjoying the little pleasures in life. Our concentration and memory may suffer. We may be pessimistic about ourselves, our lives and the future.

If you recognize these signs of distress, anxiety or depression, speak to your family doctor soon. Don’t delay and put your health last. Remember: your wellbeing will affect your ability to care for others.

With chronic conditions, we have to recognize that there may be a time when we are no longer able to care for our family member at home. Ideally, we would have these discussion early on, discussing as a family possible scenarios for future care either with homecare support or residential care at a long term care facility or assisted living. Another option is respite care – a short-term stay at a residential facility for a weekend or a week. This may allow the primary caregiver to take a much needed break.

The conversation should start early because we really want to respect the preferences and values of the individual. If we wait too long, our family member may no longer be capable of making important decisions.

 

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We All Need Inspiration

On Saturday, March 4th at 10 am, I am again honoured to celebrate Inspiration Day with Century House at 640 Eighth Street in the heart of New Westminster. Call (604) 519-1066 for advanced tickets. For only $6, you can enjoy a nice snack, a good laugh from the Laughter Zone 101 Senior Comics and a healthy dose of inspiration.

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We each need inspiration to move us through this life – to awaken from routine, meet life’s challenges and reach for our potentials.

Inspiration gives us vision – opening windows to new possibilities: what you can do with this life. It is a lens that transforms what we see in the mirror, in the face of another and our hope for the future.

It can give us courage – to persevere in the face of illness, misfortune, failure and loss; and to do what we know to be right.

What would life be without inspiration?

Imagine childhood without magic, families without love, working without meaning and living without passion.

We’d be diminished by age with each passing year, surrender to illness, be defeated by disability and leave this life with a whisper.

There would be no path to follow, no beacon to guide us, and no hope to climb higher. There would be no reason to find that little extra within our hearts and give more of our selves to the rest of the world.

On Saturday, March 4th at 10 am, I am again honoured to celebrate Inspiration Day with Century House at 640 Eighth Street in the heart of New Westminster. Call (604) 519-1066 for advanced tickets. For only $6, you can enjoy a nice snack, a good laugh from the Laughter Zone 101 Senior Comics and a healthy dose of inspiration.

Even if you can’t make it, treat yourself to one of the seven wellsprings of inspiration.

  1. Heroes. Growing up, my role models were Superman, Batman and Spider-Man. Superheroes and the bigger than life characters of mythology and our great religions reflect the human journey through life. Their stories reflect the challenges we face and the call to have courage, find our unique voices and do what is right.
  2. Models of Human Achievement. During my school days, I spent many hours at the McGill branch of the Burnaby Public Library inspired by the great figures of history who showed us what a human being can achieve. The words and actions of Martin Luther King Jr. and Gandhi continue to inspire generations.
  3. Everyday Heroes. Heroes walk among us. They are the ordinary people like you and me who choose to do extraordinary things; they express courage and perseverance in the face of overwhelming adversity and perform selfless acts of generosity and compassion.
  4. The Inspiring People in Your Personal Life. My greatest inspiration remains my mother. Though she passed away nearly 14 years ago, she continues to set my standards for morality and compassion.

She was literate, outgoing and kind. She was the most thoughtful person I have ever known. She not only looked after the needs of our family but she would be concerned with the wellbeing of every person she knew. She always gave more than she got.

She was the most honest person I have ever met. If given extra change, she would walk a mile back to the grocery store. She would always do what she knew to be right.

My mother taught me the importance of family. At age nine, she and her siblings were orphaned, and with both parents gone, the children decided to work hard to keep the younger ones fed and clothed until they had all finished school.

My mother had faith in me when I did not. She looked after me and encouraged me as I battled with rheumatoid arthritis. She believed I could do great things if I persevered. My mom and dad gave me freedom to discover my own talents and supported me in nurturing them.

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My mom inspires me still with the selfless, unconditional love she gave me. It remains her legacy, and I aspire to give that same love forward to my own children and to evert human being I can touch.

  1. Those We Serve. My patients have made me a better doctor. Their trust and confidence in me inspired me to be the best physician I can be. My golden rule of medicine is to treat each patient with the care I would expect for my family. My children have taught me humility and what matters most in life. Becoming a parent inspired me to be the best person I can be.
  2. Your Calling. Joseph Campbell called this “following your bliss” and it is your gift to the world. Your calling is where your unique passions, talents and values intersect with the needs of the world.
  3. Love. Love, kindness, compassion and goodwill come in many forms. I measure success by how well I have loved others. At the end of the day and at the end of life, that’s all that really matters.
Posted in Happiness, Positive Change, Positive Potential, Purpose, Your Calling, Your Goals | Tagged , , , | Leave a comment

What You Need to Know About Heart Disease

Central Park Lake 1

A young man at the pool asked me, “Why does blood get thicker with age?”

After telling him this wasn’t true, I asked where he got the idea.

“All the older men in the steam room are on blood thinners.”

Those men had an irregular heart rhythm called atrial fibrillation. Their doctors had prescribed anticoagulant medication to prevent blood clots in the heart from going to the brain and causing strokes.

This was an example of the common confusion about heart disease . . . and the general quality of health education in the community.

Every other organ of your body depends on the heart. It is both a muscular and electrical organ. The heart pumps blood to the lungs, and then it pumps oxygenated blood to all the tissues of the body.

The heart has its own built in pacemaker and its muscle tissue conducts the electrical signal to coordinate the contraction of the four chambers of the heart

Are you at risk for heart disease? Yes, we all are.

Two of the biggest risk factors for heart disease are beyond our control: age and genetics. The good news is that other risk factors are modifiable; these include high blood pressure, diabetes, high cholesterol, smoking and physical inactivity.

And even though having a sibling or parent with heart disease increases your personal risk, the knowledge of your family history can help you and your physician proactively reduce your risk, identify problems early and better manage any chronic condition.

There are four major types of heart disease: (1) coronary artery disease, (2) valvular heart disease, (3) arrhythmia and (4) heart failure.

The coronary arteries are the blood vessels that deliver oxygen-rich blood to the heart muscle. When one of these arteries are completely blocked, the area of the heart downstream is starved of blood – and dies. The result: a heart attack.

When a coronary artery is partially blocked, the area of heart muscle downstream receives less blood than it needs. The result is ischemia (decreased blood flow) and angina (chest pain). The symptoms include chest pain, fatigue and shortness of breath with activity.

Arrythmias are abnormalities in the rhythm of the heart beat or contractions. With tachycardia, the heart beats too fast; with bradycardia, it beats too slow. We can have premature or early beats and pauses or delayed beats. The symptoms of arrhythmias include chest pain, shortness of breath, palpitations or fainting spells. However, many patients have no symptoms at all.

Heart failure is a decline in the pumping ability of the heart. The symptoms include fatigue, shortness of breath on exertion and when lying flat, waking up at night short of breath, weight gain with fluid retention, and edema or swelling of the feet and legs.

The heart has four valves that allow the one-way flow of blood between the atria and ventricles (chambers of the heart) and through the aortic and pulmonary arteries. Valves can be narrowed (called stenosis) or leaky (called regurgitation).

To learn more about “What You Should Know About Heart Disease”, come to my next free public lecture on behalf of the Burnaby Division of Family Practice’s Empowering Patients series. You’ll learn if you are at increased risk, practical tips to reduce your risks and how to maintain your best health in spite of heart disease.

I’ll be speaking on Wednesday, March 1st at 7 p.m. at the Bonsor Community Centre at 6550 Bonsor Avenue in South Burnaby. Register online with lcullen@divisionsbc.ca or call Leona at (604) 259-4450.

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Your Happiness and the Value of Goals

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The stage of the musical, Frozen at Disney’s California Adventure in Anaheim, California.

It’s the time of the year when I’ll be expecting patients coming in with new goals to improve their health. Many will be keen on starting a new exercise routine, eating a healthier diet, reducing alcohol or quitting smoking.

But for the rest of us, it will be business as usual. Most of the patients I care for will present one or more problems to be diagnosed, investigated or treated. These could be physical symptoms, relationship difficulties or challenges in their life circumstances.

Our brains are attuned to identifying problems. We see more of what’s wrong than what’s right. This negativity bias is part of our evolution. Our ancestors survived because they were able to detect problems and dangers early.

For most people today, our negativity bias is not such an advantage. In fact, it can lead to dissatisfaction and conflict in our relationships. Who wants to live with someone who can’t get anything right, and who can live with one who always finds fault?

Whereas appreciation and gratitude bring greater satisfaction and happiness, seeing the cup half full brings misery.

All of us want to be happy, but most of us look for it in the wrong places.

If your happiness depends on getting everything you want you may never find it or you won’t be able to keep it. The trick is to be happy with what you have and engaging with the world to achieve your positive potential.

In part, it is a way of being and seeing – being present and seeing with appreciation even that which does not last.

Consider the quick passage of the past year; life and all that we experience are fast and fleeting. Opportunities arise and pass away, and so do people, including our selves and those we love.

I love the work I do, helping my patients solve their problems, but my patients and I are most engaged when we turn those problems into goals. Problems can make us feel like helpless victims of life. When we transform them into our personal goals, instead of running from or struggling against what we don’t want, we move towards what we envision.

When a patient is struggling with anxiety, I may ask, “What is your goal? What does happiness look like to you?” “Is it seeing yourself managing and mastering the challenges of each day?” “Is it experiencing a sense of abiding peace and calm?”

When one is depressed, the goal may be to see one’s self and life with acceptance and gratitude, and to be engaged in meaningful activity.

Consider your values and your greatest virtues, and set your goals. Visualize with all your senses what success and happiness look like. Create a plan of action to get from here to there, and take at least one firm step each day in the direction of happiness.

As part of the Burnaby Division of Family Practice’s Empowering Patients I’ll be presenting a free talk on “Emotional Wellbeing” at 7 pm on Wednesday, January 11th, 2017 at the Confederation Community Centre in North Burnaby. Everyone of any age is welcome to attend. Please preregister by calling Leona Cullen at (604) 807-2372 or e-mail lcullen@divisionsbc.ca.

 

 

Posted in Emotions, Empowering Healthcare, Growth, Happiness, Healthy Living, Positive Change, Positive Potential, Purpose, Self-care, Your Calling, Your Goals | Leave a comment

How Do You See the Stress in Your Life?

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Stress is part of every human life, but it’s not necessarily bad.

Positive stress motivates us to change, get things done, learn and grow.

Without the gentle wake up calls from Mom and Dad, my kids may not have made it to school on time. Without their homework and exams, they wouldn’t be motivated to study. Without ambition, we wouldn’t push our limits and achieve our personal potentials. Without discomfort with the status quo, we wouldn’t be motivated to change the world.

Yet stress unrecognized or not managed is negative. It can take its toll on our bodies and our minds.

Consider how you experience stress. It can take the form of physical symptoms, such as a racing heart, palpitations, heartburn, diarrhea, constipation or insomnia. It can affect your thinking, making you more irritable, negative, distracted or forgetful. It can impact the quality of your work and your relationships.

The amount of stress in your life can tip the balance from positive to negative. For example, if a course or a job is too easy for you, you’ll be bored. If the demands of your job match your ability to meet them, you’ll be in a happy state of flow. But when the demands exceed your time or ability, you’ll feel stressed. I see this often in my patients whose workloads increase as companies downsize.

How we think about stress can influence how we experience it. The key is the locus of control. If we feel that we have no control over our situation, we begin to feel helpless, and helplessness begets anxiety. If we feel our situation will never improve, we may feel hopeless, and hopelessness begets depression.

Both anxiety and depression shade thinking and narrow perspective. When anxious, we overestimate our challenges and underestimate our ability to manage them. When depressed, we see the worst in our selves, the situation and the future.

We may fail to see the way out.

So how does this apply to you and the stress in your life today? How can you get out of the negative spiral from stress to anxiety and depression?

Start with your perspective. Take a step back and assess your situation. Consider the locus of control. What aspects of your situation are within your control? Accept what you cannot change, but accept your responsibility to change what you can.

In every situation, we have three potential choices: leave it, change it or reframe it. It may not always be possible or easy to leave a job or a relationship. Even if we cannot change a situation, we can change our perspective on it.

Part of our emotional reaction to a situation is due to the facts of the situation, but a large part of our reaction is due to what we bring into it. That baggage includes our memories of the past and our preconceptions.

In almost every situation, we can be agents of positive change. In big or small ways, we effect positive change in our world and in our selves.

 

Posted in Balance, Emotions, Healthy Living, Self-care, stress management | Leave a comment