CRNA Wellness: Beverages are Making Us Fat

Driven to Drink?
The 6:30 a.m. drive-through line is long but the beverage baristas inside have got the gig down. Take the order, take the money, write on the cup, hand it off and move’em forward. Just across the overpass to our medical center, Starbucks customers line up bumper to bumper on their way to work. And another of the Seattle-based ‘bucks right inside the entrance to the med center picks up the slack. Mmmmm, creamy, sweet, warm…what’s not to like about lapping up your favorite frap on the way to tackling a heavy work schedule? Answer: The heavy part. Beverages are making us fat.

Getting Juiced
Let’s start with juice. Orange juice and the members of its expanding family, are loaded with sugar. They may be fortified with vitamin C, added calcium, or may contain those magical anti-oxidants that didn’t make it into your lunch bag, but most juices are also fortified with sugar, frequently over 15 grams of sugar per 8-ounce serving. An 8-ounce glass of Tropicana original orange juice has 114 calories. 70 calories are sugar and though it may satisfy 96% of your daily requirement for vitamin C, there is only a tad of added calcium and a smaller tad of vitamin A. Ounce for bounce, the payoff isn’t there. A fresh orange, however, has a much lower 62 calories of which 48 are natural sugar(fructose), and it provides 116% of your necessary vitamin C. An orange supplies twice the natural calcium as juice, three times the vitamin A plus 3.1 grams of natural fiber. Plus, you get to chew!

There are entire aisles devoted to fruit- flavored beverages in bottles, boxes and cans in your shiny, upscale grocery chain, but nothing satisfies your body’s needs like fresh, whole fruit, the more color and the more variety, the better. If ya just hafta have your bananas and berries in a beverage, get out the blender and give it a whirl. You won’t need to sweeten the pot.

Smooth Move
Blenders are used for making the smoothie. Originally, the smoothie was a fruit and ice beverage, sometimes with added sugar. Although it debuted as a beverage in the 1930’s, Wikipedia says that the term smoothie/smoothy was actually conjured up by the hippies, though I don’t remember seeing any at Woodstock, and that California, with its ready access to fresh seasonal fruit was the original venue for vending it. Now we blend smoothies choosing from yogurt, protein powder, kale, carrots, blueberries, strawberries, milk…the list is endless but the calories are increasing with the options. It isn’t difficult to find a smoothie shop right around the corner from your produce market, only you’ll drink close to 300 calories if you buy it already made. Go back around the corner, concoct your own smoothie and you take control. To get through a busy day in the OR and still get your nutrients, a smoothie is a great choice. Opt for low fat, no sugar-added, skimmed-milk, light yogurt or water-based, make either fruit or veggie drinks, and avoid expensive, high-calorie add-ins. If your smoothie is meant to enhance your work-out, a tablespoon of protein powder is a fine idea. If dessert is a smoothie, go back to the original 1930’s recipe by using simply fresh fruit and ice. Eliminate the sugar and pour it in a six-ounce wine glass. Now that’s a juice bar!

Are You a Soda Jerk?
Coke, 7-up, Pepsi, Dr. Pepper, Sprite, Mountain Dew, Orange/Strawberry/Grape/Teenage Crush(just checking to see if you’re reading closely), Cream soda and Root Beer are just a few of today’s and yesterday’s beverages-that-make-you-belch. For some reason, we get a kick out of slugging down that nutrient-free, sweet, fizzy bev and emitting a healthy g-blurp! within seconds after downing the drink. But colas do not satisfy thirst. They are wet and sometimes wild, but the ingredients are more de-hydrating than satisfying. If you choose a caffeine-loaded, high-sugar cola bathed in dark dyes, you are headed for more thirst after drinking than before. And you just slurped up at least 96 calories per 8 ounces. A 12-ounce Classic coke is 144 calories and the same fluid measurement of Pepsi or Dr. Pepper weighs in equally at 150. Don’t forget, there’s sodium in them thar streams of sugar and diet sodas have even more. When you just want a little something sweet, a clear soda is the better choice, and a tall, glass, glass of iced cold water is best of all.

The Buzz
Alcoholic beverages are a whole other fast track to fat. We try to jump-start the day with coffee; we imagine we’re getting a nutrient-dense kick with juice; we substitute meals and assume we’re enhancing exercise with smoothies; we pretend to quench our thirst with sodas; but there’s no denying the reason for consuming that 16-ounce margarita or two 6-ounce glasses of Menage e Trois…red or white. It’s recreation. Recreational drinking isn’t a sin, but be aware and compare. One 4-6 ounce glass of red wine is typically 120-150 calories, no worse than a large serving of crunchy, sweet, juicy, red seedless grapes full of fiber and dessert-like qualities, but hey, I only said, “Be aware!” White wine, though lower than red in calories by 25%, does not supply the same number of nutrients as red wine, obviously. Think spinach and mushrooms, dark and light. But neither red nor white is great for metabolizing fat… it’s alcohol, after all. You’ll still need to drink plenty of water and skip the sucrose to avoid those heart-pounding chest rhythms. And do you really want your morning mouth to feel like a cardboard balloon?

Hard liquors are worse for you than wine. If you insist on preserving your right to imbibe the hard stuff, keep these things in mind. On a regular diet of hard drink, Your tummy will get soft fast and your red nose may qualify for holiday hire. Above the others in calories ounce for ounce, more toxic to your internal organs, completely free of nutrients, and potentially more addictive than adult beverages with lower alcoholic content, hard stuff is a poor choice all the way around. Particularly if you are on a wellness program that includes weight loss, deep six the Ten.

There are those who think that a nice cold one quenches the thirst after a nice hot one. It doesn’t. You will not cool down by drinking two pints of Fat Tire after mowing the yard or after playing baseball for two hours. But you can get a fat tire. Beer does not re-hydrate; it doesn’t even hydrate; it is not a substitute for water. What’s not to understand? And if you have any interest at all in a flat tummy, fresh, sweet breath, skin that isn’t sticky and smelly and sweaty at bedtime, and if you’d like less opportunity to make a fool of yourself during Sunday afternoon’s TV Testosteronathan, then load up on water before watching the game, drink at least a quart before playing in one, and don’t touch a beer after mowing until you’ve fully re-hydrated with agua fria. That beer-belly syndrome? It’s nasty-looking, it’s high-risk and it’s for real. Try Sparks.

Be-hold!
Here’s a last word about the extent to which industry here in the States has embraced the beverage boom. Behold the cup holder! We are so dependent on doing something with our hands that nothing with wheels passes market inspection unless it sports a holder for a cup. Nothing with wheels is exempt. There’s a cup holder in your car, your truck, your child’s stroller, your grocery cart, your golf cart, your bicycle(okay, safety issue, fair enough), your yard wagon, your oversized cooler, your computer bag, your rolling backpack, your commercial bus, train or plane tray, and your beach roller bag, not to mention purses, fanny packs, exercise belts, cardboard drink holders…the list is endless, but not surprising, at least in the USA. In Germany, a Bavarian Motorwerks standard issue comes cup-free, but in Spartanburg, SC, BMW assembles the high-end European parts and adds cupholders, “nur fuer uns!”

You Can Lead a Person to Water, but Can You Make ‘em Think?
When you are offered “something to drink,” do you think coffee, water, or a shot of Jack?
Okay, so that may depend on what kind of day you’ve had in the OR and whether it’s
6:00 a.m. or p.m., but, truthfully, if you are a two-fisted cola consumer, a caffeine dependent addict, a juice bar fly, or a regular consumer at Friday Nights Live, it may be time to balance your beverage accounts. Click on some of the links below to read some nutrition facts and beverage tips’info. Start thinking about what, why, and how much you drink BEFORE you drink it. A flat tire is a lot easier to fix than a fat one. Prost!

Compare the Keurig Chai Latte to the Starbucks Frappuccino

Click here for Smoothies

How many calories in a glass of wine? Click here

How many calories in a non-alcoholic beer? Click here

What drinks cause dehydration? Click here

The truth about green tea…Click here

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Liz’s Bands In The Park mobile browser, a perfect companion for your walking or running group.

Make the Most of the AANA Meeting in San Francisco

Boston, Seattle, San Francisco, Honolulu, Jackson Hole, San Antonio…there are some amazing destinations for anesthesia meetings right here in the USA. Most of the venues are places where there is a long list of thing s to see and do. And all of the destinations provide plenty of opportunities for you to stay active.

Run For Fun

AANA’s annual meeting has been offering a 5-K fun run for just under a decade. It’s an easy 3.1 mile course along the city’s most scenic route with shuttle service provided start and finish. Runners, walkers, strollers (those are the people who stayed up late the night before) are all welcome and you’re the celebrity. Beautiful surroundings, beautiful celebs, and a free t-shirt as beautiful as t-shirts get, make all that exercise a beautiful bonus. Sometimes the local ANA offers early morning fitness classes at the host hotel with leadership provided by CRNA’s who apparently enjoy waking people up as much as putting them to sleep. Click here for the AANA wellness run in San Francisco

Take Your Bands

Exercise bands are almost as easy to use as they are to pack. You can do a complete work-out in your hotel room, in the hotel gym, in a park, at the beach or looking out over the harbor in Seattle or Boston. All you need is two or three bands, a doorjamb, railing or a pole to anchor them, a little backpack to carry them, or a waist small enough to tie them around your middle. With access to cool water and a hotel-sized washcloth, aka sweat rag, you’re good to go. Bands weigh less than an I-pad and they pack flatter than a ten-dollar bill.

Rent A Bike

One of the best ways to see your city and get some great exercise at the same time is to rent a bike. Google “bicycle tours in Vancouver” or “rent a bicycle in Austin” and refine the search from there. Be sure to use the word bicycle because otherwise you’ll end up with Harley Suzuki as your travel companion, which might be a blast, but you won’t get much exercise unless you fall off and have to walk back. You may be able to get a private, guided bicycle tour – more money, of course, but if you like to be at the head of the class asking questions, money talks and the expense will pay off. Click here to learn about bike rental in San Francisco.

Many cities have initiated bike-share programs. This service goes by a variety of names – like Q-bikes in Portland, B-cycle in San Antonio, or simply Bike-share in Boston – and features a fleet of bicycles that anyone can use. Just swipe your credit card at the vertical terminal, release one of many bikes from its locked stall, then ride it on marked cycling routes throughout the city, or directly to a destination. Parking stalls and routes are indicated on maps at each bike installation so you won’t get lost. Each time you stop to sight-see near a bike-share stall, just slide the bike into a rack, it locks automatically, and very shortly it will become someone else’s exercise partner. The beauty of the service is that it generally doesn’t require a helmet. One of the drawbacks of the service is that it generally doesn’t require a helmet… AND if you have to wait for a bike to become available when you’re in Brooklyn, you could be late for cocktails in the Bronx. Click here to learn about community bike share in San Francisco.

Walk

If you didn’t download a city map and a printable walking tour before leaving town for your meeting, you can ask your hotel concierge to highlight the best walking destinations on a brochure and outline some routes for you. Check things off on your brochure as you go so you don’t miss the major attractions, and don’t be afraid to get off the beaten path. Make note of noteworthy and eccentric establishments as your cabbie whisks you through the city from the airport, then go back and find them on your feet. You’ll run into the best coffee art cafes, the most interesting old houses, and charming little corner stores that you won’t find on Tourist Avenue. You may burn enough calories to almost justify the mouth-watering apple fritter you found at Dave’s Sugar Shack not to mention the energy you’ll have the rest of the day just from staying on your toes. If Rick Steves or Lonely Planet has published a travel guide for the city you’re visiting, it’ll be a quality purchase, and when it rains, you can walk the halls, climb stairs between 2^nd and 12^th, or go to the hotel fitness club. Remember to pack your Nike’s and your fitness duds so you can avoid blisters and excuses. Click here to learn about walking tours in San Francisco.

Go to The Fitness Club

One of the criteria for selecting a hotel is the quality of the fitness club. Every large hotel in a large city has a fitness center and some of them have glitz galore. The Omni in San Diego, the Sheraton in Seattle, the Sheraton in Boston, even the Holiday Inn in Columbia, MO all have exceptional facilities for working out. Check online or talk to the actual hotel desk staff before you reserve your room and ask about these items: Cardio equipment(treadmills, elliptical trainers, lifecycles, walking tracks); strength-training equipment(training circuit, free weights, vertical bands stations); abs room or abs corner (mats, fitballs, body bars, medicine balls); and towel service as well as a decent-sized pool. Gym-rats are going to get to the facility early, so go really early or go a bit late, but get going.

Your anesthesia meeting is a place to learn more about your ever-changing industry but it’s also a place to have fun with old friends and to make news ones, a place to experience a new city in a new way. Hike Aspen Mountain, jog the stairs next to the San Diego Convention Center, power walk the promenade while cruising between glaciers in Alaska, cycle from Fenway Park to The Old South Church. You won’t be putting anyone to sleep or trying to stay awake for one whole week. Go make the most of it!

You can visit Liz at www.bdyfrm.com and learn more about her Traveling Bands comprehensive work-out indoors or out, and how to gain access to the Bands In the Park mobile browser. Read motivational, entertaining Lizlines every weekday including the weekly original Lizlimerick.

CRNA Wellness: Heat and Hydration

Some very important things come as pairings: Your hair might be colored salt and pepper; it frequently rains cats and dogs; the OR has its ups and downs; Chez Paul offers wine and cheese. And summer? Summer pairs heat and hydration. As the temperature soars along with the humidity, here are some things to help you stay hydrated and withstand the heat.

The standard daily drinking water prescription for adults is eight glasses – that’s eight eight-ounce servings and varies by little from one body type to another. Add extra activity or summer heat to the mix and the recommendation increases to nine or more glasses. Move to an arid climate or humid tropical haven, and set RX-it a glass higher. You don’t need to drink until your food floats (see dilutional hyponatremia) but if you wait until you FEEL dry and thirsty before refilling your tank, you’ve waited too long to refill.

Click here to learn more about avoiding dehydration

Drinking water in most countries outside the USA is served without ice and often at room temp. Although it remains part of the drinking debate, there is a certain amount of logic in drinking your beverages at room temperature, even tepid. But the American Council on Sports Medicine recommends cold water to challenge metabolism and burn the most calories. Others say that water is water; just get wet.

When I counsel clients on their nutritional needs, I encourage them to up their intake of watery vegetables and fruits. Raw, grilled or steamed tender crisp, between all those tiny turgid veggie cells are gazillions of antioxidants wrapped in high-fiber packages and dressed in vibrant, low-calorie color. Stylin’ as well or better than their veggie friends, fresh nutritious fruit comes water-tight. Red watermelon and strawberries (lycopene), orange cantaloupe and papaya(beta carotene), dark blueberries and purple plums (vitamin C ), green kiwi and honeydew melon (potassium, vitamin C) are refreshing, hydrating and abundant in summer. Make use of a juicer, blender, or food processor and create a colorful beverage to accompany your dinner salad. You can eat cold and be hot!

There always seems to be some Dallas Bubba who does his five-mile run mid-day in an adjusted summer temperature of 91 degrees Farenheit. Frequently, Kansas City’s Woodside tennis round robin doesn’t even begin until 9:00 a.m. with the sun bearing down. Golfers in hot, humid Florida are notorious for teeing off after 8:00 a.m. and for some strange reason, there’s always a crowd of daytime skaters in July on both boardwalks, east and west. Are they all nuts? Did they just consume a gallon of water each? Or, fancy this possible explanation: Perhaps members of Active Anonymous tolerate the heat because they are active and in shape. Withstanding both hot and cold temperatures is easier for those who maintain a healthy weight and strong, muscular body. Between the lines you know they have developed good eating habits and skills of endurance to even be labeled “strong and muscular,” but there is also a true chemical composition to the fit body that isn’t in the make-up of a soft, flabby, heart-stopping structure that acts more as a respiratory challenge during hot weather than a shelter in the shade. Only the strong survive the heat; the flabby flail.

While you’re sipping on your unflavored, cool, spring water, contemplate the following quips while remembering: Water hydrates, it softens your skin, it aids in digestion and the absorption of nutrients, it cools the body, it fills you up…and especially during the heat and humidity, it puts out fires.

Water spots

Booze on the Beach and Coffee with Caffeine are hot-weather de-hydrants. Nix the mix.

Being in shape increases your tolerance for heat. Round is a shape, not in shape.

If your body heat comes in flashes, drink water, stay still and switch to flash drive.

Water follows Salt. Take your dips without the chips.

Water is the fountain of youth.

Read Liz’s daily Lizlines Monday through Thursday and enjoy the Frisky Friday Lizlimerick each and every week at www.bdyfrm.com.

Ms Liz is the owner of Body Firm Integrated Fitness Solutions. She has developed the Bands In The Park work-out for indoors or outdoors and provides fitness consultations and complete, integrated online instruction. Contact Liz for a consultation to receive practical, affordable nutrition and fitness assistance and access to over 60 exercises, useful recipes and lesson plans.

CRNA Wellness: The fitness group

The Fitness Group – Not Just a Numbers Game

There’s strength in numbers. If you need proof, count the number of defensive players on the football field; observe the light produced by one streetlamp compared to a dozen; taste the difference between a chicken breast with one tablespoon of pepper and one teaspoon; shake hands with each member of the medical team that successfully separated conjugal twins. A group with a goal cannot be stopped. If you want great results in your wellness program, call some numbers and form a group.

Men’s Health Magazine suggests signing up for an event as one of its “top twenty ways” in which “to keep yourself on a fitness program.” The motivation of preparing for a contest involving lots of people – and perhaps prizes – keeps you focused. And focus is something all anesthesia professionals can do. There are fun runs involving 100’s, maybe a few thousand people, somewhere every weekend through October as well as cycling tours, tennis ladders, bi and triathlons galore and all it takes is one other person to help keep you motivated. If you have more than 2 or 3 on your anesthesia team, you can have the same number on your walking team. Are you going to San Francisco for the 2012 AANA meeting? Take the team for the fun run and make healthy headlines. Did the recruiter entice you to move kit and caboodle to Kansas City? Your fitness groupies can gather at the head of the 17-mile trail at the south end and power a walk all the way to Town Center in Leawood, or keep going on a bicycle into Missouri! Promise the Biggest Loser a lean latte at Dewey’s Coffee Café or buy the “most improved” person a bagel at Einstein’s. Re-set the bar a teeny bit higher every week the team meets. Improvement and reward are inherent in teamwork.

Though expansion is a curse word of the weight-watcher, it’s the goal of the group. Your companions at the clinic need not be limited to anesthesia junkies (I use the term loosely), so once your “team” is up and running, let it grow. Evite another department, then another, and another to join you in the effort to be well. Perhaps you already have a wellness offer at your hospital and perhaps you regularly participate. Great! Now get out and evangelize and expand! Your improved level of energy and your own success at achieving and maintaining a fit, healthy body are perfect advertisements. Add your voice to the ads, and the group will go viral. Your team should “change up” because that’s what keeps it vibrant and challenging – sorta like 10,000 minutes on the schedule with five anesthetists on vacation!

Scott and White Medical Center, Temple, TX, has a hospital-wide cycling group that meets once or twice weekly, year ‘round. It is highly organized – matching shirts and shorts! – and has become so popular that spouses and community residents frequently join the 145+ membership for the Saturday morning ride policy of “no cyclist left behind.” Watertown Regional Medical Center in Wisconsin offers patients and employees one-on-one personal training sessions and several group fitness events each year. Cleveland Clinic in greater Cleveland offers free employee membership to its fitness centers where you’ll participate with a group of 1,000’s! Your upstate New York group can have a cross-country skiing team and your WEE employees in Colorado (We Enjoy Exercise!) can form a hiking club. New Mexican anesthetists can train together for the annual climb to Sandia Peak and Georgians can scramble as a team up the backside of Stone Mountain. The opportunities to form a cohesive, enthusiastic group committed to the freedom of wellness are only limited by your imaginations and the Dunkin’ Donuts sticking together in the anesthesia lounge.

It takes a leader and one friend to form a fitness group. Add a little organization with some consistent commitment, and “they will come.” Your health will improve as the result of being part of a team, and if it’s a good team, strength isn’t just added – it’s multiplied.

Click here for Cleveland Clinic’s wellness program

Click here for Scott & White cycling club

Click here for Kansas City bike trails

Please visit Liz at www.bdyfrm.com to read the daily Lizlines and Friday Lizlimerick. Discover

Liz’s Bands In The Park mobile browser, a perfect companion for your walking or running group.

CRNA Wellness: Wake-up call

My humorous Native American name for my younger daughter was Face In The Soup. When she was tired, SHE WAS TIRED, and by the 6:00 p.m. dinner hour, her face went down on the table and it didn’t come up. As a young mother, I learned quickly to make sure she had received all of life’s necessities before OUR dinner time because no matter what happened in my own life, at 6:00 p.m. her curtain was going down. If she were now an anesthetist on the job, her adopted name could be Dies on the Table or Puts Patients at Risk.

Chuck Biddle, CRNA, PhD, chief editor of the AANA Journal and multi-published author of sleep deprivation articles, quotes another anesthesia industry sleep expert, June J. Pilcher, when he reports that: Fatigue caused by lack of adequate sleep results in diminished cognitive function, impaired vigilance, decay in problem-solving ability, degradation in memory, and eroded motivation.
Click here to read the article.

Okay, so I can’t tell you anything that will make the surgeon close that thoracic cavity in time for you to be eating dinner by 6:00, or to watch Dancing With The Stars, or to shower off the sounds, smells and stress from the OR and still drop into bed by 10:00. But I can give you some simple fitness suggestions for making sleep more useful when your head makes contact with the pillow-top. People who are fit and healthy sleep better than those who aren’t. Simple. True.

Physical exercise is way at the top of ways in which to elevate energy but tire the body in such a manner as to make sleep deeper and easier. Although it is a personal choice as to what time of day you should do your cardio or tote that bail, you can figure it out in just a few morning or evening trips to the gym, or on the elliptical in front of your Netflix pick. Morning cardio elevates your metabolism and your heart rate which energizes you for the better part of the day but fatigues you in a pleasant way by or before gall bladder number six. Doing your cardio before bed does the same thing to metabolism and heart rate so you probably want to take a bit of down time between cardio and vespers. Some of you may prefer to do a lunchtime cardio on the days it’s possible, a great substitute for pop ‘n pizza. Try to create some routine so that your body says, “It’s time to cardio; it’s time to eat; it’s time to don the scrubs; it’s time to let down; it’s time to sleep.”

Stretching and crunching before bed is another great way to relax and create routine before the sandman comes. Tom S. Davis, CRNA, MAE, likes to say, “Every day that I don’t make time to stretch is one day closer to the day I won’t be able to.” If you don’t have a designated work-out area at home, keep a Pilates mat, a towel and a 55cm fitball (inflatable stability ball) in your bedroom so that it’s easily available every evening. Do various crunches that access all areas of the abs followed by a thorough five-minute stretch routine that leaves you feeling loose, relaxed and calm. Wind down by finishing your toilette routine. Then crawl in and let go.

Eat dinner right before bed…and you’ll sleep poorly. Drink coffee right before bed…and you’ll have to interrupt your sleep to offload. Consume alcohol in excess…and reflux, insomnia and restless sleep will be your companions. Wear a belly to bed that looks like an eminent delivery, and you’ll wake yourself up with your own snores, not to mention that you’ll be sleeping alone. In short, what you put in your body all day is the very same thing you’ll put into bed that night and your sleep will thrive or dive because of it. Lower the bad fat in your diet, especially lower the sugar, decrease the volume of intake and put down the fork, fingers or chopsticks between every few bites. Intentional eating of reasonable kinds and amounts of food are your fitness friend, and quality sleep will become a close relative.

Finally, stay away from negative news, time-consuming e-mails, family complaints and anything else that puts your head in a quandry and reduces your tranquility. Say, “Good-night,” to your honey, calmly go through your affirmations, prayers or meditation minutes and put out your lights. Six hours, seven hours, preferably eight hours later, your fit, healthy Self will be refreshed and ready to take your life back. Then go pop into the OR bright-eyed and bushy-tailed and clip on your nametag: Saves The Lives of Others.

Other Tips
Take a power nap during your break.
Don’t stop for restaurant food on the way home.
Don’t drink alcohol.
Avoid drugs and sleep aides.
Get extra sleep BEFORE call.
Avoid arguments.
Split your cardio into morning and evening.
Eat very lightly if it’s late.
Read relaxing lit.
Do Yoga.
Meditate.
Say, “Good-night, Gracie!”

You can visit Liz during your waking hours at www.bdyfrm.com. Read the motivational, entertaining Lizlines Monday through Friday and watch for her original Lizlimerick once a week. Ms Liz

Fitnotes
Chuck Biddle, CRNA, PhD, is a professor and staff anesthetist at Virginia
Commonwealth University, Richmond, Virginia. He is editor in chief of the AANA Journal. Email: cbiddle@hsc.vcu.edu.

Tom Davis, CRNA, MAE is chief nurse anesthetist at Scott and White Medical Center, Temple, Tx and former assistant professor of nurse anesthesia at University of Kansas. He is the owner of and consultant for Procrna.com. Email: tom@swcrna.com

CRNA Wellness: Nutrition

Gary, Gary, quite contrary
How does your garden grow?
With onions, tomatoes,
Vine-ripe sweet potatoes,
And lima beans all in a row.

April is the time to plan ‘n’ plant the garden. The delightful thing about your garden is that it will provide a solitary escape after a 50-hour work week. Or it will serve as a dual retreat for you and your partner. And, it’s sure to be a family affair in which everyone can select some favorite veggies to coax and encourage to fruition. When you grow things, you grow, and when you grow, your body heals.

Sweet potatoes are an amazing garden food, big on nutrients and huge on color. There are lots of varieties but pick one that grows well in your soil. Beta carotene has enjoyed solid mag’ rap in the last ten years having been praised and criticized nearly equally. The truth about sweet potatoes is that in addition to the starch and sugar, the abundance of A, C and beta carotene make every sweet sensation worthwhile. I recommend that my clients consume at least one serving of a variety of sweet potato each week. Prepare it clean – bake without butter, boil and peel, microwave in a potato bag and slice, cut into strips and bake as fries. You don’t need salt, fats, or seasonings of any kind to enhance the flavor of this already sweet, generous source of nutrients. Click here to learn about Sweet Potato nutrients.

Green beans provide a rich supply of vitamins A and C that do not stick to your ribs or add unwanted calories to your spring plate. You can plant pole beans or traditional snap beans in a raised garden. But if you have room for rows and rows of snaps, haricot verts or favas, go ahead and plant the seeds, fertilize, water, watch for worms, harvest and enjoy. Eat them fresh-steamed next to your grilled tuna, or stir fry them with onions and mushrooms. Cut and drop raw into veggie soup or snip, steam and eat them with your fingers in front of HGTV. If you get at this early in the season, you may have time to plant a second crop. Click here to learn about Green Bean nutrients.

Yellow zucchini is becoming more and more expensive to purchase, so you may as well grow your own and eat the best. Like sweet potatoes, the vines take up some space but vertical gardening is always a space-saving option. Packed with vitamin A and plenty of C, this vegan delight is so low in calories that you can eat a bowlful of sunshine several times a week. Stir fry it, steam it, slice it and grill it with olive oil or flavored Pam, and use the leftover slices on a fresh veggie sandwich. Watery and lightweight, zucchini begs to be undercooked. Your lean machine will love both yellow and green. Click here to learn about Zucchini nutrients.

Tomatoes are a thing of beauty in your diet and on your table. By now most guys know the health benefits of lypocene to the prostate, and both genders are continually reminded through research studies of the cancer preventative capacity in a snappy tomato. There is some proof that cooked tomatoes are a better option than raw but all kinds, sizes and methods of prep are tasty and healthful. Think A (B) C then go ahead, prepare a big old ground white turkey burger, slap on a thick slice of Beefsteak tomato, put on a layer of avocado and support it all with an unbuttered whole wheat bun and some leafy lettuce…serve steamed broccoli florets as a healthy side, and indulge. You’re a Garden Gourmet! Click here to learn about tomato nutrients.

Mary, Mary, quite contrary,
How does your garden grow?
With orange, green, yellow, red,
A rainbow in the bed,
With rich vitamins all in a row.

Gardening is an art form that delivers pleasure to every sense. Feel the cool rich earth slipping between your fingers, see the tiny sprouts and watch them flourish, hear the sweet songbirds nearby, then smell and taste the results of your labor. There is no place on earth like a garden for feeding both mind and body. This, you understand, because you’re a healer.

Read Liz’s daily column lizlines at www.bdyfrm.com

CRNA Fitness: Decompress the stress

PROCRNA asked me to mount the March podium on the issue of stress-reduction which would be nearly laughable…except for the fact that I have so much personal experience. So here it is, the Body Firm method to decompress the stress.

Where do most of my clients turn for comfort during or after a tough day with the head, hands or heart? Why, food, of course. The number one method of coping with pretty much anything these days is comfort food or drink. Some of you will turn to the box of goodies in the lounge, some of you will opt to ingest a 16-ounce cola, and some (more of you than would like to admit it) will eat two or three doughnuts pretending it’s breakfast. But be careful of calorie-dense stress relievers. Sugar elevates your mood very briefly before acting as the downer it really is, dropping you as fast as a plumb line, and leaving unwanted calories and irritation behind. And in the long run, useless food raises your stress. Instead, munch on an orange, or snack on a handful of almonds, or both. An orange will administer quick sugar, it’s true, but it’s loaded with vitamin C and will provide nutrients along with energy. Nuts are a great source of protein that can hold you over until a real meal or simply sustain you through another case. Try walnuts or pecans, too, and limit your serving to a clean, even dozen. The crunch of the munch is very satisfying and brings fast relief.

You may be tempted to just flop on the decrepit sofa in the lounge when someone relieves you in the OR, not always a bad idea. But even better: Walk the hallway, stop to do squats every 12 strides, stretch your calves and quads and stretch your arms above your head, jog down the stairs to 2nd floor and jog up the stairs to 4th. Pause to do a couple of Yoga positions and bring your heart rate back to normal, then re-enter your case room with mental peace restored.

Dr. Coyote howled, Dr. Hound bit, Dr. Wolf snarled throughout the last heart case and, quite possibly, the patient’s heart is now doing better than yours. Instead of chatting it up with staff and cohorts when you exit the room, pull out a good read. Weird Sisters is a current hoot for chicks, and author, Olen Steinauer can capture either gender’s attention in short order. Try reading the daily “funnies” for comic and cardiac relief, or read anything cheerful that will take your mind off the present and help restore your equilibrium and your gift for humor. LOL.

You may not be in charge of selecting music for the gall bladder room. Pink Floyd or
George Strait may be the surgeon’s consistent choice of genre, but when you get to choose, or when you go on a break, listen to music that relieves tension. Relax with alternative sounds like waterfalls or crashing waves from a Narada collection. Classical melody from Smetana’s “The Moldau” or Debussy’s “Daphnis and Chloe,” and even big Wagnerian themes from “Tannheuser” or “Lohengrin” can fill your soul and remove the excess tension. Schubert piano solos or symphonies, unrestrained strains from LAGQ, Chis Botti love tunes on the trumpet or any of the music you simply know and love can take off the edge, and pull you back from it. Massage your hands and feet while you listen to music and get maximum de-fusing.

Finally, here’s one of the best stress-busters known to Venus or Mars – Meditation. You’ll need a quiet corner for this activity unless you’re an excellent self-hynotic. Close your eyes and preferably a door, get seated and settled with good core support, then start with slow, deep breaths in through the nose, out over the lips, switching to all nose breathing when you’re fully “centered.” Tune out any and all distractions and focus on the breath (Toothpaste trumps garlic!); in…and out….in ….and out…”…he loves me….he loves me not….one for you…one for me…” Relaxation is in the focus and in the rhythm.

K, I hate to wake you up, but there you have it – Body Firm’s favorite decompression session. An anesthetist has almost no time to relax during the workday. Morning break is not a given. Lunch can be 11:00 or 2:00 or not at all. The comfort and outcome of the patient will always be your ultimate concern. But put your own health next in line and treat your stress with safe, un-medicated relief. Your patient will benefit, and it may keep you from becoming one.

Visit Liz online at www.bdyfrm.com Read daily Lizlines and leave a stress-free comment!

CRNA Fitness: What goes Up, Must Come Down

What goes up when the rain comes down? Answer: Your weight. If you thought the correct answer was “an umbrella,” then you probably heard it from your kids or grandkids. March does bring rain, but even more than moisture, March brings a change of seasons. And as the season changes, so do your fitness opportunities.

If you have been walking on a row of treadmills all winter, hiking virtual trails while listening to gym-girl Greta’s visions of grandeur, aka gossip, on the machine next to yours, you’re more than ready to hit the pavement, wet or dry. Asphalt streets, dirt trails, and school tracks exist in nearly every community and only really nasty weather should send you back to Greta. Fitness experts often claim that outdoor cardio actually burns calories faster just because of the elements of wind, breathing outdoor air, and dealing with natural changes in elevation. Yes, on Lion days, you can go back inside and adjust your treadmill to outdoor standards, but it would be a shame to miss watching that Bartlett pear tree on the corner of Magnolia and Vine go through its spring metamorphosis. Don’t forget to take drinking water.

Bands work-outs are a fantastic source of strength-training and once you’ve taken them to your favorite park, you just might opt to stay outside in the wind and rain if only to enjoy the freedom and flexibility of the work-out. If you’ve been going to the gym three mornings a week to lift weights, or to do Body Pump, or to zip through the circuit of machines, taking your bands outside to a park will provide a nice break in the winter routine AND if you walk there, you can keep checking on that Bartlett pear. When the nitrates start falling from the sky, you can always take the bands inside at home or at the gym. Is there a fitness center at the hospital where you work? Is there a children’s outdoor area with some poles that support swings or climbing apparatus? Perfect for bands. How about doors with hinges. If there is a low-traffic area inside the hospital where some infrequently used doors with hinges are hanging around, that’s another perfect place for anchoring bands. Maybe you’ll need “permission” to use the space or maybe you’ll need the chief’s approval, but if you really want to do your work-out, you can work it out. Don’t forget your water.

March brings a variety of weather to your exercise routine – rain, wind and even some stubborn snowfall. You will probably need to do a blend of trail walks and treadmill, outdoor cycling and indoor elliptical, and you may need to tote the Totes. But it’s a great time, a hopeful time of year when as the season changes, you can take advantage of the change. Then when April arrives and the rain comes down, the only thing that will go up is your umbrella.

Learn more about the Bands In the Park work-out on mobile browser at www.bdyfrm.com.

CRNA Fitness: Selecting a Gym

Losing weight used to be numero uno on the News Year’s Resolution list but lately it’s given way to touchy, feely hopefulness charged with sentiment and inertia. In spite of the second-place status, ‘lose weight’ is a list-maker that will open gym doors and sell overpriced clearance tights…for about three months. Over 30% of the people who join a gym in January, will stop going by March, and may never return. If you are one of those who does follow through on your resolution commitment of losing weight, here are some tips for joining a gym and/or hiring a personal trainer.

The Goals

Establish your basic goals.

That means you may need to sit down at your computer and write down two or three well-defined things you intend to accomplish by joining, then select a gym that has what you need in order to achieve your written goals.

The Proximity

Locate a gym or trainer that is close to home or close to work or right on the precise route that you take to one or the other. If you have to go the least bit out of your way or have to stop at one light a little too long, you’ll be back under the covers in less than a month.

The Money

Gyms and fitness facilities are muy espensivo to operate so they want, they need your money. Still, wangle the best deal you can get. Three-month specials abound (‘cause they know you’re gonna quit in March!) and perks like a free trial visit, personal training packages, free classes, and guest passes are often an option. Accept an automatic withdrawal from your account ONLY if you fully understand the fine print in the contract. Yep! There will be a contract and you won’t get out of it easily in March…or June, either. Read, comprehend, then pay up and USE the place faithfully. Tip: Go as the guest of your buff and beautiful friend so you don’t have to listen to marketing hype first-time in the door.

The Machines and the Maintenance

Machines should be up to date and in good repair– you can tell by getting on one and using it or by counting the number of signs on equipment that say Out Of Order. It doesn’t hurt to take note of the rips and tears in vinyl machine pads, the cracked or missing water holders on cardio machines, or single dumbbells now divorced from their partners. Check out the bathroom, the showers, the toilets – um-hmmm – and ask straight out how often the cleaning service marches their bucket brigade from ellipticals to lockers and beyond. There is no better place to get colds, flus and infected scratches and wounds than at a work-out facility. If you have to step over the spit on the floor next to the squats cage, move on dot com.

The Environment

How’s the music? Can you hear yourself think? Is this a meat market or a family fitness center? Do you recognize some people from work or bridge club? Do people behave respectfully and share equipment and clean up after themselves on the gym floor? Does Jocko Madzilla remove the 800 pounds of weight plates from the leg press when he’s finished and does Little Lucy Latte get off the elliptical promptly when her time is up without re-setting the timer when no-one’s looking? These observations take time so take that time to avoid being sorry.

The Members

Then, ask the members who are there if they are happy with the variety and supply of equipment, with the quality of classes and with the level of maintenance and overall professionalism. Discuss their payment satisfaction and what they like best and least about the facility. Find out if theft is a problem and how issues have been resolved. Observe the members as they arrive and leave, as they work out and socialize, as they interact with personnel and how they treat the place, ‘cause that’s how they’re going to treat you.

The Trainers

This is my area, Kids. I’m an integrated fitness trainer and I take this seriously. If you want a trainer whether short-term or long-term, do your due diligence as real estate people like to say. Look at other client’s results, interview more than one client to get their comments and interview more than one trainer to feel the fit. Inquire about credentials and certifications and if you’re at a gym, ask the gym leadership to tell you what the requirements are for trainers – eg, insurance, certifications, age and experience. Then observe at least one session and don’t look at the trainer’s biceps and glutes; look at the attention he/she gives the client, the focus, the total professionalism. If the client is grunting, pouring sweat and hobbles for three days after the session, run the other way while you have two good feet. Efficiency, form, and safety are tantamount and pushing clients too hard is a deal breaker. Make sure the trainer keeps good records of client progress and has some level of education in nutrition. Supplements of any kind are not necessary for achieving normal, healthy results, but trainers often earn mega extra income by selling them. If you find a high-quality trainer whom you trust and who guides you to your mutual goals, that’s the deal maker. Just offer her/him a good tip and consider yourself pumped!

A well-run fitness facility is a social mecca for exercise where you can pay for the opportunity to get in touch with your wellness and, therefore, your well-being. With precious little time and money to spare during this extended employment drought, do your homework before you slide your card then stick with your plan beyond the Ides of March.

Liz Sanner Davis is owner and trainer at Body Firm Integrated Fitness Solutions, Temple, TX. Visit Liz online at www.bdyfrm.com and read her humorous and motivational Lizlines or Lizlimericks published daily.

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