Healthy Habits for ED Trainees/Attendings

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Anyone have any tips on trying to stay healthy during residency and beyond, especially with the shift schedule and hectic time on the job that is EM? Good snacks you have on hand, ways you fit exercise into your schedule when your schedule varies so much, etc? Thanks in advance!

A few things that help me:

Look at your schedule at the beginning of the week and plan 5 (or so) workouts into your week's activities.

Bring healthy food to work (carrots, healthy sandwich, fruit, etc). It's better (and faster) than the cafeteria food.

Prioritize sleep over social activities.

Whenever I volunteered in the ED I would always do pull-ups on the bars hanging in the ortho room if it was slow. Kept me awake too.

Try and keep a happy demeanor, even if your consultants or patients won't. Remember, just because they're having an awful day doesn't mean that you have to.*





* Of course, I realize that this won't always work because we're human and have human emotional reactions to things. But as a wise attending repeatedly told me, if you don't try to be "Vagal" then you're going to burn out and/or explode. It's really helped me.

I have become a big believer in fiber. I had always preferred a mild constipated state because you don't have to wipe much. However, I got a rectal fissure a couple of months ago and that was really a pain in the butt. Now I eat bran flakes every morning and when I know I didn't eat much fiber, I take a colace just to head things off at the pass. With this regimen, I enjoy nice small caliber softies that just sliiiide right out. Now I am a firm anti-constipation advocate. Baby your colon my friend and your colon will baby you. Remember that you only have one rectum in life. Once your rectum is worn out, you are SOL.

Originally Posted by Jarabacoa

I have become a big believer in fiber. I had always preferred a mild constipated state because you don't have to wipe much. However, I got a rectal fissure a couple of months ago and that was really a pain in the butt. Now I eat bran flakes every morning and when I know I didn't eat much fiber, I take a colace just to head things off at the pass. With this regimen, I enjoy nice small caliber softies that just sliiiide right out. Now I am a firm anti-constipation advocate. Baby your colon my friend and your colon will baby you. Remember that you only have one rectum in life. Once your rectum is worn out, you are SOL.

noted.

Originally Posted by Jarabacoa

Once your rectum is worn out, you are SOL.

Tongue in (ass) cheek.

Originally Posted by Jarabacoa

I have become a big believer in fiber. I had always preferred a mild constipated state because you don't have to wipe much. However, I got a rectal fissure a couple of months ago and that was really a pain in the butt. Now I eat bran flakes every morning and when I know I didn't eat much fiber, I take a colace just to head things off at the pass. With this regimen, I enjoy nice small caliber softies that just sliiiide right out. Now I am a firm anti-constipation advocate. Baby your colon my friend and your colon will baby you. Remember that you only have one rectum in life. Once your rectum is worn out, you are SOL.

An awesome quote!!

fiber or it's semi-colon.

One word: kimchee.

Great thread. It's so hard to remember to care for myself, especially now that I'm pregnant and really need to stay hydrated. Sometimes I catch the nurses refilling my water bottle - they're fantastic.

For snacks, I really like LaraBars. They aren't hugely filling, but they are delicious and have about 4 ingredients in them. Super delicious.

For when you realize that you haven't eaten anything green yet that day: http://greensmoothiegirl.com/

I fill up water bottles with green smoothies (leafy greens, banana, berries, sometimes yogurt) and drink them when I have a few minutes at work. You have to find the right balance for your tastebuds or they can be repulsive, but I love mine! You can even freeze them and let them defrost throughout the day if you don't have a fridge.

Originally Posted by 8654Marine

An awesome quote!!

Thanks.

You know, it really was a life-changing experience. I wanted to see how bad it was, but that is a difficult proposition. I ended up asking my wife to take a picture so I could confirm the diagnosis and see the extent of the damage. It turns out that rectums are hard to get in focus. As I'm perched on the side of the bathtub and bearing down as my wife screams, "EWWWWW!" I thought, "you know, my wife is pretty cool, and I should eat fiber for my sake, and hers."

Dude, that is an image!

LOL.

I nominate Jaracoba for The Post of the Week Award.

His advice is solid, but his poops are semisolid.

in the whirlybird i have BOXES of uncle tobys muesli bars and 2 hessian sacks full of fruit....they last 2 days tops. i have 6monthly bloods done to make sure my hormone levels, cholestrol, fasting glucose a blood count are normal.

in the ED i take ankle weights and hit a vacant room then just run up and down...mostly the physio workout room because it's long

Originally Posted by WilcoWorld

I nominate Jaracoba for The Post of the Week Award.

His advice is solid, but his poops are semisolid.

Damn that, Post of the year!

Wow. That thread took a hard left turn.

As a resident, prioritize sleep and your job. Cut everything else out of your life. Exercise before or after your shift most days and on every day off.

As an attending, spend less and work less. Cures financial difficulties, burnout, and health problems. It's okay to work 12 eight hour shifts a month. You'll last a long time that way.

I work out 3-4 days a week. I either lift or run.

I also make time for a lot of down time, like surfing the net or just hanging out. Usually you can find me on some watch forum because that's my hobby and I usually find solice in that. Some of my favorite things to do would be just to hang out with the wife. We can either window shop or eat out.

I try to sleep at least 7h prior to a shift.

I also try to play some video games here and there.

Oh, and I study at least 30min each work day. Keep my brain functioning.

I also bring an energy bar to work.

Solid thread.

As a health/fitness nut, I highly recommend bringing your own meals/snacks. I make ~ 3 shakes for every shift, roughly 40 g whey, 1 tablespoon almond butter, some Coco milk and maybe a banana or something else mixed in. Roughly 400-500 calories each. Keeps you awake, energized and keeps blood sugar stable for long periods. Can slam one in less than a minute in crunch-time.

Notably, <75% of the ER nurses are obese. Unfortunately, they rely on the crackers, cookies, pizza, doughnuts, chips, soda readily available in the break room for meals and snacks. During stressful shifts, it gets even easier to cram a few more cookies into the yapper as a coping mechanism. Done throughout a shift, day after day...yikes.

Originally Posted by pinipig523

I work out 3-4 days a week. I either lift or run.

I also make time for a lot of down time, like surfing the net or just hanging out. Usually you can find me on some watch forum because that's my hobby and I usually find solice in that. Some of my favorite things to do would be just to hang out with the wife. We can either window shop or eat out.

I try to sleep at least 7h prior to a shift.

I also try to play some video games here and there.

Oh, and I study at least 30min each work day. Keep my brain functioning.

I also bring an energy bar to work.

I find that when I have an energy bar (instead of a meal) that a couple of hours later I feel shaky, nauseous, and clammy. I'm figuring it's relative hypoglycemia, but it's put me off from eating them. I used to just eat beef jerkey during a shift (no carbs to crash from), but I'm a little worried about gastric cancer if I keep that up for 20+ years. Does anyone know of any other ready-made product that can be quickly consumed, doesn't require refrigeration, and leads to a sustained feeling of fullness (and I guess stable blood sugar)? I don't really care about price, but if it requires more than minimal prep time it's a no-go.

Beer?

True story: Our ED is like a pod w/ work-stations in the middle. On a particularly busy day, I was constantly moving.

One of my patient sons noticed this and after his father was d/c'd, the son came back and handed me a can of beer and said that he thought I deserved it.

I kept it in the doc box until JCAHO.

Originally Posted by Arcan57

I find that when I have an energy bar (instead of a meal) that a couple of hours later I feel shaky, nauseous, and clammy. I'm figuring it's relative hypoglycemia, but it's put me off from eating them. I used to just eat beef jerkey during a shift (no carbs to crash from), but I'm a little worried about gastric cancer if I keep that up for 20+ years. Does anyone know of any other ready-made product that can be quickly consumed, doesn't require refrigeration, and leads to a sustained feeling of fullness (and I guess stable blood sugar)? I don't really care about price, but if it requires more than minimal prep time it's a no-go.

Beans? You can eat them right out of the can of you want.

Originally Posted by Arcan57

I find that when I have an energy bar (instead of a meal) that a couple of hours later I feel shaky, nauseous, and clammy. I'm figuring it's relative hypoglycemia, but it's put me off from eating them. I used to just eat beef jerkey during a shift (no carbs to crash from), but I'm a little worried about gastric cancer if I keep that up for 20+ years. Does anyone know of any other ready-made product that can be quickly consumed, doesn't require refrigeration, and leads to a sustained feeling of fullness (and I guess stable blood sugar)? I don't really care about price, but if it requires more than minimal prep time it's a no-go.

A peanut butter sandwich on whole wheat bread will take care of me for a few hours, and it takes about 30 seconds to make. I can't say that I have any 8+ hour solutions.

Here I've just been living on the saltine and graham crackers we have for patients. That and Diet Shasta. Maybe there's more to this....



I've found having a good scribe that likes to cook makes eating healthy easier, but it's hard to eat pork chops, rice, and asparagus during a shift.

Do not eat whatever is community property. It's usually bad for you and it can make you sick if someone sick already got into it. I lost a lot of weight by not partaking in the community snacks. No thanks became my favorite phrase. I ended up relying a lot on peanut butter crackers to hold me over during shifts. Lots of water and caffeine as well. I also bought into the colace bit, worth it to not feel miserable during shifts, especially when you have 3+ in a row and you don't take time for yourself.

I also prioritized sleep and work my first year as well as time with my significant other. Now that the SO is out of the picture, I decided I had to get out more. I still prioritize sleep, but on my days off, I now also prioritize getting out of my house. Quick day trips are wonderful when you have a day off and the weather is nice. I tend to go to the cities 1-2 hrs away for these trips. I do them when I have 2 days off in a row so that I still have time on the day after to rest up for the next shift. The traveling has made me much happier than I was without it. And life is better without dating that dude anymore. (dropping dead weight was great)

I also downloaded Tintinalli's on my iPad. This was the best thing ever. I take the iPad with me places when I take my trips and read a few chapters. I read more with it on there than I ever did before. Carrying around the textbook was less than ideal.

That brings up an excellent point: Besides having a healthy outlet for your frustrations & energies, have a social life, preferably outside of medicine.

It's great to hang w/ fellow residents and now fellow attendings, but I find I get more enjoyment with others not in the field. Not talking shop or asking for advice.

Learn new things: I learned to tear and re-build my engine, brakes, suspension, and axles.

em2be How did you get TInanalli's on iPad? Is it an ebook or pdf?

Originally Posted by jendc08

em2be How did you get Tintinalli's on iPad? Is it an ebook or pdf?

Via the kindle app (ebook). Bought it on Amazon.

Let me preface this by saying I'm about as far from being a health guru as you can get.

Originally Posted by RandomHero117

Whenever I volunteered in the ED I would always do pull-ups on the bars hanging in the ortho room if it was slow. Kept me awake too.

This sounds crazy but I've done push ups and sit ups in the office before. I always take the stairs to go to codes and tubes.

Originally Posted by Jarabacoa

I have become a big believer in fiber. I had always preferred a mild constipated state because you don't have to wipe much. However, I got a rectal fissure a couple of months ago and that was really a pain in the butt. Now I eat bran flakes every morning and when I know I didn't eat much fiber, I take a colace just to head things off at the pass. With this regimen, I enjoy nice small caliber softies that just sliiiide right out. Now I am a firm anti-constipation advocate. Baby your colon my friend and your colon will baby you. Remember that you only have one rectum in life. Once your rectum is worn out, you are SOL.

I echo this. Metamucil is your friend. I posted about the creates ER cocktail awhile back. It's 1 part Slimfast, 1 part coffee, 2 table spoons of Orange sugar free metamucil and you've gotta drink it reasonably fast or the Metamucil turns to a gel. You can sip it longer if you use less Metamucil. For fiber you can also buy plain psyllium at While Foods or Trader Joes if you don't like the orange flavor.

I take a 48 ounce water with me every day and I make sure I drink it. I drink a 16 ounce water on the drive in. That way I have to pee in 1 to 2 hours. If I don't fluid load I get busy and forget to go and I have literally gone 10+ hours without going to the bathroom. That scares me.

Try to eat smaller snacks at intervals. Granola bars and bags of trail mix can help you from grabbing a big greasy meal from the caf or eating 3 donuts.

Try to find a gym or something between work and home and try to stop by on your way.

Many medical centers have rehab facilities that have good equipment. Sometimes they will let staff work out for free or join for a nominal cost.

Originally Posted by docB

Let me preface this by saying I'm about as far from being a health guru as you can get.



This sounds crazy but I've done push ups and sit ups in the office before. I always take the stairs to go to codes and tubes.



I echo this. Metamucil is your friend. I posted about the creates ER cocktail awhile back. It's 1 part Slimfast, 1 part coffee, 2 table spoons of Orange sugar free metamucil and you've gotta drink it reasonably fast or the Metamucil turns to a gel. You can sip it longer if you use less Metamucil. For fiber you can also buy plain psyllium at While Foods or Trader Joes if you don't like the orange flavor.

I take a 48 ounce water with me every day and I make sure I drink it. I drink a 16 ounce water on the drive in. That way I have to pee in 1 to 2 hours. If I don't fluid load I get busy and forget to go and I have literally gone 10+ hours without going to the bathroom. That scares me.

Try to eat smaller snacks at intervals. Granola bars and bags of trail mix can help you from grabbing a big greasy meal from the caf or eating 3 donuts.

Try to find a gym or something between work and home and try to stop by on your way.

Many medical centers have rehab facilities that have good equipment. Sometimes they will let staff work out for free or join for a nominal cost.

Haha docB - your 7000th post on SDN is about dropping a deuce and taking a squirt! Epic!

I wouldn't have had it any other way.

After residency, I got a personal trainer. To me, it's worth the money. I workout more consistently, and the workouts are harder, more efficient and disciplined.