weight loss/workout routines

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buntatog

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So I'm a little more than halfway through my internship and I am finding myself getting more and more exhausted at the end of each day. One of my goals before starting my CA-1 was to get in shape, but months have passed and I have fallen off the health wagon too many times these past few months. I think the longest I have been able to consistently go to the gym is 2 weeks 4 times per week, then I fail to follow through after a rough ICU call or Saturday general wards call. I'm feeling a little hopeless and I definitely want to lose some weight, I don't want to be ripped, I just want to be fit. Can I fit in a good workout routine during CA years or should I just throw in the towel? Can anyone her give some tips?

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So I'm a little more than halfway through my internship and I am finding myself getting more and more exhausted at the end of each day. One of my goals before starting my CA-1 was to get in shape, but months have passed and I have fallen off the health wagon too many times these past few months. I think the longest I have been able to consistently go to the gym is 2 weeks 4 times per week, then I fail to follow through after a rough ICU call or Saturday general wards call. I'm feeling a little hopeless and I definitely want to lose some weight, I don't want to be ripped, I just want to be fit. Can I fit in a good workout routine during CA years or should I just throw in the towel? Can anyone her give some tips?

buntadog, meet NROL. NROL, meet buntadog. As for cardio, you can do some Tabata stuff, intervals, HIIT and good ole boring steady state, depending on your tastes. I like to mix 'em up personally.
 
My wife does P90X, that thing will break you.:boom:

I suggest you start out easy with a long term plan. FInd an activity you like and commit to doing it a few times a week. Join a basketball league or ultimate frisbee or something. I like hockey. THen commit to the gym every postcall day off. The next thing you know, you are wanting more. THe workouts are not enough so you start going more often. Now you are in a routine. When ICU breaks you, take a day off. It's not the end of the world. Watch what you eat. Shrink your portions. This is the most difficult.

Or you could start running 100 miles a week like Dre'.:barf:

My residency workout routine was the gym about twice a week when I was doing good. Run 5 miles (I know, I'm a wimp Dre') 1-2 times a week. On the weekends I was busy like crazy. Long bike rides or all day snowboarding. I typically added a mountainbike ride or two in every week. Usually, if I got home early I'd head to the trails but for those months (ICU or trauma) I'd be lucky to get any workout in.

It's not so much about finding a routine for me as it is a lifestyle. Corny I know but I feel much better when I am active. I find that when I try to stick to a rigid routine I doomed to fail. But when I enjoy the activity I just want more.
 
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Weight loss is 95% calorie driven. If you eat less I guarantee you will loose weight. I'm 6'1'' and only eat 1500 Kcals/day. My weight is 175lb of lean mean machine. I work out 6 hours/week. I don't care what it is or how often or long the workouts are, but they need to sum up to 6 hours/week of weights. No cardio!! I have seen so many people double and triple their workout routines, adding cardio, doing lame gimmick DVD/CD workout routines and not loosing any weight. Their increased workout routine typically coincides with an enhanced caloric intake. Some of the tools who workout the hardest in the gym month after month, year after year are still fat asses!!! Caloric intake is everything. If you want a correct looking body, one that is beach worthy, then my recommendation is 1500-1700 Kcals/day for men, 1300-1500 Kcals/day for women (averaged over 7 days). :thumbup::thumbup:
 
As Noy says, exercise and fitness have to become a lifestyle. For myself, it is everpresent, my days and vacations are planned around it. Running, cycling, backcountry skiing, backpacking...



People who are disciplined can force themselves to do things for years at a time but they don't enjoy them and they will often take any excuse not to do exercise etc.

If you dedicate yourself 2-3 times a week to an activity you enjoy, you will inevitably want more and get the positive reinforcement. Eventually, you wont have to force it. One of my best friend's is a great athlete. He hates the T word (Training). Despite this, his life is essentially a training camp. But to him it isn't "training" because he makes it fun and it is what he loves. When he starts making his workouts with goals and such, he loses it...

I am now at the point where it is an absolute requirement in my life. I make time for it no matter what my responsibilities are: ICU call, early or late days. I will run in the dark, run from men with guns in third world countries (not really), and run around my neighborhood when I am on home call.



I love being fit, able to do almost anything "off the couch." Every activity is so much more fun when you are in shape and not suffering (unless you want to!)

It is very hard to be motivated in residency, especially in the ICU. Tricks I have used: run or bike to work. No matter how tired you are you HAVE to exercise. After that first mile, even postcall, the body wakes up and I will run 5-30 miles without sleep sometimes.

If you exercise from home, do not sit down or relax at all before you start, you will end up slackin on the couch ( I do anyway!).

Watch TV, movies or motivating documentarys while on the treadmill or bike.

Talk on the phone with friends if they dont mind the heavy breathing.

Exercise makes you sleep well, happy, lets you eat and drink tons of calories even as your metabolism slows AND you won't become a vasculopath!!!!


Just got done with call, kidney tx, aortobifem, 7 fast outpt ortho cases.
I WANT to train really bad. I am in the mood for a looooong ride. Unfortunately, I am having an outpt procedure. Damn




My wife does P90X, that thing will break you.:boom:

I suggest you start out easy with a long term plan. FInd an activity you like and commit to doing it a few times a week. Join a basketball league or ultimate frisbee or something. I like hockey. THen commit to the gym every postcall day off. The next thing you know, you are wanting more. THe workouts are not enough so you start going more often. Now you are in a routine. When ICU breaks you, take a day off. It's not the end of the world. Watch what you eat. Shrink your portions. This is the most difficult.

Or you could start running 100 miles a week like Dre'.:barf:

My residency workout routine was the gym about twice a week when I was doing good. Run 5 miles (I know, I'm a wimp Dre') 1-2 times a week. On the weekends I was busy like crazy. Long bike rides or all day snowboarding. I typically added a mountainbike ride or two in every week. Usually, if I got home early I'd head to the trails but for those months (ICU or trauma) I'd be lucky to get any workout in.

It's not so much about finding a routine for me as it is a lifestyle. Corny I know but I feel much better when I am active. I find that when I try to stick to a rigid routine I doomed to fail. But when I enjoy the activity I just want more.
 
This is nonsense:cool:

Controlling calories is extremely important, but regular routine intense cardiovascular workouts will help you shed weight just as easily.

It's a lot easier not to eat 4 cookies than it is to run for an hour.
 
Yes:D.

What I am saying is that cutting back calories to a normal amount will certainly help you lose weight if you have a bad diet; however cutting calories only goes so far. 1500 calories a day just isn't reasonable for me. If your caloric intake is normal and yur diet isn't bad, sure you may lose some weight if you are heavy, but I feel that regular productive exercise really lets you trim down.

Arch, I can back my claims up with my abs!:D Can you do the same???:confused:

How much weight have you ever lost at one time via either diet or exercise?
 
Weight loss is 95% calorie driven. If you eat less I guarantee you will loose weight. I'm 6'1'' and only eat 1500 Kcals/day. My weight is 175lb of lean mean machine. I work out 6 hours/week. I don't care what it is or how often or long the workouts are, but they need to sum up to 6 hours/week of weights. No cardio!! I have seen so many people double and triple their workout routines, adding cardio, doing lame gimmick DVD/CD workout routines and not loosing any weight. Their increased workout routine typically coincides with an enhanced caloric intake. Some of the tools who workout the hardest in the gym month after month, year after year are still fat asses!!! Caloric intake is everything. If you want a correct looking body, one that is beach worthy, then my recommendation is 1500-1700 Kcals/day for men, 1300-1500 Kcals/day for women (averaged over 7 days). :thumbup::thumbup:


Or you could torture yourself:smack:

Most of us are not so narcissistic. We exercise so that we are healthy and so we can enjoy life.
 
Or you could torture yourself:smack:

Most of us are not so narcissistic. We exercise so that we are healthy and so we can enjoy life.

As do I, however, I also enjoy strutting my tan lean mass around the lake, pool or the beach and having all the ladies take notice!!!:cool: No food can taste as good as that feels!!!
 
Bunt -

I agree with big points in much of what was said above. After reading your post, here were my thoughts:

1) Weight loss can be achieved thru both calorie reduction and exercise; a bunch of the folks at my residency that are c/o wt gain often do so with a one-liter bottle of Coke and a couple of cookies on their tray at lunch. And Dinner. And the mid-call snack. Keeping a close eye on what goes into your body is huge. I've probably eaten in a dozen different hospital cafeterias, and the healthiest thing to buy at any one is probably nothing - bringing your food will almost always be healthier and cheaper. Lastly, I personally try to reverse-pyramid my carbs during the day, so breakfast is the largest proportion of carbs, and dinner is a low-carb meal.

2) Set your sights very low, but in a good way. My nadir of workouts, for some reason I still can't explain, has been my month in the ED - weird hours that seemed to not follow any logic reason, plus I hated the work. Whatever it was, I could not do anything but work and sleep for the first two weeks. To get back on my grizzle, I started with pushups and situps at home. I don't care if you're doing Penn Neurosurgery, you have time to do 20 pushups and 20 situps at home (or in the hospital if you really are doing Penn Neurosurgery). It sounds cheesy, but try it. If you buy-in, increase the number gradually. You'll be surprised how much better you'll feel. Other little things that I really think help: take the stairs everytime, everyday; and cut back gym time. Set your goal to be 30 min in the gym, and go balls-to-the-wall the whole time. Just cardio, or just chest, or just whatever.

3) See if you can join a 24hr gym, which will provide you with huge opportunity time. If so motivated, you could bang out a 1/2 hr workout before heading into the ORs.

Good luck with things.

dc
 
Weight loss is 95% calorie driven. If you eat less I guarantee you will loose weight.

...but regular routine intense cardiovascular workouts will help you shed weight just as easily.

The ol' calories in = calories out equation. Unfortunately, it doesn't work all that well for weight loss.

Restricting calories causes hunger. Most people will give in and fail.

Vigorous exercise causes hunger. Most people will give in and fail.

Exercise for fun, stress reduction, or other health benefits, not so much for weight loss.

Eat the right foods. Dump the overconsumption of carbs, especially junk carbs; eat lower glycemic load foods. Eat enough protein and fat for hormonal and satiety purposes.

Get enough sleep (easier said than done sometimes).

Get enough probiotics. Foods can help, but you may need to supplement. (We will see more and more emphasis on gut flora as it relates to weight in the future.)

That's a start anyway.
 
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The ol' calories in = calories out equation. Unfortunately, it doesn't work all that well for weight loss.

Restricting calories causes hunger. Most people will give in and fail.

Vigorous exercise causes hunger. Most people will give in and fail.

Exercise for fun, stress reduction, or other health benefits, not so much for weight loss.

Eat the right foods. Dump the overconsumption of carbs, especially junk carbs; eat lower glycemic load foods. Eat enough protein and fat for hormonal and satiety purposes.

Get enough sleep (easier said than done sometimes).

Get enough probiotics. Foods can help, but you may need to supplement. (We will see more and more emphasis on gut flora as it relates to weight in the future.)

That's a start anyway.

QUE??

Glycemic whatever is purely an invention.

It has everything to do with how many calories you consume versus burn- our earliest med school biochem classes teach us that.

The body will resort to burning fat for fuel when glycogen stores in the liver have been exhausted. By day 5 of fasting, the body will begin to breakdown muscle for fuel...

It is and has always been
weight loss occurs when calories consumed<burned.

It is also a matter of discipline.

Increasing your caloric intake with the initiation of a cardio routine (when the intention is weight loss) is purely a matter of choice and usually reflects a lack of discipline.
 
I'm 6'1'' and only eat 1500 Kcals/day. If you want a correct looking body, one that is beach worthy, then my recommendation is 1500-1700 Kcals/day for men, 1300-1500 Kcals/day for women (averaged over 7 days). :thumbup::thumbup:

Pane, what do you do to keep track of your 1500 calories / day? I haven't done extensive research, but I've read enough to be pretty interested in low-calorie diets like this.

I tried once, but it was a huge, huge hassle. My wife and I make most of our food from scratch, so it was too time-consuming to calculate up the dozen or so ingredients in each recipe. I made an account on one of those diet websites that lets you track caloric intake, but it was taking like 30 minutes a day to enter everything, so I dropped it.

Any suggestions?
 
I know because I was a spoiled kid and could easily have wound up overweight. Like several of the kids I grew up with, our mothers expressed love by stuffing us with chocolate cake, carrot cake, strudel, every conceivable form of pie the cook could whip up...

Every 'A' was rewarded with a trip to the chocolate/ice cream parlor

at 12, I discovered a love for running- it did something for me that changed the way I functioned mentally and physically. Soon I started running marathons and in high school I competed in track and took up swimming. In college, biking became a part of my life.

I wonder what would have happened if my calorie intake continued to exceed my usage.

By med school, I had completed two triathlons and biked cross country. It began as a matter of discipline.

And yes, "working out" has to be not a means to an end but the end in and of itself. for me, it's darn near close to a religion at this point.
 
How would you recommend a couch potato adopt this mindset? I mean, in real terms, what would be the first steps? Get up, scream, and do a push-up? How do you "click" over to this mode?

:laugh:

It begins a little at a time. I trust the mighty power of endorphins to keep you coming back for more the next day.

How about a 30 min walk today and 20 min run tomorrow- see how the Urea cycle sticks in your brain then.

It just makes you faster, better, happier, lighter, smarter...
 
QUE??

Glycemic whatever is purely an invention.

The glycemic index isn't perfect, but it helps people conceptualize why a blueberry has less blood sugar/insulin impact than a piece of white bread.

It has everything to do with how many calories you consume versus burn- our earliest med school biochem classes teach us that.

Well that's kind of the point. These commonly accepted ideas don't work when it comes to real world weight loss.

The body will resort to burning fat for fuel when glycogen stores in the liver have been exhausted. By day 5 of fasting, the body will begin to breakdown muscle for fuel...

It is and has always been
weight loss occurs when calories consumed<burned.

But for how long? Until the metabolism slows to adapt to the reduced calories? Or until the person tires of being hungry all the time and throws in the towel? I'm not saying calories don't count. I'm saying that too much calorie restriction doesn't work.

It is also a matter of discipline.

Increasing your caloric intake with the initiation of a cardio routine (when the intention is weight loss) is purely a matter of choice and usually reflects a lack of discipline.

Or perhaps it reflects biology.
 
I know because I was a spoiled kid and could easily have wound up overweight. Like several of the kids I grew up with, our mothers expressed love by stuffing us with chocolate cake, carrot cake, strudel, every conceivable form of pie the cook could whip up...

Every 'A' was rewarded with a trip to the chocolate/ice cream parlor

All junk carbs. Perhaps we are on the same page afterall.

at 12, I discovered a love for running- it did something for me that changed the way I functioned mentally and physically. Soon I started running marathons and in high school I competed in track and took up swimming. In college, biking became a part of my life.

I wonder what would have happened if my calorie intake continued to exceed my usage.

By med school, I had completed two triathlons and biked cross country. It began as a matter of discipline.

And yes, "working out" has to be not a means to an end but the end in and of itself. for me, it's darn near close to a religion at this point.

You should be congratulated on your accomplishments. But is biking cross-country a realistic solution for the many tens of millions of overweight/obese Americans?
 
Here's my 2 cents if anyone cares:

-- Input < output is totally dominated by the input side. You can drink a 1L coke and 3 donuts in 30 minutes and there's, say, 1000+ calories. To make that up you'd have to run/lift/play for 3+ hrs. It's easy to take in MASSIVE amounts of calories and hard to put it out. So, minimize the bad inputs. That's the first part.

-- The calorie-burning part has to be FUN and part of your DAILY life and as stated before, the END itself, not a means. If it's the means, you'll lose the will after some period of time. If that's biking/walking/running to work, hell yeah. Rec basketball, ultimate, soccer, football, hell yeah. Trail running or hiking, great. But it has to be part of your daily life to work sustainably.

If you're read "In Defense of Food," where author defends the concept of real food having great value in its aesthetics alone (and not as a vehicle for nutrient/vitamin-delivery) -- then I want to pony up a similar concept, "In Defense of Exercise," where you don't do some exercise because it's good for you, but because you LIKE it.
 
The glycemic index isn't perfect, but it helps people conceptualize why a blueberry has less blood sugar/insulin impact than a piece of white bread.



Well that's kind of the point. These commonly accepted ideas don't work when it comes to real world weight loss.



But for how long? Until the metabolism slows to adapt to the reduced calories? Or until the person tires of being hungry all the time and throws in the towel? I'm not saying calories don't count. I'm saying that too much calorie restriction doesn't work.



Or perhaps it reflects biology.

Did you learn all your knowledge in chiropractic school?
 
I'm still at the point where I don't gain weight regardless of what I do, but boxing is incredible. Every day is more intense than anything else I've done, including the 15 years of soccer. If you have a gym in your area, they're usually not a very big expense (first gym was 60/month, one I'm at now is 40/month).
 
I think physical fitness starts with mindset (before working out and calorie counting). Your biggest obstacle is achieving momentum, i.e. forming the necessary habits to get fit. Staying fit is much easier than getting fit.
I tell you this as a private practice anesthesiologist that finished residency in 2008. I entered medical school bound and determined to not gain weight and make physical fitness a priority. I felt I succeeded: since my first year of medical school I've run 9 marathons, competed in 3 olympic distance triathlons, 5 half ironman triathlons, and have done the ironman triathlon 3 times.
As a medical student/resident you will spend a fair amount of time in a sleep deprived state, but so do individuals that train in the US Special Forces. I'm not even in the same league with those guys, but we're all human and if they can do it why can't I? That was the mindset I adopted. It IS possible, there WILL be sleep deprivation, and I REFUSE to be a sedentary individual when I've been blessed with good health.

Another point: people in our line of work tend to be goal oriented. Since college, I've found that i'm in top shape when I'm training towards a goal (usually a race). I never really just train for the sake of working out. Challenge yourself with a goal; enter a 10K 4-6 months away, find a training schedule online, build up your mileage, and get after it. Also, people in our field tend to be ego driven, so tell others what your training for, knowing you'll have the added pressure of adhering to the goal for fear of telling them you failed otherwise.

Some tips to help you avoid the pitfalls:

-take your workout clothes/gear with you when you leave home if you plan on working out after work (you loose serious momentum if you go home between work and working out... go straight from work to the gym, lake, park...)

-consistency! try to go to bed at the same time every night for a better night's sleep. This is hard to do during residency, but make the effort. I'm in bed by 9pm and up at 3am for my first workout of the day.

-count calories; i use the LiveStrong App on my iPhone and log what I eat and stay at my goal. you can also use FitDay.com (it's free). These programs take age, sex, lifestyle, weight, height, and baseline daily activity to calculate basal metabolic needs and you can enter in your exercise each day and increase you daily caloric allowance

-HYDRATE!!! I find my appetite is under control when I consume copious fluids (not beer, although enjoy a good beverage every once and a while). The basic guideline for this... keep your urine clear. I drink at least a gallon of water and/or crystal light a day.

-avoid eating within two hours of going to bed. consuming calories and then partaking in the most of sedentary activities (sleep) promotes adipose deposition.

-it's more than just defined biceps, shoulders, and calves. True power and speed stars with your core. Personally, if I've been out of the weight room for a while, I work on core strength for about 2 weeks prior to resuming a lifting routine. I cannot express how much more you'll get out of training if your abdominal, lower lumber, glutes, iliacus, and psoas muscles are already trained.

I could go on and on, but my point is this: getting started is never easy. It's down right impossible if you're not in the right mind set.
 
-HYDRATE!!! I find my appetite is under control when I consume copious fluids (not beer, although enjoy a good beverage every once and a while). The basic guideline for this... keep your urine clear. I drink at least a gallon of water and/or crystal light a day.

:thumbup:

Sometimes you think you are hungry but in fact, you are just thirsty.
 
I am not sure about assigning a percentage point, but I agree that diet is clearly much easier to get a handle on than say working out 10 hours a week in addition to the hospital schedule. I will give you my experience:

STARTED SLOWLY Back in December I started working out again. I started VERY SLOWLY, working out once a week. My exercise plans have been sidelined numerous times over the past 10 years by injuries (shoulder, knee, both wrists, etc). My plan was to progress so slowly that I would not get injured and sidelined again.

I would start each workout by jogging one lap around a mini indoor track (1/14th of a mile). Then I would go to the body weight exercises, then to the weights.

I knew I would not have much time, so my workouts had to be less than an hour and I had to cover every major muscle group in just two workouts a day. I accomplished this by working out fast. No long rests between sets or even exercises. Rest for a few seconds (30 max) and move on. It is a great way to get your heart rate up and keep it up. If at any point I felt I have done too much with a specific joint or muscle group I would immediately stop and move on to the next group, or end the day.

My workouts are basically (~Push) 1 day of chest, shoulders, triceps, neck, stomach; and (~Pull) 1 day of back, biceps, legs, forearms.

As my body adapted I increased reps, sets and weight. Unfortunately to most I have been able to work out in a week is three times (but usually on twice) due to work and family life.

BODY FAT When I started my body fat percentage was over 16%. The first time I measured it was after 4 weeks, so I am not sure what it was in the beginning. My goal was to get to 8% initially. I quickly dropped down to 14-14.5% and then made no progress with it. One of the problems was that my increased exercise was balanced by an increase in appetite. Week 9 I decided to change my diet. I started bringing food to work and snacking during breaks.

DIET I started eating mostly soups at the hospital since they are one of the healthiest choices. I also consciously minimized my carb intake and maximized protein intake. If I had a grilled chicken sandwich I would tear of excess parts of the bun. I avoided chips and fries. My snacks from home were either plain low-fat yogurt with a piece of fresh fruit, low-fat or fat free cottage cheese and a piece of fresh fruit, or a plain baked sweet potato. I eat fruit often and try to get fresh vegetables into my diet. I also drink whey protein shakes at home once or twice a day with skim milk. I never count calories, it is just more work than I am interested in at this point.

HUNGER I NEVER go hungry. If I am hungry I eat something healthy. I am not super strict with all this though. I still have the occasional brownie at a lunch lecture. I have actually been trying to gain muscle and burn fat at the same time so I usually eat even when not hungry.

So my starting weight was 159 lbs at >16% body fat. I am now at 164 lbs at <12% body fat. My new goal is 170 lbs at <10% body fat.

After my early plateau, it is now clear that diet is going to be the biggest factor in me reaching my goal.

Obviously loosing weight is a different goal altogether, a few things remain the same:
1. Diet is much easier to control than making up for it through endless hours of exercise.
2. You have to lift weight and eat significant amounts of protein to maintain muscle mass as you loose fat.
3. With higher protein diets you have to get plenty of fiber (fruits, veggies) or things don't "move" the way the should.
4. Start slow and don't worry about what anyone else at the gym is lifting. If you do you will be injured and/or discouraged.

Good luck on meeting your goals.

-ENDER
 
i was in a very similar position as the OP a few months ago. my weight had balooned up to 170 , mostly fat, up from 145 in college.

i started p90x, stuck with it every day, cut out soda , dessert, and all the other crap i ate. i treat myself to 1 or 2 'cheat' meals ( like a burger or fries or something) in a week. the first month i dropped 10 lbs. i'm on day 37 of p90x and am down 14 lbs now. my body fat has been cut down a lot and i've seen nice gains in my biceps and triceps too.

diet has a lot to do with it, but working out does too - the more muscle you build, the faster your metabolism will get as well. remember, your body stores the fat you eat, along with extra protein/carbs and other unneeded stuff as fat. you need aerobic excercise to access these fat stores and burn them off.

you dont need p90x, or impossible 60, or revabs or whatever there is - if u know how to work out. i was never experienced in working out so p90 offered me a great 1 hour routine to follow every day and the results so far have rocked.

good luck!
 
i was in a very similar position as the OP a few months ago. my weight had balooned up to 170 , mostly fat, up from 145 in college.

i started p90x, stuck with it every day, cut out soda , dessert, and all the other crap i ate. i treat myself to 1 or 2 'cheat' meals ( like a burger or fries or something) in a week. the first month i dropped 10 lbs. i'm on day 37 of p90x and am down 14 lbs now. my body fat has been cut down a lot and i've seen nice gains in my biceps and triceps too.

diet has a lot to do with it, but working out does too - the more muscle you build, the faster your metabolism will get as well. remember, your body stores the fat you eat, along with extra protein/carbs and other unneeded stuff as fat. you need aerobic excercise to access these fat stores and burn them off.

you dont need p90x, or impossible 60, or revabs or whatever there is - if u know how to work out. i was never experienced in working out so p90 offered me a great 1 hour routine to follow every day and the results so far have rocked.

good luck!

Lots of residents here do P90x. I even tried it a few years back. It was just way to difficult and exhausting for anyone starting out. Who has time to exercise 1-1.5 hrs per day (the three day a week ab ripper adds almost another 30 min)? I did it for about two weeks and couldn't keep it up. I was constantly tired and had no time for my family. Don't get me wrong the workouts are really good, but just too time consuming.
 
Lots of good thoughts on this thread.

The key is consistency. Regular workouts.

The general formula of calories in must be less than calories out holds true and is the true metric.

That said, using the same calorie total everyday like Pane only works for an individual who has a baseline that is consistent.

Better for people who train unevenly throughout the week

Calculate your BMR
http://www.runningforfitness.org/ca...ctive&mileage=60&units=miles&Submit=Calculate

Figure out your calories expended:
http://www.prohealth.com/weightloss/tools/exercise/calculator1_2.cfm

Plan on a caloric deficit such as negative 500 calories a day. This will allow you to lose 1 lb a week safely.

I need about 3000 cal/day for BMR. I rode 60 miles yest which burned 3000 or so. But I ate some ice cream, m&ms and had two guiness. No 6 pack abs for me!
 
px90 is awesome. works so well. take it easy. you will be RIPPED after 90 days. diet important too.

My wife does P90X, that thing will break you.:boom:

I suggest you start out easy with a long term plan. FInd an activity you like and commit to doing it a few times a week. Join a basketball league or ultimate frisbee or something. I like hockey. THen commit to the gym every postcall day off. The next thing you know, you are wanting more. THe workouts are not enough so you start going more often. Now you are in a routine. When ICU breaks you, take a day off. It's not the end of the world. Watch what you eat. Shrink your portions. This is the most difficult.

Or you could start running 100 miles a week like Dre'.:barf:

My residency workout routine was the gym about twice a week when I was doing good. Run 5 miles (I know, I'm a wimp Dre') 1-2 times a week. On the weekends I was busy like crazy. Long bike rides or all day snowboarding. I typically added a mountainbike ride or two in every week. Usually, if I got home early I'd head to the trails but for those months (ICU or trauma) I'd be lucky to get any workout in.

It's not so much about finding a routine for me as it is a lifestyle. Corny I know but I feel much better when I am active. I find that when I try to stick to a rigid routine I doomed to fail. But when I enjoy the activity I just want more.
 
What about GET INSANITY...supposedly its like P90x but more intense...was thinking about getting it to get in shape for the summer...gained some "love weight" during a relationship that just ended and ready to go play now!

:soexcited::rofl:
 
All the above stuff are great recs--

P90x rocks- but like some others said--- WAY too long and hard to stick to with anesthesia schedules especially if you're having a hard time to begin with. Beachbody does 10-minute trainer which is a great place to start if you don't go to the gym. But the biggest thing I found that helped, especially going into CA-1 year was completely changing the way I ate.

I gained 20 pounds the first four months of CA-1. Why? Cause I would eat cereal or other carbs for breakfast at 6 a.m. before setting up my room and then not get a morning break till 11 and gorge on some sort of high carb satisfying to taste snack. Then I'd gorge again on convenient crap at lunch. The no break till dinner when I'd go home and veg and eat whatever again. horrible insulin surges. Then I started the South Beach diet. AWESOME. Three eggs with salsa/veggies and cheese at 6 a.m.- not even one iota of hungry till 11 or 12- high protein lunch (cafeteria salad, whole wheat stuff, etc.)-- string cheese, bananas with peanut butter, nuts for snacks. combined with a 30 minute workout every other day...boom-- 25 pounds gone in 2 months. And I'm still eating like this and it works-- and I'm much happier during the day in the OR.
 
I think physical fitness starts with mindset (before working out and calorie counting). Your biggest obstacle is achieving momentum, i.e. forming the necessary habits to get fit. Staying fit is much easier than getting fit.
I tell you this as a private practice anesthesiologist that finished residency in 2008. I entered medical school bound and determined to not gain weight and make physical fitness a priority. I felt I succeeded: since my first year of medical school I've run 9 marathons, competed in 3 olympic distance triathlons, 5 half ironman triathlons, and have done the ironman triathlon 3 times.
As a medical student/resident you will spend a fair amount of time in a sleep deprived state, but so do individuals that train in the US Special Forces. I'm not even in the same league with those guys, but we're all human and if they can do it why can't I? That was the mindset I adopted. It IS possible, there WILL be sleep deprivation, and I REFUSE to be a sedentary individual when I've been blessed with good health.

Another point: people in our line of work tend to be goal oriented. Since college, I've found that i'm in top shape when I'm training towards a goal (usually a race). I never really just train for the sake of working out. Challenge yourself with a goal; enter a 10K 4-6 months away, find a training schedule online, build up your mileage, and get after it. Also, people in our field tend to be ego driven, so tell others what your training for, knowing you'll have the added pressure of adhering to the goal for fear of telling them you failed otherwise.

Some tips to help you avoid the pitfalls:

-take your workout clothes/gear with you when you leave home if you plan on working out after work (you loose serious momentum if you go home between work and working out... go straight from work to the gym, lake, park...)

-consistency! try to go to bed at the same time every night for a better night's sleep. This is hard to do during residency, but make the effort. I'm in bed by 9pm and up at 3am for my first workout of the day.

-count calories; i use the LiveStrong App on my iPhone and log what I eat and stay at my goal. you can also use FitDay.com (it's free). These programs take age, sex, lifestyle, weight, height, and baseline daily activity to calculate basal metabolic needs and you can enter in your exercise each day and increase you daily caloric allowance

-HYDRATE!!! I find my appetite is under control when I consume copious fluids (not beer, although enjoy a good beverage every once and a while). The basic guideline for this... keep your urine clear. I drink at least a gallon of water and/or crystal light a day.

-avoid eating within two hours of going to bed. consuming calories and then partaking in the most of sedentary activities (sleep) promotes adipose deposition.

-it's more than just defined biceps, shoulders, and calves. True power and speed stars with your core. Personally, if I've been out of the weight room for a while, I work on core strength for about 2 weeks prior to resuming a lifting routine. I cannot express how much more you'll get out of training if your abdominal, lower lumber, glutes, iliacus, and psoas muscles are already trained.

I could go on and on, but my point is this: getting started is never easy. It's down right impossible if you're not in the right mind set.


i agree with hydration and myself drink about 2 liters a day but those 2liters are mostly consumed after i get home from the hospital. i know that you're an attending now and have different work hours than residents, but how can residents drink a gallon of water a day? do you walk around with a foley? cause no way will a resident get room coverage that often to use the bathroom every hour, that's just impossible.
 
My wife does P90X, that thing will break you.:boom:

I suggest you start out easy with a long term plan. FInd an activity you like and commit to doing it a few times a week. Join a basketball league or ultimate frisbee or something. I like hockey. THen commit to the gym every postcall day off. The next thing you know, you are wanting more. THe workouts are not enough so you start going more often. Now you are in a routine. When ICU breaks you, take a day off. It's not the end of the world. Watch what you eat. Shrink your portions. This is the most difficult.

Or you could start running 100 miles a week like Dre'.:barf:

My residency workout routine was the gym about twice a week when I was doing good. Run 5 miles (I know, I'm a wimp Dre') 1-2 times a week. On the weekends I was busy like crazy. Long bike rides or all day snowboarding. I typically added a mountainbike ride or two in every week. Usually, if I got home early I'd head to the trails but for those months (ICU or trauma) I'd be lucky to get any workout in.

It's not so much about finding a routine for me as it is a lifestyle. Corny I know but I feel much better when I am active. I find that when I try to stick to a rigid routine I doomed to fail. But when I enjoy the activity I just want more.

I agree Noy. I've always been most successful getting into shape when I've NOT made it a chore of some kind.
 
i agree with hydration and myself drink about 2 liters a day but those 2liters are mostly consumed after i get home from the hospital. i know that you're an attending now and have different work hours than residents, but how can residents drink a gallon of water a day? do you walk around with a foley? cause no way will a resident get room coverage that often to use the bathroom every hour, that's just impossible.


case turnover perhaps?
 
To me, it's not the hunger but the low sugar which makes me shake and feel weak causing me overeating more than enough carbs. Does anyone here has any idea how to deal with it?? without overeating to handle the feeling . I know I can tolerate hunger more than sleep deprivation, ie, I can go to sleep while feeling hungry but when I am at work, I can't go home and sleep.
 
To me, it's not the hunger but the low sugar which makes me shake and feel weak causing me overeating more than enough carbs. Does anyone here has any idea how to deal with it?? without overeating to handle the feeling . I know I can tolerate hunger more than sleep deprivation, ie, I can go to sleep while feeling hungry but when I am at work, I can't go home and sleep.

Eating more protein and fats at meals will help, but most importantly eat every 2-3 hours. That will require you to have snacks on hand, and those snacks should include at least some protein and fat. Avoiding obvious junk carbs will help level out your blood sugar as well, reducing the crashing feeling.
 
Eating more protein and fats at meals will help, but most importantly eat every 2-3 hours. That will require you to have snacks on hand, and those snacks should include at least some protein and fat. Avoiding obvious junk carbs will help level out your blood sugar as well, reducing the crashing feeling.
I will try . The snacks with high protein and fat, I am thinking about KFC Fried chicken wings or drumsticks. am I getting the idea?? Or I just overdo it?
 
I will try . The snacks with high protein and fat, I am thinking about KFC Fried chicken wings or drumsticks. am I getting the idea?? Or I just overdo it?

:laugh:

No, I think you're right on. Good one.
 
There are no secrets to loosing weight and keeping it off. Lean diet will ALWAYS = LEAN body. I count calories, which requires me to know exactly how many calories are in everything I consume. There are plenty of online resources to identify the caloric content of most foods if they are not already labeled. My goal every day is to limit my caloric intake to 500 (approx. five 100 cal mini meals) calories until dinner, which it typically at 6-8PM. I will then consume a dinner of 1000 calories and go to bed before I get hungry again. Dinners out, happy hours, movies, club/bar nights, vacations etc...are difficult. I will typically not eat anything all day, allowing me to consume roughly 1500 cals during these activities.

I'm not going to sugar coat this routine, it's hard as hell!!! I also lift hard core weights 6 hours per week and I'm 6'2''. I'm convinced that 99.99999% of people are simply eating WAY TOO MUCH and as a result will always be WAY TOO FAT!!! Life is too short to spend in a fat body, why not spend it in a beach worthy body. No food satisfies me like feeling 100% confident shirtless at the lake, pool, beach, locker room, anywhere I feel like it.... A 6'2'' highly active man can thrive on 1500 calories/day.:D

Pane, what do you do to keep track of your 1500 calories / day? I haven't done extensive research, but I've read enough to be pretty interested in low-calorie diets like this.

I tried once, but it was a huge, huge hassle. My wife and I make most of our food from scratch, so it was too time-consuming to calculate up the dozen or so ingredients in each recipe. I made an account on one of those diet websites that lets you track caloric intake, but it was taking like 30 minutes a day to enter everything, so I dropped it.

Any suggestions?
 
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case turnover perhaps?


yeah i guess, but at the places i've rotated, by the time you bring the pt. to the pacu the other pt is already waiting in the holding area, however rooms sometimes took a few min to turn over so i guess you could chug a few cups of water and pee before seeing the next pt. however, if it's a 4 hour case then a foley might be needed.
 
I will try . The snacks with high protein and fat, I am thinking about KFC Fried chicken wings or drumsticks. am I getting the idea?? Or I just overdo it?

You've got the wrong idea! Focus on leaner sources of protein: skinless chicken (not KFC, please), turkey, fish, lean beef (grass-fed best if you can swing it), eggs. Nuts make excellent snacks (protein plus good fats). Avoid things deep fried or cooked in vegetable oils (corn oil, safflower, cottonseed, even soybean oils...all too high in omega-6 fats, which promotes inflammation). Consider supplementing with fish oil to further tilt the n3:n6 ratio in your anti-inflammatory favor.
 
There are no secrets to loosing weight and keeping it off. Lean diet will ALWAYS = LEAN body. I count calories, which requires me to know exactly how many calories are in everything I consume. There are plenty of online resources to identify the caloric content of most foods if they are not already labeled. My goal every day is to limit my caloric intake to 500 (approx. five 100 cal mini meals) calories until dinner, which it typically at 6-8PM. I will then consume a dinner of 1000 calories and go to bed before I get hungry again. Dinners out, happy hours, movies, club/bar nights, vacations etc...are difficult. I will typically not eat anything all day, allowing me to consume roughly 1500 cals during these activities.

I'm not going to sugar coat this routine, it's hard as hell!!! I also lift hard core weights 6 hours per week and I'm 6'2''. I'm convinced that 99.99999% of people are simply eating WAY TOO MUCH and as a result will always be WAY TOO FAT!!! Life is too short to spend in a fat body, why not spend it in a beach worthy body. No food satisfies me like feeling 100% confident shirtless at the lake, pool, beach, locker room, anywhere I feel like it.... A 6'2'' highly active man can thrive on 1500 calories/day.:D

Works for you, but just not sustainable for most patients.
 
There are no secrets to loosing weight and keeping it off. Lean diet will ALWAYS = LEAN body. I count calories, which requires me to know exactly how many calories are in everything I consume. There are plenty of online resources to identify the caloric content of most foods if they are not already labeled. My goal every day is to limit my caloric intake to 500 (approx. five 100 cal mini meals) calories until dinner, which it typically at 6-8PM. I will then consume a dinner of 1000 calories and go to bed before I get hungry again. Dinners out, happy hours, movies, club/bar nights, vacations etc...are difficult. I will typically not eat anything all day, allowing me to consume roughly 1500 cals during these activities.

I'm not going to sugar coat this routine, it's hard as hell!!! I also lift hard core weights 6 hours per week and I'm 6'2''. I'm convinced that 99.99999% of people are simply eating WAY TOO MUCH and as a result will always be WAY TOO FAT!!! Life is too short to spend in a fat body, why not spend it in a beach worthy body.
No food satisfies me like feeling 100% confident shirtless at the lake, pool, beach, locker room, anywhere I feel like it.... A 6'2'' highly active man can thrive on 1500 calories/day.:D

Oh hell yeah. To quote Kate Moss, "nothing tastes as good as skinny feels"!

:laugh:

[YOUTUBE]http://www.youtube.com/watch?v=m_60PERtd6o[/YOUTUBE]
 
There are no secrets to loosing weight and keeping it off. Lean diet will ALWAYS = LEAN body. I count calories, which requires me to know exactly how many calories are in everything I consume. There are plenty of online resources to identify the caloric content of most foods if they are not already labeled. My goal every day is to limit my caloric intake to 500 (approx. five 100 cal mini meals) calories until dinner, which it typically at 6-8PM. I will then consume a dinner of 1000 calories and go to bed before I get hungry again. Dinners out, happy hours, movies, club/bar nights, vacations etc...are difficult. I will typically not eat anything all day, allowing me to consume roughly 1500 cals during these activities.

I'm not going to sugar coat this routine, it's hard as hell!!! I also lift hard core weights 6 hours per week and I'm 6'2''. I'm convinced that 99.99999% of people are simply eating WAY TOO MUCH and as a result will always be WAY TOO FAT!!! Life is too short to spend in a fat body, why not spend it in a beach worthy body. No food satisfies me like feeling 100% confident shirtless at the lake, pool, beach, locker room, anywhere I feel like it.... A 6'2'' highly active man can thrive on 1500 calories/day.:D

I think you might have an eating disorder. and i am not trying to be funny here.


edit, didn't see the video before posting this, I guess the poster above beat me to it.
 
Let's keep it civil, sport. And, no.

I was just curious if they taught you about knowledge in this subject. I didn't mean to sound like a dick if that is what you thought.
 
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