Healthy Habits for ED Trainees/Attendings

Discussion in 'Emergency Medicine' started by vengaaqui, Jun 4, 2012.

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  1. vengaaqui

    vengaaqui 5+ Year Member

    Sep 21, 2011
    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!
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  3. WilcoWorld

    WilcoWorld Senior Member 10+ Year Member

    Nov 2, 2004
    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.
  4. Bojack Horseman

    Bojack Horseman hey! 5+ Year Member

    May 8, 2011
    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.
  5. EvoDevo

    EvoDevo Forging a Different Path Moderator Emeritus 10+ Year Member

    Jun 5, 2003
    Crazy Town
    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.
  6. Jarabacoa

    Jarabacoa non carborundum ilegitemi 10+ Year Member

    Mar 24, 2005
    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.
  7. AlmostJesus

    AlmostJesus 5+ Year Member

    Mar 11, 2011
  8. tkim

    tkim 10 cc's cordrazine 10+ Year Member

    Aug 2, 2002
    New England
    Tongue in (ass) cheek.
  9. 8654Marine

    8654Marine 2+ Year Member

    Feb 6, 2012
    An awesome quote!!

    fiber or it's semi-colon.

    One word: kimchee.
  10. Pinner Doc

    Pinner Doc drop knees, not bombs 7+ Year Member

    Jan 31, 2006
    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.
  11. SnowyRox

    SnowyRox Pennwe c/o 2016

    Jan 30, 2012
    For when you realize that you haven't eaten anything green yet that day:

    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.
  12. Jarabacoa

    Jarabacoa non carborundum ilegitemi 10+ Year Member

    Mar 24, 2005

    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."
    Last edited: Jun 5, 2012
  13. 8654Marine

    8654Marine 2+ Year Member

    Feb 6, 2012
    Dude, that is an image!

  14. WilcoWorld

    WilcoWorld Senior Member 10+ Year Member

    Nov 2, 2004
    I nominate Jaracoba for The Post of the Week Award.

    His advice is solid, but his poops are semisolid.
  15. 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
  16. alphaholic06

    alphaholic06 Doctor, Who? Me? 10+ Year Member

    Jan 14, 2004
    Damn that, Post of the year!
  17. The White Coat Investor

    The White Coat Investor AKA ActiveDutyMD Partner Organization 10+ Year Member

    Nov 18, 2002
    SDN Partner
    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.
  18. pinipig523

    pinipig523 I like my job! 10+ Year Member

    Jan 6, 2004
    Missing Chicago
    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.
  19. DreamingTheLive

    DreamingTheLive (something witty here) 5+ Year Member

    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.
  20. Arcan57

    Arcan57 Junior Member 10+ Year Member

    Nov 21, 2003
    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.
  21. 8654Marine

    8654Marine 2+ Year Member

    Feb 6, 2012

    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.
  22. Bojack Horseman

    Bojack Horseman hey! 5+ Year Member

    May 8, 2011
    Beans? You can eat them right out of the can of you want.
  23. WilcoWorld

    WilcoWorld Senior Member 10+ Year Member

    Nov 2, 2004
    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.
  24. Dr.McNinja

    Dr.McNinja Nobel War Prize Winner SDN Moderator 10+ Year Member

    Aug 2, 2006
    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.
  25. EM2BE

    EM2BE Elf 7+ Year Member

    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.
  26. 8654Marine

    8654Marine 2+ Year Member

    Feb 6, 2012
    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.
  27. jendc08

    jendc08 Member 10+ Year Member

    Jun 28, 2005
    em2be How did you get TInanalli's on iPad? Is it an ebook or pdf?
  28. EM2BE

    EM2BE Elf 7+ Year Member

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

    docB Chronically painful Moderator Emeritus Lifetime Donor 10+ Year Member

    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.
  30. Apollyon

    Apollyon Screw the GST Lifetime Donor 10+ Year Member

    Nov 24, 2002
    Haha docB - your 7000th post on SDN is about dropping a deuce and taking a squirt! Epic!

  31. docB

    docB Chronically painful Moderator Emeritus Lifetime Donor 10+ Year Member

    :D I wouldn't have had it any other way.
  32. BJJVP

    BJJVP 5+ Year Member

    Feb 5, 2011
    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.

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