How do you keep from getting fatigued by long hours of mentally demanding work

[startoverat40]

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when i'm doing a lot of mentally demanding work, problem solving, planning, studying etc, I burn up a lot of energy, and even if I'm sitting the whole time, my whole body feels fatigued. Now I'm thinking ahead for clinical clerkship, internship, residency, and I'm wondering how do people feed their brains and bodies to keep up their energy levels while doing clinical work. Drinking Pepsi gives me a big energy boost (for some reason Coke doesn't work for me). But of course drinking soda is very unhealthy for our metabolism, and for our teeth. loading up on coffee is not the best thing either.

I'd like to hear from MS3/4s and above, what is your diet and exercise practices to keep up your energy levels? do you rely on soda, candy, and junk food, or do you snack on fruits, nuts, granola bars all day/night. I think just sitting all day adds to my fatigue. do you exercise before/after/during your shift? would it help if there were treadmills in the Resident/Doctor lounges?

i found this amusing page with a web search, but I hope I can get more feedback on this forum. Thanks!

http://geeeyerounding.wordpress.com/2010/08/24/med-students-dont-get-fat/

 

[VisionaryTics]

If you're stressed about school/life/health balance, check out Wellness Rounds. Terrific blog with lots of advice on everything related to keeping your head on straight in medicine.

 

[TAWS]

Drinking soda is not bad for your teeth if you use a straw.

 

[startoverat40]

VisionaryTics, that looks like a really good site, thanks! i'm not stressed about it, just want to know the tricks ahead of time.
TAWS, your molars will still get exposed, plus its bad for your metabolism. I try to avoid it, unless i'm really drained, and nothing else will do the trick. only happens once every few months.

 

[Valadi]

monster energy drinks, coffee, cigarettes, willpower

 

[startoverat40]

monster energy drinks, coffee, cigarettes, willpower

i'm looking for healthy ways to increase and maintane energy levels, not monster sugar drinks and caffein. Willpower yes, but even that is affected by mood, which is affected by physiological state. so maintaining a good physiological state will maintain a good mood, which will maintain a strong willpower.

cigarettes? 👎thumbdown👎

Tobacco use is a major cause of many of the world’s top killer diseases – including cardiovascular disease, chronic obstructive lung disease and lung cancer. In total, tobacco use is responsible for the death of almost one in 10 adults worldwide. Smoking is often the hidden cause of the disease recorded as responsible for death.

http://www.who.int/mediacentre/factsheets/fs310/en/index2.html

 

[Valadi]

i'm looking for healthy ways to increase and maintane energy levels, not monster sugar drinks and caffein. Willpower yes, but even that is affected by mood, which is affected by physiological state. so maintaining a good physiological state will maintain a good mood, which will maintain a strong willpower.

cigarettes? 👎thumbdown👎

Hey... stop being a judger. I gave an honest answer. Also judging probably takes a lot of energy and is likely contributing to your fatigue.

 

[FunnyCurrent]

when i'm doing a lot of mentally demanding work, problem solving, planning, studying etc, I burn up a lot of energy, and even if I'm sitting the whole time, my whole body feels fatigued. Now I'm thinking ahead for clinical clerkship, internship, residency, and I'm wondering how do people feed their brains and bodies to keep up their energy levels while doing clinical work. Drinking Pepsi gives me a big energy boost (for some reason Coke doesn't work for me). But of course drinking soda is very unhealthy for our metabolism, and for our teeth. loading up on coffee is not the best thing either.

I'd like to hear from MS3/4s and above, what is your diet and exercise practices to keep up your energy levels? do you rely on soda, candy, and junk food, or do you snack on fruits, nuts, granola bars all day/night. I think just sitting all day adds to my fatigue. do you exercise before/after/during your shift? would it help if there were treadmills in the Resident/Doctor lounges?

i found this amusing page with a web search, but I hope I can get more feedback on this forum. Thanks!

http://geeeyerounding.wordpress.com/2010/08/24/med-students-dont-get-fat/

It's sink or swim... the people who couldn't get motivated enough who couldn't focus enough dropped out... (one has quit completely and the other is on a decelerated track). The rest of us understand what failure means and have the corresponding amount of eustress/adrenaline to feel motivated.

Just wait until medical school starts you are in for a surprise. Good Luck!!!

 

[muhali3]

Sulbutiamine or Rhodiola Rosea

 

[Arky]

Hey... stop being a judger. I gave an honest answer. Also judging probably takes a lot of energy and is likely contributing to your fatigue.

Normally I would totally be on your side here because I absolutely hate it when people judge people that smoke and label them the term "smoker," which seems like a dehumanized derogatory insult. However... it's kinda different if you're a doctor... dude c'mon physicians have to lead by example!

 

[startoverat40]

i seem to be misunderstood. I'm not judging anyone, and I'm not having motivational issues. I'm just asking purely on a physiological basis, how to keep the mind and body going for long periods of time during clinical work, to minimize fatigue, and maintain mental function. but i'm looking for healthy ways, not with sugar drinks and smoking.

I'd like to hear from curent interns and residents. do you keep snack bars in your pockets? Do you go outside and do jumping jacks or something? Maybe you don't even have time for such a thing and you think i must be joking. Then how do you do it?

 

[MilkmanAl]

Regular sleep and regular exercise: accept no substitute. I have had no problem whatsoever being caffeine, energy drink, soda, etc.-free all through med school. I have yet to pull an all-nighter for school (ever - college or med school) and have studied past 10 a grand total of twice. For demanding rotations during which lunch breaks were unusual, I carried a protein bar in my pocket, but that's about it as far as my non-meal energy level maintenance goes.

 

[HolySmokes]

Normally I would totally be on your side here because I absolutely hate it when people judge people that smoke and label them the term "smoker," which seems like a dehumanized derogatory insult. However... it's kinda different if you're a doctor... dude c'mon physicians have to lead by example!

hahahahaha

 

[MilkmanAl]

Fast forward to residency interviews: "So, Arky, do you believe obese people can be competent physicians?"

 

[mmmcdowe]

Normally I would totally be on your side here because I absolutely hate it when people judge people that smoke and label them the term "smoker," which seems like a dehumanized derogatory insult. However... it's kinda different if you're a doctor... dude c'mon physicians have to lead by example!

K, make sure that before you start medical school you:

Always use a condom
Never drink more than two standard sized alcoholic beverages a day
Always get at least 30 minutes of physical activity a day with longer periods several times a week
Always wake up at the same time every morning and go to bed the same time every night
Get at least 7.5 hours of sleep nightly
Limit caffeine consumption to one cup a day
Never consume more than your daily energy expenditure
Never consume less than your daily energy expenditure
Never pop a pimple
Always cough and sneeze appropriately
Express your feelings
Always eat a balanced diet of fruits, vegetables, grains, and lean meats
Monthly self-testicular exams or breast exams at the same time in your cycle (blah blah don't teach people how to do it blah blah)
Take your medicines exactly as prescribed to the minute
Dispose of old medications on time in the proper manner
Floss and brush twice a day
Etc, etc, etc.

😉

 

[startoverat40]

mmmcdowe, those are great general health advice for all people. but for medical people, and specifically for my question "while doing clinical work", I'd like to know how you make it through a long shift of 18 to 30 hours, and maintain your energy levels and mental functions. how do you eat, snack, rest, exercise(if at all), during your shift, so you can make it through without crashing. MilkmanAl says just carry protein bars. anything else? thanks!

 

[TAWS]

mmmcdowe, those are great general health advice for all people. but for medical people, and specifically for my question "while doing clinical work", I'd like to know how you make it through a long shift of 18 to 30 hours, and maintain your energy levels and mental functions. how do you eat, snack, rest, exercise(if at all), during your shift, so you can make it through without crashing. MilkmanAl says just carry protein bars. anything else? thanks!

I am being serious here....amphetamines. You would be surprised at how many doctors are taking them.

 

[startoverat40]

I am being serious here....amphetamines. You would be surprised at how many doctors are taking them.

hmm, sugar drinks, smoking, and abusing drugs. I'll add those to the DON'Ts list 😉

 

[Arky]

Fast forward to residency interviews: "So, Arky, do you believe obese people can be competent physicians?"

Of course, as long as it doesn't get in the way of good patient care. If a physician can get his/her patients to listen, practice healthy lifestyles, etc, then that by definition should be considered competent, I would think. That said, if you're treating someone for diabetes and hypertension associated with obesity, the patient might be more likely to listen to you when you tell them about eating healthy, excercising and maintaining a healthy weight when you youself are practicing said lifestyle choices. People are more likely to listen to advice/directions when they are followed by the person telling them so.

 

[Arky]

K, make sure that before you start medical school you:

Always use a condom
Never drink more than two standard sized alcoholic beverages a day
Always get at least 30 minutes of physical activity a day with longer periods several times a week
Always wake up at the same time every morning and go to bed the same time every night
Get at least 7.5 hours of sleep nightly
Limit caffeine consumption to one cup a day
Never consume more than your daily energy expenditure
Never consume less than your daily energy expenditure
Never pop a pimple
Always cough and sneeze appropriately
Express your feelings
Always eat a balanced diet of fruits, vegetables, grains, and lean meats
Monthly self-testicular exams or breast exams at the same time in your cycle (blah blah don't teach people how to do it blah blah)
Take your medicines exactly as prescribed to the minute
Dispose of old medications on time in the proper manner
Floss and brush twice a day
Etc, etc, etc.

😉

Touchet, however, I will do my best to continue leading a healthy lifestyle. Some things are easier/more important than others. Nobody lives a perfectly healthy lifestyle, obviously, but we can do what we can and what is most effective for our time & effort.

 

[Alvarez13]

when i'm doing a lot of mentally demanding work, problem solving, planning, studying etc, I burn up a lot of energy, and even if I'm sitting the whole time, my whole body feels fatigued. Now I'm thinking ahead for clinical clerkship, internship, residency, and I'm wondering how do people feed their brains and bodies to keep up their energy levels while doing clinical work. Drinking Pepsi gives me a big energy boost (for some reason Coke doesn't work for me). But of course drinking soda is very unhealthy for our metabolism, and for our teeth. loading up on coffee is not the best thing either.

I'd like to hear from MS3/4s and above, what is your diet and exercise practices to keep up your energy levels? do you rely on soda, candy, and junk food, or do you snack on fruits, nuts, granola bars all day/night. I think just sitting all day adds to my fatigue. do you exercise before/after/during your shift? would it help if there were treadmills in the Resident/Doctor lounges?

i found this amusing page with a web search, but I hope I can get more feedback on this forum. Thanks!

http://geeeyerounding.wordpress.com/2010/08/24/med-students-dont-get-fat/

Lots of crank.

 

[VisionaryTics]

From Annals of Surgery this month.

Effect of Pharmacological Enhancement on the Cognitive and Clinical Psychomotor Performance of Sleep-Deprived Doctors: A Randomized Controlled Trial

Objectives: To investigate the effect of modafinil 200 mg on the performance of a cohort of healthy male doctors after 1 night of supervised sleep deprivation.

Summary Background Data: Sleep-deprived and fatigued doctors pose a safety risk to themselves and their patients. Yet, because of the around-the-clock nature of medical practice, doctors frequently care for patients after periods of extended wakefulness or during circadian troughs. Studies suggest that a group of substances may be capable of safely and effectively reversing the effects of fatigue. However, little work has been done to investigate their role within our profession.

Methods: We conducted a parallel, double-blind, randomized, and placebo-controlled study to investigate the effect of pharmacological enhancement on performance doctors. Thirty-nine healthy male resident doctors received either lactose placebo (n = 19) or modafinil 200 mg (n = 20) after 1 night of sleep deprivation. A selection of CANTAB neuropsychological tests was used to assess higher cognitive function. Clinical psychomotor performance was assessed using the Minimally Invasive Surgical Trainer Virtual Reality. Assessments were carried out between 6.00 AM and approximately 8.00 AM.

Results: Modafinil improved performance on tests of higher cognitive function; participants in the modafinil group worked more efficiently when solving working memory (F1,38 = 5.24, P = 0.028) and planning (F1,38 = 4.34, P = 0.04) problems, were less-impulsive decision makers (F1,37 = 6.76, P = 0.01), and were more able to flexibly redirect their attention (F1,38 = 4.64, P = 0.038). In contrast, no improvement was seen in tests of clinical psychomotor performance.

Conclusions: Our results suggest that fatigued doctors might benefit from pharmacological enhancement in situations that require efficient information processing, flexible thinking, and decision making under time pressure. However, no improvement is likely to be seen in the performance of basic procedural tasks.

 

[DrBowtie]

I'll go ahead and be the bad guy, could it be age related? How's your health?

 

[mmmcdowe]

mmmcdowe, those are great general health advice for all people. but for medical people, and specifically for my question "while doing clinical work", I'd like to know how you make it through a long shift of 18 to 30 hours, and maintain your energy levels and mental functions. how do you eat, snack, rest, exercise(if at all), during your shift, so you can make it through without crashing. MilkmanAl says just carry protein bars. anything else? thanks!

My list was meant to be sarcastic, implying that no one is perfect- not even physicians.

 

[Valadi]

From Annals of Surgery this month.

Effect of Pharmacological Enhancement on the Cognitive and Clinical Psychomotor Performance of Sleep-Deprived Doctors: A Randomized Controlled Trial

Limitless

 

[Valadi]

OP, all joking aside the 'how-tos' of staying awake and performing become moot when you're working in the hospital. If your concern is that you won't be able to perform, I assure you that you will. When there is work to be done on the floors or in the OR and you're at you're going to be surprised as to how much you can pull out of yourself.

Do what works and is comfortable for you, but if you have back to back free tissue transfers that put you at 24 hours, no amount of protein bar or jumping jacks is going to change that you're going to stick it out because you have and want to.

 

[startoverat40]

DrBowtie - what do yo mean age related? I didn't say I had any problems. I'm just wondering how do clinicians manage to perform through a very long day.

mmmcdowe - nonetheless that's a very good list.

Valadi - I see your point. When you have to perform, the strength and energy will be mobilized from within you.

I know some doctors who do a lot of long distance running and biking. I guess endurance training could be useful.

 

[Valadi]

DrBowtie - what do yo mean age related? I didn't say I had any problems. I'm just wondering how do clinicians manage to perform through a very long day.

mmmcdowe - nonetheless that's a very good list.

Valadi - I see your point. When you have to perform, the strength and energy will be mobilized from within you.

I know some doctors who do a lot of long distance running and biking. I guess endurance training could be useful.

Indeed. When you need to perform, the best practice is performing that task and pushing yourself to do it for longer and better. Everything else is just ancillary. Focus on doing your work and it'll come, just like it has for thousands of physicians prior.