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By Sue Shekut, Owner, Working Well Massage, Licensed Massage Therapist, Wellness Coach, ACSM Personal Trainer

I came across an interesting and, in my view, important blog today called KevinMD.com. (Founded by Kevin Pho, MD, KevinMD.com is the web’s leading destination for physician insight on breaking medical news.)

Kevin-Pho-MD, Founder of KevinMD.com

Kevin-Pho-MD, Founder of KevinMD.com

The blog is written by medical doctors and covers topics about health care in general from a doctor’s point of view. Sadly, as I read some of the posts, I realize that doctors are as frustrated with our health care system as we are. Many of them want to help their patients but health care billing and payment cause them to make some hard choices in order to survive. In the post, Why I decided to opt out of Medicare as a provider by Dr. Natasha Deonarain, it is clear why continuing to see Medicare patients is not financially feasible for many physicians. I also believe that relying on insurance companies and Medicare separates people from their own health care decisions. Health care can be costly, but there are other options for routine checkups and basic medical needs.

In another blog post, by Dr. Doug Olson, Primary care doctors may no longer be needed, he explains how nurse practitioners (with nurse practitioners complete 2,300 – 5,350 hours of education and clinical training during five to seven years, compared to physicians’ standardized path of 21,700 hours over 11-12 years) and physician assistants can see 80-85% of the patients medical doctors see. Dr Olson believes that “we need to develop systems that get that select the 15-20% of patients that need a physician.” In his view this is  a better use of primary care physicians training and expertise is to treat the more complex medical cases while the nurse practitioners and physician’s assistants treat the remaining 80% of less complex cases. as patients relatively healthy folks can self select our health care providers by only going to primary care docs if they need complex services, and using Walgreens, Target and other urgent care centers for simple colds, flues and minor injuries and illnesses. And recently in Chicago, there is a service that offers doctors making house calls, Chicago Express Doctors.

Chicago Express Doctors

Chicago Express Doctors

Massage Therapy and The New World Of Health Care

So where does massage therapy fit into all this? First off, I acknowledge that at least in the State of Illinois, massage therapy is not really a recognized health care option. According to the scope of practice for Illinois Massage Therapists, we are to provide massage therapy for the purposes of general health and well-being, but not to treat nor diagnose illnesses. Yet one of the most reported benefits of massage therapy is stress reduction (which can be thought of as pertaining to “general health”). The health effects of stress on the body include numerous illnesses and can even lead to injuries. KevinsMD has an article on How the stress of caregiving can lead to stroke. The Mayo Clinic reports that many health problems can be effected by stress including stomach pains, headaches, chest pains, sleep problem and anxiety. According to WebMD, “Seventy-five percent to 90% of all doctor’s office visits are for stress-related ailments and complaints.”

So what does massage therapy do for clients with stress-related ailments? According to one research study at Duke University, massage therapy was shown to reduce self reported stress in patients with brain tumors. Another pilot study showed that stress levels of inpatient psychiatric patients were reduced after massage therapy. And, according to the MayoClinic, massage therapy can not only reduce stress, but lead to other health benefits as well.

I do not think massage therapy is s substitute for medical care. And I do not think massage therapists should try to act as doctors nor prescribe nor diagnose illnesses. But I do believe that massage therapy sessions can be a source of relaxation, a time for our nervous systems to ramp down to parasympathetic mode versus ramping up to sympathetic (flight or flight) mode. Allowing ourselves to be cared for, relaxed and to spend time in an environment of reduced noise, stress and constant demands allows our bodies to better do what they do naturally: our hearts beat, our immune systems fight off infection and our lungs and muscles allow us to work, move and life. Allowing our bodies to stay healthy means less needs to visit the doctor so our medical providers can focus on us when we very sick, not for routine illnesses and injuries. For this reason, I think that massage therapists can offer stress relief BEFORE we get an illness, a stress-related injury or just plain get cranky from stress!

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The Rockefeller Center Christmas Tree in New Y...
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Having a hard time keeping a handle on your fitness and nutrition goals this time of year?  You are not alone.  Holiday shopping, parties and extra goodies make it tough for everyone. Read what the experts at WebMD say about keeping on track with your fitness routine during this busy time of year.

Your Holiday Fitness Program

The holiday season can be enough to derail even the most dedicated exerciser. Here are some tips to help you stay fit through New Year’s.
By Carol Sorgen
WebMD Weight Loss Clinic-Feature

You’re busy, you’re stressed, it’s chilly out… so why not just take a break from your fitness program until the New Year?

Sure, you can always come up with an excuse not to exercise. But slacking off on your fitness program during the holidays will only leave you with more pounds — and more stress — come New Year’s. Fitness experts recognize that this time of year is difficult for many people trying to stick to an exercise program, so they have some suggestions to keep you motivated and disciplined.

The first step, says lifestyle coach April Masini, is acknowledging the holidays probably will affect your exercise program to some extent. Then you can make adjustments that will help you stay fit during the season. For example, if you usually take exercise classes only offered at a certain time, skip the classes and take a hike or a swim at an indoor pool instead.

“Take an honest look at your schedule, and instead of trying to squeeze exercise into your schedule, take other things out,” Masini suggests. “The goal is not to do more (as we all have a tendency to do this time of year), but to do less, but do it all well.”

It’s also important to keep fitness a priority in your schedule, says Rich Ray, chairman of the Kinesiology Department at Hope College in Holland, Mich.

“Whether or not you already have well-established exercise habits, make sure you actually schedule time into your day for your exercise,” he says. “There’s nothing like having an entry in your Palm Pilot for exercise.”

Indeed, maintaining a workout schedule is even more important this time of year because most of us tend to eat more than usual, says Michael Thurmond, author of the 6 Week Body Makeover and resident fitness guru on ABC’s “Extreme Makeover.”

As such, Thurmond recommends not only keeping to your same schedule, but striving to add an extra workout session or two whenever possible.

Be Flexible and Mix It Up

Here are some more expert tips for staying fit during the time-crunched, temptation-packed holiday season:

  • Be flexible when your days get busy, Ray advises. Instead of simply blowing off your 5 p.m. trip to the gym in favor of an office party at the same time, wake up an hour early and walk or jog before work. Or fit a brisk walk into your lunch hour.
  • Mix up your routine to avoid boredom. “If you usually run four days a week, try running once, swimming once, and lifting weights twice,” Ray says. “The novelty of the new exercise will hopefully be a stronger motivator than the ‘need’ to do something else during your normal exercise time.”
  • To save time, Ray recommends combining exercising and family commitments. For example, hauling the kids up a hill a few times can make a sledding trip as beneficial as a jog. Taking the family snowshoeing, cross-country skiing, or on a backpacking trip will provide exercise as well as quality time with loved ones.
  • Coraggio recommends creating a home workout routine for those times you can’t make it to the gym. Crunches, push-ups, and many other exercises can be done without any gym equipment.
  • Walking is an exercise that can go anywhere, from the woods to the mall, says health and lifestyle coach Jackie Keller, author of Body After Baby: The Simple 30-Day Plan to Lose Your Baby Weight. “Always have a pair of running or walking shoes with you, along with a set of light, hand-held weights, and a clean pair of socks,” Keller suggests. “If all else fails, you have the minimum equipment necessary to get in a walk.” Another Keller suggestion: add a heavy book to a backpack to make your walk more challenging.

5 Cold-Weather Workout Tips

If cold weather is derailing your fitness activities, personal trainer Kevin Gianni, author of The Busy Person’s Fitness Solution, offers these 5 winter weather workout tips:

  1. Lace up your skates. During the winter it’s often too cold, too dark, or too slippery to walk or run outside. To get in a great workout, try ice skating — whether you go to a local pond for a pickup game of hockey, or to the local ice rink (which also offers the advantage of no wind chill).
  2. Try thermal underwear. If you really need to be outside in frigid weather, add a layer of thermal underwear, which will keep you both warm and dry by wicking sweat away from your body, Gianni suggests.
  3. Don’t push it. On days when the air feels too cold to even breathe in, heed your body’s signals and stay indoors. Cold air can trigger exercise-induced asthma (EIA). Symptoms include wheezing, chest tightness, coughing, chest pain, and shortness of breath.
  4. Try a new home routine. Bodyweight routines are exercises that need no equipment and can be done in your own home. There are many types of bodyweight routines, such as yoga, Pilates, and aerobics. Pop in a fitness DVD or download a workout on your MP3 player to get you going.
  5. Set up your own gym. Now’s the time to think about getting a treadmill, elliptical machine, or stationary bike. Having your own equipment and knowing how to use it will keep you motivated and help you stay on track.

When all’s said and done, says Tom Weede, a certified health and fitness instructor and author of the forthcoming book, The Entrepreneur Diet, it’s important to be realistic.

“Give yourself a little slack during the holidays,” he advises. “After all, it’s a time to have fun and be with family and friends, and if you have a rigid attitude toward your diet and exercise, you may end up just giving up because you’ve set the standard too high.”

So allow yourself some “cheat” days, Weede suggests. “In reality, what matters is the overall total calories you consume and the overall total you expend through physical activity over the entire holiday period. One or two splurges aren’t going to derail your efforts,” he says.

Link to entire WebMD article here.

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One of the anxiety producing aspects of Thanksgiving for my Wellness Coaching clients is the potential for overeating. Here are some tips from WebMD on how to keep up your healthy eating and lifestyle habits  even on a day traditionally known for “stuffing” (ourselves with food!).

10 Tips for a Thinner Thanksgiving

Read entire article here.

Thanksgiving dinner Photo Credit:bookcellarinc.com

By Kathleen M. Zelman, MPH, RD, LD
WebMD Weight Loss Clinic-Feature
Reviewed by Louise Chang, MD

Thanksgiving only comes around once a year, so why not go ahead and splurge? Because gaining weight during the holiday season is a national pastime. Year after year, most of us pack on at least a pound (some gain more) during the holidays — and keep the extra weight permanently.

But Thanksgiving does not have to sabotage your weight, experts say. With a little know-how, you can satisfy your desire for traditional favorites and still enjoy a guilt-free Thanksgiving feast. After all, being stuffed is a good idea only if you are a turkey!

Get Active

Gentle exercise from EverydayHealth.com

Create a calorie deficit by exercising to burn off extra calories before you ever indulge in your favorite foods, suggests Connie Diekman, Med, RD, former president of the American Dietetic Association (ADA).

“‘Eat less and exercise more’ is the winning formula to prevent weight gain during the holidays,” Diekman says. “Increase your steps or lengthen your fitness routine the weeks ahead and especially the day of the feast.”

Make fitness a family adventure, recommends Susan Finn, PhD, RD, chair of the American Council on Fitness and Nutrition: “Take a walk early in the day and then again after dinner. It is a wonderful way for families to get physical activity and enjoy the holiday together.”

Eat Breakfast

While you might think it makes sense to save up calories for the big meal, experts say eating a small meal in the morning can give you more control over your appetite. Start your day with a small but satisfying breakfast — such as an egg with a slice of whole-wheat toast, or a bowl of whole-grain cereal with low-fat milk — so you won’t be starving when you arrive at the gathering.

“Eating a nutritious meal with protein and fiber before you arrive takes the edge off your appetite and allows you to be more discriminating in your food and beverage choices,” says Diekman.

Lighten Up

Whether you are hosting Thanksgiving dinner or bringing a few dishes to share, make your recipes healthier with less fat, sugar, and calories.

“There is more sugar and fat in most recipes than is needed, and no one will notice the difference if you skim calories by using lower calorie ingredients,” says Diekman.

Her suggestions:

  • Use fat-free chicken broth to baste the turkey and make gravy.
  • Use sugar substitutes in place of sugar and/or fruit purees instead of oil in baked goods.
  • Reduce oil and butter wherever you can.
  • Try plain yogurt or fat-free sour cream in creamy dips, mashed potatoes, and casseroles.

Police Your Portions

  • Thanksgiving tables are bountiful and beautiful displays of traditional family favorites. Before you fill your plate, survey the buffet table and decide what you’re going to choose. Then select reasonable-sized portions of foods you cannot live without.

“Don’t waste your calories on foods that you can have all year long,” suggests Diekman. “Fill your plate with small portions of holiday favorites that only come around once a year so you can enjoy desirable, traditional foods.”

  • Skip the Seconds.Try to resist the temptation to go back for second helpings.”Leftovers are much better the next day, and if you limit yourself to one plate, you are less likely to overeat and have more room for a delectable dessert,” Diekman says.

Slowly Savor

Eating slowly, putting your fork down between bites, and tasting each mouthful is one of the easiest ways to enjoy your meal and feel satisfied with one plate full of food, experts say. Choosing whole grains, fruits, vegetables, broth-based soups, salads, and other foods with lots of water and fiber add to the feeling of fullness.

Go Easy on Alcohol

Go Easy on Alcohol

Don’t forget those alcohol calories that can add up quickly.

“Have a glass of wine or a wine spritzer and between alcoholic drinks, (or) enjoy sparkling water,” says Diekman. “this way you stay hydrated, limit alcohol calories, and stay sober.”

Be Realistic

The holiday season is a time for celebration. With busy schedules and so many extra temptations, this is a good time to strive for weight maintenance instead of weight loss.

“Shift from a mindset of weight loss to weight maintenance,” says Finn. “You will be ahead of the game if you can avoid gaining any weight over the holidays.”

Focus on Family and Friends

Thanksgiving is not just about the delicious bounty of food. It’s a time to celebrate relationships with family and friends.

Read entire article at WebMD here.

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Experts share tips about choosing a fitness professional who can put you on the road to better health.
By Annabelle Robertson
WebMD Feature
Reviewed by Louise Chang, MD

Laurie Heit couldn’t imagine working with a wellness coach. In fact, she didn’t even know what a wellness coach was — until one transformed her life.

A compulsive overeater, Heit had struggled with her weight since childhood. She went on diet after diet, and was finally ready to join Overeaters Anonymous when a friend told her about wellness coaching. She suggested Chere Bork, a registered dietitian and coach. Heit jumped at the chance.

After her first appointment, Heit was so impressed that she decided to do more. She has now had 12 telephone coaching sessions with Bork at a cost of $75 each. She insists they were worth every penny.

Although Heit has made significant improvements to her diet and lost weight, she says she’s gained something far more important. Through the coaching process, Heit discovered that losing weight wasn’t what she needed most. She longed to be at home with her family. So after debating the options, Heit quit her insurance job and became a full-time homemaker. She’s never been happier.

“My goal didn’t change, but how I got there did,” she explains. “The time and exploration of the right food plan helped me explore myself and my wants in life.”

Fitness Trends

According to a recent survey by the American College of Sports Medicine (ACSM), “educated and experienced fitness professionals” now constitute the most important fitness trend in the world, having jumped from third to first place since last year. “Personal trainers” rose from seventh to third place.

“We want to be well. We yearn to be in control and feel better. We want more energy,” says Margaret Moore, founder of Well Coaches, the only health and wellness coaching certification program endorsed by the ACSM. “But there is an enormous gap between wanting to be well and the everyday reality of living with the mental and physical health penalties of overeating, underexercising, and having too little down time.”

That gap is growing. The CDC reports that more than 66% of adult Americans are overweight or obese.

Doctors’ Views on Wellness Coaching

That’s one of the reasons why Moore and other wellness coaches have been working to increase awareness about the field among medical professionals. Moore readily admits, however, that although the idea is becoming increasingly popular with the public, it’s only beginning to catch on with doctors.

“Physician referral to coaches is still at an early stage,” she says. “We don’t have reimbursement, and it’s going to take years to fall into place. We see grass-roots, small-scale doctors coming to us. But most physicians just aren’t into it yet. It’s still very new.”

One doctor who has embraced the idea is Michael Lano, MD. Director of the Ridgeview Clinics, a group of primary care facilities in suburban Minneapolis, Lano refers several patients a month to Bork.

“I’m a family physician and I always tell my patients that it’s my job to help them live a long, healthy life,” he says. “But 98% is their part, and that’s what the life coach helps with — everything from diet and exercise to emotional well-being. It’s the same thing that we [doctors] deal with, but she deals with it from a lifestyle perspective.”

Lano says he sees significant improvements in patients who work with Bork. Most begin exercising and eating better. Many make other important changes as well, which tend to have a boomerang effect on their overall outlook and lifestyle, as they did with Heit.

Ideal Candidates for Wellness Coaching

However, not everyone is a good candidate for wellness coaching, says Lano. Some may be too old or sick to change. Others may simply be unmotivated. The ideal patient is someone who may not be doing anything bad, but they’re not doing the good things, either, he says. “They’re not eating well. They’re not exercising. They’re stressed. They’re stuck. They’re not making progress.”

Jim Harburger found himself in that situation. The 66-year-old clinical psychiatrist began to gain weight 32 years ago when he abandoned his heavy smoking habit. Gradually, his weight began to creep from 165 pounds to 220 pounds.

Much of the problem, Harburger says, was stress from his high pressure job as the director of a large behavioral health organization. But the trigger was the daily gift of sweets offered by his secretaries, which Harburger found irresistible.

“The metaphor was that I was being eaten alive by my job, but I was actually eating to handle the anxieties from my work,” he says.

Harburger joined a gym. But like so many others, he found it hard to get there and went only sporadically. Desperate, he finally decided to hire a personal trainer. The gym recommended Ellen Albertson, a staff member who was a registered dietitian, a licensed nutritionist, a certified personal trainer, and a licensed corporate wellness coach.

Albertson began each session with 20 minutes of walking, during which time she and Harburger would talk.

“One might think I could walk on my own, but what she was doing was listening to me about my life, learning about how I managed eating, the stressors in my life, and my relationship to my body,” he explains. “She became familiar, almost like a good therapist, with all aspects of my life. And slowly, she built a relationship that I started to value.”

Albertson also helped Harburger manage his cravings. A self-confessed sugar addict, he likened it to withdrawal from cocaine. “I felt my body shaking, I couldn’t think, and I was in total transition for almost a week,” he says. “Now I know that if I have a cookie, I need to separate myself from what I am eating or I will just keep eating.”

The result? Harburger, who visits the gym almost every day now, dropped 40 pounds over a three-year period.

Albertson says she sees it all the time. People come in expecting to be told what to do, but what actually works best for them is to slow down, think about their goals, and then determine the path themselves.

“People are out of touch with their bodies. When you listen to your body, you eat when you’re hungry, you stop when you’re full, and you enjoy food for its rightful place in your life,” she says.

Looking for the Right Wellness Coach

Michael Arloski, PhD, is the author of Wellness Coaching for Lasting Change, a training manual used by several coaching programs, works with dozens of corporate clients, training them on the finer points of coaching for long-term lifestyle changes.

“We need to move from ‘prescribe and treat,’ or what I like to call ‘education and implore’ — where we’re begging someone to change after we give them a lot of information — to a coaching model where we’re advocating for change and becoming an ally with that person,” he says.

To determine whether a coach is reputable, Moore suggests checking references and asking for testimonials. Look for people with degrees or certification from reputable organizations such as WellCoaches and then interview them extensively about their background.

Moore advises choosing a coach who makes you feel the most energized and confident. You should be inspired after a coaching session, with lots of “Aha!” moments, as well as motivated about your ability to make needed changes in your life.

Plan to pay between $50 and $150 a session, and expect to spend at least three months with a coach before seeing meaningful progress, which is typically defined as the creation of two or three healthy new habits. And don’t hesitate to end the relationship if something doesn’t feel right.

In addition to his dramatic weight loss, Harburger says the changes have had a positive effect on his career. Harburger’s wellness coaching has led him to return to private practice and reduce his workweek to 75%.

“I struggled with giving myself permission to do that, but it was miraculous. Before, I would never have initiated that. Now, I feel so unencumbered,” he says. “It’s like I’m on constant vacation.”

Link to article in WebMD .

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