We are the Lady Docs - Marsha Seidelman, MD and friends!

We are the Lady Docs

An intro

and

Some misunderstood info on exercise and weight loss

and

A recipe of sorts, of course

Welcome!!


We've talked about starting this blog for years -- so here we are -- and here's our story!


Two years ago, my friend and physician, Thu Tran, invited me to her house for a group fitness session with a few other physicians.  She wanted to introduce us to her trainer, Troy Wentzlaff, who helped her advance from runner to marathoner to triathlete.  With Thu and Troy at the helm, the weekly outdoor bootcamp grew to include about 25 women, most of whom are physicians, and others who are dentists, orthodontists, professors and other professionals.  We all know exercise is good for us, but this situation offers up more than just well-designed workouts.  There is an easy mix of intellectual discussion, physical challenge and emotional support that we could never have imagined or designed purposely.


We annoyed Troy enough with our talking during workouts that we decided we needed to start planning social activities outside of 'camp'.  What could be better after working out than eating?!  In addition to Thu's brunches after bootcamp (which surely serve up more calories than one could possibly burn in an hour), we used many excuses to have other gatherings - with kudos to Sheri Hammersley, hostess supreme.  We discovered that we had many accomplished chefs among us, and could present an international buffet with little notice.  At the same time, we grew to be a family.  When one woman had a medical crisis in her family, she sent out a group email, and within minutes had a dozen responses, with offers from members to make calls to local experts to set up appointments.  This scenario repeated itself numerous times.  We all agree that we have a terrific network of wellness-minded women who are looking out for each other and have food and fitness foremost in their minds.


For ourselves, as well as for our friends and patients, we realize that there is too much information in the popular press to read; once we read it, it's difficult to know what to believe.  Our intention here is to present valid information in an easy-to-read format, written by a variety of health professionals, about topics of our choice and yours.  We would be honored to include you in our quest for living a healthful, satisfying life in the company of others who want to do the same.


Where to begin??  I thought I'd start by presenting some misunderstood ideas about exercise and weight loss, based on a report in a recent New England Journal of Medicine(1) that was funded by the National Institutes of Health (NIH).  Many of the issues covered in this report are the same ones that my patients ask on a regular basis.


SO here we go.  The first conundrum is, if I walk every day, why can't I lose weight - why doesn't my weight follow the 3500 calorie rule?  Here's what the rule says: that every 3500 kcal ('calories' as listed on food labels) equals one pound.  If you eat 3500 extra calories without increasing your activity, you will gain a pound.  If you exercise until your favorite treadmill, elliptical, exercise monitor, whatever, says you've burned 3500 calories, you will lose a pound.  The number of calories you burn doing a certain activity depends on how much weight you are carrying.  Medical literature always uses a 70kg (154 pound) person as their example, so we'll do the same. If you are a 150 pound person and walk a mile per day, depending on the speed and incline, you might burn about 100 calories.  In theory, if you walk 1 mile daily for 35 days, you should burn 3500 extra calories.  You should lose 1 pound.  If you were disciplined in your routine for 3 years, that would repeat that 35 day cycle 30 times, and you should lose 30 pounds.  That just doesn't happen!  Why not?


There are several reasons, but here are a few of the main ones.  There is a lot of individual variation in how we burn calories.  Everyone knows someone who can tear into a package of double-stuffed Oreos without gaining an ounce.  Let's just decide that people like that are annoying, and move on.  For the rest of us, as we exercise, our muscles become more efficient (more on that in later blog entries) and we need to do more work to burn the same number of calories.  There is likely also a control mechanism that kicks in that served us well in the past, but in our current age of calorie-overload is detrimental.  Ages ago, when we start to lose weight, our bodies thought we are in danger of starvation - which might have been true when we were hunting and gathering.  Weight loss in those times usually signaled that there was no food available.  So we preserved ourselves by slowing down our metabolism to keep the fat we had.  This slowing of metabolism in response to weight loss is felt to be contributory to the yo-yo pattern of weight loss and gain that so many people experience.  Once they lose weight, their metabolism slows down, so they gain weight, the metabolism re-adjusts, enabling them to lose weight more easily, and so on.  Bottom line - If you continue to do the same activity for months or years on end, it will no longer have the weight loss effect it did at the beginning.


The second commonly held belief that was dispelled in this NEJM report was that setting realistic goals is important in avoiding frustration with your weight loss plan.  Not true, evidently.  Set your goal wherever you wish -- realistic or not -- and go for it!  Period!


Myth number three - people who lose weight faster at the beginning are more likely to gain it back.  The fact is, many people re-gain weight, no matter how quickly or slowly they lost it.  I will offer this advice, though, just from my clinical experience.  I find that when patients are on extremely low calorie diets, no-carb diets or using only pre-packaged meals, they are less likely to maintain the weight loss.  I believe they never learn to shop for and prepare healthy foods that will satisfy them and help them to change their lifestyle.  Eventually, habits that need to be changed include everything from what you buy at the grocery store and which foods you prepare, to bringing lunch to work and finding time in your daily schedule to exercise.  So, using a weight loss method that includes changing these habits is usually more successful in the long run.  In addition, when weight is lost too rapidly without attention to proper nutrient balance and exercise, there is muscle loss.  Since muscle burns more calories than fat tissue while you are at rest, muscle loss means fewer calories burned by your body on a daily basis.  This undermines your attempt to lose weight! Therefore, including exercise in your weight loss program, both cardio and strength training, makes weight loss easier and more sustainable.


Finally, sorry to burst your bubble, but evidently there's a myth out there that says a 'bout' of sexual activity burns 100-300 calories per person.  We won't ask who's applying the monitors here, but somewhere along the line it was determined that this activity burns 3 metabolic equivalents (METs),  about 3.5 calories per minute or 210 calories per hour, for a 150 pound person.  This is about the same as relaxed walking.  In practice, however, the number of calories might be anywhere from 3 to 300.  No further explanation, just don't count on the 300.  That's all I'm saying.


Well, that's all for today. In time, with our wonderful network of professionals, we hope to share with you our love for learning, fitness, great healthful foods and appreciation of the mind-body connection.  Please join us and provide us with your questions and join us on this journey for a better informed, healthier, happier you.


With each blog entry, I'd like to leave you with a simple, healthy recipe.  Here's the simplest it gets: for a lunch you can prepare at work, cut up an apple and spread a little natural peanut butter on it - no sugar or salt added.  If you're not as concerned about the calories, put it on whole wheat toast.  Or for a snack, put the peanut butter on celery - It's filling and nutritious --


Talk to you soon --
Marsha


REFERENCE:
1. Casazza, et al.: Myths, Presumptions, and Facts about Obesity.  NEJM 2013; 368:446-54.

Welcome to Ladydocscorner

We women are interesting. I know this for a fact because I have been an obstetrician/gynecologist for almost 22 years. I have seen thousands of women from all age groups and delivered thousands of babies. I have seen teenagers struggling with acne and sexuality, elderly women struggling with mobility and illnesses, and middle age and peri-menopausal women struggling with...well, everything from hot flashes to moodiness, from divorces to depression to dating and second marriages. Some of those days, my nurse Roxanne and I thought we were living in a Seinfeld episode. Other days, we pondered why so many sad things can happen to so many women, and yet they would bounce back and get on with their lives again.

As a gender, we are quite complicated. In general, most of us do not think so highly of ourselves. Maybe because most of us expect so much of ourselves. It wouldn't be enough to be a mother and wife, daughter and successful career woman . We have to be at every basketball game to see our sons and daughters play. We have to scream our heads off, knowing that they are going to lose anyway but still have the satisfaction of cheering for them. After our child's defeat, we never look back and we say to ourselves:

"Wow, what a waste of time! I should have gone shopping!"

 In between seeing patients, for example, we women physicians have to figure out how to get our children to their music lessons on time, what healthy food to serve once we get home, what homework we need to supervise, what clothes need to be worn to accommodate the weather in the morning. After the children go to bed, some of us got so exhausted but would drag ourselves to the laundry room or fold the clothes on the bed, as in my case, put there earlier by our husbands who are somewhere out of town on their business trips. We fold the clothes while watching Anderson Cooper telling us what has been going on in the world so that we can be in "the loop", the loop of humanity. If we are lucky, there would be no clothes on the bed that night and we can do push ups or sit ups while Anderson Cooper is telling his stories. We then make sure our alarm clock is on so that we will not oversleep in the morning, and then the whole scenario of our daily life plays over again. 

How do we try to do it all? I guess we were born to be multitasking. It's the only way to pack all these activities into a brief time segment of our lives. It's the only way for us to explore all the activities women were meant to do. We keep going at it and ignore all those name callings that society puts upon us, tiger moms, helicopter parents, anal retentive freaking parents... As a matter of fact, many of us even think being helicopter parents is not sufficient. We want to lurk around our kids on the ground, closer in and not from above their "periphery".

As for the women at home, the tasks can be even more daunting. We, many times, would be expected to be the classroom parent, the seamstress who makes Halloween customs for our children, the house cleaner, the chauffeur and chef.  Our days, many times, are considered "easier" than our husbands' who bring the money home and make the whole household "functional". 

And don't forget that we are expected to look good, to be feminine, to be nurturing, whether or not we work outside of the home or be the perfect "homemaker".

With all those stressful tasks, you would think we would "perish" before the guys. But, as you know, we continue to bounce back and outlive the guys. The women's lifespan now is 82 years on average, while our guys end their journey around 80!  It's not just our nagging that might have sent our guys to heaven earlier, I am telling you, it's the resiliency and endurance of our gender!  Replace that energizer bunny in the commercial with a woman and nobody can tell the difference.  Well, we hopefully look better than a rabbit!

Our blog is to be for everyone to read, although I have to say I am more of an expert in womanhood since it's my medical specialty. The men often are in the periphery when I am taking care of my patients.  I have learned many things about men from the male members of my family, but also through the eyes of the women I have the pleasure to take care of daily.  My friends Marsha and Linda, being internists, and many of the other bootcampers, on the other hand, have a mixture of male and female patients.  Their "blogging" will be on topics that involve both genders.  Most of us are in the healthcare industry, and having exercised together every Saturday for the last two years, we can't help but talk a lot about fitness and health. Since most of us are in or about to enter "middle age", aging is an inevitable subject that would come up many time.

Weight loss is a big topic on our blog. As many men would agree, there are very few women who think they are slim. As a matter of fact, the majority of the patients who decline to be weighed yearly in my office are the truly "skinny" ones. Many slim patients also get panicked as they discover that their current weight is two or three pounds more than the year before. Some very obese women, on the other hand, are well aware of their condition but also very defensive about it. I can't even tell you how many times I have gingerly told a patient about her elevated Body Mass Index or BMI, the ratio of someone's weight in kilogram divided by their height in square meters.

"I know I am fat, but I am not eating very much and I have tried every exercise!"  This is a classic conversation stopper!

Or,

"I know I am fat, but I like sweets and I can't do anything about it!" At least, this patient was honest to herself.

Eating disorders are truly illnesses.  It's no different than smoking or drinking.  It needs major behavior change to lead to normalcy.  But it can be done!  Unlike what overweight patients believe, many slim people like to eat.  I am one of those folks.  I have a weakness for sweet bubble drinks, hash browns and sausages.

The reason I can keep myself slim is the basic recognition of what goes in has to come out when it comes to calories.  If one can't exercise enough to burn 3500 Cal, one should not consume enough food to make them gain one pound. It's as simple as that. You also need to remember that a Calorie is a Calorie, no matter what kind of food you are consuming.  To run  away from "carbs" and substitute your intake with an amount of protein in equal calories will not prevent you from gaining weight!

In our future blogs, we hope to give you all many helpful tips of how to prevent breaking your scale at home.  And if you happen to break your scale, do not fuss over it for too long.  What comes up has to come down.  Many of us have seen Oprah deflated then inflated in front of our eyes, sometimes in a short time!  "Wow", we say to ourselves, "What happens?  How did she do that?" 

On the other hand, the last time I saw Jennifer Hudson on TV, I was so shocked. Jennifer looked great but I wondered if she ever stopped and thought,  "What happened to the other half of me?"  Obesity can come and go, and yes, there are many things we can do to change the way we look.

"How many psychiatrists does it take to change a light bulb?" my husband often asks jokingly.

"One! But the light bulb has to want to change!"  He gets many laughs for this old joke , but isn't it the truth about human's attitude?

Changes take time and effort.  Changes can bring fear, anxiety and impatience.  But aren't these all about attitude?

We welcome any feedback from our readers.  Come join us on our ride to your good health!  Remember we might pass this world only once, so our ride should be fun.  Always  think of a good life as a life in balance.  It is good not to be beyond two standard deviations of anything.  We want to be like the Goldie Locks girl " Not too fat, not too thin, but just right!"

Dr TNT

"Any changes, even a change for the better, is always accompanied by drawbacks and discomforts."

                         

                                                Arnold Bennett

"If you don't like something, change it. If you can't change it, change your attitude."

                                                Maya Angelou

This is my new blog.