Risky Business-Controlling Health Risk Factors

NOTE:  This post has many purposes; two of the more noble ones are to remind us all–as patients and consumers of health services–we have an obligation to pull our weight & remind patients (chronic or otherwise) that we have a large margin of control if we choose to own it.


NOW, I will elaborate on my less noble but very real reasons: I work as a medical professional and  see certain patients routinely.  They are called ‘frequent flyers”.  A few of these folks have the nerve to say “If you had fixed me when I was here before, I wouldn’t NEED to be here so much.”  Keep in mind, they have a BMI >30 , they’re stuffing themselves with potato chips & fried chicken, drink a two-liter bottle (or more) of soda daily, sometimes a hefty amount of alcohol as well, and smoke two to three packs a day (I have to physically remove the cigarettes & tell family members they will be thrown out if they bring more).  They insist they cannot afford critical $4 medication due to unemployment or poverty but these same individuals  buy two cartons of cigarettes a week, a case or more of beer weekly,  plus feed their family and themselves through the drive-thru on a regular basis.   Fix’em–really?  How in the HELL am I supposed to fix THAT??  Where do I start??  What I WANT to do is SCREAM–but I won’t.  I will continue to educate…..ANYWAY…. Does an insidious virus exist that completely disables ones sense of accountability and create a spirit of false entitlement?

Moving on…..

Our fate is determined by a number of things–some we have a measure of control over and other we’ve been dealtIt is prudent to be knowledgeable and proactive regarding the things we can’t change, such as a genetic predisposition to certain cancers or other illness,  but not obsessed with it.

In the case of risk factors within our control….HERE is where our responsibility lies. 

 SMOKING-I know everyone is sick of hearing about it & I know it’s tough.  I smoked for 25 years and I quit about 10 years ago.  Use the tools available to you, try & try again–never quit quitting and you will get it right. Applied steady force & tons of preparation will get it done.  Been there-done that-don’t preach to the choir.  For those who say “The risks associated with the medications to help quit are too great.”  I call bullshit.  None of the approved, available stop-smoking aids are more harmful than smoking.  I see TONS of people fighting to suck in a breath, crying & bargaining with GOD to give them another chance–then dying in great pain and regret.  They “got it” too late.  Yes, we’re all going to die from something, but I know a few ways I would like to avoid….  Personally, I plan on dying in a compromising situation involving  Johnny Depp….oops, sorry–TMI!!!

BLOOD PRESSURE-This is the catch-22 of the medical world.  Some folks simply have high blood pressure–period–and the tendency appears to be inherited.  With that being said, most hypertension can be moderated with lifestyle choices and consistent medication.  Increase activity, decrease sodium & bad fats, eat foods closest to their natural state….

ACTIVITY-Get up & do something!!  During the acute phases of my illness–those first two or three days out of the hospital– I live on the sofa with the TV remote & laptop.  That’s fine for the short-term, yet I want to stay on the couch after I’ve improved.  It’s comfortable & I’m accustomed to it.  For gosh sakes-it’s my ROUTINE!!!  Yet I’m pulling my flabby ass off the couch & I feel better because of it.  Seriously.  Start small, pick something you like (or can at least tolerate) and spend a few minutes daily.  Work up to 30 minutes of moderate activity at least 3-4 days a week.  As a nation we’re dying because we’re sedentary.  Truly, freedom of choice is killing us;  humans  seldom choose the right thing over the easy thing.  We need to practice taking the high road…  Everyone can do somethingDon’t fixate on what you cannot do–focus on what you can do.

WEIGHT-Obesity is a disease-causing state.  If you know someone who is healthy & fat, it’s because the problem hasn’t been discovered yet or hasn’t become serious enough to detect.  Every day I hear patients complain about “It’s my genes, my metabolism is low“, excuses, excuses, poor me, I’m disabled….On and on and on.  I’m not sympathetic when I can see the Dunkin’ Donuts Dozen box in the trash.  They are lying to themselves to make it “OK”.  I remind patients (yes, gently) that a scant few disease processes actually cause obesity & if  thyroid levels are normal and they weren’t born with with Prader-willi syndrome they need to make some choices.  Many of these folks are eating for the wrong reasons and eating huge numbers of calories–5,000 calories a day or more!  If 3,500 calories equal a pound and the patient is an average size female, she is gaining a pound a day sitting in the hospital bed (or on the sofa).  Only she (or he) can make the needed choices &  changes–but I want each person to realize it is not a constitutional right to burden the system because of their “right to choose”.  Also, the right to choose does NOT translate to “the right to exercise bad judgement & surrender accountability”.  I have a 250 lb friend who runs circles around me–packs her lunch and snacks daily and works out three days a week.  She deserves kudos, admiration and support.  She’s lost more than a 100 lbs and is going strong!! She may never get skinny, but that isn’t the goal.  She got REAL and is doing her part–Go girl!!

STRESS-Managing stress requires a couple of important things and they aren’t easy things.  Nothing good is ever easy though. 

FIRST you have to figure out what is causing your stress & determine why. Consider an example:  If your job causes you stress, ask yourself why? Is it because you  work with a supervisor who frequently criticizes your work?  Don’t stop here-keep going.  Why does the criticism cause stress?  IS a portion (or all) of the criticism warranted??  No one wants  to be seen as incompetent or stupid. Can you sharpen your skills or alter your approach?  If so–DING,DING,DING, take responsibility!!  If you had stopped asking”WHY” before the last “why” you  would’ve blamed the supervisor but not dealt with the CAUSE.   Once you clarify what’s expected, you’ve created an opportunity to be successful,  feel less criticized and improve your skills.  After you’ve given it objective thought and introspection, is the boss really a tyrant?  Talk to them calmly and reasonably.  If that doesn’t help, go to H.R.

Bottom line:  In order to manage stress we have to manage our feelings.  Once you determine the real problem you can implement changes in how you prepare or respond ~OR~ you can find another job.  Knowing WHY puts you back in control. 

Second, you have to set and maintain healthy boundaries.  This is much easier said than done, but doing it changes your whole life for the better.  Trust me-it works and it won’t kill you.  No one does something to you that you do not allow.  If you feel you’re being treated like a doormat or being taken for granted, remind yourself it’s because you are accepting it.  If you say “STOP” consistently, effectively & repeatedly-it will STOP.

In order to be effective, you have to remain objective and detach from the emotions surrounding the situation (YES YOU CAN).  I have tested this personally, in many MANY situations and it has been successful-without fail-as long as I held my ground.  Some call me a bitch; they’re entitled to their opinion.  Ultimately,  I’m trying to convey two points:

1.  We teach others how we expect to be treated.

2.  All anger is rooted in fear.  That’s why you have to detach and ask the extra “why”.


About twelve years ago, I woke up feeling especially awful.  Awful-er than usual and my schedule was beyond full.  I worked two jobs, had a husband who wouldn’t work ANY jobs, two kids at home & I was in college 3/4 time as well.  I was smoking one to two packs of cigarettes a day, not sleeping, living on sweet & salty junk foods and drinking three to four alcoholic drinks a night.  Wasn’t I living the America way??  Doesn’t the constitution say I have the right to the pursuit of happiness?  I’m not sure what I was chasing but I damned sure wasn’t happy & I could feel my health slipping away.  I had so many things in motion, I couldn’t exactly stop–but I did detach emotionally and watch myself going through the motions.  I slowly figured out what was working for me and what wasn’t; then I started formulating a plan for change.  The first thing to go was the worthless husband, but we’ll save the rest of that story for another post!  Then I started addressing the negative things in my life, and eliminating them one at a time.


2 Comments (+add yours?)

  1. Autoimmune Maven
    Mar 09, 2012 @ 07:34:40

    YAY!! for stopping before you die!! I need to find a few motivational songs to get my motor running. I spent a year on steroids–I gained 45 lbs, grew a hump on my back, watched the hair fall out of my head and grow on my face & chest. Plus that special kind of crazy that only steroids can induce….Steroids my save our life but they are NOT our friend! I’m glad you understand where I’m coming from. I truly believe that everyone can do something to improve his/her overall situation. All I can say is “watch out Johnny Depp!!” XOXOXO


  2. mo
    Mar 09, 2012 @ 00:09:26

    WHOA!! I love this post! Everything you said is so absulutely true and I especially love “all anger is rooted in fear”.

    I am one of those people that just cannot find the energy or will to exercise. BUT, a few weeks ago I bought a Taylor Swift CD (yea, I said Talor Swift) and I have been playing it and dancing in the living room. I can now get through two of the songs before I feel like I am going to die. (I stop before I die)

    My most critical chronic illness requires me to take steroids everyday…and steroids can cause weight gain among other nastiness. When I first started taking steroids I was so sick that I spent several months in bed. So….of course I gained weight…about 35 lbs of fat appeared on my ass. Once I got up and moved, and started eating a little better (underline a little better), I lost 25 lbs. I have not gained it back. But the point I am trying to make here is, that I have NEVER blamed the steroids as the number one reason that I gained that weight. Inactivity is the main reason. So many people come up with reasons for everything that is wrong in their lifes, when, like you said, so much of it can be controlled by our own actions. Not everything can be fixed by ourselves, but many things can be.

    What I am gong to say now sounds totally off the subject, but it isn’t. I have a girlfriend who has never worked a steady job. She would work until she could collect unemployment and then get herself fired so she could stay home and get paid. She has always spent her money on drugs…she loves speed and oxycodone, and she always found someone to take her in. Never me. She is now 54 years old, lives in a shelter, has lost most of her teeth and still somehow gets her drugs and cigarettes. She goes to the ER six or seven times a year and lies so she gets admitted. She is the kind of person that you probably deal with often and you want to just punch them.

    Thanks for suc a great post Sheila! But there is one thing I disagree with you about, I will die naked in bed with Johnny Depp!

    I’m glad you took charge of your life and circumstances and got rid of that crappy husband!


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