Get Moving Radiologist

A news item flitted across my radar this week: The obesity rate for adults in the United States is over 42 percent. That is compared with roughly 13 percent in the early 1960s.

It doesn’t take a medical degree to know that this is a bad trend, for either individuals or society as a whole, nor what most individuals can/should do to avoid being part of it. It might be oversimplifying to quip “Eat better and exercise,” but it would be silly to pretend those aren’t the biggest factors.

You can know these things, and you can even have a career’s worth of doctorly knowledge about the cascade of consequences from behaving well or poorly, but taking meaningful action from that knowledge isn’t a given at all. “I need to (insert good habit here)” isn’t a rare sentiment.

A quick look around your hospital, imaging center, etc. will inform that your fellow health-care professionals are not paragons of fitness. We can all offer reasons why. We could cite long or irregular hours, stressful work that leaves us feeling drained and unmotivated to lift a finger when off duty, or a sense that we’re earned the right to spend what little time we have for ourselves on leisurely pursuits rather than physical regimens.

As legit as all of that may be, it’s worth keeping in mind that, however many excuses you rehearse as to why you are a fast-food eating couch potato, you might just be reinforcing your decision to live that way. It’s not a choice I would make for myself, nor recommend, but to each his or her own. I would just urge one to make such decisions with eyes open, rather than emerging a decade later in crummy health and lamenting how you got to that point.

If/when you do decide to the contrary, it doesn’t solve everything, but then you’ve got your best chance of staying the course and going the distance. You start finding ways to make things happen rather than excuses about why you can’t. Rad work can be more sedentary than other aspects of health care, for instance, so some plunk down the coin to get “standing desks” and even walking treadmills.

That is better than nothing, but leisurely walking doesn’t scratch me where I itch. Plus, even a little head motion distracts me terribly, My productivity would take a serious hit. I do make a point of periodically getting up during the day. It’s not to aimlessly stroll around, but instead focused on small tasks around the house (I am a telerad after all): Taking out garbage, feeding the pooches, etc. Since these things need doing anyway, they “force” me not to skip my mini breaks.

My benchmark for a day’s proper exercising is to push my limits. If it’s cardiovascular, I want to feel like I couldn’t really do much more than I did in terms of intensity or duration. Strength training is a little harder to define but I have still gotten a general sense of what I want to accomplish. I used to demand of myself a long-term trend of gradually doing more than I used to, but it feels realistic after a certain age just to “maintain my gain.”

Why do I do this? My answer is probably similar to what anyone would say. I optimize quantity/quality of life. I want to like what I see when I look in the mirror (or, at least, not recoil from it). There is some satisfaction in knowing that, if I needed to, I could run for an hour, or lift my body weight repeatedly. It makes me sleep better, maintains better moods, and probably enhances my overall brain function. I could go on.

The regimen that brings about these goals does not consist of things I can cram into five-minute breaks while I am working. I aim for an hour per day, although it wasn’t that much when I started out and nowadays it can creep closer to 90 minutes if I get carried away with myself. To reliably make this happen, I have to set aside the time for it, something I will get back to in a moment.

Some people, I am told, enjoy exercising. I recall one technologist brightly telling me that she did it first thing in the morning because it invigorated her for the day. Folks in that fortunate (or insane) circumstance don’t need any help making their exercise happen.

The vast majority of people, myself included, aren’t in that camp. I found out through years of patchy adherence that counting on “feeling like it” and willpower to force myself under other circumstances were unreliable. I did best by creating circumstances where there were no barriers to good behavior. Rather, I would have to go out of my way to not exercise.

First and foremost is making the time to do it. For me, that involves sizing up my typical daily schedule, identifying options, and earmarking time for exercise in the same way I would do for other things I consider non-optional, like work or sleep. When that time of day comes around, I will therefore have zero other plans during it.

Unlike that technologist mentioned above, I abhor exercising first thing in the day. My mental and physical energy are at their lowest, and it is way too easy to override the plan by deciding I need more sleep on any given day. That is part of the reason I prefer earlier shifts; if I go from 7 a.m. to 4 p.m. for instance, I have two hours between work and dinner to make things happen. When I was in a job that needed me from 9 a.m. to 6 p.m., I bit the bullet and woke up two hours early to get things done then.

Having figured out when your show is occurring, you will want to set the stage. I find that a dose of caffeine about an hour before the end of the workday is very helpful. I want to avoid the feeling of “Work is done. Now I’m exhausted and ready to collapse.”

Other things also keep momentum going. For instance, I have found out through trial and error that, after getting out of my workstation chair, I should under no circumstances sit down anywhere else, especially somewhere comfy. I have a couple of couches and an armchair that borderline magically sucks the energy out of me and can induce naps like you wouldn’t believe so they are totally off limits.

Physical barriers are at least as important as the psychological ones. I found that my adherence was inversely proportional to my home’s distance from wherever I carried out my regimen. A 30-minute drive to a gym was nowhere near as good as when I lived a two-block walk away from one but having gear in my own basement (nothing elaborate) totally wiped out any excuses like “It’s cold and rainy out,” or “By the time I get there and change, I won’t have enough time.”

That leads to another principle. Partial adherence is better than none. If I have an appointment that encroaches on my exercise time and can only do 30 minutes instead of my full routine, I won’t throw away those 30. If my shoulder is hurting, I won’t shut down my whole operation until it’s feeling better. I will just do the stuff that doesn’t involve that shoulder.

The important thing is to get moving. Anything more than what you might otherwise have done is progress.