Success at New Year's Resolutions: They're modern-day rituals

The poster near the Jewish Community Center's locker rooms proclaims in 288-point type:  "Rabbi Loses 35 Pounds!," and then nudges:  "Exercise and eating well are the new rituals."  

"This program transformed the way I think about meals, food and fitness.  I struggled for years to lose weight and keep it off.  But the TIO (Take It Off) program put it all together in a way that helped me shed pounds, get strong and fit, and feel good about what I eat and what I don't.  Checking in each week in a private session, along with personal training, has helped me keep on track.  I'm not going back to the way I used to eat, and I'm not giving up my regular workouts.  This has truly brought positive change to my life," says Rabbi Barbara Penzner. 

She is being the change, leading by example.  Her leadership in several other realms has been inspirational and life-changing, too.  To name just two:  Years ago, she helped form and guide the Greater Boston Interfaith Organization, an important component of the coalition that brought universal health insurance to Massachusetts.  And she led the Hyatt Hotel boycott, which eventually led to fair treatment for hotel workers in Boston and across the country.

Joan Hayes has served as her personal trainer (and mine) at the Jewish Community Center in Newton, Massachusetts.  Thanks, Joan!

Read another story about sustaining healthier habits.

Our border collie is our personal trainer: Dogs' contribution to health

Groundhog Day came and went, but now we're back in the dog days of winter. Two dog lovers' stories:

Barbara Abrams' story:

We are in our 70s and have no doubt that our dog significantly contributes to our health. Gracie, a three-year old border collie, gets two long walks (two miles on average) every day, no matter what the weather. And the weather here in Rochester, New York can be brutal, with black ice on the sidewalks. But no matter how strong the temptation to stay in, Gracie demands her walks, appealing to us with her soulful, puzzled eyes when we are behind schedule. She is our personal trainer.

Will Mesa's story:

Not long ago my dog brought me my bottle of aspirin in her mouth while I was having a terrible headache, proving that pets indeed help alleviate pain in owners.

Advice: Keep using your personal trainer, of course, while leashed and curbed properly at all times.

Read another story about what dogs teach us about healthcare.

Thanks to the editor of the New York Times Letters to the Editor, for these stories published on January 10.

The alternative was to have no insurance: Betting on good health

Carl Arrington, 58, is a free-lance writer and chef in New York. When his company closed shop nine years ago, at first he chose to pay for extended coverage under COBRA. But the high premiums forced him into a difficult decision: he dropped the insurance.

"The alternative was to have no insurance, which was so scary in the beginning," he said. "And then I decided, look, when you have insurance you're betting that you're going to get sick."

He decided to change his lifestyle. He stopped eating meat, and cut excess sugar from his diet. He began to exercise, eventually losing 40 pounds.

He still sees his physician annually for checkups, but he avoids screening tests like colonoscopies. If doctors discovered something that needed further treatment, he said, he probably could not afford it anyway.

"I am in control of my health, and I'm not afraid of dying. What more do you need?" he asks.

Advice: Stay healthy – and work for universal health insurance.

Read another story about a limitation of the COBRA safety net.

Thanks to Karen Barrow for the source article in the New York Times of Nov. 4, and to Alex di Suvero.

More than five miles at a time: Recovering from post-stroke depression

Now more than a year and a half after her stroke, 38-year-old Dira Cannistraro continues to recover from her life-altering experience.

"A few months after my stroke, I began struggling with some of the emotional side effects,""says Dira. "The emotional reaction astonished me considering how well I recovered. Since then, I have learned that post-stroke depression is quite common due to brain trauma and biochemical changes. I would like to make people who have had a stroke and their families aware that they should be on the lookout for symptoms of depression. I also want people to know it is a very common reaction to stroke. This has been an unexpected complication but I've found various ways to help alleviate the symptoms."

Emotional and physical health has become a priority for Dira. Through therapy and exercise, she is feeling more like herself again. She started running just a few months after her stroke and completed the Falmouth Road Race in August 2007, just eight months after the stroke.

"I had never run more than five miles at a time before in my life", says Dira. "Running became a way for me to regulate my emotions. I decided after Falmouth that I wanted to run a half marathon and I completed the Hyannis Half Marathon in February 2008."

Though the physical and emotional recovery process has been a long road, Dira continues to be thankful for all the good that has come from that situation. "There has definitely been an upside to the stroke. The outpouring of love and help from my family, friends, neighbors and my community has been so comforting and uplifting. People made meals, helped with the boys, even offered to walk my dog...it was really touching. I was also lucky to receive great care at Newton-Wellesley. The staff all were wonderful - I have even gone back to visit and thank them for their support and kindness during a difficult and frightening time of my life."

Advice: Exercise can help reduce post-stroke depression.

The anonymous source article appeared in the most recent Newton-Wellesley Hospital newsletter, Family HealthSource.

More days happy than in the blues: A coach for diabetes care

Maria is a 66-eary-old Hispanic woman with diabetes. She receives her primary care at Massachusetts General Hospital's Chelsea health center. At her last visit in June of 2006, Maris had far too much glucose [sugar] in her blood; her hemoglobin HbA1c was 12.6, far more than a normal level of about 7. Her doctor referred her to a diabetes "coach," a multilingual, bicultural layman trained to identify barriers to care management and to assist patients in addressing barriers.

After several counseling sessions, the coach learned that Maria was taking one of her medications "only when I feel my blood sugar is too high," and was not taking her other medication at all because "it makes me dizzy." Maria was overweight, and ate a lot of rice, bread, pasta and other carbohydrates, and foods high in cholesterol like pizza, pork, meat, and fried food. She would not eat at all when she felt that her blood sugar was elevated. She was not exercising and reported often feeling depressed and "in the blues."

After working with the coach, Maria began taking both of her medications regularly and eating better. She cut down on carbohydrates and started eating more vegetables and fruit. She also ate more frequently in small portions. Due to her arthritis, exercise was a challenge for Maria, but she managed to walk 20 minutes on most days. In just a few months she lost 30 pounds. After 11 sessions with the coach, Maria felt very pleased with her progress, she is more confident, and has "more days happy than in the blues." When last seen by her coach in December, Maria's hemoglobin HbA1c had fallen to 7.7.

Advice for people with diabetes or another chronic health issue: ask your insurer to assign you a health coach.

Read an athlete’s diabetes story.

Thanks for our source, the 2006 Annual Report on Mass General's Community Benefit Program.

Not a moment too soon, I thought of Tim Russert: Early warning signs of heart attack

Most Saturday mornings, I bicycle with a group of men, mostly in their 50s, whom I affectionately call the Cheat Death group. We are all in pretty good shape, competitive but supportive, and convinced that hard-core exercise is our ticket to postponing the inevitable.

The ride a few Sundays back was a tough one. At 6:30 am, the pack took off fast and immediately headed for the hills near Durham, New Hampshire. The first few climbs felt pretty good, but by the third hill I started to feel nauseated.

Figuring that was probably a result of the four beers and large Chinese dinner the night before, I kept going. Twenty-five mles into the ride, I had fallen to the back of the pack. I was short of breath and wondering how I was going to make it much farther.

I am someone who hates to quit. But after the third time the group had to stop and wait for me, I decided I had no choice. I watched them pedal away, then lay down in the grass. Besides the nausea, my only symptoms were a persistent cough and an overwhelming feeling that something was not right. I called my wife and got a ride home.

I started thinking: Though I'm a 50-year-old guy with a stressful job and a little too much around the middle, I had a clean bill of health. I had good cholesterol numbers and a great doctor, and recently I had passed a cardiac stress test.

That's when Tim Russert popped into my head. I bolted out of bed and Googled a list of warning signs of a heart attack, according to the American Heart Association. Nausea: check. Shortness of breath: Check. Chest discomfort: Perhaps, though it really didn't feel like much.

Ignoring the web site's advice to call 911 (I was too vain to have an ambulance pull up to my house), I drove to the hospital.

I was having a severe heart attack – despite the stress test, the red wine, olive oil, and all my exercise. They gave me a stent in the cath lab [for "cardiac catheterization"] to open the artery that had suddenly been blocked by a blood clot.

As in Tim Russert's case, there had been no warning signs. If I had not gone to the hospital, I might very well have died.

Advice to middle-aged guys like me: Listen to your body. Michael risked some teasing by his bicycle buddies and quitting the ride, and going to the hospital, and it saved his life.

Read a story of appropriate care after getting a stent.

Thanks to Michael Bicks for the source article in the July 8 issue of the NY Times.

Medicine for the brain: The role of exercise in fighting depression

On Monday mornings, Theo Baar's exhausting depression often tries to seduce him into just staying in bed. But then, he says, a staffer at Appleton House, a residence for people with psychotic disorders at McLean Hospital, comes into his room and says, insistently, "You want to go work out."

So Theo, a 22-year-old surfer and musician, drags himself to McLean's new gym and sweats through a half hour of weightlifting presses and curls. And then, he finds, he doesn't want to go back to bed. And more: his confidence is pumped up. Hs thinking tends to be less delusional, more reality-based.

"Working out helps me get my self back," he says.

His experiences reflect the recent findings of careful research: exercise may be as good for your brain as it is for your body. Evidence suggests that exercise helps reduce mental health problems, including depression, anxiety, ADHD, addiction, stress and aggression.

"Exercise may be an effective treatment for patients with clinical depression, comparable to other established treatments such as antidepressant medications," says Dr. James Blumenthal, a professor of medical psychology at Duke University, who had led some of the seminal recent studies. Other studies suggest that exercise may be as effective as psychotherapy as alleviating depression.

"Exercise is medicine for the brain," says Dr. John Ratey, a Cambridge psychiatrist and author.

Advice for people struggling against depression: Find a fun form of exercise.

Read another exercise story.

Thanks to Carey Goldberg for the source story in today's Boston Globe.

No better way to pay back the universe: A cancer survivor's story

During Thanksgiving weekend in 2005, Henri Engle's throat swelled up. Two weeks later, while watching a movie, he began coughing up blood. He finished the movie before going to the Emergency Room at Massachusetts General Hospital. They took him into surgery immediately, and he awoke in the Oncology unit, diagnosed with a very rare cancer – synovial sarcoma of the throat.

The tall 24-year-old went through four doses of chemotherapy over five months, and six weeks of radiation treatment, twice a day for five days a week. He had to be fed through a gastric feeding tube, and he lost 85 pounds.

Now, he's cancer-free, and at 175 pounds he's in the best shape of his life. How? He attributes his strength to workouts with cast-iron kettlebells – which look like cannonballs, each with a handle, and weigh from 10 to 88 pounds.

Henri encountered personal trainer Anthony DiIuglio, the owner of the first American kettlebell gym, in East Providence, Rhode Island, and began working out. He progressed rapidly under Anthony's guidance. Anthony is himself a cancer survivor. He works with patients while they are undergoing radiation, to offset the scarring and stiffening ("fibrosis") of muscle tissue that radiation can cause.

Henri’s progress prompted him to ask Anthony for a license to open his own Punch Kettlebell Gym. Henri opened the gym this week in Newton Centre, Massachusetts. With the gym, he says, "I get to help people doing something I enjoy – there's no better way to pay back the universe than that. Not everyone gets that kind of direction in life."

Advice: Take heart; people are amazingly resilient. Some find that cancer has led them to find their calling.

Read another inspirational cancer survivor story.

Thanks to Rachana Rathi for the source article in today's Boston Globe.

He had a secret plan: A patient compliance story

Keith Orr thought he would surprise his doctor when he came in for a checkup. His doctor had told him to have a weight loss operation to reduce the amount of food his stomach could hold, worried because Keith weighed 278 pounds, had a very high blood sugar level, putting him at high risk of diabetes, and a strong family history of early death from heart attacks. Indeed, he himself had had a heart attack nine years ago, at age 35.

But Keith had a secret plan. He had been dieting and exercising for four months and lost 45 pounds. He imagined proudly telling the doctor what he had done, sure that his tests would show huge drops in his blood sugar and cholesterol levels. He planned to admit that he had also stopped taking all of his prescription drugs for heart disease since, he thought, he no longer needed them. He had never taken them regularly, so stopping completely wouldn’t matter much, he thought, in light of his improved diet and exercise.

But the surprise was not at all what he expected. A week before his scheduled doctor’s appointment, while at the gym in Boston on February 6, he felt a tightness in his chest—the start of a massive heart attack, with the blockage in an artery that doctors call "the Widow-Maker."

He survived, miraculously, with little or no damage to his heart.

Advice to people on aggressive diets and exercise plans: Discuss them with your doctor first.

Read another of our heart disease stories, or Gina Kolata’s source story in the April 8 issue of The New York Times, "Lessons of Heart Disease, Learned and Ignored."