Dynamic Balance and Beyond

Homeostasis is a biologic process that is self-regulated. It is a key concept in physiology that helps our bodies adjust to conditions in order to maintain survival. It is the human body’s way to remain in balance amidst change. However, unlike a scale, of which the destination is stillness, homeostasis is a dynamic equilibrium. There is fluidity and continuous change in order to adapt and evolve with feedback and integration. It is an amazing natural engineering of our human bodies. But when it comes to the art of living, why is homeostasis and balance so hard to realize and achieve?

Wanting It All

My friend Cathy has always told me: “You can have it all, just not all at once.” I understand that – to a degree. When I first embarked on a career as a medical doctor, I knew sacrifices would have to be made. Working part time was never a thought on my mind. Medicine is life’s work. But after being in practice for just over five years, I wonder, is all life meant to be work? Or should doctors really maintain more of a work-life balance?

Burnout is characterized as a syndrome of symptoms such as fatigue, decreased enthusiasm, and increased cynicism with waning job satisfaction. It is not an uncommon phenomenon. This is especially true in medicine. Recent Medscape surveys note ranges of burnout amongst physicians to be ranging from 30% – 65%, depending on specialties. Most vulnerable populations include critical care, emergency medicine, and primary care. This response is unfortunately not unique but a serious upward trend over the last decade. This not only leads to an increase in job turnover, which can cost healthcare systems millions, but if left unrecognized and untreated, can lead to a decrease in the quality of care for our patients.

Beyond the Bottom Line

Recognizing burnout early to prevent further physical and mental sequelae is important for rehabilitation. Moreover, it is important to consider breeding a culture that is able to focus on balancing dedication and self-preservation to provide excellent care to patients, as well as providing impeccable care to ourselves. It is hard to educate, counsel, empower and engage patients about their health when many physicians are nearing if not at burnout or compassion fatigue. How can we help achieve greater balance when the demands of healthcare continues to rise?

Here are three tips to consider to improve balance while preventing burnout:

  • Reflect on what is important in your life daily. What relationships, hobbies, experiences matter to you outside of your work? Write these things down. Keep them handy. Let these things help root you in times of stress. Next time it is a busy day, consider this: two feet, one breath. Read your list. Feel your feet on the ground. Take a breath. Reset and go.

 

  • Set your priorities. Being a physician means you are going to have to have to have flexibility to adapt to the unpredictable demands of our patients. It is important to note that some days are going to demand you work outside your requested schedules in order to provide the best care possible to our patients. However, it is critical to also respect the same dedication to your other priorities. So mark those family events on those calendars. Take that trip with you have always wanted. You are more than your job.

 

  • Saying “no” is not a bad thing. You have to consider saying “yes” to your life. Helping and serving is the essence of why many choose a path of medicine. However, your value is not enhanced by being a martyr and constant sacrificing. It is important to help out when you can and able, but consider saying “no” with a smile. Resentment from always stepping up and stepping in can creep before you know it.

Patient Centered Care

The art, science and career of medicine has always encouraged the patient to be put first. And this is demonstrated through value based care models that emphasize decreased cost of care while improving outcomes and patient satisfaction. It is important not to forget the importance of physician health and satisfaction in that equation. It is known that job satisfaction improves employee engagement while decreasing costly turnover. However, what directly impacts patients more is the fact that decrease in satisfaction of physicians may ultimately lead to less medical errors. It is reported by Andel et al in 2012, medical errors cost the US healthcare system approximately $19.5 billion. This amount is not trivial when considering the out of pocket costs continue to soar in the US. Despite many proposed models of cost containment have been developed, the concept of work life balance, improved physician engagement, and avoid burnout has not been largely recognized as an opportunity to not only improve quality of care but improving value to the healthcare system. It is in my hope as the population continues to grow, we all demand the wave of the future to embrace this challenge and find dynamic balance amidst the struggles in order to teach the importance of thrive and resilience.

 Dr. Joanne Wu is a board certified physician in Physical Medicine and Rehabilitation and Integrative and Holistic Medicine. Her background extends beyond traditional medicine to encompass training as a medical acupuncturist, an experienced yoga and fitness teacher, and holistic health coach. She has passion in integrated wellness and value based medicine for both patients and practitioners.

Battle the Bulge at Barreyasa

Saturday, November 21, 2015

12:15pm to 1:30pm

Barre Centric

8075 Main St, Clarence, New York 14221
Don’t let this holiday season weigh you down. Challenge your body and feel your power by sweating with me at Barre Centric of Buffalo to an intensive fusion workout of yoga and barre. Live pumping music from a talented local DJ will rock us to this flow style 75 min class that will sure make you shake, smile and walk away with sass! Best of all, it’s FREE to the community as our gift to you. We will even do a free raffle of a pair of toe socks to keep your love for Barre strong and lean into 2016!

RSVP with Barre Centric or myself as space is limited. We would love to help you celebrate your body and battle the holiday bulge in a healthy and fun way!

For more about me or Fit2bWell, check out www.Fit2bWell.com. See you at the Barre.

Fitness Edge Radio Program

I was a guest speaker on Fitness Edge Radio Episode June 20th. I love being a guest of the program.

Listen Here

Feeling Full: How Being Grateful Helps Curb the Hunger

Thanksgiving is a kickoff to another holiday season. The hustle and bustle of the mall, shopping for gifts for friends and family, making travel plans to take a break from work can leave little time for mindfulness. Not to mention the endless parties that encourages feasting and excess as a way to celebrate. So how can you stay healthy in the sea of temptations while staying happy as you do it?

Here are a few tips I shared a few years ago on WROC 8 in 2012 that I found wonderful to repurpose and share. Remember, feed your primary foods of self love, connection with family and friends, and deriving joy with purposeful work. You will then have a better sense of what it is you truly need, instead of distracted by needless wants that weigh you down, and leave you hungry for more.

 

Eating Better and Living Better Starts From True and Honest Intentions: 10 Simple and Practical Yoga Inspired Tips to Make a Great New Year

By Joanne Wu MD, E-RYT,CHHC

 

1.) Practice gratitude

Be thankful for the food in front of you, where it came from and who prepared it for you, as well as for the lives you have touched and touched yours. Be grateful for the people you share your meals with. If you are not shy, spend time to thank them aloud. You will be amazed the smiles you will see and how much better the food will taste!

2.) Be present

Don’t distract yourself. Turn off your electronic devices. Look at your food and the faces of those around your table. Enjoy their presence as much as they want to enjoy yours. Distraction is the easiest way to overeating.

3.) Exercise compassion

Kindness to others always comes more naturally, but this tip applies to leaving more time for you – “Me” time. In the season of buying gifts and resolutions, don’t forget to be nice to yourself, so you have more energy to give to others. You can’t give what you don’t have. “Me” time helps you restore, rejuvenate, and renew.

4.) Eat your breakfast

Meal skipping is not advised, especially breakfast. Most people realize by now that skipping a meal is bad, because of the glycemic control of the body. Sure, we can survive many weeks without food, but not at the risk of catabolism, the breakdown of your own tissues. You will become weaker if you simply starve. A body is like a fire, it needs to be fed kindling or small wood pieces throughout the day in order for the fire to burn efficiently and that  no wood leftover at the end of a clean burn. During the holidays, this is really important because many people think if they can “save” their calories for the end of the day, then they can binge. While it is ok to cut back on the portions of the meals before, it can work against you when you go into your holiday meals or cocktail parties eager to stuff whatever it is in front of your face.

5.) Take a pause

Going from work, then to the grocery store to stock up the fridge, or even singing a lullaby to your kids can be a lot without too much time to even breathe. Breathing slows down our heart rates, but it also helps us slow down and think about what we are doing, what we are eating, and reflect on where we are going. It is in stillness that we can truly enjoy our joy. If we have more joy, our food taste better and we are more satisfied at the end of the day.

6.) Fitness anywhere

Trying to get to a gym to workout can be challenging. Get up from your desk several times a day to grab some water, walk the stairs, and park further away from your destination. Do some deep breathing with simple back and neck healthy stretches for a five min break. Go for a brisk walk around your neighbourhood with your loved one after dinner and enjoy some warm spiced tea hand to promote circulation, anti-inflammation, and natural endorphins. Fitness is not a gym workout. It is a lifestyle, a habit, and a way of life. Balance your intake by keeping on the move!
7.) Learn forgiveness

Holding on to negative energy can lead to emotional eating. Take time to start this New Year by letting go and forgive. Whether it is a friend who has wronged you, or you being mad at yourself for eating too much pie, the negative energy can brew and stagnate. This stasis can lead to less energy overall, cycling to a weaker metabolism and a desire to eat more to sustain your body.

8.) Balance your plate

Choose your plate wisely. Join First Lady Obama and the Department of Agriculture’s campaign to bring awareness to the need to battle obesity in America by making nutrition fun and practical. Learn how to fill your plate with a balanced mixture of fruits, grains, vegetable and protein. And don’t forget your liquid fuel – water. You don’t need a measuring cup with you to get a visual sense of balance. So next time when you sit at your table, take a look at your plate. We are what we eat.

9.) De-Clutter Your Life

Think about what your need, instead of what you want. We accumulate many material things over the years and that excess can lead to a blurred sense of our essentials. Spend some time to clean out your closets once a season, donate and recycle what you can. Clean up your to-do lists by making smaller, more realistic, plans of intentional actions. Lift the weight off your shoulders, literally. By trimming down your possessions and your endless list of tasks, you will diminish your stress and slim down for the long haul.

10.)  Try New Foods

We gravitate to routine often because it’s easy, reliable, and often taste good. Consider joining an online coupon site to get great deals on restaurants and new foods out to market. Try shop more inexpensive, local and seasonal. Don’t have a recipe, feel free to check out online sites such as foodnetwork.com for fresh ideas. By allowing your taste buds to explore new flavours, and your body to enjoy a range of nutrients and wholesome vitamins with a variety of textures, you are able to flush out toxins in your colon naturally and improve your digestion. You will depend less on non-FDA regulated, costly supplements. Don’t get yourself into a rut.  Healthy starts with a sense of adventure and a thirst for change.

 

Tabouli Quinoa Salad with Turkey Remix

Whether you call this Tabouli, Tabbouleh, or Tabbouli, this hearty, filling and refreshing salad is sure to help you detox from your filling Thanksgiving meal. Aside from the clean Mediterranean flavors this dish can offer, it celebrates freshness, wholesomeness, and diversity. There are so many ways to keep this strictly raw, vegan and gluten free, but I like to propose this recipe as a nice alternative to that turkey casserole, turkey chili, turkey sandwiches or turkey shepherd’s pie recipe to use up that wonderful lean bird you may eat with your family for Thanksgiving.  It is filled with fiber, flavor, and fabulous nutrients to help you stay lean into the holiday season. Enjoy!

(Fit2bWell Tip: Try substituting quinoa with other high protein, high fiber seeds or grains for some texture and earthiness like chia, bulgur, farro. None of the above? Brown rice can be considered as well! Don’t have leftover turkey? Don’t worry. You can make this meal with any protein you desire)

Serves 4 (approx 1 3/4 cup)

1 3/4 cups water

1 cup uncooked quinoa

1 cup coarsely chopped tomato

1 cup chopped fresh mint or parsley

1 cup chopped cucumber

1 cup leftover diced turkey, reheated

½ cup fresh lemon juice

2 tablespoons chopped green onions

2 tablespoon extra-virgin olive oil

Salt, pepper, red pepper flakes to taste

Directions

Combine water and quinoa in a medium saucepan. Bring to a boil. Cover then reduce heat. Simmer for 20 minutes or until liquid is absorbed. Remove from heat; Stir in tomato and remaining ingredients. Cover and let stand in fridge for 20min. Re-heat your leftover turkey from Thanksgiving. Dice it and stir the warm meat with the cold salad just prior to eating. Delish!

 

Fitness Edge Radio Interviews Dr. Joanne Wu

We discuss a couple of different forms of yoga in today’s episode of Fitness Edge Radio.

First, Dr. Joann Wu introduces us to the world of acro-yoga. Listen to the Podcast here 

radio spotlight

Vegan Spicy Spaghetti Squash 2014

It used to be very difficult to eat or cook vegan. A vegan is one who does not eat or use animal products. Many think that a tasty vegan dish is limited to some salads or cooked vegetables. I was challenged by one of my health coach clients to help find dishes that have roots of being vegan but can have animal protein added simply in a pinch. This time of the year, when fall splashes cold and the trees are robust in colors, I like to look for squash dishes that can often spice up our palettes and warm our bellies.

I love Mexican food flavors, and I just love the color of spaghetti squash, so this recipe adopted from wholefoodsmarket.com was a treat to taste test.

(Fit2bWell Tip: There is vegan protein such as seitan and tofu that would be good additional “toppings.” But be mindful, seitan is not gluten free. Feel free to also explore many type of vegan cheese on the market and sprinkle it on last minute for a nice finish to this tasty meal)

Vegan Spicy Spaghetti Squash (serves 2 for dinner)

Ingredients:

• 1 medium spaghetti squash, halved lengthwise and seeded

• 2 teaspoons extra-virgin olive oil

• 1/2 onion, chopped (any type)

• 1 jalapeño pepper (can be more if want more spicy)

• 2 cloves of garlic diced

• 1/2 cup red bell pepper, chopped

• 1 cup of tomatoes, chopped

• 1 cup cooked black beans

• 1 cup corn

• 1 teaspoon chili powder

• 1/3 cup fresh cilantro, finely chopped

• 1 tablespoon lime juice

• 1 teaspoon salt

Directions:

Preheat the oven to 375°F. Arrange squash in a large baking dish, cut-sides down. Pour 1/2 cup water into the dish and bake until just tender, 30 to 35 minutes. Rake with a fork to remove flesh in strands. Yes, it looks like spaghetti! Don’t rake too deep as to puncture your squash as that will now serve as a dish for your meal.

For the filling, heat oil in a large skillet over medium heat. Add garlic, onion, jalapeño and bell pepper and cook until soft. Be careful not to burn the garlic. Add beans, corn and chili powder; cook, stirring frequently. Add cooked squash, cilantro, lime juice and salt, cook a few minutes until heated through. Try using tongs to fill squash halves with filling, mounding mixture in the center. Tongs will help protect the fragile root vegetable, while maintaining its integrity as you lay it into the “bowl.”

(spaghetti squash photo credit: www.skinnymom.com)

Balance: Steadiness through Dynamic Play

Another birthday recently passed as I celebrate being a Libra. This astrological sign is marked by the constellation of scales. The cosmic image often symbolizes harmony, balance and equality. I am inspired by this gathering of stars to explore the definition of balance and why we all seek it but never seem to ever truly feel it or find it.

According to the Merriam Webster Dictionary:

Balance (– noun –)
: the state of having your weight spread equally so that you do not fall
: the ability to move or to remain in a position without losing control or falling
: a state in which different things occur in equal or proper amounts or have an equal or proper amount of importance

I think we often try to have equality in our lives when it comes time to work and play. I used to have a mantra of “work hard, play hard.” The problem with that is: I become exhausted. Don’t get me wrong, I still enjoy working hard to earn my recreational leisure, but I have learned the importance of not necessary having the two be equal, or the same. I become less rigid about retaining control and have more fun with the concept of free falling into relaxation. Often, we strive to hold on to all the balls that we juggle in our lives and feel bad when we put one down. But when we continue to steady the plates by gripping tightly, we lose the sense of fun of being able to have the ability to play with so many different things going on it lives. The fear of falling and the concept of failure end in our burnout.

Work-life balance is one that often feels impossible. Burnout and stress has been often cited by many corporate wellness surveys to be the number one health issue for the last couple years. There is no “perfect” formula to achieving this task. It is one that constantly evolves and revolves around embracing power in the present moment, being flexible to change, understanding one’s values, and respecting boundaries.

Yoga is a wonderful tool to dial down, tune inward, and figure out what matters to you, what is going on around you, and what you can realistically do to impact change. I have learned with time that my yoga practice is one that always grounds me during times of stress, when I feel slightly out of control in a situation where I don’t have control, and remind me of the deeper purpose of my being. It reminds me the importance of acknowledging the role that I play not just at my work, but also in my home, in my family, and in my community. So next time you feel a bit off in your work-life balance, learn it from this Libra yogini, “two feet, one breath.” Feel the earth, inhale, exhale – it’s what defines living.

Three Stretches You Can Do during a Conference Call

Hi, I’m Dr. Joanne Wu and I am here to inspire movement in your healthful living, starting right at work.

Today, we will review three simple stretches you can do during a conference call while on a headset telephone.

1.)   Wall Squat

Strengthen your quads, practice posture, engage your core with wall squats

Stand in front of a wall about 2 feet in front of it. Bend your knees to lean against it. Tighten your abdominals; support your back as you slide down until your knees are approximately 90 degrees angle. Don’t worry if you do not hit 90 deg, Go where you feel comfortable. Do not go past 90 degrees for this exercise. Make sure your knee does not drift beyond the ball of your feet. If it is, you are too close to the wall. Reset.  Breathe comfortably as you stay connected to your call. Find a focal point in front of you or if you are focusing on reading off your notes, that is another great target to relax your thoughts. Hold for 20-60 seconds depending on your endurance level.

2.)   Front Lunge (high or low)

Static lunges not only tone your legs, but allows for opportunity to stretch your hips

Stand up straight with your legs hip width apart. Take one foot approximately 2 feet in front of the other. The taller you are, the further away you step. Relax your chin and shoulders. If you are not looking at notes and you r hands are free, you can hold your hips. Keep your chest tall as you find a focal point to let your thoughts settle on. Lift your back heel slightly as you find softness of the back knee and a bend in the front leg. To deepen your hip stretch, you can pad the back knee with a towel and place your back thigh bone near the knee on the ground. Breathe intention forward. Step back the front foot to reset after 15-30 seconds depending on your practice. Repeat the other side.

3.)   Cactus stretch

Lift your heart, open your chest with this great upper body stretch. Combine it with above to save time.

Sit in your chair with parallel feet fully supported. Relax your chin and settle your crown of the head over your spine. Raise your arms to the side and bend elbows to L shape. Extend your fingers and engage your forearms. Press your inhales to the ground and as you exhale release your shoulders, send your elbows behind you. Your shoulder blades will roll back further if you further engage your abdominals and find power in your core. Hold for 15-30s.

 Thank you for joining me today to help you find wellness in your life!

Feel free to check out my other Fit2bWell Health tips and videos to help you in your journey towards a better you.

Posture Tips – Sit or Stand, Relax and Restore

Hi, I’m Dr. Joanne Wu and I am here to inspire movement in your healthful living, starting right at work.

Today, we will review three simple posture tips that can apply to sitting or standing. Relax, rejuvenate, restore.

1.)   When Standing:

Distribute body weight evenly to the front, back and side of your body. Soften your knees to avoid hyperextension. Engage your leg muscles. Tilt your pelvis slightly forward to find your core. Support your chest and find side bodies long. Settle your crown of the head over the spine and you relax your shoulders from your ears.

 2.)   When Sitting:

Place both feet on the ground or on a stepping stool / footstep so your thighs are resting close to parallel to the ground and knees are placed over the ankle or ball of foot. Be mindful of your toes. The back of the chair should rest against your low back in a neutral position. You can try a pillow if you don’t have a lumbar support and find a level of firmness that suits you. The back of the chair should be locked. Make sure that you are close enough to the work station to avoid leaning forward. Engage your core muscles and relax your shoulders whenever you remember in between tasks. Try not to fidget or sway.

It is difficult to sit and stand properly, but remind yourself several times a day, and it will get easier with practice. The best way to keep your energy circulating is to alternate from sit to stand  through out the day.

Thank you for joining me today to help you find wellness in your life!

Feel free to check out my other Fit2bWell Health tips and videos to help you in your journey towards a better you.