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My wake up call: Changes to prolong your life

Taking personal health for granted is a disservice to your family and the community you serve; here’s my success story

Like many emergency service providers, I never went to the doctor much. As a medic, if I had an issue I just saw one of the ER docs for advice and a prescription for antibiotics if necessary.

My annual checks were usually done at a fire conference wellness booth. Once I became a doctor, I just treated myself for various ailments, which meant I had a fool for both a doctor and a patient.

I got older and continued to advance in my career, becoming an EMS supervisor, paramedic chief and then a physician. Along the way my activity decreased and my weight correspondingly increased until I weighed 30 to 40 pounds more than I did when I was a regular street medic. I was never classified as obese, but my duty belt certainly had to be extended a few times.

Recently, I turned 40 and decided to put on my big boy pants and start seeing a doctor regularly. I preached to my patients that they needed a primary doctor and to the medics and firefighters that they needed to have regular physicals.

I was being hypocritical in not doing the same myself.

The wake up call
Once I did, almost everything came back OK. Almost everything. Some of my lab values came back abnormal. Not critical, but significant.

During the next few weeks with more blood work and imaging, the major causes for the abnormalities were ruled out, essentially leaving lifestyle — diet and lack of exercise — as a likely cause.

Over the years I had eaten whatever I wanted — cheese steaks and potato chips were my favorites. I enjoyed a good craft beer or two regularly. I used to bike a lot, but had not gotten on it for a few years for various reasons.

As long as I didn’t know this lifestyle was causing any problems, I didn’t worry about it. Lots of people were my weight and if I gained a few pounds what was the big deal?

But lab tests proved that I had a significant problem that if not addressed could become life-threatening. I had to do something to reverse the trend.

Strength and stamina
In addition, I didn’t seem to have the same stamina as I used to. I was never an overly muscular guy, but I was generally able to lift and carry patients. I worked in a busy EMS system and it was often just my partner and I to carry rather large patients down from a third-floor apartment.

Now, as an EMS physician that regularly responds to scenes, I just didn’t seem to have the same strength as I used to. I figured I was just getting older.

In light of my labs, I realized that it was not just my age. I was deconditioned, overweight and out of shape.

This was my wake up call.

The changes I needed to make were all related. I needed to lose weight, probably about 30 pounds. I also needed to improve my overall strength and conditioning, especially in my core/torso. Both of these changes would require modifications to diet and exercise.

As always, before you start any diet or exercise program, discuss this with your regular physician. If you don’t have one, get one.

What we eat
We are what we eat. Corny? Maybe. But what we eat forms the building blocks for everything in our body and what it can do.

One of the biggest problems in this country is our diet. It is too easy to swing into a convenience store or a fast food restaurant and grab food. Preparing meals from scratch takes time that we often don’t want to take.

Anyone can go on a diet. Over the past several decades there have been multiple published diets that have come on gone — Atkins, Cabbage, etc. A diet can help you lose weight. But often times as soon as the goal is reached (if it is) and the person leaves the diet, the weight just comes back.

In order to have a sustained weight loss, a lifestyle change is necessary. You need to modify what you eat and keep doing so moving forward.

This modification needs to be reasonable — you still need to eat the things you love to eat, but just in moderation. The key to this is information.

A learned approach
Start by discovering the facts about everything you are eating. Count the calories and the nutritional information. You can’t make a change until you know where you are at.

There are many tools that can help. I found one of the best is a free smartphone app called My Fitness Pal. I have no relation to the makers or distributors of this application; I am just a very satisfied user.

This application allows you to track every meal and everything ingested. You can put in your target weight and how fast you want to lose it and it will tell you how many calories you should have a day.

Then, log your meals. As you do, you will learn. I found that egg whites and egg substitutes have significantly fewer calories than regular eggs. Skim milk is an excellent source of protein with less fat and calories than whole milk.

Crispy chicken salads at a major fast food restaurant are remarkably filling and tasty for a fraction of the calories as a burger. If you try a healthy food option and don’t like the taste, don’t have it again. Pick something else.

There are plenty of tools out that that can help you reach your goals, but you have to recognize a change is needed first and set the goal.

It is not easy. You have to make choices on what is important — your health and fitness should be more important than that bag of chips. But you might find that as you reach your target weight and increase your activity, you will be able to have those chips from time to time —just not everyday.

You owe it to your family, yourself, your partners and the public to be the best emergency service provider you can be — and your health and fitness are important components of doing so.

Stay safe.

The Rehab Zone. Kenneth G. Lavelle, MD, FACEP, FF/NREMT-P, is Clinical Instructor of Emergency Medicine at Jefferson Medical College, Philadelphia, and Attending Physician at CapitalHealth, Trenton, N.J. He was previously an attending physician at Albert Einstein Medical Center, and previously spent 14 years working as a firefighter and EMS provider.

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