Tips for Making Achievable New Year’s Resolutions

I give myself credit for not being in the habit of writing down a “list” of New Year’s resolutions. After all, studies show that typical aspirational resolutions are often not sustainable, even if achieved for a short while. Our enthusiasm and conviction during the holiday season for a “better self” the following year are likely due to positive mental and emotional perspective from quality time with friends and family, presents, time off of work, and even some liberal consumption of alcohol. This puts us at risk of creating resolutions without easy-to-execute strategies that will be sustainable based on our hard-wired work habits, long hours, and lifestyle that does not support being healthy. By the way, I hate to admit it, but we are now, yet again, another year further into our aging biology, naturally losing more muscle mass while also experiencing decreasing physical capacity, metabolism, and energy. Don’t stop reading! This may seem like a very pessimistic article, but I promise there is hope!

Here are some common declarations and resolutions we make when envisioning our “best selves”:

• I will lose weight.
• I will exercise more.
• I will go to the gym more.
• I will drink less alcohol.
• I will give up sugar.
• I will call my family and friends more.
• I will read more books.
• I will work less. (Denial is a VERY STRONG coping mechanism for physicians, my hubby saying, “Yeah right…”!)

You get the point.

Instead, how about creating a new list of minor changes and actions you can make for better physical, emotional, mental, and spiritual health and wellbeing? These shoud be changes that you can create a few at a time, day after day, until they become a new routine. Just as we do with our professional careers, we must have a strategy that is executable to reach the outcome. Often, people declare goals such as “I want to lose weight” and “I will exercise more” without actual details to achieve the outcome.

How about creating a new list of minor changes and actions you can make for better physical, emotional, mental, and spiritual health and wellbeing?

Before we get to my humble suggestions to help all of us achieve increased wellbeing for 2020, it’s really important to understand why we should even try. Take a close, long, detailed look in the mirror, and look at the people whom you love and who love you the most when at the breakfast or dinner table. Look at whom you kiss goodbye every time you are ready to leave the house, and whom you greet enthusiastically when arriving at work in the clinic or hospital. Your purpose for change should be very clear.

Let’s start with physical movement. I intentionally didn’t use the word exercise, which at least to me often implies absolute commitment to Orange Theory or a personal trainer, on some schedule that is firm and contradicts our unpredictable day to day in the clinic or OR. Instead, surgeons can incorporate movements that utilize already existing gravity to increase muscle mass and get a mini “workout” right in the OR, even during a free flap or long case! Here are my suggestions for healthy habits you can adopt throughout the day.

In the OR:

• Alternate standing on one leg.
• On tip toe, stand for a few seconds on your toes to work your calves.
• Exercise while waiting nine minutes from betadine prep to cut skin time for minimal SSI (surgical site infection) risk, or 15 minutes from prophylactic antibiotics infusion to incision time:
  • Wall sits (back against the wall, squat, both arms up if able, and watch the clock, holding for up to 60 seconds if able).
  • Squat in place, even with your sterile gown and gloves on.
  • Tilt head and neck back as far as able; turn side to side.
  • Squeeze shoulder blades together to stretch out pectoralis major.
  • As long as “time out” is done, airway secure, patient is prepped, all critical communication has occurred, patient is stable, consider a quick three-minute high energy song—not too loud, and maybe just dance and “shake it.”
• Leg lifts, alternate.
• Take breaks and drink much water, repeatedly, every two hours, with bonus points if you can eat some nuts or dried fruit before scrubbing back in.
• Stand parallel to door frame or edge of a wall—put arm and hand up in an “L” and line up shoulder with edge of wall (for right side, stand parallel and next to free vertical edge of wall, lean chest forward so right shoulder and right arm are against wall, and stretch out chest).
• Do a mini meditation (60 seconds):
  • Focus on the breathing through the nose; exhale as long as possible.
  • Close eyes and visualize a beautiful, serene place that brings
    calm to your mind and all senses. Mine is on a beach, white sand, single mat where I am sitting with legs crossed, hands on knees, facing the ocean.
  • Inhale slowly and make your abdomen large like a balloon; exhale slowly. Concentrate on the breath at our nose.

Days of High-Volume, Short Cases such as BMT, T&As:

• Climb a few flights of stairs (closest to the OR area) between cases during turnover (after speaking to family of those you just operated on and obtaining consent for the next family).
  • For extra fun, race the resident/fellow.
• Find nearest water station—drink, taking deep breaths while enjoying water.

Day to Day:

• Those of us who avoid lunch because it’s inconvenient, are too lazy to pack lunch, or feel the cafeteria is too far: Give your assistant a “slush fund” or “lunch money,” and plan ahead and ask assistant to bring lunch to OR lounge for you (eat lighter, skip the Alfredo sauce and fries please, or else accept the sluggish afternoon struggle post-insulin rush).
• Bring your water bottle; if it’s not at the computer station where you dictate/work, you won’t go find water.
• Tell a joke, and then another one; smile and laugh with the team and staff, as well as the patients.

At Home:

• Five to 10 minutes of meditation: Sit comfortably, close your eyes, focus on your breath, put both hands on your heart, take slow deep breaths, repeat to yourself:
  • My heart, thank you for beating all day today, and every night while I sleep, so that I may work and care for patients and others.
  • I am grateful for anyone and anything that comes into my life.
  • To my body and all of me: I am sorry I didn’t take better care of you, but I am here now and I am with you.
• Hug your partner/spouse/child for 30 seconds nonstop to release maximum oxytocin and dopamine.
• Journal: Listen to your inner voice, your mood, and your subjective reality.
• Do something you love or something really fun with family:
  • Play “exploding kittens” card game or other board games, devices down.
  • Charades is really fun these days with my 13 year old!
  • Watch Saturday Night Live from last Saturday or The Kominsky Method on Netflix with Michael Douglas.
  • Exercise: Find the J&J seven-minute workout by Chris Jordan.
  • See the sunset.
  • Listen generously to your children/spouse/partner, or walk, pet, and talk to the dog.
  • Hug the dog or brush your pet; he is relaxed, and you will be too.
  • Sit down, enjoy dinner, talk about the best part of your days, NOT the worst part. If you must share the worst part, don’t relive it in anger, but acknowledge the  experience, then simply declare, “Tomorrow will be a better day.”

By the way, please consider quitting soda (even if diet). You know better as a physician, yet somehow believe that because you don’t smoke, gamble, or do drugs, soda is fine. Not doing something worse to your health doesn’t mean your current habits support the best health you can achieve.

Surgeons can incorporate movements that utilize already existing gravity to increase muscle mass and get a mini “workout” right in the OR. —Julie Wei, MD

Happy 2020 to all of my colleagues. May this year bring you and your loved ones incredible health and increased wellbeing. 

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Dr. Wei is division chief of pediatric otolaryngology/audiology at Nemours Children’s Hospital and director of the Resident and Faculty Wellbeing Program at Nemours Children’s. She is also a member of the ENTtoday editorial advisory board.