22 Comments

This post is fabulous, yet another from you to save for reference. May I add one, particularly pertinent to the present moment? Limit time spent reading/watching the news, and sit down with a good book—either the actual printed kind, or something with limited backlight, like a Kindle Paperwhite. Right now, I am reading about medieval history in the afternoons (those times were so weird!) and a selection from the British Library Crime Classics series at bedtime. (This is a very cool series, which I recommend to all!)

Also definitely underscore your recommendation about listening to music (of certain types). My faves as of late are Schubert and Haydn—of which, particularly the latter, there is an inexhaustible supply.

Also, a note re the cold water: where we used to live, we had an outdoor unheated swimming pool. We were by no means polar bears, but what I noticed, during the summer, is that even when floating around in the pool (itself very relaxing), the immersion in cool water seemed to cool down every cell.

Anyway, thank you again for this extremely helpful and thoughtful post!

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Excellent musical choices! I should have included Robert Schumann, whom I have appreciated since a close friend and pianist gave me the heads up back in school. I totally agree with the cool water, especially in summer. "Cool" for me is probably in the 70's! The cold water immersion stuff is much colder, and unless they are in really good shape I feel like that is a real risky thing to advise people to do. Maybe I'm wrong, but still waiting for the American College of Cardiologiy to give us the green light before trying that. And limiting time watching the news is good. It is so outrageous lately, and even PBS can't help themselves broadcasting Trump hateful stuff, enemy within Nazi stuff, profanity, Arnold Palmer genitalia, etc. It's a circus show and I find it harmful, diversionary, and cynical to say the least. Hang tight.

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Unfortunately, even the media outlets that have been avoiding criticizing Trump are now compelled to show how demented and cruel he is. Whatever their reasoning, it is critically important that they're finally showing their viewers how unfit the man is to even dish out fries at McDonald's let alone run the country (into the ground) and have control of the nuclear codes.

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It's refreshing to see a primary care doctor connect the dots between the mind and body, as our western culture somehow has dissected them and convinced us one does not affect the other. While I see the value in moving toward mindfulness practices to alleviate anxiety and other "negative" emotions, I have noticed over the years that leading with physical movement allows my brain and emotions to release. In other words, I find it easier to say do a meditation AFTER I do some sort of light movement. My body leads my mind, rather than my mind leading my body. "E-motions = energy in motion." ...So for any readers who find it hard to sit still and do a meditation or other mindfulness practice, my unsolicited advice is to try moving first then try sitting quietly.

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Hi Lisa - such a great point. I really do like the natural progression with yoga, as many exercise sessions end with a more deep breathing, mindfulness practice... I think. I really am terrible at yoga. But going for a run tonight did more to burn off the stress debris of the day than the few deep breaths I managed. Thanks for the excellent advice!

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I can't run, but I can certainly breathe deeply, and do.

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I went to meditation studies taught by a student of the meditation arts from many places in the world. One interesting one was the walking meditation (kinhin). Here's one https://health.clevelandclinic.org/walking-meditation

I think you'll find that the mind body connection is more common among doctors than you think. One problem, watch out for grifters.

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Hi KB - this is great, too. Setting aside protected time to meditate is tough for most people, so overlapping with something else like walking sounds like a great way to incorporate some. Maybe I'll even put down my phone. I think that chips away at the benefit of any of these pursuits when smartphone is in hand!

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Another good piece and look at vagus nerve. I recall some clinical trials involving the vagus nerves for things like blood pressure. Also recalling tapping but cautious about this. Think you'll like this.

https://health.clevelandclinic.org/vagus-nerve-stimulation

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Twenty stars⭐⭐⭐⭐⭐⭐ for this post. And your commenters. I am a realist, I say use any or all of Ryan's suggestions but don't let the perfect be the enemy of the good. Be grateful and happy with any improvement in your well being however small, but don't be driven in the opposite direction by wanting the whole enchilada. Be happy when you find a dime on the sidewalk but not wish it had been a fifty. Above all, no self-blame that you didn't execute the suggestion(s) "properly"

That is unless execute a !ote for a certain fascist currently running for high office. Then all the self help in the world may not save you!

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Hi Michael, and thanks for those stars! I like that emoji, have to find it now. Perfection here is impossible, and even hitting a few checkboxes each day goes a long way I agree. I hit the breathing, exercise, and not much else as I'm failing with bedtime! Speaking of which, will write more later! Good night and thanks for stopping by :)

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Just what we all need right now: excellent and timely post.

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Thanks Jan :) I needed to write it just to remind myself if no one else to chill - these next 2 weeks, and potentially through some unfathomable events.

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Loved this post. Over the past year I've discovered the Essentrics workout which I'm pretty sure I'm addicted to now. It has elements of tai chi but you can also get some good cardio and stretching. I always find that I feel so good in my mind and body after a workout. I highly recommend trying it!

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Hi Lori - will definitely check that out, I have not heard of it. But any routine that feels good in body and mind sounds sustainable and comprehensive, thank you!

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So, my recent elevated anxiety is just due to garden variety [political] derangement syndrome? Sounds like we’re going through a pandemic of worry cause by putrid politics. Knowing that doesn’t help much. Traveling to Pennsylvania for some colorful nature and artistic architecture in the Laurel Highlands is more successful. I could do without the airport ordeals, though.

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Hi Jerry - careful here in PA, we are surrounded by political ads, billboards, and events. It feels like the center of the presidential election, so it's going to be hard to escape political derangement syndrome ;)

And yes, the airport is not my favorite place to spend hours and hours waiting. Doing that myself this weekend. Hope you catch some fall foliage, but it's been pretty dry.

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We saw some gorgeous scenery, got a nighttime tour of Fallingwater, ate some good food with PA beer that's always, somehow, better than TX beer, and visited with awesome folk who would never vote like us, but who are dear friends and family. Amongst all the politics, it was calming to the soul to see love transcend politics. We still have a nation of good people, and it will temain so after the election.

We've been in PA in the fall most years, and the excitement for Trump in mid state is everywhere, but diminished relative to what we observed in 2022. We hunkered down in 2020 and didn't travel anywhere until 2022.

The political stress I've been feeling has been coming from TV, newspapers, and social media. Our solution has been to vote early (yesterday), turn off the TV sooner, and walk our dog more and for longer and enjoy the 2 good fall weather weeks we get each year.

Magically, my BP has been normal after coming back from PA, so maybe we should return there more often.

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I agree with you, Dr. Ryan, that #10 is a no-no for me. It freaks me out when I see athletes lying in ice baths to cool down after they've played a game or a match.

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I'm glad you agree. Getting in a cold shower doesn't feel good, and I listen to my body on that one, too ;)

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Ryan, great column as always.

Spending as much time outdoors and moving is a big one for my wife and me.

However, so much of healthcare today for many people comes down to your zip code, income, and/or what health insurance you can afford—if any.

"For the morbidly rich, apparently so. Some spend over $20,000 a week to attend wellness retreats like the joint venture between the Mayo Clinic and Three Forks Ranch in Colorado. Here, they undergo 'medical screenings' and personalized nutrition and exercise sessions, attend lectures on topics like sleep and happiness, spend time in nature, and participate in a 'kitchen academy' to learn how to prepare healthy meals."

Wouldn't it be great if everyone's medical/health coverage included 'wellness counseling' from a team that included your PCP, nutritionist, fitness coach, and others as needed?

There is little to no hope for this if election day goes south this year.

Your patients are extremely lucky to have you as their primary care doctor; you see and get the big picture.

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Thanks Arthur - time outdoors and moving are excellent, and how we evolved, right? When I look around and see all of us sitting almost motionless and just moving the tip of one finger (clicking a mouse) in a windowless, poorly ventilated office, it makes me think just how sick this modern lifestyle can be. Hoping we can vote for the best ideas and candidate this year, and there is no contest for those who are paying attention and care about other people.

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