Workout Motivation Tips

There are a number of completely legitimate reasons you lost motivation to exercise. Work, family/friends, or maybe you just don’t feel like it. Whatever the case, there are numerous ways to combat the temptations that keep you from reaching your fitness goals. Here are some tips to stay motivated to workout. 

Keep your fitness gear in sight

You know the old saying, out of sight, out of mind? Well, if your yoga mat is tossed in the back of your closet, then you’re less likely to attend class, right? Simple visual cues can serve as a reminder to keep fitness a priority. Try placing your gym clothes next to your bed or weights close to your door.

Recall a positive memory

Remember the time you ran that extra mile, nailed your core workout, or logged in an extra hour at the gym? Positive memories can be utilized to boost your motivation levels. Studies have shown that individuals who recall positive memories are more likely to exercise than those who don’t. So the next time you’re on the verge of skipping a day at the gym, take a stroll down memory lane.

Keep track of your progress

One of the most discouraging aspects about exercising is you don’t physically notice the results right away. Keep a fitness calendar or journal to track your progress. This way you can actually see the work you’re putting into each routine.

 And remember to always reward yourself!

Ultimate Smoothie Components

By: Theresa Shank, Registered Dietitian 

Don't give up your morning smoothie because temperatures are dropping! Smoothies are a great way to consume more fruits and vegetables during the day. Registered Dietitian, Theresa Shank, recommends following 's structure for incorporating a well balanced smoothie into your daily routine! 

Liquid - 1/2 cup: You’ll need some liquid to get everything whirring in your blender, but choose wisely. Skip juices—they’re high in sugar (even when they’re 100% fruit juice).

  • Try these: Unsweetened almond milk or other unsweetened nondairy milks (soy, rice, hemp), low-fat milk, coconut water, water.
Frozen Banana - 1 cup: For natural sweetness and always rich, creamy (not icy) body, frozen banana slices are a must. Another bonus: bananas are a relatively inexpensive fruit.

Frozen Fruit - 1/2 cup: Frozen fruit makes a frosty smoothie without added ice (some blenders can’t handle ice cubes). Buy already frozen fruit or freeze your own.

  • Try these: Blueberries, cherries, strawberries, pineapple, mango, apples, raspberries, blackberries, grapes.

Protein - 1/3 cup: To give your smoothie staying power, add protein. Protein slows the digestion of carbs, keeping you full longer.

  • Try these: Nonfat or low-fat plain Greek yogurt or cottage cheese, silken tofu.

Greens - 1 cup: Add 1 cup of greens to help meet your daily veggie quota without overpowering your smoothie.

  • Try these: Baby spinach, kale (stemmed and chopped).

Health Bonus - 1 Tbsp.: Throw in chia seeds or flaxseeds, for a boost of omega-3s and fiber. Or add nut butters for healthy fats and a little more protein.

  • Try these: Chia seed, flaxseed, hemp seed, peanut butter, almond butter.

Optional: Have a sweet tooth? Add up to 2 tsp. liquid sweetener like maple syrup or agave.

Over the Counter Cold Treatments

By: Jillan Rowbotham, D.O. 

It is never a good time to get sick but unfortunately the cold and flu season is once again squarely upon us. The common cold lasts an average of seven to ten days and usually starts with a sore throat and possibly low grade fever, then progresses to nasal and sinus congestion. Finally, a cough, sometimes productive of mucus, is usually the last symptom to develop and the last to resolve. There is not yet a cure for the common cold and antibiotics not only won’t help but increase the risk of allergic reactions, side effects, and development of resistant bacteria. Plenty of rest and fluids is a mainstay of treatment but there are also many medicines available over-the-counter that can help make things a little more manageable - the key is picking the right medicines for the symptoms you are having.

Over-the-counter cold preparations are confusing with endless combinations of medicines and claims to alleviate certain symptoms. The best approach to selecting the most helpful one is to understand what active ingredients are in each pill and what they are expected to treat. This can help you tailor what you are taking to your current symptoms and limit side effects.

Dextromethorphan, also termed as “DM”, is a cough suppressant that acts directly on the cough center in the brain. It comes as a liquid cough medicine or as a pill. In some studies two teaspoons of honey were shown to be just as effective for reducing nighttime coughing.

Guaifenesin works by thinning mucus or phlegm. This can be helpful if you are having a lot of post-nasal drip (mucus down the back of your throat, clearing your throat a lot), or are coughing up mucus. It should be taken with plenty of water.

Oxymetolazone is a nasal spray also sold under the brand name Afrin. It can give you quick relief from nasal congestion but it cannot be used for more than 72 hours or 3 days in a row. If used longer than that it can actually cause worsening congestion. I like to use Afrin for those nights when you simply cannot breathe out of your nose and the misery of that keeps you from sleeping. It also can be helpful if you are congested before plane trips to help your ears equilibrate to pressure changes.

Pseudoephedrine is a very effective decongestant that is sold behind the pharmacist’s counter though you do not need a prescription for it. You will need to show identification to purchase it and are limited to the quantity you can buy at one time. It is the “D” component in Mucinex –D, Allegra – D, etc. Decongestants relieve nasal stuffiness by narrowing blood vessels and reducing swelling in the nose. This narrowing can affect other blood vessels as well, which can increase blood pressure. This medicine is not a good choice for people with heart disease or poorly controlled high blood pressure. Some people cannot take pseudoephedrine because it makes them feel jittery, spacey, or gives them palpitations. It comes in a 4-6 hour preparation or a 12-hour preparation. Until you know how it affects you I recommend the shorter lasting form.

Pharmacies tend to be sold out of it often during the height of cold season so I like to make sure I always keep some on hand.

Phenylephrine is the decongestant that is sold in the pharmacy shelves and can be a good choice for people who do not like the way pseudoephedrine makes them feel. Some feel it is a less effective decongestant.

Drowsy antihistamines include Benadryl (diphenhydramine) and doxylamine which is found in NyQuil, Alka-Seltzer Night, and other night time preparations.

Many combination pills will also include acetaminophen as a pain reliever and fever reducer. Be mindful of how much you are taking. It is best not to take additional acetaminophen, or Tylenol, with these as too much can be toxic to your liver.

 If you have any questions or concerns about the use of over-the-counter medications please do not hesitate to contact us. If your symptoms are lasting longer than usual, you have a persistent high fever, shortness of breath, or just don’t feel right it may be more than the common cold. Please come in and see us in the office.

Love the Skin You're In!

By: Molly Hagen, Aesthetic Director

Skincare is a very important aspect of a women's overall wellness because it's really about how you feel inside and out. When you look your best, you feel your best and this is going to overlap into other areas of your life. Living a healthy lifestyle is about eating right, staying active and taking care of yourself. When you treat yourself; whether that be a chemical peel or a facial, you are slowing down the aging process and doing something to better your health. It's always easier to prevent, than to fix and it's about loving the skin you are in!

How to Achieve Happiness

By: Randi Platt, M.Ed.

With the science of Psychology turning towards everyday experience, research is helping us understand how to achieve happiness and emotional well being with greater consistency. Contrary to popular belief, it is not important to build self-esteem.  The surprising news is that it is important to learn to feel compassion for self and others.  Those who regularly spend even brief amounts of time feeling gratitude, sending good wishes to others or being a good friend to themselves report greater happiness, connectedness and health. 

Outdoor Exercise Tips for Fall

Summer has come to a close and we now welcome the Fall season with open arms! This is a great time of year to exercise outdoors during those brisk, chilly mornings on Kelly Drive. In order to prepare for your new fall fitness routine, follow  these tips from our fitness specialists.

1. Dress Appropriately: The fall can be a finicky season with some mornings cooler than others. You want to make sure that you are wearing the proper attire. You want to be warm enough for the conditions but wear breathable clothes such as Under Armour's outdoor gear to help release the heat your body is producing during your workout.

2. Exercise Early: You just woke up from your 8 hours and you should feel refreshed and ready to face the day. Energy is known to be highest in the morning for most people but exercise is also known to boost energy levels for hours after your workout. Wake up, work out and you should be completely ready to tackle you day. 

3. Avoid Severe Weather: We all hate missing a workout when we are on a consecutive schedule whether it be 3 or 5 days a week but please be mindful when there is snow, ice or freezing rain outside. Once the roads clear, then you should go outside or hit the gym for the day. 

4. Hydrate: Even though you are outside during the cool months working out, it is still very important to remain hydrated. During the summer months, the temperature is a lot warmer which makes you reach for that water bottle but as the temperature drops so does your thirst. Please be sure even if you are not overheated to remain hydrated so that your body can function properly.  

5. Workout with a Friend: Once we set our clocks back one hour, it becomes darker earlier. If you are going to exercise outside, make sure to bring a friend along. This way, you can motivate each other but it is also a great safety precaution! 

Protein Energy Bites

By: Theresa Shank, Registered Dietitian

Don't get caught in a snack time rut! Try these natural protein balls from health coach Jessica Wyman for a quick energy bite pre- or post-workout. 

Theresa recommends that you try to incorporate some source of fuel 30 minutes to one hour before exercise. Two to three of these balls have enough satiating protein to get you through your workout. You can also pop a protein ball after your workout to hold off your hunger until your post-workout meal; which should be consumed no later than an hour after exercise to gain muscle-replenishing benefits.   

Raw protein energy bites

Yield: 48 servings

  • 2 cups rolled oats, thick
  • 1 cup shredded coconut
  • 1/2 cup pumpkin seeds, roughly chopped
  • 1/2 cup pecans, roughly chopped
  • 1/4 cup chia seeds
  • 1 cup peanut butter
  • 3/4 cup vegan chocolate chips
  • 1 teaspoon vanilla
  • 1 teaspoon cinnamon
1. In a large mixing bowl, fold all ingredients together. Mix thoroughly.

2. Using your hands grab some of the mixture and start rolling together in about one inch balls. Squeeze them firmly to help everything stick together.

3. Place the rolled energy balls on a cookie sheet.  You can place them in the freezer for a couple minutes to help them get firm.

4. The peanut butter will start to dry out, so this needs to be done fast. It is helpful to have two people or consider doing a half batch, which really makes it more fun. I do such a large batch because once I make them they are gone pretty fast. 

Focus on Breast Cancer

By: Monica Duvall, M.D., Board Certified Physician

As we embark on Breast Cancer Awareness month, it is worthwhile to review the statistics, risk factors, and preventive strategies of this globally devastating disease.  Breast cancer is the most frequently diagnosed malignancy worldwide.  It is the most common female cancer in the U.S., and it is the second leading cause of cancer death in women in the U.S., with over 40,000 deaths annually.

Non-modifiable factors that are associated with an increased risk of breast cancer are female gender, white race, increasing age, postmenopausal status, and prolonged exposure to estrogen, such as early onset of periods or late menopause.  Family history of breast or certain other cancers may also increase your risk--this should be discussed with your doctor.   Other factors that may increase the risk of breast cancer include obesity in postmenopausal (but not premenopausal) women, and hormone replacement therapy.  Lifestyle factors have also been implicated in the diagnosis of breast cancer.  For example, there is a significant dose-dependent relationship between alcohol intake and breast cancer, even with as little as three drinks a week.  Smoking also appears to increase the risk of breast cancer.

There are also some protective factors that appear to decrease breast cancer risk.  Breastfeeding is one example.  Physical activity appears to be another protective factor--yet another good reason to get out and exercise!  Finally, there is some evidence that soy products, and other phytoestrogens like legumes, flaxseeds, and sesame seeds may be protective.

So aside from awareness of negative/positive risk factors, how can we reduce our risk of developing breast cancer?  Cancers are most easily treated if they are detected early; therefore, the first line of attack against breast cancer begins at home, by developing "breast self-awareness".  Each woman should be familiar with her breast/axillary (armpit) exam--including skin and texture changes, as well as lumps.  Any change from your baseline should be brought to the attention of your doctor immediately.  Clinical breast exams, performed by your doctor during your annual gynecological appointment, are another important factor in screening for breast cancer.  And mammograms are advised by most professional organizations starting at age 40; the specific interval for these can again be discussed with your doctor, depending on your age.  Finally, women with family history may be advised to consider testing for one of the known breast cancer genes.   Breast cancer takes a terrible toll on the women and families whom it has affected; awareness of risks and preventive tools is the best defense we have in containing, and hopefully one day, curing, this disease.

3 Exercises to Tone Your Glutes

By: Ashley Greenblatt, Certified Personal Trainer

The days of stick-figure physiques are a thing of the past. Strong is the new sexy and your backside is taking center stage. There are songs dedicated to it, Kardashian empires built upon it — no ifs, ands or butts about it, a shapely posterior is what women want and men desire. So, pick up your phones and deflated derrieres ladies and gents, because we are dialing in a bun burner booty call. If your caboose has taken a backseat in your workout routine, you can channel your inner Brazilian beach babe with this tushie-torching workout:

Step It Up. Elevation is key when it comes to toning your tail. To perform a proper step-up, aim for a height that allows the knee to bend at a 90-degree angle. This allows the glutes to achieve a strong contraction during the step up phase of the exercise. Protect your knees by placing your body weight onto the heel of the working leg, rather than on the ball of your foot. This concept is important to practice during any glute exercise, as it is a common mistake that leads to many knee-related injuries. Practice this exercise several times until you achieve a steady, consistent balance. When ready, further the intensity by adding free-weights to the routine.

Pop a Squat. Looking to add a little junk to your trunk? Squatting is the all-star of glute exercises because it gets the job done by zoning in on the muscles necessary to plump your posterior. There is no excuse for skimping on this exercise because it can be done virtually anywhere, and further allows for a myriad of progressions to keep your glutes guessing.

The easiest way to squat with proper form is to mimic the motion of your body as you lower yourself into a chair. As a Personal Trainer, I always have my clients practice the sit-down/stand-up sequence prior to beginning a squatting routine. It is essential to first have good form before adding weights into the mix. As previously stated, you’ll want to place your weight in the heels of your feet to activate your posterior muscles (doing so will prevent shear-force on the knee caps, which will cause knee joint damage over time). Maintain a shoulder width distance in your stance, sit back on your heels, and keep your core activated with your chest up-right. Congratulations, you just did one squat.

Kick Butt. Hip extensions, also known as Donkey Kicks, exclusively target the glute muscles and cause your bum to burn baby, burn. Take a load off and drop down onto all fours (you will need a mat or carpeted floor for this). Align your hands beneath your shoulders and extend one leg behind you to hip-height, then lower your knee until it hovers about an inch from the floor. As always, keep that core engaged and your back strong. Complete 10-15 reps and switch legs.
Amplifying your ass(ets) doesn’t have to be a pain in the butt. Implement these three simple, yet effective exercises into your weekly workout routine to transform your bum from jello to J. Lo.

Irritable Bowel Disease: Diagnosis and Treatment

By: Lauren O'Brien, M.D., Board Certified Physician

One of most frequent reasons that women come to see their primary care physician is to discuss abdominal pain and bloating.  I don’t think a day in the office goes by that I do not hear those words.  Most frequently these patients have what is known as Irritable Bowel Syndrome (IBS).  Not surprisingly, it is the most commonly diagnosed gastrointestinal condition, affecting 10-15% of the population.

The true definition of IBS is: a gastrointestinal syndrome of chronic abdominal pain and altered bowel habits (without other organic cause) at least 3 days per month in the last 3 months.  Commonly, the abdominal pain is intermittent and described as “crampy”.  Exacerbations can occur frequently and are associated with eating and times of increased stress.  The abdominal pain associated with IBS can vary in intensity and location, but is often relieved with bowel movements.  Other common symptoms include: bloating, gas, nausea, diarrhea and/or constipation, and feeling full quickly.  “Red flag” symptoms such as anorexia, weight loss, persistent rectal bleeding, pain awakening a patient from sleep or certain lab findings (i.e. anemia) are rarely associated with IBS and should prompt a further workup for an alternative diagnosis.

Unfortunately there are no tests specific to the diagnosis of IBS.  Frequently, a physician will run blood or stool tests and maybe order additional procedures such as a colonoscopy to rule out other potential causes of symptoms.  If no other source is found and no “red flag” symptoms are present, a diagnosis of Irritable Bowel Syndrome is made.

There are 4 different subtypes of IBS:

                1) Diarrhea predominant

                2) Constipation predominant

                3) Mixed type

                4) Unsubtyped

Treatment options vary between the different types.

As any patient who suffers from IBS knows, making the diagnosis is only half of the battle.  Treatment for this ailment takes time, patience and diligence to improve symptoms.  IBS is a chronic disease, which means most patients will likely have it for life.  That being said, the majority of patients will be able to control their symptoms with one or more of the treatment modalities available.

Upon diagnosis, a patient should take time to keep a log of symptoms and what the circumstances were at that time (what she ate, what she did, etc).   This will help to elucidate any specific pattern or specific food that may be contributing to a patient’s pain.  It has long been thought that certain foods in certain individuals can be a source of IBS symptoms.  If a patient has been diagnosed with Irritable Bowel Syndrome, her first step should be to eliminate foods known for high gas production such as: beans, onions, celery, carrots, raisins, bananas, apricots, prunes, Brussels sprouts, pretzels, bagels, alcohol and caffeine.  In many patients, reduction in these foods can bring around a significant improvement in abdominal pain and bloating.

If still with significant symptoms despite reduction of high gas forming foods, a patient may decide to follow a stricter approach with the low FODMAP (fermentable, oligo-, di-, and monosaccharides and polyols) diet.  High FODMAP foods are poorly absorbed and are rapidly fermented in the gut causing gas and bloating.  Such foods are listed below.

Oligosachharides: wheat, barley, rye, onion, leek, garlic, shallots, artichokes, beets, fennel, peas, pistachio, cashews, legumes, lentil and chick peas..

Disaccharides: lactose (milk, ice cream, yogurt)

Monosaccharides: apples, pears, mangoes, cherries, watermelon, asparagus, sugar snap peas, honey and high fructose corn syrup.

Polyols: nectarines, peaches, plums, mushrooms, cauliflower, artificially sweetened chewing gum and other sweets

Obviously this can be a very restrictive diet.  If taking on a low FODMAP diet it is recommended that you do this under the guidance of a trained dietician in order to avoid over- restriction and malnutrition.  Ideally a patient would be on a low FODMAP diet for 6-8 weeks at which time she would gradually re-introduce the above foods one at a time to determine which specific foods are tolerated and which are not. 

Though it is thought that food allergy could possibly play a role in Irritable Bowel Syndrome, at this time there is insufficient evidence to recommend food allergy testing in patients with IBS.  This is largely due to the fact that current modes of allergy testing have not been reliable in identifying affected patients. 

In addition to dietary management, 20-60 minutes of moderate to vigorous exercise 5 days a week has been shown to significantly decrease symptoms of IBS.  It is also important to address daily stressors through counseling and stress-reduction techniques (meditation, yoga, etc) as increased stress often leads to increased IBS symptoms.

If lifestyle interventions still fail to control symptoms, your doctor can prescribe medications specific to the patient’s symptoms.  For example, anti-diarrheals in diarrhea predominant IBS, laxatives in constipation predominant IBS, antispasmodic agents, and antidepressants.

In summary, Irritable Bowel Syndrome is a very common disease affecting a large number of women.  Symptoms generally consist of abdominal pain, bloating, and a change in bowel habits.  In order to diagnose IBS, doctors must rule out other organic causes of gastrointestinal disease.  Though it is not curable, most patients are able to control their symptoms with lifestyle changes or medications.

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