Controlling your health. Part 1

Health and fitness is, without a doubt, one of the fastest growing fields in healthcare; and for good reason. The top six killers around the globe are heart disease, stroke, COPD, cancer, accidents and diabetes. What do most of these have in common? They are lifestyle based. Of course there will be medical elements to some of them but its hard to argue that a healthy lifestyle wouldn’t be beneficial.

I believe health and fitness is a state of balance between body and mind. This equilibrium in-duality  is accomplished by achieving wellness in four primary categories:

1. Muscles and joints

2. Cardiovascular system

3. Dietary habits

4.Mental health

When these four systems are healthy and happy, I believe you are in a balanced state of health and fitness. Doing so can be challenging, especially if you are lacking in self-efficacy. It will be our goal in this three-part series to get to grips with your own perception of health and self-belief. Your mindset creates, controls and influences your health, It is your beliefs, values and expectations. Ultimately, you will identify how you perceive health on three separate levels.

1.  Internal perception
2.  External perception
3.  Change perception

Once identified you will allow you to have an idea of your health expectations and beliefs. By knowing what you believe you can begin to halt destructive behaviors and begin to take action to improve your health. You are the ruler of your temple, no-body else manages your body but you.

 Internal health perception

In practice I have witnessed the difference between those who believe they can and those who don’t. The difference is huge in terms of recovery and relapse.We all know someone  that has overcome a great health crisis. Were they positive or pessimistic?

Pessimism, defined as stress resulting from hostility, resentment and despair, has been linked to a host of diseases. Men between the age of 40-55 who have high levels of hostility have a 42% higher risk of death, so relax guys because the stress is literally killing you.

Identify your internal health perception

For each of the following mark the most appropriate answer. Do this in private and be honest with yourself, knowing that you won’t be judged. Score them from 0-10. 0 being no confidence and 10 being maximum confidence.

1. My willingness to follow a good nutritional program in order to maximize my body’s healing abilities.
2. My willingness to exercise my body in order reach maximum recovery.
3. My belief in my ability to use focusing techniques to accomplish my goals in health.
4. My belief in my ability to calm my stress issues and use that energy to succeed in my physical healing.
5. My belief in my inner strength to heal my body.

Scoring your internal health perception

0-30 Low confidence in self direction

31-40 Average confidence in self direction

41-45 High confidence in self direction

45-50 Very high confidence in self direction

Understanding your score

Our perception of our health is so important to how we live, work and play. It’s within our beliefs and expectations by which we base our decisions concerning our well being. If we believe in a system there is a much better chance that it will work.

Take for example, chicken noodle soup for a common cold or flu. If you believe in it chances are it will help. Your internal health perception is how much you believe in yourself as the manager of your health and body. Your belief is important if you don’t believe in yourself you don’t have control. With that being said, there are cases and issues outside of such control. Hereditary disease or any uncontrollable events may also negatively impact your health. These are not your fault and there is no point in beating yourself up over it but instead focus on the future by what you can do now.

People who score low on this test need to understand that they are accountable. Now there is no reason to feel guilt but if you do feel guilt it is because you have violated one of your biggest standards. Now that you have acknowledged that move on!  Commit yourself to making sure the behavior doesn’t persist.Use the guilt as leverage to never violate your own standard even again.

If your scored high, congrats. Scoring high is for the most part a great thing It means that you take responsibility for your health The higher the score the more likely you are to:

1.Acknowledge your perceptions

2.Own your perceptions

3.Find solutions of your health issues.

4.Make the solutions happen

The down side to having a high score is that you may be overly self-sufficient. In this case, you may fail to seek advice or mentorship. You may fail to reach out to others that have a wealth of information. Again if the health concern you may have isn’t your fault (blindness, heart disease etc) don’t pressure yourself. Blaming yourself for issues outside your control is worthless. Focus on what you can do now to make a better future. Hold yourself accountable for your actions from here on.

In the next part of this series we will be looking at your external health perception. How you view others in regards to your health and wellbeing. If you feel comfortable leave your scores below; its alway nice to compare notes. There is nothing wrong with a low score as long as you own up to it and seek out advice or support.

In Health

Dr Anthony.

Acknowledgments.

Thank you to Doctor Frank Lawless for his health perception test.

16 simple rules to inner well being

Today I had passed onto me some well meaning axioms that were supposedly written by Buddha. I personally found them enlightening and thought I would share.

1. Take into account that great love and great achievements involve great risk
2. When you lose, don’t lose the lesson
3. Remember that not getting what you want is sometimes a wonderful stroke of luck
4. Learn the rules, so you know how to break them properly
5. Don’t let a little dispute ruin a great relationship
6. When you make a mistake take immediate steps to correct it
7. Spend some time alone everyday
8. Open your arms to change but don’t let  go of your values
9. Remember that silence sometimes is the best answer
10. Live a good and honorable life that way when you are older you can enjoy it a second time
11. A loving atmosphere in your home is the foundation for your life
12. In disagreements with love ones, only focus on the correct situation , don’t bring up the past
13. Share your knowledge, its a great way to achieve immortality
14. Be gentle with the earth
15. Once a year go somewhere you have never been before
16. Follow the 3 R’s

• Respect for self
• Respect for others
• Responsibility for all actions

In life we are merely passengers, so its best not to “back seat” drive. We are architects of our lives and great plans require great work. In many great projects there will be disappointment, discouragement and dissolution. These are nothing but tests and traps. True character is found in times of crisis. Focus on what lies ahead, stick to your true beliefs and values; and you will forge a noble reward. Remember that on the horizon of every dark  and cold winter, lies the promise of a sunny and warm summer.

Tactile Pain Management: iPhone Application

Over the past few years I have really wanted a way to be more analytical and technological with monitoring my patients outcome assessment. I have tried everything from standard forms and progress reports to mailing out weekly spreadsheets which patients fill in and return. All of these are time-consuming. Ironically enough, often patients lose motivation as well and do not always complete or return forms properly. Through this I began to develop an iPhone application that would allow for reminders and a tactile surface to measure their daily outcomes. I am happy to announce that I used my concept for the first time as a prototype today and am very excited about the potential of the application.

This may serve as a vital tool for simple, cost-effective, and reliable outcome assessment and patient monitoring.  According to the data, outcome assessment should be valid, reliable, responsive to clinical change, and practical.  I believe this application contains these components on a fundamental level.  Most importantly it is practical.  It is simple to administer, requires little input (if any) from the practitioner.  Moreover, it allows for yes/no or quantitative type responses for the user.  Therefore, this application is time and cost efficient as well as valid, reliable, and responsive.

please note these screenshots are from the prototype and are being sharpened up at the moment.

The application will allow the patient/client to monitor the following areas on a daily basis:

1. Pain and Soreness
2. Energy Levels
3. Quality of Sleep
4. Motivation
5. Impact on Others
6. Willingness to Change
7. Productivity
8. Custom Field (Add in anything you would like here; i.e. Job Satisfaction)

The custom field also allows the individual to place a baseline on the lowest and highest values.  For instance, if we use Job Satisfaction as an example, the lowest value may be labeled as “I Hate My Job” and the highest being “I Cant Believe I Get Paid to do This!”.  It will give freedom over the labels allowing the patient to connect better with their questionnaire.

The application then stores the info and begins to chart the data over time.  This is important for a few reasons:

1. It allows the patient to “SEE” their progress.  Any healthcare practitioner can appreciate the impact this has in demonstrating pain trends.
2. It allows the patient to recall and reflect on their treatment over large periods of time in a matter of seconds.
3. It allows the patient to understand flare ups and how even though they may be having a flare up, their overall trend is improving
4. It allows the patient to monitor their own progress and give a sense of accountability

The graphical input will allow the user and practitioner to see the patients progress over the course of:

1. One Week
2. 6 Months
3. 12 Months
4. Year to Date (YTD)

Furthermore, the user is able to enter in reminders so that the alarm on the phone goes off or vibrates during the day to prompt them to do one or more of the following:

1. Record their Levels
2. Do their exercises/stretches
3. Custom Field (Add in anything you would like here)

Because it is important for the patient to have great and effective communication with their personal practitioner(s) I have included a function that allows them to email the charts and data (on the spot) to their practitioner(s).  I am really excited about this because it puts the accountability in the patients hands and empowers them to understand their pain and talk about their pain in a direct and easy manner.

It will also allow the patient to upload their outcomes to Facebook as a way of showing off their improvement (or perhaps lack of).

The update pathway includes:

1. Secure data (no patient names for security) upload to a server for pain management research
2. Children’s version for child cancer patients
3. Graphical Comparison (look at perhaps pain vs mood)
4. Advanced Statistical Analysis
5. Various Graphical Forms

This application will also be able to be branded to your clinic through our brand-the-app affiliate program.  This will allow your clinic to place all branding and information on the app (such as splash screen, about, and contacts) for sales to your patients.  You will also retain royalties from the sales of the app on iTunes or other supplying stores.

In summary, I am VERY excited about the potential of this application as there is hardly anything of its kind currently available.  Its simple, easy to use, and any patient that has an iPhone will love it.  Plus, it makes something that was bland and boring, actually fun.  The potential for research using this application is also very exciting.  This form of outcome measurement is essential in enhancing doctor-patient communication and improving goal setting and decision-making abilities.  Consider this when thinking of this application:

1. Establishes quicker more reliable report with the doctor and patient
2. Unmasks Ineffective Treatments believed to be Effective
3. Improves Goal Setting and Goal Achieving (are we making our goals?)
4. Improves Decision Making
5. Reduces the “burden” of typical paperwork and progress reports
6. Highly responsive
7. Helps justify treatment outcomes to 3rd party providers

I expect this to be available in the iTunes store by the second week of October and for a very affordable price (especially when compared to the cost of a patients office visit).  I hope you share my joy in this application.

If you have any questions feel free to contact me via comments below or through my website: www.anthonyclose.com

1 part Strength, 1 part Rehab, 5 parts Uncertainty

I wonder if the team who built the great wall had musculoskeletal pain (MSP).  How about the teams that built the pyramids?  While I may never know the answer, I do know that office workers are the worst.  We all know the mumbo jumbo about how a seated posture leads to a caveman posture.  Whatever is going on with these guys we don’t need more excuses to give them.  Pretty soon, we will have “caveman” posture syndrome and all the medication to go with it.  I prefer to use, weakling behind a desk syndrome but that isn’t very PC.  But then again the mouse weights about 500g and doing anterior posterior and circumduction movements all day long tends to make for one strong deltoid.

In my reality, there is nothing more rewarding that getting people out of some serious spinal pain (except for having an ice cold Newcastle beer which New Zealand doesn’t seem to stock).  What’s better is when I get them out of pain after someone has been doing “core” exercises with them and the pain actually became worse.  In a state of humility, it’s because I have a secret agenda.  That secret agenda is that you can’t always fix a spine by doing the big three (bird dog, curl up, and side bridge).  Most (now a days) would probably agree that fixing the aberrant movement is the NUMBER ONE most important start.  For instance, if some one was bashing their head against a wall and they were complaining of a headache which of the following would you do?

A.  Strengthen their Neck
B.  Stop them from hitting their head on the wall
C.  Stretch their Neck
D. I would start with B then decide.

This article is pretty random (reckless?) and to be honest I have been trying to type something good for a few days but between patients, clients, running a wine-shop and me playing call of duty 6, this is the best I could do.  So don’t tell me it sucks.

Stop doing your stupid stretches

Being a doctor and a movement coach (personal trainer for the non-PC) I see some stupid stuff.  I remember reading from Prof. McGill, a rule of thumb for the gym, which is perfect:

“If it looks wrong, it probably is”

Now I am included in this and if I look back a few years ago, much of the stuff we were doing as kids (pun intended) was ridiculous.  TVA isolation, drawing in, rolling the spine during the descent of a back bridge, stretching the upper traps like some sort of rabid monkey… The list goes on and on.

Trainers are moving into a weird metaphysical realm of pseudo-physical medicine, while rehab specialists are moving into some weird metaphysical realm of pseudo-strength training.  What in the world is going on?  Even I get confused sometimes.  I look around and think, my God, did I miss something?  Maybe I need to attend some more muscles, meridians, myofascial train, trigger point, spray and stretch, neuromuscular technique, “you wish you were an orthopedic specialist” seminar(s).

Be Serious!

That’s what this brat girl used to say to me in 5^th grade math when I use to laugh every time the teacher said the word “duty”.    All jokes aside, be serious with what you are doing.  Exercise is physical medicine.  You wouldn’t just pop pills here and there expecting a positive result.  Well maybe you would but then again that’s a whole other type of rehab.

Anyways, exercises are exercise.  There isn’t a magical combination that automatically makes you a body-builder or pain-free.  However, there is a magical combination called “structured intelligence”.  This involves having a game plan.

Five Ways to Organize Your Training:

Know where you are at.

Know where you are going

Proper Progression

Proper Understanding

Follow Through

You’re not going to get where you are going if you don’t know where you are to begin with.

It’s important to understand where you are strength-wise at the moment for two major reasons.

So you can determine what you might need to work on

So you can reflect on where you came from

Don’t just jump onto the bench press one day and think you are going to start cranking away at a weight you saw Ronnie Coleman lifting on YouTube.  It’s been what, five years since you exercised last?  Yeah, well get assessed by a competent health care provider and figure out what needs to be added or removed from your routine.  It doesn’t mean you have to do boring corrective exercise all day long, it just means that what you do, you need to do right.  You can also look back with a proper starting point and realize the progress you are making or have made.

Knowing where you’re going is systematically and equally important.  Have a vision.  You always hear that for life and for business, well now have it for your training.  Don’t just expect to put on a Richard Simons DVD and “get fit”.  That is not training; in fact it may just be “anti-training”.  Anti-training not only affects you but others around you.  Simply put, don’t do it.  Your goals could be a progression as such:

Improve my biomechanics

Improve my  endurance

Improve my strength

Improve my speed and agility

Which leads me into progression in itself, make sure its proper, safe, and structured.  This could be stable to unstable, bodyweight to resistance, and/or closed chain to open chain.  The take home point is do not be stupid with your organization.  Advancing your strength properly week by week in a methodical way is idea.  There are many ways to do this.  Bill Starr’s 5×5 program is one of the most common ways for people wanting to build strength through compound lifting, to get organized.  Best of all, the program is free.  The internet is littered with it.  If you don’t want to exercise and still get fit, then watch this video (don’t forget your tap shoes and perhaps some nortriptyline to fight off the nasty migraine):

Don’t You Get It?

If you don’t have a clue about the muscles you are working or why, then really what is the point?  It reminds me of cattle being led to the slaughter-house.  Lame workout programs that end up causing more damage than good and guys saying that all they need to do is bench press.  Yeah, because bench press is a whole body workout just like beer contains all the vitamins and minerals a man needs.  I first read this quote on Tony Gentilcore’s site but it rings true, “the hardest person to train, is yourself”.

Take a moment and learn about some of the muscles your working on.  It doesn’t need to be specific movement diagnosis or musculoskeletal differentials; keep it simple.  But have an idea of what you are doing and why you are doing it.

Follow Through

This is as simple as doing it.  No one makes you change except yourself.  People (clinical psychologists) get paid lots of money to make people decide for change.  Perhaps you need one?  Seriously, get off your butt (if it can even be classified as that anymore, thanks Bret!) and get to work.  Find a great training partner or find a trainer.  What’s the cost of a trainer vs open heart or key-hole rotator cuff surgery?  Enough said.

The three things that have really helped me to re-motivate are:

Knowing that I CAN do it.

Knowing that I WILL do it.

Knowing that I can do it NOW.

Can, will, and now is all you need to get you into gear.  Say it enough to yourself and you will realize that you are not actually believing it, but that its true.

-Dr. Anthony Close

The iPad’s Hidden Feature

Recently I purchased an iPad.  At first the thing seemed like an oversized iPhone but the more I use it, the more I realize its potential.  The original reason for buying it?  Well, I would like to think it’s because of an iPhone application I am developing at the moment.  However, the truth is, I don’t need the iPad to develop the application; I just really like electronic stuff.

This thing is fantastic and has some amazing features, however, today during a train ride I realized a hidden feature of the iPad that far surpasses anything the iTunes store has to offer… social interaction.  Let me explain.  Shortly after the ticketing man clicked my pass he returned to sit in the seat across the aisle from me.  Then came the small talk.   He was simply curious about the iPad.  Although I really wanted to read my book (which happens to be Gray Cook at the moment), I took the time to show him how cool the device is.  He was appreciative. *side note, 20 year olds don’t know that the original apple symbol was a rainbow color (which makes me feel older than I am).

On my way back home, again on the train, another ticketing man began to speak with me regarding the device.  Instead of cutting the conversation short, I showed him a few features of the device, shut the device off, and proceeded to converse with him.  From this I earned a new client.

This train ride and communication taught me two things:

1.  Steve Jobs is truly a genius.
2.  Use curiosity to spark change, it may just lead to a new client.

Small talk can be bland.  All of us feel like that at some time or another, but never underestimate the power of it.  If you are positive (and I don’t mean that stupid, prozac type happy) you may just influence a person in a positive manner.   Who knows, that person may just become your next customer or change their career to something they truly enjoy.

P.S. It was nice to meet you Bernard.

iPad Applications That Are a Must:

1. iPages
2.iNumbers
3. iThoughts HD