International MPN News, Science & Opinion

The Empowered Patient (Feb.)

by Michael Goldstein, M.D.

New Year’s Resolutions – a Road to Empowerment

As I write this column, it is the first week of the year, a time when New Year’s resolutions are still quite fresh in our minds. My guess is that many of you have set at least one New Year’s resolution.

Because we have MPNs, it is even more important for us to reduce our risk for cardiovascular disease and other cancers by engaging in healthy behaviors (such as regular physical activity and healthy eating) and reducing or eliminating risky ones (such as smoking). If you have set a goal for the New Year, and have been successful thus far, I wish you continued success.

I also thought it might be valuable to share some perspective I have gained from helping others to make health behavior changes during my career as a behavioral medicine clinician, educator and researcher.
Changing behaviors, particularly health behaviors, can be quite challenging, as you likely know from your own experience. Research in health behavior change indicates that less than a third of people who make an attempt to stop an unhealthy behavior, or aim to adopt a healthy one, are successful in the long-term. Personally, I struggled with a weight problem for most of my life, losing and then regaining weight dozens of times. I hope this doesn’t discourage you…and it shouldn’t.

The good news is that, if folks keep trying to make changes in health behaviors, their rates of success increase, especially if they receive assistance from a coach or behavior change program. A good example of the benefits of persistence comes from the smoking cessation literature. Though the long-term success rate for an individual quit attempt is less than 10%, more than 50% of folks in the United States who have ever smoked regularly have been able to quit for good.
My own experience with weight management is consistent with research findings. With repeated effort and guidance from weight management experts, I have been able to achieve and maintain a healthy weight for the last 15 years. I believe the most important element of my weight management strategy is regularly engaging in moderate physical activity. Getting 4-5 days of walking, biking or using a cross trainer at the gym has also been helpful in managing my PV-associated fatigue. As Jeremy has repeatedly advised, regular exercise is one of the best ways to address combat fatigue and promote wellbeing when you have a MPN.

      So, the most important advice I can give you to support your efforts to keep your New Year’s resolution is to keep trying. If you slip, or lapse, try not to get discouraged. Most folks lapse at least once during a serious attempt to change behavior. It’s what happens after the lapse that determines whether a lapse will becomes a full relapse. It you get down on yourself or think that you have failed, you may lose confidence and give up or give in. Instead, try to identify the most important barriers to success and consider how to overcome them.

Brainstorm possible ways to overcome the barriers and make a commitment to keep trying. To illustrate, I had difficulty sticking to my goal of exercising regularly after work. I tend to work long hours, often longer than intended, and by the time I left work, it was too late to go for a run or bike ride before dinner. I had to figure out a way of getting my workouts in. So, I began to get up early to exercise before work. And, I made  sure I exercised on each day of the weekend. These strategies have helped me to maintain my 4-5 days a week of exercise for several years.
My second suggestion is to set initial goals that are modest and achievable, goals you are confident you can reach. For example, if you have been a coach potato for several years and you want to begin a regular physical activity program, setting a goal to exercise for an hour a day is probably unrealistic. You are better off setting an initial goal to walk for 10 minutes, 2-3 times a week. Setting a lower bar for your initial goal not only makes it easier for you to have initial success; it gives you more room address barriers that might arise. Moreover, initial success breeds confidence and stokes motivation, which in turn increases your chances of long-term success.

      My final piece of advice is to identify ways to reinforce your initial success. Tell your family and friends about your goals and ask them to give you feedback and encouragement. Celebrate your initial success and consider tangible rewards for reaching your goals. For example, you might plan to buy a new sports watch if you meet your initial walking goal, or plan a celebration dinner at a favorite restaurant with the money you have saved from quitting smoking for 2 weeks.

So, good luck with your New Year’s resolutions, and no matter what happens, try to keep at it. I also hope you will let us know about your successes in MPN Forum.
For some good advice on starting a physical activity or exercise regimen, I recommend the National Institute on Aging’s Go4Life materials, available at: http://go4life.niapublications.org/
For access to useful resources on healthy eating and weight loss, see the new US Department of Agriculture’s Dietary Guideline site: http://www.choosemyplate.gov/index.html .

Take me back to the Contents

© Michael Goldstein and MPNforum.com, 2012,. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Michael Goldstein and MPNforum.com with appropriate and specific direction to the original content.

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