Well here I am. Halfway through another rotation - wahoo! I keep psyching (haha) myself out, knowing that I have SO many more rotations ahead of me...

So far Psychiatry has been pretty chill. Definitely a "lighter" rotation, although I find myself getting to the hospital earlier and earlier in order to avoid traffic and to read up on/visit my patients.  Like I said last week, the morning is spent rounding with our attending (we're a group of three students...10 total at this location which isn't usual for most of our rotations) and seeing patients in the various Inpatient wards. Then we split off in the afternoon - this week I was at an Outpatient therapy location just down the street from the hospital. I was able to sit in on Group Therapy, spent a day in the Adolescent Day Therapy, and worked with an amazing outpatient physician as well! I started to learn a little bit about all the different types of therapy - CBT, DBT, psychotherapy, etc. and I definitely want to keep learning. We've talked about everything from shame to self-esteem to finding hope and how to deal with anxiety - topics that are just as important for all of us med students.

I'm just really loving Psych! Sure, I love the lifestyle but I mostly love the patient population and the variety of work. When people come to the hospital, they can be wildly psychotic, manic, or majorly depressed - each one so vastly different from the next. Some are withdrawing from various substances or escaping horrible circumstances (abuse, trauma, homelessness). It's amazing to watch these people get better/stabilize right in front of your eyes over the next few days. Humans are remarkably resilient - especially when their basic needs are being met. For many patients, being in a regulated environment like this is desperately needed - away from all the stressors in their life. They are able to get their required medications, participate in group therapy, interact with others, and start to sort through what brought them to the hospital. It's truly amazing to watch and participate in!

I never realized how much of Psychiatry is done through pure observation and history taking. Unlike other specialties, there aren't a whole lot of tests and procedures one can do. You don't check a lab for depression (although you may look for organic causes like hypothyroidism) and you can't just scan someone's head to diagnose schizophrenia or bipolar (although you can rule out secondary causes of psychosis). A lot of the overall impression of what's going on is based on what the patient says and doesn't say, their body language, their movements/facial expressions, previous history, etc. Collateral information from caregivers, family, friends, nursing staff, etc. is all useful in piecing together the puzzle. I find myself reading a lot of old charts - hence why documentation is so important! 

1.5 more weeks to go but I know this won't be my last psych rotation :)

Whole30

We're steadily moving along in our Whole30 journey this month to the point where I really don't think about it much anymore. Except weekends...weekends are the worst! I just want to go out with friends and not have to worry about things being compliant :/ 2 weeks to go - we can do this!

Workouts

I'm still getting used to this whole "having a job thing"...as silly as that sounds. Going to class/studying all day is just a whole different world with a ton more flexibility, more breaks, etc. So my energy levels on top of doing Whole30 have been decently low. I'm starting to get back to a good place though with enough sleep!

Monday - Crossfit 5-6p
Tuesday - Crossfit 6-7p
Wednesday - Crossfit 5-6p
Thursday - OFF, 20 minute walk with hubby
Friday - OFF
Saturday - Gym - lifting/running
Sunday - Spinning 10:15-11am

So there's my week of workouts. I was really excited I made it to all three Crossfit classes for the week and even tried a new spinning studio with some friends on Sunday morning. I loved it so much I decided to sign up for a 2 week unlimited offer just to try a few more of the classes. I may try to make Sunday morning spinning a new thing for me just to shake things up a bit!

One thing that is lacking from my routine in running. I just haven't felt like doing it lately and I'm not sure if I want to sign up for any more races or not. With my schedule being somewhat unpredictable, I would feel bad to pay for a race and then not be able to go due to being at the hospital. With Fall approaching though (my favorite season to run in) maybe I will get my desire to run back.

And sometimes you gotta treat yo self...to a new workout bag!

Derp. Hello! Just wanted to pop in really quick to recap the past week. My life basically revolves are a small percentage of things: work, making food, eating food, thinking about food, and cleaning up after my food prep. Welcome to the Whole30. 

Chicken sausage, onions, peppers, and roasted potatoes.

Everything is going just fine this time around. Like last time, weekends are pretty much the worst. It's almost sad that my husband and I don't know what to do with ourselves. We could go see a movie...but then I'll want popcorn. We could go out to dinner...but then we'll want some wine or dessert. We could go out with friends...but then I'll want to eat all the things. Whole30 is a social life killer. 

I did meet up with my friends after work on Friday afternoon. Of course they indulged in a deliciously cold adult beverage while I opted for lemon water. They noshed on chips and guac while I loaded up on a delicious unless burger atop greens with a side of broccoli. It was actually pretty tasty so I can't complain :)

See this? This is the other fun part about Whole30. Dishes. (And this is just ONE DAY's worth). Nick and I feel like our kitchen is constantly in a state of being cleaned. We never can get ahead of it! Prepping 95% of our meals certainly takes time (and seems more costly even though it isn't) but it IS going to pay off! And we keep getting better and better at it!

Now that I'm done being a grouch (yes, I've been pretty moody lately), I have to admit that Whole30 is coming at the perfect time for us! We just could NOT get out of our vacation rut. This month is the perfect time to start over. I'm already feeling lighter and more in control again. Getting plenty of nutritious, healthy foods in my system is helping my acne-prone skin clear up and my belly issues calm down. I'm feeling more energetic but I am having some minor cravings for my favorite foods.

My Psychiatry clerkship is going well this month, too. Our schedule is very manageable compared to Emergency Medicine (no overnights) and we're seeing a wide variety of mental illness and conditions. I'm actually pretty interested in Psych - I will definitely be doing an elective or two during my fourth year! Probably in Child & Adolescent Psych or maybe Outpatient. 

Our schedule changes from week to week but our mornings are always spent on Inpatient Psych with our preceptor. Then after lunch, we spend the afternoon in Groups, the Crisis Center, or two different Outpatient psych centers. I love getting to see the different levels of care and how all the team members interact to care for patients - nurses, therapists, mental health counselors, PA/NPs, & docs. 

For this week, I'm at the Outpatient center spending time with the doctors and sitting in on therapy sessions. My goal for this week is to really master the Mental Status Exam and to work on my question bank/review book daily to help prepare for my COMAT exam at the end of the rotation.

I'm also making my public commitment here to not skip out on my workouts this week. I don't know what has gotten into me but I'm back to my old ways again. I've been getting myself all worked up/anxious about going to Crossfit or running and then I talk myself out of it completely. Not happening this week! 

I'm committing to three Crossfit classes and two additional lifting/running sessions this week. There. Now it has to happen! 

Do you ever talk yourself out of workouts? How do you stay accountable?

                            

For the last few months, I have let my life be defined by one major thing: boards. All areas of my life has slowly started to crumble...not exactly the "balance" I talk about all the time. The truth is, I have been getting pretty lazy.

My husband has been taking up a lot of slack when it comes to preparing meals & doing housework (all things we used to share equally). My workouts are less consistent.  I can't even remember the last time I went for a run. Crossfit? I went ONCE in the last month. Partly due to vacation and partly due to laziness. My nutrition has gotten progressively more lax as well. Somehow things like potato chips and Taco Bell bean burritos have been making regular appearances. To say it lightly, things are a mess. 

Now starting my first rotation of third year with Emergency Medicine hasn't made it all that much easier. Random hours and long shifts have really been messing with my sleep - and I love my sleep. At this point, I feel tired All. The. Time. Sluggish, unmotivated, and ready to nap at any point. While my weight hasn't actually changed much the past few months (I'm still sitting in the low 190s), I feel bloated and heavy. I feel myself losing muscle tone. And yet, I can't seem to get out of this funk. 

Time to snap out of it. Whole 30 worked really well for me last time. The creators share a philosophy that I truly believe in so when I found out my Crossfit box would be sponsoring a Paleo Challenge at the same time that I wanted to start Whole 30, it was perfect! 

Now here's the fun part. Last Whole 30 (in February), I had a private Facebook group of women who shared the challenging experience together! We swapped recipes, tips, and tricks but most of all, we supported each other 100%. Sure, most people lost a good chunk of excess weight but the most important changes were mental. I feel more in control than I have have around food. Even when I choose to eat "off plan," I do so in smaller quantities (i.e. I don't feel powerless to stop). Overall Whole30 energized me and left me feeling lighter. 

This program isn't purely about weight loss or meant to be "restrictive". You WILL eat - whatever you need to feel satisfied but you also learn to view food as a source of fuel. You will eat more vegetables than you ever thought possible. You will learn how to read food labels and to scutinize the ingredients you put in your body. You will learn that added sugar is hidden in EVERYTHING. Most of all, you will learn that food does not have power over you. YOU decide what goes on your families plate. 

So if this sounds interesting to you, I strongly encourage you to go read "It Starts With Food" and/or the Whole30 website. Then, shoot me an email if you would like to join our secret Facebook group or  have questions!

Past posts:

• My Whole 30 Story Part I
• My Whole 30 Story Part II

Get ready for some delicious recipes and a lot of fun!

Today I wanted to share the details of how my Whole30 journey went - my timeline and all the good/bad features of the 30 days. If you haven't read Part I yet, you can do that HERE. In Part I, I shared my results and discussed the basics of the program. 

My Timeline
When I signed up, I noticed the Whole30 website published a timeline of what to expect during your typical challenge. You can find the whole timeline HERE.

My Whole30 didn't go exactly as described. I really didn't have any low-lows or high-highs. I didn't feel like terrible but I also didn't feel like I was a tiger in the rain forest. It went more like this:

• Day 1-6 No problems
• Life as usual. Everything was prepped and ready to go. I was excited to get started and see some changes. Aside from a little extra thought about what I could and couldn't have, life was very normal. I never really felt "deprived" during the whole program because it was truly a personal choice. I kept waiting to get really cranky or be really tempted to cheat. 

• Day 7-10 Death
• Just kidding. But I did get these very strange belly cramps. Kind of like hunger except it couldn't be satiated even with upon eating. At first I thought maybe it was an ulcer but after a few days the cramps went away and I felt much, much better. Side note: roasted potatoes were the only thing that really helped settle my stomach. Perhaps my body was adjusting to increased fat intake or just detoxing after removing all the junk. 
• In addition to the belly cramps, I also had trouble falling and staying asleep during this time. I still don't know the mechanism behind all of this - metabolism changes, anxiety, something totally unrelated, etc. Not sure!

• Day 11-26 Smooth Sailing
• After belly issues, the rest of the Whole30 went along relatively well. For the most part, I felt comfortable declining foods that weren't Whole30 approved. Even as my husband ate tortilla chips in front of me and my classmates noshed on free pizza. 
• My sleep improved and by this point I'm falling asleep quickly and sleeping HARD all night. I wake up BEFORE my alarm, which is how I always was before med school.
• My food choices stayed pretty consistent during this period as I was prepping 90% of my own meals. I figured out a handful of recipes I really liked and just kept making them (much to the chagrin on my husband). Had the challenge lasted longer than 30 days, I'm sure I would've had to try even more recipes but #medschoolprobs. When something works, work it.

Veggie and sausage breakfast cassarole

Paleo chicken tender salad with homemade guac and carrot chips

• Day 27-30 A little bored
• The last few days I was just a bit bored. School was starting to get crazy again and I didn't have time to make anything new so I stuck with the recipes I had been using for the past few weeks. I felt great, was sleeping well, but I could easily see the end was near. I wasn't really anticipating any food in particular, I just wanted to have a little more wiggle room in my life and not have to worry about doing everything perfectly. 

Chicken topped with some type of compliant sauce, smashed potatoes, green beans

What I Loved About Whole30

• My overall well-being and energy was good. Not OMG amazing but definitely an improvement from where I was. 
• New recipes - I promise I will share these. I'm compiling my photos and a list of all the links so I can share very soon. Nothing too fancy, either. 

• Decreased GI distress. I have been experiencing some reflux and IBS type symptoms on and off for a couple years now. My reflex virtually disappeared during Whole30 and my ummm..bowels found a more desirable equilibrium. (TMI..sorry!)
• Meal structure. Whole30 generally suggests three squares a day which departs significantly from the common clean eating suggestion of 6 meals a day. They also recommend cutting out snacking or at least limiting your snacks to only when necessary. I tend to agree with this - why should I eat if I'm not hungry? And why should I force myself to eat 5 meals a day when it is highly inconvenient and just doesn't work for me. Yep, three meals a day it is for me! Maybe a snack here or there.
• I felt satisfied. I didn't feel deprived or miserable because I was eating plenty of really GOOD food - tasty and healthy! AND I lost 11 lbs eating the same or more than I did before. I was easily eating 1800-2000 calories a day, working out 3-4 days a week (and not killing myself during it either because of my back).
• Community. Whole30 has a tremendous community for support, education, and everything in between.
• Perspective. I can either spend my time going through a drive-thru or waiting in line for Panera or I can take 3 minutes to pack breakfast and lunch. Essentially, it's the same amount of effort but the outcome of home prep is 10x better. I am NOT too busy to prep or pack meals but I have to prioritize it. 

What I Didn't Like About Whole30

• The social aspect of being on this plan is by far the HARDEST part for me. Going out to eat was nearly impossible. For one, it's a lot of work to find 100% compliant options and I'm not a big "special requests" person. I'll make the occasional substitution but that's about it - it makes me uncomfortable!
• Going along with the first point, many people just don't "get" this crazy plan you're on. I started to get kind of salty about it (which I kept to myself, except on this blog obviously) because it KILLS me that eating real food is a foreign concept. It's NOT crazy to eliminate foods that make you feel bad or are doing damage to your body. I decided to keep my explanation simple: "I'm cleaning up what I eat to see how my body reacts without certain foods. After the 30 days I will reintroduce things and see how my body responds."  If they want more information, I was happy to discuss it further. If not, oh well. 
• Lack of variety. This was simply my own doing - I just wanted to survive the 30 days so I found things that worked for me and ate the same variation of that. I think I also probably ate more fruit and nut butter than the Whole30 creators may have liked but that's just what I enjoyed. Roasted veggies and potatoes were and continue to be a daily staple. Nothing will change that :)
• I was constantly worried about cheating - I wanted to do the plan perfectly. While I never intentionally "cheated," I did accidentally ingest some added sugar a handful of times. Mostly in my tea that I drink - apparently some bagged teas contain stevia! I also tried some braised cabbage that definitely had been cooked in sugar. I only had one bite but I was still mad!

Things I Learned

• Self-efficacy. Something that has largely alluded me for nearly 25 years. It's one thing for others to believe in you, but it's quite another to complete a task based solely on your own motivations and belief in yourself. Now that I know I can stick to this plan, I know I can stick to a 80/20 version in my daily life. 
• "Paleo" does not mean low-carb. I think this is a misperception about the real food/paleo/primal movement. There is nothing that says that you have to eat low carb. I would say I eat moderate carb 150-200 g a day typically with most of that being potatoes, fruit, or vegetables. I have no interest in eating ketogenic as I need those carbs for running and lifting. And, quite frankly, I love me some carbs!
• Paleo does not mean eat all the meat. Actually, I didn't feel like I was eating more meat than I usually do and I'm not a huge meat eater anyway. I usually have 3-4 oz of protein at any given meal so I think that's pretty reasonable. You don't need to eat huge hamburgers and big ole steaks at every meal to be "Paleo" or feel full.
• Fat is a beautiful thing. Healthy fats (like those that come from coconut oil, nuts, avocado, etc.) taste delicious, keep you full, and have so many health benefits! 
• Food is fuel but you can still enjoy it! I think the key for me going forward is to remember that I need to strike a healthy medium in my attitude towards nutrition and food. Life doesn't have to be "all or none." You can enjoy what you eat while it still being healthy. Salads aren't punishment. They are nourishment, energy, fuel. 

Stay tuned for Part III tomorrow where I discuss life after Whole30 and what I have planned next for my nutrition and health goals! 

 

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Happy Weigh In Wednesday! Just FYI, we are still working on picking a new co-host for the blog but Erin and I should have an announcement soon!

So I'm finally putting my Whole30 journey out here! I finished last Monday but I wanted to gain the proper hindsight on my journey and gather my thoughts. 

When I started writing, I realized I will need to release this in a three parts: Results, The Details, and The Rebound/What's next? Today, in accordance with WIW, I will share and overview with my results!

Overview

First of all, what is the Whole30? It's a nutritional program designed to help you determine how certain foods may be affecting your health. These foods are commonly problematic for people and include dairy, legumes, grains, alcohol, added sugar, etc. At first glance, the program seems super restrictive - no fun at all, right? Wrong. 

The first thing I would tell someone who is presented with the Whole30 program is to take a mental tally of their "symptoms". Do you have reduced energy? Trouble sleeping? Gut issues such as diarrhea, bloating, constipation? Skin issues? Seasonal allergies? General aches and pains? Brain fog? (And of course, these things haven't been explained by a conventional medical reason.). Do you experience any of these things? Does it make sense that something we are nourishing our bodies with multiple times daily COULD be the problem? To me it does. 

The second thing I would tell someone who is interested in the program is to pick up a copy of It Starts With Food. For me it is really important to understand the "why" of what I'm doing. I'm pretty skeptical of dogmatic approaches to weight loss - I want science and studies! There is SO much good information in there - I couldn't possibly highlight it all here! Do the work and find out if this program may be right for you. I promise if you read the book, you will understand what is so compelling about healing your body with real food. 

Whole30 is something I came across 1-2 years ago when I was just starting this blog. I thought about it long and hard but never committed to doing it. I never talked about it, that I know of. The truth is, I really didn't think I could do it. I would peruse the list of "no" foods, would stop at legumes, and say "nope, not happening...then get a bean burrito from Taco Bell (not far from the truth...). I think that's pretty common. We take our time to come to a realization - things don't happen over night, especially when they are uncomfortable and potentially good for us. :) 

Within the last few months, though, my thinking started to change. I began to believe that MAYBE I could do it. I was cycling between losing/gaining the same 5 lbs for months. Nothing was changing and I was just stuck - I needed to shake things up. February looked like it would a relatively calm month with very few interruptions - not a lot of parties (save the Super Bowl) or holidays (just Valentine's Day) so I could really focus on success. So I finally pulled the trigger!

More advice - don't start something you don't think you can do. Whether it's a sugar detox, Whole30, Weight Watchers, Advocare, IIFYM, or just portion control, DON'T start something thinking you will fail. That makes no sense - it's wasteful and it does a number on your self-efficacy & self-esteem. If your feelings of failure are greater than your desire for success, you aren't ready. Period. Start with something smaller to build you confidence. Had I started Whole30 at any other point in my life, I probably would not have succeeded - cue the cycle of failure and self-loathing. 

This program isn't about punishment, deprivation, fad-diets, etc. I can't say it any better than the Whole30 website so here it is:

Cut out all the psychologically unhealthy, hormone-unbalancing, gut-disrupting, inflammatory food groups for a full 30 days. Let your body heal and recover from whatever effects those foods may be causing. Push the “reset” button with your metabolism, systemic inflammation, and the downstream effects of the food choices you’ve been making. Learn once and for all how the foods you’ve been eating are actually affecting your day to day life, and your long term health.  - See more at: http://whole30.com/whole30-program-rules/#sthash.52bnNvZb.dpuf

Put simply, the program is about eating REAL FOOD. That's crazy, right? No shakes, no supplements, no quick fixes - real damn food. How our ancestors ate is up for debate but I can guarantee they would probably pick an apple or piece of meat over the frankenfood we stuff ourselves with now. More on this later.

So with all that said, my Whole30 experience was surprisingly positive. I will go into the details in my next post but I feel like my overall health and well-being were positively impacted. I sleep much better, my belly problems improved (occasional reflux and IBS), and I feel more confident about my ability to achieve my health goals. I never really got the "tiger blood" that some people talk about and I don't feel like an angel walking on clouds (what?) but the improvements are enough for me to use the Whole30 program as a template for my eating habits - Paleo-ish? I know I will have toast or a cookie or cheese again (if fact, I had them during finals week which I will talk about later) but now that I know how these things affect me, I will do a better job of keeping my diet "real food" based. More vegetables, more fruits, higher quality protein sources, healthy fats, tons of water -- all the things we KNOW support our healthiest self.

Results

I don't think there is anything too earth shattering about my results. Yes, I lost weight. Yes, I lost inches. For me, the physical results pale in comparison to the mental results. When I started this blog, I don't think I really realize how disordered my relationship was with food. Food is the enemy but it's also my best friend. So it's amazing that a month of Whole30 could help improve my cravings, impulses, and most of all, the emotional eating. I still have a ways to go with improving my overall self-image and disordered thinking but I think I made big steps over this past month! 

So weight loss. I feel like the first 5 lbs were probably water weight since I was around 196 just a few days before I started. So in all likelihood, I probably lost more like 6 lbs, still pretty good. I know I lost inches because I was able to throw on a pair of size 12s the other day! They were pretty tight but hey, non-scale victory :) Clothes are fitting better but I still find myself cycling back to my old thoughts - "I have a lot more work to do..." negative nancy stuff. It's hard habit to break!

Starting Weight: 200.8 

Ending Weight: 189.6

Weight Loss: -11.2

Not too dramatic or shocking, right? Still, I'm pretty pleased with the progress I'm making. I'm getting back on track, plateau no more! 

Stay tuned tomorrow for Part II where I'll talk about all the details - the good, the bad, the ugly. 

What questions do you have that I should address about Whole30?