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Do You Have Exercise Guilt?

November 24, 2014 by Kelley Leave a Comment

Pre-kids, “exercise guilt” might have been induced by a long weekend morning reading The Times rather than jogging around Central Park, or sabotaging a 6 p.m. spin class with a second piece of conference-room birthday cake. Barring a seriously pressing work assignment, whether I worked out or not on most days stemmed from a simple question: Do I feel like it?

Nowadays, there are so many compelling reasons to bag exercise, starting with the two big hazel eyes that tear up as soon as I start to lace up my running shoes on a Saturday or Sunday morning. With three kids, an extra-busy husband, writing assignments, school commitments, and a household to manage, even a short run around the neighborhood can feel like a selfish luxury. Exercise guilt comes not from skipping a workout, but making (precious) time for it.

On the weekends, my husband and I try to trade off, shoehorning exercise between hockey practices or during Dora. Weekdays, I usually make it work on two mornings when all the three boys are in school, an alignment of stars that would have seemed freaking incredible to my newer-mom self a few years ago, when I once actually tried to do calf raises while nursing one day, in a moment of sleep-deprived delirium. But everything is relative, of course, and these days, I often find myself filling that time with extra writing, extra school volunteer projects, or extra time trying to figure out whether Pull-ups are a better deal at Target or Amazon. Before I know it, I’m late to toddler time pickup, and by day’s end, those exercise pants I pulled on that morning will have been pointless.

I realize that this is a first-world problem, and a much bigger issue for full-time working parents with inflexible work schedules. And yet, exercise guilt is incredibly common, says Happy Healthy Kids’s adviser Monique Tello, M.D. A mom of two who specializes in women’s health in her primary care practice in Boston, Dr. Tello deals with exercise guilt on a personal and professional level. Her kids, too, grab her legs when she’s about to head out the door for a run, and her patients often reveal that when they say they’re “too busy to exercise,” they really mean that they feel guilty for taking time that could be spent with their family or at their job.

“Believe it or not, this has actually been studied,” says Dr. Tello, who’s also writing on the topic this week in her own blog, Generally Medicine. “Research has shown that physical activity consistently declines with parenthood.” In a study just last month, Kansas State researchers asked parents why that they think that’s the case, and both dads and moms pointed mainly to a lack of time and, yes, guilt. (One interesting difference: While all parents felt that fitness cut into family time, dads were more likely to feel guilty about exercising in the evening, because it took away from time with their spouse; moms were more likely to feel guilty about exercising during the workday, because it took time away from their job.)

The thing is, while it may seem that “just one more story” or an extra half-hour fielding work emails can feel critical in the moment, a long run might be better for the whole family in the, well, long run. Fitness can help protect against all sort of health problems, from heart failure to depression, and, by and large, happy, healthy parents raise happy, healthy kids. If missing a run or a boot camp class is going to make you cranky, you won’t be a fun person to be around, no matter how many pancakes or Rainbow Loom bracelets you make.

Which doesn’t mean that some very real obstacles—sick kids, traveling spouses, pressing deadlines, pregnancy—aren’t going to prevent you from maintaining the type of hardcore exercise regimen you might have followed as a singleton. But this, says Dr. Tello, is where a little can go a long way, especially when it comes to exercise’s mental benefits. On days she’s unavoidably busy, she’ll do, say, 5 minutes of core work on her bedroom floor after the kids fall asleep, and take the stairs rather than the elevator at the hospital where she works. “When kids see their parents value exercise, they are more likely to value exercise,” she says. “We sometimes do things as a family, like hiking, or kicking a soccer ball around. Someday, I hope we can all run races. Thinking about all that doesn’t just ease the guilt, it erases it.”

I like that line of thinking. During the crazy-busy month ahead, I’m going to resolve to keep doing at least just a little bit most days, no matter how much I have on my plate. (Especially if that plate contains extra Christmas cookies.) Because no one really gains anything if I skip exercise, except for maybe me, and not in a good way.

Photo credit: Thomas Hawk via Photo Pin, cc

How-to: Fighting in Front of Your Kids

October 29, 2014 by Kelley 1 Comment

Okay, obviously this post isn’t an endorsement of brawling with your spouse in front of your children. But I’m hard-pressed to identify any couple who doesn’t get, shall we say, mutually testy from time to time, and if you live with kids, they’re going to pick up on it. They might not hear your 17 requests to remove the Lego bricks that somehow found their way to your shower floor, but if one parent so much as whispers something critical to the other, you can almost see their little ears perk up.

Turns out, kids learn a lot from the way their parents fight. Multiple studies have shown that young kids whose parents fight aggressively (physically or verbally) are at higher risk for depression, anxiety and behavior problems as they grow. But other research suggests that constructive disagreements—in which parents demonstrate affection and attempts to problem-solve—might actually make kids more empathetic and socially skilled than their peers.

To learn more about how exactly to role model healthy discord in front of the kids, I spoke with our advisory board member Erica Reischer, Ph.D, a psychologist and parenting coach who has her own blog, What Great Parents Do. In her practice, Dr. Reischer finds that “parenting problems” often stem from unresolved conflict between parents, and so she spends a lot of time working to foster more productive communication within couples. The trick, she says, isn’t to hide your fights from your children, but demonstrate respectful disagreement and—even more important—eventual resolution. Here are some keys to making that happen:

Question actions, not character. If you’re upset that your husband didn’t help out with the kids’ bath time like you’d asked, say that. There’s no need to throw words like “lazy” or “forgetful” into the mix. “Name calling, shaming, and hurting your partner’s feelings sends a particularly bad message to kids,” says Dr. Reischer.

Watch your tone even more than your volume. Yelling is normal in conflict—we all get agitated, and when we do the volume and pitch of our voice naturally rises, says Dr. Reischer. She’d rather parents focus less on lowering their voices and more on using respectful language and allowing others to speak. In other words: It’s worse to be quietly sarcastic than to loudly—but constructively—communicate your discontent.

Take a time-out if things get too heated. If you sense emotions are about to boil over, tell your spouse (and your kids, if they are present) that you need to take a grown-up time-out to yourself. This is better than taking it to another room, which just implies to kids that it’s okay to aggressively argue as long as it’s in private. “It’s good for kids to learn that they should take it upon themselves to go somewhere and cool off if need be,” Dr. Reischer says.

If you start a fight in front of the kids, make sure they see the kiss-and-make-up part, too. Even if you’ve shared words you wish you hadn’t, or one of you has stomped off in the middle of a fight, it’s still—if not even more—important to let them witness how you resolve the disagreement. Watching parents give some ground, see the other’s side, or even agree to disagree will not only make them kids feel better, it will also teach them the benefit of working together to solve difficult problems.

Photo credit: I’m Not Jack via Photo Pin, cc

What’s in Your Medicine Cabinet, Dr. Tello?

September 12, 2014 by Kelley 2 Comments

It recently dawned on me that since having kids, I’ve spent more money on medications and toiletries for them than myself. Their bathrooms are stocked with a variety of fever relievers, potions, lotions, and de-grimers: A quick peek revealed, for instance, five bottles of liquid ibuprofen, some sticky, honey-based homeopathic remedy for coughing, four boxes of Band-Aids in an evolving array of favorite characters, and a “soothing vapors” bubble bath for stuffy noses. I’ve even taken the time, recently, to painstakingly organize their medicine cabinet to make middle-of-the-night dispensing easier.

My “medicine cabinet” (the upper shelf of my closet, actually) is a comparative wasteland of expired or rejected products. There’s Sudafed with a 2008 expiration date, prenatal vitamins from my third pregnancy three years ago, and lots of lotion and creams that were purchased, tried, and left to languish. What did this say about my investment in my own health and wellness?, I wondered. It was time for an overhaul.

After chucking the expired medications, I asked HHK adviser Monique Tello, M.D., what she keeps in her own medicine cabinet. As a primary care physician who specializes in women’s health issues at Massachusetts General Hospital, and a busy, practical mom, she knows what products are essential, and which just hog precious bathroom space. Here’s her list and comments, with links in case you too are in a stocking-up sort of mood.

Dr. Tello's Must-Haves (for Adults, Not Kids)

Naproxen (i.e. Aleve)	"For headaches, muscle aches. Not for those with a history of ulcers, and not for taking every day."	<br />
Acetaminophen (i.e. Tylenol)	"When you’ve already taken Aleve. To be used sparingly, to spare the liver."	<br />
Diphenhydramine (i.e. Benadryl)	"For nighttime post-nasal drip cough."	<br />
Nighttime cough syrup (i.e. Nyquil)	"When Benadryl is not enough."	<br />
Neti pot with non-iodized salt packets	"Best sinus infection prevention ever."	<br />
Docusate (i.e. Colace, a stool softener)	"Because two pregnancies left me with a condition that demands regularity."	<br />
Magnesium hydroxide/ Simethicone (i.e. Maalox Anti-Gas)	"My go-to after a poor food choice, or a too- large dinner out."	<br />
Bismuth subsalicylate (i.e. Pepto-Bismol)	"Because the kids bring home GI bugs every winter." (Note: Pepto has a children's version that doesn't contain subsalicylate, which may be harmful for kids.)	<br />
Hydrocortisone cream (i.e. Cortaid)	"For itchy bug bites that are keeping you up at night."	<br />
Diphenhydramine cream (i.e. Benadryl topical)	"When Cortaid is not enough."	<br />
Triple antibiotic ointment (Polysporin)	"For hangnails and cat scratches, so they don’t progress to something requiring a doctor’s visit."	<br />
Hypoallergenic facial moisturizer cream (i.e. Eucerin)	"For daily use, wonderful for the skin."	<br />
Lip balm with SPF	"A swipe on the lips and nose on sunny or cold days goes miles in prevention."	<br />
Epsom salts	"Not only for sore muscle tub soaks, also a soothing tub soak for painful conditions in hard-to-reach areas."	<br />

Mindfulness Tips for Moms

August 27, 2014 by Kelley Leave a Comment

Photo by: Spirit-Fire

We all know it feels good to have a little quiet time amidst the chaos of our work and parenting lives. But new research shows that taking a breather—quite literally—improves health and happiness. Researchers at Vanderbilt University studied 243 moms of developmentally challenged kids; a full 85% of these women reported “significantly elevated stress levels.” During a six-month program that compared stress-reduction techniques, the moms who participated in a mindfulness training program, including specific breathing, meditation, and gentle movements, reported significant improvements when it came to depression, anxiety, sleep quality, and life satisfaction.

“Mindfulness” is a bit of a mystery to me. I understand the concept of meditation, though have never really tried it; I can appreciate the benefits of a few deep breaths, which occasionally prevent me from reflexively screeching at my children in a checkout line. But I was at a loss to incorporate a real mindfulness routine into my daily life. So I talked with HHK advisory board member Erica Reischer, Ph.D., a psychologist and parenting expert who also teaches yoga.

First, Dr. Reischer explained what mindfulness is, and why it can help moms, in particular. “Mindfulness is basically just taking a moment to pay close attention to what’s happening in the here and now,” she says. It can be as simple as noticing how your bare feet feel when you walk across a slate floor. Focusing in on these small, present moments has a mind-quieting, relaxing effect. “If you are able to be calmed and centered, you will have deeper, more accessible reserves as a parent, and you’ll be more likely to respond calmly and creatively to your children,” she says.

Meditation is simply a formal example of a mindfulness practice, in which you sit in quiet for a period time, noticing your breath, feeling your body, and letting thoughts pass without emotion or judgement. This can be surprisingly difficult for moms who spend entire days running through a mental checklist of must-dos and haven’t-dones. Dr. Reischer suggests meditation newbies start with just five minutes a day. It doesn’t matter when or where you do it; the most important thing is that you find a time and space in which you know you won’t be bothered by your kids, spouse or partner, or a beeping phone. (Setting an alarm to wake up a few minutes before the rest of the family is a good bet for many people.) Frequency, not duration, is the key to mindfulness practice, adds Dr. Reischer. “Making a routine of doing something mindful a little bit everyday is better than doing a long, formal meditation session every couple weeks,” she says. “Think of it like brushing your teeth.”

This week, I’ve been trying to do a short, daily meditation practice, with the help of UCLA’s Mindful Awareness Research Center (MARC). The good folks at MARC have posted several free guided meditations on their website, including a 5-minute meditation for beginners, in which the center’s director Diana Winston gently guides listeners to breathe, relax, and “be kind to ourselves.” It is soothing and refreshing all at once. You can listen to and download this audio clip and others here.

If your kids are curious about your mindfulness practice, Dr. Reischer suggests buying a small, decorative gong to keep somewhere central in the house (many are surprisingly nice-looking and inexpensive; check out this one, for under $20). While the whole idea of a gong in the house may seem a little wacky, it can serve as a cue to remind everyone to take a pause during an especially busy day or argumentative moment. “Children love to sound the gong, and it can be a household ‘signal’ that everyone needs to stop and take two or three deep breaths,” she says. “It can bring the whole family back to the here and now, together, and that can be a special moment.”

Do Grown-Ups Need Checkups, Too?

August 13, 2014 by Kelley Leave a Comment

Photo by: Alex E. Proimos via photopin cc

It’s no mystery why child well visits are important: they make sure that your kid is up-to-date on vaccines, growing as expected, and developmentally on-track. But here’s a question: When is the last time you scheduled a well visit? Not along ago, women typically saw their ob-gyns every year for a Pap smear, but for most of us, experts now recommend that a gynecological exam every few years is sufficient. And chances are, if you are a healthy but busy parent, the last time you visited a PCP is when your preschooler’s hacking cough relocated to your respiratory tract.

But now that I’m approaching 40, and my family medical history is becoming more complex by the day, I’m wondering if I should be making regular visits to a doctor, not because I’m sick, but because I want to stay well. So I consulted with HHK advisory board member Monique Tello, M.D., who practices internal medicine as part of Massachusetts General Hospital’s Women’s Health Associates.

According to Dr. Tello, in the absence of a clinical diagnosis, there’s no definitive guideline when it comes to adult well visits. And yet, most of her patients can benefit from an annual checkup. “The annual exam is not necessary for everyone, but it is clinically sound for most, and necessary for some,” she says. “The vast majority of my patient panel has some medical issue that has the potential to impact their lives at some point, and therefore merits a yearly checkup. The most common of these is overweight and obesity, which are associated with high blood pressure, diabetes and heart disease down the line. If someone also has a family history of these conditions, it’s even more important that they come in for counseling and screening—weight, blood pressure, cholesterol testing, liver function tests, and blood sugar, at least.”

A yearly visit with a PCP or ob-gyn can also keep tabs on gynecologic issues, which are incredibly common for women and often can be resolved more easily than we might expect, says Dr. Tello. Heavy periods can suggest anemia, which is very common, and ameliorated with an over-the-counter iron supplement. If you’ve been on the Pill long-term, docs will want to make sure you haven’t developed a condition that would merit a trial on a different form of birth control, such as high blood pressure, smoking, migraines with aura, or, less likely, blood clots. Irregular periods merit a thyroid function check. Urinary incontinence, pelvic pain, and sexual problems are also commonly picked up during the well-mom-check, because while many women don’t call their doctor to report these symptoms, they will if they are asked during a visit. The same is true for depression; it’s sometimes an office screen that picks up a problem.

If you feel you’re in tip-top shape and have a low-risk medical profile, or you have an insurance plan that’s stingy about well visits, it’s still worth a chat with your doctor: to game plan a well visit schedule for the future. “It’s the rare patient that can’t benefit from an annual exam, but it does happen,” Dr. Tello says. “If someone feels that they are in that category, they should at least chat with their doctor about spacing their visits. I do have a few patients that I see every two or three years.”

Photo credit: Alex E. Proimos