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    MD_HealThyself's Avatar
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    See one, do one, teach one: a medical professional's Primal journey

    I can vividly remember driving my car down the hospital garage ramp (I'd parked on the roof that day) and leaving NPR on the radio because there was someone speaking about nutrition, and a caller into the show mentioned how she was in the medical profession and how little nutritional education she got. The show's guest responded that he was acutely aware of the lack of nutritional know-how in medicine (or pretty much anywhere), which was in large part why he wrote his books. The guest was none other than Gary Taubes. So, I went home, pondered deeply, and ultimately downloaded Good Calories, Bad Calories (he was on the radio promoting the newer book Why We Get Fat but it sounded like a good story and I wanted to start at the beginning) to my Kindle.

    The rest of the story is probably familiar: light bulb explodes in brain, more reading ensues, get sidetracked with highly processed "low carb" stuff for a while, fall off the wagon, look fondly back at the wagon while racking up 35,000 frequent flier miles in 2.5 months (more on this later), then make New Year's weight loss pact with cousin (knowing full well that weight watchers, her plan, is not only miserable and a lot of effort, but also not nutritionally sound...decide to dedicate post-travel months to cooking more real food for myself while I have some time to get comfortable with that life skill and see how that works for weight loss sticking to GCBC/4HB/ChrisTheKiwi principles), then trip over MDA one day surfing the web for something related to eggs as I recall. Well, ok, maybe it's not so familiar as far as stories go, but you get my point: I'd been headed in the right direction, had been primed, then got Primal'd (only in the Blueprint sense of the word. *sigh* ).

    So, that's how we got here. But who is "we", exactly? For those who haven't already been subjected to my posts on the forum, I'm a medical student who will be graduating in June (as long as I can drag myself away from MDA and the primal blogosphere long enough to actually finish my senior project...yeah, about that...). Prior to medical school, I worked for a little while as a science & tech consultant who specialized in research/technology relating to improved cognitive performance. In July, I begin my internship/residency in Surgery, which is a notoriously intense experience even despite the 80-hr work week rules (that's right folks, we had to have national regulation to keep our IN-HOSPITAL work week to 80 hours...and there are lots of people who will tell you that this has had a terrible impact on surgical training...but that's a discussion for another time). Meanwhile, the end of medical school is quite light schedule-wise. So, my Grand Plan is to optimize my health and well-being maximally before the deluge starts in July. I want to get good enough at shopping and cooking that I can plan/prep a week's worth of meals on my day off, and still be excited to come home and eat my wonderful nourishing food. I want to be able to carry primal snacks in my pocket that I can wolf down easily between OR cases instead of a clif bar, and that keep me going stronger and longer. I want to be that surgery resident who is preternaturally happy and well-adjusted despite a grueling occupation (still haven't met one yet...wide-open market!). I want to be the surgery resident who *looks* like she goes to the gym every day after work, but *actually* just eats clean, takes the stairs, sprints once in a while, and lifts heavy things periodically (do patients count?).

    I have so much more to say, but in the interest of maximizing my sleep I need to wrap this up and get away from my computer screen (f.luxed though it is). Rest assured, I have a sticky on my desktop with the rest of my ideas for future ramblings. Lucky you.

    Last but not least, this is a journal. Accountability is key, and so is recording what works and what doesn't. Ergo, food log.
    B: Scrambled/fried eggs from cafeteria. Med coffee with h&h, 2 equal pks.
    L: Tomato stuffed with canned salmon. I tossed the rest of the salmon later--I went with the most authentic, least commercial looking can I could find. This was probably still the right choice nutritionally, but wow. I was NOT prepared for carcass in a can. There was, I shit you not, an ENTIRE SPINAL COLUMN in the can. I honored anatomy--I know a vertebral body, or column as the case may be, when I see one. The ribs I could live with--not thrilled about, but they seemed sorta rubbery and probably edible. Slimy skin too. Awesome. Disgust is a funny thing--as a would-be surgeon, I have a fairly strong stomach for things human. But I have a distressingly low "Eeeeew" threshold with respect to my food. Next time, we'll be trying the uber-commercial canned salmon that just looks like pink tunafish. Minus the central nervous system.
    S: 1/4 cup nuts with some dried cranberries
    D: Ground grass-fed beef with chilies and taco seasoning, topped with some cheese and organic full-fat sour cream, with avocado garnish. By garnish, I mean the entire thing. 1 glass red wine, 2 squares 86% chocolate to round things off (also necessary to facilitate the major life decision that got made tonight: how to rank my residency choices...more on this tomorrow).
    No workout/walk today--should have been my sprint day. Oh well--not going to get my cortisol up in a tizzy about it. Pilates lesson on the books for tomorrow.

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    MD_HealThyself's Avatar
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    Yesterday could have gone better. I was a little stressed because my residency list was due, I was a little miffed because Iím a social misfit in my class and wasnít picked for the dodgeball team (OK, it was the student-nominated honor society, but whatever. Same difference.), and all this culminated in me rushing to answer the doorbell and succumbing to gravity significantly sooner than expected, leading to a couple of stair-sized bruises on my back that look suspiciously like reddish-purple bacon strips (Primal side effect that anything dark and squiggly automatically resembles bacon??). At least I made it to the door before the mailman ran off with my package. Wonder what he made of the preceding thud-thud-thud-thud that was me ever-so-gracefully banana-peeling down my stairs? So, I had a square of 72% Ghiradelli and took a nap before Pilates instead of getting there early to do some slow movement prior. Well, at least I walked to school yesterday and got some sunshine earlier. (NB: even writing about yesterday is cursed: MDA erased my whole post instead of submitting it. Awesome. Re-writing from memory. If you donít like the post, imagine the erased one was better. ☺).

    Back to bigger picture issues, I thought maybe I should talk a little about the title of this journal. ďSee one, do one, teach oneĒ is a time-honored concept in medical education that highlights the role of independence, OJT, and learning by doing. Perhaps itís self-explanatory, but the idea is that you watch someone do Procedure X, which then qualifies you to perform Procedure X, which in turn qualifies you to teach a junior colleague how to do Procedure X. This idea is not officially endorsed anymore since it obviously leaves a lot to be desired with respect to patient safety and pedagogy, but you still hear the phrase a lot in medical education settings. My purpose in using it for a title is that I think it's a great model for my PB plan: Iíve seen some incredible examples of success on the blog and the forums using PB (see one), I now plan to BECOME one such success story (do one), and then hope to join the countless other members here who provide guidance to help others achieve success, as well as help my colleagues and patients get healthier and happier if they so choose (teach one).

    Iím a private and performance-driven person, so it pains me to air what I perceive as personal failings, but I think itís important to acknowledge ALL of the reasons Iím here, and what issues I bring to the table. You may not need to know them, but I need to say them in the interest of transparency, catharsis, and measuring progress. Without further ado:

    #1: Weight. Iím between 5í7-5í8, and currently weigh ~162 lbs. I wear a US size 8, sometimes 10. At my biggest, I graduated high school at a size 14. When I graduated college, I was about a size 10-12. Despite having made some very modest progress over the years and not having as great a challenge in front of me as others here might, being an overweight teen made an indelible impression. Iíve always had body-image issues. I canít remember the last time I was happy with the way I looked, and I rarely feel comfortable in my own skin from an appearance perspective (though do my damnedest to hide this fact). It has never helped that my mother, also my best friend and usual shopping companion, has always been a petite, cougarific 5í4/115# who always looks amazing. Sheís also very devoted to health/fitness and works damn hard for her figure, but itís a blow to the ego that she has ALWAYS looked better in cute jeans than I have. And she doesnít look old enough to be my mother, either. At least I have good genes. ☺ Since my parents have always been into fitness, you might imagine that this was a heavy influence on me growing up. True story, but it sort of back-fired.

    On to issue #2: Exercise/Fitness. Until I was in my early 20s, I had a physical condition that made it feel like I was suffocating every time I got my heart rate above ~150. As a kid, this meant that any endurance activities, especially running, were really miserable. I was misdiagnosed for over a decade, mostly with asthma or just being ďout of shapeĒ, and so nothing ever helped and I was just always down on myself for not getting into good enough shape. I lived with it and did what I could, which was quite a bit so long as I could titrate my heart rate carefully; spinning and the elliptical were fine (though my stridor was a little loud in spinning class), but running was categorically out. I think my favorite anecdote is the time when my *opponentís* coach stopped a Tae Kwon Do sparring match because he thought I was going to keel over (like I said, my breathing difficulty was loud, fast, and really obvious). I eventually self-diagnosed the issue and sought out a specialist for definitive surgical treatment (which helped a LOT), and have subsequently gotten over most of my conditioned aversion to cardio (though I still canít run anything other than sprints; jacks my heart rate up to 190+ for reasons that I think must be psychological rather than physiological). All of the above notwithstanding, Iím just not a person who LOVES to work out. I recognize the importance, and do it on a fairly regular basis, but not with much enthusiasm. I like lifting more than cardio (which happily works quite well with PB), but am easily intimidated by the meatheads and figure competitors in my gym (SoCal, how I loathe thee. Let me count the waysÖ), so tend to avoid lifting at the gym. I have some fairly light (10, 15#) dumbbells at home and can certainly do bodyweight work, but itís not really the ďheavy liftingĒ Iíd like. Iím very tempted to try crossfit since I think it might be a good fit, but am intimidated by the hard-core-ness of all who seem to practice (hey, Iím becoming a surgeon, itís not like I donít have hard core in meÖitís just been misplaced with respect to fitness). Clearly a work in progressÖ

    Finally, #3: Mood. This is the most personal issue, and one I really donít want to discuss, but here goes. Iíve had mood issues for most of my life. Probably best categorized as dysthymic disorder. Being happy is the exception rather than the rule in my life, and I hate that. Now Iím still a very productive member of society, and I think my colleagues would probably be surprised to learn this fact about me. Nevertheless, Iíve been on low-dose meds for some time to keep things under control and *stay* a productive member of society. Even with that, I can easily (and do) spend an entire weekend laying around my house because I donít feel particularly motivated to get out of bed or off the couch if I donít have work to do, and even if I can think of something fun to go do, it usually just seems like too much work (too much work to go play? Yes indeed.). And anyone want to guess what my favorite comfort vice is? Food. Of course. How did you guess? Now, I think that a lot of my mood issues are context driven. For example, my move to SoCal a few years ago was a turning point for the worse. For whatever reason, I donít have close friends here that I want to hang out with outside of school/work, whereas I did where I lived before. So, some of these things are in my control and I just choose to ride them out rather than change them immediately. I acknowledge a certain amount of responsibility for all this (yes, if I gave up my medical career Iíd sleep more, get outside more, and worry less), but I also believe that sticking to PB may improve some mood issues if I give it some time. I also have reason to believe that my life context will change in a few months, so thatís probably good news too. Stay tunedÖ

    Yesterdayís Meals:
    B: 3 organic scrambled eggs. 4 pieces uncured bacon. Mmm. Said ďno thank youĒ to free cupcake with sprinkle frosting made by classmate. WIN.
    S: 2 oz nuts and dried fruit.
    L: Passed on free anti-PB catered lunch. WIN. Instead waited for green salad with 4-ish oz salmon filet and a sprinkle of goat cheese with EVOO/balsamic vinegar.
    Post-stairs fail: 1 square 72% Ghiradelli
    D: Sort of lost it with dinner. Way to much of a heap of good things. Small piece of roast beast while waiting for leftover mini-meatloaf to heat up (lamb/buffalo base w/ veggies, coconut flour, eggs and topped with, what else, bacon!), then meatloaf with sugar-free ketchup. Whole avocado. Then frozen blueberries with whipped coconut cream AND a paleotreat macaroon. Then an Athletic Greens smoothie with a splash of almond milk, coconut milk, heavy cream, cinnamon, and a handful of frozen blueberries (no idea what I was thinking). Oiy. Getting full just re-reading this. Oh yeah, and topped it off with most of a square of 86% dark chocolate.
    Movement:
    Walk to/from school (~25 min total), Pilates (50 min), losing fight with gravity & stairs (2 sec)

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    dropkickallie's Avatar
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    Quote Originally Posted by MD_HealThyself View Post
    There was, I shit you not, an ENTIRE SPINAL COLUMN in the can. I honored anatomy--I know a vertebral body, or column as the case may be, when I see one. The ribs I could live with--not thrilled about, but they seemed sorta rubbery and probably edible. Slimy skin too. Awesome. Disgust is a funny thing--as a would-be surgeon, I have a fairly strong stomach for things human. But I have a distressingly low "Eeeeew" threshold with respect to my food. Next time, we'll be trying the uber-commercial canned salmon that just looks like pink tunafish. Minus the central nervous system.
    Those little vertebrae are absolutely my favorite part of eating salmon from a can!! Even my kids (18 months and 5 years) like them. I just think of them as Grok's version of a 'calcium chew' and go to town! I am so disappointed when I buy a can and only find one or two bones. But, to each their own. ;o)

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    Quote Originally Posted by dropkickallie View Post
    Those little vertebrae are absolutely my favorite part of eating salmon from a can!!
    Ha! If I'd known, I would have saved them for you. Do they crunch? Get stuck in your teeth? I consider broadening my food horizons as part of my journey, but it may take a little time to work around to this one. I'm afraid I may have the same problem with offal--turns out animal organs look a LOT like their human counterparts. May have to start with liver in ground beef. On the vegetable front, I was so proud of myself for finally discovering sweet/bell peppers, and then discovered that nightshades may be problematic. *sigh* Oh well. Back to snacking on carrots and celery and broccoli...life is so hard.
    Last edited by MD_HealThyself; 02-24-2012 at 02:46 PM.

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    Quote Originally Posted by MD_HealThyself View Post
    Ha! If I'd known, I would have saved them for you. Do they crunch? Get stuck in your teeth? I consider broadening my food horizons as part of my journey, but it may take a little time to work around to this one. I was so proud of myself for finally discovering sweet/bell peppers, and then discovered that nightshades may be problematic. *sigh* Oh well. Back to snacking on carrots and celery and broccoli...life is so hard.
    Nightshades are only an issue for some folks. If they don't seem to bother you or create inflammation, you don't have to cut them.
    ďIf I didn't define myself for myself, I would be crunched into other people's fantasies for me and eaten alive.Ē --Audre Lorde

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    Quote Originally Posted by Owly View Post
    If they don't seem to bother you or create inflammation..
    I have no idea how to tell if they're "creating inflammation"...I don't have joint problems, so the arthritis bellwether is out. I'm having the worst breakout I've had in months, but lots of variables involved in this including a definite effect from Primal eating on my birth control pill metabolism. TMI, probably. Sorry. I just hope it's not dairy. I'm trying to be good about limiting dairy to garnishes (some shredded cheese on eggs, little sour cream on spicy dishes) since there's clearly a lot of controversy about dairy but more importantly I'm prone to over-eating cheese and I'm afraid it might be sabotaging my weight loss goals. Eliminating it is possible (especially because who around here on PB says "I couldn't *possibly* live without...), but I'd rather not.

    As a side note, I'm a wee tiddlybit disappointed that I'm not making more progress on the weight loss front (essentially nada in the last week...and the week before). I know, I know--recomp and all that. I need to go home and take measurements, but not seeing as much progress as I'd like. There's plenty to lose, and I'm only going to be able to use the fat-->LBM excuse for so long. I don't track every day, but on the days I have I'm keeping carbs to 60-80g/day, mostly from veggies. And I have the sore muscles intra-/post-workout to prove it. 1 serving of berries or less daily, but pretty regular indulgence in 2-3 squares of 72-86% chocolate. Recently acquired some nuts and dried fruit that I'm going to relegate to the top cupboard shelf in light of my frustration. Possibly an omega-6 vs omega-3 issue? Just not being patient enough (almost certainly true...not my virtue!)? Other thoughts?

    Thanks for chiming in, everyone!
    ~~~~~~~~~~~~~~~~~~~~~~~~~~
    Began my Primal journey 2/5/12
    See One, Do One, Teach One: my Primal journal

    SW: 164 lbs
    CW: 161.4 lbs
    GW: 145 lbs

    Au milieu de l'hiver, j'apprenais enfin qu'il avait en moi un ete invincible.

    In the midst of winter, I found there was within me an invincible summer. -Camus

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    With you being in Cali, go to Trader Joe's and get their canned salmon. They have some that come in tins slightly larger then a can of tuna but those have absolutely no bones in them and is about as good as having fresh salmon. Seriously, check it out.
    Georgette

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    Quote Originally Posted by MD_HealThyself View Post
    I have no idea how to tell if they're "creating inflammation"...I don't have joint problems, so the arthritis bellwether is out. I'm having the worst breakout I've had in months, but lots of variables involved in this including a definite effect from Primal eating on my birth control pill metabolism. TMI, probably. Sorry. I just hope it's not dairy. I'm trying to be good about limiting dairy to garnishes (some shredded cheese on eggs, little sour cream on spicy dishes) since there's clearly a lot of controversy about dairy but more importantly I'm prone to over-eating cheese and I'm afraid it might be sabotaging my weight loss goals. Eliminating it is possible (especially because who around here on PB says "I couldn't *possibly* live without...), but I'd rather not.
    Inflammation: I'm not a medical professional of any sort (yay social sciences!) but my understanding is that if they are setting off arthritis or if the person is experiencing more issues with autoimmune conditions etc., it might be worth trying cutting them. My brother has a nightshade sensitivity that seems to create some similar issues to what I get with celiac (GI problems, increased eczema and so on), enough so that his doctor initially investigated gluten as the culprit. IMO, nightshades seem to be pretty okay for most folks, but some people are sensitive.

    As for dairy, I didn't think it was a problem for me, but since I cut it out for this paleo challenge thing at my gym for the last six weeks, I've dropped 11 pounds and seen a noticeable change in body fat. I seem to stall on it. I may add a bit back in for maintenance, but keeping it minimal has worked for me. The only thing I didn't drop was butter/ghee. Sad face--I miss brie.

    But really, you've been doing this for about two and a half weeks, yes? And the first week for a lot of people involves just trying to get all this sorted out. I would get the hang of plain old primal eating before you start playing with the macros or whatever too much. If you're still not seeing much progress after a month, then maybe worry. But from your sig, you have seen some change, so I wouldn't freak out about it at the moment.

    Oh, and I totally feel the same way about the bones (or worse, the skin) in canned salmon. Sadly that's supposed to be a really good way to get calcium, but I just feel totally icked out by it. We don't have Trader Joe's here, but I found some boneless skinless wild Pacific salmon at the grocery store, and it was quite good and much less disturbing.
    ďIf I didn't define myself for myself, I would be crunched into other people's fantasies for me and eaten alive.Ē --Audre Lorde

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    Bron's Avatar
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    Just mush the bones into the meat It's one of the best ways to get a bit of calcium into you and they're so soft, you don't feel them in your mouth that way.

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    Primal Blueprint Expert Certification
    Thanks for all the help everyone--and *great* tip about Trader Joe's, geostump! I love that place. I'd love it better if they would sell grass-fed beef, but I've found a lovely local butcher for that. Glad I'm not the only one weirded out by my salmon experience. I think it was more the shock of it than anything, but still ever so grateful to know that there's a boneless TJ's version in my future.

    I swung by Sprouts last night and stocked up on a few essentials (including some orange peppers!), and discovered my new love: Kale chips. I halfheartedly tried my hand at these once with some leftover coconut oil in a frying pan, but didn't really season them or make more than a few bites. Now I'm seriously considering buying a dehydrator. They're way too expensive and too easy to make to continue to buy them commercially, but I can totally see myself living away from home on home-made kale chips and jerky (never tried making this before, but clearly store-bought is out).

    Anyway, back to business. Yesterday's meals:
    B: 4 eggs, some sausage crumbles, sprinkle of shredded cheese
    L: Coffee w/ 1 tbsp half&half, 1 equal, 1 sugar in the raw
    D: Organic greens salad with EVOO/balsamic & little goat cheese. 2/3 lb seasoned ground beef with 2 tbsp sour cream and a little shredded cheese. 1/2 avocado. 3 small squares extra-dark chocolate.
    ~~~~~~~~~~~~~~~~~~~~~~~~~~
    Began my Primal journey 2/5/12
    See One, Do One, Teach One: my Primal journal

    SW: 164 lbs
    CW: 161.4 lbs
    GW: 145 lbs

    Au milieu de l'hiver, j'apprenais enfin qu'il avait en moi un ete invincible.

    In the midst of winter, I found there was within me an invincible summer. -Camus

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