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From the Chairside: Your cortisol levels are higher than your loan interest payments!

IMG_8221This post is authored by Dr. Mona Shoman, Calgary, AB

“Nothing personal, but I hate you”

How many times a day do we hear this statement? And that’s only one version. There is also the “God I hate coming here”; “you hurt me”; “I’ve been dreading this for a week” and the “I’ve punched a dentist before”. If you have been fortunate enough not to hear the last one yet, just wait, you will. It’s a fact and there is no way around it. People hate us. The loathe they have starts from the moment they make the appointment (even if they have never met us before) all the way to the moment they have to pull their wallets out and pay us, and still weeks after that. The horror thoughts, the needle, the smells, the sight of instruments, the sounds, all of it. That’s reality. No matter how pleasant, sweet, understanding and compassionate we try to be, we are a despised profession who should feel bad because Suzy’s crowns really are what put our kids through college and what bought us that Mercedes (sure Suzy).

We all knew that, and we chose dental school anyway. We persevered, studied hard, aced our board exams and graduated. We went on to practice, some of us drowned in work right off the bat, and some took longer to get our hands wet so to speak. And, for those of us who own practices, we have our own stress barometer.

I am a dentist, as I am aware everyone reading this will be as well. That’s why I will cut right through the chase. It’s a stressful, emotionally, mentally and physically draining career. When we were in school, they told us we are endeavoring on a profession with the highest suicide rate. Did they not? We also have a high rate of depression, anxiety and psycho-neurotic disorders. But, I am not telling you this to make you more anxious. I am telling you this so we can talk about ways we can manage these stress levels.

Like many things in life, you can handle unhealthy feelings in more than one way. Walk into any Las Vegas casino and you’ll find one way of coping. But jokes aside, we love what we do and we want to do it for a long time, so we need to first recognize the problem and then discuss methods of managing it. I am a strong proponent of fitness, and I have found it to be a successful way of getting my mind off the office, the patients, the accounts receivables and all the problems the equipment pose every day. I want to share with you the immense benefits of movement.

I know you don’t need to read all the research although trust me, there are some extremely interesting ones out there. But the point is simple. It is scientifically proven that physical activity leads to better moods and has positive psychological effects. Notice that I am not mentioning ANY physical benefits here, even though most people think of exercise as a means to a goal (i.e., to look a certain way). I am addressing movement for the emotional benefits. We all get caught in the nasty, vicious cycle of lack of time, long working hours, phone calls, charting, hiring and firing, managing overhead costs and worrying about how much we are billing. But then at the end of the day, we get angry at ourselves because we know we are neglecting our health and we all know deep in our hearts that this stress is not good for us. We forget that we are only human, and that we all have families and loved ones who watch us deteriorate and slave away. They feel us worry and it hurts them just as much. It’s a difficult cycle to break, but I am writing this to reach out to every single dentist out there who is at risk of hypertension, cardiovascular disease, obesity, and depression. Help yourself so you can be a better husband, wife, father, mother, sister, brother, uncle and auntie. Here is how…

First, it is a massive misconception that you have to join a gym and set your alarm to 5:00 am to find the time to exercise. So get that thought out of your head. I saw a commercial on TV (hockey playoffs, the only time my TV is on) about a program called “10 minute trainer”. If you have never heard of it I will brief you in. Basically, it is a program designed for people who are too busy to go to the gym and/or would like a way to exercise without having to leave their homes, for example new mums. Sounds familiar? It is a DVD that you purchase and it takes you through an at-home, no-equipment-necessary workout where you get your sweat on and get your endorphins kicking. Believe it or not, this is the sequel to another workout that was extremely popular a few years ago called “Insanity”. The company who makes it gained ridiculous following, but I guess buyers must have complained about not having the 25 minutes needed for “insanity” so they condensed it to 10 minutes!

The reason I am bringing this up is: hey, you are busy and your schedule is impossibly packed? You still have 10 minutes. We all do. We all waste time in one way or another during the day that we don’t want to admit to (social media anyone?) Come on, you can carve out a few minutes to move, release some bottled up stress, and return to whatever you were doing feeling refreshed and energized. You will be surprised at the effects. Little by little, it will transform from something you dread and feel is a chore, to an activity you really look forward to doing. And I’m not saying you have to buy this DVD. This just happened to be a genius multilevel marketing idea that I came across. You can go for a jog, run with your dog, take your kid to the park, put skates on and go on the ice, meditate, or even whip around the block on your bike. Any sort of cardiovascular exercise is what we are looking for, and it does not have to be more than a few minutes a day.

Second, find a buddy. In our profession, it’s tough to confide in someone without having to be careful what you say or being concerned about competition. Your buddy can be a dentist, if you are lucky to have someone amazing enough to share this goal of exercising with, or it can be anyone who has a great charisma and will keep you accountable. The reason it’s important having someone to do this with is simple. It’s more fun when you’re not alone. If you choose to join a gym, your buddy will harass you for wanting to bail because it’s too cold out. If you pick up an outdoor activity, your awesome wife or husband will be telling you all day how excited they are to get outside after work and breathe in the fresh air. Can you do it on your own? Of course you can, but you work so hard in every other aspect of your life. Share this part of it with someone so you don’t feel like it’s another burden.

Thirdly, get some cool new gear. No, this doesn’t have to be the newest Apple watch sport with every bell and whistle you can imagine. I’m talking about new shorts, bright colored shoes or even just comfortable new running shoes. Ladies, don’t you get excited when you have a new Lululemon top and you just can’t wait to wear it? No? Then go out and buy something that will get you excited! I’m not a very techy person but you know those FitBits? I am shocked and amazed and how loyal people are to their fitness routine when they own one. It looks like a watch but it records how many steps you have taken a day and tracks many other stats for you throughout the day. Do yourself a favor and get one. It is motivating. Whatever new gear you decide to treat yourself to, please see it as a step towards a healthier, happier you.

Finally, reward yourself. When you have come to the realization of just how crucial it is for your overall health to make time for your fitness, the satisfaction you feel will be incomparable. However, you have taken a big step, and you have made changes that you should be proud of. So it is important to reward yourself. An extrinsic reward is powerful because your brain latches on to it and makes the link that the behavior is worthwhile. This way, you will increase the odds of exercise becoming a habit. So what are examples of a reward? Well, that’s up to you but devouring a tub of ice cream kind of defeats the purpose of health 😉 Maybe get yourself a nice bike, a magic bullet for your smoothies or a really sweet coffee maker. Maybe reward yourself with a night in with your beloved watching Netflix, completely forgetting about work troubles. If a getaway is feasible, go for it. Whatever it is, make sure you acknowledge that you have overcome an obstacle which just a few months ago seemed impossible. You have earned it.

To sum up, all individuals could benefit from regular exercise, but to us dentists, the value of exercise is insurmountable. When you incorporate physical activity into your daily routine, your mental and emotional state elevates, which makes you more creative and able to better manage your life. It will put you in a much better mind frame. Your family, health and career will thank you for it. If you need any extra incentive, just know that Richard Branson wakes up at 5:30 every morning to do kitesurfing and swimming. I know we all like to think we are Richard Branson, but let me break it to you, we are not the multi-billionaire. So if he can make time to go to bed early and wake up to exercise, I promise you we all can as well.

Useful Research 

  • In 2000, Sandlund and Norlander published an article in The International Journal of Stress management analyzing the role of Tai Chi in stress management. Tai Chi is noticeable with its flowing, slow, dance-like movements and its function as a system of calisthenics and self-defense, as well as being a vehicle for meditation and spiritual well-being.
  • One study compared four different methods for stress reduction: brisk walking, meditation, reading where 96 healthy males and females (48 of each) were recruited from different Tai Chi clubs in Melbourne, Australia, and randomly assigned to one of the four treatment conditions. A “blind” experimenter who had the subjects come in twice to the laboratory conducted the experiment. The participants were then subjected to both mental and emotional stress (ex. Arithmetic problems under time pressure and loud noise) as well as an emotionally stressful movie. All four conditions appeared to be effective in reducing mood disturbance, and the Tai Chi group showed a significantly greater reduction in state anxiety compared to the reading group.
  • Szabo, Mesko, Caputo, and Gill (1999) compared post-exercise affect after sessions of aerobic dance, weight training, martial arts, Tai-Chi and yoga, and as a control, music appreciation. Results indicated that the combined Tai Chi and yoga group reported higher levels of “tranquillity” than all other exercise groups. Further, they reported lower psychological distress, fatigue, and exhaustion as compared to the martial arts group.
  • Channer, Barrow, Barrow, Osborne, and Ives (1996) studied changes in hemodynamic parameters following Tai Chi Chuan and aerobic exercise in patients recovering from acute myocardial infarction. Patients (N 4 126) were randomly assigned to three groups—Tai Chi, aerobic exercise, or a nonexercise support group—following acute myocardial infarction. Measurements on heart rate and blood pressure were recorded during eight weeks. Results indicated lower diastolic blood pressure only in the Tai Chi group, but significant trends in systolic blood pressure occurred in both exercise groups.

The opinions expressed in this post are Dr. Shoman`s.

One comment

  1. Interesting. Thanks for the info.

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