A Routine Should Be Just That

So, I was on vacation last month.

A seven thousand mile trip in my little red car, zooming from Chicago to Fargo to Billings to Seattle to Salt Lake.

I had a blast. Maybe you’ve read about it.

It was funny to me how many of my friends and readers and acquaintances, how many of you, worried about me. Not about my safety or my driving or my being run down by one of those triple rig FedEx trucks in North Dakota (I must admit, I did have a few moments of fear and trepidation around those monsters). You worried that I was not slowing down enough. That I was not sleeping in. That I was (gasp!) going to the gym and (oh, my GOD!) exercising every day. On vacation! Away from home, where the air is sweet and the food has no calories and dessert comes automatically with every meal.

When I would post that I was walking or biking at the Hampton Inn in Portland, someone would tell me to take it easy, relax, skip a day, take a nap.

Funny, that, because if you know me well, as many of you do, you know that I do NOT do well with down time. I do NOT relax if I am lying on a bed or in a chair trying to make my eyelids close for a late afternoon nap before dinner. I do NOT feel good if I skip the morning workout and sleep an extra hour, then eat two plates of free breakfast that includes pancakes, sausage, and plenty of syrup.

Oh, I’ve tried. I have. I have tried to lie down in the evening and watch television. I have tried to not set an alarm on vacation and just sleep until the sun smacks me on the eyelids and says, “Get up, rise and shine, buddy!” Every once in a while I’m successful.

But you know what, dear readers of mine? As we get older, we get set in our ways, for better or worse. Now, we can argue until the cows come home what is better for you, healthier for you, what makes you happier, calmer, lowers your blood pressure, etc. I’m not writing this to do that.

I’m writing to tell you that I firmly believe that we all have set-points, mid-points that we naturally settle into. Places and states (not literal states, no, though Washington state was killer…) where we feel our best, have the most energy, eat the healthiest for our own metabolism and where we are the most creative, productive and happy. I believe this. I think you should give it some thought.

No matter how hard I try, I keep coming back to what my body is trying to tell me is a good place, a happy place, a contented place where it wants to do what I tell it to do with minimal muss and fuss. Now, for many of you this will sound absolutely crazy, and thats okay.

It’s my set-point, not yours. Get your own!

I do best if I get up at five AM. At that time of the day, which I love, I can make coffee, eat some breakfast, read the paper, process my email, and acknowledge comments here on the blog and elsewhere. I do not need to worry about the day, because I’ve already thought it through. I can take my time, not feel rushed, get ready, and get out the door by seven or so most days depending on where I need to be.

I do not exercise in the morning, with one exception. In the winter months when basketball season is upon us, like now, I like to go watch the Aiken Pacers, who play a mile or two down the road from me in the evenings. This cuts into gym time, so I must work an hour walk into my morning routine. No problem. It just needs to get done, people. Make it happen!

I count on working until the day is done. Some clinic days, that means five PM and finished. Days that I tack a telepsych shift on after clinic, the day is done at midnight or one AM. I feel much more content if I do NOT worry about the crazy hours I work. For now, I choose to work these hours. That will change one day, no doubt. For now, I work until the work is done.

Exercise usually comes in the evening, an hour and a half or so at the gym. If I don’t have time to exercise today because I’m working sixteen hours, that’s okay. If I’m not working the whole day and I have time to exercise, there is no excuse to deprive my fifty-seven year old body of what it needs to stay active and healthy-movement. This is not a chore after you get used to it. You miss it if you miss it.

I try to eat “real” food, when my lifestyle is much more conducive to eating junk or whatever I can grab on the way from one place to another. My body has repeatedly told me, very clearly, that it does NOT like and does NOT feel good if it is topped off with sweets or excess carbs or junk food. The insulin rush and crash after candy bars and Pop Tarts is not for this boy. That said, I LOVE sweets and had rather eat that kind of stuff more than almost anything on earth. I just know that if I want to feel strong and healthy and alert and awake, I’d better not overdo it. It’s just not worth the blahs and the bloats and the mental dulling that comes with that short-lived binge of sweetness.

I use a Jawbone Up24 (Yes, I have pre-ordered the Jawbone Up3, to be shipped December 1st and it looks awesome) to help me track activity and sleep primarily. I have learned about my own non-patterns (again, I work crazy hours, have an insane schedule and most people think I am slightly off for doing so). The software for this device has told me in no uncertain terms a couple of times that it cannot figure me out! There are not enough patterns for it to process and give me meaningful feedback about. Wow.

That being said, sleep is not normal for me, but I’ve learned that this is okay too. I can try to get seven to nine hours of sleep per night as suggested by those who know, but I will just be constantly frustrated because I NEVER sleep more than six and half hours on a normal night. I have found, again, that I feel much better if I get up at the same time every day (which I CAN control most every day) and get to bed just as soon as I am finished work (which I usually CANNOT control at all most days) I do okay. I get enough sleep. I could be getting more, but in my life right now, that is not going to be the routine pattern for me. No worries. I run with it.

Some of you need eight or ten or twelve hours of sleep a night. That’s great and I’m glad you can do that. I can’t.

Any time that I have more than just a day or two off work, I plan to DO something. Go somewhere, see something new, hike, fish, travel, take pictures, visit, see a show, eat in a new restaurant. This is routine for me right now. (See down time above). I love football and basketball games. I like to see my family. I have dreams to make a few more big trips.

The take home?

Routine should be just that, whatever that means for you.

Figure out what keeps your body feeling physically good, energized and ready for action.

Eat healthy as much as you practically can.

Exercise.

Sleep as much or as little as you need to perform at your peak level.

Seek out stimulation that makes you learn and grow.

Be responsible for your own happiness.

In the end, you’re the only one that has that duty in the present.

Don’t let your future self down.

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Do What You Gotta Do

This has been one of those weeks when I need to step back, look at things critically, evaluate my performance, and make adjustments to my approach to the workload and obligations currently on my plate.

Ever had one of those weeks?

First things first.

Assessment.

What are the current assignments, burdens, schedules, relationships and tasks that I need to attend to?

I work, and I work hard. I currently have a full time job as medical director of a busy, three-site mental health center. I also work seventy-five hours a month doing telepsychiatry on some evenings and weekend days depending on how the scheduling falls. Mental health is a rewarding business to be in, but it is very stressful for psychiatrists and others who choose it as a career. Burnout is a very real possibility.

I have relationships that I cherish. These are with family, online friends, IRL friends, coworkers, confidants, and others who I want to spend time with, talk to, share a meal with, or just feel safe with. These relationships don’t happen in a vacuum, and they don’t flourish without some effort on my part. (Some of my closest and dearest friends have gently reminded me of that when I fall down on the job) Being with others is healthy. Isolation for long periods of time is not.

I have a need to create and spend time in my own head. Now, psychiatrists spend a lot of time trying to figure out what other people are thinking and feeling and why, but they need time to attend to their own thoughts as well. I am no exception. For me, writing things down and thinking things through is as important as breathing. If I go too long without doing it, I get a physical air hunger for the words, the sentences, the paragraphs and the physical look and feel of my words on the page.

My body needs my attention. I will be fifty-seven years old in October. Do I feel fifty-seven? No. Do I realize that my physical body is no longer nineteen years old? Yes. Using the old excuses (I’m too busy, I don’t have time, it hurts, it’s not fun, I’m older and I don’t need to exercise) doesn’t cut it. Attention to physical needs such as exercise, sleep and nutrition is as important as working hard to pay the bills. Probably more so. If I don’t pay attention to the former, I won’t be able to keep doing the latter.

Second stage?

Planning.

Given that I really believe that the things I just told you about are really important, how do I plan to make sure they get the time and effort they deserve as I go about my daily life?

Schedule. I make time for the work, the people, and the personal activities that are most important to me. I keep my calendar sacred. If it gets on my calendar for a certain time on a certain day, it must be done at that time on that day. No exceptions. That makes it absolutely imperative that my calendar is pruned ruthlessly and only things that need to be there are there.

I keep a constantly changing and dynamic to do list. Unlike the calendar, this list is always churning, moving, and morphing from one look to another. It is a living thing. It is meant to be a playground for ideas, projects, writing topics, shopping lists, vacation planning, and things to do. I work in it and on it many, many times every day.

Third stage?

Execution.

The most beautiful calendar and the most organized list in the world will not help you if you don’t get up, get out, and execute.

I have to show up at the places on my calendar. I must attend the meetings and participate fully. I must go to the gym. I must message someone on Facebook or call a friend or remember to schedule a dinner to catch up. I must share something of myself, open myself up to others, in order to get them to do the same. Those of you who know me well know that this does not come naturally to me. I work at it every day. I love it when it clicks, when it feels right, when I feel that special connection with a good friend or a confidant who knows exactly how I feel and sticks with me anyway!

I have to pay attention to cooking, eating right, exercising, and feeding my mind as well as my body. These things don’t happen by themselves. It takes effort. The effort is worth it.

When I am tempted to just go home and call it a day, sometimes I need to reach out to a friend. When I think I can get just one more task done at ten o’clock at night, I am learning to tell myself that it is time to go to bed, because the extra two hours of sleep I get will lead to much higher productivity the next morning.

The business of the week is behind me.

Today I will get my car serviced, buy a nice bottle of wine, spend two hours at the gym, cook a couple of nice meals, talk to someone special, sit in the sunshine, take a nap, watch a movie, and get to bed by ten.

I have assessed.

I have planned.

Now, it’s time to execute.

Have a good weekend, all.

Gregorian Calendar

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Sometimes things just get so hectic I can’t believe it. Ever have those days/weeks/months? I’m sure you have. 

I’m smack dab in the middle of one of those stretches of work, travel, visits, and obligations that feels like I got tethered to the back of a 747 and was asked to run fast enough to keep up as the plane barrels down the runway for takeoff. You know you can’t just stand still, but you also know that things are going to speed up beyond your control pretty quickly. 

As I’ve told you before, I’m a purist. I use the applications and programs that come standard with my Apple kit unless I find something better. For that reason, I use Calendar on the iMac and the corresponding app on the iPhone. I have nine separate calendars within the program. These help me to keep track of personal time, actions that need to be taken on a specific date and at a specific time, Facebook events that I have been invited to, meetings I must attend, my professional schedule including telepsychiatry and clinic work schedules, arts events I have tickets to and of course, the 2013 football schedule for the UGA Dawgs. 

All of these calendars sync with my iPhone. Make a change on the phone and it shows up on the iMac at home, and vice versa. Cool. All are color coded. I can look down at my calendar and instantly know if I have to work that day or if I have a meeting later in the day just by scanning colors. 

I also have alarms and reminders enabled via Mac OS-X and iOS 6, so this adds another layer of help to keep me on track. Things will pop up, ding and boing when I’m supposed to be somewhere, write something, or take action on a project. These alarms may come a week before an event, or thirty minutes before a meeting. 

On the iMac, I keep the weekly calendar open, and I have it set to show the entire twenty hour hours of each day. I can get a better sense of what my day or week looks like if I can see color-coded events spread over the entire time period. This lets me know just how busy I will be that week, but it also let me quickly and easily see where there are gaps that might serve as times to meet someone for coffee or plan a dinner with my daughter. 

Still and all, there are periods like this when all I can do is trust that my carefully crafted system will get me where I need to be on time. I trust that I have set alarms, put up reminders and blocked off enough time to accomplish what needs to be done today. I check the calendar one last time at home, grab my iPhone, and head out the door. Then, all I can do is show up and do what I’m told at the appointed hour and hope I make it until midnight, ready to slide into the next day. 

The good thing?

In eight days, there’s a green entry starting at 4:30 PM that says “Trip to Monticello”. It stretches out for three days. The green color tells me that this time will be set aside for personal travel, activities, fun and recharging.

Now that’s the kind of personal obligation I won’t have any problem meeting.