Great Expectations, Poor Results

In my role as a primary care Family Nurse Practitioner I often found myself reviewing lab results with patients that oft revealed a need for change. Their cholesterol was high, they were prediabetic, uncontrolled diabetic or they had high blood pressure. I would present the current situation. I would discuss the risk factors and the need for change. I would give and overview of the changes that were needed and I would tell them, “however let’s just begin with one or two things. If you try to change too much at once you are likely to become overwhelmed and you won’t stick with it. So the goal is to start with one positive change and get that down and then we will add another and then another.” My patients appreciated, understood and respected that.

In fact I had a patient that struggled with her weight. We had a very similar one step at a time discussion. I explained to her about moving. “Look you don’t have to go out and run a marathon or even have a gym membership. Just start moving. Walk. Start with 15 minutes a day for 3 days a week and build on that.” Three months passed and at her routine check up I could not help but notice her weight loss. We confirmed this with actual measurements. I asked her, “so what have you been doing?” She replied, ” Mrs. Shelly, I did what you said and I just started walking. I started 15 minutes a day for 3 days and then kept going. Now I walk about 3 miles most days of the week. That is the only thing I did different.” Wow, a patient did what I said and it worked ! I was excited and baffled.

You see even though I know this can be the truth , deep down as a person who has struggled with her own weight after a reaction to a hormone injection, I never thought this simple thing could be my truth. I can’t just walk. I need to run or lift weights. Additionally I can’t just start walking I also need to seriously restrict my food intake. I know I tell my patients one thing at a time , but I know better and should be doing better than that and more. Well guess what. I did more. I would jog, change my diet and try to “fix” everything at once. Guess how long it lasted 2-12 weeks at the most. Guess who keeps circling the same mountain of weight loss and gain and loss. I cannot tell you how many times I have lost and gained the SAME 40 pounds.

Somehow I placed expectations on myself greater than I had on my patients. I felt I should know better, could do better and yet the reality was I did not. I was not immune to the same thing of doing too many things at once and getting overwhelmed and not sticking with it. I never just started 15 min a day for 3 days a week as a goal. I once went from completely sedentary to running a 5K within a few weeks. I finished the 5k and have actually completed a few of them. But ask me how often I jog or walk in between the 5ks? I did not develop a habit of walking, moving, or exercising as I was teaching my patients. I simply saw a mountain to scale. One 5k, one 6 week restrictive diet, one major task or assignment and then nothing. There was no habit. There was just intermittent overzealous, unrealistic goals and then nothing.

You would think the the 15+ years of battling my weight that I would have finally realized sooner than now that perhaps I should take the same prescription that I gave my patients. I was willing to give them grace, encouragement, and all the patience in the world to work on their goals. However, when it came to me, I expected myself to have done it yesterday and then when I was not where I wanted to be I would get frustrated, disappointed , give up and then back slide. Thus losing and gaining the same weight. I would exercise hard and eat super clean or do nothing and eat whatever I wanted. I did not overeat, but I just was not particular about what I ate. This “feast or famine” pattern as I call it has been my routine/pattern/habit.

Well here I am 1.5 year from turning 50….. and the one thing I realize in my years of wisdom is that whomever said “doing the same thing and expecting a different result is the definition of insanity was correct.” I am living proof. There are other areas of my live I have made progress, overcome or succeeded but there are places where I am not quite up to my potential and the honest to goodness truth is this: I have never learned to pace myself. I heard slow and steady wins the race, but I wanted to sprint really hard for a few miles and then coast. Thus, having unrealistic expectations have led to poor results.

Finally as I was sending a message to a colleague about giving herself the same grace we give our patients and urging her to not place such unrealistic expectations on ourselves that we would never expect of others, it finally clicked. I have not been kind to me . I give everyone else in the world grace, but I have not extended the same grace and patience to myself and thus have set myself up for failure over and again.

So in yet another effort to QUIT circling the same mountain in the wilderness for 40 year since I am truly at about 20, I have come to realize that I must treat myself the same as my patients. I need to start with ONE THING. Do that well, and build upon it. So prayerfully by time I am 50 despite what size clothing I wear or what the scale says, I can whole heartedly honestly say, I have this one healthy habit that I do consistently. I am not the fastest, strongest, or best, but I am faithful and show up every day. This has become my new goal….to practice what I preach in a sense but to also preach the same message to myself that I proclaim to others.

We will see how it goes, eh?

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