Wellness in the New Year #121

Dr. Robin Noble:

Be a little bit more present. Savor those moments, not worry as much about what the future might bring. I think that's really helpful and I love to do something new, some kind of new activity or new hobby, and I think that's really helpful for people. There are a lot of things that don't cost a lot of money that can help us learn a new skill and enjoy something.

Dr. Tim Howe:

There is quite a bit of evidence now that the way we eat can impact us tremendously in how fast we age. And that's really what we're aiming for, is for the participants to feel better. Not, you know, in 10 years, but within two weeks. And that's what keeps us doing it.

Lyn Howe:

One thing that I have seen work really well working with change is you can't just take something out. It's really important to put something out good in and that goes for what we're eating or even what we're thinking about.

Dr. Lisa Belisle:

This is Dr. Lisa Belisle and you are listening to the Dr. Lisa Radio Hour and podcast show number 121, Wellness in the New Year, airing for the first time on Sunday, January 5, 2014. Today's guests include Dr. Robin Noble, a gynecologist with InterMed, and Dr. Timothy Howe, an internist with Parkview Medical Associates and his wife, Lynn Howe. A new year is upon us and we are all thinking about ways we might live better lives. Joining us today are people who help others to do just that. Maine Magazine 2012 Superdoc Dr. Robin Noble shares how she counsels women in her practice to achieve balance, while Dr. Tim Howe and his wife Lynn describe their lifestyle choices program at Parkview Hospital in Brunswick. They offer insights on plant based eating and the importance of spirituality in creating change. We hope you are inspired to find your own wellness in the new year. Thank you for joining us. As we head into 2014, we're all

Dr. Lisa Belisle:

starting to think about the changes we might like to make in our lives. Change is challenging sometimes, and when we have challenges, oftentimes we talk to the people who take care of us and help take care of our health.

Dr. Lisa Belisle:

One Such individual is Dr. Robin Noble, who is a gynecologist with Intermed and

Dr. Lisa Belisle:

also was one of Maine magazine, we'll call it Super Docs from last year's wellness issue. Thanks for coming in and speaking with us today.

Dr. Robin Noble:

Thanks for having me.

Dr. Lisa Belisle:

Now, why did you decide to come to Maine? You're not originally from here.

Dr. Robin Noble:

We know I'm not originally from here, but I did spend a number of summers when I was a child up in the Mount Desert island area in Southwest harbor. And I think I always loved it and had fond memories for that reason. And then when my husband and I finished our training, he's a physician as well. We, we really wanted a nicer quality of life than Manhattan afforded. I grew up in Manhattan, and as much as that pace really excites me, I didn't really want to try to practice. And now we have four small children and try to do that in Manhattan. So we looked at places where we could practice great medicine and enjoy the outdoors, be reasonably close to family, and this really fit everything on all the. On all fronts.

Dr. Lisa Belisle:

Dr. Noble, you have impressive educational credentials.

Dr. Lisa Belisle:

You went to Yale as an undergraduate, medical school at Columbia, residency at Yale New Haven. You're board certified by the American Board of Obstetrics and Gynecology, and you even

Dr. Lisa Belisle:

did a fellowship in laparoscopic surgery. With all of these qualifications, you could

Dr. Lisa Belisle:

have chosen any hospital anywhere in the country. How do you find the hospital system here in Maine and Intermediate where you've been working?

Dr. Robin Noble:

I think the practice of medicine up here is really equivalent to any of the big centers, especially in the Northeast. I mean, you're right. We could have chosen to go anywhere, and we absolutely chose to come here partly because of the medicine that's practiced here. The quality of my colleagues and the quality of life, they both are huge draws. So I don't think we feel like we compromised on that front. If I were doing medical research, there are bigger centers for that. But as far as practicing medicine and the kind of lifestyle and the kind of opportunities that Portland in this area offers were really the major draw.

Dr. Lisa Belisle:

You made kind of a big decision a few years back, and that was to really limit your practice to gynecology as opposed to obstetrics. And obstetrics, of course, is delivering babies, and gynecology is care of women and surgery that women need. Why did you make that decision and was There a lifestyle issue involved?

Dr. Robin Noble:

Absolutely. I found myself in a situation where I was on call or backup call about every fourth night. My husband was on call every third night. And we had four small children and au pairs and in laws trying to coordinate care for our children. And it just became too hectic. I think I realized that it was not sustainable. I. I did that for about seven years up here. At the time, we were covering two hospitals. And I think I recognized that I could not keep doing it. Something had to give. So I did make that decision. And I feel very fortunate that my partners allowed us, allowed me to make that decision. We actually took some time figuring out how to do it. We hired another person. It was very important to me not to change their lifestyles, not to have them take more call when I dropped out.

Dr. Lisa Belisle:

So.

Dr. Robin Noble:

So it was a process. It took us about a year. And then I stepped down from obstetrics and continued my practice in gynecology. It's not to say it wasn't difficult. I loved obstetrics, but I had to give up something, and I just found that I was too exhausted to take care of my own children and balance everything in a healthy way.

Dr. Lisa Belisle:

This is a theme that has carried through in your practice. You care for women who often have the same sorts of concerns. This difficulty with balance, this work life balance that we're all trying so desperately

Dr. Robin Noble:

to achieve, it's a very elusive thing, and I think it changes all the time as well. We're inundated with technology. I was thinking the other day that 10 years ago, we didn't have the same kind of emails and telephones, and we are under so much pressure, whether it's from our personal lives, our family, our professional lives. So I think I did realize that I couldn't quite manage to do it that way and do it well. I think we always have to ask ourselves, if we don't make a change, we what's it going to be at the end of the day? Are we going to be happy with the choices that we made? So as much as I loved obstetrics, I have not looked back. I've taken up other kinds of areas of gynecology that are interesting, and I've been able to achieve a better balance in my life. I do see patients every day that have these same kind of issues. And I think women in particular are under a lot of pressure and they're often not able to make those choices and they struggle with doing what they need to do. So I do try to help people with that, particularly there Are financial issues for people as well. I see many people that are either underemployed or overemployed to try to make ends meet. And I feel fortunate that I could make some of these changes. Not everybody can, but I think they're small changes that we can all make in priorities.

Dr. Lisa Belisle:

What are some of the biggest struggles that your patients come and in and discuss with you? What are some of the things that, you know, they come in and say, you know, I have this New Year's resolution and this is what I'd like to change.

Dr. Robin Noble:

I think people being overweight is probably the most difficult thing that I try to help them with, because most people are aware that they're overweight, that they need to work harder, that they need to put themselves first, they need to start exercising, and they just can't seem to make the time or find the time. So I spend a lot of time working through people's day. It's even asking what they eat for breakfast, how they eat lunch, whether they travel, and trying to find some area where they could actually find time to exercise or do something for them. Because I think people get overwhelmed and then it affects their self esteem and then it affects their mood and it's tremendously important. But we have to say no a little bit more. We have to say, I need to go exercise. Maybe you, you can't have the whole family to dinner for a holiday. Maybe you have to say no to certain things and make some more time.

Dr. Lisa Belisle:

It can also be a little overwhelming when we think about the recommendations that are out there around things like exercise. For example, the Centers for Disease Control has a certain set of guidelines about exercise. And if I'm a patient, I'm reading these guidelines, I might think, wow, I'll never measure up, right?

Dr. Robin Noble:

Oftentimes they're unrealistic. And I think it's extremely important that people come up with, especially given the new year, really realistic goals for themselves. And they should start small because there's something really satisfying about making a goal that you can attain. Almost brings back those kindergarten years with those sticker charts. You know, if you come up with bringing lunch to work three days out of the week or exercising three days out of the week, maybe you don't make the five right away, but I think the small steps that you can attain are really important. There's something very satisfying about that. I also recommend that people don't come up with a New Year's goal of losing, say, 30 pounds right off the bat. Start with five. Start with just exercising. Without losing weight. That can be helpful once people have

Dr. Lisa Belisle:

achieved some sort of a goal in the new year. One of the issues that people will often kind of bump up against is continuing with that over time.

Dr. Lisa Belisle:

What types of things do you see

Dr. Robin Noble:

that is a big struggle. I think you have to put in enough time so that you reap some of the benefits. And I truly believe with exercise, the vast majority of people really do get those benefits, whether it's mood, self esteem, whether they sleep better, whether they feel better. You know, I spend a lot of time talking about joint disease with women because, for example, our knees hold bear some something like five times our weight. So. So even if they lose five pounds, it's 25 pounds off their knees. So you hope that they achieve something that gives them that opportunity to reflect and say, this really is important to me. But there is always that worry about the plateau, the losing faith in your plan. And we need maybe that accountability of checking in with somebody.

Dr. Lisa Belisle:

And is that what you provide in your practice, is the accountability piece?

Dr. Robin Noble:

I do. I find that in healthcare, a lot of people don't spend time talking about weight. And I do offer my patients, if they need a place to come back to, come back and see me in two months. Let's make a realistic goal. Let's weigh you. And I think sometimes just knowing that they have that appointment helps them, or if they can find a friend or a family member or a co worker that they can work with.

Dr. Lisa Belisle:

You mentioned joint issues as one of the problems associated with obesity. What else are you seeing as problems associated with obesity?

Dr. Robin Noble:

There are cardiovascular issues, I think, beyond the joint. I think at a certain point people don't remain active if they get big enough, they just feel like they can't exercise. They don't have the endurance. And then we reach towards other options as well. Even bariatric surgery ends up being an option for some people because the data just demonstrates that it's extraordinarily difficult to lose large quantities of weight.

Dr. Lisa Belisle:

What about the psychological ramifications of being overweight in this culture?

Dr. Robin Noble:

I think they're even twofold because I think many times we see obesity and weight problems as a result of depression. And I think often people start off in a situation where they're either unhappy or they're eating for the wrong reasons, and then it really magnifies the issue. I think certainly there are issues related to discrimination. I think there are issues related to even socializing. People are less likely to go out and meet people and do new things that can be really beneficial for Their mood. So I think it ends up being a problem that has many facets.

Dr. Lisa Belisle:

And of course, we know that diabetes is another disease that's become increasingly prevalent in our country, and it's something that is associated largely with obesity.

Dr. Robin Noble:

Absolutely. And one thing I really talk to my patients about is really how we eat and how we shop and how we cook. Because what we're seeing now more than ever is this evidence of childhood obesity. And I really feel if I can get these women to eat a little bit better and be healthier, it really does have an impact on their children, because ultimately they go out to the store, they buy the food. Food is extremely expensive now, but they still can make some choices and have their entire family eating better.

Dr. Lisa Belisle:

So obesity and wanting to lose weight and wanting to exercise better, those are some of the things that our New Year's resolutions kind of circle around. What are some of the other things that your patients discuss with you?

Dr. Robin Noble:

A lot of depression and anxiety, you know, and I do find that we spend a lot of the time in our minds thinking about the future and thinking about the past and worrying about the future, and that often causes a lot of anxiety. And I think one of the things I even find I struggle with is trying to be more present in the moment, trying to, you know, savor something, whether it's as small as a cup of coffee or a hot bath, or doing something that you love in the present can really help people, because we don't know what the future holds. And I think if we spend a lot of time thinking about it and worrying about it, it's not productive and it's detrimental to our moods and our health and wellness.

Dr. Lisa Belisle:

Finances are, of course, something that everybody thinks about, but we as doctors don't always get this conversation in the office.

Dr. Lisa Belisle:

Do your patients talk to you about

Dr. Lisa Belisle:

the difficulties associated with money issues?

Dr. Robin Noble:

They do, particularly with, you know, stressors on their time and even on their marriage. Many people either try to find work or they find a partner that's unemployed. And they do talk about it, you know, strains with their children going off to school. They also talk to me about, you know, the difficult transitions in life when they have empty nest or when they retire. So they do talk about finances, and I do think it's a big piece of how we feel and our health and wellness and our mental health.

Dr. Lisa Belisle:

And so how do you approach this? Obviously, you and I both went to medical school. We don't get a lot of training on how to counsel people on their finances.

Dr. Robin Noble:

We don't. I have to say I probably learned on the job. I think I try to find some of these outlets that really don't cost a lot of money. You know, as we talked about just enjoying a cup of coffee or a walk or things that don't have to cost a lot of money. And I think sometimes you have to encourage people to make difficult choices. Maybe they don't need everything that they think that they need. Maybe they don't need that second job. Maybe they can brainstorm a way to make something else work. So I do try to help them with that.

Dr. Lisa Belisle:

Here on the Dr. Lisa Radio Hour

Dr. Lisa Belisle:

and Podcast, we've long recognized the link between health and wealth. Here to speak more on the topic is Tom Shepard of Shepherd Financial.

[Unidentified voice]:

Happy New Fill in the blank. Go ahead, put whatever you want in there. What is it about new that makes us feel happy, merry or full of joy? I opened a present for my birthday and I was mindful of the fact that the shirt I was given was new. It had all its buttons, no holes, it was white instead of sort of white. There were no ink stains. When I put it on, I felt a little less imperfect. So in my new shirt, in my new birth year and now in the new year, I feel like I can leave behind some of the mistakes and focus on being the best me. I think that is why we get a new day, a new week, a new month, a new year. Being mindful of the past, being in the past, we get that opportunity to recreate ourselves moment by moment. But sometimes it just takes somebody to wrap up a new perspective in a package that helps us feel clean, shiny and new. So get in touch with us and we'll help you get that perspective and use it to help you evolve with your money. With love from all of us at Shepherd Financial, may you have the very best start to this new year. May you and yours have a happy, merry and joyful new year.

Dr. Lisa Belisle:

You have pharmacy children and they range in age from 16 to 9 to 9. So that's kind of all. That's a busy family. I imagine you see the same sort of thing with your patients. What are some of the questions that people come in to discuss with you? When it comes to family, I think

Dr. Robin Noble:

most people wrestle with are they doing enough for everybody in their life? Are they meeting the needs of their little kids? Are they meeting the needs of their teenagers? To do they know where their teenagers are and what they're doing? Are they functioning not only in the workplace, but even at home as a mother, as a wife, or as a partner? And I think we have a hard time reassessing that all the time and worrying that we're not doing a good enough job on all these fronts. And I think at the end of the day, we have to realize that we have to do the best we can. And if we don't do some things for ourselves and if we're not happy, comfortable with where we are at some level, we're not going to be very good at those things.

Dr. Lisa Belisle:

Are you better able to offer perspective on this, given your own choices about not continuing obstetrics or making a life choice? As far as moving to Maine, I

Dr. Robin Noble:

think I have that vantage point, but I also think I've been very lucky to be able to make those choices. And not everybody has those opportunities. If you get the education that allows you to make choices, it helps. But I still think we all still have some choice.

Dr. Lisa Belisle:

What about smoking? Is this still an issue with women in your practice?

Dr. Robin Noble:

It is, but fortunately a smaller issue. It seems to be a smaller issue. I do talk about it a lot. It does have an impact on so many things that we take care of, particularly cervical cancer, cardiovascular disease, and many other cancers. But addiction like that is really difficult to handle, particularly when people feel like they're at the end of the rope and they're balancing all these things and they turn to comfort things. So I think hopefully if you get people in a better spot thinking about health and wellness and some of the ramifications that their choices are making, it can be helpful.

Dr. Lisa Belisle:

Well, that's an interesting point, that it's not just smoking. It's really addictions of any sort, whether they're substances, drugs, food, anything that you're sort of turning to for comfort.

Dr. Robin Noble:

My. And that brings us back to those resolutions, too. For some people, it might be that they need to drink less alcohol. For other people, it's Eat less or exercise more for other people, that might be organizing their life or making choices, but I think we can make improvements and recognize where in our lives we need to make them.

Dr. Lisa Belisle:

Do you feel that you've been able to be a positive role model for your own children as a result of making some of the choices that you've made?

Dr. Robin Noble:

I hope so. I don't think we know for quite some time.

Dr. Lisa Belisle:

So what are some of your favorite

Dr. Lisa Belisle:

things to do in Maine in the winter? This isn't something that comes up for me with my patients all the time. You know, it's cold. They don't want to go outside. Maybe they're not skiers. You know, they just. So what do they do? How do they keep that. How do they keep that weight up off? How do they maintain enthusiasm for living? It's kind of dark. It's kind of cold. What do you like to do in the winter?

Dr. Robin Noble:

It is dark and cold. I do think that the gear that's out there is so much better than 20 years ago. I do think it's possible to stay warm in many of those situations. And I think there's something tremendously helpful about daylight, that if we can get out in some kind of daylight hour, even if it's on the weekend, that that's. That's very rejuvenating. I talk to them about what their plan is, because often people have exercise plans that really vary throughout the seasons, and they'll be very active in the summer, and then they'll do nothing in the winter. So for some people, it has to be a piece of equipment in a room in their house. I try to recommend that they get it out of the basement because it's often not used in the basement. And they're available on all sorts of, you know, as used equipment on Uncle Henry's Craigslist. You know, it doesn't have to be a huge expense. Some people walk in the mall, some people still walk around the back cove. I think there are accessible places. But I do love to ski and get out.

Dr. Lisa Belisle:

So what's your hope for the new year?

Dr. Robin Noble:

Be a little bit more present. Savor those moments. Not worry as much about what the future might bring. I think that's really helpful, and I love to do something new, some kind of new activity or new hobby. And I think that's really helpful for people if they take a class or try some new activity like snowshoeing or do an L.L. bean discovery program. There are a lot of things that don't cost a lot of money. That can help us learn a new skill and enjoy something.

Dr. Lisa Belisle:

We've been speaking with Dr. Robin Noble, who is a gynecologist with Intermed right here in Portland. Dr. Noble, how do people connect with you? Maybe become a patient of yours or just learn more about you?

Dr. Robin Noble:

They could just call my office and the Number there is 874-2445.

Dr. Lisa Belisle:

Dr. Noble, we appreciate your coming in and speaking with us today and appreciate the work that you're doing in the wellness world and all the lives that

Dr. Lisa Belisle:

you've touched here in the Portland area

Dr. Lisa Belisle:

and other parts of New England where you've trained. So we encourage people who are interested in finding out more about you to read the 2012 Maine Magazine Wellness Issue thanks for coming in today.

Dr. Robin Noble:

Thanks for having me.

Dr. Lisa Belisle:

As a physician and small business owner,

Dr. Lisa Belisle:

I rely on Marcy Booth from Booth, Maine to help me with my own

Dr. Lisa Belisle:

business and to help me live my own life fully. Here are a few thoughts from Marcy

[Unidentified voice]:

as you settle into this new year, I hope you take a moment to consider the health of your business and how you can make certain it continues to thrive. Now is the perfect time for a business checkup. It's a perfect time to reflect on the systems and processes you had in place last year to determine what worked and what didn't run as smoothly as it should have. Write down the specific changes you'd like to implement to tighten things up over the next month, three months, six months or a year. Give yourself realistic tasks and goals. This introspection and planning will go a long way toward making certain that 2014 is a year of great success. I'm Marcie Booth. Let's talk about the changes you need. Boothmaine.com

Dr. Lisa Belisle:

I have heard about this couple for probably a few years now because I've had patients who have come to see me who have said, did you know this is great lifestyle choices program going

Dr. Lisa Belisle:

on at Parkview Hospital in Brunswick?

Dr. Lisa Belisle:

And I spent time looking into it

Dr. Lisa Belisle:

when I had my patients come and see me.

Dr. Lisa Belisle:

And it's impressive, it's really impressive in

Dr. Lisa Belisle:

today's day and age to see something that's really down, really back to basics

Dr. Lisa Belisle:

as to what we should be teaching our patients. So today we have with us Dr. Tim Howe and his wife Lynn.

Dr. Lisa Belisle:

And they are the director and instructor with the Lifestyle Choices program at Parkview Hospital. So thanks for coming in and talking to us today.

Dr. Tim Howe:

Well, thank you for having us.

Dr. Lisa Belisle:

And Dr. Howe, you have been, you're also board certified in internal medicine and you practice in Brunswick for 24 years.

Dr. Tim Howe:

That's correct.

Dr. Lisa Belisle:

So you're kind of a powerhouse of prevention over there. We thought that for our new year show we really wanted to give people some inspiration and thought, let them think about why it is that we want to live our lives in a healthy way. And you do this on a regular basis in your class?

Dr. Tim Howe:

That's right. We've been holding the class two to four times a year since 1995 and we've put, we've had almost probably close to 2,000 people go through the program now.

Dr. Lisa Belisle:

So describe this program to me and

Dr. Lisa Belisle:

what it is that makes it so. What's the core of it and why is it so special and important?

Dr. Tim Howe:

The course is a 10 day course. The participants come before the course starts and receive testing, both laboratory testing and testing for fitness level. They go through the course and then are tested again. So we have data for the last, since 1995 on all the patients that have gone through and the data is fairly consistent. The average person to take the course loses 4 pounds. The average person sees a drop of 10 points in their blood pressure and about 10 points in their pulse as well. And the average drop in cholesterol in the two week period is about 50 points. Now, some of the patients who come don't need to lose weight and they don't. Others really need to lose weight and lose a lot. So it's variable, but on average a 4 pound weight loss and they feel better. And interestingly, after the first night or two, they're not sure whether they feel better or not. But then as their body rids itself of some of the toxins, etc. They start perking up. And by the end of the first week they're uniformly feeling better. And the end of the two weeks they're all feeling much better. And it's fun to see. I Suppose that's what keeps us doing the course, is seeing the results. It's not a money maker as such. In fact, for the first 15 years I did it for free. And recently they've given us a stipend for doing it. The course breaks even, but it doesn't make a lot of money. But the rewards are, it's seeing the people change and seeing their health improve

Lyn Howe:

and seeing their excitement as well. I see, you know, people regularly at a cooking class that I do that have been graduates of the lifestyle course. And pretty uniformly they are still so excited. You know, they're walking, leading very active lives again. And some of them had had to slow down. And so it's been a real life change for them. So it is highly rewarding.

Dr. Tim Howe:

The way the program is set up is the participants come in the evening and they're fed supper and then an exercise period, and then we have cooking demonstrations and then lecture and then they get a takeout breakfast and lunch. So for two weeks, essentially it's actually 10 days, you get all your food and then you get instruction in how to prepare. You get the recipes for the food as well. And insurance covers it. We have good enough data that all the major insurances, including Medicare, cover it. So it's a good deal for the participants. You can go to live in places and get a similar program, but that's usually thousands of dollars. Whereas this is available to anyone who has insurance and to those who don't. We often work something out.

Dr. Lisa Belisle:

So the program itself is based, I know from a dietary standpoint it's based on plant.

Dr. Tim Howe:

Yeah, it's a whole food, plant based diet that is no animal products or as Caldwell Esselstyn often says, nothing that had a mother or a face. So it's a plant based diet and unrefined, that is very few if any refined sugars and no vegetable oils. And that isn't a diet that's necessary for everyone. But it is particularly helpful if you're trying to reverse serious illness, diabetes, type 2 coronary artery disease. If you're working to put those at rest, if you will, or to reverse them in some cases, that's the diet that does it the fastest.

Dr. Lisa Belisle:

You also mentioned that there has an impact on aging.

Dr. Tim Howe:

Yes, aging is an interesting process. Diet will not convey immortality and I think that's really important to understand. But there is quite a bit of evidence now that the way we eat can impact us tremendously in how fast we age. And changing our diet can make us feel younger again. One of my own Patients who took the course, he was in his, he had just retired, so he's about 65, 66. He took the course and at the end of it he said, I haven't felt this well since I was 16. And that's really what we're aiming for, is for the participants to feel better, not in 10 years, but within two weeks. And I would say the majority do feel that difference within the two week period. And that's what keeps us doing it.

Dr. Lisa Belisle:

Lynn, you have a master's in public

Dr. Lisa Belisle:

health and you also have a bachelor's degree in social work. So a lot of what you've studied has to do with change. What are you seeing people's struggles as being when they come in and you're asking them to make these dramatic changes in their lifestyles?

Lyn Howe:

That's an excellent question. I think initially, when people go from an, a meat based diet to a plant based diet, I think there's some resistance. You know, obviously for all of us, change is hard. But what I have found is once people taste something and if it tastes really good, then they say, okay, I'm on, I can buy into this. I think one thing that I have seen work really well working with change is you can't just take something out. It's really important to put something good in. And that goes for what we're eating or even what we're thinking about. You know, if we're practicing really healthy thoughts and thinking, that's, that's important. You know, if we just kind of focus in on taking out bitterness and negative thinking without putting some really good thinking, you know, being thankful for the snow and finding good ways to enjoy winter, all those things are life changing. And for people who are changing their diet, when you learn how to make a terrific salad dressing, or you figure out that you can still make a vegan macaroni and cheese that tastes amazingly good, then, then it's like, okay, you know, I can, I can be happy with this. And then also I think it's helpful for people when they're changing, when they just have that sense of renewed vitality. You realizing, oh, you know, I'm going to go hike for several miles, I can go climb a mountain. When for many people those options had been out of reach. It's very affirming for those positive choices.

Dr. Tim Howe:

I think it's much easier today than when we started. When we started the course, the biggest question that people had was how can this diet ever give me the nutrition I really need? Where are you going to get your protein and at first we had a whole night on the adequacy of protein in a vegan diet. That's not even a question anymore. Now they're vegetarian restaurants, there are vegan restaurants. There are people that are moving toward a plant based whole food diet. But it's still, that's one of the biggest impediments to change, is where do I go out to eat. Fortunately, there are some restaurants here in Portland and a few elsewhere that they can now go and eat. I was just working with one of my friends who's opened a bowling alley in Brunswick, or he's taken over management of it and he wants to have plant based whole food options in his restaurant. So we're sitting down with him and with his cook and we're coming up with some options on the menu. That's important. The other thing that's hard for patients, participants to make the change is when they go to family gatherings. And so what we encourage them is to become cooks themselves. The people that really do well at this are ones that become foodies. They just embrace this and pretty soon they're cooking for all their friends. We have one couple that's gone through it several times and at their church they have potlucks. Quite frequently they become so good at cooking. Everybody eats their dish first. And now I just heard they had a raffle where they raffled off this and that to raise money for their church. Well, they raffled off six tickets for a whole food plant based diet and they went for like 50, 60 bucks a piece. So they become, they've embraced it and now when they go out to their family gatherings, everybody wants to eat their food because it can taste really good and you just have to learn how to cook it. And that's why we spend so much time in food preparation and recipes and things like that, so that people can realize that the food can taste really good. If I'm going to live longer by eating stuff that tastes bad, I'm not interested. I want my food to taste as good as it did and better. And when Lynn and I, we've been vegetarian for quite a while, but when we went whole food plant based, at first I felt like I'd gone to Auschwitz or something. But then we learned to cook it and the food tastes better now than it used to. We have people come to our home very frequently and in fact, it's rare for us to sit down, just the two of us, and no one's ever said, oh, I don't want to come back here. They all are waiting for the next invite because the food tastes great.

Dr. Lisa Belisle:

I know that part of the reason you're interested in promoting this diet

[Unidentified voice]:

has

Dr. Lisa Belisle:

roots in your faith, in your spiritual practice. You're both Seventh Day Adventists and Parkview is a Seventh Day Adventist hospital. And I did do some reading. I believe it was Ellen White who wrote the book that you recommended, the

Dr. Tim Howe:

Day Ministry of Healing.

Dr. Lisa Belisle:

Ministry of Healing. And there is this very. There is this sense of really treating the body like a temple and there is actually the ministry of healing. This book that you suggested that I read had chapters on being a physician and this idea of healing as being akin to a spiritual calling. Has this infiltrated your work as a physician in the last 24 years?

Dr. Tim Howe:

Absolutely. I'd say it's at the core, not that I wish to convert everyone to my way of thinking, but rather as, as I think Scripture portrays Christ, he went around relieving suffering because he valued people and their bodies. And so I see myself as involved in the same type of work to relieve suffering and to teach people to value their bodies as wonderful organisms designed by God to heal themselves when treated right. I think that's so important for us and it's really core for us to realize that we have a responsibility to take care of our own body. 80% of what I see in my office is disease that is brought on in some degree because of the way patients mistreat their bodies. And if I can get them to see that their body is a gift given to them to take care of and nurture and that if they do it will take care of them and they'll have a fuller, happier, richer life, then change is a lot easier. I think that God will help people make that change whether they believe in him or not. Because I don't think his major interest is controlling people, but rather encouraging them to have the greatest freedom possible for life and health and well being.

Dr. Lisa Belisle:

The goal of the Dr. Lisa Radio

Dr. Lisa Belisle:

Hour is to help make connections between the health of the individual and the health of the community. The goal of Ted Carter Inspired Landscapes is to deepen our appreciation for the natural world. Here to speak with us today is Ted Carter.

[Unidentified voice]:

One of the things I do often is place a compass rose in the landscape. And the compass rose points to the four directions of the universe. And it's something that I really love to do because it does call out those very powerful directions. The north is really the head based energy, the, the place of white buffalo. It's where wisdom and knowledge live, but it's also where conflict lives. We live in the Northern Hemisphere. We are part of that whole ethos, I guess you might say, where South America is a place of play, it's a place of innocence, a place of trust, it's a place of love. And if you look at the South American people, they are very much like that. The east is about bringing new beginnings into our lives. So when we look toward the east, it's always about what are the new things that can happen and come into our lives. And the west is moving into the darkness, into the mysterious, into the most powerful, I guess you might say, of all directions, because we have to move through the darkness to get to the other side, to get to the side of rebirthing and bringing new things into our lives. And our lifetime is spent with a series of peaks and valleys where we move from a place of creation and the rise of that creation and the care of creating that creation to the maintenance of that creation. And then eventually we move into the disintegration of that creation. And we have to be looking toward the future and toward what's happening in our lives to not let that valley go down too deep and to start to pick up something else new and start to rise again with it. So if you look at your own life, I think you can see that pattern. It's quite evident and it's natural. It's the same thing as the seasons, the spring, the summer, the fall, and the winter. I'm Ted Carter, and if you'd like to contact me, I can be reached@tedcarterdesign.com

Dr. Lisa Belisle:

the Dr. Lisa Radio Hour and podcast

Dr. Lisa Belisle:

understands the importance of the health of the body, mind and spirit. Here to talk about the health of the body is Jim Greatorex of Premier Sports Health Health, a division of Black Bear Medical.

[Unidentified voice]:

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Dr. Lisa Belisle:

Spirituality is something that I know to be very important. I know it from my patient population as well. And it's something that's tricky because many people, when they are associated with a church, have almost felt judged by an inability to sort of achieve some sort of ideal perfection. But that's not what you're saying. You're not saying this is the perfect thing, be perfect. You're saying, this is the way I look at it. And here's a way to treat your body in a way so that it can be with you in a healthy way for the rest of your life, no matter what your spiritual practice is.

Dr. Tim Howe:

Absolutely. And we have all, all sorts of people come to our those who believe in a God, those who don't believe in a God, Jews, Muslims, Christians, people that have an inner faith. But no, and that's fine. All are welcome. We encourage people to think clearly about spirituality because it affects us all. But the purpose of the course is not to convert someone except in this sense. Sometimes we have ideas about who God is that are hurtful to us. And as I like to point out, be careful what you worship, because it is a law of our being that we become like what we worship. And so choose a God that's better than you are. That's critical. If there's a mean, vindictive God in your way of thinking, who's out to get you and who's demanding, that's not going to be good for your health and it's not going to be elevating to you as a person. And in my way of thinking, if there is a God, and personally, I think there is, but if there is a God, he's got to be better than I am.

Dr. Lisa Belisle:

You have two sons that are also in medical school, and I guess, Lynn, you just came back from visiting them, and then you have another son who is going to be doing some work out of the country in social justice. It sounds like

Dr. Tim Howe:

our oldest son was in Ethiopia with his wife for four years as administrator of a rural hospital in western Ethiopia. He is currently in administration in Florida, in Florida Hospital. But he has thought, and his wife, too, about going back overseas. I don't think they've made firm plans on that, but knowing them as I do, they're like my wife, a bit of gypsy at heart and adventurous. So I would guess that before many years go by, they'll be back overseas working in development and relief or health care where it's desperately needed.

Dr. Lisa Belisle:

So there is this possibly Sense of ministry that is being kind of filtered down in your family?

Lyn Howe:

I think so. And I think there's a spiritual imperative to give and to share and to spend your life for others. That is core for us. There's a lot of meaning and heart happiness in giving and sharing to others and seeing other people blessed. And I think our oldest son Paul has definitely really experienced that with his time in Ethiopia and really looking forward to getting back overseas.

Dr. Tim Howe:

I think if we were going to make a dividing line between what's good and what's bad or what's spiritual and what isn't, the good would be give, give, and the destructive would be get, get. And that's really the dividing line for us. Give, give versus get, get.

Dr. Lisa Belisle:

So does what you're talking about in this situation, is this somehow translated into the class that you teach at Parkview in some way?

Dr. Tim Howe:

Absolutely. We talk about this usually. It's the. The class usually starts on a Monday night. And I start with Philosophy of health. That's the first lecture. And we talk about some of this. And then again on Friday night we have a lecture particularly on spirituality and health. I think scientific literature points out very clearly that people who have faith live longer and experience less illness. There's quite a few studies out of Britain to that effect. And I think that if we ignore that, we're doing a disservice to. To the participants in the class and our patients as well. So we encourage people to explore their spirituality and encourage them to do it in such a way that it's helpful and supportive to change. Because if there is a God, he should be a good God. And if he's a good God, he'd want to help us. And God knows we all need help. The Apostle Paul many years ago wrote, the good that I would, that I do not, and the evil that I would not that do I. Or as Flip Wilson used to say, the devil made me do it. So there's a sense within us all of this struggle between doing what we know we should and what we know we shouldn't. I think it's self evident that the first major cause of death in this country is not coronary artery disease, and it's not cancer. It's people not doing what they know they should do. And the second most common is the flip of that. And that is people doing what they know they shouldn't do. Those are the two most common causes of death. Well, okay, so we've got to deal with that. Why is it that I'm not doing what I should, and I'm doing what I know I shouldn't. And I think there's a spiritual answer to that. Values clarification is the term that's used in some of the literature. But if we don't deal with that, we're not going to be very effective at change.

Dr. Lisa Belisle:

I talk to a lot of doctors

Dr. Lisa Belisle:

and of course, and health care providers of other sorts. And of course we're going through this really significant time of transition within the medical field. And I wonder if part of us trying to make it through this transition in a healthy way is understanding this higher calling again. When I began medical school, there was a sense that medicine was a higher calling as opposed to simply a business. And I don't, and I'm not sure that that is or isn't a sense anymore. But I wonder if there's a way that we can somehow lock into whatever this looks like, whether it has something to do with a God or some other spiritual entity. Do you think that this could help us as physicians better serve our patients, better serve ourselves and our families?

Dr. Tim Howe:

Absolutely. I think it's imperative that physicians regain the high ground. And in the book that I recommended, Ministry of Healing, that chapter, Physicians as Educators, I think she capsulizes well what needs to happen. She says physicians need to recognize that they're responsible not only for the patient, patients under their direct care, but also for the health of the communities in which they live. That's really why we started the program, because I've made my living off the backs of ill, broken people. In a sense, you know, they don't come to me unless they're sick and there I'm making money on them. And the number one cause of bankruptcy in this country today is illness. So if I'm not doing my best to keep people well and prevent illness, I'm a miserable sort of fellow. And I think it's imperative that we as physicians belly up to the idea that we've got more to do than make money. We have a real responsibility to work to keep our communities well in any way we can.

Dr. Lisa Belisle:

How can people find out more about the program that you teach at Parkview?

Dr. Tim Howe:

They can call Parkview Hospital, that would be 373-2000 and ask about lifestyle choices. We usually hold a program, two programs in the spring and two in the fall because the winter is a hard time to get out in Maine and no one wants to be inside in the summer.

Dr. Lisa Belisle:

Well, I appreciate your coming in and sharing your long, many years of wisdom on a whole food plant based diet and the work that you do as a physician. Dr. Howe and the work that you're doing with instructing people on cooking. Lynn We've been speaking with Lynn and Tim Dr. Tim Howe from Brunswick Freeport and we encourage people to go and spend some time thinking about their own lifestyle choices. Thank you for being here.

Dr. Tim Howe:

Thank you.

Lyn Howe:

Thank you very much.

Dr. Lisa Belisle:

This is Dr. Lisa Belisle. You have been listening to the Dr. Lisa Radio Hour and podcast show number 121, Wellness in the New Year. Our guests have included Dr. Robin Noble and Dr. Timothy and Lynn Howe. For more information on our guests and extended interviews, visit drlisabelisle.com the Dr. Lisa Radio Hour and Podcast is downloadable for free on itunes. For a preview of each week's show, sign up for our e newsletter and like our Dr. Lisa Facebook page, Follow me on Twitter and Pinterest and read my take on health and well being on the Bountiful Blog. We love to hear from you, so please let us know what you think of the Dr. Lisa Radio Hour. We welcome your suggestions for future shows. Also let our sponsors know that you have heard about them here. We are privileged that they enable us to bring the Dr. Lisa Radio Hour to you each week. This is Dr. Lisa Belisle. I hope that you have enjoyed our Wellness in the New Year show. Thank you for allowing me to be a part of your day. May you have a bountiful life.

Dr. Tim Howe:

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Dr. Robin Noble:

It.