December 19, 2018

Move:

• Do you want to look like Superman? Wonderwoman? Try this very simple exercise that Henry Cavill used to get in shape for movies..                                • You can either do a few rounds of it, or finish your regular workout. You do need a kettlebell or some other weight for this. Just grab something around the house or office.                                                                                         • Sets of 25: goblet squats (hold something at your chest and squat), kettlebell swings, thrusts (roughly 1/2 of a burpee), and then jumping jacks. 

Banking Sleep:

• This interesting study controlled sleep in 24 healthy adults for about 3 weeks. In the first week, half sleep a normal (7 hours) amount, the other half slept 10 hours. Then ALL participants slept 1 ten hour night, then 7 threehour nights, then 5 eight hour recoverynights. They assessed performance and alertness on all subjects.
• Results: The half who had “banked sleep” had better psychomotor vigilance performance, fewer attention lapses, and improved sleep latency (didn’t fall asleep as quickly). Those who banked sleep also returned to baseline function after onenight of recovery sleep, whereas the normal sleep group did not make it back to baselineas they slowly improved during the 5 recovery nights.                                                                                                    • They argue that banking sleep makes you more resilient. And that the assumed trait characteristics of susceptibility to sleep deprivation might be less specific to that person’s biology, and more a function of habitual sleep duration. That is, people who “can’t tolerate a night without sleep” might be more able to if they slept more on a regular basis. 
• Tons of actionable findings here but the top two could be:
1. If you are leading up to a call night, travel, late night, or other sleep deprivation, sleep as much as possible the few nights leading up to it
2. If you usually sleep less than 8 hours a night, you need more than one recovery night to get back to baseline, and you might need more than 5. 

Circadian Disruption:

• Who is at risk for shift work disorder? This meta-analysis found several risk factors, but only one apparent protective factor.
• Across 58 studies, those individuals at greatest risk were: older age, morning [chrono]type, circadian flexibility, married or children, increased caffeine intake, higher scores on neuroticism and lower on hardiness. The only protective factor was physical activity.
• Focus on what you can change: beware the slippery slope of increasing caffeine consumption, practice some form of meditation and gratitude (helps with neuroticism and leads to post-traumatic growth narrative (hardiness)), make sure the whole family respects daytime sleep, and be active. 

Dark Ages:

• If you feel gloomy this winter, be thankful that you didn’t suffer through the winter of 536 AD, the “worst year to be alive.” In 536, an Icelandic volcano was responsible for covering all of Europe with a dark cloud for 18 months. This dropped the temperature 2 deg C, and began the coldest decade in 2000 years.
• Byzantine historian Procopious wrote: “for the sun gave forth its light without brightness, like the moon, for the whole year.” Hard to imagine how frightening that would have been for a prescientific society. 

Wisdom:

• The Death of Ivan Ilyich is the most famous story in this solid book of short works by Tolstoy. You can find it in pdf form online. Takes a couple of hours to read. 
• This is the story of a man who prioritized bureaucratic work and accumulating “stuff” over meaning and relationships. He ends up developing psychosomatic pain (sounds a lot like TMS). 
• He cannot get out of his rut, begins to hate his own wife and distrust his physicians who give him escalating doses of opium. 
• The interesting thing is that this 150 year old story sadly plays out in narratives of many of us in the modern world. Not the most uplifting tale, but once you finish the story, you look around and realize what matters in life. 

Quote:
“We are not so sensible of the greatest health’s of the least sickness.”
– Ben Franklin

*We are very good at focusing on what we are missing, rather than on what we have. 

Martin Huecker, MD, is co-editor in chief of the free, open access Journal of Wellness. He is an Associate Professor and Research Director in the Department of Emergency Medicine (EM) at the University of Louisville. He is a member of Phi Beta Kappa, and the Alpha Omega Alpha medical honor society. Dr. Huecker graduated from UofL’s EM Residency Program and (Chief Resident in 2011). He works full time seeing patients and teaching residents in the UofL Emergency Department. His diverse research interests include substance use, accidental hypothermia, and healthcare professional wellness. Dr. Huecker is also a Certified Lifestyle Medicine Physician (DipABLM). He loves books, (cold) trail runs, dogs, and coffee. His wife is an OB/GYN and they have 4 children with cool names.