“I’m not kidding; it’s Miracle-Gro for the brain!” The statement reminded me of some ridiculous infomercial infecting late night TV. In this case however, it was generated from the mouth of a world class neurobiologist, so I took notice. He was speaking of a substance called Brain Derived Neurotrophic Factor (BDNF). What immediately intrigued me was he claimed that BDNF was the link between exercise and improved brain function. For years I had read articles in both the medical and running journals touting the psychological benefits of fitness, yet here was proof that fit folks were happier folks. Dr.John Ratey, a clinical professor of psychiatry at Harvard, outlined in his amazing book “Spark: The Revolutionary New Science of Exercise and the Brain” how exercise increased the production of BDNF which in turn stimulated nerve cells to grow and connect in the Hippocampus, a tiny area in the brain responsible for a number of high level functions. This growth of new cells actually translated into better memory and quicker learning. He went on to claim that certain other chemicals were released by exercising muscles that improved functioning in the Amygdala, the emotional center of the brain. The implications of this and other research are monumental.
Twenty-five years ago when I was in medical school we were taught that we were born with a set number of neurons (brain cells) and there were no more to be made…period. I remember joking in college about taking another late night excursion to the disco (yes, I am that old!) to “kill some brain cells” with Singapore Slings and Jack and Coke. We didn’t fret about the wholesale slaughter of brain cells as we all knew from biology class that we only used 20% of our brain anyway. In our way of thinking, that gave us a pretty good cushion! It was the unlucky folks born with fewer brain cells, and we all knew a few of those, who had the most to fear. We were wrong on all accounts. Now research is proving that new brain cells can be created, and formed in areas that have a major effect on cognition and emotions. Don’t take this as permission to guiltlessly get plastered; I don’t need to tell you of the disastrous effects of that, but it does open the door for medical miracles. The study of such alphabet soup as BDNF, IGF-1, and VGEF and other neuropeptides has given hope to developing successful treatments for senile dementia, Alzheimer’s and Parkinsonism. Medicine is not there yet, but we can conclude that getting fit by exercising regularly can reduce the incidence of these diseases as well as certain cancers and diabetes.
The great news is that you don’t have to train for a marathon to reap the benefits of fitness. The studies indicate that a brisk walk for 45 minutes three to four times a week can elicit these life enhancing outcomes.
One of the most exciting applications of this knowledge is illustrated by the Naperville school district. A middle class suburb south of Chicago, Naperville has been the focus of a real-life experiment documenting the benefits of fitness in kids. It is no surprise that kids who are active are more physically fit than their sedentary counterparts, but what has been found in Naperville is that these fit kids are also smarter! Over the past seventeen years the school district, consisting of 11 elementary schools, five junior high schools and two high schools, has made physical education an integral part of the school day (unlike the national average where only 6% of high schools have a daily PE program). Their gym class is not your typical dodge ball, basketball, softball curriculum (the average student in the typical hour long PE class spends 16 minutes actively moving). It is a program that promotes and measures fitness, not competition, and grades based on effort, not ability. They regularly run or ride bikes using donated treadmills and stationary bikes measuring effort by heart rate monitors. And they do it at a lower cost per student than comparable school systems! The results have been amazing. In 2002, 97% of entering freshmen were at a healthy body mass index (BMI) as compared to the national average of 65% and most striking was the impact that fitness had in the classroom. In that same year 96% of the eighth graders took the Trends in International Math and Science Test, an instrument designed to compare student’s knowledge level in different countries around the world. On the science part of the test the Naperville students scored the highest…in the world! Through a strict and comprehensive analysis it was shown that regular physical activity and fitness level correlated with the academic success of the Naperville students!
The message is clear. For adults and kids alike, regular aerobic exercise is not only good for the body, but it is great for the mind.
LINK TO "SPARK"



It was a family affair! On April 26th I had one of my dreams realized. Susan, my wife , and my oldest daughter Katie joined me for the Country Music Marathon and half-marathon in Nashville. Susan and Katie ran the half and I waddled through the full. I started off running with Katie (she is 15) thinking she may have a bit of trouble as her training was, well, a bit lax. At the first mile marker she told me to go on and let her do it at her pace and her way. She is a very independent young thing, so I didn't argue. I never saw her the rest of the race (some parts of the course were out and back, but we never passed each other)I was feeling pretty good at the 11 mile marker where the half splits from the full, so I decided to give it a go and made it through to complete my 12th marathon. I was most proud of Katie however as she had a great race finishing the half in 2:40. A remarkable time given her training regimen. The power of youth shines through! Susan also did grand finishing in right over 2 hours along with two of her running buddies.
The Country Music Marathon is a very well run race with all the amenities of a world class affair. The crowds were great and the volunteers were numerous and helpful. I can't think of anything they could have done better! The expo was one of the best I have been to and the race organizers had everything running like a well oiled machine. One of the highlights of this race is the post race concert. It is free to all the runners and this year featured Lady Antebellum, a group boasting two of Augusta's own, David Haywood and Charles Kelley (who just won the country music association new group of the year!)It was a fabulous weekend made all the more special by sharing it with family.
Run long and be fit!
Recently, I watched in awe as Robert Cheruiyot of Kenya won his fourth Boston Marathon. This 26.2 mile race is not only the longest continually run marathon in the world (112 years and counting) but the penultimate goal of every distance runner. As the Masters is to golf, so Boston is to marathoning. One of the great joys of the marathon is that it is not just the perview of the elite runners, but embraces and encourages us mere mortals to go the distance. Unlike the hallowed fairways of the Augusta National, where the 20 handicap golfer can only wax philosophically about what it would be like to hit a 5 iron to the green, in Boston, 30,000 common folk can cross the start line and run the same streets as the world class athletes. It is a celebration for any runner who sets and achieves a goal.
The marathon is certainly a metaphor for many things. Take for example our physical fitness. One of the most important lessons you can teach your family is that being active and physically fit is a lifelong journey and not simply a sprint to flame out in our youth. The epidemic of childhood obesity overtaking our country is largely one of inactivity. The average teen will spend 6 hours in a sedentary activity daily (TV, computer,etc) after school hours! Dr.Ken Cooper, the father of the aerobics movement, said, “The only cure for childhood obesity is physical activity.” We, as parents, have to teach our kids by word and deed that exercise is essential to good health both now and throughout their lives. No one starts training for a marathon by running 26 miles at the first session. You take baby steps, running 2 miles, then 3, then 4, eventually building on a foundation that propels you to distances that you couldn’t even imagine running months before. In the same way we need to teach out kids that you don’t need to be the best or fastest or strongest right out of the starting line. Initially, winning is simply beginning! Failure is simply failing to take action. And there is no better teacher than the parent, and no better tool than teaching by example. When I began training for my first marathon 10 years ago, I had never run more than 5 miles at any one time. My kids were 3 and 4 years old so part of my training was building a slow steady mileage increase over a period of several months while pushing one of the little monkeys in a jogging stroller. Granted they were not running themselves, but they were seeing daddy do it, and I would like to think this instilled in their subconscious an understanding that this was normal, healthy behavior (although today my daughters insist that I am very abnormal…for many reasons).
Running a marathon involves both the brains and the brawn. You have to be in good physical condition and have put in the hours of training, but you also have to had trained your brain to conquer the mental battle that inevitably plays out somewhere along the route. Every marathon I have run has had some point where my legs said no and if my brain had agreed, I would never had finished. To complete a marathon you have to do the physical training, create the will to want to achieve the goal, and have the discipline and determination to see it through. When it comes to the family’s wellness you also have to combine the body, mind and spirit to achieve wholeness. True health is a balance of mind, body, and spirit, not just the absence of disease. In a marathon, when my legs falter, I can pick up the slack by being mentally determined to meet my goal. When my determination wanes, my will and spirit can get me back on track. Likewise, when we face physical ailments, our mental clarity can find solutions and perseverance and when we are emotionally spent, our physical well being allows us to push through the sadness and come out on the other side.
Finally, there is only one way to finish a marathon, and that is to put one foot in front of the other until you cross the finish line. I am the first to admit that the Kenyans generally do that much faster and with much greater style than I ever dreamed of, yet the fact remains that both they and I finished by taking one step at a time. The health of you and your family is a daily call to take that one step at a time. Just as there are potholes on Boylston street in Boston, so there will be potholes along the way of your health. We can dodge some, we may land in others, but the only outcome that matters is whether we get up and continue planting those feet. We all remember the tortoise and the hare. In life, and in health, slow and steady often does win the race. The idea of live fast, die young, and leave a good looking corpse appeals only to folks who have a Paris Hilton mentality. Health for life is a marathon, and it often is the slowest of the bunch that has the most fun.
Where and when did our addiction to sugar begin? Are we born with an innate desire to gorge on Krispy Kreme doughnuts and Pixie Sticks? I am beginning to think the drive to consume sweets is greater than the innate proclivity to cheat on taxes or make fun of Paris Hilton. Actually, sugar is a wonderful energy source; however, like most pleasures, we tend to grossly over indulge. Every great virtue taken to an extreme becomes a vice. We are designed to utilize a variety of foods to fuel our bodies and, in our country where food choices are more abundant than greedy politicians, what we eat is largely our choice.
As I mentioned in a previous column, last year I had the eye-opening experience of chaperoning a group of eighth graders on a bus trip to Washington, D.C. At one of the rest stops (and they were anything but) we unloaded at a “buy everything imaginable” mini-mart. This was a mere two hours after a healthy, bountiful breakfast, and the only real reason we stopped was at the request of the coffee-aholic, micro-bladdered bus driver. We told the kids they could get a single snack, and I stood by the bus door casually observing as the kids returned. I was dumbfounded by the hoards of Doritos (trans-fat heaven), trunks of Twinkies (most likely years old as they won’t decompose under any circumstance), cadres of candy bars, and storage bins of sodas that they carried onto the bus. It would have been cheaper to have bought a ten pound bag of sugar and thirty straws!
So why is so much sugar bad for us? Let me introduce a concept to help illustrate the potential damage.
The Glycemic Index is a measurement of the effect a food has on your blood sugar level. Some high sugar foods such as maple syrup, honey, and candy, as well as foods which are "starchy" such as carrots, potatoes, and cereals are rated high on the Glycemic Index. Other foods, especially foods high in fiber such as whole-grain rye bread and bran cereal, are rated low on the Glycemic Index because they do not produce such a rapid rise in blood sugar and insulin. In simple terms, when you eat high glycemic foods you will experience a substantial rise in your blood sugar level. This, in turn, raises your blood insulin level. Insulin is responsible for transporting glucose into muscle and storage cells for metabolism. Ask the average Joe or Josie what insulin does and most will reply, “It has something to do with blood sugar…right?” That’s kind of like saying, “Da Vinci…he painted pictures…right?” It is a bit more complicated than that.
Some researchers postulate that spikes in your insulin level can contribute to fat deposition. The higher and more prolonged the insulin reaction, the more likely your body is to convert sugar to fat. There are some holes in this theory; however, there is enough evidence to warrant limiting your intake of high glycemic carbohydrates. In addition, a rapid rise in insulin levels can drive the blood sugar too low, which results in hypoglycemic symptoms such as shakiness, foggy thinking, fatigue, and anxiety. A review of the current scientific literature revealed 15 out of 16 published studies found that the consumption of low-Glycemic Index foods delayed the return of hunger, decreased subsequent food intake, and increased satiety (feeling full) when compared to high-Glycemic Index foods. In addition, the results of several small short-term trials (1-4 months) suggest that low-glycemic load diets result in significantly more weight or fat loss than high-glycemic load diets. Simply stated, look for low glycemic carbohydrates and make them the staples of your daily intake. Can you safely eat high glycemic carbohydrates? Of course! Just do it in moderation.
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When it comes to sugar, the old adage “everything in moderation, nothing to excess” applies.

A Woman's Guide to Hormone Health (Bethany House, 2008) is now available!

This guide through the often turbulent storms of menopause and the years leading up to it gives women answers they can trust and apply to their lives. Dr. Eaker combines the best medical information available with biblical wisdom to help women handle the natural changes occurring in their lives. His 20 years of medical practice allow him to speak with authority as well as compassion as he offers options and solutions, encouraging women to actively participate in their health care. Topics of concern such as exercise, diet, nutrition, and osteoporosis are addressed as part of a healthy lifestyle. The book includes discussion of PMS and perimenopause, as well as menopause, making it a must-have for women from 30 to 60.

Order "A WOMAN'S GUIDE TO HORMONE HEALTH" here

Reviews
"...women who wish to incorporate Christian elements into their treatment of menopausal symptoms will find it useful. Recommended for collections where there is demand for Christian health material." --Barbara M. Bibel, Library Journal
"In this book Eaker is compassionate toward women in mid-life as he seeks to offer suggestions to relieve many of symptoms of menopause. Besides the obvious, the author touches on topics such as diet, nutrition, exercise, and osteoporosis as well as perimenopause. Unique to this book is Eaker's take on alternative or complementary approaches to traditional replacement therapy and his incorporation of the Bible into the strategies he gives to help women actually celebrate this time in their lives. All in all, this was an excellent book and I highly recommend it for women between the ages of 30 and up - and their loved ones." --Patti Chadwick, BookBargainsandPreviews.com

One sunny day in the Garden, God was talking to Adam about pregnancy. (It was better than him hearing about it on the street!) “You see Adam, from the time you find out you’re pregnant to the time the baby appears will be about nine months.”

“Gee God, don’t you think that’s a bit long. I mean you made everything else in six days.”

God replied, “You need to have that time to acclimate to the idea that there will be a new person in your life.”

Confused, as he was the only person…anywhere… so far, Adam just wrote this off as one of those “I am God and I know best” things.

God continued, “During the nine months the belly will expand to about five times its normal size, the ankles will disappear, and the butt will get its own zip code.” At this Adam just had to speak up.

“Now God, I know you are the ultimate power and wisdom of the universe, but about this belly thing. I have spent a fortune on Ab-blasters and spent hours doing crunches. I really don’t want to blow my six-pack on a silly thing like pregnancy.”

“Adam, my silly, little man; you are not going to have to go through all that. Childbirth and pregnancy will be my blessing for women. Eve will throw up daily for three months, waddle to and fro, and attempt to push a bowling ball-like head…well, never mind about that.”

Relieved, Adam said, “Well why didn’t you make that clear in the first place? I can handle all that if Eve has to put up with it. What do I have to do?

God thought for a moment and replied, “Actually, you will do what you do best…simply be quiet. No, on second thought, you will be emotional support for Eve, waiting on her every need, comforting her in times of stress, lovingly painting her toe nails when she can no longer bend that low, running to the Handy Mart at two in the morning for chocolate covered Sushi, telling her that a size 18 is not really that big, and forgiving her when she hurls a crock pot at your head for no apparent reason.”

Adam, always the pensive one, took all this in and said, “So God, I know you are fond of writing things in stone, but are these duties negotiable?

God replied, “No because I have made Eve the strongest. You see Eve has strengths that amaze even me. She can handle trouble and carry heavy burdens. She smiles when feeling like screaming. She sings when she feels like crying, crys when she is happy and laughs when she is afraid. She heals herself when she is sick, can feed a family of four on a pound of any kind of meat, and can get a nine year old to take a bath! You can’t imagine what she can endure and overcome.”

“Like pregnancy!,”Adam replied.

“Like pregnancy,” God confirmed.


Here's a photo of my oldest daughter Katie running across the Las Vegas Marathon finish line. She met me at mile 24 and dragged me home!

I am a full-fledged, card-carrying germaphobe. No, that is not some new right wing political group, it is a person that fears being attacked and conquered by ever present microscopic beasties. Now you may find this odd coming from a physician. I have spent the last twenty years of my life in the constant company of bacillus, pneumococcus, spirochetes, and other associated bacteria, so you would assume that I would be somewhat immune to their presence. Physiologically speaking, I probably am. My antibodies (those PacMan-like cells in the body that eat up germs) are probably muscle- bound bullies, kicking sand in the face of any weakling cocci. But psychologically, I am like a groveling, fearful puppy facing the wrath of his master after chewing up his favorite channel changer. I picture someone with a cold as a modern day typhoid Mary, spreading their cold germs faster than the herpes virus at a Britney Spears concert. I realize that this is an irrational fear, but too much information has once again fueled my neurosis. Everyone has seen that disgusting video of the man sneezing in slow motion. This was the same film in high school health class that taught us that oral hygiene is next to godliness and burning when you winkle is not a good thing. This particular stop action sneeze gave the impression you were watching this poor guy's head explode. He looked like his head was a lawn sprinkler shooting water out with enough force to knock you over, only this was infectious laded mucous droplets.

Not long ago I watched a TV special on germs in the environment. It was titled something like: The Happy Travelers Guide to Influenza, and it scared me to death. I think I could go through the rest of my life and never know that a doorknob contains 200,000 bacteria per square inch! Do you know how hard it is to turn a slippery knob wearing gloves!

Are you getting the picture yet?

The next scene showed the host walking into a randomly selected three-star hotel room after it had been freshly "cleaned" by their supurb cleaning crew. He proceeded to dim the lights in the room and brought out a special black light apparatus designed to highlight any dirt, stains, mold, mildew and various other yuckies. He showered the room with the special light and it lit up like Christmas in Times Square! There was stuff on top of stuff- and this was a freshly cleaned room! I have decided to sleep in the parking lot of the next hotel I visit. It appears that it will be cleaner!

In an attempt to indoctrinate my unsuspecting children in to my obsessional nightmare, (how's that for a compassionate parent) I convinced my youngest daughter to do her science fair project on bacteria found on common household items. I realize that this alone may be grounds for police intervention, but I was under the delusion that it would be educational. She tested several common household items, a fork, light switch, TV channel changer, toilet handle, etc. To my great chagrin the item that hosted the greatest germ menagerie was the TV remote. There were more bugs on that thing than in the Watergate hotel. The only lesson that my daughter gleaned from this project was that dad can no longer enjoy his genetically-ordained male right to channel surf. Just thinking of the hoards of bacteria being crushed at every button push was too much to endure.

In reality, I guess it is okay for a doc to be somewhat concerned about germs, especially the bad ones. My wife has made me vow not to catch every disease I am exposed to as I did when I initially studied them in medical school. (This is an interesting phenomenon in medical students in that many experience symptoms of diseases that they are learning about at the time. I was the only guy in my class to suffer morning sickness during my obstetrics rotation). I have developed some pretty basic guidelines for helping patients avoid catching and spreading colds.

First, wash your hands - all the time. Just spend some time in any public restroom and you will be shocked at how many leave without doing this.

Second, boost your immune system. Take appropriate anti-oxidants (Vitamin C, E, B-complex) and eat a healthy diet.

Third, don't obsess! Most bacteria and germs are actually good for you. God designed a miraculous system whereby we can live together with out microscopic friends in perfect harmony (like ebony and ivory).

Fourth, never, ever go to a Britney Spears concert!

The worn out paradigm of aging as simply a time when our knees buckle and our belts won’t is rapidly and mercifully dieing. Some scientists estimate that of all the human beings that have ever lived to be sixty-five or older, half are currently alive today! The seventy-five and older age group is the fastest growing segment of our population. These are folks who are not satisfied with the status quo. They are not happy to go gently into that good night. We (and I must include my rapidly aging self) want to grow old with gusto. We want to come to the end of life with nothing left, knowing we expended every waking moment in a purposeful embrace of the miracles around us. We want to age without becoming aged!

In 1984 the MacArthur Foundation sponsored a study that assembled a group of scholars from several major disciplines to conduct long term research designed to discover what constitutes “successful aging”. They studied those folks who remained vigorous well into their seventh and eighth decades, and then experienced a “compression of morbidity”. In other words, they lived to the max and then had a rapid demise.

One of their key points was that there was not a way to prevent aging or reverse the aging process. Human’s will always age, that is a given of biological and cellular processes. The whole industry of “anti-aging” potions, pills and pundits is a misnomer; there is nothing that will stop aging. The key, and what they wanted to discover, is how some individuals age without the ensuing (some would say inevitable) “falling apart”. We tend to think of this as aging gracefully, yet I believe that is much too passive. We must, as the study found, take an active role in doing some things and avoid doing other things.

So what did these scientists conclude? They discovered that successful aging involved three major components: a low risk of disease and disease related disability, high physical and mental function, and active engagement with life. It was noted that these were by nature interrelated, yet each provided and independent variable that could be controlled. They further defined active engagement as having relationships with people and behavior that is productive. They were quick to point out that successful aging is largely a result of individual choices and behaviors and not genetics.

The researchers discovered many specific characteristics of people who “aged well”, and I want to summarize just a few of the most important behaviors they ascertained. For a more thorough reading of their findings I refer you to the book Successful Aging by Dr.John Rowe and Dr.Robert Kahn.

Here are my top ten keys to successful aging culled from the MacArthur Study and my own research.

1. Exercise. Whether you are 10 or 100, exercise is the key to getting and staying healthy. Surprisingly the studies indicate that only a minimum of exercise (20-30minutes a day) can have a marked effect in lowering your risk of a number of diseases such as cancer, diabetes, and hypertension.

2. Get regular check ups. One of the secrets to successful aging is either preventing risk factors or identifying problems very early. Both of these tasks are facilitated by regular exams.

3. Stay current on routine screenings. Somewhat linked to regular checkups, availing yourself of things like mammograms, Pap smears, prostate exams, colonoscopies, bone densities, and blood screenings can be a lifesaver and allow you to enjoy a disease free old age.

4. Don’t smoke. Enough said. You would have to be a total fool to not realize the damage that this does to your system.

5. Take an aspirin a day. The evidence is mounting that a 61 mg aspirin a day can reduce the incidence of heart disease, stroke and colon cancer, especially in older folks. Remember that some people should not take aspirin, so check with your doctor before starting something new.

6. Get appropriate vaccines. For older folks the pneumonia and flu vaccines are important as these infections are responsible for thousands of deaths every year in people over 65.

7. Eat fewer total calories. The studies are conclusive that decreasing your total calorie intake is associated with lower rates of disease and longer lives. Specifically try to increase the protein and reduce the fat, but keeping the overall amount of calories lower is the most important guideline.

8. Develop social networks. As the song goes, people who need people are the happiest (and healthiest) people. An expanding network of family, friends, church membership, and social activities have all been associated with longer, less sickly aging.

9. Stay mentally engaged. Retire only if you must and if you must, find something else to keep you mentally active and challenged.

10. Be continually productive. By that I mean participate in either voluntary or paid activities that generate goods or services of economic value. That is a broad calling, but studies indicate that those who continue to find purpose, find health.

Remember, the goal is not just to live long, but to live long and well!

As a general rule, what goes on in Vegas stays in Vegas, but I am going to make an exception. Two days ago I finished my eleventh marathon by slogging it through the 26.2 in sunny Las Vegas,Nevada. I must say that I have never felt better after a race. I don't know if it was that the course was very flat (great for any first timers out there) or if my training was smarter, or if it was the 20 second walk breaks at the water stops, or the maddingly steady(slow) pace that I keep, or that bottle of celebratory Merlot, but whatever the reason I am grateful not to be doing the post marathon-old-guy-should -know-better-shuffle. I have felt so good over the past couple of days I have started to plan the next foray into the runner's high for March. There is a marathon in Albany Ga (where the heck is that?) but I figure it is relatively close by and therefore cheap! Actually, I believe my training was much more deliberate incorporating some minimal speed work and a few days of hills to strengthen the legs. I hope that was the difference. I was also religious about my anti-oxidants (fish oil, Vit E and C) and glucosamine sulfate.
What really made this race special was having my family there. We made it a mini family vacation and we had a blast. Vegas is full of wonderful family friendly shows and fun stuff like seeing the grand canyon and Hoover Dam. The highlight of the race was meeting my oldest daughter Katie at mile 25 and having her run the last 1.2 miles with me. We raised our hands in triumph at the finish and I was soaring. She made an incredible difference in plugging through the last little bit and made it all worth while. These things are so much more special when you can share them with the ones you love the most. I have this fantasy of one day running a marathon with both my girls. I'll hold on to that dream and maybe that will be what keeps me running.
Susan, my wife, is off to Kiawah island this weekend to run in the Kiawah half marathon. She is going to run with a bunch of her girlfriends who train together when they can. Susan and I have very different running styles as I am the classic loner, always hitting the pavement by myself (intentionally) while she is the social runner (come to think of it, thats pretty much the way we are in most aspects of our lives). I know she will have a good race as she will be smack dab in the middle of a gaggle of running babes jabbering the whole 13.1 miles.
Run Long!
I did my last long run in preparation for Las Vegas Sunday. It was a 20 miler and I actually felt decent. I did most of it at a 9 1/2min pace but slowed at the end. There were a few hills, not bad, but since there are actually some inclines in the race I figured I needed some training on them. I am a bit sore this AM but can now focus on proper nutrition and tapering. I listened to an interesting podcast yesterday that stressed the importance of eating some protein and fat along with your cards the morning of the race. Physiologically it makes sense. It helps to regulate digestion and keeps the blood sugar from shooting way up after a predominately carb meal. I think I will have a bagel (carbs) with some peanut butter and honey (fat and protein and some more carbs) before the race. That seems to fit the bill and I will see if it makes a difference. I am also entertaining the idea of doing the Galloway walk/run technique. For those unfamiliar with this, he teaches to doa 30 sec-1 min walk after running about 5-7 minutes. The idea is that your legs recover faster and you are not as fatigued in the last 6 miles. I have seen that is where my times suffer the most. I can keep a 9.5 to 10 pace most of the race , but the last 3-4 miles really slows and kills my times. Maybe this will allow me to stay on pace for those miles. I'll let you know. For more on the Galloway method go to www.jeffgalloway.com . Run long!

I am forever amazed by those courageous people who face extraordinarily difficult situations with a grace and peace. Often in the course of a day, I will come across a patient who tells me a tale of woe that would make a statue cry. Inevitably it will remind me, rather poignantly, of the necessity of daily thankfulness. In this country, we are all blessed beyond imagination as compared to the multitudes around the world, yet somehow we persist in leading the charge of the whine brigade at the least provocation. I think that is why I am in such awe of those, and there are many, who face adversity, be it physical or emotional, with a calm resoluteness that all will be well. Some call it feigned optimism. I call it the blessing of thankfulness.

Jenny was thirty-two when she was diagnosed with leukemia. She forced me to reflect on and examine my own life when she stated that her disease was a “wake up call”. She said that having a life threatening illness compelled her to focus on her priorities and unashamedly establish her short term and long term wants and needs. Her wish was that people would not have to face such adversity to reach this sense of purpose, yet I am afraid that human nature is not our ally in this respect. I, and maybe you, tend to wade through the day oblivious to what really matters: God, family, home, health etc. Jenny understood the power of thankfulness. She appreciated the rising sun, the soft touch of her husband, the smell of her eight-year-old’s hair. She lived for that moment of total thankfulness when she celebrated the countless good things in her life. I know I was touched by her wisdom. I am convinced that happiness comes when we understand and embrace the knowledge that everyday day is a gift. Rich Mullins, a gifted Christian song writer, wrote these words, which apply to anyone, Christian, Jew, or Muslim, who appreciates the temporary nature of today. He said, “Live like you’ll die tomorrow, but knowing you’ll live forever.” He was killed at age forty-two in a freak car wreck, but he lived in a state of thankfulness that took him from the bright lights of the Nashville music scene to the Navajo reservations of New Mexico where he spent the last several years of his life teaching young Native Americans the joy of music.

Giving thanks is a state of mind. It is the attitude of gratitude that we take for granted. If we would take the time to reflect on even the most common miracles in our lives, we couldn’t help but prevent the terminal disease of “hardening of the attitude”.

For a time I have been seeing as a patient a wonderful woman who was a church organist for many years. She was very accomplished and even had a recording made of her favorite songs which she gave to friends and church members. A few years ago she experienced a debilitating stroke that left her unable to play the organ or even walk unassisted. Her speech was also severely affected, and her medical problems became very complicated. Yet in the midst of all she had lost, on each of her visits she would repeat a solitary phrase over and over…”Pray much, no worry!” When I find it hard to be thankful, when I find myself slipping into a massive pity party, I try to remember this glorious lady and think about how thankful I really need to be.

Giving thanks implies action. I realize this may not be a common interpretation, yet when we show gratitude or appreciation for anything it is often in spoken words or deeds. Make a point of expressing thanks for simple things, an opened door, a parking spot, or a cool breeze. If we master that, then appreciating the things that really matter becomes much more commonplace. Every time I take someone to surgery, I give thanks for the God given ability of people to clot their blood. If it wasn’t for this miracle of engineering, no one going under the knife would ever wake up! Physicians, of all people, should daily stand in awe of the miracle that is the human body. Smart docs are thankful for the ability of the body to right the many wrongs we all accrue. I had a patient tell me one time that a good day was one where she didn’t see her name in the obituaries. Truly, any day above ground is better than the alternative! There is so much to be thankful for…if we just pay attention.

Life is full of small and large blessings. Make thankfulness a part of every day and you will see your physical, emotional, and spiritual health soar!