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Us, Interrupted: What Sophia Bush Is Learning About Self-Care Right Now

Us, Interrupted: What Sophia Bush Is Learning About Self-Care Right Now

Us, Interrupted is a series that focuses on public figures as well as professionals on the front lines of the COVID-19 global pandemic. During this unprecedented crisis, we hope these stories of vulnerability and resilience will help us move forward, stronger together.

Sophia Bush is an American actress, activist, and entrepreneur. She is a member of the Directors Guild of America and has starred in various independent projects, shows, and movies such as John Tucker Must Die, Incredibles 2, One Tree Hill, Dick Wolf’s Chicago PD, and This is Us and has joined the cast of the upcoming show Love, Victor. Bush also co-founded and sits on the board for the public awareness campaign “I am a voter,” which promotes awareness of registration tools and encourages all to use their resources to participate in the voting process. Most recently, Bush launched a podcast, Work in Progress, which features frank conversations with people who inspire her about how they’ve gotten to where they are.

We spoke to Bush about how her normally busy life has been changed by the impact of COVID-19 and why she’s learning to not expect too much from herself while staying home.

1. What was your life like before we learned about COVID-19, in terms of your self-care and maintaining a sense of well-being?

I’ve always struggled with routine since on set there is no such thing. Some days I have a 4:15 a.m. call time, and some days I go to work at 6 p.m. and film until the next day at 8 a.m. So I think I’ve always been enamored with people’s routines and looked at them with total fascination. In recent years, I’ve really tried to examine how to create routine.

Read more at MindBodyGreen.

Us, Interrupted: Working On the Front Lines Of COVID-19 As A Hospital Pediatrician & Medical Ethicist

Us, Interrupted: Working On the Front Lines Of COVID-19 As A Hospital Pediatrician & Medical Ethicist

Us, Interrupted is a series that focuses on public figures as well as professionals on the front lines of the COVID-19 global pandemic. During this unprecedented crisis, we hope these stories of vulnerability and resilience will help us move forward, stronger together.

Rachel Pearson, M.D., Ph.D., is a hospital pediatrician and assistant professor of medical humanities in San Antonio, Texas. Through the Center for Medical Humanities and Ethics, she runs the website known as “Pan Pals,” which uses the humanities and allied disciplines to help preserve compassion, justice, and humanitarian values through and beyond the pandemic.

When we spoke to Pearson, she explained the way that her life as a doctor, a medical ethicist, and a newly expectant mother has been affected by the COVID-19 outbreak:

1. What was your life like before we learned about COVID-19, in terms of your self-care and maintaining a sense of well-being in and out of the hospital?
I was settling into a new job in a new city, and I had just found out that I was pregnant for the first time. I had made some friends, and one of my most important ways of caring for myself was going for walks in the evenings with a girlfriend. I would meet my friend Christy halfway between our houses, and we’d walk around the neighborhood with her two dogs.

In the hospital, one of the big joys of my new job was finding that I had lots of time to spend with my patients and their families, as well as with my residents. I could go from room to room in the afternoons and just sit down and check in with worried parents and sick kids. The human connection that comes from that time, as well as the knowledge that I was getting to practice medicine in a way I believe in, gave me a lot of peace and brought a lot of meaning into my life. I also knew that, with my own kid on the way, I would soon have a reason to want to leave the hospital as soon as possible—so, I was really relishing that deep time with my patients and families.

Read more on MindBodyGreen.

Us, Interrupted: How I’m Shifting My Mindset Right Now, From The Founder Of TOMS

Us, Interrupted: How I’m Shifting My Mindset Right Now, From The Founder Of TOMS

Us, Interrupted is a series that focuses on public figures as well as professionals on the front lines of the COVID-19 global pandemic. During this unprecedented crisis, we hope these stories of vulnerability and resilience will help us move forward, stronger together.

Blake Mycoskie is an entrepreneur, author, and philanthropist and the founder and chief shoe giver of TOMS. Since beginning with shoes, the brand has expanded to eyewear and a coffee roasting company that partners with other organizations that provide safe water in seven counties. His most recent project, Madefor, launched recently and aims to improve our brains and bodies with neuroscience, psychology, and physiology.

Here, mindbodygreen spoke to Mycoskie about transitioning to life during COVID-19 as an individual and as a business leader, and how he’s taking control of his experience and finding the good that he can:

1. What was your life like before we learned about COVID-19, in terms of your self-care and maintaining a sense of well-being?

How I start my day plays a big role in how I experience life. My morning routine begins around 5:30 a.m. and consists of a mix of contemplation, prayer, basic body movements, and a tea ceremony. There isn’t anything magical about my 30-minute routine, but I find there is magic in an intentional start to the day. It helps me be more present and leads to better decisions. Each day, I try to find the right mix of quality time with my children and friends, outdoor physical activities like surfing or climbing, and meaningful work. I’m at my best if I invest in these three areas on a daily basis.

Read more on MindBodyGreen.

Us, Interrupted: How Television Host Tommy DiDario Is Adapting His Regimen To COVID-19

Us, Interrupted: How Television Host Tommy DiDario Is Adapting His Regimen To COVID-19

Us, Interrupted is a series that focuses on public figures as well as professionals on the front lines of the COVID-19 global pandemic. During this unprecedented crisis, we hope these stories of vulnerability and resilience will help us move forward, stronger together.

Tommy Didario is a television host and on-air lifestyle expert who has appeared on The Rachael Ray Show, The Today Show, and Entertainment Tonight. He covers everything from celebrity interviews to human interest stories to lifestyle topics in the fashion, trends, grooming, travel, health, fitness, and wellness worlds.

We spoke to Didario about how his formerly regimented lifestyle has been changed by the COVID-19 outbreak and how he’s doing his part to slow its spread.

1. What was your life like before we learned about COVID-19, in terms of your self-care and maintaining a sense of well-being?

I was very regimented. I get up at 5:30 a.m. every day, and I do a 20-minute yoga session. Then I’d head to the gym for a workout and come back to have breakfast before getting to work. With my work, which is in the entertainment/lifestyle business, I never know what the day is going to look like, so getting my core “me” time in early on is key. And living in New York City, I crave my outdoor time, so I’d make a point to walk to any meetings that might be a 20-minute or less walk. I also enjoyed writing for fun or work—it was a creative outlet for me—and reading. Eating healthfully with a balanced diet was also important.

Read more in MindBodyGreen.

Us, Interrupted: How This Internist Is Responding To The Impact Of COVID-19

Us, Interrupted: How This Internist Is Responding To The Impact Of COVID-19

Us, Interrupted is a series that focuses on public figures as well as professionals on the front lines of the COVID-19 global pandemic. During this unprecedented crisis, we hope these stories of vulnerability and resilience will help us move forward, stronger together.

Mark Shapiro, M.D., is an internist and the associate medical director for hospital services with St. Joseph Health Medical Group in Sonoma County, California. He is also the creator and host of the Explore the Space podcast, which considers the relationship between health care and society.

We spoke with Shapiro about working in the medical field during the COVID-19 outbreak and how it’s affected his work and personal life.

1. What was your life like before we learned about COVID-19, in terms of your self-care and maintaining a sense of well-being in and out of the hospital?

I was in a pretty good place balancing family life, my clinical and leadership work, Explore the Space podcast, and my own self-care. Keeping an exercise routine, good nutrition, reasonable sleep, and having fun were things I was feeling more and more comfortable with.

Read more in MindBodyGreen.

Us, Interrupted: How Uché Blackstock, MD, Is Taking Care Of Herself While Caring For Others

Us, Interrupted: How Uché Blackstock, MD, Is Taking Care Of Herself While Caring For Others

Us, Interrupted is a series that focuses on public figures as well as professionals on the front lines of the COVID-19 global pandemic. During this unprecedented crisis, we hope these stories of vulnerability and resilience will help us move forward, stronger together.

Uché Blackstock, M.D., is busy. She is the mother of two small children, the founder and CEO of Advancing Health Equity, and an emergency medicine physician working on the front lines of the COVID-19 pandemic in New York City.

We spoke to Blackstock about a life working in medicine during the pandemic, and how she’s balancing caring for herself, her children, and her patients during these unprecedented times.

What was your life like before we learned about COVID-19, in terms of your self-care and maintaining a sense of well-being in and out of the hospital?

To be honest, it’s hard to remember what life was like before the COVID-19 pandemic hit NYC. I’ve been immersed in the crisis for the last two weeks caring for patients in urgent care clinics in central Brooklyn. As a parent, practicing physician, and the CEO of my own consulting firm, I’ll admit that finding the time for self-care has been quite challenging for me. I try to eat healthy and to maintain a healthy exercise schedule. Before COVID19, I took up journaling, especially in the evenings to decompress before I fell asleep. I also consider self-care to be maintaining my connections with my loved ones and friends, so I try to be intentional about finding meaningful time to spend with them.

Read more in MindBodyGreen.

Us, Interrupted: How Writer Charles Yu Is Adapting To COVID-19 With His Family

Us, Interrupted: How Writer Charles Yu Is Adapting To COVID-19 With His Family

Us, Interrupted is a series that focuses on public figures as well as professionals on the front lines of the COVID-19 global pandemic. During this unprecedented crisis, we hope these stories of vulnerability and resilience will help us move forward, stronger together.

Charles Yu is a writer of fiction and nonfiction whose writing has appeared in numerous magazines and literary journals, including Slate, Esquire, Wired, and New York Times Style Magazine. He has also written for television, including HBO’s Westworld. Yu’s newest book, Interior Chinatown, was released in February 2020. His first book, How To Live Safely in a Science Fictional Universe, was named a New York Times Notable Book and listed as one of the best books of 2010 by Time magazine.

Here, Yu shares with us how he and his family are adapting to life during COVID-19: with exercise, getting outside, and maintaining connection with loved ones online, as well as the challenges of self-care during this difficult time:

1. What was your life like before we learned about COVID-19, in terms of your self-care and maintaining a sense of well-being?
It actually wasn’t that different from my life now. Since 2014, I’ve been writing full-time (after having been a lawyer for many years), and although I have worked in a number of TV writers’ rooms (for the past couple of years, I have been lucky enough to be writing scripts in development), I have been working from home.

My day-to-day routine is get up, walk my dog, pour coffee, and write. I tried to exercise at least three times a week, either a class or a 3- to 4-mile walk. My wife ordered some home exercise stuff (resistance bands and floor sliders), so we can try to get workouts in while isolated at home.

Read more in MindBodyGreen.

Us, Interrupted: How Soledad O’Brien Prioritizes Well-Being Amid COVID-19

Us, Interrupted: How Soledad O’Brien Prioritizes Well-Being Amid COVID-19

Us, Interrupted is a series that focuses on public figures as well as professionals on the front lines of the COVID-19 global pandemic. During this unprecedented crisis, we hope these stories of vulnerability and resilience will help us move forward, stronger together.

Soledad O’Brien is a powerhouse. As the CEO of Starfish Media Group, host of the show Matter of Fact, and an award-winning broadcast journalist, she is used to busy days. She also started the PowHERful Foundation with her husband, supporting women in their journey to higher education.

Here, she shares with us how she and her family are adapting to life during COVID-19: with schedules, long walks, and how it has affected her physical and emotional well-being.

What was your life like before we learned about COVID-19, in terms of your self-care & maintaining a sense of well-being?
I don’t think I was very good at self-care. I travel a lot for work, and it’s easy to get exhausted. I tried my best to get six to eight hours of sleep and avoid red-eye flights as much as possible. The main thing was eating well and trying to get enough sleep.

In terms of other aspects of my well-being, a big part of it for me was needing to feel “useful,” as in getting stuff done. I’m a box checker, and I’d feel good knowing if I got everything on my list done. I never found much relaxation in cooking, but I’d volunteer to clean up, for instance; that would help me feel like I was being useful.

Read more in MindBodyGreen.

Resolving to Be Coached

Resolving to Be Coached

The secret to sticking with your resolutions may be having a coach to help strategize and cheer you on.

My teenage patient looked nervous as I reviewed her glucose readings from her glucometer and her glucose logbook, which people with diabetes use to track their blood-sugar test results. There were a lot of high levels — ranges in the 12’s and 14’s, when the goal was around 7 or 8. The peaks were mostly in the middle of the day and on weekends. (This was in Canada; blood glucose readings of 12 to 14 are equivalent to 216 to 250 mg/dL in the United States.)

“What do you usually eat at home?” I asked. She said that her mother was careful to make her a breakfast that balanced carbohydrates with protein. Her dinners were similar.

“What do you usually eat at lunch?” I asked. My patient started tearing up. She ate whatever her friends were eating in her high school’s cafeteria that day — like spaghetti, hamburgers or pizza, and something like a cupcake for dessert. This was probably what led to her readings being so high.

She had met with diabetes educators before, and she knew what uncontrolled glucose does to a person with diabetes, from speeding up nerve damage in the feet to hastening blood vessel damage in the back of the eyes and the kidneys, to increasing her risk of heart disease.

I knew she could have told me all of that, so lecturing her wasn’t going to help.

Instead my patient needed empathy and the tools to help her make healthier decisions, and part of that required understanding what was important to her, specifically “fitting in” with her friends in high school, the ones who didn’t have a chronic disease. It also would have involved helping her find the motivation within herself to make the change.

But my skill set for helping her was limited, especially on top of everything else I had to cover within our allotted time of 45 minutes.

Research suggests that behavioral and lifestyle factors are a big part of what contributes to chronic disease. In medical training, we learn a lot about the body and how to prevent and treat disease, but little about how we can motivate a patient to change old habits or even stick with a current management plan.

It struck me that what my patient really needed was a coach. At this time of year when many of us have made resolutions to get healthier, working with a health coach might be one way to reach those goals.

A health coach is someone trained in behavior change, who primarily uses an interview style called “motivational interviewing” to help patients see their ability to make change. While some may have clinical training in fields like nursing or medicine, they hail from a wide variety of disciplines or train in health coaching as a secondary career.

As a relatively young field, it’s still finding its footing — for instance, a systematic review found that the definitions of “health coaching” varied widely, though the authors recommended that health coaches take a patient-centered approach to help with goal setting while encouraging self-discovery and accountability.

The evidence that health coaching may spur general lifestyle changes is mounting. A 2018 study looked at clinical trials for coaching for nutrition and weight management and found that over 80 percent of these studies found improvement. And a 2017 study found that coaching can lead to increased physical activity in older adults. Studies suggest that health coaching may also provide benefits for conditions such as obesity and diabetes as well as attention deficit hyperactivity disorder, chronic pain, hypertension and high cholesterol. A recent review found that health coaching can improve quality of life and reduce hospital admissions among patients with chronic obstructive pulmonary disease, and it may help patients to become more engaged in the health care system.

It may even improve health outcomes through encouraging patient adherence to medication.

“Health coaching recognizes that we cannot help people by expecting them to act if that person is not ready to act,” said Leila Finn, a health coach based in Atlanta. “We help people take big goals and break them down into accessible, bite-size pieces — not by telling clients what to do but by helping clients figure out what will work for them.”

Health coaching gets to the heart of what providing good health care is about: acceptance, partnership, compassion, and helping patients feel respected and understood.

Though my clinical training is in pediatric medicine, inspired by what I had read, I recently completed a certificate in health coaching myself. The experience was eye-opening and humbling. I learned new ways of communicating with my patients, specifically ways to encourage them to see their own ability to make lifestyle changes while setting manageable goals. I also learned ways to cheer them on when they reach their goals, without shaming them if they relapse: Both pieces are critical to the process of making sustainable change.

While research is beginning to show the value of health coaching, the principles of communicating with the intent to inspire and motivate are transferable to all health professions — and could reap dividends if taught early on in the training of nursing students, medical students, pharmacy students, and other allied health professionals.

And when I think back to my teenage patient with diabetes, while I was empathetic, that was only half of the solution. The second half could have involved coaching her to see which small changes she could begin to make moving forward. I’m hoping that choosing my words more effectively, even within the pressures of time, may make all the difference for my other patients.

**Originally published in the New York Times**

Protecting Sleep in the Hospital, for Both Patients and Doctors

Protecting Sleep in the Hospital, for Both Patients and Doctors

What if sleep were considered a continuous infusion of a medication that helped patients heal faster?

It was 11 p.m. and my 2-year-old patient was sleeping peacefully in her hospital bed, snuggled up with her mother and several stuffed animals. Her breathing was quiet and soft. Her bedside heart rate monitor, which glowed a faint yellow in the dark hospital room, was turned to “silent.”

“Sorry, I have to take a listen to her heart,” I whispered to her mother, tapping her shoulder lightly. Her mother and I had a good relationship: I had served as an advocate for her daughter several times during her seven-week stay in the ward. She had a rare disease that had been a medical mystery for many months, but she would be transferred to a more specialized center soon.

I hated to wake her, but recently, when I had offered to wait to examine a child until after a nap, my attending physician had scolded: “You can’t care about that. If you do, you’ll never examine them. They have to get used to it — they’re in the hospital, after all.”

But the poor girl was tired. She was poked three times a day for blood and taken to the M.R.I. or CT scanner at various times. I completed my exam: her vital signs, her heart, perfusion (how well her heart was pumping blood to her body), and palpated her abdomen to check her liver and spleen (which were enlarged, but no more than they had been). She seemed stable. I backed out slowly.

The next morning, the girl’s mother mentioned that it had taken another hour for her to fall asleep again. Was there anything that we could do to allow her to sleep through the night? Wouldn’t a good night’s sleep help with her condition? She had a point.

This is a fundamental question we have to ask about all of our patients, as research now shows that sleep disruption isn’t just inconvenient and doesn’t merely affect our moods or increase risk of disease. Disrupted sleep can in fact drastically affect how well patients heal from the condition that brought them into the hospital in the first place.

If sleep were regarded as a continuous infusion of a medication that helped a patient heal faster, provided them with emotional stability, and ensured they were in the best mind-set to understand the risks and benefits of that care, we would think twice about disrupting it.

Matthew Walker, a professor of psychology and neuroscience at the University of California, Berkeley, and the author of “Why We Sleep,” explored this issue in his research.

“Sleep is one of the most powerful, freely available health care systems you could ever wish for,” Dr. Walker told me. “But the irony is that the one place a patient needs sleep the most is the place they’re least likely to get it: in a hospital bed on the ward.” This year, his research found that a lack of sleep can worsen pain perception.

Recently, a study in Nature found that sleep disruption is directly linked to atherosclerosis, a buildup of plaque in blood vessels. As such, it doesn’t just increase the propensity for a heart attack or stroke, but in patients admitted for a condition related to clogged arteries, interrupted sleep could actually affect how well they heal in a hospital.

study published last year found that sleep affects wound healing, including wounds from surgery or any type of procedure. Using the Pittsburgh Sleep Quality Index score, the researchers looked at patients with inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease. These diseases are characterized by wounds primarily in the bowel, treated most often by medications to suppress the immune system. The wounds took longer to heal among the patients who had lower sleep scores.

Similarly, researchers have hypothesized that the healing of diabetic foot ulcers may be affected by undiagnosed obstructive sleep apnea.

And recently, a study on sleep and healing published in the Journal of Applied Physiology concluded that wounds were less likely to heal when sleep was disrupted.

Sleep fragmentation or disruption is not just an issue for patients, of course. It also affects health care workers — particularly medical residents who may be on call for a 26-hour shift several times a week — or nurses and emergency medicine doctors who work irregular hours that often disrupt their circadian rhythms.

A recent study in the journal Anaesthesia found that sleep deprivation among health care workers was directly linked to DNA damage. Research has found that a lack of sleep among residents can be a predictor for depression. Sleep-deprived doctors are also over eight times more likely to omit a crucial patient-care issue. Extended shifts even put people at risk outside the hospital: They triple the risk of a hazardous driving event, with 40 percent of attending physicians reporting that they’ve fallen asleep while driving.

Dr. Michael Farquhar, a sleep expert based in Britain, writes that many hospitals remain unaware of the impact of this issue. Particularly for night shifts, he writes: “We are not evolved to be awake at night. Our circadian rhythm, the powerful drive that helps regulate wake and sleep, means that we are at a physiological low when working at night.” One London-based campaign, “HALT: Take a Break,” offers ways to reduce fatigue.

As Austin Frakt noted in The Upshot last year, several hospitals are taking steps to address the problem. For example, nurses at Yale-New Haven Hospital try to give patients their medications before they go to sleep to minimize sleep disruptions.

Dr. Walker has suggested giving patients ear plugs and an eye mask if they stay overnight in a hospital, and having doctors be more mindful about when they wake patients for a question or an assessment.

As to the standard argument that American doctors have to work brutally long hours to be properly trained, Dr. Walker counters, “Countries such as France, Switzerland and New Zealand train physicians in the same amount of time despite limiting resident shifts to less than 16 hours, yet these countries continue to rank in the top 10 for quality of medical care and practice.”

He added: “It’s worthwhile remembering that after being awake for 22 hours straight, you are as cognitively impaired as if you were legally drunk. Nobody would accept medical care from an inebriated doctor. Yet we must accept medical care from doctors who are similarly impaired due to the lack of sleep the system imposes on them.”

As for my 2-year-old patient, she was transferred to a different hospital a few days later and eventually discharged. She is now getting outpatient care and is back on a regular sleep schedule at home.

Would she have healed faster if her sleep had been less frequently interrupted in the hospital? I can’t say. Maybe the sleep interruptions were justifiable for other reasons that could have improved her care. But the opportunity to have stretches of restorative sleep in a more comfortable environment at home will probably be a big part of keeping her well. And knowing that, I sleep better, too.

**Originally published in the New York Times**