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Avoiding the Oreo cookie effect

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By Emily Zaragoza-Lao, M.D.

Women are so busy these days, trying to balance their lives with caring for their family and careers that it is hard for them to take the time to care for themselves. Some are caught in the “Oreo cookie effect”: taking care of their own children and their aging parents. As a family doctor, I see many female patients that fall victim to doing too much for others. They wait until everything is done for their children, their jobs and their extended family before looking inward and providing self-care. Consequently, with the stress of such a hectic life, my patients only find rest when their immune systems are compromised and cannot fight simple viral infections anymore. Instead of resting and providing self-care, they continue to care of others until the simple infection becomes complicated, prolonging their illness and adding more stress to life.

Self-care is a concept not common in the United States; however, it has been studied and promoted by the department of health of London, England, in their self-care report in 2006. Self-care is a daily part of life – when an individual cares for his or her own health and well-being. Most care in life is self-care. This includes maintaining good physical and mental health, meeting psychological and social needs, and preventing illness or accidents. Caring for minor illness will help prevent future medical complications. Properly following up on chronic conditions on a regular basis to prevent acute episodes is self-care. Finally, self-care is maintaining health and well-being after an acute illness from the hospital. Self-care empowers people and avoids unnecessary and costly health care. In London, minor illnesses account for 75 percent of ambulatory visits to the doctor, of which 40 percent of the doctor’s time is spent dealing with self-treatable illness.

Several of my patients have adopted self-care as a tool to help them find balance in their lives. A working mother with a teenage daughter started to see me regularly after being seen in the emergency room for chest pain. She is morbidly obese at 350+ pounds, with multiple medical problems all related to her obesity. She works full time and takes care of her disabled husband and newly widowed father. She has no emotional support from her husband and has not developed many friendships. When her 14-year-old daughter came into the office for a pregnancy test, this sent her into a panic and chest pain. I began seeing her every two weeks at my practice at St. Joseph’s Hospital over the past three months to help her gain control of life. She took needed time off work to set her priorities and started delegating tasks to her teenage daughter to help with the household chores. She started to meditate and take time for herself, like walking to provide exercise and clear her mind. She is able to control her panic attacks with deep breathing exercises. She has started to sleep better and make healthier food choices.

The impact of self-care on patients shows better symptom management, such as reduction in pain, anxiety, depression and fatigue. Patients have improved feelings of well-being and overall quality of life and greater independence. The impact on medical resources in London showed significant reductions in the number of hospitalizations, visits to the general doctors by 17 percent and reduction of prescribed medications by patients.

In our fast-paced world of e-communications – email, texting, Facebook and Twitter – we have made life more complex and perhaps cause more stress rather than ease. Women need to empower themselves to set priorities in their busy lives. The top priority is self-care, so they are able to take care of others who they love and love them.

Emily Zaragoza-Lao, M.D., is a physician and teaching faculty member in the Family Medicine Center at St. Joseph’s Hospital and Medical Center. She is board certified in family medicine, with special areas of interest in women’s health and adolescent medicine. As medical director of the Family Medicine Residency Program, she oversees the clinical teaching of the resident physicians. She is also an assistant clinical professor in the Department of Family and Community Medicine at the University of Arizona College of Medicine.

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