To Begin Anew We Must End the Old

Why Do You Deserve Health?
Mary Alice Anderson, MS, RN, CNOR, NASM-CPT, FNS



I have struggled with my weight my entire life. Even to this day, I try to focus on living and enjoying instead of anxiety and fear. That’s all it is, a struggle. I’m happy to have the one that I’m dealing with.

In 2011 I started nursing school. Within 5 weeks, I was 21 years old, living alone in Dallas, failing my first test. I cannot remember for sure, but even if I started at 195 pounds (at 5’3”), I began that October at 217 pounds of too much Mary.

Along with questioning my academic ability, I started to wonder if any patients would take an overweight nurse seriously. Especially when diabetic management teaching came up, who was I to tell someone not to eat the entire bag of Hershey kisses or drink the entire bottle of champagne?

I didn’t flip 180 degrees alone. I sought help because this mental struggle was affecting my grades, note I did not say that I wanted to get healthy or look good, just pass my classes. It was through the school counselor that I decided to get physical. But I wasn’t all in or convinced that this switch would actually help, so I took a small step by putting my Concept notes on the treadmill for an hour each day.

Five pounds later, I gained a little confidence. I was still drinking to get by, but my ability to say no to food was actually strengthened by my friends’ lack of control. It felt good to be the one who was saving money and packing her lunch. It felt great when my friends started to follow suit too!

I dropped down to 155 two months before graduation. That’s when things got rocky. I was in a familiar relationship based on alcohol and sailing through the semester until finals and NCLEX. I decided I really wanted to wear a beautiful dress with heels for pinning and graduation. Please don’t ask me why I associate heels with grace, but it was important to me that my newfound body had the height to go with it!

I walked into the shoe store confidently, and left with the worst pain ever. In attempting to walk in wedges (I had heard they were easier to wear even though I had already picked out the perfect pair of heels, nude to match my black lace/nude slip dress), I busted my butt all over that floor.

Ego hurt but unwilling to walk out empty handed (unaware of the damage done), I stuffed my swollen foot into my tennis shoes, waited in the longest line, and purchased the original pair of heels.

Flash forward one month, after walking San Antonio in the flat shoes because I was still unable to wear my orthotics in my tennis shoes due to pain, I’m sitting in my podiatrist’s office. 6 weeks. If I’m lucky, I’ll only wear this boot for 6 weeks. If I deviate, it’ll be 8 or more. Graduation is in 4. Flying and walking all over Boston in 5. Driving and walking all over El Paso in 6.

Deep breath. How will I exercise? Just the bike? Okay.

Deep breath.

Why me? Why now? Why was I so stupid?

In two months I gained back 20 pounds. I walked into every interview without the boot and spent my graduation day standing without the boot. I spent the night at the airport in a boot. I walked up El Paso mountains with a boot.

I got clearance a week before my NCLEX.

I got a trainer a month after starting my training in the operating room.

I ate like he suggested, and did cardio before Zumba and Yoga three or four times a week. I drank like a sailor and went out with my friends and roommate as much as possible. I thought this is what life supposed to be - work to eat and drink and work out to continue to eat and drink. I got myself back down to 155 but held stagnant throughout my training.

A year later, I was working each and every shift known to the OR, I could not keep the trainer. At the same time, my favorite Zumba instructor left my gym. I gained back the 20 pounds I had lost and did not know why life was not working the way that it should.

Through online dating, I met a guy who wanted to come to Dallas for graduate school. Purpose. That’s what I needed, a purpose. I applied and got into the Master’s of Science in Nursing Education program at Texas Woman’s University. With a little soul-searching, I accepted a weekend-shift-only position.

Life was going to work out. I was going to work the weekends, I was going to go to school during the week, I was going to keep my favorite kickboxing classes, and I was going to have a boyfriend who was willing to work it out.

Funny how things change. I got suckered into the New Year’s Eve special at the kickboxing gym. For half off, I got to train with a guy who never taught a class but was always working out with very fit women. I wanted to squat like them. If it was half off, maybe I’d attempt a trainer again.

My roommate and I went out for Lights All Night and once more January 2, 2015. I went all out, the next week I would start training with Eric, in two weeks I would start my Master’s, and in four weeks my boyfriend was moving to Dallas.

I showed up at the gym, bright-eyed and bushy-tailed, totally unprepared. “I want to look like Ronda Rousey” I told him, explicitly giving him my life story. No alcohol, no cheese, run a mile before we work out twice a week. Punch in the gut.

Go talk to my nutritionalist. I can’t even move after our first session. I’m invigorated though. I’ll be squatting in three months and he believes in me. He supports me so much he’s willing to keep the low price if I don’t drink for three months. I could actually look like Ronda.

I’d never had confidence like that before.

Go talk to Mike. Punch in the gut. What do you mean my protein is so low you can’t understand how I’m alive? I eat like the other trainer told me! Why would he lie? I can’t eat more than 1200 calories, I’ll gain a million pounds! You want me to spend money on shakes? Heck, I don’t know what else to eat.

I’m all in.

I’m all in.

I decided I’m all in and that was that. Wipe my hands of the decision because it’s been made.

The first week was hard. Maybe because my protein was so low that actually eating enough helped me not feel so awful during my withdrawal.

I wasn’t addicted to alcohol, but I was completely addicted to forgetting.

I used alcohol as a crutch to forget whatever anxiety I had. Now I didn’t have that crutch, but I had something better. Every time I went to the gym I got better. I looked better. In three months I didn’t look like Ronda Rousey (although my coworkers would tell me I did), but I lost 20 pounds. That same 20 pounds I gained back working off shifts? That took me 9 months to lose the second time?

Then I got better. I got under the squat rack.

When Eric moved gyms I did too. I couldn’t lose the only person who had believed in me enough to push my limits.

I’ve been with him every since. I’ve never doubted myself, only my injuries or mental capabilities to perform. Any time I cheated on the diet, I doubted. Any time I drank, I doubted. Any time I was inconsistent, the pain of disappointment was more than any comfort or joy that the cheat gave me.

Fast forward two and a half years. I’m still struggling. I’ve changed diet plans. I’ve grown and learned myself more. I rely on routine. But the one thing that doesn’t change is the absolute sheer joy that comes from discipline and the reward of being consistent.

And you can do it too. I know, because I changed my entire life.

And you can maintain this lifestyle. I know, because I would never go back.



Thank you for giving me your time and attention,

Mary Alice Anderson, MS, RN, CNOR, NASM-CPT, FNS








Meal Prep Action Plan













Why You?

• nurses are the role models for the nation
• we have integrity, however, do our patients take us seriously when we do not look like health
• you deserve health
• you deserve the respect
• you deserve to feel great at work - related to nutrition, physical ability, and mental health related to sleep and emotional intelligence
• so plan for yourself and allow yourself the ability and permission to be healthy
• sit down and make goals, not just related to professional or education goals
• you deserve to feel healthy, when was the last time you audited your life and feelings and made yourself aware of how you feel about your life
• take a second and mute the distractors
• build confidence with small wins, creates history of wins to make bigger changes, you can because you have done

Barriers

• tell me what your barriers are:
• nutrition - time, guilt, exhausted
• gym - time, exhausted, guilt
• sleep -
• mental health -
• personal time - how is it spent, do you feel relaxed afterwards, do you have a good system, a good time and scheduled plan - you have to plan if you want to get it all done
• don’t you deserve to get it all done?
• be present. what are you using to run away or escape from your exhaustion?

Literature

• there are real results of goodness happening when you take care of yourself
• mental health, breaks in the OR, sleep, nutrition, exercise
• if you’re interested, let’s chat
• I’ll create a reference list in the future

Basics

• prep for 3-4 days, 12 hours at a time - 4-5 small meals q 3-4 hours
• palm of protein, fist of veggies and carbohydrates
• plan to eat on the way to work and have a snack for going home
• drink water - 8 bottles a day
• sleep 6-8 hours
• exercise 3-4 weeks, resistance preferred
• mental relaxation - mediation, journaling, personal, me time

Nutrition

• 1 gram of protein per body weight
• less than 20% body fat for weight loss
• 30% for gain or maintenance
• rest carbohydrates
• less than 6 grams of sugar per meal for weight loss
• protein examples - lean meats, protein powder,
• carbohydrate examples - sweet potatoes, brown rice,
• fat - avocados, olive oil
• maintenance - whatever you’re doing
• gain - increase by 100 calories a day, 50/50 fat and carbs
• dairy - watch fat and carbohydrate levels, watch extra calories and assess whether you really want or need those calories in this meal
• alcohol - one drink = carbohydrate macronutrients
• try to eat within 30 minutes of waking to wake up metabolism
• never eat carbohydrates without protein
• drink a glass of water upon waking, before bed
• eat before bed, be ready for catabolism by eating something that will last 2-3 hours like a protein powder or meat that will not keep you awake
• no studies show that eating before bed will increase your risk of retaining fat, it depends on calories in and out

How to Meal Prep

• pick a protein, carbohydrate, and vegetable source
• 1 pound of raw meat generally 14 oz /4 meals = 3/5 oz/ meal
• carbs 1 pound sweet potatoes generally 400 grams/4 meals = 100 grams/ meal
• veggies - enough to feel full, gives meal flavor
• try to keep spices, not condiments
• mustard is best for calories
• watch sodium/water retention/drink more water

Exercise

• do whatever you will do consistently, potentially and hopefully also for yourself as a mental break
• cardio sports
• team sports
• group work
• resistance training
• lift both hypertrophy 15-20 reps and strength 6-12 reps
• build size and build muscle mass power
• can split week depending on days in the gym
• cardio before or separate days
• make sure to get quick-acting protein after work out, protein powder is quicker acting than meat that your body has to break down
• your blood is in your heart, brains, and muscles after a work out
• your body is eating up your glycogen stores then burning fat stores (awesome!)
• little micro tears need carbohydrates and carbohydrates cannot move without quick acting protein, to repair
• but if you do not quickly give back carbohydrates, shuttled by protein, your body will break down the muscles even more and take the protein source for your brain’s fuel

SSS cardio

• keep heart rate low to build cardiovascular resistance
• practice mental clarity
• requires at least 20 minutes

HIIT

• keep heart rate fluctuating 30 seconds as fast as possible, 1-2 minutes lower to 120 for 3-5 rounds
• builds cardiovascular resistance
• may increase risk for injury

Do you want to change?

• figure out where you are and a SMART goal
• track your meals for a few days - typical week day, typical weekend
• what do you want to accomplish?
• how will you measure your success?
• is it attainable?
• is it realistic?
• create a specific time
• become determined and develop the habit
• small action steps a day, until habit you have not won until you have “tried your best today to”
• once it is a habit and no longer a struggle, create more goals and continue to win the day
• basic mathematics with life and individual differences
• 3500 calories = 1 pound
• create a deficit through exercise or nutrition
• always feed back nutrition