ASHP InterSections ASHP InterSections

February 18, 2020

Active Pharmacists Use Exercise to Boost Health and Well-Being

Abhay Patel, Pharm.D., M.S., R.Ph.

AFTER FOUR MONTHS OF TRAINING for a half marathon, Abhay Patel, Pharm.D., M.S., R.Ph., Pharmacy Manager for Ambulatory Services at Children’s Hospital of Philadelphia, was amazed by not only improvements in his endurance and strength, but also by how his attitude about his work had changed. “Things that used to be a source of stress did not seem as stressful anymore,” he said.

Benefits of Exercise

As Dr. Patel and other pharmacists are finding out, staying fit can yield a multitude of rewards, from bolstering mental resilience to reducing symptoms of depression and anxiety. Staying fit through regular exercise is also one way individuals can address the problem of burnout, which over 50% of pharmacists in acute and ambulatory care settings experience.

The benefits of a fitness regimen became clear to Dr. Patel after he finished a short jog in the park near his home in the summer of 2015, during his PGY-2 residency. “At the end of that day, I looked back and realized I had accomplished even more than I normally did on a day without any deliberate physical activity,” recalled Dr. Patel, an ASHP member since 2011.

Fitness Journey

That realization left him wanting to exercise more. After completing residency and starting his job, he began to integrate short bike rides after work, weightlifting at his local fitness center, and taking advantage of his workplace’s wellness services. “I started by squeezing whatever I could into my day, and that laid the groundwork for establishing a more targeted, consistent routine,” he said.

As it turned out, squeezing in those bits of exercise yielded additional benefits. “My demeanor began to change positively, I had more energy, I was more focused on the tasks I was doing, and I felt better about myself and about the care I was providing, as well as my role as a team leader,” said Dr. Patel.

Exercising is not a panacea, he admitted, and his days include “all of the same highs and lows that I had before,” but his ability to manage these fluctuations has improved. There have been important changes in his perspective on work and life, Dr. Patel added. “It’s clearer to me that professionally and personally, it is not just about the pursuit of the finish line, but about pursuing progress instead,” he said. “It truly is a marathon, not a sprint, and about appreciating the journey.”

Yoga Unites Mind and Body

Jogs and gym visits are two ways to stay fit, but exercise can take other forms, as Christina Martin, Pharm.D., M.S., CAE, ASHP’s Director, New Practitioners Forum, has shown.

Christina Martin, Pharm.D., M.S., CAE

Dr. Martin started practicing yoga roughly seven years ago, an interest she developed when she began her first post-residency pharmacy supervisor position and fell into the trap of working too much. “Things went out of balance,” she said. “Yoga was something that I could commit to beyond work.” Over the years, Dr. Martin has learned to enjoy not only the physical aspects of yoga but also its inward, meditative focus.

“The Sanskrit word for yoga is ‘yuj,’ which means to control or to unite, and that is what my yoga practice has transformed into – controlling the noise from the outside world and uniting my mind, body, and soul,” said Dr. Martin. “One of my teachers regularly reminds us that coming to the yoga mat is an escape to our own private island.”

Yoga has also added another layer of meaning to her life, she said, as she recently completed a hot yoga teacher training program so that she can share her passion for the practice with others. The 200-hour training program included learning about human anatomy, how to address common ailments that yoga practitioners face, as well as studies in yogic breathing, nutrition, and chakra theory. A chakra is a center of spiritual power in Hindu thought.

“Being part of any community – including the yoga community – can be an antidote to the pervasive isolation and loneliness that we see in today’s society,” Dr. Martin said.

CrossFit Champ

A strong sense of community built around the goals of fitness is one reason Robert Weber, Pharm.D., M.S., FASHP, Chief Pharmacy Officer at the Ohio State University Wexner Medical Center in Columbus, Ohio, has fallen in love with CrossFit, a high-intensity form of exercise.

Robert Weber, Pharm.D., M.S., FASHP

As Dr. Weber recalls, his journey toward developing a rigorous CrossFit regimen began after years of struggling with weight gain as well as complications from a colon cancer diagnosis in 2008 and chemotherapy and surgery that eradicated his cancer, but left him with neuropathic pain in his hands and feet.

“I was told that I should not and could not [do any vigorous exercise] because of the neuropathy and that walking with some light yoga was sufficient,” said Dr. Weber, an ASHP Fellow and member since 1980. He assumed his physicians were right, because at the time, “I wasn’t able to balance myself, jump, and do all the things that are part of exercising.”

With the neuropathic pain limiting his ability to exercise, Dr. Weber tried to stay healthy through a proper diet, but eight years of a sedentary lifestyle left him overweight, and in need of cardiovascular medications, he said.

“The turning point for me came when my brother died of cancer in 2017,” Dr. Weber recalled. “I was standing over his grave, and I said to myself, ‘I need to make a change and start exercising again and move the dial in terms of my overall health and wellness.’”

His daughter urged Dr. Weber, who is now 63, to take CrossFit classes. While the exercise leaves him feeling “tired and winded, once I’m done, I feel like a million bucks,” he said. Dr. Weber noted that he overcame the neuropathic pain in his feet by increasing the frequency and intensity of the exercises in “baby steps, and not pushing too hard at first.”

Today, as a result of regular exercise and proper nutrition, Dr. Weber is 42 pounds lighter and has been able to discontinue most of his cardiovascular and neuropathic pain drugs. “I’m now more stable on my feet, more confident, and I make better decisions at work,” he added.

For those in his age group interested in starting an exercise regimen, Dr. Weber cautioned first to get a physician’s approval and also to start at a low intensity. He noted that a personal trainer or coach has the expertise to design a safe exercise program customized to your needs. This is important because performing too many repetitions too early can cause cardiac stress, he said, and lifting too much weight initially can lead to several days of discomfort and possibly serious injury.

“Particularly at my age, it can be frustrating if you start an exercise program and get stiff and sore for a few days,” said Dr. Weber. “I’ve seen many people my age quit after a brief time because they can’t tolerate the soreness that follows exercising.”

With those caveats in mind, Dr. Weber believes that almost anyone of any age can build an exercise regimen that works for them and reap the benefits. “You can do anything you set your mind to do,” he said.

 

By David Wild

 

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November 5, 2019

Namaste: ASHP Members are Pharmacists and Certified Yoga Instructors

Seena Haines, Pharm.D., FASHP, BCACP

SEENA HAINES, Pharm.D., FASHP, BCACP, has long embraced physical fitness. Throughout her career, the professor and chair of the Department of Pharmacy Practice at the University of Mississippi School of Pharmacy has lifted weights, taken kickboxing and spin classes, and attended boot camps. Even when she exercised twice a day, she sometimes felt overwhelmed and in need of something to help reduce stress.

About three years ago, a pharmacy colleague suggested she try yoga. Dr. Haines took advantage of an introductory special offered by a local yoga studio. Within a few sessions, she was hooked, going to class several times a week. She has since become an instructor who teaches yoga to residents and college students at the studio where she trained. She also teaches yoga at national conferences.

“I was completely amazed by the impact it had on my mindset and my stress levels,” she said. “It helped quiet what I call the ‘monkey mind’ and focus on the present moment. This was exactly the mind-body connection and stillness that I was searching for that I couldn’t find through other group conditioning activities.”

Yoga provides calm and balance
Dr. Haines is one of several ASHP members who have not only embraced yoga but have gone on to become certified yoga instructors. Kathryn Samai, Pharm.D., BCPS, is an emergency medicine clinical pharmacist at Sarasota Memorial Healthcare System in Florida. She is an instructor and enthusiast of Ashtanga yoga, a vigorous physical form of yoga that combines synchronizing breath with various postures.

She said the practice has helped her better interact with her colleagues. Yoga reminds her that everyone has stress and difficulties. She approaches each person with more compassion and a sense of shared connection. “As pharmacists, we deal in this very fast-paced workflow where you have to be extremely meticulous and extremely detail-oriented,” Dr. Samai said. “We interact with a lot of people who are upset, hurting, and stressed-out, whether it’s our co-workers or our patients.”

Hala Hijazi, Pharm.D.

She has discovered that yoga gives her more time because she operates in a different mindset. “It’s almost like you can slow things down even though the workflow is never going to slow down,” she said. “Yoga is the attainment of a calm and peaceful state of being.”

ASHP member and yoga instructor, Hala Hijazi, Pharm.D., agrees. She is a clinical staff pharmacist at King Faisal Specialist Hospital in Riyadh, Saudi Arabia. Dr. Hijazi found yoga as a teenager when her aunt suggested she try it to help manage the stress surrounding her ulcerative colitis.

Dr. Hijazi noted that practicing yoga helped her survive her pharmacy residency and today makes her feel more balanced in her life, work, and spirituality. A breathing technique called pranayama, also known as the life force, helps her get into a meditation state.

“I learned to slow down, be more patient, and focus more,” Dr. Hijazi said. “Now, when I have a few tasks to do, I don’t become stressed-out about them. I prioritize and take it task by task.”

Benefits of yoga
Published studies demonstrate many benefits to yoga, Dr. Haines noted, including lowered anxiety, depression, and risk for cardiovascular events. “I feel that practicing yoga is essential for success in preventing disease onset and severity,” she said. “It can provide dividends now and in the future as we continue to age.”

Yoga not only is good for flexibility and physical health but also can help people become more centered, added Dr. Samai. “When you start to do these physical postures, you lengthen your spine and [improve your] ability to bend and move. You find yourself becoming more patient, more compassionate, making a little more room for kindness,” she said.

Yoga for beginners
There are many ways for busy pharmacists and student pharmacists to incorporate yoga into their lives, said the interviewees. Ideally, try a class at a local studio or even online, Dr. Hijazi advised. Initially, she said, “just an hour a week was enough for me to feel like I was going to be ok.”

Kathryn Samai, Pharm.D., BCPS

Some hospitals or institutions host classes. In addition to her studio classes, Dr. Samai teaches 15-minute sessions of gentle yoga at her hospital a couple of times a month. These short sessions are focused on relieving stress and fatigue.

Dr. Samai advises individuals who are new to yoga to try different types. Some may seem too physical or too gentle, or have too much chanting for your taste, she said.

According to Dr. Haines, there are many styles of teaching, and it may take some time to find what works for you. Be patient with yourself as your body adjusts to some of the positions. Over time, you will see improvement, she added.

Dr. Hijazi explained that yoga doesn’t have to take up a lot of time. Take five minutes when you wake up, after work, or before you go to sleep, to turn your attention inward. Do some breathing techniques to slow down, or think of things for which you are grateful, noted Dr. Hijazi, who teaches classes at her home, a local studio, and online.

Dr. Samai sets alarms on her phone to remind her to repeat one of her mantras. Pharmacists can do something similar each time they do an automatic task, like washing hands or using sanitizer before entering a patient room. When a pediatric patient died in the ED recently, she took a few minutes for breathing as a transition before resuming work. “You don’t have to get yoga pants, you don’t need to drive somewhere or do something,” said Dr. Samai. “Those little moments of mindfulness are yoga.”

Remember that yoga is a life journey, not just a session where you go and work out, said Dr. Hijazi. “I would say to any pharmacist or health care practitioner, we should give ourselves time every week to find ourselves, and yoga helps us do that,” she added.

 

By Karen Blum

 

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