When you fall off the wagon..

First, I would like to thank each and every one of you who took the time to email me or comment when you saw me about my weight loss or my shoulder recovery. I appreciate you all.

So it’s summer. Unfortunately for me, this is going to be a rebuilding summer. See, before my shoulder surgery in December of 2023, I was in the BEST shape of my life. I lifted weights twice a week, did Pilates on the reformer once a week, rode my horse 3-5 times per week, and played golf (albeit mediocre at the golf). I was convinced that after my surgery, I would be back doing the gym and Pilates exercises ASAP. 

It turns out that even though this is my second rotator cuff surgery, I was in SO much pain post-operatively that I could not have fathomed getting back to the gym. Coupled with scheduling issues with my trainer and Pilates instructor because my life had become hectic, I almost couldn’t find a moment to do anything besides work or physical therapy.

 And then the depression strikes. I felt like I was withering away. I wasn’t exercising. I was not riding my horse. I was not playing golf. It was now both physically AND mentally a challenge for me. 

Fast forward, it’s suddenly May. And I start getting back to my gym and pilates. I would lie if I had not started horseback riding and playing golf before Dr. Freeto wanted me to. But I HAD to return to the things I loved for my sanity. 

Let me say that returning to exercise after a long hiatus is painful. I understand why so many people give up. When trying to exercise, things hurt, and pushing through almost feels impossible.

In addition to exercising, feeding your body the right foods to power your exercise is important!

Did you know you can use ChatGPT to help create a weight-loss meal plan? It can be an efficient and personalized way to achieve your health goals. Here’s how you can leverage ChatGPT for this purpose:

Steps to Use ChatGPT for Meal Planning

1. **Define Your Goals**: Clearly state your weight loss goals, including how much weight you want to lose and your desired timeframe. Provide any specific dietary preferences or restrictions (e.g., vegetarian, gluten-free, low-carb). 

2. **Provide Personal Information**: Share relevant details such as age, gender, weight, height, and activity level. This information helps ChatGPT calculate your daily caloric needs more accurately.

3. **Set Nutritional Guidelines**: Specify any macronutrient ratios (carbs, protein, fats) or calorie limits you want to adhere to. For example, you might want a plan focusing on high protein or low carbs.

4. **Request Meal Suggestions**: Ask ChatGPT for meal ideas that fit your criteria. Be specific about the number of meals per day and any snacks you’d like to include. For example, “Can you provide a 7-day meal plan with three meals and two snacks daily?”

 5. **Customize Recipes**: If you have favorite ingredients or dishes, let ChatGPT know so it can incorporate them into your meal plan. You can also ask for alternative recipes if you have allergies or aversions.

 6. **Seek Variety and Balance**: Request various meals to prevent monotony and ensure a balanced intake of essential nutrients. Ask for different cuisines or types of dishes (e.g., salads, soups, stir-fries).

 7. **Incorporate Shopping Lists**: Ask ChatGPT to generate a shopping list based on the meal plan. This can help streamline your grocery shopping and ensure you have all the necessary ingredients.

 8. **Get Tips for Meal Prep**: Request tips for meal prepping and batch cooking to save time during the week. ChatGPT can provide advice on how to store meals and keep ingredients fresh.

 9. **Monitor Progress and Adjust**: Use ChatGPT to periodically review and adjust your meal plan based on your progress. You can share updates on your weight loss journey and ask for tweaks to the plan if necessary.

 ### Example Interaction with ChatGPT

 #### User: 

I want to lose 10 pounds in 2 months. I'm 35, female, 160 pounds, and 5'6" tall. I prefer a low-carb diet and need a meal plan with three meals and two daily snacks. Can you help me create a 7-day meal plan? 

#### ChatGPT:

Absolutely! Here’s a 7-day low-carb meal plan for you:

**Day 1:**

- **Breakfast**: Scrambled eggs with spinach and feta cheese

- **Snack**: Greek yogurt with a handful of almonds

- **Lunch**: Grilled chicken salad with mixed greens, avocado, and olive oil dressing

- **Snack**: Sliced cucumber with hummus

- **Dinner**: Baked salmon with asparagus and a side of cauliflower rice

**Day 2:**

- **Breakfast**: Chia seed pudding with coconut milk and berries

- **Snack**: String cheese and a small apple

- **Lunch**: Turkey lettuce wraps with avocado and bell peppers

- **Snack**: Celery sticks with peanut butter

- **Dinner**: Beef stir-fry with broccoli and bell peppers

...

Would you like me to generate the rest of the week’s plan?

### Additional Features of ChatGPT for Meal Planning

- **Nutritional Information**: ChatGPT can provide calorie counts and macronutrient breakdowns for each meal.

- **Recipe Instructions**: Detailed recipes with step-by-step instructions can be provided for each suggested meal.

- **Substitutions**: If you don't like certain ingredients or have dietary restrictions, ChatGPT can suggest alternatives.

- **Meal Prep Tips**: Guidance on preparing and storing meals in advance can help you stay on track.

Using ChatGPT (link to chatgpt.com) for meal planning not only provides personalized suggestions but also saves time and helps you stay organized, making your weight loss journey smoother and more enjoyable.

These last few weeks, I have been pushing myself to get back to the consistency of exercise I had participated in before my surgery. Additionally, I found many options to help manage the pain and discomfort of starting an exercise program.  

As a pain management physician, I understand the importance of restarting an exercise program cautiously and progressively to avoid exacerbating pain or causing new injuries. Here are some evidence-based tips to help you restart an exercise program, manage delayed onset muscle soreness (DOMS), and maintain consistency.

Tips for Restarting an Exercise Program 

1. **Start Slow and Gradual**: Begin with low-intensity exercises and gradually increase the duration and intensity. Research suggests that starting with low-impact activities like walking, swimming, or cycling can help ease your body into regular exercise without causing excessive strain (American College of Sports Medicine, 2021).

2. **Warm-Up and Cool Down**: Incorporate a proper warm-up before and a cool-down after your exercise routine. This helps prepare your muscles for activity and reduces the risk of injury. A study published in the *Journal of Strength and Conditioning Research* emphasizes the importance of dynamic warm-ups for enhancing performance and preventing injuries (Behm & Chaouachi, 2011).

3. ** Listen to Your Body **: Listen to your body's signals. Stop and rest if you experience pain (not to be confused with normal muscle soreness). Overtraining can lead to injuries and setbacks. 

4. **Use the 10% Rule**: Increase your exercise intensity or duration by no more than 10% per week. This gradual progression helps your body adapt to increased demands without overloading it (Herring et al., 2016).

 5. **Cross-Training**: Engage in different exercises to work various muscle groups and reduce the risk of repetitive strain injuries. Yoga, pilates, and resistance training complement aerobic exercises and improve overall fitness (Warburton & Bredin, 2017).

### Managing Delayed Onset Muscle Soreness (DOMS)

1. **Active Recovery**: Light activities such as walking, stretching, or gentle yoga can help reduce muscle soreness and improve circulation. A review in the *Journal of Athletic Training* indicates that active recovery effectively mitigates DOMS (Dupuy et al., 2018).

 2. **Hydration and Nutrition**: Stay hydrated and consume a balanced diet of protein, vitamins, and minerals. Proper nutrition supports muscle repair and recovery. A study in the *Journal of the International Society of Sports Nutrition* highlights the role of hydration and nutrition in recovery from exercise-induced muscle damage (Kerksick et al., 2017).

 3. **Massage and Foam Rolling**: Self-myofascial release techniques like foam rolling can alleviate muscle tightness and soreness. Research in the *Journal of Athletic Training* shows that foam rolling can reduce the severity of DOMS (Cheatham et al., 2015).

 4. **Cold and Heat Therapy**: Alternating between ice packs and warm compresses can help reduce inflammation and promote muscle relaxation. A meta-analysis in the *Journal of Clinical Rehabilitation* suggests that cold therapy can be particularly effective in the acute phase of DOMS (Bleakley et al., 2012).

Tips for Maintaining Consistency

1. **Set Realistic Goals**: Establish achievable short-term and long-term goals to keep yourself motivated. Goal setting is a well-documented strategy for enhancing exercise adherence (Sniehotta et al., 2005).

2. **Create a Routine**: Designate specific times for exercise and incorporate them into your daily schedule. Consistency is key to forming lasting habits. The *European Journal of Social Psychology* discusses the importance of habit formation in maintaining regular physical activity (Lally et al., 2010). 

3. **Find an Exercise Buddy**: Working out with a friend can provide motivation, accountability, and enjoyment. A British Journal of Health Psychology study found that social support positively influences exercise adherence (Molz et al., 2020).

4. **Track Your Progress**: Keep a journal or use a fitness app to monitor your progress. Tracking improvements can boost motivation and help you stay focused on your goals.

5. **Reward Yourself**: Celebrate your achievements, no matter how small. Rewards can be an effective way to reinforce positive behavior and maintain motivation. 

By following these tips and incorporating these strategies, you can safely and effectively restart your exercise program, manage muscle soreness, and maintain a consistent routine. Always consult a healthcare professional before beginning any new exercise regimen, especially if you have underlying health conditions.

See you at the gym!!!!

 References

- American College of Sports Medicine. (2021). ACSM's Guidelines for Exercise Testing and Prescription.

- Behm, D. G., & Chaouachi, A. (2011). A review of the acute effects of static and dynamic stretching on performance. *Journal of Strength and Conditioning Research, 25*(11), 3159-3174.

- Bleakley, C. M., Costello, J. T., & Glasgow, P. D. (2012). Should athletes use ice baths after training? A systematic review of the clinical evidence. *Journal of Clinical Rehabilitation, 26*(7), 639-653.

- Cheatham, S. W., Kolber, M. J., Cain, M., & Lee, M. (2015). The effects of self-myofascial release using a foam roll or roller massager on joint range of motion, muscle recovery, and performance: a systematic review. *Journal of Athletic Training, 50*(1), 30-36.

- Dupuy, O., Douzi, W., Theurot, D., Bosquet, L., & Dugué, B. (2018). An evidence-based approach for choosing post-exercise recovery techniques to reduce markers of muscle damage, soreness, fatigue, and inflammation: a systematic review with meta-analysis. *Journal of Athletic Training, 53*(2), 144-157.

- Herring, M. P., Campbell, M. J., & Rhudy, J. L. (2016). Psychological stress and self-reported physical activity in relation to pain sensitivity: a population-based study. *The Clinical Journal of Pain, 32*(11), 955-964.

- Kerksick, C., Harvey, T., Stout, J., Campbell, B., Wilborn, C., Kreider, R., ... & Kreider, R. (2017). International Society of Sports Nutrition position stand: Nutrient timing. *Journal of the International Society of Sports Nutrition, 5*(1), 1-23.

- Lally, P., Van Jaarsveld, C. H. M., Potts, H. W. W., & Wardle, J. (2010). How are habits formed: Modelling habit formation in the real world. *European Journal of Social Psychology, 40*(6), 998-1009.

- Molz, P., Davis, E., & Begg, M. (2020). Social support and exercise adherence: A meta-analysis of group vs. individual interventions. *British Journal of Health Psychology, 25*(4), 987-1004.

- Sniehotta, F. F., Schwarzer, R., Scholz, U., & Schüz, B. (2005). Action planning and coping planning for long-term lifestyle change: Theory and assessment. *European Journal of Social Psychology, 35*(4), 565-576.

- Warburton, D. E. R., & Bredin, S. S. D. (2017). Health benefits of physical activity: A systematic review of current systematic reviews. *Current Opinion in Cardiology, 32*(5), 541-556.

--