January: Achieving Your Goals in 2018!
Setting meaningful goals for your better health in 2018 is important. How you go about it is even more so. I like the SMARTS goals approach. SMARTS goals need to be Specific, Measurable, Achievable, Realistic, Timely, and Sustainable. For example, rather than focus on an elusive goal such as weight loss, consider lower blood pressure or lower fasting blood glucose as a Specific goal. These are Measurable, Realistic, and Achievable for most individuals using simple equipment and a variety of do-it-yourself interventions often without medication. Let me know what your health SMARTS goals are for 2018 and I can help you get there in a Timely fashion. Timely, by the way, does not mean instantaneous. One of my favorite sayings is, "Go slow to go fast!" Slow and steady wins the race and leads to Sustainable goal achievement.
John A. Schmidt, MD
My TWO Picks for SMART Goals in 2018
My top two recommended SMARTS goals for 2018 are normal blood pressure
and smoking cessation. As discussed in previous newsletters, high blood pressure is dangerous
, prevalent and silent.
A Perspective Article published online in the
New England Journal of Medicine
on January 17 reminds us that blood pressure is best measured in the comfort of your home.
Simple measures such as salt restriction and exercise make it Realistic.
The goal is a morning blood pressure less than 130/80. And if salt restriction and aerobic exercise doesn't get you there, generic medicines with essentially no side effects make normal blood pressure Achievable for almost everyone.
My second recommended SMARTS goal for 2018 is smoking cessation. Some might challenge the Achievability of this goal because nicotine is so addicting and such a hard habit to kick. Progress is Measured not by the number of cigarettes smoked in a day, a common misconception known as "cutting back," but by the number of days without a single cigarette. By stopping cold turkey and counting/extending the number of days between relapses, one can eventually Achieve a smoke-free lifestyle. Attaching rewards can also help. For example, the money saved can be used for a wonderful evening at a movie theater or your favorite local bistro with the one you love! (Note: I will write a prescription for nicotine patches, bupropion, or Chantix® for anyone without an appointment. Just call my office with the person's name, date of birth, and mailing address.)
SMARTS Goals and STRETCH Goals
Whereas SMARTS goals are often achievable by self-disciplined persons, STRETCH goals
are more challenging even for the most determined.
View STRETCH goals as a bonus in your quest for better health.
An example might be a
lower hemoglobin A1c
which will require caloric restriction, vigorous aerobic exercise, and avoidance of sugary foods, white potatoes, chips, and Super Bowl food!! To tackle a STRETCH goal (pardon the pun), you have to reflect on what motivates you. A number on a lab report may not do it for you. But attach that number to a lifelong dream, an important relationship, a team effort, and, best of all, altruism for another person, and you have a good chance of achieving it. This requires some introspection to find out what motivates you. To get started, view the TED talks
on motivation. You will learn things that will help you and the people you care about attain your personal health goals together!
With all due respect to Don Quixote
, the beloved
Man of la Mancha
, Dreams are not goals. I am amazed by patients who have "goals" built on hopes rather than plans.
I have to be careful here.
Envisioning how much better you will feel three months smoke-free is not a dream; it's a forecast, a key step in goal Achievement. Dreams, on the other hand, are diversions from reality that only serve to distract us from our goals.
Purveyors of "
, and quick-fix fads of all kinds use dreams as a billboard tactic to entice the unwary. There are no short cuts to goal attainment.
Only hard work and perseverance will succeed!
Rate of Heart Attack Increases Dramatically During the Week Following Influenza or other Respiratory Infection
As published in the Jan 25 issue of the New England Journal of Medicine
, the rate of
(heart attack) increases approximately 6 times during the seven days following a documented case of
. Why? Influenza is a serious infection that puts a load on your heart, just like shoveling snow. A heart attack can turn an episode of influenza into a life-long crippling event.
There are two take-home messages: First, schedule your
every year to prevent influenza and the complications of flu infection, such as heart attack. Wash your hands with soap and water, keep your hands away from your face, and avoid sick contacts. Second, it's about time that the
National Institutes of Health
work harder to develop a "universal" flu vaccine that consistently provides reliable patient protection season after season!!
Allscripts Temporarily Brought to its Knees by Ransomware!
I subscribe to Allscripts
, one of the nation's leading providers of cloud-based
Electronic Medical Records
(EMR), to safeguard your personal health information
(PHI). Sorry to say, after more than six years of reliable service, Allscripts's firewall was breached by ransomware. The attack occurred on the evening of Wednesday, January 17. Allscripts responded appropriately by quarantining their servers in Raleigh, NC, thus denying my office access to your PHI. The good news is that your PHI was not compromised. The bad news is that we were unable to serve you adequately for the next eight days while Allscripts purged and rebuilt their servers in Raleigh. Please keep in mind that everything we do including scheduling, messages, refills, fax transmissions, and referrals requires access to your PHI with Allscripts. I sincerely apologize for this breakdown and appreciate your patience!! Now that we are up and running again, please call the office at (732)-282-8166 and we will do our utmost to catch up and address your needs!!
Doctor-Patient Relationship in Reverse!
During the Allscripts meltdown, I was having a challenge of my own! My dear wife suddenly needed open heart surgery
! A retired cardiologist, the mother of four and grandmother of four beauties, my wife decided to have her surgery at
Jersey Shore University Medical Center
. The doctors, nurses, and staff were unbelievable in their care and they saved her life!!
Now that caring nurses and therapists are coming to our home every day, I have a new appreciation for all the caregivers necessary to return a person to health!! To say that we are grateful does not begin to express our gratitude!
As a doctor, you think you know everything. It's not until someone you love is a patient, that you begin to understand!
Valerie, Morgan, Amanda, Ms. Clark and I are back at full strength following the Allscripts outage. We are grateful for your patience and understanding!
Board Certified Internist
Dr. Schmidt is one of the leading internists in Monmouth County offering
He is an attending physician at Jersey Shore University Medical Center.
Dr. Schmidt is enrolled in the Maintenance of Certification Program of the American Board of Internal Medicine
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"And now we welcome the new year, full of things that have never been."
- Rainer Marie Rilke