What does your future look like if your lifestyle remains the same?

If you’re thinking about a healthy lifestyle change, you’re not alone. Per the Center for Disease Control, 6 in 10 adults have a chronic disease, 4 in 10 have two or more, and America spends $4.1 Trillion in annual Health Care costs (1). Yikes!

In 2020, the pandemic struck and further illustrated the importance of our individual health and illuminated the fact that many of us are more than just physically unwell, but holistically unwell. We are physically, mentally, emotionally, socially, and spiritually drained. As a community, we started to ask ourselves some important questions:

• What does optimal health and well-being mean to me? 

• Why am I feeling dis-ease throughout my day? 

• Is there a correlation between my lifestyle and existing health problems?

So, what would a healthy lifestyle change entail? Let’s start with a better understanding of the stages of change and how one might modify health behaviors over time.

A popular theory utilized by clinicians and coaches is Prochaska et al. (1992) Stages of Change Theory or Transtheoretical Model (TTM). A recent study concluded, “Treatment becomes personalized based on the individual and the stage in which they reside. With this method, “change behavior” is thought of as a fluid and dynamic evolution, with possible recycling of stages, rather than focusing on the end goal of change.” (2).

The five stages include:

• Pre-Contemplation 

• Contemplation 

• Preparation

• Action

• Maintenance.

Example Scenario:

Katherine is 46, married for 21 years and has two children. Katherine works full time as a manager of a daycare and is settled into a routine of spending time with her family, working, daily walks, volunteering at church, and traveling with friends. Recently her mom started having additional symptoms of high blood pressure and difficulties ambulating around her home. Her mom is her best friend and always there for her, so Katherine didn’t hesitate to jump into action as the role of her primary caregiver. She started cooking, cleaning, running errands, and taking her to doctor’s appointments. With her new role, Katherine started to put her routine of self-care on the back burner (i.e., walks, volunteering at church, spending time with family, and traveling with friends). About 10 months into her new role, Katherine starts to feel dizzy at least once a day but doesn’t pay much attention to it. She’s always been healthy and thinks it’s probably nothing. 

After a couple of weeks, Katherine decides maybe she should set up an appointment with her primary care physician to ask about the dizziness. At the appointment, the physician completes the assessment, takes labs, and asks Katherine if she’s staying hydrated. Katherine responds, “yes” and the doctor asks if she has any further questions. Katherine responds, “no” and the physician has the nurse discharge her home with a prescription and mentions to contact the office if she continues to feel dizzy. The office would call with lab results and request a follow-up in 6 months.

Pre-Contemplation

Katherine walks out to the car and her husband asks, “Katy, what did the doctor say?”. Katherine replied, “I think I’m okay, he gave me a prescription and said to stay hydrated. I told him I do; I mean, I drink 3 cups of coffee every day and it keeps me running to the bathroom all day and night. What does he want me to do? Wear diapers?” They share a chuckle, fill the prescription, and continue with their day-to-day routine.

In the precontemplation stage, you may not be fully convinced a change is necessary. This period is thought of as the denial stage or when rationalizing current behaviors is the primary focus. Often the health goal and motivation are initiated by an external source (i.e., health professional, family, or friend). In general, the perceived benefits do not outweigh the perceived effort to change. 

In our scenario, Katherine is focused on her roles and responsibilities at home and work. She feels somewhat healthy and that her current behavior of drinking coffee is adequate hydration. This experience happens often when our body is giving us a message and we often dismiss it over time by saying, “I’m fine” or “I’m too busy”.

During this stage it is a great opportunity to define what optimal health means to you, now and in the future. Begin to create a list of questions, concerns, or barriers. 

Katherine might start to ponder: “What caused me to feel dizzy (root cause)? Will I be on this prescription for the rest of my life? Why did the physician ask about my hydration? Am I dehydrated? Does dehydration cause dizziness? Are 3 cups of coffee enough fluids? Why am I running to the bathroom all day and night?”

Contemplation

Katherine continues with her routine and takes the medication as instructed. The labs come back as normal, and she doesn’t notice the dizziness as often. After about 5 months, Katherine is feeling more tired throughout the day and last night, she tripped over the bedroom rug walking to the bathroom. She twisted her ankle but determined she didn't need to have it checked out. The following week she returns to the doctor to have her 6-month follow-up and prescription refilled. At the visit, Katherine mentions her fall during conversation. It prompted the doctor to ask additional questions and open the door for Katherine to feel more comfortable. Katherine decided to ask further about hydration, current fluid consumption, and her frequent trips to the restroom. Over the conversation, the doctor gained insight into Katherines many roles and responsibilities and how her routine had drastically changed over the last 2 years. The doctor reviewed the physiological effects of stress over time and caffeine on the bladder. Again, the doctor encourages Katherine to drink more water, decrease caffeine, and try to rest when possible.

During the contemplation stage, you have identified a health behavior that you are thinking about changing but are sorting through feelings about the change. You have more information gathered and begin evaluating the pros and cons of implementing the change. You are starting to think of strategies to overcome barriers that may trigger feelings of uncertainty.

For Katherine, her minor fall really scared her. She started to play out the “what if” scenarios in her head. “What would happen if I couldn’t take care of my family or unable to work” or “What if I start to have heart issues, could we afford it?” She started to see the benefits of remaining healthy but concerned she wouldn’t find the time to start healthy habits or rest. Where would she begin her health journey? 

If you find yourself in the contemplation stage, continue to play out the “what if” scenarios with possible solutions. Write out a list of pros and cons of the behavior change.

Preparation

Katherine decides it’s worth a try and begins to plan how to implement water into her routine. She gets on the computer and calculates how much water she should be drinking daily. Wow, that seems like a lot compared to what she’s been drinking. She also wants to drink less coffee. She starts off strong and maintains for a few days, but with her busy schedule, she often finds the day has passed and it’s too late to catch up before bed. 

During the preparation stage, you have found ways to overcome the previous feelings of ambivalence and believe change is possible. You have determined the benefits outweigh the comfort of a familiar routine causing health challenges. You have started the planning process and are taking small steps of action towards the goal. Note: It is best practice to start with a goal that is specific, measurable, actionable, realistic, and time-bound (SMART).

Action 

Katherine starts to feel the difference in her body when she remembers to drink her water and is fully committed. She starts every day with a glass of water and takes a water bottle with her when she leaves the home. She drinks one cup of coffee in the morning before work and does avoids caffeine for the rest of the day. At 5 pm, she sets an alarm to check her daily water consumption and drinks the remaining water before 7 pm. At 7 pm, she stops drinking fluids to ensure she gets a good night’s rest without running to the bathroom.  

The action stage gets exciting! You are putting your SMART goal into action and seeing progress. Katherine is feeling better and found a routine that works for her. During the action stage, you are committed and have personalized your routine for consistent behavior change. You are aligned with your strengths and motivated to reach your health goal. Note: This is a time where a relapse to old patterns and behaviors can occur. Do not despair, this is not a failure, but an opportunity to reflect on your “why”, modify strategies, and get back in the game. Round up your support team, affirmations, and vision board! This will help encourage you during times of setbacks. 

Maintenance

Katherine has consistently followed her new routine for months and talks with the physician about stopping the medication. She hasn’t felt dizzy and even swapped out her cup of joe to a caffeine-free tea in the morning. She’s back to her daily walks, volunteering with her mom, and spending time with friends. Katherine has successfully adapted her lifestyle to include her health and well-being while maintaining her roles and responsibilities!  

During the maintenance stage, you have developed a new healthy habit! You are reaping the rewards of your desired change and confident in your new lifestyle. The habit is so comfortable you can hardly remember a time it wasn’t part of your daily routine…like brushing your teeth. You might even start thinking of ways your experience and skills can help you achieve new goals. 

Summary

Many of today’s chronic dis-ease can be traced back to lifestyle behavior, food choice, minimal to no activity, stress, and exposure to environmental toxins. In Katherine’s situation, she started her journey with a symptom of dizziness. She learned how caregiver fatigue, dehydration, caffeine, and stress were disrupting her day-to-day routine with physiological symptoms and the potential consequences it could have on her health now and in the future. 

When we nurture the most valuable human asset—health and well-being—we can achieve an optimal quality of life!  Embrace those internal messages and physiological changes. They have sparked your inner wisdom, intuition, and innate ability to determine the next steps in your health journey. Behavior change is possible! You can get back in the driver seat and feel whole.  

If you would like to learn more about Sensibly Holistic and how a board-certified nurse coach can support you in your journey to optimal health and well-being, please request a free consultation. We promise to meet you where you’re at, looking at all areas of your life and the relationships between your lifestyle behaviors and dis-ease.

References

National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). (2022, July 21). Retrieved from Centers of Disease Control and Prevention: https://www.cdc.gov/chronicdisease/about/index.htm

Raihan, N., & Cogburn, M. (2022). Stages of Change Theory. National Library of Medicine.

This information is for educational and informational purposes only and solely as a self-help tool for your own use. I am not providing medical, psychological, or nutrition therapy advice. You should not use this information to diagnose or treat any health problems or illnesses without consulting your own medical practitioner. Always seek the advice of your own medical practitioner and/or mental health provider about your specific health situation. For my full Disclaimer, please go to www.sensiblyholisticllc.com/disclaimer.