How Do You Manage Your Health?

Stanton Shanedling: Hello, everybody! Welcome to today's show on Health Chatter. The subject is: how do you manage your health? We're only going to have the Health Chatter crew talk about this. It'll be an interesting discussion, for sure. We've got a great crew. As always, they help us make these shows successful and interesting and get them out to you, the listening audience. Maddy Levine-Wolf is helping us today with the recording and also does background research for us. Aaron Collins will be with us shortly and does background research. Deondra Howard, Matthew Campbell is our production master, who gets the shows out to you with a little music attached to it. And then, of course, there's Sheridan Nygard, who helps us with research and also transcribing the shows on our website. My partners in crime here are Clarence Jones and also Dr. Barry Baines, who should have some interesting insights today for today's show on managing your health. So, thank you to everyone—your great colleagues and friends. Human Partnership is our host, co-host, and sponsor for our shows, and they're a great community health organization. Check them out at humanpartnershipalliance.org, and check us out at HealthChatterPodcast.com. All our shows are available on the website. Our background research is also available. From time to time, we add research to particular shows as guests send us information. Also, if you have questions or comments, feel free to check us out there as well. Again, healthchatterpodcast.com. So today's show, like I mentioned, is about how you manage your health. I was thinking about this two months ago and thought, God, that would be just an interesting question because I'm sure we all manage our health differently to a certain extent. I also have a feeling that it's a function of age. I also believe it's a function of whether or not you have a particular medical condition that you're dealing with, either acutely or chronically. But regardless, we're in this mode of managing our health.

Stanton Shanedling: So, Barry, I'm going to let you kick it off a little bit. Just say, okay, what's the story here? You're a doctor, you've seen patients all your career. What is it about managing our health?

Dr. Barry Baines: Well, like I say, it is a lot to talk about, so I'm going to ask you and Clarence to give me the high sign when you want me to pause.

Stanton Shanedling: Okay, I just did. No, I mean… go ahead.

Dr. Barry Baines: You know, both of you have been involved in public health and community health for a long time. From my perch, I was more in the weeds, in the sense of being on the frontline seeing patients. My perspective is that prevention is always the catchword for managing your health, but it's changed in a way that offers opportunities for people to manage their health better. The flip side is that the information can be overwhelming. It's one thing to go to a grocery store and pick one of three salsas for your chips; another when there are a hundred jars. How do you choose? It's overload, and you get paralyzed in making decisions. When we were discussing managing your health, the thing that came to mind is mostly primary prevention. I think we should nail down some definitions so our audience understands: there’s primary, secondary, and tertiary prevention. Primary prevention is where you prevent an illness or disease from ever happening. One example is vaccines: get a vaccine for polio and you never get polio, a vaccine for measles and you never get measles.

Stanton Shanedling: Yeah, and there’s another aspect too, like wearing your seatbelt.

Dr. Barry Baines: Yes, right. Behavioral actions are part of it. That’s a big part. That appeals to me the most because it has the biggest impact if you can prevent something before it happens. Secondary prevention focuses on early diagnosis and interventions. For example, through regular checkups, if someone is found to have adult-onset diabetes, you can intervene early with lifestyle changes and medications to prevent worsening. Tertiary prevention is where you try to limit disability and death.

Stanton Shanedling: In public health, we defined secondary prevention as diagnosis and treatment, including screening. Tertiary prevention includes rehabilitation. What's interesting is that prevention can be circular: if you have a heart attack and live through it, your rehab and medication become primary prevention for another episode.

Dr. Barry Baines: Exactly. I'd like to focus on primary prevention: things you can do to prevent disease, follow through with early diagnosis, and even in later stages, these are fundamental building blocks of managing your health. Medicines play a role, mainly in secondary and tertiary prevention. My small list for managing health includes: exercising, attention to nutrition, getting enough sleep, maintaining social relationships, and limiting sedentary time.For exercise, even a 10-minute walk three times a day can have amazing physical and mental health benefits. You don’t need to lift weights five times a week or run marathons. The key is finding an activity you like.

Stanton Shanedling: I wonder if people are negative about exercise because they don't see immediate results.

Dr. Barry Baines: You need faith and trust. The benefit is often what you avoid. You may not see immediate results, but exercise improves cardiovascular and mental health over time. Walking is one of the best exercises if you have no mobility issues.  Eating well means fruits, vegetables, and whole grains. Even in food deserts, including these in your daily diet has a big impact. Food prices and accessibility can make this harder, but the principle is simple: eat healthily every day.

Stanton Shanedling: That’s number two.

Dr. Barry Baines: Number three is sleep. Lack of sleep contributes to Alzheimer's and other cognitive problems. Sleep is when the brain processes information. Most adults need 7–9 hours. Less than that affects concentration, focus, and overall health, including cardiovascular issues.

Stanton Shanedling: So that's number 3.

Clarence (9): That's number three. And then number four is this idea of having a social community, having interactions, relationships with people. I think we talked about one time on the Blue Zones. You know, looking at the five different communities—Dan Kuttner, is that the… correct? He looked at five communities around the world where, like, the number of people who live… you know, talk about longevity, right? The number of centenarians, people who live over 100. They also, on the nutrition side, add nuts, like, the importance of cashews, Brazil nuts, and nuts and seeds—they are really, really important. But this idea of having social relationships and social connections… again, we've had shows and podcasts talking about the effect of isolation on mental health. Right?

Stanton Shanedling: Yeah, we could even talk about that as it related to COVID, where people became more isolated, and I think the jury is still out on the effects of that.

Clarence (9): Yeah, yeah. And so the social isolation—the social piece—is very important, and it also supports other things. Well, what do I mean by that? You know, I have a group of people that we started off running with; now we walk most of the time. But, you know, if I was going to have to get up and go by myself…You know?

Stanton Shanedling: Hard.

Clarence (9): That’s tough. That was tough.

Stanton Shanedling: She had a dog.

Clarence (9): One, two, three, or four of my friends standing outside my door waiting for me. That's the social piece that encourages activity, and so…

Stanton Shanedling: It's social, not guilt.

Clarence (9): That's right. Yeah, we should do a show on gifts.

Stanton Shanedling: Alright, number 5! Number 5!

Clarence (9): And then the last one is this whole idea that so many of our jobs are sedentary. And we sit too much. For me, fortunately, I have one of these watches that, if I don't stand in an hour, it dings and says, “Hey, it's time for you to…”

Stanton Shanedling: Stand up.

Clarence (9): I walk around for a minute. If you can't do your work standing up and you're sitting most of the time, every hour you should just get up and walk around for a minute, because they're finding that not only is sitting too much really bad for you, but in a number of different ways.

Clarence (9): Sitting contributes to arthritis in your neck and shoulders, because you're…

Stanton Shanedling: Right, right.

Clarence (9): Punched up. Things like that. Even while you're doing that, you can do some yoga stretches or whatever to limber up. But getting up every hour during the day is important—you don’t have to do this at night.

Clarence (9): They're finding that a sedentary lifestyle is worse than… the equivalent of smoking a pack of cigarettes every day.

Stanton Shanedling: Yeah.

Stanton Shanedling: So, what's interesting about all of this is… you're telling us what we should be doing.

Stanton Shanedling: The question is, how do you manage your health? Do you exercise? Do you eat properly? Do you have social contacts, etc.? Alright, Aaron, are you there?

Stanton Shanedling: Aaron, Aaron!

Erin Collins: Here.

Stanton Shanedling: All right, you're an important voice in this discussion on how you manage your health. I’ll start with you, Aaron. You’ve made it known on our shows that you’re diabetic. How did you manage your health before diagnosis versus now?

Erin Collins: I think my answer is really simple. Before getting diagnosed with Type 1, I was healthy and didn't have to think twice about health. I didn’t see the doctor more than once a year, worked out, ate well, and had a generally healthy lifestyle. After diagnosis, I see my doctor quarterly, different specialists, and my primary care twice a year to ensure everyone is on the same page. I’m much more proactive now—a preventative mindset. I don’t want to end up back in the hospital, so I keep it at the forefront and stay up to date with preventative visits. It’s just a good mindset.

Stanton Shanedling: So, alright, Clarence.

Clarence Jones: I’m glad Aaron went first—it’s interesting. Managing my health wasn’t on my mind when I was younger. I’d see older people worrying about health and think, “Don’t you have something better to do?”

Clarence Jones: But as you get older, you notice different issues. For me, as a Black male, certain health concerns became relevant. I had to decide whether I was willing to take actions, like prostate exams, dietary changes for pre-diabetes, etc. Managing health involves awareness, willingness to act, and emotional/mental readiness.

Clarence Jones: For example, I had a higher PSA 8–10 years ago. I did “watchful waiting” before having surgery. I monitored, made decisions, and adjusted. Same with pre-diabetes—deciding whether to follow guidance or not. Health management also involves emotional response until ignoring it is no longer an option. Awareness and action are key.

Stanton Shanedling: Yeah, when I reflect, certain things happen, and you have to adjust. I had both knees replaced and detached retinas in both eyes. Recently, I had an eye exam, and the ophthalmologist checked the retinas first, knowing it was on my mind. This ties into how providers and technology help manage health. Erin, you researched this—like MyChart, watches, and other devices that track ECG, pulse, steps, and reminders. Apps also track yoga, meals, and exercise. Technology helps manage health. Clarence, thoughts?

Clarence Jones: I got a watch in the last two weeks. Interesting to see what it indicates. My sleep was 4 hours 15 minutes one night. Heart rate, blood oxygen, all that—technology provides data to make informed decisions. Balance tech with personal awareness.

Stanton Shanedling: For our audience, who uses one of these watches? How do you use it?

Clarence (9): I like the Apple Watch because I have atrial fibrillation at times. Apps are good tools for motivation. In public health, there’s the concept of readiness for change—you can only act if motivated. As a person, it helps me keep track and motivates me, e.g., walking my dog to close my exercise ring. As a physician, the data can help doctors get a bigger picture.

Clarence (9): For example, I showed my cardiologist my AFib history over six months. These tools, like diabetes monitors, provide continuous data for better management.

Stanton Shanedling: Aaron, you use a monitor for health. Thoughts?

Erin Collins: I like it for fitness tracking and heart rate zone training. I’m religious about sleep—usually 8–9 hours. On poor sleep nights, I adjust my activity. I also view my continuous glucose monitor on my watch, which is convenient. Technology helps monitor health, track patterns, and inform decisions.

Erin Collins: Like, keeps you accountable for your health or something. I remember you were asking

Erin Collins: what sort of things you use for that, and I… I feel like I have a very strong opinion on this, that it's… it's…

Erin Collins: not really your doctor's job to keep you accountable, right? Their doctor's job is

Erin Collins: to give you advice to keep you healthy, but like Barry said, at the end of the day, if there's no mindset on your part of wanting to change, and wanting to be engaged in that aspect of your life, and keeping… keeping yourself healthy, then…

Erin Collins: it's just not gonna work that way. Like, we need to find a way to engage people in their health and stay interested in their health.

Erin Collins: I don't think people are going to take anything their doctor has to say to heart if they're not in the mindset of wanting to be healthy.

Stanton Shanedling: You know, as it relates to that a little bit,

Stanton Shanedling: certain people are scared into doing certain things for their health, as well, okay? And, like, for instance, you might get into a car accident.

Stanton Shanedling: And you haven't been wearing your seatbelt, and now you do.

Stanton Shanedling: Okay? It's after the fact, or you've had… you've experienced a heart attack, or you've had a stroke. Oh, geez, I have to adjust my lifestyle.

Stanton Shanedling: now. And it also doesn't always depend upon you doing it. It also, if you have a significant other, you know, they're involved in it

Stanton Shanedling: as well. Maddie, are you there?

Maddy: Yeah, I'm here.

Stanton Shanedling: What do you think? Got any thoughts on all of this?

Maddy: …

Stanton Shanedling: Alright, let me put it this way, how do you manage your health?

Maddy: That's a good question. Honestly, you might wanna… Matt, you might wanna cut out this part, because I don't really have a fully formed thought that I wanna share.

Maddy: I've mostly been just, like, listening and absorbing…

Maddy: I manage my health mostly by…

Maddy: just trying to eat, quote-unquote healthy, whatever that means, because I feel like there are different definitions, and making sure that I'm moving my body to some extent throughout the day. And then also keeping up with my, like, annual physical appointments, whether that's, like…

Maddy: my annual physical with my primary physician, my annual body scan with my dermatologist…

Maddy: and things like that, because I think… You know, there are different…

Maddy: parts of your health that you…

Clarence Jones: Don't stop you.

Maddy: have to keep up with in order to have, like, a holistic approach. You know, seeing the dentist every six months, like, that's part of your overall health. So, I think it's a combination of doing things on my own, like Erin said, you know, it's my responsibility to manage my own health, and then…

Maddy: making sure I'm keeping up with my appointments and everything, too, to make sure that I'm getting, like, the professional opinions as to how my health …is… looking.

Stanton Shanedling: So, do you find, as health professionals—I mean, we're all health professionals—do you find that you give advice to others? Whether it's your friends, significant others, family, whatever, do you… do you get into that mode, or do you try to… do we try to stay away from it? What do you think, Barry?

Clarence (9): I'm being asked for advice. A fair amount… a fair amount, you know? And that's… and that's okay. I usually, again, couch it in a term that it puts it back, I think, as Erin and Maddie said, you know, it's not my decision, it's your decision. Here's information. And, you know, hopefully you… will choose the healthy track, or if not now, maybe at some point in the future. So, you know, yeah, I mean, I get, you know, we talk about health things a lot, but oftentimes the other, the other issue, of course, is not only what you talk about, but when you're with your friends, there's also things like leading by example. Like, yeah, you gotta eat healthy, please pass me the cheese danish. Yeah, so… And typically, the answer to that's good for your mental health, right? You know, so it's, you know, it's a mix of things. But I think that idea is, again, trying to, you know, live healthily. And part of it is at least, you know, whether we do these things or not. The first step is to know what are the kind of things that you could do, because the reality is you can't do everything all at once. I mean, there's only 24 hours in the day, and if you have to sleep for 7 to 9 of them, you know, okay. Right. One thing is, you know… so, the person who exercised 12 hours a day so that he could live 5 years longer, those 5 years were actually just spent exercising.

Stanton Shanedling: Right, right, right, right. So, alright, we're gonna wrap it up here. So, I've got…I'm just gonna throw this out, and I'll let everybody, the audience, think about that. There are other things as well that affect our health. Like, for instance, climate.

Stanton Shanedling: Okay? That individually, you might not think that you have as much of a choice on how to affect it, but if we all, somehow or other, we're more cognizant of things in the climate, maybe that would… that would have an adjustment to our health. So here are… here are a couple of words that I think, kind of nail it, at least for me.

Stanton Shanedling: 1. Listen. Listen to your body. And adjust accordingly. If something hurts after you've done a bunch of exercise, okay, listen to your body, your body's telling you, and you might slow it down a little bit the next day. Adjust. I think we get into the mode of adjusting, especially after we've had an event. Continue to do it, even if you have your ups and downs. As long as you continue, I think that really helps to manage. And then finally, although this isn't one word, there's no need to be perfect. You really… just, like, you know, Barry, you were saying, 10 minutes! Your body will love you for it. Okay, Clarence, last… last thoughts?

Clarence Jones: You know, this has really been an interesting conversation, and I do believe that it's important to talk about it.

Stanton Shanedling: I think it's important to enter into the conversation, because I think, you know, as we said a little bit earlier, when you…

Clarence Jones: When you're young, you don't think about it, but…I think our health is important, and to be able to do that in a way in which you feel like you can actually do something and make some positive changes, you know, it's great. So this conversation is good to have.

Stanton Shanedling: Yeah, and it's good to share it with other people. Barry.

Clarence (9): Three quick points. One builds on yours, Stan, and that is, the saying, perfect is the enemy of good enough. Okay? So, you know, if it's good enough, it's okay. The other thing I want to strongly advocate for is to be kind to yourself. Be forgiving.

Stanton Shanedling: That's a great one, yeah.

Clarence (9): Forgiving of yourself. And then the last one is that the idea of managing health— what's the goal? And the goal usually is that so you can live a life where you get to do the things that you want to do.

Stanton Shanedling: And you feel better.

Clarence (9): And that you enjoy, so…That's all I have to say.

Stanton Shanedling: And I hope that, you know, for our listening audience…

Clarence (9): You take some of these ideas and…

Stanton Shanedling: quote, run with them, unquote.

Stanton Shanedling: So, great, great, great show, everybody. Our next show that we're gonna be doing is on meditation and health, which is actually kind of a nice linkage

Stanton Shanedling: to this show. Okay? It's like, what do you do to kind of slow it down and relax and breathe? And we're going to be talking that with Dr. David Alter on our next show. So, thanks to all of you, great insights, and thanks to you, the listening audience, and remember to keep health chatting away!