- The Washington Times - Tuesday, February 11, 2003

Doctors have long had a reputation for not taking enough care of their own health needs, which makes the familiar phrase "Physician, heal thyself" a doubtful prescription.
"We tend to diagnose ourselves," says Dr. Angela Patterson, 39, a neonatologist, a specialist in the study of the disorders and development of newborns, at Washington Hospital Center. "We are too busy taking care of other people. We don't take enough time for ourselves, although the single ones take a lot more care of themselves than the married ones."
Even so, that picture is changing. Many doctors have come to see that part of their job is to be a role model, especially for patients with health problems.

"Something is different now," says Dr. Marie Pennanen, a surgeon and associate professor at Georgetown University Medical Center. "When I started medical school, everyone smoked and drank, but I think there has been an attitude change in the past five to 10 years."
Dr. Richard Pestell, director of Georgetown's Lombardi Cancer Center, agrees that doctors are expected to lead the way. "It's important to practice what you preach and set an example for patients," he says.

How do today's doctors take care of themselves?
Dr. Ramin Ofkoui, 38, a cardiologist at the Washington Hospital Center, was 20 pounds too heavy when he took some advice from a patient: Try a low-carbohydrate diet. It worked.
"It was crucial," he says.
His extra weight had come through eating unhealthily and doing it late at night when he was working hard. Today, at 5 feet 10, he weighs 185 pounds and seems determined not to go back.
He gets up at 5 or 5:15 a.m. and works out daily and weekends on a machine he calls a cross-aerobic system made by Stairmaster.
"It's very intensive, and because of the way it is configured, you can't cheat," he says. "I like a machine because it is all-weather and has no impact on joints. I had some knee problems when I was a skier and had done biking but was almost killed by a driver in a car.
"I think you need to do something you enjoy. People don't do enough exercise. They look at it as a burden instead. I watch TV while doing it CNN every morning. On vacation, I scuba dive since I would rather go someplace warm and tropical than cold."
A graduate of Georgetown and Columbia universities, he teaches at both Georgetown and George Washington University medical centers. Dr. Oskoui is equally controlled about diet choices far more than most health-conscious people. He avoids almost all white starches including white rice, potatoes, pasta and bread in favor of whole grains.
"It's very hard to change one's habits, since for many people food is comfort and bad foods are easy to obtain. Also, it's easy to function in society without exercise since you don't have to chop wood or even walk," he says.
"Foods we eat generally are calorically dense and unhealthy," he asserts. "Unfortunately, we still imbibe a lot of carbohydrates late at night."
For dinner, he has a low-fat cut of meat with a bowl of vegetables and maybe some fruit. He drinks "a fair amount of water" daily and has dessert just once or twice a week at the most. He seldom drinks alcohol "because I am on call so often."
He advises others to err on the side of caution, believing that "it is clearly not a free ride. The American Heart Association says that if you aren't drinking, don't start for the heart's sake, and I agree with them."
The most important point: No matter what your diet, "you have to complement it with exercise," he insists.

Dr. Patterson, the neonatologist at Washington Hospital Center, is a kickboxer and a tae kwon do advocate.
The sport of kickboxing she calls "awesome, because it is cardio-involved, and you probably get 20 good minutes of upper arm work hitting a punching bag with gloves. It is a good way to relieve yourself of frustrations if your kid or your work is driving you crazy."
Plus, she adds jokingly, "you gain a lot of respect from people who know Mike Tyson or George Foreman." Both she and her husband have a pair of boxing gloves and belong to a kickboxing club.
In medical school at Howard University College of Medicine, where she teaches in the department of pediatrics, Dr. Patterson did aerobics and for a while swam a mile twice a week.
Now, only weeks after giving birth to a second child by Caesarean, she has a slightly reduced athletic schedule, but she says she fully intends to return to tae kwon do to earn a black belt. It will mean training two or three times a week at a studio around the corner from her home right before dinner and on weekend mornings while juggling a session with her 2-year-old daughter's gymnastics class.
"She needs her exercise, too," says the peripatetic doctor, who says she has lost 20 pounds in the eight weeks since she gave birth. Breast feeding helps with slimming, she notes, but she also has gone on what she calls "a modified Atkins diet." That means cutting back on carbohydrates and drinking a lot of water.
Now back working full time, she relies on a home elliptical exercise machine that she describes as a cross between a Stairmaster and a treadmill.
"Exercise renews your energy and helps [you] get through work, keep up with the kids and not want to kill them," she says with a laugh.
Having a partner "who is equally interested in trying to reach the same goal" is an indispensable asset, she adds.

Dr. Pestell of the Lombardi Cancer Center is a fully committed outdoorsman who gets up daily to run 40 minutes at 6 a.m. even in the cold weather. He also finds time to swim indoors three times a week in the pool at Georgetown's Yates Field House.
Australian by birth, he is adamant about the advantages of activity. His family, including his wife, Nicky, a radiation technologist, and two sons, ages 12 and 14, go hiking and camping together as well as scuba diving and white-water rafting.
A graduate of both medical and Ph.D. programs at the University of Melbourne and most recently chairman of the Division of Endrocrine-Dependent Tumor Biology at the Albert Einstein Cancer Center at New York's Yeshiva University, he was a competitive athlete as a youth, doing triathlons and winning state championships in the 500- and 10,000-meter track competitions. At 44, he competes in masters' tournaments and will be part of Team Lombardi taking part in the Marine Corps Marathon in October.
Running, he says, "helps you to focus and be more efficient and cut down on stress in your life."
And, oh yes, he also was a race walker who once was invited to join the prime minister of Singapore in promoting a walking program for the elderly in that city republic.
Hearty in speech and manner, Dr. Pestell keeps to a balanced diet he describes as "predominantly vegetarian and dairy and occasionally carnivorous." He seems a walking advertisement for the good life, prone to upbeat statements: "The trick is to make each day a new day … the past is history, the future a mystery, but today is a gift. Every day is the first day of the rest of your life."

Like many others in the profession, Dr. Pennanen of Georgetown University Medical Center doesn't hesitate to actively counsel patients in preventive health matters.
"I try to be very conscientious about this," she says, "because I've read that physicians don't do enough about encouraging patients to lose weight."
Living near Rock Creek Park is a special blessing for Dr. Pennanem, 42, a full-time surgeon and mother of four children age 8 and younger. Apart from walking the stairs to and from her fourth-floor office at the medical center, she gets most of her exercise walking or riding bikes with her family and using the swing set in the back yard of their home in Northwest Washington.
"A lot of time I'll take one of my children bike riding and run alongside," she says. "That is a real workout, with the 5- or 7-year-old especially.
"And you get a great upper-body workout pushing four children simultaneously on swings," she adds proof of her belief that "if you have a really busy schedule, you have to find ways to accomplish several goals at once."
Every Friday night, the entire family, including her husband, goes swimming at the Maryland Aquatic Club in Rockville. They swim the length of the pool with the youngest child, who is 3, in a swim vest.
She finds she can control much of what she and her family eat by doing the grocery shopping herself, often using an online delivery service. Fresh fruit and vegetables and low-fat milk are routine.
"I see health not only in terms of my own, but in making sure the whole family has a good lifestyle," she says. "Children [and not only patients] look up to you as a role model."

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