Joey Wahler (Host): It's an often overlooked key to good health, so we're discussing self-care. Our guest is Courtney Neal. She's an advanced practice registered nurse and family nurse practitioner. This is WickCare Talks, the podcast from Wickenburg Community Hospital and Clinics dedicated to helping our community lead healthier, more active lives. In each episode, we connect you with trusted health experts to share valuable insights on a wide range of topics, from managing chronic conditions to simple tips for everyday wellness. We're here to provide practical information to support you on your health journey. So, be sure to follow us so you never miss an episode.

Thanks so much for being with us this time. I'm Joey Wahler. Hi there, Courtney. Welcome.

Courtney Neal, APRN: Good morning, Joey. Good to see you again

Host: Same here always. Now, first, what exactly in this context do we mean by self-care, and why is it actually becoming quite the buzzword in health discussions these days?

Courtney Neal, APRN: Self-care is really anything that you do to take care of your mind and body on a daily basis. I know that seems very overwhelming for a lot of people because time is an issue for a lot of very busy moms and dads, but it's essential to their overall mental wellbeing. I think that it's become a big buzzword over the last couple of years, really coming out of COVID where people were very isolated, everybody was locked down. People were doing Zoom meetings without pants on. It got very easy to become very lazy about our health and wellness. And coming out of that environment, I think it became very important to people to take a little bit more of an active role in their health overall. And so, they're finding ways that they can do that to kind of nurture themselves every day.

Host: And speaking of figuring out ways to do that, how does one's self-care directly impact our health, both mentally and physically?

Courtney Neal, APRN: You can see the difference when you look at somebody who is physically fit and somebody who isn't. It's the difference between walking into a room with confidence and walking into a room with the weight of the world on your shoulders. So, it all starts with self-care, and that will manifest mentally in anxiety and depression over time. If you feel like crap, you look like crap, period.

Host: Very simply and well put, I would say. So, what are some common signs that someone may in fact need to focus more on this self-care?

Courtney Neal, APRN: You can tell when people are neglecting themselves when they're too busy. They say yes to everything. A lot of times it will start to manifest in a heaviness, a feeling of heaviness. Their, you know, shoulders are slumped forward. They really look like they are truly carrying the weight of the world on their shoulders. And they typically will start to get very edgy and have feelings of anxiety and some depression.

Host: And so specifically speaking, Courtney, what are a few things that are examples of self-care, things that we need to do on our own independently without someone motivating us, instructing us, holding our hand, so to speak?

Courtney Neal, APRN: So, that looks different for everybody. I have a self-care routine that I do every day. My wife has a self-care routine that she does every day, and they're very different. She loves to journal. I love to go and lift 12,000 to 15,000 pounds in the gym every morning. So, self-care looks different for everybody, but it's whatever you do on a daily basis that will fill your cup.

Because I see it in my practice all day, every day, people coming in and they are just overextended. And you cannot pour from an empty cup, yet there are millions of people out there that continue to try doing this on a daily basis. So whether it's journaling or spending time in prayer or spending time in the gym or just taking a little extra time to have a bubble bath in the morning and, you know, put your makeup on and, you know, feel good about yourself before the kids wake up and all the to-dos come together. It depends on the person, but whatever works in your life that you can find time for that just really nurtures your soul so that you can pour out to others.

Host: Certainly makes sense. So, can neglecting self-care lead to serious health risks or conditions? Can it really contribute to things spiraling out of control?

Courtney Neal, APRN: Sure it can. That's really easy to do. Ask anybody that's gone off of their strict diet for a week. It's super easy to gain all of that weight back really, really quickly. So, it starts subtle, and it just snowballs from there. So, not taking care of your body physically through exercise or movement of some sort and eating improper foods can lead to things like diabetes and cardiovascular disease. But not taking care of yourself, not filling your cup every morning can lead to serious mental health implications like severe depression and crippling anxiety.

Host: Now, you touched earlier on stress. When we talk about that and being burnt out, how does that manifest itself when self-care is lacking, and what should we be aware of there?

Courtney Neal, APRN: Stress can come from a million different places in our life. It looks different for everybody, right? So, you can have stress from your job, you can have stress from being a busy parent and, you know, having all of these expectations. And, you know, I think one of the things that people really fall victim to is these societal norms that they have to do all the things and be everything to everyone and go everywhere and, you know, say yes to every party and, you know, every meeting and every committee and all of these things that we're just expected to do to keep up with each other, which is absolutely ridiculous.

But these things can very quickly manifest into really severe problems. And so, you know, the people that are closest to you tend to take the brunt of all of it. And so, we need to be aware when somebody's personality is changing or when it looks like they're slipping in their day-to-day self-care routine. Those are things that we need to know so we can intervene very quickly. If we don't know, then it becomes a very, very difficult problem to attack.

Host: And speaking, Courtney, of intervening, what role do healthcare providers like you play in guiding patients toward better self-care?

Courtney Neal, APRN: So, I have this conversation at least two or three times a day with my patients. Fatigue is one of my absolute favorite chief complaints, because it could be a million and one different things. So, I get to really dive in and explore and put the pieces of the puzzle together. But it also opens the door for me to have a conversation with the patient.

So, taking a more holistic approach to patient care, I like to know what their environment looks like. I like to know what their demands are on their life so that I can help them and guide them into determining what they can do or what they can cut out so that they can make time for themselves.

You know, and I have this conversation, I have it with both men and women, but it seems to be a lot more women lately. When they come in, I ask them, "What are you doing to fill your cup?" And I'm almost always met with a blank stare. Because they've got kids, they've got a job, they've got a spouse at home, they've got a home that they have to clean. They might have parents that they're taking care of. All of these demands on their time, and I tell them flat out, "Look, no child has ever died because their mom forgot to cut little rosebuds into the orange slices for the soccer team snack. Knock it off. You don't have to be all things to all people."

And I often will tell them there are two lessons that I learned in my 40s that were probably the most valuable lessons of my life. The first one is know is a complete sentence. Stop explaining yourself. You don't have to tell them why you're not coming to that third party this week. It doesn't matter. It doesn't work in your environment. It doesn't work in your life right now. It's okay to say no.

And the other thing is that what people think of me is none of my business. And that one really, really struck a chord with me, and I wish that I had learned it a lot sooner. Because I feel like with the societal norms that are out there, so many people are trying to keep up and trying to one-up each other and do better and be all things to all people, and you just can't. You're setting yourself up for failure on a daily basis. So, just stop. There is nothing wrong with self-care. It is not selfish. It is absolutely essential, and you cannot pour from an empty cup. So, stop trying.

Host: Great advice indeed. Couple of other things for you. First, we're talking about self-care, of course. But it seems from what you're saying here, Courtney, that a lot of it is about self-control, right? And realizing—just even realizing in the first place—that a lot of this is under our own control, that we shouldn't be waiting for someone or something to make these changes, that it just seems like many of the types of changes you're discussing are things we can do ourselves. We don't need anyone else to make them happen, right?

Courtney Neal, APRN: Absolutely. And by the time they come to me to have these discussions, it is often because they are so entrenched in the anxiety or in the depression, or the fatigue even, that they're looking for me to intervene. And had they made these changes earlier, we probably wouldn't be here at this point.

That's one of the things that I really try and hone in on with my patients is that you're not being selfish. If you're going to pour out to other people and do all of these things, you have to have the energy and the stamina to do them. And if you're not taking care of yourself, you're not going to be able to do it.

Host: But it's important, isn't it, to make the distinction between self-care, self-control, taking the reins ourselves, so to speak, but also being open to others in our lives offering emotional support. So doing it yourself, but having someone as a cheerleader, a partner, a support mechanism along the way, how important is that as well?

Courtney Neal, APRN: It's extremely important. And, you know, one of the pieces of the conversation that I have with my patients quite often, as part of this entire self-care conversation with them, I ask them, "If I asked you to name everything in this world that you love, how long would it take before you named yourself? And if you're not in the top five, you're doing it wrong." And every single time the patient cries because nobody has ever tapped into that part of it. And having somebody that can lead you, that can be your biggest cheerleader, that can hold you accountable, that can remind you that you're extremely important and that you deserve to carve time out for yourself, is critical to your success in the long run. And if you don't have people in your life that can do those things for you, you need new people in your life

Host: Absolutely. There's a saying, "To love oneself is the beginning of a lifelong friendship," right?

Courtney Neal, APRN: Absolutely.

Host: And in summary here, Courtney, what's most important here for those joining us in a nutshell to remember about self-care? And I love to ask you these questions that just kind of break it all down at the end. How can they start incorporating it today? if they only do one thing so that they have no excuses, what can they do to start?

Courtney Neal, APRN: The most important thing I think is just starting. You know, we talked about this when we were talking about the GLP-1s and the exercise. Starting is the hardest part. I get it. It's awful. But if you do it today, you only have to start over once, then you never have to start again, and you just keep adding on every 21 days.

So, I don't expect people to suddenly say, "Okay, you know, I'm not going to be soccer mom anymore. I'm not going to do the daily rounds of dropping kids off and picking kids up and making dinner." I don't want you to, you know, turn over your whole entire life. I'm talking about adding in like a 30-minute walk when you get up in the morning that's just for you out in the sunshine. It just kind of wakes you up or journaling for a half an hour. What went right yesterday? What went wrong? What can you do better? What are you setting out to do today? Setting little mini goals for yourself, but taking that time, whether it's a half an hour or an hour before everybody else wakes up, it's essential to your overall health and wellness.

And I have patients constantly that are telling me, "Well, I don't have time for that." Well, why do you have time for everyone else but not yourself? I don't have time for it either. I see 25 to 30 patients a day in eight hours. I get it. That's why I wake up at 3:00 AM to work out. You make the time for the things that are important to yourself. Be important to yourself.

Host: " Wake up at—wait a minute up? Time out here. Wake up at 3:00 AM to work out? What time are going to sleep, Court?

Courtney Neal, APRN: I do. Eight PM on the dot.

Host: Is that right?

Courtney Neal, APRN: I am a very structured, very routine person. Yes. And very disciplined.

Host: I could've guessed that. Wow. Well, hats off to you just for getting up at 3:00, never mind the weightlifting that comes shortly after, right?

Courtney Neal, APRN: Yeah, that was not an easy habit to get into. But, you know, I'm a firm believer that I have to set the right example to my patients, and I will never ask a patient to do something I'm not willing to do myself. So if I'm not willing to get up and work out and be the example of what true physical health looks like, then I'm not in the right job.

Host: Yeah, I've always found personally when it comes to working out that it's hardest for me to work out very early in the morning. But if I do it, which I sometimes do, it's the best feeling in the world to get it over with and now you've got the rest of your day and it's checked off the box, right?

Courtney Neal, APRN: Yeah. And you walk out there with confidence feeling like you can conquer the world, and it actually sets you up for better health habits throughout the day. If you've put out all that energy in the morning to work out, you're not going to run through the nearest drive-through. You're going to be a little bit more discerning about the things that you put in your mouth.

Host: Very true. You don't want to undo what you just did. Well, folks, we trust you're now more familiar with self-care. As Courtney says, for some it looks more like journaling. For others, it looks more like having the alarm go off at 3:00 AM to start pumping iron. Just find something that works for you. Courtney, as always, a pleasure.

Courtney Neal, APRN: Thanks so much again.

Host: Absolutely. And for more information, please visit wickhosp.com/wickcaretalks. We hope today's discussion has provided you with valuable insights to support your well-being. Remember, every step you take is a step toward a healthier life. To ensure you don't miss future episodes, please follow us on your favorite podcast platform. If you found this episode helpful, please do share it on your social media. And thanks again for being part of WickCare Talks. I'm Joey Wahler. Until next time, be well.