Wendy Kelly (Host 1): Welcome back to Outer Banks Health, the official podcast of Outer Banks Health. I'm your co-host, Wendy Kelly.

Jennifer Schwartzenberg (Host 2): And I'm Jen Schwartzenberg. Today's podcast topic is tied directly to our mission, which is to enhance the quality of life by promoting wellness. It's through our podcast topics and our health coach newsletter, as well as our health coach vehicle that hosts countless of free screenings, lunch and learns, and awareness events that we can constantly strive to offer ways for our community to reach new horizons in health so that they can live their best life.

Host 1: Exactly, Jen. And that's why we want to discuss self-care today, and how it's directly tied to our quality of life. You know, it's so often we push off self-care because we believe we don't have the time for it. But the reality is that by making our responsibilities and obligations more important than our own health, we're setting the stage for higher levels of stress, anxiety and fatigue, all of which can lead to chronic disease.

Host 2: Yeah. That's right, Wendy. And I honestly can't think of anyone more appropriate to speak on the topic of self-care than today's guest. She is the Medical Director for our Center for Healthy Living here in Nags Head, as well as the Chief well-being Officer at ECU Health, and holds board certifications in Family Medicine, Hospice and Palliative Care, Integrative Medicine and Lifestyle Medicine. Please welcome our returning guest, Dr. Christina Bowen.

Christina Bowen, MD: Thank you so much for having me here today. What a joy to get to talk on the topic of self-care. And really just thinking about that, it aligns with our mission, yes, to take care of our health and well-being. Sometimes it can feel hard to practice self-care because there are a lot of other responsibilities that can get in the way. Life seems to get in the way. And so, it does require some intentionality and setting boundaries, which can be a stretch and feel like a growth opportunity for us. But we have to know that, you know, you're ultimately doing this because you really want to care for yourself, give yourself compassion and grace when it comes to self-care. And it helps us be our favorite version of ourselves so that we can be our favorite version of ourselves for those that we love and serve on a daily basis. And so, it's just really, really important when we think about caring and optimizing our well-being.

Host 1: Dr. Bowen, can you talk a little bit about how someone might start practicing self-care?

Christina Bowen, MD: Sure. One of the things when I'm talking to my patients is a talk about just starting with small attainable goals. Because sometimes we think about, "Oh, I've got to take care of myself. I need to hit on all those pillars," that I know you all have heard about, the pillars of lifestyle medicine. "I've got to eat well, I've got to exercise, I've got to maximize my sleep. And am I taking the right supplements? And am I drinking enough water?" It can feel a little bit overwhelming. And so when I talk with patients, I did that today in clinic, what's the one thing that you want to start with that feels like something that is attainable to you over the next month?

We can just start working with those small goals. And I really talk about how we can build on those and really to give yourself compassion, right? Give yourself grace because when we set small goals, sometimes we don't attain those. And so, just remember that tomorrow is a new day. If it's a nutrition goal, the next meal is another goal. So, setting those small goals is really important. And it really what happens with patients. What I've seen is when they start putting themselves first, and truly this can be with nutrition and exercise, this can be going to get your wellness checks, right? This can be getting those preventative screens that are so incredibly important. I know for myself when I get those, I'm like, "I took care of myself today." They're a very important part of self-care when we think about preventing and optimizing our well-being. So, starting with those positive lifestyle habits. They're small and just setting a routine for those and giving yourself grace. You know, it takes about four weeks to develop a habit. So, start setting yourself up. I talked about boundaries and intentions. Be intentional with setting up a routine and setting boundaries in your day, making that appointment with your life for that small goal that you're going to start with.

Host 2: Dr. Bowen, to know you and to listen to you today, you can tell that you're really passionate about this. In fact, you've helped to develop an ECU Health system-wide self-care effort for our team members by focusing on the six pillars of health with the Blue Zones book. Can you tell us a little bit about that and the why behind this approach for our team members?

Christina Bowen, MD: Sure, I'd be glad to. We've talked a little bit about why self-care is so important and how it helps us to optimize our well-being, and can help us even if we're at risk for cancer, even if we're at risk for chronic diseases, that by focusing on these healthy habits and those pillars, those six pillars: nutrition, physical activity, stress, sleep, alcohol and connection, that we can directly impact possibly never getting cancer and then possibly never getting a chronic disease. So, knowing that power behind self-care and these lifestyle modifications and optimizing our well-being, we really wanted to bring that to our team members and our providers, right? They're our most precious resources as a health system as we're caring for Eastern North Carolina.

And so, one of the ways that we brought those pillars of lifestyle medicine to our team members and providers, was utilizing a book called the Blue Zones Challenge. And it really served as a launching pad for us to start a well-being initiative for our team members and providers. I'll tell you a little bit more about why we chose that book. The Blue Zones are five areas that across the world that are not geographically located close to one another, but that communities have found to be living into their 90s and thriving, they have lower incidences of cancer, they have lower incidences of chronic disease. And we found that an epidemiologic study done about 20 years ago found interestingly, though they're not located near one another, they share nine behaviors. They call them the Power Nine. And when you look at those Power Nine behaviors, they're very similar to the pillars of lifestyle medicine. It was a really fun way for us to bring this topic of well-being and this holistic approach to well-being to our team members. And so, we started by, during Hospital Health Week, utilizing this book as a giveaway and 496 members of our ECU Health team signed up. I believe you were one of those people, Jen.

Host 2: I was.

Christina Bowen, MD: And then, we led six weeks of webinars just to focus on well-being. And it's really been incredible. And like I said, it served as a launching pad because this is something we know that has worked really well for us here in the Outer Banks at the Center for Healthy Living with our patients and our community. And so once again, I'm so grateful to practice here in the Outer Banks and be a part of such a progressive healthcare team that we utilized many of those principles and we have now scaled it for the whole system for our team members, which is pretty amazing when you think about well-being. And so, we'll continue to be focusing our efforts on that holistic approach to well-being. So, it's just the beginning.

Jennifer Schwartzenberg (Host 2): Yeah. That's exciting because I definitely got a lot from that. You know, you mentioned it before that it can be a little overwhelming to think about all the things that you want to change in your day to day lifestyle, but to really be able to focus and think about, you know, and just have one goal for the day, "What do I want to do differently?" And ask that question and that really kind of being a part of that cohort really helped me kind of focus on what my goals were. And I think my favorite part was absolutely the weekly meetings with all the people that were involved and just hearing little snippets and success stories and getting ideas from other team members about, you know, "Oh, if that worked for that person, you know, that could work for me too." And we're definitely doing more walking, team meetings and things like that. So, that's kind of fun as well.

Host 1: It's huge. I love doing that. Maybe we could talk a little bit about some of the resources we can offer our communities so they can maybe experience something similar to what you did with Blue Zones, maybe like the Center for Healthy Living Jumpstart Classes, Dr. Bowen?

Christina Bowen, MD: Absolutely. I would love to talk about that. So, the Center for Healthy Living has been running classes, the Healthy Living Jumpstart classes, that are six weeks classes that go over those pillars of lifestyle medicine that I very quickly ran through. There, you'll learn more about nutrition, plant-forward nutrition. You'll learn about how do we enhance our physical activity if it's not exactly where we want to be. Stress reduction and coping with stress, both good and bad stress. Sleep, sleep is so important. So, how do I optimize my sleep? And what does that look like? Limiting alcohol, because we know that directly impacts our well-being, it impacts our sleep and it impacts how we deal with our stress. And then focusing on what you said, Jen, that connection, that sense of community. It's been incredible.

Just to your point, you know, one of the things that we know is when we get in a group, there's synergy and there's energy with that group. We learn from one another. And so, the Healthy Living Jumpstart Class has been pretty incredible. And that's what people have said, "Oh, I don't want to stop meeting. It's so fun," that we've developed maintenance classes. And, you know, they've seen the results. They've seen drops in their A1c. They've lost weight. And one of the things that we are very intentional about in those classes is asking people-- we don't walk into those classes with goals set for our patients. They set their goals, just like we talked about. Nobody can set your self-care goals. That's about you. Bringing your self-compassion and saying, what do I need to be my favorite version of myself? And so, that's what we ask patients in these classes. Each week, they get to tell us what they're going to focus on. And we ask them, they have some accountability, "How did it go?" If you had a barrier, "Well, let's talk about it. How could we help you think through removing that barrier so you can meet that goal?" They've truly been incredible.

And one of the things that we know when we focus on self-care and we focus on optimizing our personal well-being. It's one of the reasons we're doing this with our team members at ECU Health, here at Outer Banks Health as well, is that we're more productive, right? We're more engaged with this amazing life that we get to live. We are more present. So, we get to really fully enjoy our life more. We're more present with our life when we're caring for ourself. And so, this Healthy Living Jumpstart is just another way that Outer Banks Health is just really pouring into our community. And then, you can continue to see us at the Center for Healthy Living so we can make sure you meet those goals that you set for yourself.

Host 2: That is such great information about those Healthy Living Jumpstart Classes. For our listeners out there that might not be able to be able to be in one of those classes quite yet, we do have this awesome new booklet that we're sharing all over the community. It's called Helping You Reach New Horizons in Health. It's free. You can find it at libraries, senior centers, area of medical practices, in the lobby of the hospital, at any of our outreach events that we do in the community on our health coach. Dr. Bowen, why don't you tell us a little bit about what folks can find inside this booklet?

Christina Bowen, MD: Yeah, it's incredible. Speaking of self-care, just picking this booklet up and taking a look through this book is self-care. It is wonderful. You know, I spoke earlier about prevention and screening and how that's a very important aspect of caring for ourself. It goes over what do I need to do at certain ages, how often do I need to do those, and how can I sign up for those. And so, that's in the book, so very important. The Center for Healthy Living information is in the booklet. So if you're listening and you hear about these jumpstart classes, I think I'd like to do that. Or maybe you want to focus on tobacco cessation, information's in there. Maybe you want to cut back a little bit on drinking. Our gray area drinking that's led by our nurse practitioner, Marielle Silk, information in there is about that. It's important to remember too, you can see us virtually at the Center for Healthy Living. So, how do I call and make an appointment? If I can't do the six weeks of classes, how do I call for a virtual appointment?

And other things that it offers in the booklet are something that I've said to patients that I think is so very important. Always to know any medications that you're taking. And another important thing is any supplements that you're taking as well. And so, there's an opportunity in the book to write those down. If you want to record your blood pressure or your provider's asked you to record your blood pressure, there's an opportunity, there's a nice, beautiful space for you to write those down as well. In the back, there's a notes section, so we're more likely to reach our goals when we write them down. You can write down your self-care goals. What do I want to do to optimize my well-being is in the back. A lot of other opportunities in the booklet. I think I'm walking all the way through the booklet. You can tell I love this booklet. Everyone should have one.

Host 1: And they can.

Christina Bowen, MD: And they can. It goes over our urgent care opportunities, our emergency department, and when to go, I think that's really confusing. I know I have friends in the community that'll shoot me a text on whether they go to the urgent care or to the emergency department, and so that's in there. How do I utilize virtual care? And then, signing up for myChart. Another thing, it's really important to remember as you're setting these self-care goals. And one of the things we say at the Center for Healthy Living, is this is really a partnership and that's how you should view healthcare. You are in partnership with your care provider. So, utilizing myChart is just another way that we can layer on that partnership so that you can directly reach your healthcare team, whoever that might be. And so, there's information in the book on how to sign up for myChart if you haven't signed up for it. So as you can tell, I'm pretty excited about this book.

Host 1: Yeah. And Jen was right. You're very passionate about this topic, that's self-care. Thank you so much for joining us today. Is this your second or third time here? Second?

Christina Bowen, MD: I'm not sure. I just love it every time. I've lost count. It's so fun!

Host 1: Maybe three more times, you can be in the five-timers club like SNL.

Christina Bowen, MD: Okay. That sounds great.

Host 1: If you enjoyed this podcast, please visit outerbankshealth.org/podcasts for our growing podcast library. I'm your co-host, Wendy Kelly.

Host 2: And I'm Jen Schwartzenberg. We'll talk soon.