Surgeon as Athlete
I am writing this post after finishing a 30-minute rowing workout at 6 am on a Sunday morning on vacation. I have never been an athlete. In fact, I was always the last to be picked in high school for any sport team because I was that bad. Perhaps that is a good thing since now I do not suffer from any lifelong injuries to nurse. I am also late in life to get married and have kids. I didn’t get married until my mid 40s and now at 56 have two small children who are just about to turn 4 and 6 years of age. In my last textbook, I wrote about how to train as an athlete when you are a surgeon because you must be in peak physical condition to perform your work. Unlike an athlete though, a surgeon has a much longer professional lifespan, so health maintenance becomes a higher order of necessity over a much more protracted window of time. The two longest and meticulous procedures I do are FUE hair transplants and comprehensive facial surgical rejuvenation of the face and neck (combined upper/lower blepharoplasty, fat grafting, deep-plane facelift, deep neck lift, lip lift, etc.), both of which I routinely perform. I am actually happy that I perform a variety of taxing surgeries on my body rather than just one because it gives my body challenges in different ergonomic positions to limit injury. Not only do I need to be in top form to do these procedures but I need to limit injury and to avoid an early retirement. I also need to be in good shape and alive to see my kids grow up. That begins with the reason to do what I do or, more simply put, my why. As many books that I have read, which I will share momentarily with you, talk about is to start with the why. In this blog, I will talk a little bit about the what, that is, what I do to help you if you are looking to become more fit, but you must start with your why, as a motivating factor to keep you going in a quest that is not easy to sustain day in and day out.
As everyone talks about, nutrition is key. I start each morning with a healthy shake consisting of various nuts (almonds, walnuts), seeds (sesame, basil, chia, ground flax, sunflower, pumpkin, hemp), spices (turmeric, cinnamon, ginger), vegetables (frozen kale, at times frozen broccoli), and other great stuff (lion’s mane, whey protein, cardamom, dandelion root, cacao beans, olive oil, CoQ10 liquid, flax seed oil) and I blend it in nut milk (don’t use oat milk, which has a high starch load). It takes me 5-10 minutes to prepare this every morning, and I do this 7 days a week. I also take daily supplements of Omega-3s, vitamins, and those specified for my metabolic health by my physician. I do intermittent fasting and skip lunch Monday through Friday, which helps me on days where I am doing 6-hour cases anyways and would not be eating lunch. There is controversy about intermittent fasting now with proponents and detractors on both sides. I believe that it is good for my health overall, as I supplement my protein load with whey protein in the morning (which is what the detractors now argue against intermittent fasting). I have prepackaged meals that our nanny prepares for me for weeknights except when my wife and I go out for date night on Fridays and, of course, other special occasions, or vacations. For me portion control is a big problem, and having prepackaged meals rather than a buffet of food is very helpful. Another great thing to get is a continuous glucose monitor (CGM) that can track your minute-by-minute glucose levels and see what foods spike your glucose levels unfavorably with repeated, large spikes causing more risk of prediabetes and diabetes onset. Read the book Glucose Revolution by Jessie Inchauspé for a lot of helpful hacks, and the CGM model I use is Stelo by Dexcomm (stelo.com) since they are catering to a cash-paying, non-insurance (that is, non-diabetic) market. It costs less than $100 per month with two sensors each lasting about 15 days. Once you get your understanding of what foods cause you the most problems, you do not necessarily need to keep wearing one. My stepsister Celia is also a great resource for me, as she is a health coach (@celiawchen on Instagram)
I work out 5 to 7 days a week with an average of 6 days a week. Exercise is critical for overall health. I try to vary it up every day: I do biking, hiking (treadmill on an incline), rowing, and three days of weights (arms/shoulders, legs, chest/back) every week with HIIT (high-intensity interval training) as parts of these workouts. I add additional HIIT with compound movements and Pilates on the weekends when I can as well. I wasn’t doing weights until about over a year ago but was greatly inspired by a book, Outlive, by Peter Attia that argues that our muscle mass starts to degrade over the decades and we need to plan for how weak and frail we will become in our 70s and 80s if we do not start now. I religiously perform a minimum of two and a half hours of elevated cardio work per week (that includes weights, which I avoid on delicate surgical days), with the prescribed weekly time as recommended by the American Heart Association. By the way, I use Peloton to track and to do my workouts. I own the Tread, Bike, and Row and use their weight classes. You can follow me @samlammd on Peloton if you like. I have not missed a 2.5-hour time/week for the past year and usually exceed that goal. I no longer go to the gym mainly because I have a very efficient morning routine where I build in time to paint, which is a ritual that I can’t give up and I am sure adds to my overall health as well. I also do a chiropractic adjustment in the style of fascial/muscle adjustments rather than bone popping (and definitely no neck cracking, which I believe is dangerous) along with a weekly sports massage. I also try to get 7 hours of sleep a night and track my sleep with my Apple Watch (which is a recent purchase). On weekends I do not deviate from my Monday through Friday routine, waking up at 5 am and going to sleep at 10 pm, but adding a short 30-minute nap when I can. I also avoid all alcohol, tobacco, drugs, and caffeine in my life.
Beyond these fundamental techniques on living healthier, I believe that my family and my faith are huge contributors to my overall health and sanity. They are a bedrock to my existence and I cannot understate how important they are in my life and my overall health and wellbeing. I also believe that I am a very passionate person and that my career and my avocations also provide me a deep sense of fulfillment and joy. I am very active academically on four boards and will be running the Annual Congress in Berlin for the International Society of Hair Restoration Surgery next year, which all give me deep satisfaction and meaning. I also use my art as a charitable vehicle and have raised over $100,000 for abused children through my art and also a considerable amount against human trafficking through the profits from my twelve textbooks I have written. You can follow my art on Instagram @samlammd. I am constantly innovating in my professional career as a surgeon, thinking and creatively developing improvements in both surgical and non-surgical techniques, which is fueled by my ongoing hunger for better results (follow me on Instagram @lfpdallas [for face] and @hairtx [for hair]). All of this drives me, motivates me, and gives me profound satisfaction. I hope that some of these tips you may incorporate into your life and also drive you to live a healthier and happier life, which it has done for me.