Voices: Fitness into a Specialty | J. Brian Szender, MD, MPH

Fitness into a Specialty | J. Brian Szender, MD, MPH

My residency graduation included the “yo-yo” awards. While this was actually short for “yo-yo, you got this,” whenever I see the plaque in my office now I can’t think help but about what an up-and-down ride my training was, both physically and emotionally. The physical rollercoaster is a major part of why I elected to join SGO’s Wellness Task Force. Between medical school, residency, and fellowship I managed to gain and lose more than 150 pounds, 20 to 30 pounds at a time. I suffered from the classic signs of poor fitness including:

J. Brian Szender, MD, MPH

• Excessive fatigue
• Dyspnea after walking up a flight of stairs
• High resting heart rate
• Prolonged recovery heart rate
• Reliance on caffeine or excessive sugar cravings

When I completed my fellowship and started into practice, one of the resolutions I made for myself was to stop this vicious cycle and take control of my health and fitness once and for all.
As a husband, father of four, and early career gynecological oncologist, my time is split (sometimes unevenly) between my wife, children, and my practice. Because there are only so many hours in a day and I cannot overcome the need for at least a few hours of sleep, there isn’t much time between rounds, robots, and rides home with the kids for a regularly scheduled fitness class or a trip to the gym.

I had to get creative with my time and find short intervals throughout the day to elevate my heart rate.
The most effective way I have been able to ensure that I get at least a little exercise in every day is to start from the first time my feet hit the floor when I get out of bed. Five exercises in five minutes helps start the day off on the correct path; no matter what other decisions I make or how little time I have between patients, the rest of the day can’t take away those first five minutes from me.

1. The routine starts with a slow walking lunge across my bedroom. This stretches the legs and engages the muscles of the lower body.
2. Next, perform 10 slow-count push-ups, taking five seconds to lower the body and one second to push back up.
3. The third movement is supine leg raises, holding the feet off the floor about 6 inches for a five count, repeated for 10 repetitions.
4. Return to the push-up position and plank for 60 seconds.
5. Finally, 10 air squats and you can move on to start your day.

Dr. Szender completing a race at Disney World.

Micro-breaks for exercise can also be extremely useful, whether it is the decision to run up the stairs instead of taking the elevator or performing isometric leg lifts while writing notes, opportunities to exercise abound throughout the day for the gynecological oncologist.

Every location around the country is going to have different local resources for to incorporate fitness into your life, but there are some universally available resources that can help the busy physician reduce any guilt related to “time away from study” in their practice while exercising:

1. SGO ConnectED – use the streaming audio/video of last year’s SGO meeting–especially the trainee sessions with seminal clinical trials–as the soundtrack for your workout. Nothing says “run faster” like listening to Dr. Kushner talk about ovarian cancer!
2. Research to Practice – offers free podcasts across a range of oncology topics.
3. YouTube – There are taped grand rounds, medical lectures, and chalkboard talks.
4. Podcasts – Pearls of Exxcellence from the Foundation for Exxcellence in Women’s Health are available for download.

Finally, make sure that any of the above activities are performed with a goal in mind. Remember that you can’t care for your patients if you are too sick or fatigued to do so, but that you were also a person before you became an oncologist and one aim of fitness should be to help preserve that humanity. If you’ve never participated in an organized fitness activity before, consider signing up for a local 5k fun run. Get online, find a weekend that you’re not on call, pay the entry fee, and commit. The National Ovarian Cancer Coalition (NOCC) has 5k races throughout the country, find your local event at http://runwalk.ovarian.org. The National Race to End Women’s Cancer, hosted by SGO’s Foundation for Women’s Cancer, will be held Sunday, Nov. 3 in Washington, DC. https://endwomenscancer.org/

J. Brian Szender, MD, MPH, is a gynecologic oncologist at START Center for Cancer Care in San Antonio, TX.