Thursday, November 6, 2014

The New Four Fs

Last year, I spent a couple of months doubled over with post-prandial pain after dinner. We’re talking pain that would sometimes incapacitate me, having to lie down while my husband tended to the kids and got them ready for bed. I’ve been lucky to be generally healthy so this was a fairly disturbing turn of events—was I now starting to fall apart physically as I neared 40?

It turned out to be a gallstone. A single but determined gallstone: too large to pass, too much of a drama queen to peacefully co-exist in my right upper quadrant. Of course, I remembered that mnemonic from medical school about the Four Fs of risk factors for cholesterol gallstones: Fat, Female, Fertile, Forty. This did not improve my “downhill” meme. As a 23-year old medical student, hearing that mnemonic involving 40 was downright depressing. That was my future: declining bone mass, fertility, metabolism and physical health. Awesome!

Back to those fun months of pain, I was given a referral to see a surgeon. I made a joke about the Four Fs and my meeting multiple risk factors. He shot me down, “Those are not true.” Hmmm. Apparently I never got the updated gallstone mnemonic memo.

Having recently crashed the “now 40” party, I have decided that I will ascribe to a new 4 Fs system going forward:

Fit, Fearless, Fabulous, Forty.

Fit. I am fitter than I have been in years. Sure, I don’t have the time or will to work out daily like in college and medical school (and probably that was a little pathologic anyway), but I have been consistently exercising about three times a week. I rarely have enough time (or will – time is not the only barrier) to do more than 30 minutes at a time, but I’m really proud of sticking to a routine even if I am traveling. My body is not built for running long or hard but it can do 2-3 miles if gently prodded without disintegrating into a rubble of bone fragments. As a family, we’ve taken to going to the nearby high school track on the weekend so the kids can ride bikes, run, or play while I do my laps. I have no lofty aspirations of marathons or anything of that high-achieving jazz but to stay committed to regular exercise for stress relief, brain preservation, and of course all of the physical benefits.

Fearless. I have had plenty of fear and anxiety in my life. Do they like me? What if I say the wrong thing? Who is that man on the bike path? What if I get pregnant? What if I don’t get pregnant? Why didn’t my husband call me at the agreed-upon time during his deployment? Etc etc. My goal now is to be more mentally strong. Easier said than done, but I think understanding myself better, having more internal security in who I am is the key – and that’s happening as I get older. I’m not trying to morph into a daredevil risk-taker (although, I did recently swing on a rope, suspended in the air by a cable, into a large aerial web of rope and climbed spider-style onto the adjoining tree platform – THAT was fun), but to doubt myself less, believe more. That brings me to the next F.

Fabulous. Fabulous is not just how you look but also a state of mind. It’s feeling amazing and worth it. I have outfits that make me feel fabulous. I have work that I engage in (particularly involving education, research and leadership) that I know I have talents for and thus makes me feel fabulous. Being able to make my family (children and husband included) individually and collectively feel loved and important = more fabulousness. No one can feel fabulous all the time, but doing things that make me feel this way as much as possible is my goal.

Forty. Forty is nowhere near downhill. I feel like I am at my height as a mother, as a contributing member of society, as a partner, as a physician, as a human. I would not want to trade places with my 20-year old or 30-year old selves, even if she did have higher bone mass, faster metabolism and better skin. I have come so far! (Products also help, skin-wise.)

So those are my new Four Fs. What would be yours?


  1. Great post. Everyone tells me that your 40s are the best years of your life, because you have already established your career. But you are not old and sick yet :-) I don't know what my words would be, but something involving more sleep.

  2. I have always thought you were fabulous! I'm so glad I found your new blog. I haven't blogged in awhile, and I should get back to it.


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