by Carolyn Thomas ♥ @HeartSisters
Well, we’re into the New Year now. For some of us, that’s almost enough time to notice small cracks beginning to appear in the boldly announced resolutions made in the midst of all those post-Christmas excess guilt pangs. When I was one of the volunteer run leaders at our local Y Marathon Clinic during the last century, we’d often hear such resolutions from the first-timers starting our training workouts at this time of year – something like “This is the year I’m finally going to quit smoking, lose 20 pounds and run a marathon!”
“Honey,” I would gently say to them: “Pick one!” .
A New Year can be a discouraging time for those living with chronic illness – and I blame those damned resolutions. Many adults make at least one resolution for self-improvement for the coming 12 months. By the second week of February, however, about 80 per cent of resolutions are abandoned, often replaced by the remorse of personal disappointment.
Chronic illness like heart disease throws a wrench into the best-intentioned resolutions. In the PURE study (Teo et al, JAMA, 2013), for example, researchers followed over 7,500 heart attack survivors in 17 countries. They found that:
• ♥ 48% of smokers continued to smoke
• ♥ 65% did not exercise
• ♥ over 60% did not improve their diet
• ♥ 14% had not adopted even one lifestyle improvement
This reality gives us lots of guilt-driven reasons every year to make big resolutions to do better.
One of my blog readers recently wrote that she ditched the word “resolutions” in favour of the term “self-care promises”. I like that. It has a kinder, gentler ring to it, and just maybe a higher likelihood of keeping those promises.
Regular readers already know how I feel about non-inspirational advice from motivational types, advice like “Follow your dreams! Reach for the stars! Eat more kale!“
The eternal question for me is this: can accomplishing small but still personally meaningful goals actually be better for our health and self-esteem than screwing up yet another list of big New Year’s personal improvement resolutions? And will success at small wins entice us to do even more?
The realization that true wins are not limited to heroic resolutions is also why I began to change the way I reward myself the shiny sparkly stickers I use to track my daily exercise. ←Here’s a picture of one of my old exercise calendar pages. When I first I hung up a little calendar on the inside of my bathroom cabinet door many Januarys ago, my plan was that each hour of exercise I was able to do on good days (such as walking, biking, weight training, gardening, hiking, Zumba classes, whatever) would earn a shiny sparkly sticker. (I find that the shiniest sparkliest ones work best as motivational awards!)
But on bad days, when the debilitating symptoms of my coronary microvascular disease diagnosis flare up, and when doing an hour of almost anything seems impossible, every blank calendar square staring out at me made me feel even worse.
So I changed my official sticker policy.
I started deliberately awarding myself a sticker for small accomplishments on a bad day. Even if I was barely able to manage only a slow 10-minute walk around the block, I got a shiny sparkly calendar sticker. You go, girl! Whoooop!
Why? Because those were the days I really deserved an extra pat on the back for even the briefest attempt, because what I had really wanted to do instead was to crawl back into bed and pull the covers over my head.
As I do every January, I’m starting a new sticker reward calendar – but instead of calling them resolutions, this project is called 52 Small Things. I learned about this a few years ago from The Mighty, an online health community for people living with chronic illness. Full disclosure: I’m a (very occasional) contributor to The Mighty – here or here, for example!
It’s important to remember that the kind of resolutions (oops, self-care promises) that sick people tend to make are very different than those of your average Peloton enthusiast – although this “pandemic-era stock darling” (as described by Forbes in late 2022) has itself been struggling lately with both declining sales and excess inventory. In fact, people who boast about their own successful dream-following, star-reaching, kale-eating achievements can often make us feel exhausted and inadequate instead of motivated.
But I digress: by comparison, the 52 Small Things project works like this:
“Ask yourself, ‘What’s one small thing I want to accomplish this week?’
“Keeping your things small simply makes them easier to do. Cleaning your entire house in a week seems overwhelming, but cleaning just one room or spending 10 minutes a day organizing a drawer is likely doable.”
I started my 52 Small Things list this past week. First on my list seems like a very small thing indeed for most people, but one that I’d been avoiding for years: “Sort Christmas decoration storage bins BEFORE packing them away.” I managed to get two big bins culled down to just one, and loaded the unwanted stuff into the car to donate to the local church thrift shop. A win-win! And a nice sparkly shiny sticker!
When one of my Heart Sisters readers started her own 52 Small Things exercise, she wrote:
“Allowing myself to celebrate mundane tasks — ones that healthy people may take for granted every day — allowed me to tackle increasing my wellness in very small increments. And it helped me look at the positive side of things, instead of always dwelling on the negative. It made me take pride in my ability, instead of feeling the shame of what I wasn’t able to do.”
That practical wisdom brings us to the type of goals we decide upon. Behaviour scientists tell us that the most effective goals are ones that move you toward a particular objective, rather than away from something you’re trying to avoid.
As I often remind myself, an avoidance goal (“Do this so you won’t get sick”) is far less effective than an approach goal (“Do this so you’ll feel better!) For example, I could decide to head out in the sunshine today for a brisk walk to help me ward off another heart attack (an avoidance goal) or I could go for a walk to enjoy the beautiful views off Beach Drive (an approach goal).
For many of us, it’s also all about small steps. And as the late tennis legend Arthur Ashe once advised:
“Start where you are, use what you have, do what you can.”
♥
Q: What are your own “self-care promises” for 2023?
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NOTE FROM CAROLYN: You’ll find much more about goal-setting for heart patients in my book, “A Woman’s Guide to Living with Heart Disease” (Johns Hopkins University Press). You can ask for it at your library or favourite bookshop (please support your local independent booksellers) or order it online (paperback, hardcover or e-book) at Amazon – or order it directly from Johns Hopkins University Press (and use their code HTWN to save 30% off the list price when you order).
See also:
Please! No more bragging about mountain climbing!
Why don’t we listen to doctors’ heart-healthy advice?
Non-inspirational advice for heart patients
No, really – patient education that’s actually useful!
Heart Sisters 
Hi Carolyn,
I’m not a fan of making resolutions either and stopped making them years ago. I do set goals, though I’ve learned to keep them to myself, for the most part.
Affirmations work better for me too. Less pressure and less about fixing what’s wrong with me. And gosh, I love the idea of “thinking small”.
In fact, I’ve included this tidbit of advice in the blog post I’m working on – my first for 2023 – I might add. I’m easing back into blogging in the new year. Can’t keep up with you, I guess!
Thinking small can be helpful for anyone. It reminds me of my teaching days when certain kids needed stickers and praise for achieving – or even striving toward – the smallest amount of progress. Sometimes, small progress isn’t small at all.
And besides, what’s wrong with small anyway? Why is more and/or bigger so often the gold standard? Thank you for validating my feelings about forgoing resolutions and that small steps are just fine.
Love all the comments left too. Happy New Year! Looking forward to reading more of your blog posts in 2023!
x
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Hello Nancy – I too love that “think small” advice. As you know, it’s tiresome to be continually “inspired” by mountain climbers as if that’s the only calibre of achievement that deserves cheering on. It also suggests that there’s only one “correct” way to do life, by constantly striving for certain kinds of BIG success.
I look forward to reading your first blog post of 2023!
Take care, stay safe. . . ♥
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This resonates with me. I was diagnosed in April with Congestive Heart Failure and almost immediately had to start dialysis for my Chronic Kidney Disease. I get up at 6 am 3 days a week, drive 45 minutes, spend 4 hours at the hospital and drive back. By then I only have energy to eat, and go to bed.
So I live the rest of my life in the other 4 days, while also recovering from dialysis. I have a new book to promote, and one to help find a home for. I enrolled in a research exercise project for dialysis patients. I CAN’T find time to do it! And my brother wants me to take on some of the cooking too… sigh.
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Hello Carol – I’m sorry you’ve been facing not one but two serious diagnoses in the past year. No wonder you are feeling overwhelmed. When we’re recuperating from more than one challenge, it’s important to rank our priorities more carefully than ever.
It seems like some of the prioritizing is straightforward: those 3 days of dialysis are the days carved in stone for you until you learn more about at-home dialysis – everything else must work around those days if (and only if) you can comfortably fit them into the remaining four days of the week. Anything that isn’t on your Like-To-Do list (including your brother’s suggestion that you do more cooking) could reasonably wait. Unless he is also a heart and kidney patient undergoing three days of dialysis per week like you, his expectations for you might be unrealistic at this time. Remember that NO is a complete sentence, as I wrote more about here:
“If you’re someone who is used to saying YES even when you don’t want to, it might take courage to practice saying NO. You may feel guilty, or pressured to give in, or worried that you’ll be seen or talked about in a negative light. . .”
Other priorities like promoting your book or participating in research depend entirely on how much you enjoy such activities on those precious four free days. If you enjoy them, great. It’s recommended that you make the most of those free days you have by building in fun or interesting plans. Try to balance the routine of your dialysis days with something that feels good for YOU. Remember that many patients on a dialysis schedule like yours do continue to work, go to school, or volunteer. Some need to take time off when they first start dialysis treatment and then go back to work or other pursuits after they have gotten used to the regimen. Speak to your local dialysis clinic staff for more info on this.
It seems like you could also use some basic support during this stressful time. Please check out the National Kidney Foundation, which has a free peer support program that you might find useful.
Good luck to you Carol – take care and stay safe. . . ♥
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Thanks for the suggestions. I do belong to a couple of peer support groups through Kidney.ca:an online group local to the Ottawa area, and one in the Toronto area. And I just completed Women@Heart, an online program for women with CHF, sponsored by the Ottawa Heart Institute. These groups are wonderful, especially at a time when we all worry still about COVID. I’m new to this site but with surely be following!
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I decided to ditch the word…RESOLUTION, because it leads to failure!
My word for 2023 is INTENTION i.e. my intention is to walk. No mileage involved, no blocks. . .just walk.
Maybe it will be a few steps today and maybe it will be more tomorrow. . . Who knows? Just go outside for a walk. I used the walk as an example, however, I too am a “Heart Sister” and for me my intention is to honor my heart.
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Hello my Heart Sister Elaine! Thanks for sharing your perspective. I love your word INTENTION this year.
It’s funny that you mention “maybe a few steps today and maybe more tomorrow”.
Yesterday my granddaughter Everly Rose (age 7) and I were in the car on our way to the bookstore together when we drove by a fantastic Snoopy/Charlie Brown nativity display on the front lawn of a nearby house. I pulled over so we could get out of the car to take a closer look at this really fabulous hand-made display. We admired every painted character, and then as we were walking back to the car, Everly Rose pointed to the big school up the road. I used to push her in her baby stroller past that school on her way to daycare every weekday morning from the age of 18 months to age 5 when she went off to kindergarten. “Let’s walk past the Big School again!” she suggested.
So we walked the block or two to the school, where she counted the wooden fish attached to the chain link fence – just as she used to when she was little. Then she suggested we could walk up the hill along her favourite back lane which she also remembered from our daily daycare walks. Along the way, she pointed out the rock pile she used to collect rocks from, the blackberry bushes we used to stop at, the big white boat on a trailer parked in the lane, the lawn fountain that we had to peak through the crack in the wooden fence to see – until we were all the way at the top of the hill at her former daycare. We stayed there for a while as she poked her nose over the playground fence, pointing out her old favourites like the sandbox, the climbing wall, the play dumptrucks.
The most fun part was that this was a totally unplanned long walk on a sunny winter day (turned out to be over 4,200 steps by the time we returned to my car!) and we had such a great time revisiting her “memory lane”.
Had I said to her at the Snoopy display: “We’re going to walk 4,200 steps this morning!” – I’m sure she would have tried to talk me into just driving to the bookstore as we had planned. And we had so much fun that we never did make it to the bookstore.
Thanks Elaine for that reminder to keep space open sometimes for unexpected fun – take care, stay safe . . . ♥
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Elaine, this resonates with me because I am struggling with everything I need to do, want to do, or someone else wants me to do.
I go to dialysis three days a week and am up at six to drive to the hospital on the far side of the city. I am exhausted afterwards. As well as renal failure, I was diagnosed with Congestive Heart Failure last spring at the same time I began dialysis, and while I am mostly without symptoms, it is hard to fit a week’s worth of living into 4 days while also trying to recover from having all my blood taken out and put back for 3 hours x 3 days.
I have a new book of poetry out, need to promote that, and a joint book to edit, and I signed up for Nordic pole walking as a research participant but don’t seem to find the time to start that at all.
I am hoping to start training for home dialysis, and once up and running I hope I will have more flexibility. Right now, though, I am struggling with it all. And my brother wants me to do some of the cooking…sigh.
Carol
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I made my last resolution at 25 and haven’t broken it in the 42 years since.
I realized that the things people made as resolutions were things that were unachievable and far from realistic. They were image-oriented, but I’ve been told over the years that I have too much self esteem. I tried working on my personality and that too was a no go, I’m not a people person because I don’t gossip or do the small minded things, but work on real issues.
My last resolution was not to make a useless resolution of things that I knew I wasn’t going to keep.
Take care,
Robin
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Hello Robin – That last resolution at age 25 was a good one. Congrats on successfully keeping it!
Take care, stay safe. . . ♥
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Bravo Robin, I’m with you. The only ritual I have for New Years, which I’ve been doing for 25 years, is writing a list of everything I want to let go of, tying it up with a red string and burning it.
If we just let go of the worldly interferences, it allows our light to shine. If that light bothers people, it is their problem – not ours.
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Tying up that written list with a red string and then BURNING it? Sounds far more effective than just thinking about what needs letting go of! ♥
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Hi Jill C,
The whole resolution thing is highly overrated.
Robin
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When I was raising a special needs child, I was the champion of noticing small steps in his progress. Like today he put on a single sock without coaching! Yay! Great Job!
But for some reason I never transferred that celebration of small things to myself. Instead I have mentally tried to whip myself into shape. I’ve told myself I could do more if I just tried harder. This was my modus operandi even before my heart and fatigue issues.
When I listened to myself, I realized I sounded just like my mother and father! Who I’m sure sounded just like their mother and father!
When my daughter was small she hated being sent to clean her room. It was just too overwhelming. So I had her count tiles in a 3 foot square and told her to only clean up that square. Which of course was easy! Then we moved to the next square. Somehow again, I didn’t learn my own lesson.
But I am ready now to make the effort to adjust my attitude from seeing the negative to celebrating the positive. As well as being grateful and celebrating small steps.
Yesterday, I brushed my teeth, changed out of my bathrobe, made my bed, emptied the trash, cleaned the table next to my reading chair, read part of a book and meditated. Yay!
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Hi Jill! I love-love-love your comment this morning! You’ve hit upon such an important point (i.e. why is it so much easier to cheer others on, while we keep telling ourselves that we need to try harder?)
These days, I think it’s much better for my self-esteem to stop co-operating in making myself feel bad!
Congrats to you on the teeth-brushing/bathrobe changing/bed-making/trash-empyting/ table-cleaning, reading and meditating day you had yesterday. You definitely deserve a shiny sparkly sticker!
Take care, stay safe out there. . . ♥
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