Kimberly Callaway on Medicine + Lifestyle + The Worried Well

Meet Kimberly Callaway. She is a mother, a horse rider, a gardener, a wife, and the community’s ‘house-call’ doctor. She has an MD specializing in family practice and a Ph.D. in public health and nutrition sciences. After three decades in the medical field, Kimberly brings a refreshing perspective to human health.

worried well conversation by a water fall

Nutrition + Medicine

Sydney, “What was your area of focus in your masters/Ph.D. in nutritional sciences?”
 
Kimberly, “In 1987, I defended my doctoral dissertation on cholesterol metabolism. The question I asked was, ‘Can medication and diet affect cholesterol metabolizing enzymes?’
 
“Heart disease and cholesterol management were hot topics. The thought was that cholesterol was the bad guy. The pharmaceutical and nutrition fields focused on enzyme research to get the body to make less cholesterol. The goal was to get people to have fewer heart attacks. We developed the drug interventions we have today from this research. It is important to remember that at the time I was studying, cholesterol beta-blockers and cholesterol-lowering drugs were not yet developed.
 
“I took my knowledge of nutrition into medical school and family practice. For example, we now have many medications for cholesterol and diet-related illnesses. My goal as a family doctor was to work on diet and lifestyle changes that naturally lower cholesterol. This was either in conjunction with or in place of medications.
 
“There are people with a heart attack higher risk because, genetically, they make more cholesterol. These people often need medication and lifestyle interventions. Interventions can delay heart attacks in at-risk individuals, often men. This will either prevent or delay heart attacks and heart-related illnesses. These combined efforts have extended the lives of people who would have prematurely died.”

a woman holding a wine glass and talking about the worried wellNature Versus Nurture

Sydney, “To what extent can you out-lifestyle bad genes?”

Kimberly, “Medication can delay manifestations of diseases. Health, in the long run, comes back to diet and exercise. I am not talking about daily vitamins. I am talking about a healthy lifestyle.

A good example is a type-1, adult-onset diabetic. This is not a lifestyle-induced illness. For some reason, the pancreas stops producing the necessary insulin. We do not know why, and there is neither a genetic tie nor a cure. Type-1 diabetics must take insulin every day and manage their lifestyles.

“If these people are exercising and eating healthy, in conjunction with their medications, their lives are significantly enhanced and lives extended. Without medication, a type-1 diabetic dies within two years of the disease’s onset. This often occurs around adolescence or early adulthood. Now, these people can live into their 40’s, 50,s, and even longer.”

a woman in a dress with cooking gear near her

Shifts in Medicine

Sydney, “This sounds like helping the body heal itself.”

Kimberly, “This is a new idea [in Western medicine}. We don’t want poly-pharmacy so we are looking for alternatives. Medication prices can be quite high and drug side-effects are unpleasant. Modern medicine may extend life, but it has not extended the quality.”

a woman and her husband

Boundaries Between Medication + Lifestyle

Sydney, “Where is the boundary between lifestyle interventions and medications or serious treatments?”

Kimberly, “For most illnesses– diabetes, hypertension, back pain, etcetera, it is a lifestyle. You cannot exercise yourself out of breast cancer. However, healthy people with good habits and a positive mindset who develop cancers do appear to handle treatment better. This is the holistic approach. If a cancer patient believes they will survive, if they continue to take care of themselves, this affects the disease.

“From a statistical, epidemiological perspective, Outlook and lifestyle affect the immune system.”

a doctor in glasses talking about the worried well
Kim in Canada

Mental Health + Medication

Sydney, “Some mental health diseases are best controlled through medication. Other mental health aliments show mixed or neutral results with medication. There is a trend to medicate all mental health issues. What are your opinions on that?”

Kimberly, “In the ’60s and ’70s, there was a belief that science should be able to do anything for people. This was because science and medicine were improving at a quick, exciting pace. We invested in pharmacology and developed great medications. Now, we can affect people’s mental and physical health with a simple pill. Anti-depressants, uppers, downers, street drugs all affect our brain and body chemistry. They also produce psychological effects. But are these medications giving us the desired outcome? Are we happier as a result?

“We have learned that pills do not do the full job. Pills, prescribed or not, do not create a happy life. You need to focus on a person’s psychology through behavior changes and talk therapy. “Medications may help the neurotransmitters and alter the chemical physiology. SSRI’s can recharge the battery, so to speak, but it does not sustain an individual’s mental wellness.

“In the end, you have to deal with how you deal.”
 
a family

Placebo’s Power

Kimberly, “Looking back in history, humans used snake oil and other strange medications to treat illness. Most of these practices do not have an effect. But we have always had a placebo effect, and this cannot be dismissed. If people believe they are taking an effective drug, their health will improve. Drug studies with control groups show this effect. The control group believes they are taking the medication. In reality, they are the placebo group. These control groups do quite well, sometimes producing results equal to the group that takes the actual drug.

“Excluding fatal illnesses like brain tumors and birth defects, medicine integrates with psychology. We need a whole body/mind approach to who we are and how we take care of ourselves. Medicine is becoming more spiritual, the belief of our wellness is equal to our physiological state.

“Placebo drugs can ‘cure’ illness quite well. If you believe in your treatment, you will have real, biologically measured effects. This is important for the worried-well population.”

a woman drinking beer who talks about medicine
Kim and her beer

The Worried Well

Sydney, “What about when you worry yourself sick?”

 

Kimberly, “I saw this often, I would do a workup with many ‘worried well’ patients who had real symptoms. Doing a workout shows a patient that there was no problem. While reviewing the results, I would talk to my patients and uncover personal issues. These personal issues often manifest into symptoms, be it stress, divorce, or overworking. This is an example of worried-well, and this does not dismiss their symptoms. To cure their symptoms, the worried-well need proof that they are well. Then we can focus on the worry that that produces feelings of illness. Once you provide physiological proof of non-illness, people did not feel a need to come back. And their symptoms, miraculously, clear up.”

talking about the worried well with a family and two dogs

Mind Over Matter

Sydney, “So, you can have physical effects from the outlook that you have?”

Kimberly, “Yes, it seemed to me. It matters what your outlook is, how you see the world, how you see symptoms, and how you focus. We do not feel great 100% of the time. Old age comes with aches and pains. So, we will all have symptoms of illness and genetic markers of potential diseases. If you focus on this, becoming ‘all consumed’ by biomarkers or signs, you grow into unwellness. You start seeing other patterns, starting a cycle that puts you at unease and makes you feel unwell.

“The disease is ‘diss- ease’; it is not at ease, the opposite of being at ease or feeling healthy and comfortable. Constant introspection and physiological analysis disrupt your ease. It leads to a downhill spiral of un-wellness.”

a woman in the mountains

Health Defined

Sydney, “What are the parameters and definitions for health and unhealth?”

Kimberly, “I’ve been thinking about how beauty ties into health. Disease is not feeling healthy. Beauty and radiance are about how we feel about ourselves, no matter what we look like. As a doctor, I want to know: can you move your body every day? Are you eating a healthy diet with enough water?

“We catch viruses, develop cancer, and develop illnesses like rheumatoid arthritis, allergies, eczema. You will feel terrible and unhealthy when you suffer from illness or immobility. How you look and your physical beauty become less relevant. This is why I define health as a state of mind. Beauty is someone who is physically and mentally are ease.

I feel grateful to be mobile and active. Often, people my age limit their daily activity as the body starts to give out. I don’t suffer from this. Walking and gardening, pain-free, make me feel healthy, it makes me feel good. Simple things like your body working are what make you beautiful and make you feel healthy. I think this is universally true.

“Can you move? Do you have something that is preventing you from moving and being?”talking about the worried well with a couple next to a clear lakeLimitations

Sydney, “How does this apply to someone with chronic physiological issues? For example, someone in a wheelchair with permanent mobility-loss?”

Kimberly, “I have never had to deal with such issues. Personally, it would be hard to mentally overcome this. There are people who do, they keep going and will not allow mobility-loss to bring them down. I consider these people healthy. They are doing the best with their circumstances.

“We all have circumstances we must overcome in life. How you deal with those obstacles, your attitude and behavior, influence your health. Mustering the courage to move on can be difficult. We do not live disaster-free, at some point we all deal with struggles. Remaining aware of this truism positively influences your health. There are people who live their life in a wheelchair. They continue to engage with life, help society, and give back. This refocuses their energy off of their suffering. Often, they are the happiest people because of their outlook on life.”a couple next to a blue lake

Spirituality + Strife

Sydney, “Existential psychology claims that happiness and meaning come from overcoming struggles. From my understanding, many religions promote overcoming or grappling life’s inherent suffering.”

Kimberly, “In the New Testament, Jesus criticized the Pharisees during their day of fasting. The Pharisees moped around, poorly dressed, and showed their suffering. Jesus said that when one fasts, we must dress in festive clothes and maintain a positive outlook. He conveyed that no matter what you are going through, you rise above your suffering and think of others.

This shifts the focus away from you and your daily aches and pains. Intense introspection does not help us overcome our situatedness. It further isolates you from the company of others and takes you away from the world.

“There are always people worse off and better off than you. For those of us blessed with good health, we forget to appreciate our blessings.”

a woman in a meadow in the mountains who thinks that nature helps with mental wellness

Mindset + Age

“When I did my rotations in the hospital, I treated older people. Their reactions to old age and illness were split. They were either bitter and upset about what life had given them or remained positive. The people who said, ‘I will get over this and go back to my life’ were happier and achieved better health.

“I can’t tell you why some people have a better outlook than others. It seems like a choice. We must remember that modern medicine cannot cure everything. Today’s best medicine may be a positive outlook. It prevents illness, enhances life quality, and speeds recovery.”

a woman and two horses

Disease as Choice

Kimberly, “Most of the population does not have genetic illnesses preventing them from living well. Therefore, we have to ask ourselves, ‘Do I want to live in wellness or in disease?’

“As a family doctor, the motto we have is, ‘Get off the medicine and work from the ground up’. “My patients appreciated this motto. Many did the hard work of getting off poly-pharmacy and towards a healthy lifestyle. My patients felt their best living in daily wellness by building a holistic health practice and removing medications.

“The societal issue of poor health is changing. Workplace gyms, mental health awareness, and healthy food choices are becoming the new normal.

Personally, my health philosophy is getting out, exercising, and living well. I try to stay active every day. I love chocolate and sugar and beer, but I limit these by eating whole grains and vegetables daily. I am active every day and I will sometimes take a Motrin to relieve aches and pains.”

a woman and her horse
Kim + the famous Trabero

Beauty

Sydney, “What makes you feel beautiful?”

Kimberly, “I feel the most beautiful when I am active and outside– getting sunshine and going for walks. When I wake up, I have tea or coffee, work on projects, and keep my mind active by reading medical journals or other books. I am not practicing medicine but I like to keep up with my field. I also keep up on politics, science, and current events. For me, I need to challenge myself intellectually and physically.

“If I’ve addressed both body and mind, get my chores done, and my projects are progressing, I feel satisfied. The contentment from these achievements makes me feel beautiful. I am covered in dirt from the garden and paint from my projects, but I look in the mirror and think I look good. And that is what makes me feel happy, beautiful, and healthy each day.”

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