Start Now: Why thinking about the New Year in October is a really smart move.

Most of us wait until New Year’s Eve — New years evewhen we’re one or two glasses of champagne deep into the night — to make our New Year’s Resolutions.

In the harsh light of day, the next morning, those big resolutions can feel pretty tough to keep. Football and chili may overtake the first day of the New Year, and it’s hard to be mindful of new intentions.

I love thinking about the future and dreaming about what’s next in life, but I’ve found that when it comes to making resolutions that actually stick, it’s all about…

-    Quiet reflection
-    Advance planning
-    Sane expectations
-    and Tiny habits

With that in mind, I’ve decided to start mapping out my goals for 2015… now! Fall seems to have a focused and productive energy that seems to encourage big questions like “What matters most to me? And how do I want to feel?”

Long before the hectic rush of the holidays is upon us, it time to reflect and plan for success, and to define what that means for you.

Grab a notebook or journal. Mark some recurring dates with yourself in Google calendar. I’m a paper planner fan, and there are some beauties available. My personal favorite, Danielle Laporte’s Desire Map Day Planner .

Want to join me?

Here’s a few goals to ponder — based on the most commonly-broken New Year’s Resolutions — plus my tips on how to get started, sooner, and really stick with it:

GOAL: Make Health a Priority.

Weightlifter James Clear puts it best: “Focus on lifestyle, not life-changing.”

As James writes in this brilliant article:

“Losing 50 pounds would be life-changing, drinking 8 glasses of water per day is a new type of lifestyle.

Running a marathon would be life-changing, running 3 days per week is a new type of lifestyle.

Squatting 100 more pounds would be life-changing, squatting 3 days per week is a new type of lifestyle.”

Instead of focusing on the gigantic end-goal — “losing 50 pounds” — try focusing on the tiny habits that will get you there — “drinking 8 glasses of water per day.”

Start now, with the tiniest habit imaginable. Then another. And another.

Just imagine beginning the New Year feeling like you’re already in the best shape of your life!

GOAL: Learn Something New.

As a total information and inspiration junkie, I can relate to this desire, big time.
But don’t procrastinate until January 1st to start thinking about what you’d like to learn.

Start now, by signing up for a course at a local college (many colleges have adult education programs for people who just want to stretch their brains, but not necessarily pursue a degree. Don’t wait until your dream class has already filled up!)

Or take a free online class (here’s a list of 1,000 of them!).

Or check out this massive directory of workshops, conferences and festivals, choose one that looks intriguing and sign up… now! You’ll have something special to look forward to, for months and months to come!

GOAL: Travel to New Places.

I always fantasize about taking lots of fun summer trips every year, but I tend to wait until it’s the tail-end of spring to start planning. No longer!

Start now, by blocking out a couple of weeks (or weekends) on your calendar for next year and label them “travel days.”

Even if you don’t make specific plans right now, make a promise to yourself that you won’t fill up those days with work or any other commitments. They are ONLY for travel.

Seeing those clear labels on your calendar will make you less likely to “forget” to travel… and less likely to overcrowd your calendar and run out of time.

GOAL: Get to the Next Level of My Career.

If you want to upgrade your career (or business) next year, start by assembling your dream team, now.

Need a new website? Reach out to a designer that you like and get on their calendar, soon. (The good ones tend to get booked up — fast!).

Need a coach or strategist to help you? Set up consults with a couple people that you like, now. Start early so that you can find the right match.

Need to revamp your resume? Start the process now, so that you’re confident and ready to send it out at the beginning of the New Year (historically, a great season for job-hunting!) instead of procrastinating and then rushing to get your ducks in a row.

GOAL: Spend More Time With Family.

Like traveling, this one is all about blocking out chunks of time — sacred, untouchable time — and making a solemn oath that you won’t fill it up with non-family obligations.

Why not block out one night a week for a home-cooked family dinner? …starting now, not January 1st.

Why not designate every Sunday afternoon as “technology-free time” so that cuddling and conversation and board games can happen, instead.

Instead of trying to pack an uncomfortable amount of “family time” into a hectic holiday season, or postponing quality time until January, you can start… now.

As Tony Robbins says:

“Setting goals is the first step in turning the invisible into the visible.”

The sooner you set your goals & resolutions, the sooner you can start taking tiny steps to make them real.

Waiting until New Years Eve won’t make things any easier.

Give yourself a fresh start & a head start… today!

~ Dr. Sue

P.S. What’s one tiny, positive “upgrade” that you’re ready to make, today?

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“Why do I want to be healthy?” How to get “emotional” about your wellness goals — and truly commit.

In his groundbreaking book, Start Apple computersWith Why, Simon Sinek urges business owners to uncover their “why” — the mission, the belief system, the deeper motivation — that drives them to do business. If you want the 18-minute version, watch his talk.

When a business has a clear “why” — and expresses that “why” consistently — then people feel invigorated and inspired.

People are no longer just customers, purchasing products & services with a sense of detachment — they become loyal, devoted fans.

They are emotionally invested in THIS particular business, and THIS business alone. They are part of a movement. Part of something that matters.

Apple Computers, for example, has a very clear “why.”

Apple believes that technology should be accessible to everyone, even non-geeks, and that machines should be aesthetically beautiful, not clunky.

Apple believes that with the right laptop and enough creativity, you can do anything. Launch a business. Create a recording studio in your bedroom. Change the world.

Apple customers are loyal, devoted and often fanatical about the company’s products. Not because the products are “the best” in the world (one could argue that they’re not). But because of what the company stands for.

Customers get emotionally invested… not because of “what” Apple makes, but because of “why” Apple exists.

So what does all of this business & technology talk have to do with your health & wellness goals?  A lot.

As a physician — and as a human being who is always striving to get a little healthier — I have learned that the secret to sticking with healthy habits is to get “emotionally invested” in your goals. In other words, you’ve got to “find your why.”

You can begin by asking yourself one question:

“Why do I want to be healthy?”

What’s your “why” when it comes to the way that you eat, sleep, hydrate and take care of your mind, body and spirit? What drives you?

When it comes to my patients, many people think that their “why” is to “look more attractive” or “have better skin.” This is often true, and perfectly reasonable, too.

But there’s often a deeper “why” that they’re not acknowledging… yet.

You’ve got a deeper “why,” too.

For example…

You might want to be healthy because:

1.    You want the energy to be able to play with your kids, instead of saying, “Not today. Mommy is tired.” When you eat poorly, you can’t be the kind of parent you want to be.

2.    You want the mental clarity that’s necessary to serve clients through your business. When you skimp on sleep, you can’t be the kind of service provider you want to be.

3.    You have a cause that you’re trying to promote in the community. You need funding. You need traction. You need others to say “Yes!” to your propositions. When you neglect your health, your light shines less brightly. People are less likely to be inspired by you — and less likely to be inspired by your cause.

4.    You want to live a long, happy, pain-free and positive life. Good health sets you up for more fun and joy and movement as you age.

5.    You want to look great. And there’s nothing wrong with wanting aesthetic results — shiny hair, bright skin, a slimmer body, or smooth, toned legs. But it’s important to dig a bit deeper to discover a “why” that goes beyond the surface level. How does it make you feel?

If you ask yourself, “Why do I want to be healthy?”…and come up with a “why” that’s so powerful, it practically brings you to tears… that’s the one you want to focus on.

Why do YOU want to be healthy?

Ask yourself. Do some reflection. Write down your “why” or list of “why’s.”

Is there a “why” that makes you feel inspired, energized, excited… or even makes you cry?

Circle it. Pin it to your vision board. Repeat it to yourself every day.

That’s the “why” that you need to remember in order to get “emotional” about your wellness goals — and truly commit.

~ Dr. Sue


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Got a big event in less than 24 hours?

…How to make your skin look amazing (or at least, a lot better!) super fast.

Not long ago, I was chatting on the phogreat skinne with a friend who had a live webTV appearance coming up in less than 24 hours.

She generally has good skin, but lately, it’s been feeling a little dry and uneven, with a wayward pimple or two.

When she asked me, “Is there anything I can do to make my skin look amazing, like… really quickly?”

I thought it over and replied, “Actually, yes!”  I gave her my short list then put my head together with my trusted Catalyst team of aestheticians (skin care specialists) Abbie Boyle, Trisha Desautel, Amber Wogsland and Lindsy Sheeley.

If you’ve got a big event, job interview, hot date or major opportunity coming up in less than 24 hours, here are our expert recommendations for you to get your skin into the best possible condition… fast:

: Hydrate. Drink lots of water to flush out your system and make your skin look as full, smooth and plump as possible.

You can also try a hydration spray for an instant refresher. Evian water makes a canister that spritzes your skin. Jane Iredale makes one with grapefruit peel extract, green tea leaf and vitamin C antioxidants for a quick pick-me-up, and is also a great setting spray for makeup.

: Exercise. Even just a brisk walk around the block will bring a beautiful, healthy flush into your cheeks and improve your circulation—and your confidence! Check out Dr. Amy Cuddy’s TED talk on body language and power poses.

: Get your eyebrows shaped. A good eyebrow shaping — whether it’s tweezing, waxing, sugaring or threading — can change your entire face! For starters, check out the incredible “brow makeovers” from O: The Oprah Magazine. If your eyebrows are very thin, either from over-plucking or just natural genetics, has this tutorial to help you to create a fuller-looking brow. And if you’ve lost the outer part of your brow, consider getting your thyroid levels checked.

: Cool down puffy eyes. You’ve probably heard about using cucumber slices or cold tea bags. Here’s a less messy trick—cold spoons. Put them in the fridge overnight, then use them under your eyes to decrease puffiness.

A high-tech option is the Clarisonic Opal. This little gadget has a soft tip just a little bigger than a pencil eraser with an ultrasonic action. We use it with a dab of cool eye cream to infuse the area around the eyes, which decreases swelling and dark circles, and minimizes fine lines.

: Exfoliate. Use a fine, delicate scrub — like my favorite Finishing Touch from Revision Skincare — to remove the top layer of dead skin cells. This will instantly smooth out & brighten your skin. Take care not to rub too fiercely, though, especially if you have any pimples. You don’t want to aggravate them! You can follow with a few minutes of facial massage to give your skin a healthy glow.

: Shrink those pimples. When celebrities develop pimples (yes, even the stars have bad skin days!) an on-set dermatologist will often administer a small steroid injection directly into the pimple to reduce redness and swelling.

You probably don’t have a live-in dermatologist (if only!) but you can try a do-it-yourself version of this treatment with a small dab of over-the-counter hydrocortisone cream. Just dab a small, micro-pea-sized amount onto the pimple and let it sink in like a moisturizer. Also try a cold compress to shrink it more.

: The professional touch. For big events — especially if there’s going to be lots of photography or video cameras popping around — I always encourage women to get their makeup applied by a professional. A little bronzing powder adds contour and livens up your coloring to start out, and can be helpful even for the guys.

My aesthetics staff was on site at TEDxFargo doing makeup for the speakers, who shared that it was relaxing and a great confidence booster. They take care of me before photo shoots too! You can also pop into a MAC cosmetics store for a complimentary makeup session, as long as you purchase $50 in products.

Or, go DIY after watching a couple of fun makeup tutorials on YouTube! (This “Picture Perfect Day” tutorial from YouTube superstar Michelle Phan is full of brilliant, simple tips that even non-makeup pros can handle.)

Special occasions are a great excuse to play, pamper yourself, try something new and express your definition of beauty to the fullest.

Ready, set… go!

You won’t believe what a difference 24 hours can make.

~ Dr. Sue

P.S. Do you have any last-minute rituals just before a big event or special occasion?

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Friends, food & glossy fun. Why not… start a magazine club?

A book club.

It seems like such a fabulous idea. magazinesGathering with friends to discuss the great literary classics… or perhaps the latest NY Times bestseller… or the must-read personal development hit of the season.

I have fond memories of my book club in Seattle. I was a surgical resident at the time. I didn’t get to go often and I rarely read the books. And when I when go, I often fell asleep in my chair. But it was so good to be in the presence of normal people with normal lives, that I treasured the times I made it there. The women were sympathetic and didn’t kick me out. Instead they fed me, and cheered my efforts to become a doctor.

That book club is still going strong since the early 1990’s. I remain on the email list, keeping up with the book choices, and seeing friends from the group when I travel to Seattle. Someday, I’ll join them for their annual retreat.

For years, I’ve fantasized about starting — or joining — a book club here in Fargo.

But I’ve realized that with my work schedule, family time and volunteer commitments, life seems even busier than it did when I was a resident! But I miss the connection.

My friend Cris Linnares, once mentioned having a magazine club as a more realistic option, and I’ve been dreaming of it ever since.

Magazines get a bad rap. They’re often considered to be the frivolous, fluffy younger sibling to big, grown-up books. But I disagree! I do love books, but magazines provide a different kind of stimulation… and inspiration.

I turn to books when I want depth, food for thought, or fictional characters that I can fall in love with.

I flip open a magazine for a quick lift, a neat idea, or a sip of visual beauty in the midst of my day.

I’m excited to start a new tradition and host the first annual magazine club at my home this autumn, complete with cozy drinks and baked treats. Everyone is going to bring a big stack of gently used magazines, share a favorite article, then put ‘em in a pile… and swap!

Here are a few of the magazines that I’ll be bringing to the table:

The Intelligent Optimist.

Smart, well-researched stories covering science, innovation and creativity with — you guessed it — an uplifting, positive perspective.

Eating Well.

My go-to choice for delicious, healthy recipes. The photos are always stunning — and their website is a treasure trove of terrific recipes, too.

Edible Seattle.

My dear college friend and Seattle book clubber Heidi Nelson gave me this as a birthday gift. I’ve enjoyed it for years, since I’ve got a nostalgic spot in my heart for the Pacific Northwest despite the traumas of residency.

There are Edible magazines for many US regions, so try to find an edition in a city close to you, because they focus on local, regional produce and recipes. Sadly, Edible Twin Cities ceased publication last year, but it was good while it lasted.

MORE magazine.

A magazine that “celebrates women of style and substance.” I love that they feature models of diverse ages and ethnicities, and feature articles on career topics & personal finance… not just the latest eye shadow trends. (Not that I don’t love a good eye shadow, too!)

Real Simple.

I could just dive into the pages of Real Simple and live there, forever. It’s the only magazine that can make organizing your junk drawer look like a total dream!

O: The Oprah Magazine.

Gotta love Oprah! Her “Favorite Things” and Book Club picks are always fantastic.
And much like MORE, Oprah’s editorial team also intentionally chooses models that reflect a diverse range of body types, sizes, skin tones, cultures and ages.

New Beauty.

This magazine covers all the latest and greatest trends in make-up, skincare, hair treatments, lasers and even surgery. It helps me keep the patient perspective in mind, and I enjoy the tips too!


Their motto? “At home in the modern world.” One day — mark my words! — my home WILL look like the pages of Dwell magazine.


No, it’s not a magazine devoted to celebrating everybody’s favorite trashy pizza franchise!

This style, decor and shopping magazine is bright, playful and filled with fresh ideas. Their “Get To Know” series offers a neat glimpse into the lives (and homes) of artists, designers and other creative spirits.

When my inner entrepreneur needs an info/inspiration fix, I read IncFast Company and Wired magazines. And since women are starting businesses at a record-breaking pace, I think these would be fun to bring into magazine club as well!

Overflowing with too many magazines?

If you’ve got a bit of a magazine fetish, like me, and need to de-clutter a bit, here are 7 places where you can donate used magazines.

Your local library, nursing home, or women’s shelter would love your used magazines. Oh, and your local doctor’s office might want them, too!

Or… you can start a magazine club like me, and then gently encourage (read: force) your guests to take home at least five magazines, each.

Happy reading!

~ Dr. Sue

P.S. If you could appear on the cover of any magazine, what would be your dream ‘zine?
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Daring Greatly, chipping slowly: Lessons from the Crazy Horse Memorial

A few weeks ago, my family and I took a trip Crazy Horse Memorialto the Black Hills of South Dakota.

Grant’s highlight of the trip was definitely the water slide attached to our hotel in Rapid City. I even went out of my comfort zone and did a few slides myself. I enjoyed floating around “The Lazy River” and went against the current to make it not so lazy!    

My personal highlight of the trip was the Crazy Horse Memorial.

If you’re not familiar with this particular memorial, here’s the Cliff Notes version of the story:

In 1948, Lakota Chief Henry Standing Bear tapped a sculptor named Korczak Ziolkowski to undertake a completely “crazy” project:

They wanted to carve a sculpture … out of an entire mountain.

Korczak had worked with Mount Rushmore sculptor Gutzon Borglum for a time. He then became an award-winning sculptor in New York. Chief Standing Bear noted his work and felt that Korczak was the man for the job.

This 563-foot-tall sculpture would be carved to honor Crazy Horse, a hero amongst North American Indians, and to honor the culture, tradition and living heritage of his people.

Some people called it art. Some people called it a moving tribute to a great leader. Other people called the idea… insane! But Standing Bear and Korczak were determined to see their vision realized, even if it took multiple lifetimes to complete.

Nearly 70 years later, the carving is still incomplete. It remains, to this day, the largest and most ambitious sculptural project in history. Piece by piece, with precise explosive blasts, the sculpture moves slowly towards completion.

Just before his death in 1982, Korczak’s his final words to his wife were, “You must work on the mountain — but go slowly so you do it right.”

His family continues the project — and the legacy — today. His wife Ruth, died this May, but was actively managing the project along with 7 of her 10 children. We saw several of them attending to various projects the day we were there.

The Memorial Campus has plans for a Native American university, medical school and hospital. There is already a very impressive museum. Summer training programs for Native American students have been active for several years.

The project will not be finished in my lifetime, or even in Grant’s. But one day, thanks to the tireless efforts of an entire community, the dream will become real.

To me, the Crazy Horse Memorial is a testament to the power of personal vision and enterprise, patience, tenacity and a willingness to “make progress” no matter what.

Because of Crazy Horse, I remember that…
1.    You don’t need a bank loan, government funding or a Kickstarter campaign to make a big dream come to life. Chief Henry Standing Bear and Korczak believed that the public would see their vision and support the project, piece by piece, dollar by dollar. They were right.

2.     Great projects take on a life of their own — and the twists and turns can be very surprising. I’m sure Korczak never imagined that his sculpture would become the site of an annual organized hike, a laser light show, a rodeo, or a summer lecture series and tribal dancing events. One project can be the “spark” for a dozen other amazing ideas. You never know what the full impact of your work might be!

3.    Patience and slow, deliberate refinement can be beautiful. Like so many people, I often want things in my life to happen as quickly as possible, but it takes more than a “24-hour bootcamp” or a “6-week online training course” to carve a mountain. It takes decades. It takes devotion. Medicine is my mountain, and as I learn, my body of work becomes more refined. And more helpful, I hope.

4.    You don’t have to ask for permission to begin something amazing. Just dare greatly as Teddy Roosevelt declared in his famous speech and Brenè Brown emphasizes in her best-selling book.

Climb up that mountain, whatever it might be, and start chipping away.

~ Dr. Sue

P.S. What is the most ambitious, magnificent project you’ve ever seen? How did it feel, being in the presence of that kind of work?

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Tomato Overload! Zucchini Insanity!

*How to keep produce fresh (and use it all up) when you’ve got too much of a good thing.*vegetables

Last night, when I tried to close the door of my fridge… it wouldn’t seal. That’s when I realized: I might have a problem. A produce problem.

My kitchen is bursting with delicious veggies from our Farm In The Dell community garden (next door to our office) and the Bluebird CSA (Community Supported Agriculture) deliveries once a week. I also have a nice little crop of tomatoes from my patio pots.

I’ve been making an effort to do some juicing and a few veggie stir-fries as we savor the last few nights of summer, but… I have to admit: I’m up to my elbows in tomatoes — and I just can’t use them up fast enough.

In a moment of panic, I began researching tips on how to keep produce fresh, longer.

I found some terrific ideas — but my research generated lots of ideas about what to “do” with all that produce, too, besides just try to preserve it.

Got a serious “produce problem,” like me?

Here are seven things to know and do to use up that beautiful, healthy food:

1.    Know your storage basics. Did you know that you should never store fruits and vegetables together, in the same bin? Or that tucking a bunch of bananas in a bowl will accelerate the ripening (and rotting) of everything in close proximity? Who knew? This handy storage guide from will get you up to speed.

2.    Get a BluApple. This little device looks like — you guessed it — a bright blue plastic apple with a little packet inside. When you tuck it in a bowl of produce, it absorbs ethylene gas (a gas that accelerates ripening) and keeps fruits and veggie fresh …  up to three times longer! It’s completely non-toxic and BPA-free, too. And cute!

3.    Check out Debbie Meyer’s Green Bags. I’m usually skeptical of infomercial products, but these really work to keep greens fresh longer. I would purchase them again.

4.    Throw a veggie-swap party. Got a zillion tomatoes, while your neighbor is drowning in summer squash or sweet corn? Host a potluck, have everyone bring their extra produce along, and divvy up the goods so that everyone goes home with a little bit of everything… instead of too much of one thing!

5.    Get blog-spired. When I need a dose of home & cooking inspiration, I always turn to the blogosphere. Michelle from Rosy Blu has a terrific series called “Oops, I Have Too Much!” — “a blog series dedicated to the inevitable abundance of seasonal produce.” Chef Jamie Oliver’s website is another treasure trove of veggie-focused recipes. (He’s got a great collection of How-To Videos, too!)

6.    Remember the Three S’s: Sauces, Soups and Salsas. Three great ways to use up a LOT of produce, quickly, and then freeze it for later. Here are oodles of sauce recipes45 speedy soups and stews from one of my favorite magazines, Real Simple, and dozens of salsa recipes, too. Really pressed for time? My sister-in-law Marcene and step-daughter shared this gem with me: Just rinse your tomatoes and put them whole in a freezer bag. Use as needed to make salsa or pasta sauce.

7.    Give it away. This is a great way to introduce yourself to new neighbors. Non-profit organizations like Ample HarvestSecond Harvest and locally the Great Plains Food Bank accept produce donations and deliver them to thousands of emergency food shelves, homeless shelters, senior community centers and children’s after school programs. If you’re not going to eat it all yourself, don’t that all of that nourishment go to waste.

Happy rinsing, sealing, storing and saucing. And, wish me luck as I try to get that darned fridge door to close!

~ Dr. Sue

P.S. Fill in the blank: “I could never possibly have enough ________ in my kitchen.”

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“Quiet, please!” How to create peace & silence… in a very noisy world.

“The best cure for the body is a quiet shhhhmind.” —Napoleon Bonaparte

If it feels like our world just keeps getting louder and louder… you’re right. It is.

The average volume of songs played on the radio has steadily increased every year, since the ‘50s. TV ads are notorious for being several decibels louder than the actual TV shows. Restaurants are louder than ever. Burgeoning populations & frequent construction projects mean that our cities are getting noisier, too.

It’s no wonder that 15% of adults suffer some degree of noise-induced hearing loss. And we are very worried about the ears of our younger generation, as our digital music players allow for lots of loudness with little distortion, setting up a dangerous situation for the delicate neurons of our auditory system.

Hospitals are infamous for noisy nights, with beeps and alarms and frequent disruption of patients’ sleep. Noise consistently gets the worst marks on patient surveys, with many reporting difficulty resting due to loud sounds. The more we know about sleep, the more we realized that it is vital for healing. Hospitals are now asking staff to use hushed “library” voices because quiet murmurs can be more soothing than normal speaking tones. White-noise machines are used in patient rooms and hallways to aid sleep and relaxation.

But noise pollution doesn’t just harm people — tragically, it damages the natural environment, too. Peaceful whales are often killed, diving deep, deep down — too far down— to escape the loud, frightening noises caused by large ships.

Sometimes, it can feel like there’s no escape from the chattering and pulsing and jack-hammering of our modern world.

To have some peace & silence, you have to actively create it.

You can create more quiet-time in your life by popping earplugs into your ears, of course.

Or by taking a walk in the woods — what the Japanese call Shinrin-yoku, or forest bathing. Breathe deeply.

Or by booking a session in a sea salt isolation tank, where you can float in total darkness, stillness and silence for an hour, or more. I did this as part of a college class long ago. It was so peaceful, but I don’t remember much about the class!

Or simply by waking up a bit earlier — before the outside world begins its hectic din — and taking a few quiet moments to sit peacefully, reflecting on your goals for the day to come. Early to rise is my secret sauce. I do all of my writing in the morning before my family wakes up.

Author Susan Cain is leading a quiet revolution. Her book Quiet: The Power of Introverts in a World That Can’t Stop Talking celebrates a quiet, contemplative style in an extroverted world.  Her TED talk on this subject has over 9 million views and is worth the few minutes to watch. She argues that businesses and schools need to consider solitude as well as collaboration to enhance outcomes and well-being.

Today, create a few moments of quiet-time. Drive home without the radio blasting, take a quiet walk at sundown on a not-so-busy street, or try a silent meditation. Or just flop on your bed, arms and legs sprawled out like a starfish, with a “do not disturb” sign on your door.

Quiet renews the spirit like nothing else.

Do whatever it takes to get the quiet-time that you need.

~ Dr. Sue

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Decoding the Secrets of Skincare Labels

I always say knowledge is power. It helps product bottlesyou make good decisions about your health as well as products that may affect your health. Since skin is your largest organ, it makes sense to know what’s in the lotions and potions that we dab, rub and slather on our faces and bodies.

But if you turn the bottle, tube or jar around and try to read the label, you may want to look away, or even run away!

Companies are required to list ingredients of external packaging, but reading and understanding the label seems to require a PhD in chemistry. The words are long, and unpronounceable. The type is microscopic.

These info tips will help you understand labels so you can be conscious about your skincare purchases.

1.    Ingredients are listed in descending order by concentration meaning the main ingredient is listed first, and so on. If you are interested in a particular ingredient, make sure it’s high on the list.

2.    If an ingredient is considered a drug, it is listed first, no matter what the concentration is.
3.    Sometimes active ingredients are in a separate list.
4.    When ingredients have a concentration of less than 1%, then they can be in any order at the end of the list.
5.    Fragrance and color are not required to be listed by concentration and usually appear last.
6.    Trade secret ingredients don’t have to be listed at all and can be shown as:  “And Other Ingredients.” This can be a tricky spot. All you can do is hope for an ethical company, or avoid products with mystery ingredients.
7.    Humectants bring moisture to skin’s upper layers, keeping it moisturized. Examples include glycerin, urea, panthenol, hyaluronic acid (sodium hyaluronate), and ceramides.
8.    Emollients are also moisturizers and make skin feel smoother, filling in cracks or rough spots caused by dryness or irritation. Popular emollients are oils from plants and fruits, like shea butter, avocados, jojoba, sesame, almonds, coconuts and sunflowers.
9.    Silicones are considered emollients and have a “slip” factor that give cosmetics and moisturizers that silky feel and help give an even application of pigments and active ingredients. The most common forms of silicone are cyclopentasiloxane and cyclohexasiloxane, dimethicone and phenyl trimethicone. Most silicones will have “-cone” or “meth” in the name.
10.    Alcohols are widely used in cosmetics and skincare, and have positives and negatives. Alcohols can be drying and irritating, especially for oil-prone skin, as they can encourage oil production. Alcohols to avoid: ethanol, denatured alcohol, ethyl alcohol, methanol, benzyl alcohol (when it’s among the main ingredients), isopropyl alcohol, and SD alcohol, especially if they are listed at the top; when at the bottom they are fine. Good or “fatty” alcohols are emollients as described above and include cetyl alcohol, cetearyl alcohol, lauryl alcohol & laureth-23, stearyl alcohol, behenyl alcohol.
11.    Occlusives create a layer of film on the skin to prevent moisture from escaping.  But some can make skin cells clump together, clog pores and cause acne. Common occlusives include paraffin, mineral oil, pertrolatum, cetyl palmitate and dimethicone.
12.    Surfactants help create lather and foaming action in cleansers. They also make creams easier to apply. Examples include ammonium laurel sulfate, cocamidopropyl betaine and ingredients ending in “stearates.”
13.    Botanicals are derived from plants and/or trees. Examples include aloe vera, green and white tea, and tea tree extracts.
14.    Vitamins have powerful anti-aging effects, as they protect against free radicals, sun damage, moisture loss and environmental threats while encouraging healthy cell renewal. Scientific studies Vitamins can be listed under different names on product labels: Vitamin A is retinol, retinoic acid, and tretinoin; vitamin C is L-ascorbic Acid, magnesium ascorbyl phosphate, ascorbyl palmitate, ester-C, or tetrahexyldecyl ascorbate; and vitamin E is tocopherol, d-alpha tocopherol, or d-alpha tocopherol acetate.
15.    Acids exfoliate dry surface skin cells to reveal a fresh, smooth complexion. These include alpha hydroxy acids (AHAs) like glycolic or lactic acids, and beta hydroxy acids (BHAs) like salicylic acid.
16.    Sunscreens basically come in two categories: physical sunscreen, which block the UV rays, and chemical sunscreen. Both are considered safe and effective for most people, but some people can be sensitive to the chemical ones. Physical sunscreens usually have names like titanium dioxide, or zinc oxide. Chemical sunscreens have names that end in “-one” or “-ate” like avobenzone, oxybenzone, homosalate and octisalate. Sunscreens are classified as “Active Drugs” so are listed in the Active ingredients section and have their % listed.
17.    Put these on the “no” list: Parabens, sodium lauryl sulfate, formaldehyde-releasers, fragrance, and phthalates.
18.    Parabens are preservatives used to prolong the useful life of products. They include methylparaben, ethylparaben, propylparaben and butylparaben. They may have estrogen-like effects which some believe can influence breast cancer, so many choose to avoid these.
19.    Sodium lauryl sulfate is a detergent that can irritate sensitive.
20.    Formaldehyde releasers are commonly used as preservatives, but can cause skin allergies. Avoid DMDM hydantoin, imidazolidinyl urea, diazolidinyl urea, quaternium-15, bronopol, 5-bromo-5-nitro-1, 3-dioxane hydryoxymethylglycinate.
21.    Fragrance is also a common allergen. It can take hundreds of chemicals to create one fragrance.
22.    Phthalates are chemical used in soft plastics and PVC. They have no place in skin care. Dibutylphthalate (DBP, DEP, also butyl ester) has been used to enhance product absorbtion. DEHP has been classified as a “probable human carcinogen” by the EPA, and also has known endocrine-disruption effects which can impair future fertility.

The Cosmetics Safety Database from the Environmental Working Group is a useful tool for getting to know your ingredients. Ingredients are scored 1-10 regarding potential toxicity, with 10 being the worst.

My favorite is the Cosmetic Ingredient Directory in I also like that this company lists what each ingredient does in brackets right on their labels.

After reading this, I’m sure you feel worthy of a lab coat and a few extra letters behind your name! Grab your favorite product and learn more about it.
~Dr. Sue

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An open letter to medical school students, everywhere.

This fall, about 20,000 Americansstudy table mostly young people, fresh out of undergraduate programs, and others with a bit of life experience and families to balance — will begin their first year of medical school.

I remember, clear as a bell, how I felt during my first day at med school.

A blend of emotions — overwhelming, at times. I had deferred admission for a year so that I could do volunteer work in Peru and see the world before jumping back into the whirlwind of education. Nervous. Determined. Panicked. Passionate.

And while it’s been a few years since I tossed my graduation cap in the air and added a couple extra letters behind my name, I remember that feeling, too. Vividly.

Becoming a physician is not easy. Being a physician is not easy, either.

There are a lot of misconceptions about what a doctor’s “lifestyle” looks like. Fun TV shows like Grey’s Anatomy and Scrubs depict a world of romance, intrigue, exotic cocktails with your colleagues to celebrate a successful surgery, celebrity clients, and money flowing easily.

The reality is starkly different.

Sure, most physicians make decent salaries, but I wouldn’t want to calculate the hourly rate. And many young doctors are saddled with crippling student loan debt, some over $250,000.

The hours are long. The patients are sick. The rewards are great, but so are the sacrifices.

But I’m not writing this to complain, or to frighten anyone. My real purpose in writing this open letter to med school students, everywhere, is to honor you.

I honor you for choosing such a demanding, but meaningful career. And I’d like to offer the following advice, which likely applies to most other types of students too.

1.    It’s tough, but you can do it. Doctors are made, not born, and some liken school to a pressure-cooker. For the first time in your life perhaps, there will be so much that you don’t know. You will be confused, as you are learning several new languages at once. You will doubt your intelligence and abilities. But one day at a time, you show up and engage and do the work to the best of your ability, and you will succeed.

2.    Do it your way. Figure out how you best study and process the work flow. Library, coffee shops, lectures, books, highlighters, sticky notes, flow charts…find your own best way. Our entire med class took turns taking notes for lectures, and most of us studied from these. Study groups work for some people, if the other members are focused and efficient. Try not to compare and stress when your colleague has read the microbiology textbook twice. It’s what you retain, not how many words your eyeballs looked at.

3.    Be curious. The first two years are usually book and lecture based, but there is usually one class that introduces you to patient care so that you remember why you enrolled: to help others. Talk to your patients. They say that 90% of the diagnosis comes from clues that patients give you when you ask good questions. Also ask them how it feels to be a patient. You will gain empathy from seeing things through their eyes and learn important communication skills.

One of my favorite patients in medical school was a tiny elderly man who came in with dangerously high blood pressure. He also had low potassium. I learned that he was a retired jockey, and still worked with horses. He also chewed a lot of tobacco, a licorice-flavored brand. It turned out that the licorice flavoring caused his body to lose potassium and this caused his blood pressure to rise. Everyone has interesting life stories, and some impact their reason for needing care. Your job is to learn from these stories, in medicine and in life.

4.    Get to know faculty in your field of interest. Everyone needs to know the basics, but if you already have an idea that you want to deliver babies, or be an orthopedic doctor, or do dermatology, or ENT, seek out extra learning opportunities. You might get to help with a research project or receive invaluable advice for your future career.

5.    Be open. You might think you know what you want to do, but be open to changing your mind. One of my favorite classmates was a 40-year-old man with six kids. He was already a successful dentist, but wanted the MD degree as well to expand his practice to oral surgery. He lived in a dorm during the week and went back home 250 miles away on weekends when he wasn’t on call. Over the course of medical school, he changed his mind, became an OB/Gyn doctor and went on to deliver many babies. As he was a father to six, I thought this was the perfect career choice for him!

6.    Pace yourself. They say that medical school is like trying to take a drink from a fire hose. Try to balance and do some productive study and work each day. Cramming is hard on the brain and not very effective for retention. Create an organized study ritual that sets you up for success.

7.    Be humble. Every good doctor knows that you can learn a lot from an experienced nurse, lab or X-ray tech. It’s a healthcare team, so play with respect and they will likely save you from making mistakes. Everyone wins, especially the patient.

8.    Be assertive and muster up some confidence as best you can. This is no time to be a wallflower. You have to be an active participant in your education. Ask to do procedures. Ask many questions, as attending doctors usually love to teach. Volunteer to answer questions too, and do it with gusto and enthusiasm. Dare to be wrong.  Women struggle with this, and rarely raise their hands unless that are 90% confident but most men will give it a 50/50 shot at the answer.

Enjoy your studies. Work hard. But don’t forget to rest, play, and breathe. You need some medical friends, to share the experiences and stresses of med school, but you also need some friends from the real world.

Remember: in order to be the best doctor you can possibly be, you must take care of your own health and well-being. Plan healthy meals, don’t make caffeine your only beverage, and get some exercise. An exhausted, unhappy, resentful doctor isn’t helpful or inspiring to patients. In fact, you’re more likely to make dangerous mistakes.

Take good care of yourself. Lead by example. And you won’t just be a great physician — you’ll be a great human being and role model, too.

Congratulations! I’m rooting for you.

~ Dr. Sue

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Back to School for Your Brain, Anytime!

Grant goes back to school this week, brainand I doubt I will ever tire of shopping for fresh pencils and pristine notebooks, all ready for new ideas. I always want a few new school supplies myself!

How about you? What are you excited to learn?

“Anyone who stops learning is old, whether at twenty or eighty. Anyone who keeps learning stays young.” -Henry Ford

Mr. Ford was onto something, friends. This fall, as the kids in your home or neighborhood are getting revved up for a brand new school year, why not take your own brain “back to school,” too?

It’s been proven that learning something new — especially if it’s mentally challenging, like a musical instrument, a new skill, a foreign language or even a complex video game — is one of the best ways to keep your brain in tip-top shape as you grow older.

Being a “lifelong learner” can improve memory, heighten creative thinking, and even accelerate the speed at which you process information.

As one neuroscientist put it, “Your brain is a learning machine.” And it’s a machine that likes to stay active — not get rusty.

The company Luminosity touts 60 million users paying 15 dollars per month to play neuroscience backed computer games to power up their up their cognitive prowess.

From a health standpoint, it doesn’t matter WHAT you learn, as long as it’s challenging and new!

I asked a few of smart and talented people what they are excited to study, this year.
If you’re wondering, “Hmm, what do I want to learn, anyway?” … I bet this list will inspire you!

Samantha Kundinger.  Director of Bold Giving at Dakota Medical Foundation.

I’m excited to learn… about “design thinking.” I attended the MN Council of Nonprofits’ 2014 Annual Leadership Conference this June and was inspired by a session called, “Design Thinking: Social Innovation Through Empathy.”

The concept of people-focused problem solving takes advantage of learning from and involving the beneficiaries of systems we seek to improve as we develop solutions. Learning from the users of a system is key if we ever hope to improve anything!

Brittany Sickler. Small Business Administration.

I’m excited to learn… about diverse topics such as the sharing economy, how to do home repairs, the importance of community interdependence, and how to steer a canoe.

Cris Linnares. Speaker and Philanthropist. Women’s Impact.

I’m excited to learn… how to make delicious Chia deserts: pudding, chocolate chip cookies, muffins…I want to make to my family sweets that give us pleasure without the guilt!”

Kathryn Helgaas. Marketing and Real Estate Development.

I’m excited to learn… more about how to live with the philosophy less is more: fewer things, meetings, distractions, and technology leaves more time to live with intention.

Alexandra Franzen. Writer.

I’m excited to learn… more about hairstyling!

It has nothing to do with my career as a writer, but I’ve always been fascinated by hair cutting, coloring and styling. I love the way a simple blow-out or bang trim can transform your whole day. I’m going to hire a professional stylist to give me a one-hour crash course, and finally master the basics.

Ellen Fondiler. Career and Business Strategist.

I’m excited to learn… more about blogging! I’ve been an entrepreneur practically my entire life, running multiple businesses, but the “blogosphere” is uncharted territory for me.

Now that my very first blog is up and running, I’m excited to absorb everything I possibly can about what it takes to run a sensational blog that my readers will love.

Brandon Weeks. Pastry chef at The Painted Lady Restaurant near Portland, Oregon.

I’m excited to learn… more about tiny houses! For years, I have fantasized about designing + building a “tiny house” — a pint-sized, eco-friendly home that’s built on wheels, so that it can roam!

I just watched a documentary called Tiny, and I’m going to a “tiny house mixer” to meet fellow tiny-house-enthusiasts. After that? I’m setting up a consult with a design firm to learn even more.

Shanna Lee. Fashionista and Proprietess of Shanna Lee.

I am excited to learn… Portuguese so that I can speak with my new mother-in-law on the phone and my new family when we go to Europe to visit!

As for me? I’m excited to learn more about…

: Writing. I love writing, and I always feel like I never have quite enough time to do it as much as I’d like. But that doesn’t stop me from wanting to learn!

: Crazy Horse. We just returned from the Black Hills and I went to the Crazy Horse Memorial for the first time. I want to learn more about the man and the monument that honors all Native Americans.

: New skincare + sleep innovations. I love discovering new ways to help my patients enjoy glowing skin… and a good night’s sleep. Did you know the two are related? I’ll be popping into a medical conference or two, to learn about the latest developments.

No matter what’s piquing your interest, it’s always the perfect season to take your brain “back to school.”

What are YOU excited to learn?

~ Dr. Susan

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