Month: March 2022

Pay Off Debt or Invest? That is the Question…

I have struggled with the idea of paying down our mortgage quickly or letting it be, to payoff slowly per the standard schedule instead. I see the mental benefits of ridding ourselves of all debt.  But looking at the situation objectively, our mortgage size compared to our income is not debilitating.   And having some debt is considered, by many, a good financial strategy, particularly when the debt is backed by something tangible like a property.

We are fortunate to keep our expenses lower than our income, so we have excess money leftover each month to use for saving, investing, and debt paydown.  We refinanced our mortgage about 2 years ago as well with the lower rates (thanks to the pandemic), so the amount of interest charged on our mortgage is not too high as well.  And if we remain disciplined (that is the big “if”) and invest the extra funds in the stock market (instead of throwing it at the mortgage), the average return may be higher.  This is of course, not a given, as the market is hard to predict.  But keeping money in the market over the long term generally yields higher returns than the amount of interest on our current mortgage.

This is thus the great debate I struggle with in my head as I approach our savings goals.  I have long pondered this question in my own mind, and have looked for inspiration from others by reading blogs, discussion boards, and books.  I have come to the conclusion that this is a personal decision, and both avenues can be correct.

I think one thing that guides me in my financial goals is how I feel when I make a decision to throw “X” amount at a goal.  For example, I remember feeling much greater peace and less anxiety a few years ago when I committed to prioritizing every last penny I could at my student loan debt.  And after paying off my student loans, I thought about how much to save toward college for each child.  Thinking through amounts, I remember feeling a large amount of inner calm after committing to a certain amount for each child, to hopefully achieve a certain goal amount by the time they graduate high school.

I would love to see these two cuties smiling on their high school graduations. I would also love to help fund their college experiences so they can minimize the large student debt load that is all too common these days.

I think that the student loan debt I paid off aggressively was a different beast, and I am thankful I got inspired to pay it off quickly by The White Coat Investor.  (I wish I could have paid it off even faster, but I did the best I could, paying it off in 6 years.)  That student loan debt initially had much  higher interest, and the end result (my own mind development/career development) is not something we can sell later on.  A house, on the other hand, is a physical asset that can be sold, so I think it is a different kind of debt, that has more investment qualities to it.

And also, we are fortunate as a couple not to carry credit card debt. That also, I think is a totally different beast from mortgage debt, and something to pay off ASAP due to its much  higher interest rate.  Your loan balance can get insurmountable and can stick around forever if you are not careful, even if you are still paying the minimums.  This I think is to the credit card company’s advantage, and what they obviously would prefer.  They want our money.

Right now, we are paying the mortgage with a bit more each month, plus I have set up to make payments every 2 weeks. This way, once or twice a year there is an extra payment being made.  I am toying with the idea of changing goals and putting more toward the mortgage, instead of my IRA, just for the psychological benefits.  And with the backdoor Roth IRA potentially going away soon, this has made me think even more about throwing more of my money at the mortgage instead of my IRA. I still max out my 401k, and still invest in a brokerage account a bit extra, and save to my kids’ 529’s, and save some in a cash account for future expenses and to buildup a cash cushion.  I wish I could “do it all,” but there are only so many funds available, so you need to pick and choose your priorities, and how much you want to throw at each goal.

 

My perspective and approach may change in the months or years to come.  I think this is a healthy part of evolving interests and goals, not necessarily a sign that my current pathway is wrong.  But I hope and plan to keep chipping away at this debt. Paying off more of our debt will be a rewarding experience.  I am sure owning your home outright is a great feeling, a feeling I hope to know firsthand someday soon.

Like a Small Boat on the Ocean…

My daughter has recently been singing Rachel Platten’s song, Fight Song, repetitively over the last few weeks.  It sounds like a classmate of hers really likes the song and got her hooked on it, too.  I know, it is a few years old, but I still the lyrics inspiring and timeless.   I also find it endearing she likes this powerful song, and hearing her sing it made me ponder over the lyrics more and more today.  (And, of course, she is adorable with her passionate singing style, which makes it a very enjoyable experience to listen to her.)

Rachel Platten wrote the song as an anthem to keep pushing back, as the song industry was rejecting her.  I love its strong message.  The message I take from the song is this: you matter, and your actions matter, no matter how little you think you are as one person, or how trivial you think your single action is.  Don’t short change yourself, don’t underestimate your power, even if you feel you are small or insignificant.  Say what is on your mind, especially if it will help others.  If you feel down and out, fight back, because you matter.    You are strong.  Keep going, because you can keep on fighting and keep going, even in moments that are tough.  You are more significant and powerful than you think, and your voice has power.  My thought is, you never know when one action will inspire someone else, or help someone else in their time of need.  Your smile or kind word to another person today may turn their day around.  It may inspire them to be kind to someone else, which in turn may help someone at the end of their rope.

So never stop being nice to others. Never stop pushing forward and fighting the good fight in this life.  Push back against challenges and setbacks, because you can persevere.  Never discount your actions, no matter how insignificant you think they are.  You can be that one spark to create change for good.  I hope you find this post inspiring and take this positivity forward throughout your day and week.  I have included her video link below for your viewing enjoyment.

https://youtu.be/geLfC4g_jv4

 

Put in the Work, Reap the Rewards

I was trodding my way through an iFit Winter treadmill workout with Billy Demong (the former Nordic combined skier and Olympian gold medalist) yesterday.  During this, I think he said something that helped me put workouts and the point of workouts in perspective.

What Billy Demong said was this: Put in the work, do the workouts, follow the simple formula of “keep your hard days hard, and keep your easy days easy,” and you will improve.  Your endurance and your speed will get better.  Time on your feet and building endurance is like increasing the size of your engine, but by also doing hard work on hard days (speed play), you improve the speed of your engine.  Both are important and vital to improving.  I have heard this time and again in other books and lectures about workout plans and improving performance in sport, particularly distance running.  It is a simple idea.  But putting in the work itself is definitely not easy.  The work is hard, and often painful, and it could be easy to give up.  Showing up and doing each workout requires perseverance and diligence.

Our cat Oscar shows inspiring perseverance and grit, jumping over 3 feet in the air to reach my precious flowers. Nothing will hold this little guy down.

Billy also said it well later on in the workout that if you put in say an hour most days of the week (5-6 days/week), you will advance. It does not require many hours to get better.  To be the best, you can put in 3-4 hours/day.  But for my own novice athlete purposes, I can see 30-60 minutes/day, most days of the week way more doable, and achieves what I want to get, which is 70-80% better.  Getting that last 10-20% improvement takes way more time and effort.

I have definitely seen this myself, particularly in my first year of following marathon training plans.  In that first year,  I went from essentially 0% ability to about 60% ability in marathon running pretty easily, by doing the work and finishing the workouts.  From here, though, over the last 4 years, the gains have continued but are not as dramatic and not as plentiful.   I agree with Billy that the key is steady, repeated work.   I like seeing how my endurance and enjoyment of a longer run has steadily improved.  I feel comfortable running at a faster baseline pace.  I find it comforting and cathartic to get in a run most (if not all) days of the week, as my schedule allows.

I think the same thing holds true with everything else.  We put in the work in school and professional/job training.  Being in the very moment of grade school, high school, college, and med school, the work is hard, but doable.  We do the same at work with our work goals and projects and deadlines.  Chunking it up into a day, or week, or month, I can see that each goal I strive for is relatively simple and achievable.

If I focused too long or too hard on the end goal (26.2 miles, graduation from a 4 year college degree, or achieving a degree in medicine, or finishing a tough, grueling residency), I could see myself getting demoralized or overwhelmed.   By being nearsighted though, each day or each week, I can see myself achieving and growing.  And indeed, by piecing these days and weeks and months together, I have definitely improved and grown. I see the parallel with tough workouts and tough segments of workouts.  A 2 minute push at tempo pace is hard in the moment.  But afterward, the feeling of accomplishment is a huge reward in and of itself.  I am sure that is why we keep going back for more workouts, and keep pursuing more goals.

I don’t yet have another race or goal in mind.  But I strive to put in workouts most days, if not every day, of each week, to keep my endurance up.  And it also serves to help me decompress and keep my mental health in check.  I have not yet come up with a perfect schedule to coalesce with my family responsibilities and work responsibilities.  I tend to squeeze in a workout here or there where it will fit, and it is not consistent day to day or week to week.  But by prioritizing my health and my workouts, I can see myself performing better in my personal life and my work life.

I think my health is the best reward of all of this hard work, better than any particular medal or time on the clock at the end of the race.  (But don’t get me wrong – I will keep pushing for the PR (personal record)!)  Health is one of the most valuable commodities we have.   I feel I need to put in the work each day and each week to nurture myself, body, mind, and spirit, to approach the best version of me.  Self improvement (health wise and professional wise and family wise) is one of the most valuable rewards I have seen through my fitness journey and my journey in life. The process of getting better is a never ending process, and I look forward to continuing to improve.

Celebrating Modern Medicine

6 years ago, almost to the day, my family and I were able to bring our son, Luca, home from the NICU after a 12 day stay following his premature birth.  It was a very triumphant, heartfelt moment, and I am forever grateful that his stay resulted in good health, with no lasting complications.  He is a healthy 6 year old boy now, and I sometimes forget how tiny he was back then.  I remember how happy and relived I was to finally take him home, safe and sound, after his hospital stay.

Mr. Luca at his 1 year old birthday. Proud big sister not far away, always eager to help and guide him.

He was born about 4 weeks early, at 35 weeks+6 days.  Due to him being so young, he was having problems maintaining his temperature.  Hence, he spent many days spent in the NICU under the experienced, watchful eyes of the nurses and physicians.  Being postpartum, I was full of emotions and was fatigued and overwhelmed, but I had an underpinning, massive desire to take my new little guy home.  I was indescribably happy when the NICU team gave us the good news that March 10, 2016 would be Mr. Luca’s discharge date, and we could take him home with us to help complete our family.

Thinking back, I contemplated how different the results would have been for both me and my child decades ago.  I am astounded and amazed each day by modern medicine and all of the knowledge and technology we have acquired.  It enabled my son’s care to go so smoothly and enabled such good outcomes. I realize our issues were very small in retrospect as well, compared to other family’s trials.  I can only imagine with what other families go through with children born even earlier or with more challenging health concerns.  My outcomes also would like have been very different if the physicians and nurses did not have their experience and modern technology to monitor me closely, with my vitals, how my labor was progressing, and how my child was doing during the labor process.

Seeing also how doctors care for me and my family as we see them, I marvel at how different things were 50-100 years ago.  I often credit our good health and good outcomes on all of this collective knowledge our healthcare teams have obtained.

Working in telemedicine, a relatively new player in medicine, I see that medicine still has a lot of evolution to go.  I know that telemedicine has limitations, but it also opens many doors in caring for patients.  I can see them right where they live and work.  I can see patients with limited access to care, and all it takes is each of us having a good device (computer, cell phone, or tablet) and a good internet connection.  I never shy from telling patients when telemedicine is not the right avenue to go down.  But I am surprised each day by how much I can accomplish, and how grateful patients and their families are for the care we provide with this service.

Going forward, I will keep observing how modern medicine can help me, my family members and friends, and my patients.   I know that things will always evolve and change, as things must.  I hope that things continue to evolve and improve.  I hope good and better outcomes become common place.  I hope that everyone can enjoy better health because of all of these continued changes and advances.

The Fine Art of Being Flexible

As a parent, I hope to instill in my children an appreciation and respect for flexibility.  With this, I am talking about mental and emotional flexibility, though physical flexibility is to be respected and is something to strive for too. (Though I admit, my mental flexibility far surpasses my physical flexibility at this time.  My physical flexibility is yet another thing I need to improve upon.  My kids can likely teach me a thing or two!)  I am by no means an expert in flexibility, but I truly value the skill of “going with the punches” and being able to bend to adapt to whatever situation I am in.

Teaching each other the fine art of cartwheels (which require grace, poise, and of course, flexibility).

I think patience is another valuable skill closely related to flexibility.  Without patience, you can easily lose your cool and waste negative energy wishing and ranting for things to be a different way.  Instead, being more accepting of a situation helps you better tackle whatever challenge are coming your way.  And in addition, flexibility, over rigidity, is definitely key to overcoming life’s challenges.

 

A good way I try to show this to my children is by helping them navigate their afternoon routines.  It never seems to go to plan to get all their homework and afternoon activities done in the exact order I plan.  Instead of panicking or being upset by this, I feel it is way more productive (and less dramatic) to accept the events as they come, and simply tackle the next step when you can.  This teaches grace under pressure, but also helps them navigate the fine art of time management.  Time is truly valuable to me, a finite resource you cannot get back, and I hope to train my children to better utilize the time they have.  Being young, I can see that time feels infinite and plentiful.  Perhaps though as we get older, we start to see the reality of the finite aspects of time, and that it is a gift to be cherished.

 

One thing that has helped me tremendously with flexibility is goal setting, and trying to prioritize my goals.  I try to set up to 3 goals per day, and prioritize them.  If I can get at least one of them done, as I planned it, I am pleased.  Getting all 3 is a nice bonus, but if I cannot get to all 3, I try to be more accepting of this, particularly if I got my #1 goal done.  I won’t totally abandon those other goals, but I try to look forward in my week and see where they can fit.

 

Again, this is a lifelong pursuit to be more flexible and patient.  But I hope that I can guide my children how to do this well, by giving advice and by setting the example. With these two invaluable tools of flexibility and patience, I can foresee my children being valuable members of a workplace, a family, and a team.  They will be productive and well respected, and I think they will be well adjusted and more satisfied with their lives and accomplishments.

Timing is Everything – With Better Sleeps Come Better Energy

I have gave the sleep energy tracker app, Rise, a try, and have found it insightful into my energy patterns.  The app lists my energy peaks and dips throughout the day, depending on when I go to bed and when I wake up. I can compare what these graphs show and how I feel, and I find it interesting how it shifts depending on the amount and quality of sleep I get the days before.   The app makes the argument that you can catch up on sleep (though I have read in other places this is not possible).  So it encourages me to go to bed a bit earlier for a few days here or there to catch up, or to catch a quick cat nap in my afternoon lulls.

Our cat, Oscar, sure knows how to catch a nap on a comfy, sleeping Luca.

Instead of fighting my tired times in the early afternoon (that “afternoon slump” we all are familiar with), I see them as times now to get mundane and simpler tasks done, like packing lunches, putting away laundry, and answering simple emails.  I admit now that those times are not the ideal time for a creative process or a process that takes a lot of brain power. And when I get a chance, I take the app’s suggestion and try to do a short burst of exercise like a brisk walk or (if I be so lucky that the stars align!) a short nap.

 

As I am getting older, I see the value of being more in tune with my body and its energy tank.  The energy tank is not infinite, sad but true, and getting older I think this gets more and more apparent.  I have tried often (particularly when I was in a younger, more spry state of mind) to push through my tired spells.  But in the long run, working or pushing while tired often yields less quality results for me.  And I just feel crabbier and unhappy.

 

I think the hardest thing to accept is that I do need more sleep than I grant myself.  This is something I am working on improving.  In an ideal situation, I think I would go to bed when my kids go to bed.  But there are always more tasks and chores (and good books to read) left on my to do list that I try to squeeze in.  I need to learn to accept that it is okay to leave things undone, and give in to my body’s melatonin window and let sleep overtake me.

 

I can see my “sleep debt” in the app that is the sleep I am behind on.  It is almost always (sadly) negative, except when I was on a nice, restful vacation.  (I guess there is hope someday when I retire!)   I can see how that affects my mood and my mental energies, and it gives me motivation to squeeze in my tasks and “to do” list items in the dead spaces in my schedule earlier in the day, particularly when I have my peak energy.

 

My goal in the next few weeks and months is to see my sleep debt (hopefully) stay lower, and see how my energy and productivity and efficiency increase.  In addition, I hope to see my mood in interacting with my friends and family improving.  Sleep is the wonder drug. It is free, but often overlooked.  I hope to really harness its power in the coming weeks and months in my quest to be a better steward for my time and energy each and every day.

Facing Pain and Adversity with Grace Under Pressure

Endurance running as my training ground to help me face life’s inevitable pain and adversity with grace and strength.  Life has pain.  Life has heartache.  There are wars, there is famine and poverty, and there is injustice in this world.  Of course I wish there were no challenges and heartaches in life.  But this sadly is not our reality.

Looking strong on a straightaway. Don’t get too complacent…there are plenty of Pittsburgh hills to tackle ahead!

In a parenting podcast I was listening to today, Zen Parenting Radio, the hosts talked about a common theme in parenting in the last couple of decades of protecting and shielding our children from pain.  I agree with the discussion that this is a disservice to our children.  Of course we will all face challenges and setbacks.  I agree it is better to help kids navigate their way through heartache and challenge, rather than eliminating anything negative from their lives.  As in running, there will be miles that hurt and are harder than others. There are times you will want to quit.  Rather than giving up and going home, though, I strive to push through.  This, I think, helps me improve my strength and stamina to face life’s challenges, too.  And I hope, that by setting a good example, I can teach my kids that the goal in life is not avoiding pain.  It is hitting it head on with a mindset of creativity, perseverance, and grit.  Get through it, survive, and this too shall pass.

 

Like everyone else, I have faced challenges in life.  Anyone perceiving that life is easy or without setbacks is clearly off base.  I wish that life was not always so hard or painful, but it is impossible to go through life without setbacks.  These setbacks, in retrospect, make the happier and positive days that much greater.

 

The biggest setback for me in my life was being sued several years ago.  Do I wish this never happened? Absolutely.  If I could go back in time and erase that entire situation from my life, I would do so in a heartbeat.  And I wish that no one ever has to go through that situation.  It is unfortunately a true and ever present specter in our American litigious society.  It made me feel less than.  It made me feel betrayed.  It gave me indescribable shame.  Should such a situation do this, though?  Being sued as a physician is seldom discussed, I feel, due to the negative feelings it evokes.  It took me many months to heal from this event, but I have come to accept that I cannot control another person’s perceptions or another person’s view of a situation.  I can only control my own actions and my own perceptions. I have power over my own thoughts and my own emotional health. I can study and I can read and attend courses.  I can work hard.  I can exercise and care for my body and mind.  I can devote my time and energy to perfecting my personal growth.  I cannot be perfect.  But I can own my own actions, thoughts, and emotions, and I can use these to positively shape my perceptions and mindset.

 

The setback of being sued, however, did teach me to persevere.  You must face pain and adversity head on.  In the toughest of situations, survival is the only choice you have.  You face your challenges, and you learn to forgive and let live.  You learn to hold on to all that will serve you and help you grow.  You let go of anything that does not make you a better person.  You take it one hour at a time, one day at a time, one week at a time, one year at a time.  It is still an indelible memory on my psyche and definitely shook my confidence and feeling of self-worth. It will always be with me.  I hope, though, in spite of all of its negative connotations, it will shape me into a caring physician, an empathetic mom, a devoted wife, and a compassionate friend.  I hope I can teach others that through resilience and vulnerability, you can persevere through all of life’s challenges.

 

You can wish and hope that a painful situation does not stand before you.  Believe me, I have tried.  But wishing and praying will not make it go away.  You must often hit it head on, face that awful situation, and know that tomorrow, the sun will rise again.  Another day will come.  Your children and your family will still need and love you.  Another patient will appreciate and value the care you provide.  Life goes on.  I have accepted the fact that this situation will always be a part of my past.  As time goes on, I see that the situation was like a fire, forging my resolve and my strength.  It could have destroyed me and brought me down, but instead, I feel it built me up and made me that much stronger.

 

I know nothing in this life is perfect.  I can simply exude confidence and work hard each and every day.  I show up each day at work, ready to do my job.  I can show others empathy and patience, and I strive to give all of my patients a kind and listening ear.  I try each day to share my knowledge and skills with the world.  I hope also, that in the process of living my life with strength and fortitude, I can set an example for my children that life is hard, but you can and will survive.  Through practice and grit and determination, you can persevere through life’s challenges, and come out of the battle a stronger and better person each and every time.

This is 40

Today I turn 40!  At 40, I feel I am right at middle age.  I sure hope to live longer than 80, but reaching 80 seems like a decent and reasonable life span I  can achieve in this day and age.  Of course, I have no control over how long I may get to be on this planet.  But I will do what I can to optimize both the quantity and quality of my life through what I can control: my choices and decisions in life and my mindset.  I am by no means perfect, and I never will be.  But I feel that by being a work in progress, I can hopefully live a healthier, fuller, and fulfilling life.

Our family
Circa January 2022.  Posing for the camera, smiles all around!

Do I feel 40?  Sometimes, but sometimes not.  Some days, for sure, I do, when I get a tight or strained muscle (thank goodness for massages!), or my joints in my hands or feet ache a bit, I am out of touch with the youngest generation I am seeing as a patient (I am still blown away there are college aged “adults” who were born when I graduated high school.  Insane).  Or when I see the wrinkles (ahem, “lines of dignity”) as I examine my face.  I feel also, though, that I am just getting started in this thing called adulthood.  I get a sense I just finished high school, college, and med school a short time ago.  I cannot shake the feeling that I just got married, bought our house, and had our two kids a “year or two ago.”  Reality hits, though, and I realize these milestones are all many years behind me.  (And don’t even remind me I graduated high school over 2 decades ago!)

 

My hope for this day is simply to reflect and stay in the moment and chill.  I don’t have any grand plans for this day.  I am thankful that I have a rare day off from work.  And that my to-do list today is short.  I have a rare moment of quiet in this house as the kids are at school and my husband is at work.  My pet kitten, Oscar, is keeping me quiet (and sometimes rambunctious) company today as well as I reflect.

 

I am grateful for this quiet, slower moment to myself without hustle and bustle.  I like this quiet day off to truly analyze where I am at.  Today, I am happy I get to slow down and simply to think about where I am now, where I have been, and where I hope to go.  My goal for the coming year is to continue to nourish my career, my relationships, and my self growth.  I realize life is about tradeoffs and time is finite, so I cannot tackle all of these all at once, nor can I maximize everything or make everything perfect.  But I hope to make myself just 1% better this year in my professional life and my personal life.  And I hope to treat myself well and accept “good enough” when it truly is sufficient and all that I need.  And as each year goes forward, I hope I can keep compounding another 1% improvement each and every year to reach the very best version of me.