Episode 043: Midlife, Menopause & Motivation: Staying Consistent with Healthy Habits When Life Gets Busy

Why does staying consistent suddenly feel so much harder in midlife and menopause — especially when life already feels overwhelming?

f you’ve ever thought, “I know what I should be doing… I just can’t seem to stay consistent,” — this episode is for you.

In this episode of The Lifestyle MD, Dr. Angela Andrews sits down with returning guest and midlife consistency consultant Cara Michelle to explore why so many women struggle with consistency in midlife, especially when balancing careers, family, changing hormones, stress, and the demands of everyday life. Together, they discuss a refreshing, realistic approach to self-care that moves away from perfection and focuses on building sustainable habits that actually fit your life.

Whether you’re navigating perimenopause, menopause, burnout, changing energy levels, sleep struggles, or simply feeling unlike yourself, this conversation offers practical encouragement and a framework for moving forward.

In this episode, we discuss:

✔ Why consistency matters more than perfection
 ✔ The role of vision and identity in lasting behavior change
 ✔ Why healthy habits feel harder in midlife
 ✔ Menopause, hormones, and changing energy levels
 ✔ Creating realistic nutrition, movement, and sleep routines
 ✔ Building a “bounce back” plan when life gets overwhelming
 ✔ How women can redefine self-care without guilt

Cara shares her Midlife Consistency Framework, which focuses on:

•  Anchoring your vision 
•  Creating a realistic journey 
•  Building an environment that promotes success 
•  Developing a sustainable bounce-back plan 

This episode is a reminder that thriving in midlife isn’t about doing everything perfectly — it’s about finding a sustainable path that works for your life.

Connect with Cara Michelle:
Website: strengthvitalitywellness.com

Webinar: strengthvitalitywellness.com/msvwebinar

Email: caramichelle@strengthvitalitywellness.com, 

🎙️ If you enjoyed this episode, please subscribe, leave a review, and share it with another woman who may benefit from this conversation.

Transcript

Midlife Empowerment: Consistency and Vision with Cara Michelle

Cara Michelle: [00:00:00] The women that come into my office, I'm sure it's the same for you. They can rattle off the things they know they need. I should be eating a little bit better. I should be moving my body a little bit better. I should be getting better sleep. The problem is that we can hit it once in a while, but that consistency factor is just missing.

Angela Andrews MD: This is Dr. Angela. Welcome to another episode of the Lifestyle md and I have a return guest Cara Michelle. And she has been with us before talking about midlife which if you don't know me very well you should know that midlife and women especially is a huge area of interest and, and what great timing because so many people are taking an invested interest, both from a medical standpoint, from a scientific standpoint, from a coaching standpoint.

[00:01:00] Cara does amazing work. She is a midlife consistency consultant, and we were just talking about how your framework had been evolving, but the gist of what you do and how you coach women hasn't really changed. You've been in practice for 19 years. You've taken care of more than 3000 clients. Your reviews are stellar and you've just been refining what this looks like. If anyone isn't evolving, then you're dying. I'm so excited to hear how things have been going and how things have evolved. What have I missed? What else do you wanna tell our listeners?

Cara Michelle: Dr. Angela, I'm just super excited to be here with you. I know how dedicated you are to midlife women, and so this is a, privilege to talk with you and your audience. , As you pointed, the issues for midlife, women haven't changed. Women know what it is they need to do for themselves.

The women that come into my office, I'm sure it's the same for you. They can rattle off the things they know they need. I should be eating a little bit better. I should be moving my body a little bit better. I should be getting better sleep. The problem is that we can hit it once in a while, but that consistency factor is just missing.

And it can [00:02:00] be really devastating. Most professional women are go-getters, and they know how to put their structures together. They know what it is they need to do for themselves. But it's tricky when you're trying to take care of so many other people and projects that are calling and pulling on our energy, and time regularly. It's just super easy to put ourselves in the background. 

Angela Andrews MD: Tell me about it. Let's define a couple of things. What does it mean to be midlife? 

Cara Michelle: I was just sitting with a client yesterday and I said, welcome into midlife. And she sat back in her chair and dropped her head back and just like, oh, no, don't tell me. It's so interesting. The consensus is that's a negative thing, but it doesn't have to be. It doesn't need to be, and honestly, I'm 57 and I feel better now. Mentally and emotionally. I know more about myself, who I am, what it is that's important to me. Much better than I did before. So there's a lot of advantages to aging. I think what most women are concerned about is not feeling their best. And that just takes a little bit of [00:03:00] focus. So if we're trying to live to 90, somewhere around 45 is gonna be midlife. That's the true biology. 

Angela Andrews MD: Yes. I resonate with that because first of all, I'm spot on, rated at 45 and, since entering my forties, I and a lot of my friends and patients in this space, we all say the same thing. I feel the most confident about who I am, what matters to me, and how I want to spend my time than I've ever felt, in my entire life. And yet, we talked a little bit about, the physical challenges, the things that come with that, and that is there that is real, but it doesn't have to be, a negative experience. And in fact, it shouldn't be. We're just, looking the full trajectory of where you are. And if anything hopefully as women, we can learn to lean into that and, , it doesn't have to be a downer. And it's too bad that a lot of women have seen it that way. Society and culture has positioned it as being, oh, you're old or you're in the middle, and, you're not as important, whatever that looks like. When you meet a woman or a client who has that oh, I'm midlife kind of reaction, how do [00:04:00] you approach that with them?

Cara Michelle: The first thing that I've noticed over the years and working with so many different women is that sometimes we're thinking that midlife is going to be difficult and hard and not enjoyable because we haven't taken the time to create a vision for what it is we want it to be. The first part of the midlife consistency framework is anchor your vision. It's like anything else. If we don't know where we're going, we're gonna take some side roads. It's gonna take us off in this direction, in that direction, put us in places and take up our time in ways that we didn't really want it to be. So it's really important to slow down and take time to clarify , what's important to me now, what are my values? What do I want my life to stand for? How do I want to show up for the people and the projects that I really care about? And what impact do I want to have now? We did a a retreat this January. And the women really loved having that space to just sit quietly, reflect, share information. [00:05:00] When you do that, all of a sudden it's oh, I have something to look forward to. That's really mine and not what my partner wants or what the kids are excited about, but something that I'm actually excited about.

The funny thing is that when you have that vision, now your self care activities, have a purpose. You're not just doing them to check them off because the podcast or the radio show or the book said you're supposed to do these things. You could now understand how getting good sleep is actually a tool for helping you with whatever your vision is. You want to go climb a mountain, or you want to go travel more often, , now you understand that I'm going to figure out how to get better sleep. Better nutrition and , those are the tools that are gonna generate the mental and physical energy I need in order to be able to go do the thing that I really want to do.

Angela Andrews MD: Let's talk about the framework. It starts with anchoring your vision. Number two is adopting a realistic journey. Number three is having an [00:06:00] environment or creating an environment. That promotes consistency. And then the final one is bounce back path.

Cara Michelle: I can't tell you how many times I've sat down and written out my new goals, and then two weeks later, I've lost the paper. I've forgotten where I put the file. . And it happens regularly, so it's really important to anchor, not only come up with the vision, but to actually put it in places, tell important people what you're working on, so that it's constantly in your face. You wanna bump into that information over and over again several times a day, because life is gonna pull you in a million directions. You're gonna have well-meaning people tell you, oh, I know what you need to do next. Oh, I know it should be important for you next. And that's how we wake up five years later and we're wondering like how did I get? Instead, can we. Frame a copy of it. Can we put it on our screensaver? Can we tell our best friend so that when we have conversations, she can repeat it back to me? That way you're constantly being re indoctrinated [00:07:00] with this vision. That's what the anchor your vision is about. 

Angela Andrews MD: What are some examples of the different, places where you can do that?

Cara Michelle: You hop on Canva, create something , people don't mind actually putting it on the outside, the hard side of the computer so that even before they open it up, pull it out of their bag, it's on your monitor. If you've got a desktop monitor, well, let's just put it on a sticky note and pop it up there. I'm a good one for literally writing on my bathroom mirror with the, Dry erase markers. So it's right there. That's good in my face all the time. I've got it posted in my car. , I love using mechanical pencils, so I just took, two lines and wrote it really small on a piece of paper and then taped it right on my pencil, so I see it all the time. My wife knows, my friends know, the people that you can count on, are wanting your best interest. They all know what I'm up to, so that when we talk, it's oh, before we go, how's such and such going?

Angela Andrews MD: Oh my gosh, that makes so much sense. For our audience, share an example of something that [00:08:00] you've posted in all the different ways, in all the different places.

Cara Michelle: At this point in my life, I really want to move from a place of inspiration. I don't want to get caught up in what I think everybody else is doing, what everybody else wants me to do. And I'm not saying it's easy, it is not easy for me to be perfectly honest, so that's why it's in front of me all the time. What I've learned is that having it in as many places as possible is a way to go because there's just too many opportunities to get disconnected. And because we're not accustomed to putting ourselves first. And then you wake up two weeks later and you're like, dang, go it. Like, how did I say yes to this? We were just talking about the fact that you're trying to say no to more things. So having it and is bumping into it.

Angela Andrews MD: It basically becomes effortless. I love that. Okay. What's the next, level in your framework? So once we have a vision.

Cara Michelle: We've got that vision anchored. , Remember the big goal of self-care is to be able to feel your best. That's all we're doing this for. And that often boils down to [00:09:00] having high levels of mental and physical energy. Energy tends to be the bottom line for most of us. Energy matters because being thoughtful, being playful, being able to think outside the box, being a good listener all require mental energy.

Being able to take the steps, being able to, walk on the cobblestones , in Italy, being able to, take the long way, home on a walk. Squat down to pick up the grandkids or get the dog. That's all physical energy. So we need both of those in order to live the life that we truly want for ourselves.

Angela Andrews MD: What that makes me think of is what do you want to be able to do when you're like 60, 65? What do you want your life to look like? And in order for that to happen, guess what? You need to start now. It doesn't just begin later.

Cara Michelle: It starts now. . There's a lot of conversation in people's heads that, oh, I'm too old. I didn't get started early enough and, maybe it's not really for me, I'm just supposed to be in pain. And, I understand how women get into those conversations, [00:10:00] but I want everyone to know for sure that , doesn't need to be you.

It doesn't have to be you. And we don't have to take any huge leaps in order to make that different. We just have to decide, come up with the clarity of , who we wanna be, and then we start moving towards it. And so that brings me to the second piece of the pillar of the framework, midlife consistency framework.

Whatever it is you believe that you need, whatever parts of the foundations of health and wellness, which there's five, right?

So we know that we need good sleep, good nutrition. We have to move our bodies regularly. We need good hydration, and good stress management stress tolerance skills, if we can get some rhythm and momentum with those five, we're going to feel pretty doggone good.

So whatever part of those five, however you're gonna approach one of those five, it needs to be a realistic journey. It needs to be something. That you can access right now. The problem is, as we said before the women that I'm working with, and I'm sure it's the same for you, they're all go-getters, right?

And [00:11:00] when you have that mentality as that's your way of being in the world, you just grab it all, tuck it under your arm and take off running. But that doesn't work.

Angela Andrews MD: I'm just gonna do it right. I'm just gonna make it work.

Cara Michelle: But we have to remember that what we're looking for here is consistency. We're not looking for perfection. We don't need it to be, difficult in order to be worthwhile. It doesn't have to be hard in order for it to be impactful.

What we're looking for is consistency with those five foundations of health and wellness. So consistency doesn't happen when you overload yourself. That takes you in the opposite direction. We just have to be honest about our starting point with those five things. I believe you're athletes in high school, college, right?

Exercise is not foreign for us, for my wife, she didn't do that at all. So it was tricky for her start getting into a regular exercise routine. So for her to start off with my routine, because she sees me swinging kettlebells and doing all kinds of body weight exercises, that's [00:12:00] not gonna last for her.

If she actually gets through a workout, she's gonna be sore, she's gonna be tired from it. It's gonna interfere with how she shows up at work and how she feels mentally. . And she's not gonna wanna come back to it.

Angela Andrews MD: This is something I struggle with, is getting people to move along that continuum when they're not active and they're not already doing those things, how do you get them to move on that continuum?

Cara Michelle: I sit down with them and we start off with a conversation. What do you believe? Let's say it's exercise. What do you believe you can actually perform three times a week right now? , And they swirl in their head a little bit because what they wanna say is, oh, I can do that 10 mile run.

Angela Andrews MD: But that's not realistic. Come on let's come up with something that doesn't feel insurmountable right off the gate.

Cara Michelle: Something that you can do that's not going to wear you down mentally or physically, that you can check it off every other day, week after week and say, yes, I got that done.

And usually we have that conversation and they whittle it down themselves. They actually talk themselves off of, trying to [00:13:00] hold the whole basket at one time and just, you know what, if I'm being honest with you Cara Michelle, I can probably do that 10 minute stretch routine three times a week right now.

Angela Andrews MD: And that's really, the key that I think is often missed in medicine and coaching, is if you're not allowing the client or the patient to make that decision they've gotta come to that conclusion. It has to be out of their own mind and their own experience. You can't tell them what to do.

Cara Michelle: It feels very, easy and convenient to just hand people, pads. Paper with the information written on it, or just tell 'em what to do.

Angela Andrews MD: Especially if you're in a hurry, right? And I feel like that's one of the things that, medicine is guilty of. Quick, quick here. These are the things you need to do. , You got 150 minutes of exercise per week and two, strength training, sessions every week too. Done. Bye.

Cara Michelle: And , luckily for us, there's, many medical professionals like yourself , who understand that we need to slow down and have space and time with folks. Because each person, understand what their goals are. So as a practitioner, my job is to help them meet their goals.

Isn't, that's not for me to [00:14:00] just tell them what to do. Here's an example, I have had client tell me. You know what? I'm about to retire in two years, and all I really wanna do is sit on in my rocking chair and watch my grandkids pet play.

 I've done the traveling, I've gone to the events and, I might do a little bit of, bocce ball here and there, maybe hit some tennis balls with the girls, go to lunch. But , I don't wanna do much more than that. Okay, great. So that person is gonna need a certain amount and there's an effective dose of exercise, nutrition, all those five .

 But if we have someone else, who says, I'm gonna retire in two years and I wanna hit all of the national parks in the United States, and I wanna climb to the top of the highest peak in each one. These are totally different visions for their life that need a totally different, effective dose. so it's really important to slow down and listen to the person so that we can understand how much of this do they need. I would hate to prescribe the amount of nutrition and exercise [00:15:00] and stress management that client, number one, who wants to sit on her porch needs for client number two, who wants to go hiking, she's not gonna make it with that dose, so we have to slow down and understand what that person is, and the ownership needs to be on the client because they need to know what it is they're trying to do themselves.

Angela Andrews MD: And it's also feasible that, what a client's vision is now is gonna be different, what their vision might be in two years. Especially if we're talking midlife folks. What you want and desire out of life is a moving target. So do you counsel people on that upfront and say, Hey, this is what we're aiming for right now, but it's okay to change that 

Cara Michelle: 100%. Your vision is a working document. It's a live living document. Encourage folks to set aside a little bit of time each day, have a little sacred time for themselves. I think the mornings are the most, impactful time to have that space for yourself where you are reviewing your vision.

You might also be making some adjustments. Maybe you heard something different or you had an experience that's changed your mind or the kids now are off on [00:16:00] their own and now the vision changes .

Angela Andrews MD: What's your favorite vision that you've heard from someone so far?

Cara Michelle: I have a client who actually, a member of the Strength and Vitality Accelerator, who was telling we go over our visions regularly when we meet once a week. And she was saying how she really wants to be more physically fit so that she can just do whatever she wants to do when she wants to do it.

So it's really inspiring to hear folks take their time and play with those visions and see them shift and change over time and tighten them up. And here's the point about the vision. You gotta keep massaging it so that it is something that really juices you up. It's gotta be like, yeah, that's me. This is what I'm doing. 

Angela Andrews MD: Yes. Now what about specificity? .

Cara Michelle: You wouldn't wanna say, I wanna feel good. And sometimes people start off with that, and that's natural, if you've never done these kind of exercises before, if no one has coached you and this is your first time trying to, oh right? I guess I wanna feel good, that's a typical answer.

Angela Andrews MD: And one of my favorite questions is, okay, [00:17:00] so what does that mean? What does feel good mean to you? 

Cara Michelle: We need a realistic journey. We need something that you can actually accomplish.

Based on your relationship with those five foundations of health and wellness, we don't want something that's gonna cause more struggle more stress. We don't want something that you hate to engage with. What women often, miss is that when you allow yourself to just play at this lower level for a while, you automatically increase without effort.

 So let's take exercise. If you're gonna start off as this one client said, 10 minutes of stretching three times a week, if you do that for a couple weeks. You're gonna start feeling a lot better. Your energy levels are gonna pick up, your body's gonna feel a lot more limber, your pain's gonna reduce, and you're going to wanna engage with that.

When you make the association that I'm feeling better mentally and physically, because I'm doing this stretching and that stretching is not interfering with my life. You're gonna want more of it. That's [00:18:00] how it starts to increase on its own. The idea that, oh, 10 minutes isn't gonna really get me to, to being able to hike those mountains.

We just have to be honest about where we are now and slowly move ourselves in that direction over time.

Angela Andrews MD: That comes back to, the whole overarching theme here is consistency. Because it's the consistency that drives the improvement. No matter how big or how small that activity is, or that vision.

Cara Michelle: What we're trying to do in the beginning, more than anything else, that 10 minutes of stretching three times a week starts to build your identity as a person who moves their body regularly.

See, nothing's gonna change if you don't believe that's you. If you don't see that in yourself, if you don't see yourself as a person who pays attention to what they're eating, even if you are only making small shifts and changes, you are paying attention to your nutrition and the effect that it's having on your body. So you want to own that identity, and that is just as important as anything else in the beginning. When you [00:19:00] start to know yourself as a person who gets quality sleep most nights then you're less apt to. Abdicate that because somebody else needs you to stay up

Angela Andrews MD: I really like that. I've had this concept and I just haven't really framed it that way. You mentioned earlier talking about, some people might just dismiss , I'm not an exerciser, or I'm not a person who does X, Y, and Z. 

And so you're trying to reframe how they see themselves. So many times I am frustrated by what people say about themselves, and part of the reason that some people might be so negative is that they just have never envisioned or experienced themselves in a different light.

Cara Michelle: Absolutely. At 57 when I go back to being a 10-year-old, yes. Women were playing more sports and there were more opportunities of course. But the conversation is still very strong that our role is to be a good wife and to, take care of the kids. And, many of the women in my age group , that's still a haunting story back there.

And knowing themselves as a [00:20:00] person who thinks twice about what they're actually eating might not be upfront for them yet, even though intellectually they've heard the conversations, they understand it, but the practice of it is very different. The other thing that I try to encourage women to know and to bring forward in themselves is that the truth of the matter is that nobody ever taught us how to be consistent with self-care. Yes. That is so true. There's no structure, there's no social cues for that, we didn't witness it with our mothers and our aunts and our grandmothers, so this is a new concept, to understand

they understand it intellectually, but the practice of that to live your life knowing that I give my best when my battery is full, and so that's can come first and then I'm able to give whatever it is that people need from me. Yeah.

Angela Andrews MD: Pouring from a full cup. Executing with a full battery. Things, that we need to, in essence be taught, and to be normalized and to [00:21:00] see and experience what that actually looks and feels like. Because if you've never witnessed it, you've never done it, then how are you supposed to know?

Cara Michelle: And I think again, taking our time and allowing women to express where they are with it all, what is it that they're trying to do for themselves, give space for all of that is important because we're experiencing huge changes in our physical body, with menopause. So there's a lot of shifts and changes, and we just need a little bit of space in order to settle with all of it.

Angela Andrews MD: What you can't do is compare. Accustomed to in your twenties and thirties to where you are in midlife, because that's another mistake people make all the time, is thinking that you're always gonna be and feel the same way, or that there's something wrong with you as opposed to adapting to the new phase of life and how to optimize yourself in that new phase.

Cara Michelle: After estrogen and progesterone drops, we have a different body. Your body is different now.

Angela Andrews MD: Your makeup is different, your metabolism is different. The way your neurons [00:22:00] respond is everything is different.

Cara Michelle: So you are literally learning how to operate, this body differently.

Angela Andrews MD: With no user manual?

Cara Michelle: I'm hoping to play the role of a user manual.

Angela Andrews MD: And that's what you're here for. To help these newly minted, midlife and maybe folks who have been on the journey for a little bit longer pick up the pieces and figure out how to function. So the next phase of that is create an environment that promotes consistency.

Cara Michelle: This is super important and often overlooked. What we're trying to accomplish here is to make it super easy to access. the activity that goes along with one of those five foundations.

Let's talk about nutrition. And we can get into the conversation of recipes and do I need to be vegan or do I need to be this or that, really nutrition at this stage of life is about how do I have energy producing meal ready for myself when I'm hungry?

That's the goal, creating an environment that promotes consistency. [00:23:00] Consistency with nutrition is what do we need to do to make sure that when I get hungry, I can reach out, get a meal that I want to eat. I enjoy eating and promotes energy in my body.

So does that mean that, we gotta figure out when are we gonna have those fresh fruits and vegetables? When do we need to go shopping? What things do I actually like to eat? And do those things actually promote energy? Sometimes they're two different things.

So we have to figure that out. Am I a person who likes to cook, so when am I gonna do my meal prep and what is my meal prep gonna look like? Am I gonna cook it all up and put it in a container so that I just reach in every day and pull it outta refrigerator? Or am I gonna just have my stuff chopped up, my veggies chopped up, and my protein's marinating and I can put it together when I get home.

Michelle, I'm not cooking anymore. I cook for forever for all these kids and my husband. I'm not cooking anymore. Let's keep going though. How are you gonna have that? Where are you gonna go to get it? Are you gonna have it delivered? Do you want it delivered so that it's already just cut up, you want it delivered so that it's already cooked [00:24:00] and you just warm it up?

And when you do now, your kitchen environment is now set up for you to be able to easily access nutritious meals when you're hungry. 

Angela Andrews MD: I love how you frame that you didn't say , Hey, you need to do all this meal prep, you gotta plan all this stuff. You kept it very , user friendly. And you're helping the client to create a plan that works for them and what they want and desire, and then you can kind of mold it to make sure that it's nutritious. But the first step is how do you want that to look and how do we set you up for success?

 And I'm sure that hits people really good. They're really probably motivated by that. 'cause they're so used to people telling them, you can only do it this way.

Cara Michelle: Yeah. My members feel honored by that. They don't concede, they don't have to give in, they don't have to do something they don't wanna do because the group is doing it this way. Whoever you are and whatever you need. Great. Let's just keep moving from that point. Because

I don't [00:25:00] understand how we feel that it's okay to get involved in self-care, healthcare programs, exercise, nutrition, whatever it is. But it makes us feel worse. It is a struggle. It makes life harder. The goal is not, nutrition.

 The goal is not even exercise. The goal is to live a really fantastic, exciting life. So nutrition and exercise and sleep, stress management tools, they are nothing but tools that we use.

Now of course, I'm speaking about the average midlife woman. Like some would sure wanna be you, yourself have been a bodybuilder. But that really wasn't about just generating energy. You had a goal over here. You wanted to see your body in a certain way so great.

I'm a martial artist, right? But, for the average woman, that's the bottom line is that, we just wanna, be able to show up and have fun with the family and feel like we're contributing and we're, communicating and loving and sharing and helping, all of those things that make life juicy and worthwhile getting up and doing it again, dealing [00:26:00] with all the negative things because you got all of this great stuff that's going on. That's just really the goal. 

Angela Andrews MD: Then, you have to come back to what you were saying in the very beginning. Is this aligning with your vision? Is this helping you achieve that ultimate goal of what does your life look like? And your vision for your life isn't to dread. What you're gonna have for a meal and how you're going to get all your meals prepared or whatever. It's not about that. It's so much bigger than that. .

Cara Michelle: That's right. Engage with the exercise so that you can squeeze it like an orange and get that juice out of it. Yes. That juice is your mental and physical energy. That's what you're trying to do it for.

Angela Andrews MD: I do wanna bring it back to this piece that I am very passionate about, is yes, there's different ways to go about getting that nutrition so you can get the energy to drive your vision, but also being mindful of not all energy is created equally. You, not all nutrition is created equally. And there still are some boundaries on that. You're not gonna be ordering McDonald's, DoorDash and eating it on a daily basis. That's a bad idea.

Cara Michelle: Yeah. Listen, so here's the thing though. When I open the door and let women design it in a way that really fits [00:27:00] them, we all end up at some point eating pretty much .

Similarly, because isn't that wild? People are the same. Yes. The bodies need what the bodies need. We are cellular beings. 35 trillion cells make up all of our organs, our skin, our eyeballs, our hormones, everything. And so there's not a lot of difference between my cells and your cells and my neighbor's cells.

So we end up zeroing in to a neighborhood where we're all kinda living in terms of nutrition.

Angela Andrews MD: You're being thoughtful about ahead of time, so you're not making snap decisions and impromptu things that , you might not have otherwise made because you're being intentional and thoughtful about it ahead of time.

Cara Michelle: The strength of Vital Accelerator is my program for teaching midlife consistency. And oftentimes in the beginning, women make these choices again, as we were saying before, this is their journey.

And just because I've said, I really think probably, oh what diet should I have Cara Michelle? I think one that's heavy on, on vegetables and some lean protein and this and that and the other, some good fats is [00:28:00] gonna be really great, so even though I shared that information, their habit is still stopping at McDonald's on the way home.

They start to notice how awful they feel, how their sleep is interrupted. Because we're having the conversation now, they're starting to see that this might be connected to that. , They look at me a little bit crazy, but I'm a little excited when they start having these ahas.

Angela Andrews MD: When they make that conclusion on their own, and that's so much of what the coaching looks like, is helping people giving them a little plug here, a little bit plug there, and then they're coming to realization on their own,

Cara Michelle: Often what happens is they'll clean up their diet and they're feeling a lot better. And then something, an event or a time of the year will spark something and then they'll go back off and they're back at McDonald's and then they, oh my God, I don't know what's going on.

I know you had cleaned up your nutrition. How's that still going? I'm still doing pretty good. Okay tell me about it, now that you mention it. I have had, McDonald's and fries or whatever it is.

Angela Andrews MD: Yeah, and I feel like a lot of the things [00:29:00] that I talk to patients about let's say I'm thinking about specifically chronic diseases and maybe someone's struggling with diabetes specifically, and it's really can be as simple as just bringing things to their awareness. Because we operate in an automatic habitual kind of way. It's a lot of things escape our awareness, and most people don't realize that. It's just bringing it to their awareness. 

Cara Michelle: Absolutely. Even when women are trying to learn and , they come into the office and then this is their time for themselves, half the time their brain is still that conversation I had and what time are the kids getting all off? Yes. It takes a little bit of time to really get it all together.

Angela Andrews MD: It comes back down to that consistency consistently making that time for yourself and eventually that starts feeling like, oh, this is my time. I guess I don't need to think about all those other things right now.

Cara Michelle: That is a practice all in itself, just having space for yourself. It really is.

Angela Andrews MD: Definitely something I want to make sure that I'm doing on a daily basis. I know that when I don't do that, things are a little bit outta sync. Even if everything else [00:30:00] is, going along habitually, like it should be, it's ah, oh, I didn't have my quiet time this morning. 

Cara Michelle: The thing is that you can't really explain that to anyone. They have to experience it themselves. You're like what difference does it make that you took those 15 or 20 minutes? Like, how is that really gonna help me? But it's very focusing it sets the tone for the day. 

Angela Andrews MD: It really does. So what's the next phase?

Cara Michelle: Once we have our vision and once we've designed a realistic journey, one that we can effortlessly get to and check off and be excited about. We've gotten our environment and the other piece I wanted to say about environment is but once we get those pieces in place, then the last piece of the framework is that we need to design a bounce back path. If we don't have those other pieces in play, if we're not practicing and creating some momentum with those first three, then there's nothing to bounce back to.

Angela Andrews MD: This is novel. , I've never heard this element to a framework, so this is good.

Cara Michelle: A bounce back path is important because we just have to accept [00:31:00] that, our lives are crazy that all lives go through this kind of sine wave, design, there are days when things are pretty good, and then five minutes later you get a phone call and now you gotta figure out something down here, right?

Yes. I have a client who has four teenagers. And they have three cars, her and her husband. Four kids, three cars. Two cars broke down in the same week. Let's think, like what's her morning routine looking like? What's her exercise looking like No matter what time of day that she's doing it, right?

Everybody scramble because now they're trying to get their schedules together so they can drop this person off and who's gonna get a ride from that person and this and that and the other. And we can't see that as an anomaly. That specific thing might be an anomaly, but something is going to happen.

It's always fascinating to me that some clients are like you know what? I got this thing with the family going on, but we're gonna smooth out. And then I'll be good. And I'm like, okay, you'll be good for. Maybe we can count the hours, right? And we give it a couple days, maybe it's a week, but then something's going to [00:32:00] happen because your life takes this up and down trajectory.

Their lives take the up and down trajectory. And because you are connected with them, their life, their ups and downs affect you to be consistent, we have to just accept that's the truth.

And so if we know that and we prepare for it ahead of time, Dr. Angela, do we ever have to go through falling off the wagon? I say no. What we do instead is we adjust and we pivot. So I coach my members to have a plan A, a plan B, and a plan C for each one of those five. So let's say

Jane gets a call and Uncle Bobby, who lives two states away, is going in for surgery. He's gonna need some support. Now Jane here at home, she gets up and goes for that walk in the morning. She does a little bit of weightlifting. She has her meals ready, those kind of things.

She knows her sleep routine, but now she's staying at the uncle's house and his house lives right on the highway. And so the walk is a little trickier for her. She doesn't really know [00:33:00] where she's going. She's not sure of the neighborhood. The cars are there.

He lives in a food desert. So it's trickier for her to get. The nutritious food that she wants to prepare. So she's gotta be prepared. So instead for the exercise routine, she's already practiced a 15 minute body weight session.

She's doing some squats, pushups lunges, so no matter where she is, she can pull out that routine and then generate that mental and physical energy that she's gonna need because she's still working, she's working online. The kids are still trying to get to their activities.

Now, this is the time when we need to even more. We need that mental and physical energy because we wanna show up at high level,

One of her strategies for nutrition is that she just maps it out so she knows where the grocery stores are. She's got a couple of restaurants, around this area.

She grabbed an Uber, she ran out and got a couple things from the grocery store. She had to drive a little further to get there, but she went and got the stuff because she already has a couple of recipes that a [00:34:00] little more simple.

They don't need as many spices can you see how powerful that is? Yes, absolutely. So having that a, b, c plan, that pivot when life gets a little bit crazy around sleep, exercise, nutrition.

What can we do with sleep? Do you have some kava with you? So a supplement. Are you taking ashwagandha? Do you have those things with you that are gonna help you settle down even though there's different noises and all, you're sleeping in a different place.

I'm a wus, I bring my pillows, I need my pillows. Lemme be honest about it, right?

Angela Andrews MD: I'm to the point where I wanna bring my sound machine, I need that green noise in the background. 

Cara Michelle: But can you see, Dr. Angela, if you get the phone call about Uncle Joe's surgery and you don't have this in place, you got a day, maybe two to get yourself ready, get everybody in the house ready for your absence, and make your reservations and get yourself out there. 

Angela Andrews MD: And then everything falls apart. 

Cara Michelle: There's two sides to that bounce back path, because things are gonna happen, even if you got a plan the [00:35:00] situation turns out to be bigger than you expected it to be, and you're off of everything for a few weeks, maybe even a month.

So part of that bounce back path is knowing how you're going to restart. Can you allow yourself, will your mind allow yourself to go back to that 10 minute stretch or exercise routine, even though before this event happened, you were at 20 minutes or 45 minutes?

Even when I go on a vacation that I love now, that's something planned. Even when a planned vacation, it takes two weeks to get back in the rhythm. 

Angela Andrews MD: It absolutely does. Yes. And I feel like the older you get, the harder.

Cara Michelle: This is just the truth of our lives, but we try to make up these stories. We look on Instagram and people flying here and flying there and they look like they're doing great. Forget all of that. Let's just be honest.

Angela Andrews MD: And also giving yourself grace. Giving yourself permission to not bounce back to exactly where you were before this disruption. That's okay. Something is better than nothing.

Cara Michelle: And it's [00:36:00] so hard women, we don't wanna let go of that. We're always a little bit, hard on ourselves. And I have to just say that sometimes women are hard on other women, yes. Absolutely. Want to feel like we're behind or we're not keeping up, or we're not. 

Angela Andrews MD: And some of that being hard on other women is a reflection on maybe how we feel about ourselves and if things aren't going well in your mind or you're not living up to some expectation , I need someone else to feel as bad as I do. And it's not necessarily intentional, it's just that . It is not conscious. Being aware of that and trying to recognize when that's happening and, reset.

So a common thread that I'm getting here is for one, being healthy , and, living better doesn't necessarily mean that you're doing all the things perfectly you're not following someone else's recipe for life success you're creating your own and you have your own starting point and what you're doing is, you're helping women reframe what living better looks like , and changing that mindset of what traditional self-care looks like, without the pressure,

Cara Michelle: It's not easy to be different. I wanna give women, the [00:37:00] permission to be different. Need to follow the pack because everybody's doing jazzercise doesn't mean that's what you need to be doing. Everybody's doing Pilates. Doesn't mean that's what you need to.

Angela Andrews MD: I'm one of those people where if everyone's doing it, I don't wanna do it. It makes me question it.

Cara Michelle: When I look around at the majority of women my age I see a lot of folks that I don't want to follow in those physical or mental footsteps. And so I think that's a useful strategy, when you see folks, who their main meals are coming from convenience stores or gas stations. Just sit for a second and see, it's not judgment, we just have to be honest. Is that the kind of physical health that I want for myself?

Angela Andrews MD: Is this normal, this thing that I'm perceiving as normal really the normal I want.

Cara Michelle: That's right. And you get to design it. , To me, that's one of the benefits of older age,

Give yourself permission to do life on your own terms.

Angela Andrews MD: As you were talking about the bounce back plan and you said before that in order to have the bounce back, you have to have had the foundation to begin with. [00:38:00] And it really does becomes this circle and it really further reiterates the importance of creating, the consistency.

And I would even also add. Simplicity. We are over complicating our lives and, midlife for a lot of women looks like juggling career spouses and children that are still in the house and then aging parents. And some of those things you don't have any control over.

But, one thing that I'm taking a personal example I'm doing less of is why am I over complicating birthdays? Does it need to be a Pinterest birthday every time? No. No, it does not. There are certain things that I really enjoy,

and if nothing else, that's what I've decided my priority is, when a special person's birthday comes up, and that's my kids, my spouse, my immediate family, the cake is my priority. And so that's one of the things that I've done to try to simplify something that I've often made a big task.

Cara Michelle: One of my members said that she's just really simplified Christmas, she has four children, I believe, and she's [00:39:00] always gone out, done a ton for Christmas, making her own advent calendars and all kinds of different things. Her kids are grown now and she's still doing that, and she's this year I'm just not doing that anymore.

Angela Andrews MD: It's amazing when you cut back on some things, and then it goes fine. And everyone's okay. . And it's one of those things people have to experience. Because if all you know is doing things a certain way and you put yourself in other people's heads and you created this story in your own head. You keep telling yourself that story, it's hard for you to believe there's anything different. So you mentioned, pillars. And I think about lifestyle medicine, there's six pillars in lifestyle medicine. It sounds like there's a little bit of overlap with your framework whole food plant forward eating or healthy eating is one. So the nutrition piece, the exercise, I like to say movement because people have a relationship with exercise. They hear exercise and they think a certain thing. So I want them to think more broadly. Restorative sleep. Not just sleep, but good sleep. Positive social connections, so that community and a community doesn't have to look the same for everyone, but having that community [00:40:00] connection getting outside of, your circle.

So that could be religious, it could be volunteer, being in connection with other people. We need that, and stress management is such a broad term. I like to think of even more in terms of, maybe recognizing what your stressors are.

And getting ahead of those. And if you can manage that, 'cause stress can look a lot of different ways for a lot of different people. And then avoiding risky substances. So those are our six pillars of lifestyle medicine. And then I throw in there time and nature. In your framework, what are the five areas? You mentioned sleep, exercise, nutrition. What are the other two? ,

Cara Michelle: So we had nutrition, movement, hydration stress management or stress tolerance is another one.

Angela Andrews MD: Stress tolerance. I like that.

Cara Michelle: And sleep.

Angela Andrews MD: So a lot of overlap there. I'm curious to hear how you approach stress tolerance. That's a tough one for me.

Cara Michelle: This can show up in a lot of different ways for different people, the truth of the matter is like the nutrition, what we're trying to do nutritious food ready when we're hungry for stress tolerance. We wanna be able to bring our neurological responses to people and events and things [00:41:00] back to a level where we can respond in ways that we're gonna feel good about later on.

So what is that? Is it taking some adaptogens that are supporting me and my breathing? Did I make sure I got good sleep the night before? I was talking with the client about this yesterday, that sleep is not for that day. So today is Friday when I go to bed on Friday night.

This has nothing to do with Friday. Friday night sleep is the precursor for Saturday. That's a different way of thinking about it. So it is a stress tolerance, tool for the next week. We wanna notice what does that feel like in our bodies? What happens to my thought patterns? What does the feeling that I'm having in my chest or in my stomach that indicate to me, oh, my nervous system is getting really ramped up. And then I have those tools that I can use in that moment. 

Angela Andrews MD: And I think that's something that's interesting when we think about things in frameworks like that, stress management, stress tolerance. It ultimately comes back to all those other things. You're well hydrated, you have good nutrition that gives you the [00:42:00] energy. You're getting good sleep. We've all been hangry at some time, or sleep deprived. And that really does a number on your mood. And your tolerance for all kinds of things.

If you don't know what I'm talking about, just look at a hungry, tired toddler. And that's all you need to see. So bringing it all back together ultimately, you've got a coaching program that's built on this framework, and this framework is just a really clear visual way to help your clients conceptualize it. What is one thing you want to leave listeners with today?

Cara Michelle: The framework, I think about it like a triangle or a pyramid.

And that base is the anchor, your vision. I think that is the biggest portion because without it we don't have a purpose for our self-care and we don't where we're going. And, give yourself some room to think through again, who are you at this stage of your life and what's important to you, if you had a magic wand or all things were equal, how would your days go?

What would you be involved in? How do you wanna [00:43:00] feel when you're engaging with your family and your friends? What kind of work do you wanna do? What kind of impact do you want to have on those that are close to you life just has a different kind of hue to it. When you are doing only for others, it's really easy for your light to start to dim. And so I think that's the big thing, give yourself some permission to understand what's important to you, what do you want to be involved in, and then you start to have some intention and purpose around taking care of yourself so that you can go and be involved in those things .

Angela Andrews MD: The basic principles are timeless.

Cara Michelle: They are the foundation. If I could say a second thing for your listeners to hold onto is that you can't lean in on exercise and not be sleeping well and not getting good nutrition. At some point, you're not going to be able to exercise like that. The physical human body is the same in those patterns, and your cells need a certain environment in order for you to be able to engage in those things.

Angela Andrews MD: All these things have to coexist, this is [00:44:00] beautiful and it's simplicity and clarity. Something that a lot of people are probably craving is the, simple, thoughtful approach that doesn't overcomplicates self-care and makes it something that is applicable to anyone and everyone based on whatever their goals are and what their vision is for their life. I love it. It resonates very well with me and I'm gonna start incorporating some of those principles in how I approach, my patient care. I think it's very powerful, so how can people find you?

Cara Michelle: My website is strength vitality wellness.com. On the website, there's a link there where folks can watch my webinar. It's a 50 minute webinar that goes into the framework so you can learn more about it's really useful because it helps you to understand where are you with this, framework, what part might be missing for you.

I'll send you the link and you can put it in the show notes as well if you'd like. Perfect. And then there's also a little survey. It's 10, 15 questions. that kind of helps you and me understand where you are. And then I'm happy to have a one-on-one call to [00:45:00] talk about which one of those pieces of the framework might be holding you back the most.

Angela Andrews MD: I am so grateful for you, Cara. You always have wonderful things to share and I'm looking forward to sharing this with other people. I will be sharing your information in the show notes. If anyone wants to reach out to you, is that the best way to contact you through the website or do you have an email address that you wanna share? 

Cara Michelle: Sure. The email address is CM as in caramichelle@strengthvitalitywellness.com, but you can find us the website as well.

Angela Andrews MD: Excellent. Thanks again and hope you have a wonderful spring.

This has been another episode of the Lifestyle MD. Special thank you to Lou Moussa for the show theme music, Heather Mahony Photography and Makeup by Janai for the cover photo. And if you enjoyed this podcast and you haven't already, please subscribe today and share with another woman who may benefit.

You may also follow me on Instagram at Angela Lifestyle MD. I am Dr. Angela, thank you for joining me today.