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Scot: I have a question for you guys. Do you know the best way to make sure you never fail to achieve your goals?

Mitch: Never set them in the first place.

Scot: Yes.

Troy: Just don't set them, yeah.

Scot: Unfortunately, that's probably not the best plan because goals are useful, right? They can help us achieve the things we want to achieve. But sometimes even when you set goals, you don't achieve them. Just like you never set the things in the first place. And today on the podcast, we're going to talk about goal setting, if you've kind of gotten off track, how you can get back on track. That's what the podcast is going to be about.

I'm curious, do you guys have any sort of goals you've been working on that have gotten off track? Let's start with you, Troy. Anything you'd like to bring up?

Troy: Yeah, without question. It's funny. We talked about this, or we were in touch about this beforehand, and I gave it some thought. My first thought was, "Wow, I'm doing really great. Look at all the stuff I'm doing." And then I thought more about the stuff I had wanted to do over the last couple years where I've just failed miserably, and I thought, "Wow, I've really gotten off track." So, absolutely.

Scot: Could you be specific? You got a couple that you'd like to share?

Troy: Yeah. Oh, for sure. A goal I set like two years ago was I wanted to write more, with the goal of actually writing a book. And I have not even gotten started on that, so that is so far out there. And we can talk about specifics of why I have failed miserably at that, but I haven't even started it. So that one is one where I've really failed.

Another one I set where I did pretty well, but have definitely gotten off track, is trying to keep in touch with friends. And I tried to be more specific on this goal of just being in touch with friends on a weekly basis and trying to get out at least once a month to do things with friends. I'm saying this and I'm embarrassed that I'm saying it because it makes me sound like a total recluse, which at this point in my life I probably am. I tried to set a very achievable goal. Again, to some extent, I was successful, but I am definitely off track on that as well.

Scot: Mitch, do you have any goals that you've been working on, you've kind of gotten off track, or you're not making the progress you want?

Mitch: Oh, do I. So over the last couple of months I've tried really hard to . . . I've been going through some mental health struggles, etc. We're trying to work through it, and I know that I will feel a million times better if I get back into a routine, if I have a reasonable bedtime and I get the same amount of sleep, if I wake up, I do my exercises, my physical therapy, etc.

I set time aside every week to do some meal prep. That was really, really effective for me. I know what I need to do. I write down the things I want to do. And what kind of makes it harder was that I did it really well for a week or two, and it just feels like I'm not doing quite everything I want to in all of those areas right now. So I know that feeling very well.

Scot: Okay. I have some goals too. I would like to read more. I don't feel like I read enough. I want to declutter my office and my garage, get rid of some of the stuff here. That's good for your mental health. And I also want to lose some body fat. So those were kind of some of my goals that I feel like I'm not making the progress on.

And today, we're going to talk about all of our goals and we'd like you to even think about what a goal is you'd like to accomplish and maybe you've stalled out on. We're all together going to try to get a framework so we can all get back on track.

This is "Who Cares About Men's Health" with information, inspiration, and a different interpretation of men's health. I'm Scot Singpiel. I bring the BS, and I also bring a lot of experience to this conversation because I've failed to achieve the same goals for the past 10 years.

Troy: Nice.

Scot: Or I guess we could call it I've practiced the same goals for the past 10 years.

Mitch: There we go.

Scot: The MD to my BS, Dr. Troy Madsen. He's the one that suggested this topic, and although he did say he has some that he hasn't met, I don't know that he's ever failed to achieve a goal.

Troy: I wish that were true.

Scot: And always coming with a unique perspective, welcome to the podcast Mitch Sears.

Mitch: Yep. Always unique. That's me.

Scot: So this show, in a way, as I talk about these things, I feel . . . I don't know. It's just like, "Could you whine more about some of the simplest things in the world to accomplish?" I just feel like there are guys out there that can set a goal and they just laser in on it and they just get it done.

And as I joked in the open, I've kept daily pages and I've looked through my pages in the past, and really it's the same stuff over and over again for me. It's just like, "Come on, Scot. Let's get it done. What's so hard about this?"

So I'm really hoping maybe this show gives me some clarity on some of the things I'm not doing right so I can kind of restructure my thinking a little bit and feel less like a loser and a failure.

Troy: Well, you've got to give yourself credit too, Scot, because you have done a lot of things. And to be successful at achieving these other goals, I think we have to at least recognize where we have been successful and what we've done to be successful in those things. So I think there's no question you've been successful in things.

Like I said, as I thought through it, at first I was patting myself on the back saying, "Oh, wow, I've done this and this," but then I thought more thinking, "Wow, these are some big things I wanted to do and I just haven't done them." So I think you kind of have to look at both things.

Scot: Yeah. That's interesting that you had the positive vibe at first, and I had the negative vibe, like, "Oh, I've still got all these things to do." How about you, Mitch? Where'd you fall in on that whole deal?

Mitch: I just am feeling kind of awkward talking about it, but that's where I'm at. I felt kind of negative, but I felt I had a pretty realistic, like, "You know what? This isn't working, and I'm trying really hard not to feel like a failure." But just in saying it aloud, like, "Yeah, I had these goals and they're not quite working" . . . I don't know. I just feel like that thought that you were talking about, about being a loser, being a whatever, it's just like, "Ugh, I don't like admitting aloud to other people that I made a goal and I am not reaching it right now."

Scot: Well, let's dive into figuring out maybe why we're not achieving these particular goals. I think Troy is right. I think we've all probably set out and have accomplished goals, but I don't know, it sounds like Mitch and I are kind of the same. We tend to focus on the negative.

Mitch: Oh, no.

Scot: Yeah, I don't know. But anyway, I think the first thing that you need to ask yourself is "Did you set yourself up for success in the first place when you made your goal?"

One of the frameworks that I found, and probably we've all heard of . . . and actually, after revisiting it today, I thought, "Wow, this is actually a lot more useful than I gave it credit for in the first place" . . . is setting something called SMART goals. Have you guys heard of this?

Troy: I haven't, no.

Scot: Oh, you haven't? Mitch?

Mitch: No, I haven't.

Scot: You haven't either? Really?

Mitch: No.

Scot: Oh, wow.

Troy: Not specifically. I'm sure I've heard of a lot of the concepts involved in this, but I don't know that I'm familiar exactly with SMART goals.

Scot: Yeah. I'm not talking smart like, "I'm bright and I'm dumb." It's an acronym.

Troy: I knew it.

Scot: A SMART goal . . .

Troy: I figured this was going somewhere.

Scot: SMART goals are these things. The S stands for specific. So is your goal specific enough or is it too vague? Run these against the goals that you have or the goal that you came up with.

Troy: Okay. So my writing goal, already I failed on that.

Scot: M is for measurable. What does success look like and how will you know if you've obtained it?

So within measurable, I've heard them talk about two different types of goals, process goals and outcome goals. So a process goal is "I'm going to exercise every day." That's a process goal. "Every day, I'm going to do something." Now, of course, it doesn't meet the specific in SMART goals, but that's beside the point on this one. Or outcome goal is "I'm going to lose five pounds." That would be an outcome goal.

A is for attainable. So is it something you could attain at this point in your life or is it too much too soon? With fitness goals, I think a lot of us set goals that are unattainable.

Is it relevant? Does it tie back into your objectives, the things you want to accomplish? Or I've seen it talked about as "Does it tie back into your values?" What is your why? Why are you trying to do this? And is this goal actually helping you to accomplish your why?

And T in SMART goals is time-bound. So you're supposed to put a time on it and then reevaluate at that time. Maybe the timeframe is unrealistic.

Troy, with your goals, where do you think the problem was based on this SMART goal framework?

Troy: Well, the writing thing, I think for me, I did have a measurable outcome. I wanted to write a book. So I guess that was measurable. If I had actually written a book, I would've said I achieved it. But in everything else, I really kind of failed. It was not very specific. What kind of book did I want to write, first of all? Did I want to write a novel? Did I want to write a medical education book? I had no specifics.

Mitch: Just a book.

Troy: Yeah, just a book. I mean, who knows?

And then in terms of measurables, I tend to do a lot better with process-oriented things where it's not like, "My measurable is I want to write a book." My measurable in the process thing . . . The thing that would've been a lot more helpful for me would've been to say, "Okay, I'm not concerned about the outcome. I just want to sit down and write for an hour every day." And then ideally, something proceeds from that.

So I think in terms of what I at least thought two years ago I was going to try and do, I just wasn't really set up for success from the beginning.

Scot: I want to dig into this a little bit more because I think this could help people formulate their goals. So specific, is it specific or vague? You want to write a book. That's pretty vague, right?

Troy: That's vague. Super vague, yeah.

Scot: So maybe your objective is to write a book. This is the way I kind of started framing it, and I don't know if this is how it's framed elsewhere. But your objective is to write a book, so what are the steps that you would need to do to write that book? And like you said, you don't even know what kind of book.

And measurable, you kind of got towards that, right? You said, "I want to write for an hour a day."

Troy: Well, I just said that now. Yeah, I should have said that at the time.

Scot: But you're getting closer, right? So is writing for an hour a day attainable though in your schedule realistically, or is a half hour a day better, or 15 . . .?

Troy: You're right. Yeah, probably something that's actually attainable and consistent would be 15 minutes. You're exactly right, if I really said, "What is attainable?"

If I set out to do an hour a day, I would not do that. There's no way I could maintain that. So yeah, 15 minutes a day, you're right. I could do that consistently, and then maybe some days I just keep writing because I have more time or I'm kind of in the groove or whatever. So yeah, in terms of something that's actually attainable, that's what I would need to do.

Scot: And then the relevance part, the R and SMART goal, does writing a book tie back into your objectives or values? I mean, what is your why? Because if your why is not strong enough, you're not going to sit down and do that 15 minutes. I mean, that's a pretty deep question to ask yourself. Why do you want to write a book?

Troy: Yeah, it is a deep question. I think it's something I've always wanted to do, and so that's maybe more the relevance, but I think the relevance would have to relate more to actually what I was writing about. Is it something that just the process brought joy to me? If so, that makes it very relevant.

Does it get at a deeper purpose or something else I'm trying to bring attention to, whether that's a medical topic or health topic or something that entirely has nothing to do with health?

So you're right. I think the relevance would have to . . . Just saying, "I'm going to write a book," that in itself maybe there's some relevance, but I think I'd need a lot more relevance to really stick to it.

Scot: Yeah, and then, too, if the relevance is, "I just want to go through the process of writing a book to say I did that," that would then maybe dictate what kind of book you're going to write. Maybe you want to make that process as easy as possible as opposed to learning a whole bunch of new skills, like writing fiction.

And then time-bound. Did you ever put a time on it as far as, "I'm going to get this part done in this amount of time"?

Troy: No, I never did. It was two years ago and I believe it was a New Year's resolution sort of thing, and I think I envisioned within the next year I would be able to do it. But I can't say I ever put any timeframe on it.

Scot: Mitch, do you have a goal you want to run through the SMART thing?

Mitch: Well, it dawned on me as we're kind of talking through it that my goal was . . . I had little micro ideas that were specific, but the idea of "get into a healthy routine" is way too broad. I'm much better these days. I used to be very much outcome-focused when it came to my health, right? How many pounds I wanted to lose or . . . It was a lot of that kind of stuff.

Scot: How many abs you want to see.

Mitch: I want to see eight abs, whatever it is, right? So I'm getting better about process. It's like, "Hey, I want to work out 30 minutes a day so many times a week."

Scot: Which ties back to the overall objective of healthier habits.

Mitch: Yes. But also I think I'm trying to do a whole lot of things. I've got bedtimes and meal preps and I want to reach out to people more and I want to work through this ADHD CBT workbook that my therapist gave me. I put those all together in the same goal, and I think that might be what's screwing me up.

Troy: Just too big, too much.

Scot: I love that insight, because I think this is something I observed as well, very similar. Sometimes we make a statement like, "I want to live a healthier lifestyle," and we don't think how complicated that really is until you start really breaking it down and trying to do something.

Sometimes seemingly simple things are very, very complicated, and then we get mad at ourselves because we can't achieve this seemingly simple thing that actually has a lot of complicated steps. And each step might take learning some new knowledge or might take overcoming who knows what obstacles.

Troy: Well, I think even just the more specific goal, like you said, Scot, "I want to lose five pounds," even that is very non-specific in a way because it doesn't talk at all about exactly what you are doing with your diet, what you are doing with exercise, all those other things.

So even beyond just the general healthy lifestyle, I think even sometimes some of these specific things we want to achieve are just far too . . . We need more specifics there of how we're going to get there.

Mitch: I think that one of the things with this particular issue I'm having is that, yeah, it's complicated, but also change of any sort can be hard and taxing and it takes effort. And I don't necessarily think that this was overly complicated. You said, "Think through it," and everything. I wrote everything down. I got my little panda planner out and I wrote down when I'm going to do certain things, and what time of the day I'm going to do them, what kinds of blah, blah, blah. I wrote it all out.

But I think for this particular one, you look at at attainability and how reasonable the whole thing is and it's just like, "This is a lot of changes all at once." This isn't a small easing into it. I'm trying to get myself to do four or five big changes, and while I might understand what I need to do, that's still a lot to do all at once.

Scot: Yeah, it is. It can overwhelm you and then it's like, "What's the point? I'm never going to achieve all of this."

Mitch: And then they're all linked together in my case where it's like, "Well, I didn't get to bed on time, so I guess I'll eat McDonald's in the afternoon."

Troy: That's right.

Mitch: Why are those connected?

Troy: And that's a really tough thing too, because I think sometimes when we do set goals that are really tough and we don't achieve them or we fall off the wagon, so to speak, we just kind of give up and just say, "Well, so much for that." And that's the hard thing about it.

I like the attainable piece of this as well, of the SMART goals. I think not just attainable, but something that's . . . We want to set hard goals in a way, but at the same time, I think we want to have steps along the way that we can be very consistent with and that aren't overwhelming.

And I think there's so much more value in just being consistent in something rather than just having a huge effort and just putting that forth and saying, "Wow, I did it," whether that's a workout or whatever it might be. But just consistency every day, something that's relatively easy to do, and if we're consistent at it, I think we see big results.

Scot: I'm going to say overcoming an established routine to do something else in a routine is extraordinarily hard. We have routines for a reason. It's to conserve brain energy. If you had to make all the micro decisions you have to make on a daily basis from "How am I going to get to work?" to whatever, that's why routines are helpful, because they allow us to then turn that brain off to do those things we have to do. So just realize that's a tough thing to overcome.

And in my instance, for example, my "declutter my office and my garage," this is another complicated thing, right? I can get very specific and say, "I'm going to take one thing out of my office or my garage and put it in a box for Goodwill every day." But here are some things that I've struggled with. Well, first of all, I'm a "I might need that someday" kind of guy.

Troy: That's totally me. Trust me, since we did the declutter challenge, I have said to myself so many times, "Why did I do that?" because I need that thing now. And then it keeps you from getting rid of stuff.

Scot: Right. Even if that thing is something I could easily go and buy for a dollar at the hardware store, I get mad at myself because I didn't store it for 20 years, right?

Troy: Yeah, you could have saved a buck because you saved it.

Mitch: Yeah, a buck.

Scot: So I have to overcome that aspect of my personality. And some of the things in this office are tied to my identity. They were things I purchased at a time that, for whatever reason, I identified with, or they were part of who I was at the time.

For example, a picture of me on the cover of a radio magazine when I used to be in radio. That was tied to my identity. I don't necessarily care about it anymore, but it's tough to throw that away or get rid of that.

And some things are stuff my mom saved from my past and I don't have a connection to that anymore, but because my mom saved it and it's from my past, I don't want to get rid of it.

Some things are like, "Hey, I could sell that and make some money," and that slows things down.

So just the simple thing of getting rid of one thing a day can really tie into a lot of complicated issues that we have as people that we have to overcome in order to do that, right? So isn't that crazy? I think that's just completely crazy.

Mitch: Yeah.

Troy: Well, it is. But again, I think if you do have that specific goal, and if you just make it very easy and very attainable . . . I like what you said, just getting one item every day that's going to go to Goodwill, or maybe it's even one item every week if you just need a starting point.

But it seems like once you do that and then you get that item, then there are going to be some days where you say, "Well, I can get rid of this too." Then you kind of get on a roll there with it, and then the next week you just may not be in the mood to get rid of anything, but then you think, "Oh, it's just one item."

So making it a low bar that's achievable and you feel like you've achieved that on a weekly basis, I think, is really key to the larger success.

Scot: The next part is kind of the troubleshooting. So let's say you've got what you believe to be a really solid SMART goal, but you're still not quite accomplishing what's going on. So this is a troubleshooting step that I found in the "Harvard Business Review."

And the process is this. The first thing you do is you think about that goal and you imagine achieving it. I mean, you really picture it. You feel the pride or the excitement or the sense of accomplishment or whatever emotions that you have that accompany that goal.

And then you ask yourself, "What's in the way of achieving that goal? What's it going to take to realistically get there?" And that might be more knowledge. It might be putting together an actual plan, how you're going to make that happen.

For example, if your goal is to eat more vegetables every day, do you have vegetables in the house? Maybe the plan is make sure you pick up a couple of bags of frozen beans.

Then going between the future that you want and the obstacles you have to overcome to get there, according to research, will help develop motivation and the clarity to succeed. And they call this mental contrasting.

They've actually done research on this, that people who do this mental contrasting of thinking what they want, really putting themselves in that position and then thinking, "What are the obstacles between me and that?" are more likely to put more effort into achieving their goals. They're more likely to make them happen.

I took two things out of this. The first thing I took out of it is this process of looking at where you want to go, what it is you want to accomplish, and then troubleshooting it. What's in my way? What is it that I have to do? And that helps you come up with that plan. What is it that I need to do to realistically get there?

And then you can evaluate that along the way and go, "Boy, is this really that important to me? If this is what I realistically have to do, maybe it's not that important to me after all."

But it's a process that you can go through to maybe troubleshoot those SMART goals and figure out, "Is this worth it to me? What do I need to do to get there specifically? How can I break this down into smaller things, into smaller SMART goals, perhaps?"

And then I think the other part that they're talking about is this actual mental imaging of the accomplishment. I think the psychiatrists are saying that that helps motivate people. According to their research, people will put more effort into achieving their goals.

Troy: That's interesting. Sometimes I worry too much though that I try to see the end from the beginning, which is kind of part of that process. I don't know. Like I said, for me it just works just to focus on the process and the achievable goals, and then it seems like that end piece eventually comes.

Sometimes I think when I do focus on the end from the beginning, I get a little overwhelmed. I don't know. I'm interested if that's worked for you, just what they recommend, envisioning that end and how you'll feel and everything associated with it.

Mitch: See, and that's what kind of . . . It's like every so often these things come into my life, whether it's you sharing it on this podcast or whatever. It's like, "I didn't know about SMART goals. When was I supposed to learn about SMART goals? There's a process here."

And it's the same with this "Harvard Business Review" thing. I think, in kind of a similar but different way with Troy, that most of my goals, I don't spend a lot of time thinking about the end. I think about all the steps that I have to do to get there, and that can be overwhelming.

But then on top of that, because I don't take the time to be like, "How will I feel if I accomplish this? How good would it be? What would I appreciate? What will I be able to do?" I don't spend any time thinking about that. So it stays nebulous and it doesn't feel like something I actually want. It doesn't feel relevant.

You have to think about it or else it's not going to be in your brain and it's not going to be real. Why is the "Harvard Business Review" coming into my life right now? Ugh, it's so frustrating.

Troy: So maybe in your case, maybe that's helpful. Like I said, for me, maybe I've focused too much on that, on the end, and not so much on the specifics. But like you said, maybe sometimes, in other cases, you focus so much on the specifics that you find them overwhelming without really focusing on what the reward is going to be. So it's probably something . . .

Mitch: If it's worth it.

Troy: Yeah, exactly.

Mitch: And if it's worth it to you, yeah.

Scot: Yeah, and you can discover that along the way, right? Maybe it was never really worth it to you after some deep analysis.

Troy: Right.

Scot: Some other troubleshooting tips that I came across here. So is it the goal you really want? When somebody says, "I want to get healthier," is that what you really want?

Maybe you said, "All right, I want to get healthier. I'm going to go walk 30 minutes a day for a few months," and then you gave it up because you weren't losing weight. Well, that's a little bit of a different goal, right? The true goal reveals itself. So was that a failure? Well, maybe, maybe not.

But is the goal you really want the goal you're working towards? You've kind of got to ask yourself that question. I think being specific can help with that, the SMART goals.

Did you have a plan in place? It's great to have goals, but what's that plan you're going to do to get there? And I think that's the HBR, the "Harvard Business Review." What are the obstacles? What are the things that are in your way? What is it you need to do to make that goal?

Another piece of advice is getting started again as soon as possible. So if you have set a goal and you've noticed that you're not making steps towards it, don't keep putting it off. Get back into it as quickly as you can.

This is another big one we've talked about on the show. Be compassionate. And we talked about it at the very top of the podcast, right? Don't focus on your failures. Focus on your progress made.

So I wanted to have two kettlebell workouts a week, and I did pretty good for a couple of weeks and then I got off track for a week, and I'm like, "Oh, I failed." Well, no, I can start doing it again. And I did it again last night, right?

And not only that, but I've got my sheet of exercises now. So that was something I accomplished. I went and did the research on the exercises I wanted to do, so it wasn't a failure. I'm starting at a different point, right? If we use the mountain analogy, I'm 20 steps further from my beginning point. I'm not back at the beginning.

Troy: You've taken a nap along the way, but you made 20 steps.

Mitch: Got a breather. You got this.

Troy: You got a breather, yeah.

Scot: So it's not a failure.

Troy: But you're higher up the mountain.

Scot: And then accountability partners was something else I came across. So seek out others who share similar goals or at least will be supportive and help you be accountable. So that might be the missing key for some people.

And then this one really spoke to me. I think we want things to go as smoothly as possible, and when they don't, I think sometimes we're like, "Well, that was not a success." But plan for obstacles. They're going to happen. That's part of the process. They're problems to be solved.

Troy: Yeah. And I think the compassion piece of it is huge because I think the biggest challenge for us, like you said, is just recognizing what we've actually done. We set these goals, we want to be perfect in them, we want to do this every day. Whatever it is, we want to achieve it. And then we just find that we're just not getting there or we're not getting there as quickly as we are and we just are like, "Why am I doing this? What's the point?" And so I think that's probably the biggest piece of it and the biggest challenge.

Mitch: Yeah, that's kind of the thing that I come across a lot, is that it's so easy to fall into a shame spiral. It's so easy to be like, "Ugh, no, I'm terrible. This is bad," or whatever, for me at least. I really like that idea of "I've done something."

For my particular goals, I have a plan. It took me some time to sit down and write down the kinds of things that I wanted to do. Was it maybe a little too much? Sure. But that doesn't mean I need to beat myself up about it. I made some progress. And if we keep focusing on that aspect of it and can forgive ourselves for not being Supermen, I think it might be a little easier to get back on the horse.

Troy: Yeah. And I think if you just do absolutely nothing to achieve your goal, you make zero steps, you can still pat yourself on the back for the fact that you actually set a goal. That's worth something. You envisioned it. You set it. That's a step.

Scot: All right. Are we at a point where we can wrap this up? I think we kind of covered some stuff. Do we want to do some takeaways?

Mitch: Oh, sure.

Troy: Sure.

Scot: Boy, Troy sounds a lot more excited about doing takeaways than Mitch, but that's okay. What's yours, Troy?

Troy: My takeaway is SMART goals. Again, I've heard of certainly pieces of this, but I like the way it breaks it down. I'm not a big fan of acronyms, but in this one I kind of like the acronym.

And then for me, I think getting back to the goal where I've obviously failed, the piece of the SMART goal I need to find . . . there are lots of other pieces, but the big piece I need to find is the relevance. So that's the thing I'm going to take from this. If I'm going to write a book, what is the relevance to me? And maybe rethink this goal and potentially move forward on it if I can find that relevance.

Scot: Maybe a short story would be . . .

Troy: Maybe a short story. Maybe a haiku. Keep it simple. I'm going to start small.

Scot: I do want to throw one thing in. So as I was working through SMART goals, it can be easy to take these acronyms and think that everything has to happen in the order that it is in. I found that that's not the case. I found that I got midway through and then that changed actually what the first thing was. Attainable, that's halfway through. Well, when I started thinking about that realistically, that changed the specificness of the SMART goal, right?

Mitch: Sure.

Scot: So I don't think you necessarily . . . They all are interactive and I think one answer could change previous answers before that, and that's okay.

I think it's a great way to set a goal, and I think it's also a great way then, if you do have a breakdown and it's not working, to analyze your goal a few days later or whenever that breakdown is to see, "Well, maybe where wasn't I quite what I needed to do here?"

Cool. Mitch, your takeaway?

Mitch: I think I'm like Troy, where it's like, "An acronym? That's not going to help me. A listicle? That's not going to . . ." But at the same time, just having a process or a method for being intentional about anything in your life can be really helpful.

And so the two things for me that I really kind of appreciated was the "Harvard Business Review" talking about focusing on the goal, and I think that ties into the relevancy for me. A lot of times, it's really easy for me to let goals come and go. Whether that means I'm afraid of not reaching them or whatever it is, I don't do that step.

Because I don't think about where I'd like to be or what it would feel like to be at that point, it never becomes relevant, and so it's easy to let go of.

And then on top of that, the attainability part, I think that's huge, and being honest with oneself and really understanding, "Where are you at, and what can you actually do in this moment in time?" and not defaulting to, "I am a failure if I am not achieving at 100% effectiveness as an idealized super person would be."

Scot: What is your goal? Did you have a goal that you kind of started out with the first of the year, or a goal like Troy that's a couple years old, and you just really haven't made much progress on it, or not the progress that's making you happy? Think about what that goal is, run it through the SMART goal tenets, use some of the troubleshooting steps, and get back on track. You weren't a failure. You just took a nap, like me.

Troy: You just took a little nap.

Mitch: Just a little nap.

Troy: But you're higher up the mountain.

Scot: That's right.

Troy: It may be later in the day than you thought it would be, but you're doing all right.

Mitch: And you're well rested. You're ready. You're ready to go.

Scot: If you want to share any of your experiences, if you have a different take on any of the things we talked about today, or just need accountability partners, we would love to hear from you. You can send us an email hello@thescoperadio.com.

Thank you very much. Good luck with your goals. Thank you very much for listening, and thank you for caring about men's health.
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A baby that is wanted and planned for, a child by choice and not by chance, that is what modern contraception offers men and women. But you have to know what's out there, how it works, and where to get it. This is really important now more than ever.

This is Dr. Kirtly Jones from Obstetrics and Gynecology at the University of Utah Health, and this is the "7 Domains of Women's Health" on The Scope.

Women and men all over the world have wanted to plan their families for thousands and thousands of years, but methods used in Cleopatra's time in ancient Egypt probably weren't as effective as what is available now. If no method of contraception is used, women in sexual relationships that would make them pregnant could expect to have more than 11 babies. That's in these days of good obstetrical and pediatric care, where women are less likely to die in childbirth and babies are much less likely to die in the first five years of life. Eleven babies sound like too much? One more baby sounds like too much right now?

Let's talk about contraception. It's an egg and a sperm problem. You need to stop egg production, stop sperm production, or stop the sperm from getting to the eggs. These are the main ways that modern contraception works.

About 50% of unplanned pregnancies happen to people who are "using" contraception but using it incorrectly. This is the most common reason that methods like abstinence or periodic abstinence, think natural family planning, or methods like barrier methods like condoms or diaphragms actually fail. They weren't used correctly or at all. Methods that you have to think about at the time of sex are more likely to fail because you're more likely to fail to use them. If you combine two methods, abstain during your fertile period and use condoms all the rest of the time, your chance of getting pregnant by accident is much lower. Two methods are better than one, and this is a combo where men can be the important user. You can get condoms most anywhere, and anyone with some smarts and gumption can figure out their fertile period.

So let's talk about hormonal pills, patches, and rings. They are considered moderately effective methods or ones that have an annual failure rate between 1 in 10 to 1 in 100. That means if women use them, the chance of getting pregnant is about 1 in 10 to 1 in 100 per year. Of course, you might be at risk for pregnancy for multiple years, so these chances literally add up. Considering a lifetime of contraception using these methods, it was calculated that women would have about two unplanned pregnancies. These methods work by blocking ovulation and by changing cervical mucus so sperm cannot get to the eggs, but women don't always take the pills, or patches or rings correctly. They miss some days or they stop for a week as directed, but they stop for longer than seven days, and they are very likely to ovulate. But you could team up with your sex partner and use a moderately effective method and condoms and get much more bang for your buck birth control-wise.

Hormonal methods aren't right for everyone, and you should know by reading up or asking knowledgeable clinicians if they're right for you. Now, there may be immense hormonal contraception on the horizon, transdermal hormones to block sperm production. If it has about a 10% failure rate per year, and women taking the pill as they will, not perfectly, have a failure rate of about 10% per year, if both members of the sexually active couple use the method not perfectly, the failure rate would be about 1 in 100 per year. The two methods multiply in terms of their effectiveness. If they both used effectively, if they both, men and women used hormonal methods effectively, it would be about 1 in 10,000 women per year, and that is effective contraception.

Now for highly effective methods, these methods have failure rates of about 1 per 1,000 women per year. They are so good because you don't have to think about them and using them correctly almost always happens. These include copper IUDs, hormonal IUDs, and hormonal implants under the skin. The hormonal implants' primary method of action is to work by blocking ovulation. The IUDs' primary method of action is by blocking sperm. Copper in the copper IUD kills sperm on their way up to the egg, and the hormonal IUD blocks sperm from getting through the cervix. The IUDs and implants are highly successful at preventing pregnancy but require a trained clinician to put them in. They last a long time, the copper IUD for 12 years, the hormonal IUD for 5, and the implant for 3, but they are immediately reversible as soon as they come out.

Now, all contraceptive methods have some side effects and risks, but none have as many risks and side effects as an unwanted pregnancy. Uh-oh, did you just say, "Oops?" Did you forget to take your pills? Did the condom slip off or stay in his back pocket? Was sex forced on you and you weren't using anything? Emergency contraception is for people who had unprotected or under-protected sex. They are pills over the counter or by prescription, that must be used in the first three to five days after the unprotected sex act, and the earlier, meaning the next day or the day after, the better. The copper IUD and hormonal IUD can also be used for emergency contraception, but they aren't FDA approved for that use, and you have to find a clinician to place one in a timely manner.

Using contraception means some work on your part. You have to know what you can use and want to use. You need to know where you can get them. You need to know how you can pay for them. All this information is available from many sources, but an overall good resource is bedsider.org. Many clinics around the country provide contraception on a sliding fee scale based on the ability to pay. Most insurance plans pay for a significant amount of the cost of contraception. There's a national family planning grant called Title X, that provides low-cost contraception to anyone who needs it, and it's available in most states. But you have to lace up your boots or put on your flip-flops and do it. Children deserve to be by choice and not by chance now more than ever. Thanks for joining us on The Scope.

Announcer: Health tips, medical news, research and more for a happier, healthier life. From University of Utah Health Sciences, this is The Scope.

Dr. Stoesser: Hi, my name is Kirsten Stoesser, and I am a family medicine physician. A question that a lot of new parents have is whether or not they need to supplement breastfeeding with formula. In most cases, this is not necessary but in some cases it can be helpful.

One of the times where we recommend that somebody supplement with formula is if the baby is not gaining weight appropriately, especially in those first few days to the first week. If we see that a baby has lost more than 10% of its birth weight and is not able to gain that back adequately enough and quickly enough with breastfeeding, then we will recommend to do supplementation with formula.

This doesn't mean, though, that you have to do a bottle feeding. There are actually some ingenious ways to be able to administer formula. One of my favorite ways is what's called the "Supplemental Nursing System," or the SNS system, and this involves sort of a drip line. There's a line that's taped over the mother's shoulder and then this line comes down and is taped across the breast and the nipple.

So a baby can still breastfeed and even if they're not getting much while breastfeeding, they are getting the formula that drips in and baby is still getting practice with breastfeeding so they're not losing that skill and mothers are still getting the stimulation at the breast, which helps to promote further breast milk production. Usually, when babies do the SNS system, they just need to do this for a few days and then they're able to catch up the growth and the weight that they need and are able to go back to breastfeeding.

There are different ways to supplement. Sometimes it can be because the baby's not getting enough nutrition, and sometimes it's because the mother's not producing enough milk. And so if the mother's not producing enough milk, having ongoing stimulation at the breast is important. So in addition to having the baby feed, one thing that I'll recommend to moms to do is to get a breast pump and after baby feeds to actually pump for five to ten minutes on both sides so that the breasts are getting adequate stimulation.

Another thing that's really important is for the mom to get plenty of sleep, which I know is hard, to make sure that she's eating regular meals, to drink plenty of fluids and to try to relax as much as possible. Another thing I'll recommend is that sometimes if just even one feed in the middle of the night, if somebody else can do that feeding, they can do a bottle feeding with either formula or with pumped breast milk, then that can allow mom to get a few hours more of uninterrupted sleep and sometimes that can help with breast milk production during the day because mom's not as exhausted.

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Interviewer: What should you do if you get a splinter? I know it sounds like a silly question, but maybe there's something we need to know. We'll find out next on The Scope.

Announcer: Health tips, medical news, research and more for a happier, healthier life. From University of Utah Health Sciences, this is The Scope.

Interviewer: Dr. Troy Madsen's an emergency room physician at University of Utah Health. And I think, you know, everybody's gotten a splinter at some point in their life. And normally, you'd grab a safety pin or maybe your pocketknife and you just start digging. Is that okay, or is that not so good?

Dr. Madsen: Probably works okay.

Interviewer: Okay.

Dr. Madsen: It hits home for me, because just a couple days ago I was picking up some stuff and got a splinter in my finger. And it's just one of those things where you get a splinter in there, it just drives you crazy. So the reality is you probably don't have to go digging for a splinter to get it out. It will work its way out on its own. It might take a couple weeks, but if you're like me, you get that splinter in there, it's all you can think about because it hurts and it stings and it's like, "I've got to get this thing out." So I probably did everything wrong. I grabbed a thumbtack off our bulletin board and just dug at it and got it out. That's probably not the best way to do it.

Interviewer: Yeah. Because I remember my mom whenever anybody would get a splinter, she'd either take a lighter and the safety pin and burn it, or alcohol. I mean. . .

Dr. Madsen: That's right. You know it's probably best to have something that's at least sort of sterile. So if you do take a lighter and you've got a safety pin or something and just run that over the lighter or, like you said, dip it in some rubbing alcohol. Something like that is going to at least get whatever germs are on there, get that off there.

And so that'd be probably the one thing I'd say is that if you can use something that's at least reasonably clean and reasonably sterile, you're going to reduce the risk of introducing some kind of infection in there. Because as you're digging for that splinter, you're sticking that thing in there, it might go a little bit deeper. It might push something down into the wound. And you don't want to then deal with some sort of a finger infection or something more serious just because you're trying to get a splinter out.

Interviewer: All right. What about, you know, as far as getting it out, do you just start digging? Or is there a method that works better than another method?

Dr. Madsen: I'm guessing everyone has their own method.

Interviewer: Nothing you learned in med school anyway, huh?

Dr. Madsen: Well, having . . .

Interviewer: Or not a procedure you use in the ER.

Dr. Madsen: It is a procedure. You know, we do occasionally have people who come in for that sort of thing. And . . .

Interviewer: Like big splinters, I mean . . .

Dr. Madsen: Usually bigger splinters or much deeper foreign bodies. And those can be just so frustrating because I'll have people come in that say, "I know I stepped on something. I know it's in there." Sometimes I'll use an ultrasound just to see if I can see anything that jumps out on there. Sometimes I'll just go right over the point where they say, "This is where it hurts." And I'll numb it up and cut in there. But, usually, these are much deeper than anything you're going to be doing at home.

So my technique for home is to say, "Okay. I see the end of the splinter kind of sticking out right here. Or I can see kind of the tip of it there." I'll go right in that spot, try and lift up the skin a bit and just open it up along that line. And then, you know, as I'm in there, scrape around with that thumbtack or that safety pin to try to feel it and work its way out. And wash it off really well, see if I can just wash everything out. And it's kind of like what I'm doing in the ER. You know, in the ER, it's a little bit deeper. Again, I'm feeling around with some forceps as I'm going in there, hopefully feeling something that I can pull out or wash out.

Interviewer: And what is the risk of infection, really? I mean, you know, I . . . we don't want to give advice, we don't want . . . but, I mean, is it a high risk, low risk?

Dr. Madsen: I would say, if I had to put a number on it, the risk of infection with having a splinter in there is less than 5%.

Interviewer: Okay. But it is a possibility.

Dr. Madsen: There's a possibility.

Interviewer: Yeah.

Dr. Madsen: And usually, when it's infection, you're going to see a little, sort of a blister formed there, something that has what looks like pus in it. Even then, quite honestly, you're probably okay taking the safety pin, running it over the lighter, whatever to sterilize it, popping that thing open, opening it up a little bit and getting it to drain.

The biggest things I'd watch for, in terms of infection, are the hand. We always get concerned about infections in the hand. If you start to get a lot of pain along the finger or pain that's tracking up into your wrist, that's a really serious thing, because then we're worried about infection actually in the tendons. That'd be the number one thing I'd say you really need to watch out for, especially, you know, if you're digging in there with a pin or safety pin, or you start to get an infection from a splinter.

Interviewer: Got you. But otherwise, however you're doing it is probably fine.

Dr. Madsen: It's probably fine. Exactly.

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Interviewer: Newborn acne, is it something to worry about? What should you do about it? We'll find out next on The Scope.

Announcer: Health tips, medical news, research and more for a happier, healthier life. From University of Utah Health Sciences, this is The Scope.

Interviewer: Dr. Amy Williams is a pediatrician with University of Utah at the South Jordan Clinic. And a parent has a child and the child gets a rash. And I understand that's a call you get a lot.

Dr. Williams: Yes.

Interviewer: They tend . . . a little freaking out happens. So let's talk about when you should be concerned about that rash, and when it's probably not a big deal, and what to about it.

Dr. Williams: Yeah, great question. I think it's a really difficult thing sometimes to know what a rash is. And quite honestly, a lot of times, doctors have to get second opinions. Rashes can be sometimes very easy and sometimes they are just confusing. So the newborn, usually, they come out with a lot of rashes and I think that's something we can focus on because a lot of them are things that parents can do at home and they don't need to bring them in.

The rash that I most commonly get questions about is the newborn acne, and it usually start to show up a couple of weeks after they're born and they get something that looks very much like a teenager's acne: the white pimples and the red on the cheeks, on the forehead. Sometimes it's all over the neck. And parents get really concerned because it shows up and we . . . they don't know what to do.

A lot of times, this is all just related to the changes that are happening in the baby during that first couple of weeks: they came out of mom, they were exposed to mom's hormones and everything and they're having this changes in their body. And the acne shows up, but quite honestly, it's a very healthy, happy, non-urgent rash. And it's something that parents can do nothing about and just allow the baby to recover from it. It usually takes a couple of weeks, sometimes a couple of months.

Interviewer: And no harm done?

Dr. Williams: No harm.

Interviewer: No skin damage?

Dr. Williams: You don't have to start buying over the counter acne medicine.

Interviewer: It's a little early to start, right?

Dr. Williams: In fact, we encourage you not to do that for a baby. Their skin is so sensitive that they really can't handle any of the medication we do for teenagers or adults. It's very healthy rash and you don't have to do anything about it all, and it will go away on its own.

Interviewer: Are there ever any instances where it doesn't?

Dr. Williams: Sometimes they are so severe that we will have a dermatologist look at it and have an evaluation to see if there's any treatment. Obviously, if there are any signs that it's getting infected or the rash is changing, those are things I would definitely bring the in for. And you can always bring them in for a concerning rash and we can always talk to you about it. If it doesn't feel all right to you, bring your baby in.

Interviewer: Yeah. And you said this lasts for about two weeks, generally?

Dr. Williams: It lasts a couple of weeks to sometimes a couple of months. Sometimes, it lasts until they're four months old and then it resolves on its own. But it's not related to food, it's not related to anything else other than their body just changing.

Interviewer: So if the acne is kind of coming and going and a new one appears, and then disappears and the new appears that goes on for a couple of months, that's totally normal?

Dr. Williams: Totally normal. Don't pop them.

Interviewer: Okay. That more good advice. For the rest of your life, that's good advice, right?

Dr. Williams: Don't ever pop them. It is something that is natural and although maybe they won't look great in baby pictures, it is absolutely normal and fine. Please don't put makeup on the baby. Just let them be who they are, let them transition.

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Dr. Gellner: Every year, it seems more and more children are coming in to see me and other pediatricians because of anxiety issues. And the kids are getting younger and younger. So what do you do if you have an anxious child? I'll give you some tips on today's Scope. I'm Dr. Cindy Gellner.

Announcer: Keep your kids healthy and happy. You are now entering "The Healthy Kid Zone" with Dr. Cindy Gellner on The Scope.

Dr. Gellner: A lot of parents have concerns that their child is developing anxiety. Their child will stress over everything and no matter what they say, nothing seems to be able to calm their child down. Some anxiety is okay. We all have fears. But when this anxiety starts causing a lot of problems, that's when they should come to us.

Some parents want anxiety medications for their children. Others do not. Medications really should be a last resort, as many are not really safe in young children, often not approved use until age 12. And like any medications, they come with their own set of side effects.

So how can you help your anxious child before things get out of hand? There are some things you can try before resorting to medication. I'm going to give you some suggestions that could help change your child's fear-based thinking on both the conscious and subconscious level.

First, let your child know it's okay to feel afraid at times. But don't act too worried. Anxiety gets worse if your child feels anxious about being anxious. Remind your child how strong they are. This will help them believe in themselves. Explain that their anxiety is their body's automatic response to fear because their body thinks they're in danger. Sometimes the body gets tricked and it thinks it's in danger when it really isn't in danger. And that's just the brain's way of trying to protect them.

Have your child close their eyes, focus in the moment. Have them tell you what they're hearing or smelling and pay attention to their breathing. Tell them slow, deep breaths remind the brain that they are safe.

Give them a pillow or stuffed animal or even a box of tissues and tell them to grab it and throw it as far as they can. This can help release the high energy they have. Teach your child that panic attacks are temporary and they have the skills to make it through them.

Remember, if you make a big deal about it, this will make it bigger for them and it only serves to increase the anxiety. Figure out what your child is really afraid or anxious about. Once you understand this, you will understand what they need to help feel better. You will be able to better explain the difference between fears that help and keep us safe and fears that hurt and only cause more anxiety.

Teach your child to ask, "Will worrying about this do any good?" If the answer is no, then it's a fear that hurts. Finally, teach your child relaxation and self-calming skills. I call this their toolbox for when they get anxious. Once they learn how to calm down their fears, remind them that they can do anything.

If your child's anxiety is still keeping them from enjoying the things that children should enjoy, talk to your pediatrician about helping to find a good therapist. By coming to a pediatrician, we can help with figuring out some things to help your child initially. But if things are too complicated, we can find exactly who you need to see and get you a referral to a mental health specialist that will work with your child and do exactly what your child needs.

Tell your child that this is someone that they can talk to that will help with their feelings. And remind your child every day, "You can do this." Empowering them to be in charge of their feelings will give them the courage they need to face their fears.

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Interviewer: Three alternatives to handing out candy on Halloween, that's next on "The Scope."

Announcer: Health tips, medical news, research and more for a happier, healthier life, from University of Utah Health Sciences, this is "The Scope."

Interviewer: All right, here's the deal. You've decided you want to make Halloween a little healthier for the trick-or-treaters that show up on your door stoop, how can you do that? Well, we're going to find out right now. Registered Dietician Theresa Dvorak is from the Department of Nutrition and Integrative Physiology at the University of Utah College of Health and, first of all, I've got to know, as a dietitian, what are the gInterviewers and goblins getting at your door stoop on Halloween?

Theresa: A combination of things, I usually do, kind of, a bucket that they can choose out of.

Interviewer: So like, apple slices, oranges, I mean, are you handing out candy?

Theresa: Well, I guess I do more non-food things and then maybe some candy things.

Interviewer: All right, so here's the premise, you're thinking maybe you might want to make Halloween a little bit healthier for the kids in the neighborhood and not get your house TP'ed at the same time. So, let's start with number one here of, like, three candy alternatives, what's your first one?

Theresa: Things like school supplies, so pencils, erasers, that have a Halloween theme to them, keeping within . . . you know, you don't want to send out just a boring pencil or something of that sort, but maybe get ones that are decorated with a Halloween theme.

Interviewer: All right, that's pretty good, I like that. How about a second alternative?

Theresa: Another alternative would be things like trinkets or toys, you know, things like the spider rings or . . .

Interviewer: Ooh, I like that.

Theresa: . . . items of that nature that might be fun to play with.

Interviewer: And what are you going to recommend for candy-alternative number three?

Theresa: And then, third could be something of a healthy choice, a healthy snack like a string cheese or apple slices, prepackaged, healthful foods. Interviewer: Yeah, because that's another one of the tricks, right? Like, I think, well, you could hand out apples, but no you can't because of the safety concerns.

Theresa: Right, just like candy, you want to make sure that it's fully packaged and sealed, so even if it was just those miniature boxes of raisins, those are great things to hand out as well, those dried fruit, individual packages.

Interviewer: Like, what about granola bars? Are those better than candy? Like, little, small granola bars?

Theresa: It depends, a lot of them, honestly, have about the same amount of sugar that a candy bar would, so incorporated into a balanced diet, maybe, but that certainly could be a choice that looks different than, say, a Snickers bar.

Interviewer: And you said that you, kind of, give out a mix of things, so why is that?

Theresa: You know, I like to let the kids choose.

Interviewer: Do they choose the apple slices ever?

Theresa: They do.

Interviewer: Do they?

Theresa: They do, honestly, yeah. I think part of it is just that it's something different that they're not getting at all at the other houses, so it's that unique piece. Yeah, and you know, Halloween too is really just about the experience, right? Going out and trick-or-treating, going door-to-door and dressing up, and out with their friends or family. And so it's the fun of the trick-or-treating and then often, too, the sorting of the items when they get home, right? Putting them into different piles and "What am I going to choose first?" or what have you. That's really the fun of Halloween is the trick-or-treating and the sorting.

Interviewer: So as a registered dietitian, it sounds like you do give out . . . do you give out candy at all?

Theresa: I do, I do a combination.

Interviewer: Yeah but kids will go for the healthier stuff?

Theresa: They do, yeah.

Interviewer: And does your house get TP'ed every year?

Theresa: No, thankfully. Interviewer: No, everything's good, all right, that was very helpful, some, maybe, alternatives to giving out candy or, I like your idea, maybe even giving a mix or giving kids the choice.

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