The Art of Routine

May 22, 2026

By Nancy W. Burkhart, EdD

COVID-19 produced an element of uncertainty in our world, and we heard from many of you during these years 2022 and even into 2025. Some patients expressed comments concerning more outbreaks of lichen planus and lingering lesions that were more difficult to control. The masks that were used during these years may have contributed to the lesions that appeared on the lips and oral tissues.  The psychological trauma for patients certainly increased during this time. Along with the issues of lichen planus, the development of COVID-19 caused even more problems that patients needed to deal with during these years. Patients found themselves out of their normal routines and this promoted a cascade of problems for individuals.

When routines are disrupted, individuals often feel anxiety, confusion, agitation, hopelessness, depression, and loneliness. Older individuals may experience this even more than younger individuals. Researchers and practitioners refer to major changes in routines as a “disruption of one’s time bubble.”  We even saw the effects with seniors who were relocated to senior living facilities during this Covid period. The effects were so noticeable that they were termed, “Relocation Stress Syndrome.” 

The term “Routineology” has gained acceptance in medical/dental circles and is discussed by Dr. Angel Iscovich, M.D. in his book, The Art of Routine. The recognition that we all have routines in our life that help us plan, cope with daily activity and function clearly plays a major role in our overall health and well-being. Dr. Iscovich suggests that “the difference between a habit and a routine is that a habit is recurrent with little or no conscious thought whereas a routine requires a high degree of intention and effort.”

If you are one of the individuals who believe that your “time bubble” has not regained the same function, with clarity and momentum that you once had, there are steps you can take to create the rhythms that you enjoyed pre-COVID. With an oral lichen planus diagnosis, there is a sense of loneliness because you probably do not know anyone else who suffers with the chronicity of these oral lesions, skin lesions or in some cases, genital or esophageal lesions.

There is a value to support groups, sharing information and having your health questions answered. Establishing new health habits, can make a huge difference. Some of the following points may assist you in regaining your “time bubble” that you enjoyed previously.

• Re-evaluate your daily schedule and try to conduct your activities on the same time schedule each day. At one time, many people kept a diary of the years throughout their life. Although, this is not as common anymore it is an excellent way to look for patterns, life passages, future direction, and clarity.
• If you have lost connections with a group or a friend, try to make the connection again. Set up a date or meeting time. Even if you meet the same friend or relative once a week.
• Make sure that you see your healthcare provider for oral exams and ask about any new information regarding oral lichen planus.
• Meaningful “rituals” within your family or close friends that may have been lost during our “lock down” periods of COVID represent an importance in your “time bubble,” and re-establishing these can give you renewed connection and optimism. Rituals have always been common in family traditions, religious organizations, and service organizations.
• Take time daily to meditate, pray and coordinate future opportunities that you have always enjoyed in the past years. A sense of routineology may provide you more time to plan and even daydream future activities.
• Exercise plays a major role in health. Find an activity you like such as tai chi, yoga, a dance class or walking through a nature path on a regular basis. Staying active with daily exercise will  have a calming effect and may promote a profound change in your overall health.
• Sitting for extended periods of time can affect your energy, but also disrupt your blood sugar control. A recent study provided support that suggests short bursts of movement can have an impact on improving glycemic control. Participants who walked 3 minutes or performed 10 bodyweight squats every 45 minutes positively affected their blood sugar levels. This was in comparison to a control group who stayed seated and even those who engaged in a 30-minute walk daily. Frequent movement will have a profound benefit to your overall health. Many individuals have become sedentary working on computers daily, sitting- whether job related activities- or just watching television.
• Pets provide comfort, calmness and promote a serenity affect for individuals. Enjoy your pets!

Again, we are always here and happy to talk with you.

Routineology can become contagious!!

Dr. Nancy W. Burkhart                

Gao Y, Li QY, Finni T, Pesola AJ. Enhanced muscle activity during interrupted sitting improves glycemic control in overweight and obese men. Scand J Med Sci Sports. 2024 Apr;34(4):e14628. doi: 10.1111/sms.14628. PMID: 38629807.