Stress Relief, Anyone?

Nobody out there is stressed, right?  Nah, I didn’t think so. So you won’t be interested in how to reduce and better handle your stress, would you?

Just in case there ARE any folks out there who would like to feel more relaxed and on top of things, I have a few suggestions.  In case you didn’t notice, I have a fair amount of experience with stress.  I personally carry a fair amount, and I also see lots of people in the office with problems that are partly or wholly due to stress. Depression, anxiety, sleep problems, ulcers and reflux, headaches, irritable bowel syndrome, fibromyalgia, chronic back pain, obesity, high blood pressure, the list goes on and on!

How can someone keep their stress down to manageable levels?  There are lots of options to reduce stress.  Some will probably be easier than others for each individual person.

First of all, take a look at your commitments. Are you overstretched?  What responsibilities can you delegate to others or reasonably let go?  If you have four kids and each plays three sports, you’re going to be stressed trying to keep up with everyone’s meets and games and practices. Setting limits is important. When my husband was undergoing his cancer treatments I had to step down as Chair of Family Medicine at my hospital. Although it was important to represent the members of my department I wasn’t able to make the meetings and it was putting extra stress on me.

Secondly, make sure you’re getting enough sleep. Rest is very important for your health and mood. If you wake up tired in the mornings that’s a signal you’re not getting enough rest.

Third, make time to exercise. It doesn’t have to be a lot of time, but exercise releases feel-good hormones in the brain called endorphins. They reduce stress, decrease anxiety and depression, and improve sleep quality. It also feels good to make a commitment to do something regularly that’s good for you 🙂

One other way to reduce stress is to spend time with your loved ones. Snuggle with your sweetie, call your mom, have lunch with a friend, or take your kids to the zoo. Treat it as a special treat for yourself, not a chore. Enjoy yourself and feel yourself relaxing!

If the above measures aren’t successful in helping you feel more on top of things, there are a number of different supplements that can help.  Check this page for some suggestions.

Stress can make you sick!  The good news is there are ways to reduce it so that your life is exciting and stimulating, not exhausting and overwhelming.

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Don’t Get Sidetracked By Cravings!

First of all I want to mention that I finally got all my Shaklee clients ported into my email list!  If you prefer to just receive the newsletter or to not receive any emails at all, please click the link below to change your subscription or unsubscribe.  I am NOT trying to spam you!

I had a great request from Jackie:  review strategies for combating cravings.  This is an awesome topic heading into the holidays.  Many people find they lose control of their diet when the holidays arrive.  With all the sweets and treats passed around, it’s not surprising that the willpower takes a nosedive.  It’s easy to think “I’ll get back on track after New Year’s.”  It would be so much better to STAY on track through the holidays and maintain or even lose weight while your friends and family are gaining and feeling out of control.

My best suggestion for combating cravings is to plan for them!  Take a moment to think honestly about when you lose control of your eating.  What are your “danger foods?”  Is there a certain time of day when you find really difficult to stay on track?  What about a certain place?  A certain person who seems to trigger cravings for you?  Brainstorm and write down all of the triggers you can think of.

The next step is to take each trigger you’ve listed and write out a plan to get around them.  Let me tell you some of my triggers and how I (try to) handle them.

  • Sweets.  I have a TERRIBLE sweet tooth.  I do better if I simply don’t eat them at all.  I joke in the office that an open bag of M&Ms is an empty bag if I’m around.  Some very nice person gave me a big tub of Jelly Bellys for a gift once and it almost killed me.
  • Mid-afternoon.  3 o’clock is a time of weakness for me.  That’s when I go looking for chocolate in my office manager’s office.  My trick is to eat a Cinch snack bar which gets me through to dinner.  (Click HERE to see what the Cinch snack bars are).  For some reason the snack bars don’t trigger my sweets cravings.  Go figure!  It’s the safest chocolate I know 😉
  • Stress.  I snack when I’m stressed.  As I can’t avoid stress (you DO know what I do for a living, right?) I plan for it.  I pack my lunch every day and I pack a snack that I can enjoy guilt-free.  Triscuits are my favorite when I’m craving something salty (7 crackers for 120 calories) and fruit or a Cinch snack bar kills the sweets craving.
  • The lunchroom at work and the doctors’ lounge at the hospital.  This is where the junk food is.  If I know the drug reps brought cookies I do NOT go into the lunchroom without backup in the late afternoon.  I really DO love my reps but I wish they would bring fruit not cookies!  Similarly, the doctors’ lounge at lunchtime when I’m on call (did I mention stress?) is a VERY bad idea.

Get out a pen and paper and write down some ideas.  Carry it with you for a few days and write down when you eat something you wish you hadn’t eaten.  What triggered it?  What and where and when and why did you eat what you ate?  After a week or so look back at the notes you made.  Notice any themes or trends?  Until you have a thorough understanding of the problem you can’t create a lasting solution.  And don’t worry, you won’t be graded on your success 😉  Any insight you can get into your own problem eating habits (and as I showed you we ALL have them) will help you correct them.

As we go forward I’ll offer some suggestions for each specific holiday as it approaches.  I love the winter holidays but it seems like Halloween through New Year’s is one big junk-food festival!  Those of us who struggle with our weight need all the good ideas we can get.  If you have a suggestion I missed please leave a comment!

Thanks again Jackie for the great topic suggestion!

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Here Comes Cold And Flu Season!

Hello everybody.  I received multiple requests to review how to stay well during the winter.  This is a great topic and very timely.  There are a couple of things you can do to stay healthy during cold and flu season.

First of all get your flu shot!  I hear a lot of people tell me “I got the flu shot once and I got sick anyway so it’s not worth it.”  If you had ever had a true case of influenza you wouldn’t say that.  The flu shot will not protect you against “stomach flu,” food poisoning or the common cold, and not ALL strains of influenza are covered.  However the flu shot is good protection against the included strains and is very safe.  You should not get the flu shot if you’re allergic to it (duh) or if you’re allergic to eggs.  The most common side effect is local arm soreness.  There is a VERY serious and rare complication of ALL vaccinations called Guillain-Barre syndrome but in twelve years I’ve only seen it once.  Flu is most dangerous for the very young and the very old, as well as for those who don’t have healthy immune systems.  Babies under 6 months can’t get the flu shot so everyone in the house should be vaccinated to protect the baby (especially schoolage siblings).  Pregnant women should be vaccinated once they’re out of the first trimester.

Other things you can do to keep from getting sick this winter are fairly commonsense.  Wash your hands frequently with soap and water.  Cover your cough with a tissue or cough into your elbow.  Use antiseptic cleansers on telephones and doorknobs (use cleansers that don’t make fumes, click HERE to see which one I use).  Eat healthy, stay hydrated, get plenty of sleep, take a high-quality multivitamin, control your stress and try not to worry about or focus on getting sick (I’m a big believer in a positive attitude).

So in spite of all the above measures you’ve caught a bug anyway.  How do you know what it is and what to do about it?  Most of us know what a cold feels like.  It starts with the tickle or scratchy feeling in the back of the throat and progresses over a day or two to a runny nose, sore throat, body aches, headache and cough.  The mucus is thin and clear at first and may evolve to yellow or green mucus especially first thing in the morning.  My general recommendation is to ride it out, drink extra fluids, get extra sleep, and eat chicken soup (there is some evidence that it thins the mucus and helps it drain more easily).  Using a nasal saline spray or wash seems to help too, but use distilled water instead of tap water to make the saline solution.  Antibiotics DON’T help a cold and can cause diarrhea or a rash or yeast infection.  Expect symptoms to peak on the third or fourth day and gradually get better, feeling fully well again after 10-14 days.  If symptoms are still not getting better after a week or they get better then worsen again, you probably should see the doctor.

Influenza is a common and potentially life-threatening viral illness that’s spread by airborne transmission (you can get it by breathing the same air as someone who has influenza) and by touch.  It has a very sudden onset, causes a high fever and severe headache and body aches, dry cough, occasionally vomiting (especially in children) and lasts 7-10 days.  If you think you have the flu STAY HOME!!  Do not go to work or send your sick child to school.  Most healthy people can ride it out without specific treatment other than rest and fluids and over-the-counter cold and flu medicine.  If you develop shortness of breath or chest pain you should see the doctor though, sometimes flu patients get pneumonia.

Can supplements help prevent and treat colds and flu?  If you’d like to try supplements to boost your immune system, first of all be careful what you buy.  Please read THIS before choosing a supplement.  There are a number of supplements I CAN recommend.  Everyone should take a high-quality multivitamin (read THIS to see why).  Check the Shaklee Family tab above for specific age-and-gender recommendations.  If you’d like to read about the only supplement developed by a Nobel prize winning researcher to naturally increase the body’s production of interferon and strengthen the immune system, click HERE.  I also have a great supplement I use when I’m starting with a cold, usually knocks it right out.  Click HERE for more info.

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Yes I’m Vegan But…

But I love ice cream, so I’m not giving it up. Life is for living and it’s too short to avoid the things that give me pleasure.

Last year at this time I was dealing with a husband who had just undergone an autologous stem cell transplant for multiple myeloma. Basically he had received a lethal dose of  the chemotherapy drug melphalan which destroyed all the fast-growing cells in his body. Luckily we heard slushies could help protect the lining of his mouth and throat so on chemo day I kept him stocked up. (A year later he still can’t look at them.) They worked like a charm, no mouth sores! Then the next day they gave him his own blood stem cells (collected about 6 weeks previously and frozen) to save him from dying of bone marrow failure. After a fairly routine (but to us pretty harrowing) 15 days in the hospital he came home, 1 year ago today. Weak as a kitten and sleeping more than not, still he was home.

We have come a long way in a year. More chemo, more research, more tests and more bills. But the good news is Russ is still in remission, still cancer-free. We praise and thank God every day for His grace and for guiding us to Dr. Warren and Dr. Lazarus who have shepherded us safely through our journey this last year and a half.

Some of the research I have done involved looking into the links between diet and cancer risk. One of the strongest links I’ve found connects cancer risk and the intake of animal-based foods. There is evidence that the more animal-based foods a population eats, the higher the risk of many cancers including breast, colon, lung, stomach and others.  Yikes!

I looked at the evidence and I looked at myself in the mirror and said “Once is enough! If giving up animal-based foods and switching to a whole-foods, plant-based diet will reduce the risk that my family will have to go through this ordeal again, I can do that. I’m more attached to my health than I am to meat, milk and eggs.”

After a year of being vegan I can honestly say I don’t miss meat. Tonight we had dinner at FlipSide and I happily ate a housemade chickpea patty with shiitake mushrooms, caramelized onions and truffle aioli. But I’m not religious about it. Russ gave me the avocado from his salad (yum!) which had a little bleu cheese and ranch dressing on it. Mostly when we go to get ice cream I will have sorbet (Cold Stone has awesome sorbet BTW) but every so often I want real honest-to-goodness full-fat dairy ice cream. Usually it’s when I’m near a Graeter’s shop 😉  So I eat it, and I enjoy it.

My life is a wonderful gift from God and I’m enjoying every moment I can. I’m doing the best I can to protect my life and my health and my body as the precious gifts they are, but every so often you’ve got to splurge. I hope the choices I’m making now will let me chase my great-grandchildren around the yard someday and keep me well until it’s time to return the gift to the One who gave it to me.

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What Do You Mean I’m Fired?

No, don’t panic, I’m not leaving State Road Family Practice 🙂

I’ve had some interactions with patients and their families this week that prompted me to write about what constitutes a good doctor-patient relationship.  Sometimes (actually I’m blessed to say it’s much more often than not) the relationship is like a great friendship, with lots of mutual respect and a sense of working together for the good of the patient.  However, sometimes the relationship is rocky from the start or things happen to break the trust between the doctor and patient.

Usually building a good relationship in medicine is like building a good relationship anywhere else, you have to earn the trust and keep earning it by being honest, reliable and respectful of each other.  In medicine however it is critically important that each half of the relationship is confident that the other half is being honest and can be counted on to do their best.

Most people have had the experience of being let down or disappointed by someone.  When it’s your doctor that lets you down it’s really troubling because sometimes the doctor’s decisions are life-or-death.  Some folks make the decision to vote with their feet and change doctors without ever telling the doctor what prompted that decision.  Some brave folks decide to leave but make a call or write a letter explaining their decision in order that the doctor can learn from the experience.  Others (usually after a lot of hard thinking) decide to stay and give the doctor another chance.

When it’s the patient that lets me down it’s really hard for me to continue taking care of that patient.  In order to make good therapeutic decisions I have to be able to trust that the patient will do what they’ve agreed to do and that they’re answering my questions truthfully.  You’d be surprised how regularly I find out that patients have lied to me.  Whether they’re trying to get something they don’t think I’ll give them (like an inappropriate narcotic prescription for instance) or they simply don’t want to disappoint me, I’ve learned to “trust but verify” important information.

There are some patients that simply won’t take my advice.  Whether it’s the diabetic who won’t work with me to get her diabetes under control, the fifty-three-year-old executive who’s too busy to go for the colonoscopy, or the parents who won’t allow their children to be vaccinated, these people make me crazy.  I’ve looked one in the eye and asked her “Why do you come to see me when you don’t believe I know what I’m doing and won’t do what I ask you to do?!”  Another patient has had just about every possible bad consequence of uncontrolled diabetes and refuses to come in regularly for visits or get bloodwork done.  When I can’t take it anymore I usually will apologize to them for not being able to motivate them to take better care of themselves and ask them to find another doctor.

If it shocks you that a doctor would dismiss a patient for refusing to follow his/her advice, you should be aware that while I do it very rarely it’s going to get more common.  The government and many health insurance providers are instituting a “pay-for-performance” program that is supposed to pay doctors more for providing better care.  They will be defining “better” care as care that produces better outcomes.  For instance, a better diabetes doctor has patients that have better-controlled blood sugars and better cholesterol numbers and see the podiatrist and the eye doctor regularly.  When these measures are implemented what do you think will happen to a doctor who takes care of a lot of noncompliant patients?  His numbers will look bad and he won’t be paid as well.  We’re human too and while doctors are in medicine because we love doctoring, we find noncompliant patients tough to deal with.  When you add the financial incentive, doctors will be more likely to send noncompliant patients away and tell them to find another doctor.  Before long noncompliant patients won’t be able to find a doctor willing to take care of them (especially as medical records are centralized and a doctor will be able to quickly and easily access records from multiple previous doctors).

The next time you’re tempted to disregard your doctor’s advice, please keep this discussion in mind.  Please make sure you understand why your doctor wants you to do a certain thing or get a certain test or see a certain specialist.  Make sure your doctor is aware of and fully understands the reasons you might not want to or be able to do what he or she recommends.  Maybe a compromise or less invasive/expensive/involved option is available.  Remember that good relationships are based on mutual respect, trust and good communication.

If you’ve done all you can to communicate well with your doctor and you’re not getting better or you don’t feel your care is all it should be, then it’s probably time to move on and find another doctor.  On the other hand, if your doctor has made recommendations and ordered tests and referred you to specialists and you can’t find the time to follow through, you just might find that YOU’RE the one getting the pink slip.

PS – if you don’t believe me about Pay For Performance, check this site:  http://www.ahrq.gov/qual/pay4per.htm

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