Banish The Bully Of Self-Doubt

Fair warning for anyone new to the blog:  I’m going to talk about God in this post.  If you’re a person who thinks medical doctors should leave their faith at church and just focus on physical health, please stop reading and wait for next week’s post.

When I was a child, I wasn’t particularly popular.  I had friends but was a bit shy in groups and tended to be socially awkward.  (Yep, I know, I can still be socially awkward…)  I was most comfortable one-on-one with a good friend.  Isn’t it funny that I wound up with a career that generally is a series of one-on-one encounters?

Anyway, I was targeted by bullies in elementary school.  On the bus, at recess, sometimes even in class right under the teachers’ noses.  To this day I don’t understand how the bullies knew just what to say to get under my skin.

The good news is I had (and still have) wonderfully supportive parents.  I would come home upset, angry and hurt, and embarrassed because there was a small part of me that wondered whether the mean things the bullies said about me just might be true.  Once my mom or dad was able to drag it out of me, they always were able to help me see that it WASN’T true, and that I was a good and smart and worthwhile person.

Did you know that sometimes your own mind can be a terrible bully too?

Think about it.  Think back to the last time you made a mistake.  Maybe it was something stupid and careless like losing your wallet or your phone.  Maybe it was a bigger deal like forgetting to pay the credit card bill or bouncing a check.  Maybe it was a REALLY big deal like a car accident.

Did you find yourself beating yourself up about it?  Calling yourself stupid or worse?  Casting doubt in your own mind about whether you’re REALLY a good and smart and worthwhile person?

I received an emailed blog post from Dani Johnson not long ago that crystallized an idea, a very deep truth that resonated with me.  You can read that blog post for yourself here.  I’d like to share that with you today, hoping it will help you get out of the habit of giving in to the bully in your head.

The truth is that not every thought in your head is really YOUR thought.

If you have been reading my blog for awhile you know I have a very strong faith in God.  God also has an Enemy who thoroughly enjoys creating strife and pain and fear among God’s children.  The Enemy can plant the seeds of painful doubt in your mind.

The truth is that I am as susceptible as the next person to self-doubt.  Am I a good mother, a good wife, a good daughter, a good friend, a good doctor, a good coworker, a good employee, a good teacher?  All the roles I play in my life and all the juggling I do frequently results in me feeling like I’ve shortchanged someone or something important.

After reading that post from Dani, which honestly came at just about the perfect time in my life, I learned that just as my parents helped me see those stupid bullies’ words for lies when I was a child, I have someone who can help me see the Enemy’s words as lies too.

God will help.  When I was doubting myself and wondering whether I was really “good enough,” worthwhile enough, I practiced praying.  After all, we are human and do make mistakes.  Feeling bad about it can be healthy, a reason to be more careful and avoid making that mistake again.

Feeling bad because you made a mistake can too easily slide into feeling bad about YOURSELF, though, feeling worthless, stupid, fat, ugly, and lots of other hurtful descriptions that should never be allowed inside your own mind.

Next time you find yourself feeling bad about yourself because you made a mistake, try this prayer.  “God, if this thought is from You, I accept it.  I trust You to help me find a way to make it right and avoid this problem in the future.  If this thought is NOT from You, I reject it and banish it to Hell where it belongs.”

Pay attention to how you feel immediately after saying this prayer in your mind.  Do you feel better?  I did.  And in fact I was able to see the problem more clearly in a constructive way, to plan steps to improve the situation that was making me feel bad in the first place.

We have a mighty God whose power outshines that of the Enemy, but we have to ask Him for help.  The Enemy is sneaky and never agreed to wait for permission to mess with us.  God loves it when we run to Him and ask Him to give the Enemy a good swift kick and send him back to Hell with all his tricks.  He won’t stay there for good, but with practice it gets easier to recognize the voice of the Enemy.

Like a child who runs home crying to her mother because the neighborhood bully said mean and hurtful things to her, you have someone to run to when the Enemy or your own mind start bullying you.  Turn to God the Father.  Just like a mother who reassures her child that she is good and smart and loved, the Father says that YOU are good and smart and loved beyond imagining.

QUESTION:  Do you struggle with self-doubt?  Does prayer help?

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Vaccination Recommendations: An Update

Sudden fever.  Terrible headache and body aches.  Dry, hacking, painful cough.  Stomach upset and loss of appetite.  Overwhelming fatigue.  Yep, it’s the flu.  You can expect 7-10 days of this misery, and the only medicine available doesn’t do much and may give you diarrhea to boot.  What’s the best way to deal with the flu?  Don’t get it in the first place.

Last year I wrote about ways to avoid colds and flu.  While this is all still good information, this week I want to focus on vaccination as a method of preventing illness.

There have been a number of recent changes to the vaccination recommendations for children, adolescents and adults.  This week, since we’re heading into the flu season and everybody seems to be talking about shots, I thought I’d review them.  It’s a good reminder for me, too!

Since we’re talking about the flu, let’s start with the flu vaccine.  Not much has changed, except that there are both 3-strain and 4-strain versions available (my office gives the 4-strain version without preservatives).  Children receiving their first dose ever should get 2 half-doses a month apart.  All healthy adults and children 6 months of age and older can be vaccinated;  the vaccine changes every year because new and different vaccine strains keep popping up (darn bugs!!).

Speaking of the little ones, the major change to the primary vaccination series (birth to 18 months of age) is the addition of the rotavirus vaccine. This is an oral vaccine given at 2 and 4 months of age.  It prevents a horrible diarrheal illness that just about every baby got before they turn 2.  Both my boys had it.  As a resident doing my inpatient pediatric training, rotavirus season would see an endless parade of exhausted parents and listless, dehydrated babies admitted to the hospital for IV fluids.  The vaccine has dramatically decreased hospitalizations and deaths from diarrhea and dehydration not just in the USA but around the world.

For the adolescents, most of them know they have to get a shot before they start 7th grade.  What they DON’T know is that they actually need FIVE shots (insert evil laugh…)  At age 12 kids get a TDaP (which is required in the state of Ohio), their first meningitis shot, and the 3-shot Gardasil series.  Meningitis gets an booster at age 16 to hold them through college.  High school and college-age people (particularly if they live in a dorm) are at risk for meningococcal meningitis, a thankfully rare but extremely contagious and devastating disease.

Debating about the merits of vaccinating against a sexually transmitted disease is outside the scope of this post.  I strongly encourage all parents to discuss with their children the dangers of sexually transmitted diseases (I have the “cootie talk” with my teens and preteens in the office too) and advocate chastity until marriage.  This is the healthiest choice both physically and emotionally.  However, I also expect my teens to drive safely but to wear their seatbelts every time they’re in the car as an extra safety measure, and I consider Gardasil the “safety belt” for HPV.  The science suggests the HPV vaccine is one of the safest and definitely one of the most effective vaccines ever developed.

In adults, the recommendations haven’t changed much.  We still need a TDaP shot every 10 years or sooner if we hurt ourselves.  Unfortunately it still causes pain, redness and swelling at the injection site (I know because I just got my booster in August, ow!).  We need annual flu shots, of course.  Adults with chronic illnesses like asthma, diabetes, and COPD should have a shot for pneumococcal pneumonia.  At age 60 anyone who has had chickenpox should get the shingles vaccine.  If you know anyone who has had shingles, you know how miserable it is.

This is just an overview of the general recommendations and some changes that have been made in the last few years.  You should discuss with your own doctor what your specific vaccination recommendations are.

Vaccinations are one of the reasons we enjoy the health and long life we have in the United States.  In other parts of the world illnesses like measles, polio, hepatitis and pertussis are major causes of illness and death.

QUESTION:  Are you and your family up to date on shots?  Have you ever refused a vaccine?  Why?

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Caregiver Stress And The Sandwich Generation

Hi, everybody!

I’ve been asked to give a talk on caregiver stress in a few weeks, and just like I did several months ago, figured I’d ask my lovely readers to help me make this talk awesome.

What is a caregiver?  A caregiver is defined as someone who provides care for another person in need.  Generally the person being cared for is unwell in some way and needs help with daily tasks.  Those with cancer, dementia, and many other chronic conditions may need help with dressing, bathing, eating, medication management and many other critical tasks.

Who are our nation’s caregivers?  According to womenshealth.gov, over 20% of adult Americans will provide unpaid care to an elderly or disabled person each year.  61% of informal or family caregivers are women, and most are middle-aged.  59% of women who provide informal care to a family member are also employed. Over half of these employed female informal caregivers have made changes at work to accommodate caregiving, such as scaling back their work hours or changing their schedules.

There is an interesting term to refer to those providing informal or family caregiving:  The Sandwich Generation.  There are several types of Sandwich Generationers:

  • Traditional Sandwich – those caring for both aging parents and their own children
  • Club Sandwich – those caring either for both aging parents and their own adult children and grandchildren (4 layers!) OR aging parents and grandparents and their own children
  • Open-Faced Sandwich – anyone else involved in informal caregiving

Sandwich generation caregivers have an extra level of stress because they have competing priorities.  There is only so much time and they often feel they can’t do justice to any single task because they’re pulled in so many different directions.

Caregivers have definitely Got Stress.  How do you know that caregiver stress is becoming unhealthy?  The Alzheimer’s Association has a lot of information on their website about caregiver stress and burnout.  Symptoms can include anxiety, irritability, trouble concentrating, depression and anger.  Caregivers may be in denial about their loved one’s illness.  They may withdraw from friends and family, have trouble sleeping and feel exhausted.  Their own health may suffer due to stress and burnout.

If you are a caregiver and find yourself struggling with stress and burnout, what can you do about it?  Better yet, if you find yourself (or know someone else who is) in the caregiver role, how can you minimize the risk of burnout?

  • Don’t beat yourself up because you can’t do everything.  Recognize you’re only human and be gentle with yourself.
  • Look for resources.  Check with the local Area Agency on Aging to explore what services are available near you.  There may also be disease-specific resources and services available.
  • Be proactive and take a problem-solving approach, rather than worrying and feeling helpless.
  • Do your best to take care of yourself.  Exercise, eat right, and get enough sleep.  See your doctor for your annual physical and other scheduled visits.  Remember, you can’t take care of others if you’re not well yourself.
  • Don’t be afraid to ask other family members for financial help if you need it.
  • Ask for and ACCEPT help.  Have a mental list of things people can do and let them choose one.  For instance, a sibling can take Mom for visits on weekends to give you a break.
  • Be realistic and don’t be afraid to say no if you can’t commit to something.  Someone else will be able to chair the PTA and run the fundraiser.
  • Stay in touch with family and friends.  Isolation makes stress worse and accelerates burnout.
  • Keep a sense of humor!

I want to make sure you realize that there are significant upsides to the caregiver role too.  Many of my patients are providing care to aging parents and grandparents and find it incredibly rewarding.  For instance, one patient was the full-time caregiver for her father until he passed away in his 90s about a year ago.  She has told me it was wonderful being able to share that time with him, knowing the time was limited and coming to a close.  Focusing on the blessings rather than the trials and keeping her (boisterous!!) sense of humor helped her keep burnout at bay.

Research has also shown that the healthiest and longest-lived people on Earth tend to live in multi-generational households.  Maintaining close relationships between generations is good for your health and for society.  One of my friends is a caregiver for her grandfather who has Alzheimer’s disease.  She is homeschooling her son and they spend the day together as a family.  Her grandfather is fascinated by his great-grandson’s schooling and the little guy adores spending time with him every day.

Providing family caregiving services to an elderly or ill family member is stressful, no doubt about it.  Caregiver stress is common and falls largely on women.  It doesn’t have to lead to conflict, burnout and physical illness though.  Acknowledging your limitations, asking for help, practicing good self-care, and seeking out the positive can help keep you healthy and make caregiving a rewarding experience for you AND your loved one.

QUESTION:  Are you providing caregiving services for someone you love?  What are you struggling with, and what helps you manage?

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I Don’t Feel Good

Over the last two weeks or so I’ve had a number of patients who don’t feel well.  They’re tired, their energy is low, they have body aches, their digestion isn’t good.  They all came in saying “Doctor, I don’t feel good!”

I used to hate it when patients came in with this problem.  There are SOOO many problems that can cause people to not feel well!  I always felt like I was hunting for a needle in a haystack.  That was before I learned more about Integrative Medicine in general and Functional Medicine in particular.

Functional medicine principles state that the very first thing to do for ANY problem is to give the body what it needs, and STOP giving it what it doesn’t need (i.e. stop poisoning it).  So we start with providing good nutrition and proper rest, and avoiding toxins.

How do we define good nutrition?  Plenty of fresh fruits and veggies, lean meats in limited amounts, fatty fish, whole grain breads, nuts, seeds and fresh clean water.  I’m a proponent of a completely plant-based diet (watch “Forks Over Knives” on Netflix or get it from your library if you’re not familiar with Dr. Esselstyn’s work at the Cleveland Clinic) but if people aren’t ready to go completely plant-based then limiting animal-based foods is a great first step.  After all, perfect is the enemy of good, right?  Any small steps taken in the right direction are reason for a happy dance 🙂

Another addition to consider in the interest of good nutrition is a high-quality multivitamin.  If you’ve been following me for awhile you know I work with the Shaklee Corporation (click here to see why).  You can check this link to see some age-and-stage-related recommendations for nutritional supplements.

As far as avoiding toxins goes, what are you taking into your body that may not be good for it?  Do you eat a lot of added sugar and processed food?  Do you drink alcohol too much?  Do you smoke?  Use drugs?  Do you use a lot of artificial sweeteners?  Everything you eat, drink, breathe and put on your skin has to be gotten rid of in some way.  Are you putting a big strain on your lungs, liver and kidneys by asking them to process too many chemicals and additives and other toxic substances?

Toxins aren’t just substances you eat and drink.  What kind of people are you hanging out with?  Are they people you enjoy spending time with?  Are they supportive of you, or do they drain your energy and make you sad and frustrated?  In general I recommend my patients hang out with people THEY WANT TO BE LIKE.  If you want to be a happy person but you constantly spend time with people who are angry, negative downers, maybe you need to find some new friends.

If you don’t feel well, of course I’d be happy to see you in the office to help you figure out what’s wrong.  However, there are things you can do to get started feeling better.

  1. Get enough sleep.
  2. Take a look at your diet and get it cleaned up.  Eat real food, not processed food or junk food.  Fruit, veggies, nuts, seeds, whole grains, and limited amounts of lean meats and fatty fish.  Avoid dairy if at all possible (that’s a topic for another post) and the jury is out on eggs.  I don’t eat them myself.
  3. Add a high-quality multivitamin or nutritional supplement program.
  4. Avoid toxins of all sorts, as much as you can.

If these measures don’t improve how you feel, it’s time to see the doctor.  Bloodwork and other testing based on your symptoms would be in order.  If your personal physician isn’t successful in figuring out and correcting what’s wrong, you might consider a second opinion from doctor trained in integrative medicine.  Click here to find one near you!

There’s nothing worse than going through life feeling tired, run-down, achy and blue.  Don’t give up, you CAN feel better!

QUESTION:  Do you have symptoms that just won’t let you feel good?  What have you done to get rid of them?

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