Category Archives: change

by

quit

I’ve quit

again
stop start

stop
quit

I don’t think I’ll go back
it wastes the days
makes me so sick
takes so little for me to overdo

I resent lost time
and suffering

my body doesn’t want it
and tells me so
ferociously

alcohol you say?

that too

but I was talking about men

 

The photograph is my mother’s father’s mother. I have one of the originals. The back is stamped: Battle Creek, Michigan. So she was having a “rest cure” at Dr. Kellogg’s famous health retreat.

by

Stress and the sympathetic nervous system

People talk about adrenal fatigue: what is it that they mean? And how can we address it?

When we are relaxed, or less stressed, we make more sex hormones and thyroid hormone.

When we are in a crisis, or more stressed, we make more adrenaline and cortisol.

The pain conference I went to at Swedish Hospital took this a step further. They said that chronic pain and PTSD patients are in a high sympathetic nervous system state. The sympathetic nervous system is the fight or flight state. It’s great for emergencies: increases heart rate, dilates air passages in the lungs, dilates pupils, reduces gut mobility, increases blood glucose, and tightens the fascia in the muscles so that you can fight or run. But…. what if you are in a sympathetic nervous system state all the time? Fatigue, decreased sex drive, insomnia and agitated or anxious. And remember the tightened fascia? Muscle pain.

When we are relaxed, the parasympathetic system is in charge. Digesting food, resting, sexual arousal, salivation, lacrimation, urination, and defecation. So saliva, tears, urine, and bowel movements, not to mention digesting food and interest in sex. And muscles relax.

If the sympathetic nervous system is in overdrive, how do we shut it off? I had an interesting conversation with a person with PTSD last week, where he said that he finds that all his muscles are tight when he is watching television. He can consciously relax them.

“Do they stay relaxed?” I asked.

“I don’t know.” he replies, “but my normal is the hyperalert state.”

“Maybe the hyperalert state, the sympathetic state, is what you are used to, rather than being your normal.”

He sat and stared at me. A different idea….

So HOW do we switch over from the sympathetic to the parasympathetic state?

Swedish taught a breathing technique.

Twenty minutes. Six breaths per minute, either 5 seconds in and 5 seconds out, or 6 in and 4 out. Your preference. And they said that after 15 minutes, people switch from the sympathetic to the parasympathetic state.

Does this work for everyone? Is it always at 15 minutes? I don’t know yet. But now I am thinking hard about different ways to switch the sympathetic to parasympathetic.

Meditation.
Slow walking outside.
Rocking: a rocking chair or glider.
Breathing exercises.
Massage: but not for people who fear being touched. One study of a one hour massage showed cortisol dropping by 50% on average in blood levels. That is huge.
Playing: (one site says especially with children and animals. But it also says we are intelligently designed).
Yoga, tai chi, and chi kung.
Whatever relaxes YOU: knitting, singing, working on cars, carving, puttering, soduku, jigsaw puzzles, word searches, making bean pictures or macaroni pictures, coloring…..and I’ll bet the stupid pet photos and videos help too….

My patient took my diagrams and notes written on the exam table paper home. He is thinking about the parasympathetic state: about getting to know it and deliberately exploring it.

More ideas: http://www.wisebrain.org/ParasympatheticNS.pdf

I like this picture of Princess Mittens. She looks as if she has her head all turned around. Isn’t that how we get with too much sympathetic and not enough parasympathetic nervous system action?

by

Random confuse the engine search

A friend and I are using Facebook to message this am and she says she hates that Facebook is mining for advertising all the time. I said we should do a random confuse the engine search every day. Something silly! I searched enamel zebra hamsters first…. And it’s fun to watch the internet try!

What silly search would you use to confuse the big data mining on the internet? Go wild! Confuse your feed!

by

Armour Suit IV: Walk like a toddler

At each massage, one every two weeks, I have locked my hips back up in the Armour suit. This is really annoying.

My massage person says he wants to be able to lie face down like a baby: head, arms and legs all lifted and playing. That is core strength. Babies can do that… why can’t we? He says that when he does play therapy with kids, by a certain age they lose that. He picks them up and flies them around lying on his arms: by age 4 or 5, they fold up. They have lost touch with that core.

I think about that.

During a massage a few months ago he pokes my lower belly. “Tilt your hips using your abdominal muscles.” Feels weird, but I do. “You aren’t engaging your core.” I find it really annoying to have to relearn how to walk.

Engaging my core. Little children who have just learned to walk do lead with their bellies. And they can still lie on the floor on their bellies, all limbs up.

I am trying to picture an adult who walks with their belly. Who? The Buddha’s belly comes to mind. But I can’t see him walking. Who? Toshiro Mifune: the old samurai movies. He and the others walk like small children: from their core, from their bellies.

I try it for two weeks. I flatten the arch of my lower back by using my abdominal muscles, not my gluteus maximus. I walk with my feet apart a bit, my belly leading. I am trying not to walk with my toes gripping the ground. I walk with toes up. He says I have walked with my toes gripping the ground for years, and that is the only place that I have early arthritis.

It feels a bit silly to walk like a samurai. When I do it right, I can feel that engaged core and my legs and hips feel looser. It is not elegant, not a catwalk uptight shake your ass walk. It is more of a loose free walk, like a toddler, like a buddha. I don’t care. I have to concentrate to keep my abdominal muscles flattening the arch of my back, and so I walk slower.

After two weeks I am back: it’s worked. Partially. My hips are LESS locked. The metatarsal phalangeal joints, the big toes, are less sore then they’ve been for years. And I can feel that abdominal core.

Skiing I try to do the same thing. Engage the abdomen and keep it engaged, and ski with my toes up. I ski slowly and with great swooping turns, letting the skis do the work. Rentals. They give me 158s the first day, I talk them into 165s the second day and then I am on 172s. Finally feels stable. I am getting used to that core feeling. I quit when I get too tired, going in before my kids.

Walk like a toddler, walk like a samurai, walk with core engaged.

First published on everything2.com January 7, 2016. I needed the right picture: this is my sister and me about a month before she died of breast cancer. I miss her so.

by

Wean yourself

SoFarSoStu has tagged me for the three days, three quotations and tag three other people. This is day three, only I am a day late.

β€œThe rules are to post 3 quotes over 3 days and nominate 3 bloggers each time to carry on with the challenge.”

Today I choose Rumi’s phrase “Wean yourself” and post his poem. This is one of my two favorite Rumi poems.

Wean yourself
Little by little, wean yourself.
This is the gist of what I have to say.
From an embryo, whose nourishment comes in the blood,
move to an infant drinking milk,
to a child on solid food,
to a searcher after wisdom,
to a hunter of more invisible game.

Think how it is to have a conversation with an embryo.
You might say ‘The world outside is vast and intricate.
There are wheatfields and mountain passes,
and orchards in bloom.

At night there are millions of galaxies, and in sunlight
the beauty of friends dancing at a wedding.’

You ask the embryo why he, or she, stays cooped up
in the dark with eyes closed.

Listen to the answer.

There is no ‘other world’
I only know what I have experienced.
You must be hallucinating.

_____________

I love this poem. To me it’s about our human development and I love that we go from a searcher after wisdom to a hunter of more invisible game. Have you ever had the feeling that you have figured some part of your life out, that aha! moment? Smooth sailing now, you think…. only to find out that new challenges present.

I use this poem in clinic. When I am talking to a new patient I have to find out where they are, what some of their medical beliefs are, what their level of education is, what their prior experience with allopathic medicine is, do they see a naturopath, are they taking ANY pills? Prescription, over the counter, alternative, herbal, homemade? I read Rumi’s poem as a discussion about our levels of development: we come out of the dark to be an embryo. Where do we go from there? I have to understand at least some of my patient’s background in order to communicate with them: I have to meet them halfway. Sometimes I fail. Sometimes my doctors fail…. we experienced that when my mother was in hospice. We were not given instructions for how to take care of her nasogastric tube at home…. and it got blocked. I think that the inpatient nurses made assumptions and the hospice nurses may have too… or just didn’t know.

This poem also relates to how my thoughts about healing and health keep evolving. Currently I keep reading on the internet and hearing from patients that they want a stronger immune system. There are all sorts of “immune system boosters” being sold. I think this is interesting and I think it is a wrong approach. Why?

I have gotten seriously ill four times. Each was triggered by severe stress in my life: mononucleosis at age 19, influenza in 2003, systemic strep A in 2012 and systemic strep A in 2014. So… do I think that my immune system needs boosting? No. When I got symptoms in 2014, my thought was “I am so stupid.” My father had died in 2013. His will confused me, the house was full of his things, my mother’s things, my sister’s things, my grandparent’s things, all dead. I would work in clinic and then go out there and try to get things done and mostly sit and cry. I did deal with the estate, but what is wrong with this picture?

I ignored what I would tell a patient to do…. I did not take time off to rest and to grieve and to take care of myself. Rather than a failing immune system, I pictured my immune system marshaling troops. “She won’t rest. We are going to have to take her down AGAIN. Won’t she ever learn to listen to her body? When will she learn to REST? Let’s see, who doΒ  we have to knock her down…. ah, strep A! Great! Here, the door is open, take her out.”

And boy howdy, did it. I was out for ten months and ten months later am still on half time work. And I could have kicked myself! How stupid I am! If there is a major emotional loss in your life, cut back and rest and take time to let yourself heal!

So when people say, “I need an immune booster,” I wonder. I wonder what is happening in their lives, what their level of stress is, are they taking care of themselves. I worry that our culture thinks that we just need the right combination of supplements and then we can keep going and drive our bodies into the ground, instead of stopping and saying: “Oh. I am really cumulatively tired. I really need to rest, and sit at the beach and stare at the waves, or lie on the couch and read a silly novel, or just have a cup of tea and do nothing.” I don’t really like pills. I think that pills are often a band aid on a deeper wound than we admit. If I had rested, I would not have needed high dose penicillin: though I am deeply grateful to have another try at healing and health.

And three people to tag to do the three days of quotations if they so choose… everyone may be too busy at this busy time of year:

hargunwai

mindlovemisery

ohmyglai

The pink edged cloud looks like a giant paramecium or other bacteria, up in the sky….

by

Armour Suit III

My trial run for this vacation is swimming 400 yards. The swim is slow but fine. However, at 4:30 am I start having vertigo and throwing up. Have to cancel clinic. Lasts about 4 hours. Not reassuring for our Christmas plans.

My daughter has her wisdom teeth out on Monday before Christmas, so is instructed to not exercise heavily for five days. I got dry sockets and was sick as snot in college, but mine were much more impacted. She does fine, stops the hydrocodone in 24 hours, and drops to a 200mg ibuprofen three times a day by Christmas. On with the ski plans!

We head for a family resort on the east side. Up to to slopes on a hotel ski bus the first day, renting skis. For the first time ever, my goal is to ski gently. I have been skiing since age 9, but have not skied in five years and had two major bouts with strep A that affect my muscles. The second time my fast twitch muscles didn’t work for ten months. The first goal was to survive and the second is will I get my muscles back?

I rent downhill skis. Last time I skied telemark, but they don’t have any to rent, and anyhow, tele is harder. In college I had 190cm dead straight Heads for downhill, so now they rent me 163cm skis. We ride the lift up. 20 degrees at the top, an inch of new snow on groomed slopes and gorgeous. And… I can ski.

I am trying NOT to engage the armour suit. My massage person thinks that’s what made me sick swimming, reengaging it and just trashing my muscles. He’s right, I think. I just swam the way I always have, but slowly. My goal down the hill is NOT to fall into old patterns. I ski gently, let the skis do much of the work, carving swoopy turns. Every so often I get quickly and feel the suit kicking in and I back off. I drag my right pole for balance when I am tired.

My daughter asks for pointers on our third or fourth run. She has not skied for five years either. She is doing the work and I show her how to finish a turn using the curve of the ski. Finishing the turn lets her slow down, so she gets the swoopy feel in the turn but doesn’t lose control. On the lift we watch people. Nearly everyone drops their hands. Try turning your lower body with your arms dropped behind. Doesn’t work. Hands and shoulders down the hill and let the lower body do the turning….

I can ski! I ski with my toes lifted, not curled and gripping the ground. It changes my balance and I have to pay attention not to engage the suit. By 11 I want food and on the chair at 2 I am on my last run: I can feel the cold through my coat. We have a few more days, save energy. Also my right shin is informing me that I’ve bruised the crap out of it…

And the next day! Bruised shin, but more skiing, still gently. Now I have hope that I will get muscles back! Hooray for hope! Hooray for skiing toes up! Hooray for skiing without armour!

by

I will fight no more

I am tired of fighting
I am tired of fighting for justice
I am tired of fighting discrimination
I am tired of fighting for health care for all

I am tired of fighting insurance companies
I am tired of fighting medicare’s contractee
I am tired of fighting for prior authorization
I am tired

I will fight no more forever

I heal
I am a healer
I am trying to heal patients
I am trying to help patients heal

I am a healer
I help heal cancer
I help heal heart disease
I help heal PTSD
I help

heal cancer
heal heart disease
heal PTSD
heal addiction

I am a healer

heal the insurance company
heal the medicare contractor
heal the pharmaceutical company
heal

heal anxiety
heal depression
heal addiction

I will fight no more forever

I heal

The legs in the photograph don’t look delicate, do they? They are strong and beautiful and powerful. I took this at the National Junior Synchronized Swimming Competition in 2009. Those girls on the edge of being women are strong, they are a team, they work and play together. They have the skills and the strength to lift their bodies out of the water that far using their arms… think about the practice and strength needed to do that. We all want to heal and create fun and play and beauty. Let’s work as a team.

also on everything2.com