Archive for January, 2018

January 16, 2018

How Many Cures are we Missing?

After happening across a documentary entitled, “Unrest” this weekend, I’m pondering the question: How many cures are we missing?

dna

“You can miss a cure because people are telling the wrong story about you.” – Jennifer Brea

That’s the powerful quote that stuck with me after watching the heart wrenching story of Jennifer Brea and others who suffer from Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) also sometimes known as Myalgic Encephalopathy.

“You can miss a cure because people are telling the wrong story about you.” – Jennifer Brea

ME/CFS is a complicated illness affecting the neurological, immune, endocrine and energy metabolism systems. Like Multiple Sclerosis, Lyme Disease, Celiac Disease, and Fibromyalgia, ME/CFS has attracted controversy. For many years, it was a debated whether it was an illness at all. Today, up to 90% of people with this syndrome go undiagnosed. Approximately 75% of those affected can no longer work and 25% are homebound and sometimes bedridden.

monsterUnfortunately, the story we often tell when an illness has vague symptoms, is chronic or intermittent, is difficult to diagnose, has no cure, or is difficult to treat is that the patient has a psychological disturbance rather than a physical illness. Some doctors directly tell patients the symptoms are all in their head.

It has happened to me. During the two years I spent with an intracellular parasite encapsulated in a capped tooth, I was told by two different doctors that the extreme fatigue, abdominal pain, abnormal bleeding, and pain behind my right eye that occurred between each round of pneumonia were all in my head. The story they were telling nearly caused my death.

I had psittacosis that I contracted from pet Cockatiels which unbeknownst to me had been illegally imported. My diagnosis was confirmed by both a blood titer and a positive test of the birds. The good news is, I lived. The bad news is, it was an immense struggle to get medical help until I had 104 temperature, incessant vomiting, and pneumonia. At that point, I was considered ill. The fact that it kept recurring was considered unrelated.

That illness was 30 years ago. Any time I have crossed paths with one of those two doctors since then he asks me, “Are you sure those birds had something to do with it?” Yes, I’m sure. The tests indicated the birds carried the organism. The USDA asked for custody of the birds so they could save tissue samples to use as evidence against the pet store owner. YES, I’M SURE!

I am sure, but he is not. In spite of the supporting science, this doctor who is an animal rights advocate cannot bring himself to let go of his story. In his story, animals do not cause harm.

“You can miss a cure because people are telling the wrong story about you.” – Jennifer Brea

Every time I hear someone condescendingly say, “I believe in science,” I cringe. It’s not that I don’t believe in science. It’s that I recognize that we don’t have as much scientific knowledge today as we will have tomorrow. And what we learn tomorrow may turn today’s knowledge on its ear.

I also recognize that the story we construct around scientific observation may be filled with bias that can do real harm and, as Jennifer Brea so astutely points out, may cause us to miss a cure for a very real disease.

It can be difficult to develop a narrative most likely to cure. Some physical illnesses have associated psychological components. Sometimes depression is a reasonable response to the altered life circumstances we face from physical illness. Some wounds to the psyche manifest as somatic symptoms. There’s no doubt it’s complicated.

Just because it’s complicated is no reason to take a shortcut, rely on assumptions, perpetuate myths, or be dismissive of a patient because they have something outside your realm of expertise or experience. Perhaps my greatest disappointment with the medical community came when no one seemed remotely curious why I got pneumonia every time I stopped taking antibiotics and why I had continual symptoms in between rounds of pneumonia.

diagnosisI wanted someone to be curious to solve my puzzle. I thought that’s how diagnostics worked. I believed getting curious and trying to figure things out were a large component of practicing medicine. I believed that until the point at which I read my medical charts. It was an eye opening experience.

If you have an autoimmune disorder or auto-inflammatory disorder like MS, Celiac Disease, Lupus, CREST Syndrome, or Moersch-Woltmann syndrome, it may take months or even years to get an accurate diagnosis. The same is true of ME/CFS and many other chronic conditions – even common ones.

A study published in 2007 in The International Journal of Clinical Practice (found here on Pub Med) found “The under-diagnosis of common chronic diseases in the developed world ranges from about 20% for dementia and cirrhosis to 90% for depression and osteoarthritis. The delay in the prompt diagnosis and initiation of treatment is associated with increased morbidity and mortality for most of the reviewed diseases.”

There are models of hope: A movement toward Patient and FamilyCentered Care makes the patient part of the care team. Translational Research embraces the input of patients and the community as it seeks to implement scientific research into patient care. Systems that value the input of patients can help shift the story that is told about a disease.

Systems that invite curiosity, innovative thinking, imaginative approaches, and new information (even that which challenges current beliefs) rather than treating them as threats could vastly improve diagnostics and treatment plans.
curiosity
I view curiosity, a willingness to question, and the willingness to sometimes be wrong as confident qualities. I don’t believe that any physician will have all the answers. That would be unrealistic.

What I do hope for is physicians who are willing to exhaustively pursue knowledge that will help their patients. I hope for doctors who ask good questions. I long for a system that is not dismissive of ANY patient. I hope for physicians who can embrace and incorporate other opinions. I wish for practitioners with enough strength, character, and perspective to recognize areas in which they may be biased and with enough courage to question themselves.

“You can miss a cure because people are telling the wrong story about you.” – Jennifer Brea

Until we begin to question our stories, how many cures are we missing?

Resources
https://www.unrest.film/

https://www.cdc.gov/me-cfs/about/index.html

https://prevention.nih.gov/programs-events/pathways-to-prevention/workshops/me-cfs

https://www.meaction.net/about/what-is-me/

http://www.meassociation.org.uk/about/what-is-mecfs/

https://multiplesclerosis.net/living-with-ms/portable-history-ms/

https://www.ncbi.nlm.nih.gov/pubmed/17686096

Disclosure of Material Connection: I have not received any compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: “Guides Concerning the Use of Endorsements and Testimonials in Advertising.”

January 9, 2018

Make the Kitchen Your Happy Place

If you want to improve your family’s eating habits, make the kitchen your happy place! Watch any home improvement show and you’re sure to see a lot of emphasis on kitchen design. Even tiny house occupants often insist on full-size appliances. This could lead you to believe that Americans love to spend time in the kitchen. But according to former consumer packaged good consultant Eddie Yoon, only 10% of Americans love cooking.

Why do we go to all the trouble and expense of large refrigerators, stone countertops, and multiple small kitchen appliances if we don’t want to be in the kitchen? It doesn’t make much sense. On some level, we must still believe the kitchen is important. Since the only way to really know what’s in your food and thereby ensure you are meeting your health and nutrition goals is to begin with fresh food, it would be good if we enjoyed our time in the kitchen.

So, how do we take a basic space or a beautifully appointed kitchen with a custom pantry, elegant countertops, decorative backsplash, and ample refrigerator and turn it into a space we want to use, a space that draws us in, a space that feels like our happy place?
pancakes
Make it Yours

Forget all the sparse, neutral images you see on TV and online. Those are just showing you a blank canvas waiting to be personalized. Let your kitchen become a place filled with things that make you feel good.

Personalize
Put your grandmother’s cookie jar on the counter and keep it filled with homemade cookies just like she did. Add a wireless speaker to the top of the refrigerator so that meal prep can be choreographed to your favorite dance tunes. Get a spoon rest that makes you laugh. Buy a handcrafted cutting board that makes you feel connected to the outdoors. Get cabinet organizers that reduce frustration by making everything easily accessible. Get rid of appliances you never use so you don’t feel guilty for having them. Buy a small appliance if it will invite you into the kitchen to use it (for more than the first week or two). Add a collection of decorative objects you love. A kitchen does not have to be cold and clinical to be functional and efficient.
teapot
Add Color
Don’t be afraid to add some color!!! All white, mostly gray, or somber black and brown can dampen my mood! Unless your house is listed for sale, there’s no reason to be hesitant about adding something bright and happy to your kitchen. If you’re not comfortable with painting the walls or cabinets, bright curtains, a painted island, decorative plates, unique pottery pieces, wall art, vintage salt and pepper shakers, flowering plants, or potted herbs can help make you feel happy to spend time in the kitchen.

Get Comfortable
If you love to converse while you prep veggies, add a bar stool or a comfortable chair near your prep space. Share a cup of hot chocolate, hot tea, or coffee and conversation with a friend, neighbor, partner, spouse or child while your hands are busy. They don’t necessarily need to help. They can just keep you company. This can be a great time to exchange recipes or share cooking techniques.

My great aunts used to shell peas together. They’d gather at my Aunt Nola’s house, sit outside in metal chairs with a bushel basket in front of them and talk while they worked. They actually did many things as a group – crocheted, quilted, and painted ceramics. The grandkids ran free in the yard or around the farm while the women stayed in touch and made work seem like play.

Experiment

If you’re new to cooking from scratch (without the use of something that is already prepared or in existence), but love to play around with color, texture, and flavor, the kitchen may soon be your favorite place! I tend to visualize how flavors will taste together in my head before I try them in real life, but I also get inspired to pair flavors when I taste something that excites me.

A cucumber, jalapeño ice lolly I ate on a hot day inspired my recipe for Chilled Honeydew Soup, a delightful and refreshing combination of honeydew, cucumber, with a hint of jalapeño. Soon after eating that ice pop, I began experimenting with ingredients in varying proportions and possible additions until settling on the best combination. After that, the recipe faced 2 more tests in order to meet the Cooking2Thrive quality standard. For me, each of the experiments was fun!
tomatoes
Good Taste

Even if experiments don’t excite you, It’s hard to resist a room filled with delicious food. Remember, many ingredients do not require cooking to be scrumptious! If you are reluctant to cook, consider constructing simple salads. These following salads rely on flavorful fruits for their flavor and texture. They do not require cooking and they are both delicious.

No Cooking Required
Tomato and Avocado Stacked Salad
Layer tomato slices, avocado, and mozzarella cheese. Drizzle with a vinaigrette made from olive oil, red wine vinegar, minced garlic, chopped basil, salt, and pepper. Add a slice of crispy prosciutto if you like.

Simpleberry Salad
Combine fresh blueberries and blackberries with sliced bananas and tiny cubes of cantaloupe. Dollop with sour cream or plain yogurt and top with grated nutmeg. Add a dash of cinnamon if desired. You can also sprinkle with a granola crumble if you like some crunch.

Bake Something
When you add baking to the equation, the kitchen will fill with warmth and the smell of browning cookies, yeast bread, pizza dough, and cake. Yummmmmm!! Who can resist the kitchen then? It’s like having your own personal bakery.

Add the Family

The smell of fresh baked cookies, pork tenderloin, or a casserole will bring the family running. A kitchen filled with all ages creating a meal is a wonderful place to connect and bond. Food is a source of comfort. Connection is another source of comfort and joy. When you begin to associate cooking with comfort and joy, it automatically becomes your happy place! Even the cleanup process ceases to be work when it’s a shared experience of laughter and fun.
dough
When my kids were growing up, there was always someone sitting on a counter in my kitchen. Sometimes it was my kids. Sometimes it was their friends. Sometimes it was me. One or two of us would be preparing a meal and the others would be engaged in the conversation while warming the counter. I don’t know why this seemed natural in that particular house, but it was. During cleanup, the roles reversed. In between, we enjoyed a meal together. This didn’t happen every day of the week, but it happened enough that that’s how my kids remember meal time.

Both of my sons are good cooks. Not only can they fix pancakes or steak and blacken Brussels sprouts, they bake yummy pies and cakes. They feel no limits when they’re in the kitchen. It’s a place they’ve always felt comfortable. I didn’t emphasize cooking back then. It was just a regular part of our lives, but it set the stage for them to cook in their own homes. That’s the benefit of making the kitchen your happy place!

My grandson DJ and I read “Green Eggs and Ham” on a regular basis. Whenever he balks at a new food, I simply say, “Try them, try them, and you may. Try them and you may, I say.” He knows exactly why I’m saying it. If you have never really gotten your hands dirty in the kitchen using fresh ingredients and cooking from scratch, but don’t think you like cooking, I’d probably say the same thing to you, “Try it, try it, and you may.”

And if you don’t, every family needs a cleanup crew in a happy kitchen!

https://hbr.org/2017/09/the-grocery-industry-confronts-a-new-problem-only-10-of-americans-love-cooking
http://time.com/money/4370620/food-spending-restaurants-versus-groceries/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3471136/
http://www.cooking2thrive.com/blog/the-benefits-of-cooking-part-1-the-food/
http://www.cooking2thrive.com/blog/the-benefits-of-cooking-part-2-the-fun-2/
http://www.cooking2thrive.com/blog/the-benefits-of-cooking-part-3-the-lessons/

January 4, 2018

Forget Resolutions – Answer the Big Questions

As this year begins, forget resolutions! Until you answer the big questions, it’s pointless to make them anyway.

Is there really much chance you’re going to hit the gym an hour a day for a whole year if you haven’t explored why you’ve purchased 3 yearlong gym memberships before and worked out a total of 3 times?

Will you be able to achieve your goal of reducing clutter if you don’t know why you buy more clothes, but don’t remove anything from your closet?

Is it realistic to set a goal to prepare most meals from scratch if you don’t know whether you believe that anticipated long-term health gains are more important than the convenience that gets you through today?

We’ve talked before about setting up a life structure to support change, but that’s really starting in the middle. Before you set up that structure, you need to know yourself and be clear on your values.

Most of us believe we have a clear view of ourselves, but I can tell you from interviewing many employees and then subsequently observing their job performance, we are either terrible self-assessors or willing to be incredibly dishonest to get a job. If we’re not good at self-assessing, we’re not being honest with ourselves.

I have only a passing knowledge of Brené Brown’s research into shame and vulnerability, but it seems logical that feelings of shame regarding our perceived inadequacies or the vulnerability of being unemployed contribute to our construction of a story that doesn’t match other people’s perception of us over time. While this may feel necessary for landing a job, or our social mask may feel necessary for navigating public interactions, it is important for us to connect to our true selves. If we don’t, we simply can’t construct a life that will benefit us.

Think of it this way, if you build a house with standard height doors, it won’t comfortably fit LeBron James or Kevin Durant. If you love to sleep late and work at night, a 7am – 3pm job does not fit you as well as an 11pm – 7am job. If you value routine, outside sales will make you crazy. It doesn’t matter that your earning potential is increased because the job is not a good fit! On the other hand, if you love flexibility outside sales will let you blossom.

Asking the big questions helps to identify our strengths, obstacles, and things that bring us joy. Answering the big questions with courage solidifies our values. With the resulting clarity, we can construct a life framework that supports us becoming our best, healthiest, most joyful selves, even if our new plan is 180º from where we’ve been headed.

Is it seriously possible to go from an inability to keep a single resolution to a 180º turnaround? I believe it is. I’m not saying the path will be straightforward – your particular trail may never have been blazed before. I never expect a journey that has a straight up trajectory, or is without failure. Forward progress most often requires a foundation of commitment, diligence, learning from mistakes, and holding yourself accountable.
question
What does a big question sound like if I should want to ask one?

Big questions are things like:

1)What are my greatest inherent strengths?

2)What are my greatest learned skills?

3)What are my greatest weaknesses?

4)What am I most lacking right now?

5)Can I sit still in total quiet without distractions or company and feel calm and comfortable?

6)What do I have in great abundance?

7)What do I have that I can live without?

8)Am I invested and engaged in my family, my job, and my community?

9)Am I able to feel my real feelings in the moment?

10)What do I do to avoid my feelings?

11)Do I embrace my emotions, both positive and negative, and lean in?

12)Can I look myself in the eye in the mirror and sincerely utter the words, “I love you?”

13)What is the worst thing I’ve ever done? Have I forgiven myself for that?

14)If I have not yet forgiven myself for my worst action, can I do it now?

15)Do I have good boundaries?

16)Do I contribute more often to peace or to conflict in my relationships?

17)Am I more likely to display compassion or judgement?

18)Do I take responsibility for my contribution to family or work conflict?

19)How do I behave when I’m my best self and during what percentage of each day am I my behaving that way?

20)Am I willing to practice gratitude, bravery, health, fitness, kindness, thoughtfulness, and generosity?

21)Am I reliable? Can others regularly count on me?

22)What kind of friend am I to myself? Do I take care of myself as well as I do my husband, wife, children, friends, coworkers, or clients?

23)What inspires me?

24)What motivates me?

25)If there were no obstacles, what would a perfect week look like?

26)What steps can I take today that will move me toward that perfect week?

27)If there is no way to change my current circumstances, will I be okay and can I learn to thrive?

28)How much time am I willing to commit each day to improving my physical health and fitness?

29)How much time am I willing to commit each day to strengthening my emotional & spiritual health?

30)What percentage of the time do I say no when I should say no?

31)What do I believe is the biggest obstacle standing between me and my #1 goal?

32)Do I have the courage to sit with my fear?

33)What one thing can I do each day that will add joy, laughter or connection to my life?

34)What do I believe I deserve in life?

35)Am I aware of the effect my choices have on those around me?

36)What one kindness can I offer someone else today?

The answers to big questions often reveal themselves in stages of realization slowly over a period of time as we gain insight. Many of us have had our relationships to ourselves interrupted in a manner that leaves us feeling alone, helpless, weak, undeserving, defective, or numb. When this is true, it can be a monumental task to reconnect with our emotions. If you have difficulty seeing yourself as lovable, deserving of good things, or feel a need to avoid all emotions, Somatic Experiencing® may be a good place to start.

Somatic Experiencing® Therapy allowed me to reconnect with my body so that I could relax the defenses that prevented me from feeling. Developed by Dr. Peter A. Levine, SE can easily be practiced with or without the assistance of a practitioner. Using SE tools still helps me trust my body to support me while I free my mind to know what I know and my heart to feel what it feels. That puts me in a much better position to answer big questions in a manner that is consistent with supporting my best self.

If you’re already feeling concerned that you may not keep your resolutions this year, forget them and try answering some big questions! After all, there’s no danger in trying something different and the knowledge you gain about yourself can give you insight into a better strategy for sustaining positive change.

Take your time, you’ve got all year! Let’s just call this a rebuilding year.

https://brenebrown.com/

http://somaticexperiencing.com/