Setting the Stage

A question I asked myself daily when my children were growing up is what am I setting the stage for? That may seem like a less than emotional approach to parenting. It is. But based on my family of origin, thoughtfulness was always better than my initial emotional instinct.

I didn’t sit and study an issue for hours. I just quickly played out the lesson I was teaching to the extreme. Quick example: When my 2-year-old took a Happy Meal toy from another 2-year-old, I suggested he apologize. As I watched his fury and reluctance, I knew he wasn’t sorry. If I pursued pressuring him at that moment, I was teaching him to be disingenuous aka lie.

I’m not discounting that he needed to learn to be polite and kind and function well in society. But that required a more thoughtful and lengthy discussion repeated over time.  

If I teach a child to lie at a time in their development that I’m also attempting to teach him to tell the truth about throwing my ring in the trash, feeding the dog chocolate, or breaking his grandmother’s vase, can he differentiate or will he determine he should just ignore me because I make no sense?

You could argue I’m only teaching him to be emotionally disingenuous. Okay, well how will that play out in his adult relationships, especially intimate ones? Will he adopt polite appeasement over the truth? Maybe or maybe not, but the stage has certainly been set for it.

Each decision we make as a parent sets the stage for something. It is worth considering for what. This is also true as business owners or corporate citizens. And it is true of healthcare.

Young man with dark curly hair sitting at white table next to black chair pulling his hair with both hands.

The US healthcare system set the stage for people to seek answers elsewhere. Unfortunately, this has led to doubting science along with healthcare professionals. But dismissing people who run to Dr. Google first is to miss the point of the patient experience.

The aftermath of 2020 led many institutions away from the emphasis they were putting on patient-centered care. This is unfortunate. And even with a movement toward listening to the patient, the system in general needed hearing aids.

Many patients with GI problems suffer through years of no diagnosis, misdiagnosis, ineffective medication, being treated as though they’re crazy. And then years of paying off the invoices generated in getting them no relief. Why wouldn’t they mistrust a system that is not serving them?

A lot of those patients want to be treated by someone who cares to get to the root of the problem even if it means trying something besides medication. I’ve written before about the doctor I had coffee with who said he would never put someone on a gluten-free diet unless they had a positive biopsy. I understand the importance of best practices, but a gluten-free diet does no harm and might give him helpful information toward diagnosis.

Can we get past rigidity of thinking when we know our diagnostic tools are limited? Opting for surgery in an unclear diagnostic situation is considered acceptable. Is that because surgery gins more money through the system?

Why is a non-harmful approach rejected when a potentially dangerous procedure is considered acceptable within the standard of care? The answer may not be simple. Sometimes, it’s just that the physician you rely on is not well-informed on new research or developments. Sometimes, it’s fear of being sued. Often, it’s that huge systems are not nimble and move slowly.

But sometimes a complex answer gets simplified to – we’re following science – and presented to the patient. Great job! Now you’ve set the stage for that patient to distrust science.

And such incidents may come on top of setting the stage for patients to distrust the way medicine is practiced because they haven’t been provided a diagnosis or effective treatment. Further, they may have been treated as if they’re crazy (especially if they’re female).

Posters on Reddit and BlueSky last week asked people to post the most ridiculous thing a doctor had ever said to them with a straight face. These posts received hundreds of replies and thousands of replies and reposts.

We’re reaping the results of distrust in science in things like measles outbreaks. That is bad and dangerous. But until the healthcare system chooses some self-reflection, it will continue to set the stage for distrust.

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.”

Acupressure For Gastrointestinal Improvement

Can we consider acupressure for gastrointestinal improvement? Directly or indirectly, a lot of us adopt specialized diets because our gastrointestinal system causes us distress. Sometimes we adopt the change because of a specific diagnosis. Sometimes it’s because we can see an observable difference in how we feel when we avoid certain foods. Sometimes, we’re at the point we’ll try anything in an attempt to get relief. And sometimes it’s a mix of all three plus some.

inflamed belly

Being in constant pain or worry about needing to find a bathroom makes even the most routine tasks miserable, tiring, and anxiety producing. It becomes a natural reflex to stay home in order to avoid embarrassing situations. No one wants to limit themselves. But what do you do when you can’t seem to find the thing that brings relief?

I’ve lived this in varying degrees for over 20 years. I became gluten-free in 2003. Eliminating gluten helped. Eliminating dairy products helped. But it was only in the last year that I discovered eating low histamine foods would vastly improve my lingering symptoms.

As I’ve experimented with dietary changes, I’ve also explored the effects of stress and ways to rein in feelings that overwhelm my system. I have no doubt the function of my digestive system is related to the function of my emotional regulation system.

Recently, I’ve explored using acupressure to calm the vagus nerve. Mind you, I’m early in the learning process. I haven’t really found any documentation that indicates acupressure will be effective.

What I did discover were some small studies that researched the effects of acupressure on post-operative hysterectomy and colorectal cancer patients. If these studies hold true in larger numbers, it appears that adding acupressure to post-op care could result in better bowel motility and quicker, less painful recovery. That sounds positive to me.

Acupressure has also been effective in reducing post-operative nausea experienced after general anesthesia. Acupressure can also reduce vomiting when no antiemetic medication is used.

If acupressure can reduce nausea and vomiting in a post-op situation, I’m wondering whether it can work for stress or trauma related nausea and IBS. It seems possible given that the physical mechanisms involved may be the same or similar.

There are many websites and books touting acupressure as effective trauma treatment. They may all offer great tools. I do not know. I haven’t tried any of their techniques and I haven’t yet found randomized, controlled trials to confirm anecdotal improvement.

If your doctor indicates acupressure will not create complications for your existing health conditions, I see no harm in giving it a try. If it works, you don’t need anyone to prove it to you. If it doesn’t, you can stop including it in your health plan.

Minimally invasive, non-pharmaceutical interventions that result in a healthier gut will complement the dietary changes you make. This can lead to generally feeling better and having less need for isolation.

I see lots of possibilities for acupressure as a tool for gastrointestinal improvement in situations beyond post-op recovery.

Travel Tip #18 Push the Limits?

Travel Tip #18 Push the Limits is written with you in mind if you suffer from IBS, IBD, Crohn’s Disease, Celiac Disease or other conditions that may lead to a sudden need for bathroom facilities. I just got back from LA. During Sunday brunch I had a sudden reminder of how uncomfortable it can be to travel with a gastrointestinal condition. This travel tip deals with a subject that’s difficult to discuss in public.
cypress
If your guts are constantly in a knot and you can’t predict when diarrhea, gas, or pain may suddenly hit, it can be hard to imagine taking a long trip on an airplane or even in a car full of people. A fear of embarrassment or discomfort can lead to a gradual withdrawal from family outings and vacations.

Reluctance to disclose the real reason for resistance to certain situations often leads family and friends to misinterpret what’s happening. I mean who really wants to say, “I just can’t face the chance that I’ll poop myself during a 3-hour plane ride?” I don’t. It really doesn’t matter how close we are, I just don’t want to discuss that with you.

So, what should I do?

Pretend to be too busy, too sick, or too angry with Aunt Jane to attend?
Insist on a different trip that no one else is excited about?
Wear adult diapers?

Sometimes saying no may be the best choice. If your only motive is to take care of yourself, you’ve explored all the options that might make the journey enjoyable for you, and you still can’t find a way to make peace with attending, then say no. It’s only when you have an ulterior motive or when continual refusals begin to limit your access to a full life that saying no becomes detrimental.

Say yes within limits. If it’s hard for you to take care of yourself, establishing certain parameters in advance can make it easier to decide in the moment when presented with an invitation. For instance, you may want to have a rule that you only agree to car trips in areas with ample facilities. You may want to limit flights to 1 hour at certain times of the day. You could have a rule that you will not stay at friends’ houses so that you have the privacy of your own space. Along those lines, you can have a rule that you don’t share hotel rooms. If you know you usually have fewer problems an hour after eating, join the family after the meal rather than for the meal.
breakfast
Make sure you eat properly and/or take your medication on time. When you’re willing to say yes, there’s no reason to tempt fate. Adhering to the regimen that works best for you while varying your activity can make all the difference. Investing a little time in research and advance planning can make it possible for you to have plenty of medication on hand even when you miss a connection.
It can also mean that you have plenty of tummy friendly snacks on hand when meal times or restaurant options unexpectedly change.
orange tree
Focus on the good stuff. A beautiful view, a warm hug from your favorite cousin, or the smile on your grandson’s face when he meets LeBron James can all mitigate a little discomfort. After all, you may not feel perfectly well at home. If you can feel equally good and add some great memories, it may be worth risking possible inconvenience or embarrassment. If things turn out badly, you can make a different choice next time. If you always stop yourself before you start, you’ll miss out on a lot of good stuff.

Bring the party to you. If you need to be in your own space to be comfortable, make your home the place everyone gathers. Let the travel be someone else’s problem. Instead of missing out on memories and contact with people you enjoy, develop your hosting skills.

That doesn’t mean you have to do a lot of work and throw a party. Just establish that you’d like to see everyone at a certain time and invite, invite, invite. When someone visits, relax and enjoy them. It may take some time to develop momentum, but eventually word will spread that your place is the place to be. Making your guests feel welcome is all it really takes to be a great host.

If you suffer from IBS, IBD, Crohn’s Disease, or Celiac Disease, should you push the limits and travel or should you stay home? There’s no right or wrong answer. What’s right for today may not be right for tomorrow.

The important thing is to always, always take very good care of yourself. For some of us that is in and of itself pushing the limits.