Monday, December 21, 2009

50 Ways on Facebook

Sheila Key and I have joined the swelling ranks of midlifers doing social media and have made a Facebook fan page for our book, 50 Ways to Leave Your 40s. If you're on Facebook, please come visit our page and become a fan. If you're not on Facebook, where are you? In a cave?

Be there.

:)

The Facebook page title is the same as the book title.

Sunday, November 29, 2009

Practicing Meditation for Life

In my last post I wrote about practicing meditation as an end in itself. But that isn't all there is to it. The practice in meditation is practice for life. By this I mean that the skill you learn "on the cushion" can be applied in everyday life. It isn't just about sitting on the cushion and bringing your mind back to the breath over and over. It is about refining that skill for the rest of your life, life off the cushion.

Why? Why bother? What is the point?

As a beginning meditator I'll offer my thoughts. The main reason to carry the present-moment awareness skill into daily life is so that you can live this life -- as it happens -- to the max. If you are really right here, right now ALL the time (good luck with that, but it's worth trying) then you will have the full, real experience of your life. You won't be distracted from whatever is going on by ruminating over the past or worrying about the future. You'll HAVE this moment in all its glory. Or sorrow, pain, joy, whatever it is. You'll be right there, rather than some-where else or some-when else, like most of us usually are.

Another reason I have found for meditating is that the skill of bringing my mind back to the present serves me in relationships. During an interchange, if I am able to hear the other person, to see them as they are right here, right now, without past baggage or future fear getting in the way, things between us go much better. Talk about challenges! But on the rare occasion when I get a glimpse of this, I see the value.

Beyond these, there are the health benefits of meditation, which are becoming more documented with each passing day.

I'm sure I'll find more of my own personal reasons to continue meditating as time goes on. For now, this is enough to get me onto the cushion for 20 minutes each morning.

Friday, November 13, 2009

Practicing Medicine and Meditation

I have been practicing medicine for about twenty years. I have always thought it a little odd that we call it "practicing." When I was a kid, that word always meant getting out my cello, rosining the bow, and playing my scales and assigned pieces. When I practiced the cello, I was aiming for a concert, or a recital. Preparing for the big event. Practice was a means to a specific end.

In medicine, there is no big event for which we're preparing. We just practice every day. There are the usual jokes, like "someday maybe I'll get it right" and so forth. But for the most part, "I practice medicine" is just another way of saying "I'm a doctor." I don't know any other profession that uses that term. Do you? A mechanic doesn't say, "I'm practicing auto mechanics." Imagine your chagrin if he did! A teacher doesn't say, "I practice education." He better not; not with my kid in his class! But nobody seems to mind that their doctors are practicing.

About a month ago I began another kind of practice: meditation. Here again is an activity for which the practice is the activity, is the point. Sure, some people say or think, "I'm meditating now" but I think most or many experienced meditators refer to it as "practicing meditation." I really like that. If I thought I were practicing for some big meditation performance, which I had to pull off without a false note, I'd have given up after the first five minutes!

Meditation is practicing. Every time I bring my attention back to my breath it is like playing a note in tune just for a moment, before my unruly mind goes stumbling all over the neck of the cello again.

Thursday, November 05, 2009

Meditation Pearls

I'm taking a class called Mindfulness Based Stress Reduction. Based on the work of Jon Kabat-Zinn at the University of Massachusetts, it is basically a meditation class. This is the beginning of the 5th week out of 8 weeks. Over the course of the course, as it were, the teacher has offered up some good one-liners to help us. Here they are, so far.
  • The mind can only be in one place at a time.
  • You can only change in the present.
  • Every thought is accompanied by a physiological response.
  • Consciousness is contagious.
  • Bring it back, baby! (the mind to the breath)
Meditation is simple and difficult. If you've ever tried it you know. Bringing my attention back to the feeling of my breath, over and over and over and over again. And again. Each time my focus comes back to the breath, thoughts roll off like water off a duck's back. For a fleeting moment I am in the present moment. Right here, right now. Then before you know it I'm off on a trail of thought again and I don't even notice it until I'm halfway to tomorrow. Oops, there I go again! Bring it back, baby!

Do that about a thousand times in ten minutes, and that's a meditation practice.

Sunday, November 01, 2009

H1N1 is here

It’s true. Swine flu is here. It is all over New Mexico including here at UNM. Have you had it yet? How about your friends and classmates? How many are out today with flu? I’ll bet there are at least a few, and there will likely be more next week.

We have seen lots of H1H1 influenza or “Swine Flu” at Student Health and Counseling. Since September 1st we have had over 100 cases of “influenza-like illness.” Most of these were H1N1. All have recovered. And those are just the ones who have come to the clinic. There have been many more cases where people just stay home and take care of themselves.

The virus continues to spread. It is very contagious and likes young people. Chances are good that you’ll get it, and chances are excellent that you’ll survive. Here are some tips to help you manage before, during and after you get H1N1.

Before you get sick: Get the regular seasonal flu shot. Make sure you have basic medications at home for fever, cough and congestion. Buy a thermometer, and maybe some soups and juices. Once you have flu you won’t feel like going out to the store for this stuff, and they won’t want you there spreading germs. So stock up. Try to avoid getting the flu by staying away from sick people, keeping your hands away from your face, and washing your hands often. Get plenty of sleep and eat well so your body is strong for the fight against germs.

Once you are sick: Flu symptoms are fever over 100.5, cough, body aches, sore throat, headache, chills, fatigue, and sometimes diarrhea and vomiting. If you have some or all of these you might have flu. Take to your bed! Drink lots of liquids and treat your symptoms. Expect to be out of commission for five to seven days. Please do NOT go to work or school or out to eat at a restaurant! I know students who have done all of these things. If you go out in public you are putting others at risk. Be considerate and stay away. Contact your professors by email or phone to let them know you are sick.

Should you get medical care? If you are a basically healthy person who gets the flu, you probably don’t need to see a doctor. Self treatment at home is usually adequate. If, however, you are pregnant, have asthma or other lung problems, are under 2 years old or over 65, or have any chronic medical condition, you should seek care. There is a medication called oseltamivir (Tamiflu) that is recommended for people in these high risk groups, to decrease the risk of flu complications like pneumonia.

If you are not in these risk groups, there is a small chance that you could still get seriously ill from flu. We have all heard the stories of people who died from H1N1 who had no underlying medical problem. Those stories are scary to be sure, but thankfully also very rare. It is unlikely to be you. That said, if you do get any of the following symptoms, regardless of who you are, please hustle in to the nearest emergency room:

Severe difficulty breathing, severe pain in the chest or belly, sudden dizziness or confusion, severe or persistent vomiting.

After you recover. First of all, this takes a while. As I said before, expect to be out of commission for five to seven days. That means at home resting. Even after the worst of the symptoms have passed, you’ll be weak and easily tired for several days. Take it easy. Don’t return to sports until you feel really good.

Once you are well, step outside and take a deep breath of our crisp Fall air. Stretch your strong body, look up at our New Mexico Blue sky and give yourself the gift of gratitude for your life and good health.

Wednesday, October 07, 2009

Doctor's Notes for School and Work

What is it with teachers and employers requiring doctor's notes? It is a silly requirement that wastes a lot of everyone's time. This has become one of my pet peeves.

I work at a university. The students are paying to come here and get an education. They are responsible for their own learning. This includes, in my mind, deciding whether and when they'll go to class. If they decide that they'll get more out of reading the book than attending the lecture, that's their choice. I had a classmate in medical school that showed up only for exams (no classes) the first two years. He is now a successful physician. If students get sick and decide they need to stay home and rest, more power to them. That's probably where they belong. Home resting, letting their body heal.

When a teacher requires attendance, she is deciding for the students that the class is worth their time, every time. When she requires a doctor's excuse for absences due to illness, she is making a decision for this adult as to when they need to go see a doctor. Sometimes all a person needs is a few days in bed. Not a visit to the clinic, not a doctor to confirm that yes, in fact, they have a cold, or a stomach virus. Many of our patients know this. They get sick, they go to bed. But then, because their teacher requires a note, they come in to the clinic, wait with all the sick people (possibly catching a new germ in the process), then waste their time and ours telling us they were sick and stayed home and asking for a note. The next time they get a cold, they'll come right in, knowing they'll need a note. It sets up a pattern of unnecessary office visits and contributes to the culture of dependent patients who think they need a doctor for every little sniffle.

It's ludicrous. In my humble opinion.

Wednesday, September 16, 2009

H1N1 - article in last week's Daily Lobo

In polite company we call it Novel H1N1. It’s the Influenza Formerly Known as Swine Flu. Originally thought to come from pigs, this flu virus is actually a mix of pig, bird and human. Believe it: only a virus could pull off that combination.

This rascal made a big splash last Spring, as you no doubt remember. After making its debut in the southern hemisphere it worked its way north, and by late summer there were so many cases the CDC stopped counting.

The media hype is hopping about this new germ, and lots of people are afraid. Since it is a new germ, and we haven’t been through a winter with it yet, there is a fair amount we don’t know. But what we do know is reassuring. Most of this comes from statistics but some comes from experience: we have already seen several cases here at Student Health and Counseling.

So far it looks like H1N1 is going to be gentler than the regular flu. Most cases of H1N1 are mild, and over with in a few days. Yes, there have been deaths around the country, but mostly in people who had serious medical problems. If you are otherwise healthy when you get the flu, you can put money on your survival.

Still, any flu can be miserable, so I suggest you don’t catch it. How to avoid it? Keep your hands off your face! That’s the best thing you can do. The flu enters your body through your respiratory system. That means through your mouth or your nose. How often do you pick your nose or your teeth? Don’t answer that. Just know that if the virus is on your hands when you touch your face, you’re toast.

Before I go further, I need to teach you a new word. Fomite, pronounced with a long O and a long I, accent on the Fo. Fomite is a medical term that means any object that can carry germs and pass them along. Fomites are things like towels, drinking glasses, pens, money. Here’s why this word matters.

The H1N1 flu is passed in large droplets. That means if a flu patient coughs, the virus flies out of their mouth in droplets. The droplets then fall onto the nearest surface. H1N1 doesn’t hang around in the air for long, unlike some other viruses that are passed in smaller, lighter droplets. How do you catch the flu then? Either you were unlucky enough to be in the line of fire when that person coughed, or – and here’s where that new word comes in – you touched a germy fomite and then touched your own face.

Think about it. Our hands are everywhere. We use them for everything. Opening doors, using a phone, handling money. As soon as you touch a fomite, your hands are host to whatever little nasties got on there from the other people who touched it. Then you wipe your nose or rub your eyes and wham. Germ transfer.

Yes, it is important to wash your hands, especially before you eat or otherwise touch your face, but washing your hands isn’t enough. The germs don’t soak in through your hands to make you sick, after all. So wash and sanitize, by all means, but mostly keep your hands off your face. If you have to touch your face, like to eat or put on makeup, wash your hands thoroughly first.

Besides washing your hands and keeping them off your face, take good care of your body in the usual ways so that your immune system is on max alert at all times. Sleep enough. Eat well. Exercise regularly. You know the drill.

If you’re already sick, please be responsible and protect others. Keep away from people! If you get symptoms of the flu, stay home! Symptoms are primarily fever, cough, and body aches. You might also have a sore throat, stuffiness or stomach upset. H1N1 typically comes on over a short period of time. Like a Ferrari that goes from zero to 60 in a matter of seconds, H1N1 will rocket you from well to miserable in a matter of hours.

If you are sick, cover your cough. Not with your hands! The latest official advice is to bend your arm at the elbow and cough or sneeze into your elbow, or the fabric of your sleeve above the elbow. If you choose to spray your germs into a tissue, fine, but then please discard the tissue and wash your hands.

The best treatment for H1N1 is rest. Your body is a pretty efficient virus-killing machine, but it needs your support. Stay in bed, drink plenty of fluids, and take medicines for your symptoms. Acetaminophen or ibuprofen for fever and body aches, dextromethorphan for cough, phenylephrine for congestion, or pick your own personal favorite.

If you decide to go to the clinic for H1N1, you’ll probably leave with nothing more than good advice. There are some anti-viral medications on the market, but so far they’re only being used for flu victims that are so sick they need to be in the hospital. Those are the folks with chronic medical problems like asthma, emphysema, diabetes and others. If you have a chronic medical problem and you get sick with flu, you should definitely seek medical care, and you might get treated with antiviral medication. But if you are the typical UNM student, young and healthy, it’s better for you and the rest of the community if you stay home.

UNM is doing its part. We’re expecting an H1N1 vaccine, probably in October, and we’re planning for campus-wide vaccinations. In the next few weeks, watch for announcements about the regular seasonal flu shots, which will be free of charge this year. Meanwhile, you’ll see hand sanitizers around campus, along with signs reminding you to wash your hands. SHAC has provided flu kits to the dorms, with thermometers, surgical masks, hand sanitizer and Tylenol. If you get the flu and you live in the dorms, LaPo will bring you "flu meals." Professors have even agreed to lighten up on asking for doctor’s notes if you have the flu.

For more information, visit our website.

Sunday, September 13, 2009

Women Veterans in NM - some numbers

Yesterday I spent the day at a conference for women veterans, designed to provide information and resources for everyone from WWII WACs (and there were two of them there) to Viet Nam Vets to active duty OIF/OEF (Iraq/Afghanistan) personnel, and everyone in between. Not a veteran myself, but with a blossoming interest in a second career in veteran health, I went to learn. Here are some numbers I learned.

New Mexico has 200,000 veterans. Of these 16,000 are women. That's about 8%. Of all the veterans in NM, only about 40,000 have even applied for veterans services and benefits from the state. That means three out of five vets could be getting benefits they aren't getting. At the state level, these range from a free fishing license to scholarships and property tax breaks.

More women are currently in service. Of all American active duty, 15% are now women. The women vets I met and heard yesterday were all very proud of their service and deeply loyal to their country.

The presence of women in the military has brought to light a phenomenon termed MST, or Military Sexual Trauma. This is any kind of sexual harassment or assault experienced while in the military. The Veterans Administration now has a MST coordinator at every facility in the country. Every vet, male and female, who applies for services now gets asked if they experienced MST. They can answer "Yes," "No," or "I don't want to answer." In 2007, 25% of American women vets screened answered Yes.

Of course there was discussion of PTSD, and one speaker reviewed some of the alternate terms being considered for this. There's a move to get rid of the part that says "disorder" so as to reduce any perceived stigma. "Trauma Stress Injury" was my favorite of those mentioned.

There were more numbers, like Chapter 33, which is a GI bill specially for those who serve after 9/10/2001 in OIF/OEF. And 20%, which is how disabled you have to be to receive vocational rehab on the VA's penny. And 22, which is the number of days Shoshana Nyree, the first female American POW of the Iraq war, and our guest of honor, was held before the marines rescued her. (She has a book coming out soon titled Still Standing)

Numbers can be impressive. I know I was impressed with the number of services and benefits available to veterans. I believe they have earned it, and I hope it all helps. And I know that behind the numbers and the statistics are real live women and men, some damaged so badly that no matter what number of services they get they will never heal.

Monday, August 17, 2009

ROTC Physicals

I did three ROTC physicals today. ROTC stands for Reserve Officers' Training Corps. In return for financial assistance for their college expenses, students complete training sessions while in school, and fulfill a military commitment once they're out. They graduate as officers, bypassing the unlisted ranks.

My job was to make sure they didn't have any glaring physical problems or contagious diseases that would prevent them from doing the rigorous PT (Physical Training) program.

All three of these young people were vigorous, healthy and intelligent. Each had an upbeat attitude about their education and their future. They were polite and correct, answering my questions with "Yes Ma'am" and putting their best foot forward.

As I handed the finished paperwork to the last patient, he thanked me with a breezy smile. I looked at this young man, healthy and whole, and marveled that he and the others would voluntarily take this step. The first step on a path that could lead to unknown lands, to injuries of body and soul, even to death.

"Thank YOU for your future service," I responded. His face softened and this time his smile reached his eyes .

Friday, July 10, 2009

Forgiveness

Forgiveness is good for your health. Really. They've done studies on it. People who are 'forgivers' have lower blood pressure and pulse, fewer physiologic stress responses, and more positive emotions. They also sleep better, are more energetic, have fewer physical symptoms and use fewer medications.

Sounds like a no brainer. Let's all be forgivers. Too bad it isn't as easy as it sounds, eh?

What is forgiveness anyway? What does it mean to forgive someone? Say somebody hurts you in some way. They say, "I'm sorry." You say, "That's okay." Have you forgiven them? What if it really isn't "okay?" What if it will never be "okay" what they did? What are you going to do?

"I forgive you" sounds like it's more about what I do to you than what is going on in my own mind. It even has a slightly haughty, patronizing tone to it, as if I'm anointing you or something. But forgiveness isn't something you do TO someone. In reality, forgiveness has little to do with the other person.

If you forgive someone, that doesn't mean you condone what they did. It doesn't mean you excuse it, or even that you think it was "okay." It doesn't mean you will forget what happened, or even necessarily that you reconcile with them. Forgiveness happens in your own mind, and is a process of letting go of the anger and resentment you have. How do you do that? You make a decision that you will not allow those thoughts to dominate your well being or mess with your peace of mind. We control our own thoughts, after all. You can decide what you will or won't think about or dwell on. Our thoughts create our experience to a huge degree.

Thoughts can open the back door for unwelcome feelings to come in. If you hurt me, I can decide to stew about it. "How dare she? I can't believe what she did! That really hurt me. Ow! She's such a *&^%!" etc etc. If I start thinking like that, anger and resentment will soon be invading and before I know it I'm hogtied in my own kitchen. Who wants that? Not I.

You cannot count on someone who hurt you to apologize, to try to make amends, or even to recognize that they hurt you. If you hold your breath for any of that, well, you'll suffocate, that's what.

Let it go.

The Authors of "50 Ways" Interview on KCHF TV

50 Ways to Leave Your 40s TV interview with Phoenix' Pat McMahon