Saturday, May 28, 2011
Melissa's mom came into my office wondering if I could provide a different option for her daughter to get healthy. Mellisa has cerebral palsy, psychological imbalance that results in difficulty controlling anger and an intestinal absorption problem (called leaky gut syndrome in alternative and complementary circles). Mom is bringing her daughter (with electronic wheelchair, computer talker/voice, and handicap car) to Rush GI department, Rehab Institute of Chicago and mostly a visiting counselor for Behavioral Health. She has handpicked the best of the best. I liken this to the FBI, CIA, National Guard, TSA; all powerful individually but difficult to get in the same room. Melissa has been maintained on specific protocol medicines well established for each diagnosis. The problem I see is that as she ages, the dynamics of her role as a patient change. Interpersonal self esteem, mom daughterrelationship, handicapped/caregiver status all will change no matter how solid and stable the physical home and care situation is.
Think of the typical guy that comes into my office at 40 years of age; hasnt seen a doc for 20 years aside from coughs and colds, then says "fix me doc". High cholesterol, high blood pressure, overweight, erectile dysfunction.....suddenly the small tolerable problems that were previously stable, all become problematic. I quickly stabilize the problems with prescription meds, highly suggest lifestyle changes and dont hear back until a refill is needed. Few years go by and no lifestyle has been changed, same bad habits fall out of control as more weight is gained, more family dysfunction is accumulated and more bad habits are continued. I give more medicines, stabilize and make more suggestions on seeing specialists. Then the specialists use a host of medicines for severe disease with individual suggestions for lifestyle change and diet modification. [I firmly believe it takes less effort to take a powerful pill than to submit to saying, I will switch to mostly vegitarian food, exercise 3-5 times a week, meditate daily or find another job with less stress.] The problem is that coping skills and pills will make things better until the next crisis occurs (and this is bound to happen because human interaction and interpersonal relationships are dynamic and always changing.)
I will see people after several crisis have been dealt with, and controlled. With each intervention, a bigger more poweful medicine is used or another specialist is called in. When the episodes occur with more frequency or regular medicines dont help and only harm (or make the other problems flare up); then hospitalization is attempted and intense polypharmacy, poly-specialist control, poly-therapy is thrown into the mix to stabilize and discharge. I used to just blame this cresendo-like occurance to total-body-failure on aging but I really believe this is just over medicating and not allowing the body to heal. Of course there are disease states that do not have a way out, when the spirit is really challenged .....but.... there are more disease states that have a way out (better living) but those doors are not opened.
Back to Melissa's case, it was mom who, even with every well known specialist in Chicago, listened to her instincts and went outside the box and looked for help. (In Bruce Liptons Biology of Belief-every cell in your body has an energy to it and every cell can create a message, the idea that about having a "gut feeling" takes the power of decision making away from the brain and more into your cellular DNA) I looked at her mom and saw someone that that was reaching out for answers not being given by conventional medicine. Melissa was in the hospital with a decompensating gut that didnt work and caused pain (I had a fear that she wouldnt leave the hospital at that point). The only nutrition was with an IV bag. (called TPN) There was a tube that went from her stomach straight out to her abdominal wall for feeding but her gut was too inflammed to even put water in the g-tube. I listened to moms story and it sounded like all the specialists were circling the wagons for the last fight. I didnt think I could add much more. AAhh!!! Then I turned on the part of my brain Deepak and Herb Benson trained and I thought......lets try to create a relaxing environment for Melissa. Soothing music, aroma therapy, a relaxed mom with hope (suggested she take a short vacation). Then I thought about sending out an SOS to 2 gurus-Dr Dave Rakel a fellow grad from the AZCIM and Jennifer Hoschel my herbalist from Clermont FL. We put together a few suggestions that the specialist were ok with and some the specialist didnt approve for lack of US studies. (these were mostly nutritional implementations) I didnt hear from mom for a while then 2 months later....here is Melissa- out of the hospital, out of her house for the first time in a year, in my office with mom and her caregiver Mindy, smiling dressed up and with more weight than the initial videos mom played for me during our first meet (since back then Mel was too weak to get out of the house). She talked to me via her computer board and I had a great meeting with everyone. After we finished and I said my goodbyes, I stepped out of the room feeling great then suddenly ......this unusual feeling came over me.....as if I just watched an episode of Oprah-the tears started flowing- I had to duck into an empty exam room to protect my testosterone. There are more challenges ahead, (and my gut is telling exactly what we have to do next) but Melissa and her mom have captured my heart. To see the dedication and instinctual bond they share even in the face of great challenge, makes me thankful I am able to experience their energy. (check out the smiles in the pic, that is a true dedicated family!)
Saturday, May 7, 2011
Got back into my Deepak Chopra Audiobooks and I forgot the beauty of his wisdom. As I did my first hike for 2011 coming out of Chicago winter hibernation, I noticed during the portions of my hike that were on stone path, I was with some runners, the majority of which seem to have facial grimace. I do remember the feeling while running my marathons, I had to put myself into the "zone" to fight the urge to quit and turn in my electronic chip for a ride back to the finish line. So I tried to support these guys as I passed by but not much eye contact either. I mentioned my hike experience with Cristina and she said maybe they were just trying to push themselves for the health aspects of getting out. Then that got me thinking.....we probably train ourselves routinely with calling out the Hans Selye "stress response" but aside from getting our heart rate to tick at a lower rate than a non-exercising person, does a low heart rate and bp give us peace? I run into this in the office with big, muscular 20-30 year olds that come in for physicals and say "I'm healthy doc, I get enough exercise every day with the work I do", then I look at their blood pressure and find, pre-stroke levels. It's true they could lift more than I for 8 hours at a time but thats not the exercise that results in long living. Then there is the athlete type that comes in and although playing league basket ball or pushing weights and body building, cholesterol is high and liver a little fatty from alcohol use. I remember seeing a group of college guys hanging around the power rack at the gym taking turns in round robin full squats (not recommended for people who like to avoid cortisone shots in the knees) and one of the guys had a bite plate/mouth guard he was gnashing his teeth on when his turn to push the weight.
I only bring up the scenarios of anger associated exercise bursts to call for regular practice of calm and peace as well. I always go back to my first experience of relaxation and yoga with a patient of mine in his 40's with hypertension. I was giving him 2 daily medicines and leaving it at that as long as he was ok with taking the pills. One year he came in and stated he was going to try a new yoga place for exercise. (Back in the mid 90's, not too many yoga studios to choose from) I was skeptical but when I saw him the next season, his blood pressure was lower. Ok, I weaned him off the pills and the next time I saw him, he actually gained weight, not to the point of obese but little handles here and there, and his BP was still low!!! So to summarize, I controlled his BP with 2 different blood pressure pills, he started yoga, got pressure controlled and got heavier with continued control all with yoga and nothing more. No supplements, no surgical procedure, no job change....lin fact he was still running his business 40-50 hours a week. I started watching this "yoga cult" and their ideas of moving meditation and cultivating the "relaxation response".
Western medicine always pushes aerobic activity, cardio, exercise to bring the heart rate to 80% of your age maximum; all in efforts to postpone the onset of diseases of stress. (heart attack, stroke, diabesity) Its all scientific, proven with randomized control trials and pushed as an adjunct to eating healthy and controlling symptoms with prescription meds. But then cultivating the relaxation response, sitting in stillness and quiet, mindful living and spending time in nature; I feel is just as powerful, more rewarding and cost saving. For cultural reasons, the practice of spiritual grounding is looked at like the profession of psychiatry, its there and works but not embraced like the others profesions in healthcare. I thought is was just the baby boomer generation that thought of psychiatric illness as "nuts", but when a young guy came in for a school bus driver physical, the entire office sensed the very "bipolar-like" personality and demeanor so I told him respectfully that I cant approve his department of transportation card until fully evaluated by his primary care doctor for some underlying psychological tendancies I see coming out in the interview. The 30 year old said "so you think I'm crazy?" and started going into uncontrolled manic bursts (reinforcing my diagnosis of bipolar disorder).
I think most people are missing the boat with very beneficial techniques that work to allow the body to think better, heal faster and perform at maximum even without expensive gyms, equipment, or foods. I wouldnt substitute yoga and meditation for the whole exercise healthy living kick, but I would inter-twine the practice of cultivating Herb Bensons "Relaxation Response" amongst all the grunting, grimacing, panting, shouting, power movements everyone seems to try and turn a new leaf with.
Sunday, May 1, 2011
Most people have heard about the food that you crave is probably the food your body finds most harmful. (ie....people with hypertension crave salt, diabetics crave sugar) Not to say this is set in stone, but most comfort foods are the ones that have "turned on us". How dare a food become bad for my body! Lets talk about "the how". Food when it is broken down by the gut goes through some fancy chemical reactions and then introduction into the blood stream is made. Once in the blood stream, the different food types (protein, carb, fat) can induce a hormone wave to be released. The blood stream has delicate sensors that essentially tell the brain/body life is good so rejoice, relax and procreate or life is bad, fight, flee or scavenge. The take home point is that the body/mind can be coersed into creating an altered environment "inside" just by manipulation of hormones.
At a conference we presented saturday on Depression, it was cool to see some dynamics of communications with strangers. Most people have been taught to not open up too much to new aquaintances as part of a ritual in society of "getting to know others". Others will have some idiosyncratic habits of jumping into a conversation with very intense and saddening or argumentative personal revelation. And this would be in a first meeting! Most people would usually start to move away from the conversation, some will stay and engage. Aaahhaaaa! When the boistrous or codependant person gets an audience, the emotional stories begin... (both extrememly saddening or annoyingly involving-like the joke teller who laughs so loud one would be expected to also join in on the laugh for fear that you "don't get it")
Some people feel so comfortable in their diagnosis of depression or bipolar disorder that life seems stable when in tears or in argument with others. There will seem to be comfort in going back an environment that may be bad for health and socializing but it is what they are used to. There will be a talent of creating a tornado of emotion around the individual that you either get pushed away or get sucked into the conversation. The feeling or emotion thats evoked in a listener or innocent bystander to the tornado is called counter-transference. Those folks that can change the emotional feeling of a conversation to "depressing" or "defensive engaging arguments".....are creating a local climate change all around them- the saddened person will have everyon weeping with them or the argumentative person will always through out a new debate to keep one constantly defending another point. Either way, they feel comfortable having that type of "feel" within their mind/body and it is more empowering when others around them are involved with the feeling. It may not be your way of thinking/being but if allowed to engage, the force will be strong not to get involved emotionally. If not well grounded, the chance meeting with someone like this can subconsciously impact your actions the rest of the day.
Although my religious upbringing tells me I have to reach out to these folks, my actions has a healer are to help others first; engaging a tornado of emotion will hinder my ability to do this, so I confidently will respond with a simple answer and move on without guilt. If anything, I would reach out to the person supporting this tornado epicenter because they are exposed to this type of engagement every day.
......“If someone comes to give you a gift and you do not receive it,” the master replied, “to whom does the gift belong?”