Saturday, October 31, 2015

Those You Help May Reject You and How to Avoid It

I recently asked a colleague and friend about a person whom she had provided considerable help to. Her response was interesting. Besides recounting what she had done for this person, which was considerable and well beyond the call of duty, she noted, She went home and a couple of months later she told me online that she didn't have time for me now that she had friends where she lives who accepted her "as is." That was the last time I had any contact with her. I felt like I had gotten kicked in the gut and then slapped across the face.

In my response, I commented, when you provide support and help to people who are in extremely vulnerable situations they will often reject you over time simply because they don't want to be reminded of their one time dependence on you. I could have also added that “over helping” can make people uncomfortable. Shame goes hand in hand in many of these situations and if they are embarrassed about how they behaved, they may keep their distance.

Shortly after this e-mail exchange, I listened to the On Being Podcast of Adam Grant Successful Givers, Toxic Takes, and the Life We Spend at Work.  Couldn’t have been more timely. While his focus is on giving/helping in the workplace, the same rules apply in other areas of one’s life, particularly as it pertains to our kids and when we’re in the role of caregiver. These are two instances where we are more likely to over help and not for the betterment of ourselves or them. 

I’ve watched parents literally make themselves sick trying to provide for adult children. Sadly I know more than one caregiver who became ill and died before their charge did. If anything, the following recommendations are most important for those in these situations, because it’s easy to go overboard, forget boundaries and absolutely expect something in return.

In order to be helpful, and avoid being rejected and/or burned out, consider the following:
• Help without the expectation of return or benefit.

• Be productive in your helping by setting appropriate boundaries, prioritizing who you will help (e.g. family, then job, friends, community, etc.) and in what manner. You can’t be all things to all people. The thinner you spread yourself, the less helpful you become. By the same token, by focusing in areas where you have knowledge and expertise, people are more likely to call on you for that type of help.

Understand your own cues when you’re bordering on giving too much or becoming burned out. Such signs may include:
-       You start resenting the person
-       You find your self saying things like “haven’t I done enough?”
-       Caring seems like a waste of energy.
-       You feel like nothing you do makes a difference or is appreciated.

• Empathy is a wonderful characteristic but if you continually allow yourself to shift priorities because of other’s needs you may end up short changing yourself. Selfless is not something you can sustain for very long and remain productive and healthy. Keep in mind the flight attendant’s message regarding the need for oxygen-“place the mask on your face first before helping children and others around you.” In short, you are most helpful when your needs are taken care of and you help from a position of strength.

• Solicit others to help. This is particularly important for caregivers and in situations where the need is great.

They type of help you provide can change relationships. Making a loan to a friend in financial difficulties alters the dynamic of the relationship and not one that can be easily reversed. Think carefully before doing this.

Helping doesn’t have to be a grand gesture. Adam Grant has coined the phrase of the Five Minute Favor-something you can do because it’s very helpful and it doesn’t take more than five minutes of your time. It can be as simple as sending a check for membership to a condition specific organization or writing a “hope you feel better” card or e-mail.

My favorite quote on the idea of being helpful comes from the film critic Roger Ebert, who wrote the following towards the end of his life. “Kindness” covers all of my political beliefs. No need to spell them out. I believe that if, at the end, according to our abilities, we have done something to make others a little happier, and something to make ourselves a little happier, that is about the best we can do. To make others less happy is a crime. To make ourselves unhappy is where all crime starts. We must try to contribute joy to the world. That is true no matter what our problems, our health, our circumstances. We must try. I didn’t always know this and am happy I lived long enough to find it out.

Resources that might be of interest
 Adam Grant’s Website: Be sure to check out his newsletter and Facebook page 

Wednesday, October 28, 2015

Take a Break: Halloween/Samhain: Take time for Reflection/Meditation

In Ireland and other Celtic cultures, “samhain” [Sah-win] is celebrated on Oct. 31. Half way between the fall equinox and the winter solstice, this is the time of year that many believe the veil between this life and the next is very thin. While it’s a time for tricks, treats and laughter, it’s also a time for silence and contemplation. With “summer’s end” it’s a harvest thanksgiving, bonfires, maple leaves and pumpkins, as well as a time to remember those who have gone before.

Take a break from making last minute Halloween costumes, decorations and special treats for a short meditation, reflection, nature walk, or bonfire (woodstove and fireplace are fine). Below are some places to start:

Saturday, October 24, 2015

They Ask for Help, You Try, But Nothing is Right

Ever been in a situation where someone asks for your help, yet everything you suggest, offer or do is rejected for one reason or another? Further, because of the request, you realize they’re in trouble and you’ve been turning yourself inside out trying to help.

Recognize that the single biggest reason for not viewing possibilities and/or accepting help and suggestions is fear-fear of judgment, rejection, failure, success and ultimately change. So unless you are their therapist-and you can certainly make the suggestion that they consult one-consider the following when you realize your hitting your head against the wall:

• Stop and detach emotionally from the situation. Don’t take the continual “no’s” personally and recognize that your self worth isn’t based on resolving their problem. You aren’t a bad person, friend, less compassionate or less loving because your help is discounted, ignored or rejected. 

• Let them be who they are, trying not to judge or change them. These can be very stressful situations, and you can take on a burden “to help” that’s not yours, let alone appropriate. Remain mindful and foster contentment within yourself. Don’t fall down “their rabbit hole.”

• Be clear about who you are. If you are a “change agent” type of person, and the individual you’re dealing with wants to talk about their problems, with no real intent to change, that’s not a good mix.

• Depending on your relationship with the person, as well as the nature of the problem(s), you may find a very direct approach is appropriate, where you kindly let them know that you’re out of suggestions, aren’t willing to take on their problem etc. Reframing and recapping their concerns (why they asked for your help), along with proposed solutions and the reasons for rejecting them, may help them see an underlying problem, which they can correct. For example, “It’s clear you are wearing yourself out taking care of your Mom. We’ve discussed a number of possibilities including talking to mom’s medical provider, case manager, and your sister about respite care but you rejected that and other ideas because you believe your mother doesn’t want anyone in the house but you.”

• While most people muddle through somehow, if you really think they are a danger to self or others, report it to the proper authorities-adult protective services and/or police.

Bonus:  Healing the Whole Person: Ways to Increase Well Being has been updated for 2015. 

Wednesday, October 21, 2015

Take a Break: Halloween: Seasonal Treats-Yummy and the Eerie

First the Sweet Treats
• Witches Hats: Take a fudge stripe cookie. Adhere a Hershey’s Kiss with orange frosting to the chocolate side. If you want to make sure the hat peak and rim match, melt some Kisses and ice the cookie of your choice with the melted chocolate, quickly topping with the Kiss so that it will stick. Decorate with orange icing.

Make your own candy corn. Haven’t tried it, but it does look interesting. 

• Candy corn cookies: With refrigerated sugar dough-unless you want to make your own cookie dough-add orange food coloring. Cut out triangles and bake. Allow to cool and dip the bottoms into melted dark chocolate and the tips into melted white chocolate.
• Dark Candy Apples: Select twigs from your yard and wipe clean, insert into a deep red apple. Now dunk in melted chocolate.

Red Velvet Brain Cake: This is really clever and looks like it would be easy to do. 

 Caramel Pop Corn: Like the sound of this recipe since it doesn’t use corn syrup and you bake it in the oven thereby eliminating the need for a candy thermometer. This recipe calls for air pop corn. You can easily do this in the microwave. Place the popcorn kernels in the bag: Depending on how much popcorn you need, you can use 1/4 to 1/2 cup kernels. Fold the bag: Fold the top of the bag down three times, making sure to leave plenty of room inside the bag for the popped kernels. Microwave the bag: Microwave the bag on HIGH for 4 minutes. No brown bag around? Make it in a bowl using a 21/2 cup microwave-safe bowl. Add ¼ cup popcorn to the bowl and cover with a microwave-safe plate that completely covers the bowl. Microwave on high until the popping slows down to about 4 seconds between each pop, 4 minutes and 45 seconds. Remove just the plate using a potholder or thick dish towel, being careful to avoid direct contact with the hot steam from the bowl. Then remove the bowl.
 Now for the eerie treats:
The Raven by Edgar Allan Poe, read by Christopher Waken 

• The Criminal: Stories of people who’ve done wrong, been wronged or gotten caught somewhere in the middle. The artwork alone sends shivers up my spine. Just went to a conference where the co-founder of this site Phoebe Judge spoke. She was amazing and not at all creepy though. 

• 23 Two Sentence Horror Stories: As the tag line says, “That will scare the hell out of you.” Read the first one and yeah, they’re right. 

Saturday, October 17, 2015

Journal Watch October 2015

Multicenter study examines safety of medical cannabis in treatment of chronic pain: A Canadian research team has completed a national multicenter study looking at the safety of medical cannabis use among patients suffering from chronic pain. They found that patients with chronic pain who used cannabis daily for one year, when carefully monitored, did not have an increase in serious adverse events compared to pain patients who did not use cannabis. The Journal of Pain 

 Pain is in the brain: Chronic pain results from disease or trauma to the nervous system. Damaged nerve fibres with heightened responses to normal stimuli send incorrect messages to pain centres in the brain. This phenomenon, called "peripheral and central sensitization" is one of the key mechanisms involved in the condition which touches people with diabetes, cancer, and those suffering from multiple sclerosis, among others. Journal of Neuroscience 

• Spinal Cord Implant for Chronic Pain: Doctors in Australia have carried out a pioneering procedure to treat chronic pain, fitting a permanent spinal cord implant which can record signals from the nervous system and adjust the strength of impulses sent to affected areas. Joe Grewal, the first human to be fitted with a permanent implant, said he has suffered chronic back pain for more than 30 years and now “feels amazing”. The Telegraph 

• Early PT Not a Cure All for Low Back Pain: More than 200 people with recent-onset low back pain were randomly assigned to physical therapy or no treatment for the first month after their pain began. Physical therapy included back manipulation and exercise. Early physical therapy produced a modest improvement in the study participants' ability to function after three months, compared with no physical therapy. However, after a year, no significant difference in function was found between the two groups. JAMA 

• Tai Chi Might Help People with Long-Term Health Conditions: The slow, fluid movements of tai chi -- an ancient Chinese exercise -- appear to help older adults with chronic conditions improve their physical function, a new review suggests. Specifically, those with breast cancer, heart failure, osteoarthritis or chronic obstructive pulmonary disease (COPD, which includes emphysema) saw improvements in strength, balance and posture without worsening pain or being out of breath, researchers said. British Journal of Sports Medicine 

• Marijuana Extract Ill Suited for Preventing Nausea After Surgery: The active chemical in marijuana, tetrahydrocannabinol (THC), doesn't prevent nausea or vomiting in patients emerging from surgery, new research indicates. Anesthesia & Analgesia 

• Warns of Risk for Dosing Errors with Intravenous Ceftazidime/Avibactam
• Will improve process used by food processors to submit information to FDA on Acidified an low acid canned food.
• Aristada approved for schizophrenia
• Expanded approval for the Optune device to include newly diagnosed aggressive brain cancer.
• Approved Keytruda for lung cancer treatment

• Flu Vaccine May Also Protect Against Pneumonia: Getting a flu shot may protect you not only from flu, but also from pneumonia, the leading cause of flu-related hospitalizations and deaths, a new study suggests. Most children and adults hospitalized for flu-related pneumonia haven't had a flu shot, the researchers said. JAMA 

 Move More to Prevent Heart Failure: When it comes to preventing heart failure, the more exercise, the better. How much more? A new study suggests maybe as much as two to four times the U.S. minimum recommended levels of 150 minutes of moderate physical activity a week. A meta analysis, which included more than 370,000 people found that who did two to four times more exercise than the U.S. minimum activity recommendations lowered their risk of heart failure by 20 percent and 35 percent, respectively. Circulation 

• Low Nicotine Cigarettes May Help Smokers Quit: Smokers are more likely to cut back or quit if they switch to cigarettes made from tobacco containing very low levels of nicotine, new research shows. The best results came with cigarettes containing 0.4 milligrams of nicotine per gram of tobacco. NEJM 

• Bike Helmets Protect Against Severe Brain Injury: A study of 6,200 people who suffered a traumatic brain injury in a cycling crash, just over one-quarter were wearing helmets. Compared to those without a helmet, patients with a helmet were 58 percent less likely to have severe brain injury. They were also 59 percent less likely to die, 61 percent less likely to require surgery to remove part of the skull to expose the brain, and 26 percent less likely to have facial fractures, the study found. American College of Surgeon

• Even a Short Stroll is helpful: If you have to sit almost all day while you work, take a short walk whenever you can. Researchers report that even a 10-minute stroll can restore blood flow to legs affected by prolonged sitting. Experimental Physiology 

 Sitting for long periods not bad for health: New research has challenged claims that sitting for long periods increases the risk of an early death even if you are otherwise physically active. The study followed more than 5000 participants for 16 years (making it one of the longest follow-up studies in this area of research) and found that sitting, either at home or at work, is not associated with an increased 

• For a better calorie Burn, Adjust Your Speed While Walking: The new research, from Ohio State University, found that changing your pace could burn up to 20 percent more calories than maintaining a steady stride. Biology Letters 

 Vaccines Rarely Cause Life Threatening Allergic Reactions: Just 33 people had a serious, potentially life-threatening allergic reaction -- also known as anaphylaxis -- out of 25 million vaccines given, according to research from the U.S. Centers for Disease Control and Prevention. That's 1.3 people in every million who gets a vaccine. Journal of Allergy and Clinical Immunology 

• Anti-Smoking Drug Chantix More Help for Women than Men: The study, from Yale School of Medicine, found that Chantix (varenicline) helped women more than men for the first year of treatment. After a year, however, the anti-smoking medication worked equally well for both men and women. Nicotine and Tobacco Research 

• Higher Protein Diet May Help Some with Type 2 Diabetes: People with type 2 diabetes may benefit from a higher-protein diet, but it likely depends on whether or not they have a particular gene related to vitamin D metabolism, new research suggests. Diabetologia 

Metabolic Syndrome Leads one in three Americans to need more Vitamin E: New research shows that the estimated one-third of Americans who have a cluster of health problems that add up to metabolic syndrome don't absorb dietary vitamin E as effectively as healthy people. The same study also had good news for the whole population: Cow's milk with or without fat promotes absorption of the natural form of vitamin E found in foods. Science Daily 

• Vitamin D3 Supplementation Helps Women Build Muscle Even After Menopause: The benefits of vitamin D supplementation for postmenopausal women have been widely debated. But a new study now documents that vitamin D supplementation can significantly increase muscle strength and reduce the loss of body muscle mass in women as late as 12+ years after menopause. The North American Menopause Society 

• High Dietary Fiber Intake Linked to Health Promoting Short Chain Fatty Acids: Eating a lot of fiber-rich foods, such as fruit, vegetables, and legumes--typical of a Mediterranean diet--is linked to a rise in health promoting short chain fatty acids, And you don't have to be a vegetarian or a vegan to reap the benefits, the research findings suggest. Gut 

• Unsaturated fats, high-quality carbs lowers risk of heart disease: While eliminating saturated fats can improve heart health, a new study shows that it makes a difference which foods are used in their place. A study shows that replacing saturated fats with unsaturated fats and high-quality carbohydrates has the most impact on reducing the risk of heart disease. When saturated fats were replaced with highly processed foods, there was no benefit. Journal of the American College of Cardiology 

• Carrots Do Help Aging Eyes: Leafy greens, brightly colored veggies such as orange peppers also may stave off macular degeneration.  JAMA Ophthalmology 

• Vitamin D, Calcium May Not Prevent Colon Cancer After all: Neither calcium nor vitamin D, taken alone or together after precancerous colon polyps were removed, significantly reduced the risk of new polyps developing, researchers report. NEJM 

 Daily Glass of Wine May Boost Type 2 Diabetics’ Heart Health: Relaxing with a glass of wine at the end of the day may help improve heart health and blood sugar levels for people with type 2 diabetes, new research suggests. Red wine was better at improving cholesterol, while both red and white wine helped blood sugar control in those who metabolize alcohol slowly. Annals of Internal Medicine 

  Daily Sotagliflozin Improves Glycaemic Control in Patients with Type 1 Diabetes: Daily oral sotagliflozin improves glycaemic control in intensively treated patients with type 1 diabetes, compared with placebo, according to a study presented here on September 17 at the 51st Annual Meeting of the European Association for the Study of Diabetes (EASD).

• Taking Blood Pressure Medication at Bedtime Lowers Diabetes Risk: Two articles published in Diabetologia show that taking blood pressure medications at bedtime, rather than in the morning, reduces blood pressure (BP) whilst asleep and also reduced the risk of developing type 2 diabetes by half. 

• Finafloxacin More Effective Than Ciprofloxacin for Complicated UTIs: Results from a double-blind phase 2 study showed that finafloxacin was a more effective and safe option than ciprofloxacin for the treatment of complicated urinary tract infections (UTIs) and acute pyelonephritis. 2015 Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) 

CPAP Therapy Reduces Symptoms of Depression in Adults With Sleep Apnoea: Depressive symptoms are extremely common in people who have obstructive sleep apnoea (OSA), and these symptoms improve significantly when OSA is treated with continuous positive airway pressure therapy (CPAP). Journal of Clinical Sleep Medicine 

 Combination Drug Reduces Agitation for Patients With Probable Alzheimer Disease: In a preliminary 10-week randomised trial, patients with probable Alzheimer disease who received the combination medication dextromethorphan-quinidine demonstrated less occurrences and severity of agitation, compared with patients who received placebo. JAMA 

• Endocrine Society Publishes New Guideline on Menopause Treatment: The Endocrine Society issued a Clinical Practice Guideline (CPG) on identifying women who are candidates for treatment of menopausal symptoms and selecting the best treatment options for each individual. The CPG was published online and will appear in the November 2015 print issue of the Journal of Clinical Endocrinology and Metabolism(JCEM). Experts have formed a consensus that the benefits of menopausal hormone therapy exceed the risks for most healthy women seeking relief of menopausal symptoms. 

• Some Blood Pressure Drugs May be Risky for Certain Surgery Patients: Some people on blood pressure drugs called beta blockers may face heightened risks of heart complications during non-cardiac surgeries, a new, large study suggests. JAMA Internal Medicine 

Higher Volume Rehab Centers Better of Hip Fx Recovery: Seniors who break a hip receive the best care in skilled nursing facilities with the most experience handling such fractures (25 cases or more a year), a new study suggests. Journal of the American Geriatrics Society 

• Tennis Elbow usually heals without therapy: Most people with tennis elbow recover without physical therapy and steroid injections, according to a study by researchers in Norway. BMC Musculoskeletal Disorders 

Placebo Effect Might Help Predict Response to Depression Treatment: - People with depression who show improvement when taking fake drugs get the greatest benefit from real medications, a new study finds. JAMA Psychiatry 

No Proof that 85% of depression treatment apps accredited by NHS Actually work: But the seal of approval from one of the world's leading healthcare systems may falsely reassure patients, many of whom are increasingly opting to fund their own treatment in the face of overstretched mental health services and the associated lengthy waits, they warn. Evidence Based Mental Health 

• Young Cancer Survivors Often Develop New Malignancies: Teen and young adult cancer survivors are at increased risk for other cancers later in life, a new study reveals. Researchers analyzed U.S. National Cancer Institute data on people who survived cancers before age 40. They had the most common types of cancers in that age group: leukemia, lymphoma, testicular, ovarian, thyroid, breast, soft tissue and bone cancers. Those who received radiation treatment appear at higher risk. Cancer 

• Drugged Driving on Rise in US: In the report, 38 percent of drivers killed in accidents who were then tested had drugs in their systems, while about 42 percent of those tested for alcohol had positive results. And the number of drunk driving deaths has been sliced in half since 1980, government statistics shows. Over one-third of the drugs identified in the tests were marijuana in some form, followed by amphetamines, at almost 10 percent, the researchers found.

• New Antibiotic-Resistant ‘Superbug’ an Emerging Threat: A relatively new antibiotic-resistant bacteria called CRE is making inroads in some major American cities, U.S. health officials report. Surveillance of seven U.S. metropolitan areas found higher-than-expected levels of CRE in Atlanta, Baltimore and New York City, according to the U.S. Centers for Disease Control and Prevention. 

• Depression Adds to Burden of Alzheimer’s Caregivers: Depression increases the mental strain on people caring for loved ones recently diagnosed with Alzheimer's disease, a new study finds. The highest levels of mental stress occurred in caregivers who had depression when their loved one was diagnosed with Alzheimer's. Journal of Geriatric Psychiatry and Neurology 

• Americans Spend More on Health Care, But Fare Worse: When compared to 12 other industrialized nations, Americans shelled out the most cash on health care services, but they fared worst in terms of life expectancy, according to the Commonwealth Fund findings. By some measures, the United States did fare relatively well. For example, the nation's cancer death rate was near the bottom of a list that includes Australia, Canada, Denmark, France, Germany, Japan, the Netherlands, New Zealand, Norway, Sweden, Switzerland and the United Kingdom. 

• Tribal Study Finds Shot Sleep Not Just Curse of Modern Living: Researchers tracked the sleep habits of three traditional hunter-gatherer groups in Bolivia, Namibia and Tanzania, and found their sleep timing and duration to be similar to those of more "modern" people-just under 6.5 hours of sleep per night.  The finding "has important implications for the idea that we need to take sleeping pills because sleep has been reduced from its 'natural level' by the widespread use of electricity, TV, the Internet and so on." Current Biology