Saturday, June 24, 2017

Life with Chronic Conditions: Care for your brain


June is Alzheimer’s & Brain Awareness Month, so it seemed fitting that I’d learn about a good friend with early onset dementia from Alzheimer’s Disease (AD). Consequently, there has been a lot of conversation about “cognitive” and “brain training”- you “work out” the brain the same way you strength train muscles in order to retain memory and avoid dementia. But is it the same? Are there specific things that you can do that will help different parts of the brain? What if you already have signs of dementia?

A study of 10 patients with early stage AD has shown that the disease can be reversed. Reversal of cognitive decline in Alzheimer's disease.  Lead by Dr. Dale Bredesen Professor at the Buck Institute for Aging, each person received a tailored made 36-point therapeutic program. This included combining comprehensive diet changes, brain stimulation, exercise, sleep optimization, specific drugs and vitamins, and other steps affecting brain chemistry. The Bredesen Protocol is now available at the APOE website.

All subjects showed memory improvement within the first few months and increasingly so over a two year period. All were able to return to their jobs or continue working with improved performance.  The program works for patients in the early stages of the disease. Bredesen’s own daily protocol includes:
• eating a Mediterranean diet high in vegetables and good fats
• regular cardio exercise
• fasting at least 12 hours after dinner
• brain training exercises
• getting at least 8 hours of sleep
• a regimen of supplements to address each patient's deficiencies.

After 30 years of research Bredesen believes that the treatment of AD isn’t just in doing one thing but rather addressing a number of factors all at once.

In the Blue Zones, those parts of the world where people live the longest, dementia is almost unknown. The Blue Zones project offers 5 Scientifically Proven Tips that Prevent Dementia :
• Walk Daily Walking about 5 miles per week increases brain volume, and correlates well with prevention of AD and other forms of dementia. Additionally, a sedentary lifestyle can more than double the risk of developing AD.

• Combat Depression A growing body of evidence supports the preventive effect of a positive attitude and purpose in life on mental decline. Strategies to help you in this endeavor include volunteering, appealing to a higher power (i.e. practicing a religion), meditating and using deep breathing techniques.

• Cut the smoking habit: Smoking actually doubles the risk for contracting AD. Luckily for current smokers, quitting seems to reduce these effects to that of a non-smoker.

• Learn New Hobbies: Knitting, playing board games or learning other crafts during mid-life can reduce memory loss by 40%-50%. Playing a musical instrument also helps protect cognitive function.

• Get Social: Socially active people have up to a 50% reduced risk of developing dementia.

The Alzheimer’s Association offers 10 Ways to Maintain Your Brain.  When we think about staying fit,  we generally think from the neck down. But brain health plays a critical role in  almost everything we do – thinking,  feeling, remembering, working,  playing – even sleeping. The good news is we now know there are things we  can do to keep our brain healthier as we age – and these steps might reduce  our risk of Alzheimer’s

1. Head first: Good health starts with your brain. It’s one of the most vital
body organs, and it needs care and maintenance.

2. Take brain health to heart: What’s good for the heart is good for the brain. Do  something every day to prevent heart disease, high blood pressure, diabetes and stroke – all of which can increase  your risk of Alzheimer’s.

3. Your numbers count: Keep your body weight, blood pressure, cholesterol and blood  sugar levels within recommended ranges.

4. Feed your brain: Eat less fat and more antioxidant-rich foods.

5. Work your body: Physical exercise keeps the blood flowing and may encourage  new brain cells. Do what you can – like walking 30 minutes a day – to keep both body and mind active.

6. Jog your mind: Keeping your brain active and engaged increases its vitality and builds reserves of brain cells and connections. Read, write, play games, learn new things, do crossword puzzles.

7. Connect with others: Leisure activities that combine physical, mental and social elements may be most likely to prevent dementia. Be social, converse, volunteer, join a club or take a class.

8. Heads up! Protect your brain: Take precautions against head injuries. Use your car seat belts;  unclutter your house to avoid falls; and wear a helmet when  cycling or in-line skating.

9. Use your head: Avoid unhealthy habits. Don’t smoke, drink excessive alcohol  or use street drugs.

10. Think ahead - start today! You can do something today to protect your tomorrow.

“Brain fog” is a common complaint among those with chronic conditions, but similar to preventing dementia, diet, sufficient sleep, exercise and even supplements can significantly help.

In looking at the various recommendations for preventing/reversing AD or dementia, as well as eliminating brain fog, the Power 9  of the Blue Zones is a good way to maintain health and protect the brain. It’s also easy to remember and isn’t “numbers” focused the way so much of American healthcare has become.  These factors include: incorporating movement throughout your day; having a sense of purpose; de stress; modify diet where you eat until 80% full, plant slant (mostly fruits, beans, veggies with the occasional small portion of meat, and moderate alcohol (1-2 glasses of wine with friends and/or with food); belonging to- faith based community, family (put family first) and social circles that support healthy behaviors.  

It is also important to protect your brain by avoiding drugs, smoking and excessive alcohol. Some studies are now showing that older people should avoid alcohol all together. Wearing a helmet and seat belts for sport and while driving, as well as de cluttering your home and office to avoid falls, can make a big difference in preventing a brain injury. Research continues to show a strong correlation with brain injury, which includes concussion, to AD, dementia and Parkinson’s Disease











Wednesday, June 21, 2017

Take a Break: Cool off with a Granita


Temps are miserable all over the country, so making a granita is easy, healthy and incredibly cooling. The first one I ever had in Rome and I’ve been hooked ever since. If you’ve never heard of a granita, it is an ice usually made from fruit. During cider season, I heat up some cider with some apple pie spices, pour into a glass Pyrex pan and put in the freezer. Every couple of hours I run a fork through it to make lovely big ice crystals. When it’s done, pile into a cup and serve. It’s like having apple pie without any of the guilt. To get started go to 
How to Make Granita Without a Recipe from Epicurious: This recipe does call for some “simple syrup” but in VT we just put in some maple syrup, and for apple cider and watermelon, you don't really need to add anything.

 Not interested in today’s activity, go to the Take a Break Pinterest and pick out something else.

Saturday, June 17, 2017

Journal Watch June 2017


CHRONIC PAIN
• Half of adults with anxiety or depression report chronic pain: In a survey of adults with anxiety or a mood disorder like depression or bipolar disorder, about half reported experiencing chronic pain. Journal of Affective Disorders 

Chronic Pain Opioid Guidelines Updated for State Medical Boards: The Federation of State Medical Boards (FSMB) has updated its guidelines on the use of opioids in the treatment of chronic pain, with new policies underscoring the need for physicians to be proactive in helping to turn the tide of the nation's opioid epidemic. Medscape

• Acceptance and Commitment Therapy reduces depression, anxiety among chronic pain patients: The results of a study presented at the Annual European Congress of Rheumatology (EULAR) 2017 has shown that Acceptance and Commitment Therapy, a form of cognitive behavioral therapy (CBT) that focuses on psychological flexibility and behavior change, provided a significant reduction in self-reported depression and anxiety among patients participating in a pain rehabilitation program. This treatment also resulted in significant increases in self-efficacy, activity engagement and pain acceptance.

 

Womenwho focus negatively, magnify chronic pain, more likely to be taking prescribed opioids: Female chronic pain sufferers who catastrophize, a psychological condition in which pain is exaggerated or irrationally focused on, not only report greater pain intensity, but are more likely to be taking prescribed opioids than men with the same condition. Anesthesiology

 

Does Chronic Pain Cause Cognitive Decline? A study appearing in JAMA Internal Medicine links persistent pain with progressive cognitive decline and dementia. But the mechanism is quite unclear. There are actually a few possibilities.

Can Virtual Reality Sessions Treat Chronic Pain?Stanford Doctor Yes Dr. Kim Bullock, a neuropsychiatrist at Stanford University, says she made the remarkable discovery by accident. While studying virtual reality for conditions like severe anxiety, a welcome side benefit of that treatment: patients’ chronic pain disappeared. NBC 

 

• Cool’ New Knee Procedure Eases Arthritis Pain Without Surgery :A new, non-invasive knee procedure could bring some relief for patients suffering from debilitating chronic pain, for whom surgery is not an option. The treatment, recently approved by the Food and Drug Administration, is called “cooled radio frequency ablation” and is a less drastic option for people with moderate to severe osteoarthritis pain who are not ready to have knee replacement surgery, or who have health conditions that don’t make them a good candidate for surgery. NBC 


 COMPLEMENTARY & ALTERNATIVE MEDICINE
 Study Documents Range of Challenging Meditation Experiences: Though it has gained popularity in the West as medically and psychologically beneficial, meditation can produce a much wider variety of outcomes, not all of them calm and relaxing, according to a new study that analyzes meditation-related challenges. Plos One

Marijuana Increases Periodontal Disease: Of 2,000 Americans studied, 27 percent reported the use of cannabis (marijuana, hashish or hash oil) one or more times for at least 12 months. Frequent recreational cannabis users were more likely to have signs of moderate to severe gum disease than less-frequent users, the researchers found. ournal of Periodontology

Copaiba: Silver bullet or snake oil?: Sales of the essential oil copaiba [koh-pey-buh] are increasing, at least in part, because more than 54 million Americans suffer from arthritis. The traditional way to treat arthritis is using NSAIDs and COXIBs, which are not without adverse events. For arthritis sufferers, copaiba may turn out to be a silver bullet or, perhaps, snake oil. Integrative Medicine


• Tai chi significantly reduces depression symptoms in Chinese-Americans: A new study finds that a 12-week program of instruction and practice of the Chinese martial art tai chi led to significantly reduced symptoms of depression in Chinese-Americans not receiving any other treatments. The Journal of Clinical Psychiatry

 FDA ACTION
• Asks Maker of Opioid Painkiller Opana ER to Pull Drug From Market
• Fast tracks Tanezumab for Treatment of Osteoarthritis and Chronic Low Back Pain

PREVENTION
• Loneliness May Lead to Sleepless Nights: More than 2,200 18- and 19-year-olds in England and Wales provided information about their loneliness levels and sleeping patterns. Between 25 percent and 30 percent of the participants said they felt lonely sometimes, and another 5 percent said they frequently felt lonely. Lonelier people were 24 percent more likely to feel tired and have difficulty concentrating during the day. Psychological Medicine 

Specific long-term therapy may not prevent fractures in older women: Data from the Women’s Health Initiative Study found that women who took bisphosphonates for 10-13 years had higher fracture rates, compared with women who took the medication for 2 years. Taking bisphosphonates for 3-9 years was not linked to a higher fracture risk. "Our study and several others have found higher risk of fractures among very long-term bisphosphonate users, compared with short-term users. However, the ideal length of bisphosphonate use has not yet been studied in randomized clinical trials. Journal of the American Geriatrics Society 

 

• Excessive exercise may damage the gut: A review of published studies has found that people who exercise excessively may be prone to acute or chronic gut issues. Alimentary Pharmacology & Therapeutics


• Take a coffee or tea break to protect your liver: New study indicates that drinking even a few cups a day may prevent hardening of the liver. Researchers found that drinking coffee and herbal tea may protect against liver fibrosis, estimated as the degree of liver stiffness, which is high in extensive scarring of the liver. Because these beverages are popular, widely available, and inexpensive, they could have the potential to become important in the prevention of advanced liver disease. Journal of Hepatology

Flu Shot Falls Short More Often for Obese: New research reveals the vaccine doesn't work as well for people who are obese. International Journal of Obesity

 

Couch Potatoes' May Face Higher Risk of Kidney, Bladder Cancers: Add greater risk of kidney and bladder cancer to the long list of why a lifetime of sitting on the sofa isn't good for your health, a new study suggests. Specifically, lifetime recreational inactivity was associated with a 73 percent increased risk of bladder cancer and a 77 percent increased risk of kidney cancer. Cancer Epidemiology

 

NUTRITION/SUPPLEMENTS/VITAMINS
• Dairy products a good dietary source of some types of vitamin K: New study adds to knowledge about natural forms of vitamin K in dietary sources, their appreciable presence in commonly consumed foods. In the study, published June 1 in Current Developments in Nutrition, researchers quantified the activity of two natural forms of vitamin K in dairy products of various fat contents and found that common U.S. dairy items, including milks, yogurts and cheeses, contain appreciable amounts of multiple forms of vitamin K. Vitamin concentrations varied by fat content. Vitamin K helps blood to clot.

• Probiotic use linked to improved symptoms of depression: A new study is the first to show improved depression scores with a probiotic. It adds to the whole field of microbiota-gut-brain axis, providing evidence that bacteria affect behavior. Gastroenterology 

Flax: These sesame-seed lookalikes are considered a functional food -- a food that goes beyond basic nutrients to provide health benefits and/or reduce the risk of chronic diseases, according to a report in the Journal of Food Science and Technology. 

Low Fat Dairy Habit and Parkinson’s Risk: A 25 year study of 130,000 men and women found that those who consumed at least three servings of low-fat dairy a day had a 34 percent higher risk of getting the disorder than those who only consumed one serving a day. No such association was seen with the consumption of full-fat dairy products, such as whole milk. Experts who reviewed the study stressed that the findings are preliminary -- the effect was a modest one and the research wasn't designed to prove cause and effect. Neurology

Even Moderate Drinking May Dull the Aging Brain: Researchers found that those who regularly drank alcohol showed greater brain shrinkage than non-drinkers by old age. They also lost more of their language "fluency" -- a measure of memory and thinking skills. And, the effects were seen even among people who drank "moderately" -- roughly four to seven drinks a week, the researchers found. The findings do not prove that alcohol was to blame. BMJ 

• Excess Alcohol May Speed Muscle Loss in Women: A study of 2,400 postmenopausal women, average age 62. Of those, 8 percent had sarcopenia (condition of loss muscle mass and strength). Rates of sarcopenia were nearly four times higher among high-risk drinkers than among low-risk drinkers, the study found. Menopause

Dietary Supplements and Cognitive Function, Dementia and Alzheimer’s Disease: This issue of the NCCIH Clinical Digest summarizes current information on “what the science says” about several dietary supplements that have been studied for cognitive function, dementia, and Alzheimer’s disease. Although a few trials of natural products for the prevention of cognitive decline or dementia have shown some modest effects, direct evidence is lacking. In addition, research on some mind and body practices such as music therapy and mental imagery, which have shown promise in treating some symptoms related to dementia, as well as alleviating stress among caregivers, is ongoing.

Healthy Dietary Fats Help Beat High Cholesterol: Replacing saturated fats with healthier ones found in some vegetable oils can reduce cholesterol levels and heart disease risk as much as statins, a new American Heart Association (AHA) advisory says. Those healthier fats are poly-unsaturated fats and mono-unsaturated fats. Poly-unsaturated fats are found in corn, soybean and peanut oils. Mono-unsaturated fats are found in oils such as olive, canola, safflower and avocado. Saturated fats are found in meat, full-fat dairy products and tropical oils such as coconut and palm. In clinical trials, reducing use of saturated fat in favor of poly-unsaturated vegetable oil reduced heart disease by about 30 percent, similar to statin drugs, according to the advisory. Several studies found that coconut oil -- which is widely promoted as healthy -- increased LDL cholesterol levels in the same way as other saturated fats do.

 

TREATMENT
• Online Treatment: new research suggests that online therapy programs can help some people with mild to moderate depression. The study found the results lasted at least three to six months after therapy ended, and the programs don't necessarily need to have a therapist directly involved to produce benefits "There was a significant effect in decreasing depressive symptoms after completing the programs," American Psychiatric Association meeting

New Combo Pill for HCV Offers Hope to those who fail other treatments: The pill -- which contains the antiviral drugs sofosbuvir (Sovaldi), velpatasvir and voxilaprevir -- was nearly 100 percent effective in curing hepatitis C in patients whose disease returned after treatment with other antiviral drugs.

Drug Xeloda Prolongs Survival for Some Breast Cancer Patients It cut risk of relapse, death by 30 percent over 5 years, trial found. NEJM 

• Adding abiraterone to standard treatment improves prostate cancer survival by 40 percent: Adding abiraterone to hormone therapy at the start of treatment for prostate cancer improves survival by 37 percent, according to the results of one of the largest ever clinical trials for prostate cancer. Science Daily

For older adults, antibiotics may not be appropriate treatment for some UTIs: Prescribing antibiotics for urinary tract infections (or 'UTIs') may often be avoided among older adults, suggests new research. Journal of the American Geriatrics Society


Drug for refractory psoriatic arthritis shows promise in clinical trial: Patients with psoriatic arthritis for whom standard-of-care pharmaceutical treatments have provided no lasting relief experienced a significant reduction in symptoms, including joint tenderness and swelling, have reported promising results when they were given a new drug-SPIRIT-P2 The Lancet 

Patients’ Own Fat Tissue Can Help Treat Joint Problems: Body fat now can help treat bone joint conditions, including injuries and osteoarthritis -- the type of arthritis caused by wear and tear in tissue between joints, which affects 27 million people. A new device gently suctions, processes and uses a patient's own fat tissue to provide a potential source of stem cells and growth factors to promote healing. The FDA approved Lipogems for widespread use in November of 2016. 

Is the finger-stick blood test necessary for type 2 diabetes treatment? In the first large pragmatic trial of its kind in the United States, results from a UNC School of Medicine study show that checking finger-stick blood sugars may not help diabetes patients who do not use insulin. JAMA Internal Medicine

For Diabetics, Nasal Powder Fixed Severe Low Blood Sugar: New product much easier to use than rescue injections. For many people with diabetes, low blood sugar levels are a serious health risk, but researchers report that a new nasal powder quickly reverses the effects of this dangerous condition. Better yet, it can be administered even when someone is unconscious. American Diabetes Association meeting

Study Confirms Link Between Diabetes Med and Rare But Dangerous Complication: A new class of type 2 diabetes drugs called SGLT2 inhibitors (Invokana, Invokamet, Farxiga, Xigduo XR, Jardiance and Glyxambi) could increase the risk of a rare, life-threatening complication of the disease called ketoacidosis, a new study warns. NEJM



Online cognitive behavioral therapy for insomnia is effective for military: A new study focused on soldiers at Fort Hood who had chronic insomnia. Some received therapy from clinicians for six weeks and some received online therapy for six weeks. For military personnel, internet-delivered cognitive behavioral therapy appears to be an effective alternative to meeting regularly with a therapist, although it is about half as effective as traditional methods, according to results of a study. Sleep 

Major Study Heralds New Era in Treatment of Type 2 Diabetes The findings published in the New England Journal of Medicine found the drug canagliflozin reduced the overall risk of cardiovascular disease by 14 per cent and reduced the risk of heart failure hospitalisation by 33 per cent. It was also shown to have a significant impact on the progression of renal disease.

OTHER
• MS Related Brain Changes May Affect Social Skills: Subtle brain changes may explain why some people with multiple sclerosis (MS) lose their ability to interpret clues about what other people are thinking and feeling, a new study suggests. It doesn't happen to everyone with MS, but experts agree that it's a big deal for those who experience it. Neurology

• Nearly 10 Million U.S. Adults Suffer From Mental Illness: Nearly 10 million American adults have a serious mental illness, and a similar number have considered suicide during the past year, according to a new government report on the nation's behavioral ills. The report also said that 15.7 million Americans abuse alcohol and 7.7 million abuse illicit drugs. he researchers found that 12.5 million people are estimated to have misused prescription painkillers such as oxycodone (OxyContin, Percocet) or hydrocodone (Vicoprofen).. Behavioral Health Barometer -- United States, 2016 

Depression Can Slow Hospital Patients' Recovery: A review of 20 studies on depression screening in hospitals showed that 33 percent of patients had symptoms of depression. Patients with depression are less likely to take their medications and keep all recommended appointments after leaving the hospital, potentially leading to longer hospital stays and an increased risk of readmission. Journal of Hospital Medicine

• Home Blood Pressure Monitors Wrong 7 of 10 Times:  Checking your device against ones used at your doctor's office may be advised, experts say. A small, new Canadian study suggests that readings from the devices are wrong most of the time and could put patients at risk. American Journal of Hypertension





Wednesday, June 14, 2017

Take a Break: Five Ways to Relax





• Listen to waves, birds, rainfall for two minutes at Calm’s Do nothing for 2 minutes 

• Drink a glass of water and savor it. Add some ice for a change. Maybe some lemon

• Create a “do not disturb area” in your house and use it. Fill it with things that you enjoy and can help you calm down such as candles, plants, special items from nature such as stones, twigs

• Visit your local animal shelter and pet the cats and dogs.


Not interested in today’s activity, go to the Take a Break Pinterest and pick out something else.

Saturday, June 10, 2017

Understanding the Connection Between Chronic Conditions and Suicide


Recently a former neighbor and friend commit suicide. His obituary stated that he died unexpectedly after a long illness. A kind and generous man, it has left many sad, confused, hurt, angry, devastated, guilty and wondering if there wasn’t something more that could have been done. This post is dedicated to D, his family and friends and to the hope that it can help someone else struggling with a chronic condition.

The link between chronic conditions and higher rates of suicide can’t be ignored. It needs to be a conversation that those affected -medical providers, those with a condition, caregivers, family and friends-need to have. To aid in this discussion, the post below outlines why people with chronic conditions are more at risk, what the signs are, what you can do to help yourself or someone else who may be contemplating suicide as a way of coping and physician assisted suicide.

Why those with chronic conditions are more at risk
• Physical symptoms, which can decrease mobility and function, as well as create sleep irregularity, chronic pain and memory lapses. Note that with the opioid addiction epidemic raging, and the crack down on physicians writing prescriptions, there is now an increased risk of suicide among people with chronic pain.

• Loss of meaning and purpose: Not being able to work, take care of one’s self or perform daily functions can quickly erode sense of self  worth and meaning.

• Loss of hope that they can feel better.

• Long-term injury and illness creates isolation and loneliness. Due to reduced capabilities and/or appearances, people are inclined to reduce or  eliminate opportunities to socialize and be with others. In addition, family and friends can often withdraw for a host of reasons-don’t know how to be around someone who has an illness; out of sight out of mind; it’s scary to them etc. People fear being abandoned by family, society or both.

• Perception of being a burden. Whether it’s financial or their daily care needs, feelings of being a burden for family and significant others can lead to the erroneous conclusion that “everyone would be better off without me.”  Guilt is a very negative emotion and it’s easy for someone in this position to think they are ruining the lives of those that love them the most.

• “It’s all in your head:” When family, friends, work colleagues or even medical providers say this, not only does it cause people to withdraw but it also considerably reduces self image.

• They don’t necessarily look sick so people are clueless to how they are feel or are doing.

Recognize Signs of Suicidal Thoughts.
• Unrelenting low mood, pessimism, hopelessness, desperation
• Withdrawing from people, events etc.
• Increased alcohol and/or drug use
• Impulsiveness and unnecessary risk taking
• Talking about suicide or wish to die
• Giving away prized possessions; sudden interest in firearms, obtaining other means of killing oneself such as poisons or medications
• Unexpected rage or anger.

If Someone is Suicidal: Take comments about suicide seriously. Many don’t want to die but they also don’t know how to continue to live in their current situation.
Do not leave them alone.
• Seek immediate professional help, 
• Take the person to an emergency room to the nearest hospital.
• Contact the person’s medical provider.
• If the above options are not available, call the Suicide Prevention Lifeline at 1-800-273-TALK (8255), or text HOPELINE at 741741 with the word “start” to get the assistance that you need.

If You are Feeling Suicidal: You are not alone. Whether you realize it or not, there are ways to help you feel better and recognize that your life has value and meaning not only to you but also to others.
• Share your suicidal thoughts with someone-family member, friend, therapist, medical provider, clergy, teacher, coach. Call the Suicide Prevention Lifeline at 1-800-273-TALK (8255), or text HOPELINE at 741741 with the word “start” to get the assistance that you need.
 If you can’t voice your plans and thoughts, put them in writing, text or e-mail and give them to someone you can trust.
• If the first person you reach out to doesn’t seem to understand, tell someone else or call the suicide crisis line.
• If you are dealing with significant symptoms and pain, let your care provider know. If current treatments aren’t helping, ask for a referral to a palliative care program, or pain program.
• Don’t act on your feelings. Thoughts and actions are two different things. Just because you may think about suicide doesn’t mean you need to act on it.
• Avoid drugs and alcohol
• Create a safe environment by removing items you could use to hurt yourself such as guns, knives, razors, pills etc.
• Take hope that you can live through these feelings and you can get help with problems that currently seem insurmountable.

What can be done
Caregivers
• Learn what you can about their condition, join a caregivers’ support group.
• Be their advocate and help them seek out the best possible care. Keep in mind that if symptoms such as pain and sleep deprivation can be controlled, suicidal thoughts are significantly reduced. Palliative care programs specialize in how to eliminate pain and suffering. Chronic pain clinics can also be helpful.
• Just because you can’t see it doesn’t mean it’s not real. Believe them when they tell you how they feel.
• Reassure them they are not a burden: Let them know what they mean to you.
• Let them do for themselves as much as possible.
• Include them in social activities.
• Recognize signs of depression and suicidal thought. See above
• Ask them if they are considering suicide. You will not make someone suicidal by asking this question.
•  Talk to their care provider or the local chapter of a condition specific organization. Thinking that suicide is a passing fancy is risky.

For those living with a chronic condition, please read Healing the Whole Person: Ways to Increase Well-Being When Living with a Chronic Condition, which outlines specific ways to achieve healing and hope regardless of your diagnosis. This page is continually being updated and it’s better for you to go to the page than to try and summarize it here.

 Physician Assisted Suicide
Now available in some states, the physician assisted suicide (PAS) movement was started for those with terminal illness. However, as time has passed, those with disabilities and chronic conditions have started discussing this as an option. It’s important to note that those who receive proper pain and symptom management, generally do not opt for suicide. “Kill the pain, not the person” is the underlying belief of palliative care, which is a good specialty to check out if pain and other symptom management is not being adequately controlled.

Working in AIDS, PAS was something we discussed a lot. One woman explained that she was saving pills as she wanted to spare her family seeing her at end stage AIDS. However, her choice at the end of her life was something none of us could have predicted. Her oldest child was in the military and her mother’s dying kept her stateside and out of the Gulf War. Now she was doing everything she could to live so she could keep her child safe. In fact, one of the hospice nurses had to tell her daughter to give Mom permission to let go and die. This was the ultimate sacrifice a mother could make for child. It also taught me that Dr. Kubler-Ross was right that you need to “Live until you die and live fully.”

Sometimes the purpose in our life is to receive, to let others care for us. In doing so we give more than we realize. We help others understand about their capabilities, explore their feelings or in the case of my friend, you can even save a life.

I’m concluding this post with part of an article written by a physician with Parkinson’s Disease, as it highlights both the problems those with chronic conditions encounter but also how they can find meaning in their lives.

”Now in the tenth year of a battle that will continue for as long as I live, I have watched as huge swaths of my abilities have calved like chunks of ice falling from a glacier into the sea. My circle of friends has shrunk, the role I used to play in family life has diminished dramatically, and my medical career is over. The physical word I am capable of navigating has become a fraction of what it once was. My mental processes have slowed to a veritable crawl. My ability to express myself is profoundly compromised... Control over my body is a formidable, ongoing struggle of mind over matter. As the disease progresses, my sense of myself erodes in parallel and I mourn those bits and pieces as I would the loss of a loved one.”

 “However, there is one aspect of the self that even my disease cannot touch and that is the soul. Though not religious in a traditional sense, I remain spiritually whole, comfortable in the knowledge that my life still matters both to the patients I treated, the family I have raised, and the family I have, by second marriage, adopted. And that is where hope lives; not a naıve hope that I will, by some miracle, have my former self restored, but hope that tomorrow, and the day after, can still be days from which a measure of joy and meaning can be derived. And from hope springs optimism that, even with great limitations, there is life to be lived.” “Finding Hope in the Midst of Despair: My Decade With Parkinson’s Disease and Lewy Body Dementia” by Dr. Thomas B. Graboys. “Life in the Balance.”

Additional Resources

• Are You Feeling Suicidal?: How to Deal with Suicidal Thoughts and Feelings and Overcome the Pain 

Project Semicolon:Your Life Matters



But You Look So Good: How You Look Isn’t Necessarily How You Feel



Wednesday, June 7, 2017

Take a Break: Name the people on the Cover of Sgt. Pepper


In honor of the reissuing of Sgt. Pepper’s Lonely Hearts Club Band, see how many of the people you can name on the cover.


Check out The Story Behind the Sgt. Pepper Lonely Hearts Club Band Album Cover for how the album cover was made.




Not interested in today’s activity, go to the Take a Break Pinterest and pick out something else.

Saturday, June 3, 2017

Living with Chronic Disease: Cut the Cable Cord/Reduce “Watch Time”


Unwittingly if you watch TV you are continually exposing yourself to sub limitable messages, from unrealistic portrayals of romance and relationships to the encouragement of spending money you don’t have on products you don’t need. The endless stream of messages you are barraged by-15 minutes and 38 seconds of commercials alone for every hour of TV watched-subtly sends messages that being different in any way is a problem. The news is presented in a “if it bleeds it leads” manner. A continual barrage of stories about pain/suffering/disaster/death skews your mindset and not for the good.

Since TV shows exist to sell product, millions of dollars are spent to influence you to not only feel bad about yourself (my house isn’t clean enough, I smell bad, my car is too old) but to encourage behaviors that aren’t helpful in the long run-buy products, or become part of some lawyers scheme against drug companies. The major advantage of “cutting the cord” is you eliminate a significant portion of the commercials, while at the same time saving a bundle on monthly fees. Check out Your Guide to Cable TV Cord-Cutting to learn how to get rid of cable bills. It’s much easier than you think.

Continually watching TV, whether it’s streaming on your laptop or your TV, promotes a sedentary life, numbs your brain and ultimately reduces quality of life. Human beings are designed to be social. Instead, of watching TV participate in life by developing a hobby; join a book club, support group or other group activity; talk to a friend; go for a walk; exercise; go out to dinner; garden or try Take a Break Pinterest.

Bottom Line: Cutting the cable cord and reducing your watch time saves money and improves your health and well-being.

Wednesday, May 31, 2017

Take a Break: Re Purposing T Shirts


This past week a friend sent me an article to read about how bad most fabrics are for the environment, particularly the microfiber cleaning cloths.  A few days after reading that, I was at a friend’s house and used a tee shirt cloth I made for her two years ago. She said uses it nightly to wash her dishes and its been washed many times. Wow!

So here are some new ways to re purpose old t-shirts

Wash Cloth: There are other directions on line, but my approach is to take a T shirt, mark off how large I want it to be and sew around it and zig zag back in forth to keep the two layers together. I just have a regular sewing machine, but if you had a serger machine you could just go around the edges. Here are several tutorials to check out

• Make a rug: Cut the T shirt into strips (about 1 inch) and start crocheting into a rug. Be sure to use Tees of similar fabric-all cotton, 50/50 blend.

                                         Three ways to re cycle T shirts

This is by far the most interesting way to turn T-shirt into art. Basically it's taking strips of T shirts and sewing them down. The pictures at the left show the process. It appears they are using the type of cloth you'd use for needlepoint. Think a hefty fabric, such as felt would work just as well.Plan on trying this for making Christmas ornaments this year.

Not interested in today’s activity, go to the Take a Break Pinterest and pick out something else.