Journal Watch February 2019

CHRONIC PAIN

Positive self belief key to recovery from shoulder pain: Positive self belief is the key to recovery from pain, say Uresearchers. The research team studied over 1,000 people undergoing physiotherapy for shoulder pain. They found that people are more likely to recover if they have the confidence to carry on doing most things, despite their pain. Those who expected physiotherapy would help them were likely to recover more than those who expected minimal or no benefit. British Journal of Sports Medicine,

Higher Optimism Tied to Lower Odds of Pain After Deployment: For U.S. soldiers, higher levels of optimism are associated with lower odds of reporting new pain after deployment, according to a study published online Feb. 8 in JAMA Network Open.

Certain Opioids Less Effective With SSRI Antidepressants: Certain opioids are less effective for postoperative pain in patients taking selective serotonin reuptake inhibitor (SSRI) antidepressants, according to a study published online Feb. 6 in PLOS ONE.

Discord Found in Clinician-, Criteria-Based Fibromyalgia Diagnosis: There is disagreement between clinical diagnosis and criteria-based diagnosis of fibromyalgia, according to a study published online Feb. 6 in Arthritis Care & Research. Physicians fail to ID half of criteria-positive patients, incorrectly ID 11 percent of criteria-negative patients. "It is likely that misdiagnosis is a public health problem and one that can lead to over diagnosis and over treatment, as well as to inappropriate treatment of individuals not recognized to have fibromyalgia symptoms.” 

Compounded Topical Pain Creams No Better Than Placebo: Compounded topical pain creams are no better than placebo creams for neuropathic pain, nociceptive pain, or mixed pain, according to a study published online Feb. 5 in the Annals of Internal Medicine.

Evidence Lacking for Benefit of Surgery for Vertebral Fractures: Surgical procedures do not appear to provide significant benefit for patients with vertebral fractures (VF), according to a second American Society for Bone and Mineral Research Task Force report published in the January issue of the Journal of Bone and Mineral Research.

COMPLEMENTARY & ALTERNATIVE MEDICINE

Evidence of Therapeutic Efficacy Substantial for Cannabis Use: Most qualifying conditions for which patients are licensed to use cannabis medically have substantial or conclusive evidence of therapeutic efficacy, according to a report published in the February issue of Health Affairs.

Mindfulness-Based Stress Reduction Also Benefits Chronic Pain: For patients with chronic pain (CP), both mindfulness-based stress reduction (MBSR) and cognitive behavioral therapy (CBT) improve physical functioning, pain intensity, and depression, according to a review published online Jan. 31 in Evidence-Based Mental Health.

Medical Cannabis Decisions Being Made by Users, Not Doctors: Many patients use medical cannabis without their mainstream health care provider's knowledge, and further, they self-adjust their pharmaceutical use in response to cannabis use, according to a study published online Jan. 8 in the Journal of Psychoactive Drugs. 

Yoga regimen reduces severity of rheumatoid arthritis symptoms: According to a new study, eight weeks of intensive yoga practice significantly decreases the severity of physical and psychological symptoms in patients with active rheumatoid arthritis (RA), a debilitating chronic auto-immune inflammatory disease. Marked improvements were seen in the levels of certain inflammatory biomarkers and assessments of functional status and disease activity in patients studied, demonstrating yoga's promotive, preventive, curative, and rehabilitative potential for achieving optimal health. Restorative Neurology and Neuroscience

FDA ACTION

• Issued Statement from FDA Commissioner Scott Gottlieb, M.D., on new policy to improve access and foster price competition for drugs that face inadequate generic competition

• Authorizes first interoperable insulin pump intended to allow patients to customize treatment through their individual diabetes management devices

• Issued statement from FDA Commissioner Scott Gottlieb, M.D., on the agency’s new efforts to strengthen regulation of dietary supplements by modernizing and reforming FDA’s oversight

• Takes action against 17 companies for illegally selling products claiming to treat Alzheimer’s disease

• Approved Cablivi (caplacizumab-yhdp) injection, the first therapy specifically indicated, in combination with plasma exchange and immunosuppressive therapy, for the treatment of adult patients with acquired thrombotic thrombocytopenic purpura (aTTP), a rare and life-threatening disorder that causes blood clotting.

• Warned patients and doctors, who use at-home or in-the-office medical devices to monitor levels of the blood thinner warfarin, that certain test strips used with the devices may provide inaccurate results and should not be relied upon to adjust the drug dosage. Medical product distributor Terrific Care/Medex Supply LLC issued a voluntary Recall of certain Roche Diagnostic test lots used with CoaguCheck test meter devices.

• Approved the first generic of Advair Diskus (fluticasone propionate and salmeterol inhalation powder) for the twice-daily treatment of asthma in patients aged four years and older

• Permitted marketing of a new test to aid in the diagnosis of a sexually-transmitted infection (STI) called Mycoplasma genitalium (M. gen.).

• Approved the first generic version of Sabril (vigabatrin) 500 mg tablets for treating complex partial seizures, also called focal seizures, as an adjunctive therapy (given with another primary treatment) in patients 10 years and older who have responded inadequately to several alternative (refractory) treatments.

PREVENTION

How exercise may protect against Alzheimer's: A hormone called irisin -- produced during exercise -- may protect neurons against Alzheimer's disease. Nature Medicine

Aerobic Exercise Tied to Better Cognition at All Ages: Aerobic exercise contributes to brain health in individuals as young as 20 years, according to a study published online Jan. 30 in Neurology. The researchers found that aerobic capacity increased significantly and body mass index decreased significantly in the aerobic exercise group but not in the stretching/toning group. In the aerobic exercise group, executive function improved significantly, with the effect moderated by age. The aerobic exercise group had significant increases in cortical thickness in a left frontal region, with no interaction with age.

How sleep can fight infection: Researchers have discovered why sleep can sometimes be the best medicine. Sleep improves the potential ability of some of the body's immune cells to attach to their targets, according to a new study. The study helps explain how sleep can fight off an infection, whereas other conditions, such as chronic stress, can make the body more susceptible to illness. Journal of Experimental Medicine

Accelerated risk of mobility loss for people aged 60+ tied to excess weight/inactivity:New study shows older women with obesity at higher risk of mobility loss compared to older men. The combination of excess weight/obesity and an inactive lifestyle represents a powerful joint risk factor for developing mobility loss after age 60, according to a new study. International Journal of Obesity. 

Fewer Older Men Assessed, Treated for Osteoporosis: Fewer older men than women undergo evaluation for or management of osteoporosis, according to a study published online Feb. 12 in the Journal of Investigative Medicine. 

Most A-Fib Patients Have at Least One Identifiable Trigger: Most patients with atrial fibrillation (AF) report at least one identifiable trigger, with the most common triggers being alcohol, caffeine, exercise, and lack of sleep, according to research published online Feb. 14 in HeartRhythm.

CDC Examines Safety of Recombinant Zoster Vaccine: During the first eight months of recombinant zoster vaccine (RZV) use, there were reports of 4,381 adverse events, 3 percent of which were serious, according to research published in the Feb. 1 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

E-Cigarettes More Effective for Smoking Cessation: Electronic cigarettes are more effective for smoking cessation than nicotine replacement therapy, according to a study published online Jan. 30 in the New England Journal of Medicine.  

New Type of E Cigarette as Bad as Regular: “Heat-not-burn” tobacco products are already incredibly popular in some overseas markets, but they haven’t made inroads into the United States yet. Promoted in a similar fashion to e-cigarettes as a safer alternative to traditional smoking, public health experts worry that “heat-not-burn” products could be the next big phase for the tobacco industry. New research looked at the in vitro effects of vapor produced by IQOS devices (IQOS is the brand name of a “heat-not-burn” tobacco product by Philip Morris International, an American tobacco company) on human cells found in the lungs and airways. IQOS device’s vapor was found to have a comparable toxicity to traditional smoking. ERJ Open Research

Trained Alert Dogs Can Detect Impending T1DM-Related Events: Trained alert dogs can help patients with type 1 diabetes regulate their blood glucose levels, according to a study published online Jan. 15 in PLOS ONE.

NUTRITION/SUPPLEMENTS/VITAMINS

Higher sodium intake associated with increased light headedness in the context of the DASH-sodium trial: Study turns common knowledge on its head by challenging experts' traditional recommendations Researchers found that higher sodium intake, when studied in the context of the DASH-Sodium trial (Dietary Approaches to Stop Hypertension), increases lightheadedness. These findings challenge traditional recommendations to increase sodium intake to prevent lightheadedness. The Journal of Clinical Hypertension 

Fried Chicken, Fish Linked to All-Cause,Cardiovascular Death: Among postmenopausal women, fried food consumption, especially fried chicken and fish/shellfish, is associated with an increased risk for all-cause and cardiovascular mortality, according to a study published online Jan. 23 in The BMJ.

Body building supplement could be bad for the brain: L-norvaline is an ingredient widely used in body building supplements and is promoted as a compound that can boost workouts and aid recovery. Similar compounds have been linked to neurodegenerative diseases, and a study on human cells suggests L-norvaline may also cause damage to brain cells. People taking the protein supplement L-norvaline should be aware of its potential for harm, scientists say. Toxicology in Vitro 

Bone Health in Older Adults Not Improved by High-Dose Vitamin D: There is little benefit for older adults taking high-dose vitamin D supplements to improve their bone strength and reduce the risk for falls, according to a study published online Jan. 8 in The American Journal of Clinical Nutrition.

 Study examines aspirin use to prevent colorectal cancer: The US Preventive Services Task Force (USPSTF) concluded that aspirin reduces the risk of colorectal cancer by 40 percent as well as recurrence of advanced polyps, which are a major risk factor. To explore whether high risk patients are adhering to USPSTF guidelines, researchers analyzed data from structured interviews with 84 patients and found that less than half (42.9 percent) reported taking aspirin. These findings pose major challenges that require multifactorial approaches by physicians and patients.  The American Journal of Medicine  

Meta-Analysis: Aspirin Linked to Lower Risk for CV Events in Primary Prevention: For individuals without cardiovascular disease, use of aspirin is associated with a reduced risk for cardiovascular events and an increased risk for major bleeding, according to a meta-analysis published in the Jan. 22 issue of the Journal of the American Medical Association.

 Artificially Sweetened Drinks Linked to Stroke After Menopause: Among postmenopausal women, consumption of artificially sweetened beverages (ASB) is associated with an increased risk for stroke, coronary heart disease, and all-cause mortality, according to a study published online Feb. 14 in Stroke. 

 TREATMENT

Direct-acting antivirals reduce risk of premature mortality and liver cancer for people with chronic hepatitis C, study finds: The first prospective, longitudinal study investigating treatment of chronic hepatitis C with direct-acting antivirals finds that the treatment is associated with reduced risk of mortality and liver cancer.  The Lancet 

Shorter course of radiation therapy effective in treating men with prostate cancer: A long-term study finds that those with low- or intermediate-risk disease can safely cut treatment to four to five days.  This type of radiation, known as stereotactic body radiotherapy, is a form of external beam radiation therapy and reduces the duration of treatment from 45 days to four to five days. The approach has been in use since 2000, but has not yet been widely adopted because of concerns over how safe and effective this approach would be in the long term. JAMA 

Study links psoriasis treatment and improvement in heart artery disease: Researchers have found that treating psoriasis, a chronic inflammatory skin disease, with biologic drugs that target immune system activity can reduce the early plaque buildup that clogs arteries, restricts blood flow, and leads to heart attacks and stroke. The findings highlight how immunotherapies that treat inflammatory conditions might play a role in the reduction of cardiovascular disease risks. Cardiovascular Research

Subsymptom Threshold Exercise Speeds Concussion Recovery: For adolescent athletes, subsymptom threshold aerobic exercise prescribed during the first week after sport-related concussion (SRC) speeds recovery, according to a study published online Feb. 4 in JAMA Pediatrics.

Trazodone Not Associated With Reduced Risk for Dementia: Trazodone is not associated with a reduced risk for dementia compared with other antidepressants at the prodromal stage of disease, according to a study published online Feb. 5 in PLOS Medicine. 

Intensive BP Treatment Does Not Reduce Dementia Risk: Treating systolic blood pressure (BP) to a goal of less than 120 mm Hg rather than 140 mm Hg does not result in a significant reduction in the risk for probable dementia, according to a study published online Jan. 28 in the Journal of the American Medical Association.

NOACs Recommended as First-Line Prevention of Stroke in A-Fib: For patients with atrial fibrillation, novel oral anticoagulants (NOACs) are recommended over warfarin to prevent stroke and weight loss is recommended for overweight and obese individuals, according to updated guidelines published online Jan. 28 in Circulation.

OTHER

New scan technique reveals brain inflammation associated with post-treatment Lyme disease syndrome: More than 1 in 10 people successfully treated with antibiotics for Lyme disease go on to develop chronic, sometimes debilitating, and poorly understood symptoms of fatigue and brain fog that may last for years after their initial infection has cleared up. Now, in a small study, Johns Hopkins Medicine researchers report they have used an advanced form of brain scan to show that 12 people with documented post-treatment Lyme disease syndrome (PTLDS) all show elevation of a chemical marker of widespread brain inflammation, compared with 19 healthy controls. Journal of Neuroinflammation 

Health Care Spending Per Person Increased to $5,641 in 2017: In 2017, health care spending per person reached $5,641, according to the Health Care Cost Institute (HCCI) annual Health Care Cost and Utilization Report.

USPSTF Still Recommends Against Pancreatic Cancer Screening: The U.S. Preventive Services Task Force (USPSTF) recommends against screening for pancreatic cancer in asymptomatic adults. These findings form the basis of a draft recommendation statement published online Feb. 5 by the USPSTF.

AHA: Nearly Half of U.S. Adults Have Cardiovascular Disease: The prevalence of cardiovascular disease (CVD) is 48.0 percent in adults in the United States based on 2013 to 2016 data, according to a report published online Jan. 31 in Circulation. Forty-six percent of U.S. adults have hypertension

Large Insulin Price Hike to Be Investigated by U.S. Congress: "I have heard stories about people reducing their lifesaving medicines, like insulin, to save money," said Senate Finance Committee Chairman Charles Grassley, R-Iowa, the Associated Press reported. "This is unacceptable and I intend to specifically get to the bottom of the insulin price increase."

Life with Chronic Conditions: Develop a Compassionate Mindset

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Mindfulness and compassion — the practices of cultivating a focused awareness on the present moment, and extending a loving awareness to others — are part of every religion and wisdom tradition, and we’re at last beginning to understand the profound impact that they have on the brain. Dr. Dan Siegel.

In 2016, I went through an experience that made me incredibly angry, creating unbelievable amounts of stress and anxiety, which I wrote about in Defusing One’s Anger.   My  “take home point” of that experience was the realization that approaching situations from a place of compassion for my self and others, wishing no harm to them and vice versa, works.

As Rick Hanson, psychologist and senior fellow of the Greater Good Science Center at UC Berkeley,  notes The brain is the organ that learns, designed by evolution to be changed by our experiences: what scientists call experience-dependent neuroplasticity. Neurons that fire together, wire together. This means that each one of us has the power to use the mind to change the brain to change the mind for the better. To benefit oneself and other beings.... Life is often hard. To cope with hard things, to be effective and successful, or simply to experience ordinary well-being, we need resources inside, inner strengths like resilience, compassion, gratitude and other positive emotions, self-worth, and insight. Just One Thing: Be Mindful of Good

Thanks to all the advances in brain imaging, the field of neuroplasticity, neuroscientists agree that both animals and humans have “compassionate instincts” that have helped us to survive for thousands of years. It’s always been important to understand if someone was having a hard time. On the Savannah's of our ancestry, if someone was unable to function properly, it could endanger the tribe, so it was a life or death matter to be tuned in to one another.

Our brains are not as evolving as quickly as our technology. While our “old brain” can help us survive a disaster, such as running away from a tree that’s about to fall, our new brain causes us to obsess over the fact that we could have easily been killed. The threat is over, but the brain can’t let it go and so we ruminate on it with the “what if” questions and scenarios. Obviously it has advantages in keeping people from avoiding certain situations again, but all too often, the rumination goes on too long and we get fixed into a negative way of thinking. As Rick Hanson notes the brain is Velcro for negative- and threat-based things but Teflon for positive ones. In short, we quickly let go of the good things, instead focusing on the bad, which ultimately results in anxiety, stress, depression, and a myriad of health issues.

However, the stresses of modern life and it’s impact on our brain and ultimately our well being,  can be modulated by the use of certain “tools” that do not require any prescriptions or money. There are many ways to develop a practice that can create a healthy mindset and improve well being based on scientific research. 

While the Dali Lama stresses that if you want to be happy be compassionate - to recognize the suffering of others and wanting to alleviate it, this turns out to have a strong scientific basis. Dr. James Doty of Stanford Medicine The Center for Compassion and Altruism Research and Education, explains how this work in the video:

Learn more about compassion, your brain and how to develop a practice that works best for you by checking out the following sites

• The Center for Compassion and Altruism Research and Education: Contains lots of videos and information, including a number of James Doty’s videos.

• Into the Music Shop-The exercises associated with Dr. Doty’s book of the same name.

• Center for Healthy Minds University of Wisconsin-Madison

• A Guide to Cultivating Compassion in Your Life, With 7 Practices 

• 16 Compassion Focused Therapy Training Exercises and Worksheets 

• 30 Day Wellness Challenge Cultivate mindfulness and self compassion

Take a Break: Make Valentine Cut Out Cards

 Below are a variety of fun and easy Valentines you can make for all those people you want to remember on Feb. 14. I’m particularly fond of making holiday themed glasses.

Patterns for I Heart U

Valentine’s Day Glasses Here are two types. The DLTK one may be easier to cut out and color while the one from Mr. Printables will be best using red or pink. card stock

Note that the Mr. Printables also includes a pouch template and message tags

Heart Pop Up Valentine Cards

Not interested in today’s activities, try the Take a Break Pinterest Board.

Life with Chronic Conditions: Don’t Give Up Your Landline

This past week we had an emergency for a couple who are quite compromised. In an effort to save money they opted for one of the cable/Internet/Phone services. These combined services, offered by companies like Comcast, have what is called “voice over Internet protocol phone” or a VoIP line. Basically, the phone line transmit over the same cables and wires used for the Internet.

Landlines use copper wires that connect to switch boxes and transit calls between phones plugged directly into the wall. The benefit of these copper wired connections is that the phone company is supplying power through the copper wires, and that’s what keeps the lines up and running. Even when the power goes, there’s still a dial tone when you pick up the phone.

Unfortunately, when our neighbors lost power, they were unable to call for help as their phone line was operating on a VoIP line.

I’m sensitive to this topic since I live in an area that deals with major storms and power failure happens more than most of us would care to think about. Yes, many have generators and almost everyone has cell service of some type. However, time and again, we’ve seen where a landline made a difference.

Consider the following:

• When you opt for a three in one service from carriers like Comcast, recognize that even though you keep the same number, your telephone is now being powered by Internet and if your power goes, you loose your phone.

• Landlines should work even when you experience an outage. In the event of an emergency that requires a call to 911, the operator will quickly track a call from a landline, but a cellular device cannot necessarily be traced. This may seem absurd in the era of GPS technology, but, emergency call centers can only track a cellular call to the nearest cell site.

• The sound quality is much better with a landline than a cell phone. This is very important if you have any type of hearing deficit.

• Landlines can be cheaper than cell service

• Home security systems use your telephone line to connect to an emergency call center. Although there are more options for wireless security services, these present similar challenges that cell phones do during storms or in areas with bad signal.

• Many phone service providers offer landline service without a contract.

Take a Break: Kirie

 

This is made from one sheet of paper

Kirie is the Japanese art of paper cutting. It’s mesmerizing to watch the masters at their craft.

You’ll need an Exacto knife and a mat.  Try your hand at it.

Not interested in today’s activities, try the Take a Break Pinterest Board.

Life with Chronic Conditions: Staying Tidy/Alternatives to Retail therapy

Several years ago,  I wrote a post The KonMari Method for Tidying When Affected by a Chronic Condition that generated a lot of interest. With the arrival of the Neflix series, “Tidying Up with Marie Kondo,” the popularity of de cluttering by only keeping what “sparks joy” is making headlines. This time it’s because so many people are doing it charity shops and landfills are overwhelmed with the amount of stuff people are dropping off. In short, it’s gone from a cluttering problem to a “waste crisis.”

Because her initial book came out in 2014, there are millions of people who have and continue to use some aspect or all of it. There is a lot to be said for her method of tidying and getting rid of clutter. If you’ve haven’t tried it, read The KonMari Method for Tidying When Affected by a Chronic Condition. 

However, our buy, buy, buy economy combined with get rid of it if it doesn’t “spark joy” is creating a perfect storm for waste haulers. Yet, there is another Japanese tradition-mottainai-the interdependence and impermanence of things-which we should be aware of along with KonMari

Mottainai follows the four Rs: reduce, reuse, recycle and respect. It attempts to communicate the inherent value in a thing and encourage using objects fully or all the way to the end of their lifespan. It is an ancient Buddhist philosophy deeply rooted in Japanese Culture for centuries, to have respect and not to waste the resources and to use them with a sense of gratitude.

While Konmari appears to incorporate some of these ideas, one has to wonder at the giant bags sitting outside the homes of the Netflix series that have undergone the “spark joy” purge.

The big “miss” of KonMari is that  many find “retail therapy” a  release from life’s anxieties and stressors. They also use it as a way to reward themselves as well as celebrate when good things happen. Very often it’s a social opportunity, with shopping combined with lunch or dinner at a special restaurant or cafe.

Research shows that shopping gives people a “sense of control,” which many of those affected by chronic conditions feel like they don’t have much of. It’s also been found to reduce sadness, and there is also the added bonus of walking and getting exercise if you go to the mall or a big box store.

The down sides of retail therapy are obvious-financial issues; creating more clutter in your home; and ultimately a waste crisis-the landfills are already full.  However, there are ways to turn this around, which is the focus of today’s post.

Tips to help you control your “retail therapy” so you don’t end up amassing “stuff.” Yes you can still indulge in a favorite past time but with some clear guidelines:

• Set a budget and don’t waver. Your better off leaving credit cards at home and only using cash.

• Know your “spending triggers” What moods or things will tempt you to make unplanned purchases? Recognizing them can help reduce their power over you to make unnecessary purchases.

• Follow the 48 hour rule. Before you drop a “want” into your shopping cart, write down the item and price and give yourself 48 hours to think about it.

• Remove spending and coupon apps from your phone and unsubscribe to Emails that will encourage you to spend.

•  If you are shopping in a store, don’t give them your e-mail address or agree to a credit card

• Window Shopping can improve moods. Try shopping with a friend where you design a wardrobe, a room in someone’s house etc. Make it a game. Set parameters such as how much money can be spent, what colors can be used, etc.

• Make reminder lists-use your smart phone to create various lists such as-groceries; items you may need from a specific store; gifts-when you learn about items that you think are right for someone add the item along with their name. Only shop from your list.

• Before you make a purchase think about how you will dispose of the item when you are through with it.

• Shop thrift stores over retail, though stick to the needs vs the wants.

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Alternatives to Retail Therapy: Shopping provides opportunities for choice, exercising, and socializing. Yet, there are a number of things to do instead that offer the same benefit resulting in your feeling better as well as reducing waste.

• Repair rather than discard. With sites like IFIXIT  (electronics); the Family Handyman and 8 websites to find DIY & Home Repair Tips  learn how to repair items that you may have normally discarded. Do it long enough and you can start helping friends and maybe even turn it into a small business that you can run from home.

• Create a local swap group. You can do this via Facebook or with friends.

• Host an abundance swap. These can be a great deal of fun, particularly if you do this around the holidays when people are looking for gifts and don’t have money to spend. Every year our town holds a town wide tag sale and we have one village green that is designated as a freebie zone.  Check out the Ashland Abundance Swap that has been held every year since 2004.

• Look for, start or host a “fix it clinic.” Basically these clinics will teach you repair skills. At Fix-It Clinics, people small household appliances, clothing, electronics, mobile devices and more and receive free guided assistance from volunteers with repair skills to disassemble, troubleshoot and fix their items. Check out the Fixit Clinic Facebook page.

• Shop online, put items in the cart but don’t buy. According to research, the actual act of putting items in a cart and not buying produced the same sadness reducing effects as actually purchasing something. So, it’s not the actual purchase which produces the results, but the selection of items as if you were going to buy them that reduces sadness.

• Go to the library and pick out a book. You have a sense of control over what you choosing but without spending anything.

• Focus on the part of your social circle that don’t use retail therapy. Yes it is fun to go shopping with a friend, where you have lunch or dinner as part of the experience. However, if you are having a rough patch make a social engagement with a friend(s) that isn’t necessarily tied in with the retail therapy scene.

• What alternatives are there in your community to celebrate good news or combat a negative experience? Some options could include inviting friends over for a bonfire; tea; dinner and a movie; game night; or a walk in the park. Check the newspapers and on-line resources for local events that offer entertainment alternatives. You’ll meet new people that way that share a common interest.

• instead of walking the mall, go for a walk in your neighborhood, a park, by the beach etc.

• Join an exercise, Qigong, or yoga class

• Attend in person support groups that pertain to your particular chronic condition

 Ultimately,  if you don’t need it, don’t bring it into your home or, if it’s a gift, don’t allow it to settle in if you don't like it. 

Take a Break: Explore the art of Yayoi Kusama

 A celebrated Japanese artist, Yayoi Kusama, has lived voluntarily in a psychiatric hospital since 1977.  With an international following, Kusama was born in 1929 in the mountain town of Matsumoto, began painting from hallucinations she experienced as a young girl. Some of her antiwar sentiments stem from the fact that she lived through World War II in Japan, going to work at a military factory to sew parachutes when she was just 13 years old. “Since I was 10 years old I have been painting every day,” she said. “And even now there is not a day that I do not paint.” She added, “I still see polka dots everywhere.”

As Kusama explains, "one day I was looking at the red flower patterns of the tablecloth on a table, and when I looked up I saw the same pattern covering the ceiling, the windows and the walls, and finally all over the room, my body, and the universe. I felt as if I had begun to self-obliterate, to revolve in the infinity of endless time and the absoluteness of space, and be reduced to nothingness."

How to paint like Kusama

Not interested in today’s activities, try the Take a Break Pinterest Board.