Starting this Sunday, we will be posting the latest information about chronic conditions that has appeared in the news and medical journals.
Beyond Tender Loving Care: TLCs’ Promise Health and Happiness Lifestyle changes -- such as getting more exercise, time in nature, or helping others -- can be as effective as drugs or counseling to treat an array of mental illnesses, according to a new paper published by the American Psychological Association.
Struggling to follow Doctor’s Orders: Paid caregivers may lack the skills to take on health-related tasks in Senior’s Homes. Paid caregivers make it possible for seniors to remain living in their homes. The problem, according to a new Northwestern Medicine study, is that more than one-third of caregivers had difficulty reading and understanding health-related information and directions. Sixty percent made errors when sorting medications into pillboxes.
Higher Levels of Social Activity Decrease the Risk of Developing Disability in Old Age Afraid of becoming disabled in old age, not being able to dress yourself or walk up and down the stairs? Staying physically active before symptoms set in could help. But so could going out to eat, playing bingo and taking overnight trips.
Zinc Reduces the Burden of the common Cold: Zinc supplements reduce the severity and duration of illness caused by the common cold, according to a systematic review published in The Cochrane Library. The findings could help reduce the amount of time lost from work and school due to colds.
Study Unravels Link between stress and chronic health issues: People's emotional response to challenges may affect how their body reacts to stress, according to a new study. To reach that conclusion, researchers from the University of Pittsburgh had individuals make a speech in a laboratory in front of a video camera and a panel of judges. The participants' physical responses were monitored during the speech, and they were later asked about the emotions they felt while delivering the speech.
Vitamin D May Help Keep Blood Sugar Under Control: Drinking yogurt with extra vitamin D may help people with diabetes regulate their blood sugar, a study from Iran finds. In the trial, 90 adults with diabetes were divided into three groups, all given daily yogurt drinks: one group received plain yogurt, one got yogurt with extra vitamin D, and one was given yogurt with extra vitamin D and calcium. At the end of 12 weeks, "we found a relatively remarkable improvement" in blood sugar levels in the groups that got extra vitamin D, compared to the plain yogurt group, co-author Tirang Neyestani, associate professor at National Nutrition and Food Technology Research Institute in Iran, told Reuters Health in an e-mail.
Cell Phones Alter Brain Function, but health effects still unknown
New Research sheds light on when it’s safe to drive after a stroke
When it comes to elective surgery in the United States, where patients live and which doctors they see play a big role how they are treated.
Joining a Support Group just as helpful as group therapy for people with depression.
5 Steps to Take After a Traumatic Diagnosis by Joseph Nowinski, PHD
Why Doctors are Ordering Too Many CT Scans and MRIs
Sunday, February 27, 2011
Saturday, February 26, 2011
Fear: Gaining a Perspective on It
As I continue to work on the updating of my Care of the Whole Person for the year, I’ve noticed that I’ve written several posts on fear but haven’t included something about it in my handout. That will certainly change with the new update. So in preparation for it, here are some things to think about in terms of fear.
Rick Hanson, the neuroscientist and author of “The Buddha’s Brain,” continues to write a variety of articles on fear, how fear impacts us and what we can do to help keep it in check. In one of his most recent posts, “Are You Uneasy?” he starts off by saying, “Consider these two mistakes:
1. You think there's a tiger in the bushes, but actually there isn't one.
2. You think no tiger is in the bushes, but actually one is about to pounce.
Most of us make the first error much more often than the second one, because:
· Evolution has given us a paranoid brain. In order to survive and pass on genes, it's better to make the first mistake a hundred times rather than make the second mistake even once; the cost of the first mistake is fear for no reason, but the cost of the second mistake is death.
· Saturated with media, we get keyed up about murders, disasters, economic turmoil, horrible things happening to other people, etc. - even though our own local situation is usually much less dangerous.
· In ways that have been repeated throughout history, some political groups and even governments try to make the public more compliant by exaggerating the threat of apparent enemies.
· As a child, you were stuck with certain family members or peers, and had little power and limited coping abilities. Naturally, a person develops expectations and anxieties based on that history - even though today, you have much more freedom to find the people you want to be with, much more say over what happens to you, and many more ways to deal with tough situations.
People living with chronic conditions not only deal with their own fears, but also that of friends and family and the medical system. It’s the fear of “what if,” that prompts providers to order more tests, x-rays and even treatments. Since illness of any sort implies vulnerability and possible death, does this make providers more vigilant about finding even the remotest “tiger?” Of course, that and the fear of being sued.
While fear can be healthy when it helps to modify risky behavior- smoking, not wearing a seat belt, unprotected sex etc., it is uncontrolled or unrealistic fear that interferes with health and well being. How can we reign some of this in?
• Understand that fear is part of being human and we all experience it to one degree or another. Do not be ashamed of your fear. You wouldn’t be human if you didn’t have some fears, particularly when it comes to death, pain etc. Since you are not alone in this, reaching out to others can help-participate in a support group, talk to a friend, provider and/or counselor about your fears.
• Check in when you fear has a hold on you and ask yourself the following questions:
- Is my immediate safety at stake?
- Is the immediate safety of someone I love and care about at stake?
- Is the amount of fear I’m experiencing reflective of what’s actually going on or what I think might happen?
Unless there is an immediate threat-not there might be a treat-try to remind yourself to live mindfully in the now. Be realistic in your fears as much as possible.
• Spirituality can help you answer some of life’s mysteries and fears.
• Meditation is an excellent way to help calm the brain, which effects how you think.
Other Resources
Fear of Death
Fear in the Patient Provider Relationship
Fear How to Live with It
Rick Hanson, the neuroscientist and author of “The Buddha’s Brain,” continues to write a variety of articles on fear, how fear impacts us and what we can do to help keep it in check. In one of his most recent posts, “Are You Uneasy?” he starts off by saying, “Consider these two mistakes:
1. You think there's a tiger in the bushes, but actually there isn't one.
2. You think no tiger is in the bushes, but actually one is about to pounce.
Most of us make the first error much more often than the second one, because:
· Evolution has given us a paranoid brain. In order to survive and pass on genes, it's better to make the first mistake a hundred times rather than make the second mistake even once; the cost of the first mistake is fear for no reason, but the cost of the second mistake is death.
· Saturated with media, we get keyed up about murders, disasters, economic turmoil, horrible things happening to other people, etc. - even though our own local situation is usually much less dangerous.
· In ways that have been repeated throughout history, some political groups and even governments try to make the public more compliant by exaggerating the threat of apparent enemies.
· As a child, you were stuck with certain family members or peers, and had little power and limited coping abilities. Naturally, a person develops expectations and anxieties based on that history - even though today, you have much more freedom to find the people you want to be with, much more say over what happens to you, and many more ways to deal with tough situations.
People living with chronic conditions not only deal with their own fears, but also that of friends and family and the medical system. It’s the fear of “what if,” that prompts providers to order more tests, x-rays and even treatments. Since illness of any sort implies vulnerability and possible death, does this make providers more vigilant about finding even the remotest “tiger?” Of course, that and the fear of being sued.
While fear can be healthy when it helps to modify risky behavior- smoking, not wearing a seat belt, unprotected sex etc., it is uncontrolled or unrealistic fear that interferes with health and well being. How can we reign some of this in?
• Understand that fear is part of being human and we all experience it to one degree or another. Do not be ashamed of your fear. You wouldn’t be human if you didn’t have some fears, particularly when it comes to death, pain etc. Since you are not alone in this, reaching out to others can help-participate in a support group, talk to a friend, provider and/or counselor about your fears.
• Check in when you fear has a hold on you and ask yourself the following questions:
- Is my immediate safety at stake?
- Is the immediate safety of someone I love and care about at stake?
- Is the amount of fear I’m experiencing reflective of what’s actually going on or what I think might happen?
Unless there is an immediate threat-not there might be a treat-try to remind yourself to live mindfully in the now. Be realistic in your fears as much as possible.
• Spirituality can help you answer some of life’s mysteries and fears.
• Meditation is an excellent way to help calm the brain, which effects how you think.
Other Resources
Fear of Death
Fear in the Patient Provider Relationship
Fear How to Live with It
Wednesday, February 23, 2011
Take a Break: Start a Journal
Struggling with next steps I needed to take in my career, a board member and friend, Cris, told me to set aside some time and “just write.” I bought a notebook, found a pen I liked, and parked it on my nightstand. I spent about a week writing at the same every day for about 20 minutes. I was amazed how much it helped.
I didn’t assign myself anything to write, or even a format. Sometimes I wrote a poem, others an endless stream of words. I think I might have even doodled some. While I’ve tried doing something similar on the computer, I seem to do best when I use a pen and paper. Ultimately, I’ve found that when I’m obsessing about something-it helps to just write.
I’m far from alone in finding journaling helpful. As Jennifer Moon wrote, A journal is a friend that is always there and is always a comfort. In bad moments I write, and usually end up feeling better. It reflects back to me things that I can learn about my world and myself. It represents a private space in my life, a beautiful solitude, the moments before I go to sleep just to stop and note what 'there' is about the day or about my life at the time. I think that it has enabled me to feel deeper and more established as a person, more in control and more trusting of life.
There is a growing body of research that shows that journaling is healing. It helps to clear your mind, encourages mindfulness, gets the creativity juices flowing, plus serves the practical purpose of letting you know a year from now what you were thinking and doing on this date.
Writing about traumatic, stressful or emotional events has been found to result in improvements in both physical and psychological health, in people with chronic and life threatening diseases as well as the general population. The journal Advances in Psychiatric Treatment has a good review article on this topic Emotional and Physical Health Benefits of Expressive Writing, by Karen A. Baikie and Kay Wilheim.
Unless you feel compelled to use something more elaborate, a notebook or computer works just fine for journal writing. If you want to make your own journal, check out “How to make a hardcover min art journal."
So some basic journaling tips
• Try to write daily . Twenty minutes is recommended, but do what you can do
• This is private. You can share if you want, but keeping it to yourself helps to free you to write what you think and feel.
• Don’t worry about grammar, spelling, formatting etc. Just get it down.
• If you feel like drawing instead of writing that’s fine.
• There are a variety of types of journals-diaries; memoirs; travel logs; history and events; or even scrap booking. Do what feels right for you.
• Writing utensils and the journal itself are up to you. Felt tip pens, markers, pens, pencils and so forth all worth. If you are so inclined, taping and pasting items in your journal is just fine.
For more tips on journaling check, as well as prompts to inspire you to write, check out the following
Scribe Time Journal Writing Tips
Women’s Memoirs: Blog about journaling and writing memoirs
I didn’t assign myself anything to write, or even a format. Sometimes I wrote a poem, others an endless stream of words. I think I might have even doodled some. While I’ve tried doing something similar on the computer, I seem to do best when I use a pen and paper. Ultimately, I’ve found that when I’m obsessing about something-it helps to just write.
I’m far from alone in finding journaling helpful. As Jennifer Moon wrote, A journal is a friend that is always there and is always a comfort. In bad moments I write, and usually end up feeling better. It reflects back to me things that I can learn about my world and myself. It represents a private space in my life, a beautiful solitude, the moments before I go to sleep just to stop and note what 'there' is about the day or about my life at the time. I think that it has enabled me to feel deeper and more established as a person, more in control and more trusting of life.
There is a growing body of research that shows that journaling is healing. It helps to clear your mind, encourages mindfulness, gets the creativity juices flowing, plus serves the practical purpose of letting you know a year from now what you were thinking and doing on this date.
Writing about traumatic, stressful or emotional events has been found to result in improvements in both physical and psychological health, in people with chronic and life threatening diseases as well as the general population. The journal Advances in Psychiatric Treatment has a good review article on this topic Emotional and Physical Health Benefits of Expressive Writing, by Karen A. Baikie and Kay Wilheim.
Unless you feel compelled to use something more elaborate, a notebook or computer works just fine for journal writing. If you want to make your own journal, check out “How to make a hardcover min art journal."
So some basic journaling tips
• Try to write daily . Twenty minutes is recommended, but do what you can do
• This is private. You can share if you want, but keeping it to yourself helps to free you to write what you think and feel.
• Don’t worry about grammar, spelling, formatting etc. Just get it down.
• If you feel like drawing instead of writing that’s fine.
• There are a variety of types of journals-diaries; memoirs; travel logs; history and events; or even scrap booking. Do what feels right for you.
• Writing utensils and the journal itself are up to you. Felt tip pens, markers, pens, pencils and so forth all worth. If you are so inclined, taping and pasting items in your journal is just fine.
For more tips on journaling check, as well as prompts to inspire you to write, check out the following
Scribe Time Journal Writing Tips
Women’s Memoirs: Blog about journaling and writing memoirs
Saturday, February 19, 2011
Take Ten Through out the day: Exercise and Meditation
Exercise: There are many benefits from exercising:
• Improves mood and energy levels while helping to reduce stress and depression. It can also help to improve both sleep and your sex life, to say nothing of your immunity.
• Can help to maintain or lose weight;
• Can help to reduce and/or keep in check chronic diseases, such as heart disease, osteoporosis and type 2 diabetes.
At least 30 minutes of aerobic exercise three days a week seems to reduce cognitive decline in older people. Studies also show that people who participate in regular aerobic exercise live longer than those who don’t.
According to the Centers for Disease Control and Prevention (CDC), adults need muscle-strengthening activities on 2 or more days a week that work all major muscle groups (leg, hips, back, abdomen, chest, shoulders and arms) and one of the following
• At least 2 hours and 30 minutes (150) minutes of moderate intensity aerobic activity (i.e. brisk walking) every week; or
• 1 hour and 15 minutes (75 minutes) of vigorous-intensity aerobic activity (i.e. jogging or running) every week and muscle; or
• An equivalent mix of moderate-and vigorous-intensity aerobic activity
The good news is that you don’t have to do this all at once. 10 minutes at a time is fine. This is often a lot easier for people to squeeze into their busy days, and ideal for those with chronic conditions, where even five minutes feels like enough.
Not only is it best to spread your activity out during the week, but you can break it up into smaller chunks of time during the day. As long as you're doing your activity at a moderate or vigorous effort for at least 10 minutes at a time.
There are lots of things you can do in 10 minutes. Try some of these:
• Walk, ride your bike, or jog to places you are going to have to go to anyway, such as the post office, grocery store, around the block, to a friends etc.
• Park the car as far away as possible when you go to the store.
• Household chores count, so the next time you have to mow the grass, shovel snow, make beds or clean think of it as helping you towards the 30 minutes of exercise you need.
• Take stairs instead of an elevator
• Jump rope
• “Boot camp” it with some of the many 10 minute exercises available free on line
Fitness Magazine’s 10 Minute Workouts
Exercise TV: Lots of free workouts of all types of lengths. Includes free yoga and Pilates.
Yoga: Recommended as both exercise and meditation, yoga has the benefits of both. Two for the price of one. My kind of deal.
According to the U.S. National Institutes of Health, proper yoga practice combines: Physical postures that participants flow into and then hold, before proceeding to the next posture; a focus on breathing techniques that make participants more aware of their bodies; and deep meditation and relaxation, allowing participants to focus on their spirituality.
Because of its roots in ancient Indian philosophy, yoga is classified as “alternative” in western medicine. However, a growing body of research is showing that yoga can help people with a wide array of health issues-women with breast cancer, men with back pain, and anyone with headaches, sleep issues, pain, anxiety, stress, depression, or high blood pressure.
There are many styles of yoga, and you may have to shop around to find what works for you. Check with your condition specific organization (e.g. Parkinson’s Disease Foundation, American Cancer Society), as some have designed yoga videos, tapes and even instructional booklets.
And yes, you can take quick yoga breaks throughout your day at the following links:
Kripalu Yoga Breaks: Also includes guided relaxation.
Office Break Yoga
Yoga Breaks 10 minutes through 60 minutes
5 Minute Office Yoga Break Podcast with Jennifer Maagendans
Sitting Yoga
Qigong /Tai Chi: Similar to yoga, you will find Qigong is often recommended as exercise and meditation. Sometimes referred to as “moving meditation,” there is a growing body of research that indicates that regular practice of Qigong /Tai Chi have many of the health benefits of Yoga. While there is a lot that can be learned on-line, it is best to start with an instructor. Again, check with the condition specific organization for any information they might have on this topic.
Meditation: Helping to calm and relax us, there are significant health benefits to daily meditation. There are many different approaches, from moving meditations, such as Qigong and yoga, to quietly sitting in place, it can be practiced throughout the day. While links are provided below for practicing meditation on-line, many hospitals, clinics and condition specific organizations now offer mindfulness based stress reduction (MBSR). Developed by Dr. Jon Kabat-zinn, this has been well studied and documented for its benefits to help deal with pain and illness. Ask where you receive care about what programs may be available in your area.
Mindful Meditations from the UCLA Semel Institute
Meditations from Beliefnet
Take a Break to Meditate
Other Resources
Fitness from the Mayo Clinic
National Center on Physical Activity and Disability
Physical Activity for Everyone
Meditation: Take a Stress reduction break wherever you are
• Improves mood and energy levels while helping to reduce stress and depression. It can also help to improve both sleep and your sex life, to say nothing of your immunity.
• Can help to maintain or lose weight;
• Can help to reduce and/or keep in check chronic diseases, such as heart disease, osteoporosis and type 2 diabetes.
At least 30 minutes of aerobic exercise three days a week seems to reduce cognitive decline in older people. Studies also show that people who participate in regular aerobic exercise live longer than those who don’t.
According to the Centers for Disease Control and Prevention (CDC), adults need muscle-strengthening activities on 2 or more days a week that work all major muscle groups (leg, hips, back, abdomen, chest, shoulders and arms) and one of the following
• At least 2 hours and 30 minutes (150) minutes of moderate intensity aerobic activity (i.e. brisk walking) every week; or
• 1 hour and 15 minutes (75 minutes) of vigorous-intensity aerobic activity (i.e. jogging or running) every week and muscle; or
• An equivalent mix of moderate-and vigorous-intensity aerobic activity
The good news is that you don’t have to do this all at once. 10 minutes at a time is fine. This is often a lot easier for people to squeeze into their busy days, and ideal for those with chronic conditions, where even five minutes feels like enough.
Not only is it best to spread your activity out during the week, but you can break it up into smaller chunks of time during the day. As long as you're doing your activity at a moderate or vigorous effort for at least 10 minutes at a time.
There are lots of things you can do in 10 minutes. Try some of these:
• Walk, ride your bike, or jog to places you are going to have to go to anyway, such as the post office, grocery store, around the block, to a friends etc.
• Park the car as far away as possible when you go to the store.
• Household chores count, so the next time you have to mow the grass, shovel snow, make beds or clean think of it as helping you towards the 30 minutes of exercise you need.
• Take stairs instead of an elevator
• Jump rope
• “Boot camp” it with some of the many 10 minute exercises available free on line
Fitness Magazine’s 10 Minute Workouts
Exercise TV: Lots of free workouts of all types of lengths. Includes free yoga and Pilates.
Yoga: Recommended as both exercise and meditation, yoga has the benefits of both. Two for the price of one. My kind of deal.
According to the U.S. National Institutes of Health, proper yoga practice combines: Physical postures that participants flow into and then hold, before proceeding to the next posture; a focus on breathing techniques that make participants more aware of their bodies; and deep meditation and relaxation, allowing participants to focus on their spirituality.
Because of its roots in ancient Indian philosophy, yoga is classified as “alternative” in western medicine. However, a growing body of research is showing that yoga can help people with a wide array of health issues-women with breast cancer, men with back pain, and anyone with headaches, sleep issues, pain, anxiety, stress, depression, or high blood pressure.
There are many styles of yoga, and you may have to shop around to find what works for you. Check with your condition specific organization (e.g. Parkinson’s Disease Foundation, American Cancer Society), as some have designed yoga videos, tapes and even instructional booklets.
And yes, you can take quick yoga breaks throughout your day at the following links:
Kripalu Yoga Breaks: Also includes guided relaxation.
Office Break Yoga
Yoga Breaks 10 minutes through 60 minutes
5 Minute Office Yoga Break Podcast with Jennifer Maagendans
Sitting Yoga
Qigong /Tai Chi: Similar to yoga, you will find Qigong is often recommended as exercise and meditation. Sometimes referred to as “moving meditation,” there is a growing body of research that indicates that regular practice of Qigong /Tai Chi have many of the health benefits of Yoga. While there is a lot that can be learned on-line, it is best to start with an instructor. Again, check with the condition specific organization for any information they might have on this topic.
Meditation: Helping to calm and relax us, there are significant health benefits to daily meditation. There are many different approaches, from moving meditations, such as Qigong and yoga, to quietly sitting in place, it can be practiced throughout the day. While links are provided below for practicing meditation on-line, many hospitals, clinics and condition specific organizations now offer mindfulness based stress reduction (MBSR). Developed by Dr. Jon Kabat-zinn, this has been well studied and documented for its benefits to help deal with pain and illness. Ask where you receive care about what programs may be available in your area.
Mindful Meditations from the UCLA Semel Institute
Meditations from Beliefnet
Take a Break to Meditate
Other Resources
Fitness from the Mayo Clinic
National Center on Physical Activity and Disability
Physical Activity for Everyone
Meditation: Take a Stress reduction break wherever you are
Wednesday, February 16, 2011
Take a Break: In Six Words or Less
How would you write about your day, life, lover, friend, pet or anything else in six words or less? While the Smith Magazine website is all about telling stories, they are also the home to the six word story. Here are a few of their recent entries (you can tell it was recently Valentine’s Day):
e-harmony rejects found love on facebook
You lost me at hello “ma’am.”
My quiet day is getting loud.
Wistfully polish my stilettos with babywipes.
Pick a topic and write your six-letter story and publish it instantly, if you so choose, at Smith Magazine. In the mean time, here’s my six-word story on life in rural northern New England. More snow and sleet. Enough already!
e-harmony rejects found love on facebook
You lost me at hello “ma’am.”
My quiet day is getting loud.
Wistfully polish my stilettos with babywipes.
Pick a topic and write your six-letter story and publish it instantly, if you so choose, at Smith Magazine. In the mean time, here’s my six-word story on life in rural northern New England. More snow and sleet. Enough already!
Saturday, February 12, 2011
Health Advocate- Who What When and Where
Most people with chronic conditions have probably heard or read that it’s a good idea to have an advocate at medical appointments, when you are hospitalized and to help you navigate the medical system.
So who makes a good advocate-spouse, best friend, parent, adult child or some one trained in that role? When do you need them? What do they do? Can I hire one? Where do I look for one?
Advocates can fill a number of roles. Simply put, an advocate helps to make sure you get the care you need and want, medically as well as at home. Because many advocates are often family and/or close friends, they can also be the one helping to care for you physically.
With the majority of people living for many years with a chronic condition, the role of advocacy has taken on a new meaning in the last several decades. Providers have embraced the idea that it’s up to the person to decide about how they want to live, whether to do treatment or not, what type etc. In short, the more complex health care becomes, the more choices we have and the more we are asked to make them. An advocate can help make a lot of this easier.
Start by addressing how you would use an advocate. Do you want them to go to appointments with you or the person you are caring for? Do you need help figuring out treatment options, insurance forms, payment plans, care at home, clinical trials and/or how to navigate the health care system?
If you, or the person you are caring for, are in need a personal care attendant, keep in mind that some will have good advocacy skills. Others may be excellent at meeting personal care needs, but are not comfortable with a strong advocacy role. For the most part, an advocate that you hire isn’t going to do the personal care.
As noted, you can hire a nurse manager or care manager. However, many people with chronic conditions can’t afford it. Since aspects of advocacy are covered by medical (care) and service managers (social workers), and hiring an advocate can range anywhere from $35 to $200 an hour, start by finding out what type of advocacy resources are available from the following:
• The local chapter of a condition specific organization, e.g. The Diabetes Association l A growing number of groups are offering advocacy training and some even have trained staff who can act as your case manager.
• Independent Living Center for your state Call 713-520-0232
• Medical center, hospital or clinic where you receive your care.
• Offices on Aging, Senior centers
• Cancer centers and other condition specific centers within a medical system, e.g. Motion Disorders Clinic, often offer peer-to-peer advocates.
• Support group: Often through these groups, people become each other’s peer advocate.
Depending on the community where you live, churches and even local ambulance services can offer some advocacy related services. You can always dial 2-1-1, the state specific helpline, and ask about advocacy resources for your community. Eldercare Locator connects older Americans and their caregivers with sources of information on senior services, including case management. You can also reach them by calling 1-800-677-1116 weekdays, 9:00 am-8:00 pm.
Peer-to-peer programs can be very helpful in assisting you in navigating the healthcare system, making decisions and identifying community resources that will be helpful. These programs are often free.
Who makes a good advocate? Truth be told it may not be your spouse, partner or best friend. It can be hard for them to be objective about the information and choices being offered. You may not want to share certain aspects of your with them. They also may not have the background or skill sets to deal with getting you in quicker to see a doctor, dealing with your insurance company or actively listening. It’s sometimes best to have a neutral third party.
These are things an advocate can do for you:
At a Medical Appointment
• Can help you prepare for the visit by going over various issues and problems you may be experiencing. They can be a “check and balance” to make sure that all of your questions are answered and an effective plan is in place before you leave.
• Take good notes during the visit with the medical provider.
• Listen objectively and can discuss with you what went on at a visit, hospitalization etc.
• Will provide you with a good written summary of office visits.
• With your permission, can speak on your behalf during the visit about issues and concerns you might be having and make sure that all questions are answered and a follow up plan is in place.
• Will keep your confidence and not discuss what happens with others unless you direct them to do so.
At the Hospital
These recommendations came from my colleague Grace, who not only has been a long standing board member for the non profit I am co director of, but has lived for many years with multiple chronic conditions:
1) Be an advocate for the person who is ill. Speak with (polite) authority to his/her medical providers and make it clear what you know the patient needs and what you reasonably expect them to offer.
2) Question procedures and prescriptions, making sure that what the provider is doing is not going to have a detrimental impact on the patient.
3) Explain the patient’s home situation to the doctor so (s)he will prescribe outpatient care and prescription medicines that are realistically affordable for the patient and can actually be realized; it does no good to recommend physical therapy or “third tier” medications if the person can’t afford them or has no access to get treatment.
4) Act as or organize an information conduit so the patient doesn’t have to answer dozens of phone calls from friends asking the same questions over and over again about the state of her/his health. Make sure other family and friends are informed as much as the patient wants them to be and request that calls be limited to encouragement and support instead of asking for daily healthcare updates from the patient. Also, be willing to return calls on behalf of the patient so (s)he isn’t overwhelmed with inquiries when (s)he doesn’t feel up to talking.
5) Offer to take care of some of the daily responsibilities the patient may have at home or organize a group of volunteers to help out: feed the pets, mow the lawn, shovel the snow, take in the mail, do the laundry, clean the house, do whatever makes sense to alleviate the patient’s worrying about what (s)he will find upon coming home.
For more information about advocacy during hospitalizations
Hospitalized: What Family and Friends Can do
Hospitalized What Family and Friends can do Take 2
Hospitalized Consumer Reports Study
At Home
• Help to arrange services so that you can remain at home. Such services might include: transportation, home health, meals, hospice, housing, fuel assistance and more
• Handle insurance and payment issues.
• Deal with work related issues.
Keep in mind, with the baby boomers now turning 65, there is going to be a growing demand for health advocates. Don’t be surprised that even if you qualify, the service may not be available any time soon. Therefore, as noted in the November post on social networking, staying connected with family and friends can help you draw upon advocates when you are most in need. To help them help you, share with them the post How to be a Friend with a Pen.
So who makes a good advocate-spouse, best friend, parent, adult child or some one trained in that role? When do you need them? What do they do? Can I hire one? Where do I look for one?
Advocates can fill a number of roles. Simply put, an advocate helps to make sure you get the care you need and want, medically as well as at home. Because many advocates are often family and/or close friends, they can also be the one helping to care for you physically.
With the majority of people living for many years with a chronic condition, the role of advocacy has taken on a new meaning in the last several decades. Providers have embraced the idea that it’s up to the person to decide about how they want to live, whether to do treatment or not, what type etc. In short, the more complex health care becomes, the more choices we have and the more we are asked to make them. An advocate can help make a lot of this easier.
Start by addressing how you would use an advocate. Do you want them to go to appointments with you or the person you are caring for? Do you need help figuring out treatment options, insurance forms, payment plans, care at home, clinical trials and/or how to navigate the health care system?
If you, or the person you are caring for, are in need a personal care attendant, keep in mind that some will have good advocacy skills. Others may be excellent at meeting personal care needs, but are not comfortable with a strong advocacy role. For the most part, an advocate that you hire isn’t going to do the personal care.
As noted, you can hire a nurse manager or care manager. However, many people with chronic conditions can’t afford it. Since aspects of advocacy are covered by medical (care) and service managers (social workers), and hiring an advocate can range anywhere from $35 to $200 an hour, start by finding out what type of advocacy resources are available from the following:
• The local chapter of a condition specific organization, e.g. The Diabetes Association l A growing number of groups are offering advocacy training and some even have trained staff who can act as your case manager.
• Independent Living Center for your state Call 713-520-0232
• Medical center, hospital or clinic where you receive your care.
• Offices on Aging, Senior centers
• Cancer centers and other condition specific centers within a medical system, e.g. Motion Disorders Clinic, often offer peer-to-peer advocates.
• Support group: Often through these groups, people become each other’s peer advocate.
Depending on the community where you live, churches and even local ambulance services can offer some advocacy related services. You can always dial 2-1-1, the state specific helpline, and ask about advocacy resources for your community. Eldercare Locator connects older Americans and their caregivers with sources of information on senior services, including case management. You can also reach them by calling 1-800-677-1116 weekdays, 9:00 am-8:00 pm.
Peer-to-peer programs can be very helpful in assisting you in navigating the healthcare system, making decisions and identifying community resources that will be helpful. These programs are often free.
Who makes a good advocate? Truth be told it may not be your spouse, partner or best friend. It can be hard for them to be objective about the information and choices being offered. You may not want to share certain aspects of your with them. They also may not have the background or skill sets to deal with getting you in quicker to see a doctor, dealing with your insurance company or actively listening. It’s sometimes best to have a neutral third party.
These are things an advocate can do for you:
At a Medical Appointment
• Can help you prepare for the visit by going over various issues and problems you may be experiencing. They can be a “check and balance” to make sure that all of your questions are answered and an effective plan is in place before you leave.
• Take good notes during the visit with the medical provider.
• Listen objectively and can discuss with you what went on at a visit, hospitalization etc.
• Will provide you with a good written summary of office visits.
• With your permission, can speak on your behalf during the visit about issues and concerns you might be having and make sure that all questions are answered and a follow up plan is in place.
• Will keep your confidence and not discuss what happens with others unless you direct them to do so.
At the Hospital
These recommendations came from my colleague Grace, who not only has been a long standing board member for the non profit I am co director of, but has lived for many years with multiple chronic conditions:
1) Be an advocate for the person who is ill. Speak with (polite) authority to his/her medical providers and make it clear what you know the patient needs and what you reasonably expect them to offer.
2) Question procedures and prescriptions, making sure that what the provider is doing is not going to have a detrimental impact on the patient.
3) Explain the patient’s home situation to the doctor so (s)he will prescribe outpatient care and prescription medicines that are realistically affordable for the patient and can actually be realized; it does no good to recommend physical therapy or “third tier” medications if the person can’t afford them or has no access to get treatment.
4) Act as or organize an information conduit so the patient doesn’t have to answer dozens of phone calls from friends asking the same questions over and over again about the state of her/his health. Make sure other family and friends are informed as much as the patient wants them to be and request that calls be limited to encouragement and support instead of asking for daily healthcare updates from the patient. Also, be willing to return calls on behalf of the patient so (s)he isn’t overwhelmed with inquiries when (s)he doesn’t feel up to talking.
5) Offer to take care of some of the daily responsibilities the patient may have at home or organize a group of volunteers to help out: feed the pets, mow the lawn, shovel the snow, take in the mail, do the laundry, clean the house, do whatever makes sense to alleviate the patient’s worrying about what (s)he will find upon coming home.
For more information about advocacy during hospitalizations
Hospitalized: What Family and Friends Can do
Hospitalized What Family and Friends can do Take 2
Hospitalized Consumer Reports Study
At Home
• Help to arrange services so that you can remain at home. Such services might include: transportation, home health, meals, hospice, housing, fuel assistance and more
• Handle insurance and payment issues.
• Deal with work related issues.
Keep in mind, with the baby boomers now turning 65, there is going to be a growing demand for health advocates. Don’t be surprised that even if you qualify, the service may not be available any time soon. Therefore, as noted in the November post on social networking, staying connected with family and friends can help you draw upon advocates when you are most in need. To help them help you, share with them the post How to be a Friend with a Pen.
Wednesday, February 9, 2011
Take a Break-Eatable Valentines
My Mom made the best sugar cookies, but only for special occasions-Christmas, Valentine’s Day and Easter. One year for Valentine’s, my mother suggested I take some of the sugar cookies instead of cards to school. From then on, whether it was for my class or one of my kids, sugar cookies were the card of choice.
This are not the type of cookie that does well dipped in royal icing. Instead, sprinkle colored sugars on before baking, or, try my current favorite, use “decorating pens” on cooled cookies. Both Wilton and Williams and Sonoma carry them. They come in lots of different colors and need to be warmed up to use.
While I’m including my Mom’s sugar cookie recipe below, use whatever dough you like, including the ones that are located near the cheese section at the grocery store. The idea is to make a cookie that you can have fun decorating.
I’ll be honest, I didn’t enjoy making these cookies as a kid as it seemed that it took forever with my mother’s hand maker. I now make the dough in no time in my food processor. Whether you use a mixer, your hands (my Aunt Margaret’s approach) or a food processor, the order of things is the same:
• Cream together 2/3 cup shortening and 1 1/4 cup sugar
• Add 2 eggs Mix well
• Add 3 cups flour, 11/2 t salt, 2 t baking powder and 11/2 t vanilla. Mix
• Form a ball and wrap in wax paper. Store in the refrigerator overnight-if you are desperate 30 minutes in the freezer works.
Pre heat oven to 350.
Cut the cookie dough into at least quarters. I like mine very thin, so I cut the dough into 8ths. Put a baking paper on a cookie pan. Start rolling out your dough a section at a time on a well floured board. Cut with cookie cutters. My Mom would do a quarter at a time and would make “blobs” with the small pieces left from cutting out. We were allowed to eat the blobs, saving the “nice” cookies for later.
Cook for 12-15 minutes. Check periodically.
If you are looking for other Valentine’s Day activities, check out these past posts:
Paper and Scissors (chains, cobweb, German Paper cutting)
Quilling
Valentine’s Paper Basket
This are not the type of cookie that does well dipped in royal icing. Instead, sprinkle colored sugars on before baking, or, try my current favorite, use “decorating pens” on cooled cookies. Both Wilton and Williams and Sonoma carry them. They come in lots of different colors and need to be warmed up to use.
While I’m including my Mom’s sugar cookie recipe below, use whatever dough you like, including the ones that are located near the cheese section at the grocery store. The idea is to make a cookie that you can have fun decorating.
I’ll be honest, I didn’t enjoy making these cookies as a kid as it seemed that it took forever with my mother’s hand maker. I now make the dough in no time in my food processor. Whether you use a mixer, your hands (my Aunt Margaret’s approach) or a food processor, the order of things is the same:
• Cream together 2/3 cup shortening and 1 1/4 cup sugar
• Add 2 eggs Mix well
• Add 3 cups flour, 11/2 t salt, 2 t baking powder and 11/2 t vanilla. Mix
• Form a ball and wrap in wax paper. Store in the refrigerator overnight-if you are desperate 30 minutes in the freezer works.
Pre heat oven to 350.
Cut the cookie dough into at least quarters. I like mine very thin, so I cut the dough into 8ths. Put a baking paper on a cookie pan. Start rolling out your dough a section at a time on a well floured board. Cut with cookie cutters. My Mom would do a quarter at a time and would make “blobs” with the small pieces left from cutting out. We were allowed to eat the blobs, saving the “nice” cookies for later.
Cook for 12-15 minutes. Check periodically.
If you are looking for other Valentine’s Day activities, check out these past posts:
Paper and Scissors (chains, cobweb, German Paper cutting)
Quilling
Valentine’s Paper Basket
Saturday, February 5, 2011
The Importance of Spirituality
Through out February, I will be looking at the various recommendations of the handout Care of the Whole Person, which will have its annual update in March. Let me know your ideas and suggestions for revisions.
Develop or use your spirituality and/or faith: For some this may be a renewed faith in their religion for others it is an opportunity to find beliefs that provide comfort.
I have been reluctant to write much about spirituality for several reasons, the biggest one being that for many people spirituality and religion are interchangeable terms. This is not true. While a religion can nurture spiritual beliefs, they are dictated by institutional practices, rites and specified beliefs. My biggest problem with many organized religions is that they exclude people for one reason or another. Given how living with a chronic condition can make one feel apart from others, the less we divide the better.
I would like to note that not all religious groups practice such divisions. In fact, one of the most healing places I ever held retreats in Vermont was the Weston Priory. This group of Benedictine monks opened up their facilities to our women and families living with HIV/AIDS. They never once asked about religious affiliations, invited us to participate as we wished in their services and always referred to us as their sisters and brothers. They even allowed us to use a small area of their land as a memorial to the women and children who had died of AIDS. Each time we went, they would join us on the hillside as we remembered those who had gone before us. Their prayers could be from a Native American or eastern tradition just as easily as it could be Christian. The important thing is that we all felt accepted, loved and connected. Their gift of hospitality was enormous and one I will never forget.
Howard Clinebell, who practiced pastoral psychology and counseling for three decades at the School of Theology in Claremont, California, believed that humans have seven spiritual hungers in common:
• All people need to experience regularly the healing and empowerment of love - from others, self, and an ultimate source/God.
• Every one needs to experience renewing times of transcendence - moments that expand us beyond the immediate sensory spheres.
• Every body needs vital beliefs that give some sense of meaning and hope the midst of losses, tragedies, and failures.
• Every person needs to have values, priorities, and life commitments - usually centered in issues of justice, integrity, and love - that guide us in personally and socially responsible living.
• Each human being needs to discover and develop their inner wisdom, creativity and love of their unique transpersonal/spiritual self.
• All people need a deepening awareness of oneness with other people and with the natural world, the wonderful web of all living things.
• Every human being needs spiritual resources to help heal the painful wounds of grief, guilt, resentment, unforgiveness, self-rejection, and shame. We also need spiritual resources to deepen our experiences of trust, self-esteem, hope, joy and love of life. University of Minnesota’s “Taking Charge of Your Health”
For those with a more scientific bent For 40 years, laboratories at the Harvard Medical School have systematically studied mind body interactions. The research established that when a person engages in a repetitive prayer, word, sound or phrase and when intrusive thoughts are passively disregarded, a specific set of physiologic changes ensue. These changes — decreased metabolism, heart rate, blood pressure and rate of breathing — are the opposite of those induced by stress, and have been labeled the relaxation response. Surveys indicate that over 60% of visits to health care professionals are for conditions caused or exacerbated by stress and that the relaxation response is an effective therapy for stress-related conditions.
Many people who elicit the relaxation response also note increased spirituality. Spirituality is expressed as experiencing the presence of a power, a force, an energy or what was perceived of as God, and this presence is close to the person. Spirituality and Healing in Medicine
Maybe the simplest way for me to describe why spirituality is so important is that through illness, hardship and the various ups and downs of life, we become disconnected from each other, the land on which we live and even from ourselves. Spirituality helps to restore the connections and strengthens them. We heal best when we are connected.
In order to have a sense of where you might be in terms of your spirituality, George Washington Institute for Spirituality and Health has come up with the FICA Self Assessment.
F – Faith and Belief Do I have a spiritual belief that helps me cope with stress? With illness? What gives my life meaning?
I – Importance Is this belief important to me? Does it influence how I think about my health and illness? Does it influence my healthcare decisions?
C – Community Do I belong to a spiritual community (church, temple, mosque or other group)? Am I happy there? Do I need to do more with the community? Do I need to search for another community? If I don't have a community, would it help me if I found one?
A – Address in Care What should be my action plan? What changes do I need to make? Are there spiritual practices I want to develop? Would it help for me to see a chaplain, spiritual director, or pastoral counselor?
If you are looking to develop a spirituality, there are no set rules or ideas that you must conform to or a God or belief that you must adhere to. It only needs to make sense, and provide comfort, to you. So how does one go about doing this?
For starters consider the last question in the FICA Self Assessment, would it help you to see a chaplain, spiritual director or pastoral counselor? Many hospitals, medical providers and care centers understand the importance of the mind, body and spirit connection and either offer these services or can connect you to someone that can. Ask about them at a visit to your provider.
An aside note: Be aware that just like snake oil salesmen providing “sure fire cures, “the spirituality movement abounds with scam artists. If they are asking for a lot of money, a lot of your time, and/or are being unrealistic in expectations, steer clear of them.
If you grew up in a faith community, is this something that might be right for you now? Yoga, mindfulness meditation, Qigong, Tai Chi and other such practices can help to develop a sense of spirit. Some hospitals and health care centers offer such programs for low cost or for free. You can also go to the Kripalu website and take five minute yoga breaks all day long. Other sites to consider include:
Taking Care of Your Spirit from Mental Health America
Mindful Meditations from the UCLA Mindful Awareness Research Center
University of Minnesota’s “Taking Charge of Your Health,” Links for their Life Purpose and Spirituality
Develop or use your spirituality and/or faith: For some this may be a renewed faith in their religion for others it is an opportunity to find beliefs that provide comfort.
I have been reluctant to write much about spirituality for several reasons, the biggest one being that for many people spirituality and religion are interchangeable terms. This is not true. While a religion can nurture spiritual beliefs, they are dictated by institutional practices, rites and specified beliefs. My biggest problem with many organized religions is that they exclude people for one reason or another. Given how living with a chronic condition can make one feel apart from others, the less we divide the better.
I would like to note that not all religious groups practice such divisions. In fact, one of the most healing places I ever held retreats in Vermont was the Weston Priory. This group of Benedictine monks opened up their facilities to our women and families living with HIV/AIDS. They never once asked about religious affiliations, invited us to participate as we wished in their services and always referred to us as their sisters and brothers. They even allowed us to use a small area of their land as a memorial to the women and children who had died of AIDS. Each time we went, they would join us on the hillside as we remembered those who had gone before us. Their prayers could be from a Native American or eastern tradition just as easily as it could be Christian. The important thing is that we all felt accepted, loved and connected. Their gift of hospitality was enormous and one I will never forget.
Howard Clinebell, who practiced pastoral psychology and counseling for three decades at the School of Theology in Claremont, California, believed that humans have seven spiritual hungers in common:
• All people need to experience regularly the healing and empowerment of love - from others, self, and an ultimate source/God.
• Every one needs to experience renewing times of transcendence - moments that expand us beyond the immediate sensory spheres.
• Every body needs vital beliefs that give some sense of meaning and hope the midst of losses, tragedies, and failures.
• Every person needs to have values, priorities, and life commitments - usually centered in issues of justice, integrity, and love - that guide us in personally and socially responsible living.
• Each human being needs to discover and develop their inner wisdom, creativity and love of their unique transpersonal/spiritual self.
• All people need a deepening awareness of oneness with other people and with the natural world, the wonderful web of all living things.
• Every human being needs spiritual resources to help heal the painful wounds of grief, guilt, resentment, unforgiveness, self-rejection, and shame. We also need spiritual resources to deepen our experiences of trust, self-esteem, hope, joy and love of life. University of Minnesota’s “Taking Charge of Your Health”
For those with a more scientific bent For 40 years, laboratories at the Harvard Medical School have systematically studied mind body interactions. The research established that when a person engages in a repetitive prayer, word, sound or phrase and when intrusive thoughts are passively disregarded, a specific set of physiologic changes ensue. These changes — decreased metabolism, heart rate, blood pressure and rate of breathing — are the opposite of those induced by stress, and have been labeled the relaxation response. Surveys indicate that over 60% of visits to health care professionals are for conditions caused or exacerbated by stress and that the relaxation response is an effective therapy for stress-related conditions.
Many people who elicit the relaxation response also note increased spirituality. Spirituality is expressed as experiencing the presence of a power, a force, an energy or what was perceived of as God, and this presence is close to the person. Spirituality and Healing in Medicine
Maybe the simplest way for me to describe why spirituality is so important is that through illness, hardship and the various ups and downs of life, we become disconnected from each other, the land on which we live and even from ourselves. Spirituality helps to restore the connections and strengthens them. We heal best when we are connected.
In order to have a sense of where you might be in terms of your spirituality, George Washington Institute for Spirituality and Health has come up with the FICA Self Assessment.
F – Faith and Belief Do I have a spiritual belief that helps me cope with stress? With illness? What gives my life meaning?
I – Importance Is this belief important to me? Does it influence how I think about my health and illness? Does it influence my healthcare decisions?
C – Community Do I belong to a spiritual community (church, temple, mosque or other group)? Am I happy there? Do I need to do more with the community? Do I need to search for another community? If I don't have a community, would it help me if I found one?
A – Address in Care What should be my action plan? What changes do I need to make? Are there spiritual practices I want to develop? Would it help for me to see a chaplain, spiritual director, or pastoral counselor?
If you are looking to develop a spirituality, there are no set rules or ideas that you must conform to or a God or belief that you must adhere to. It only needs to make sense, and provide comfort, to you. So how does one go about doing this?
For starters consider the last question in the FICA Self Assessment, would it help you to see a chaplain, spiritual director or pastoral counselor? Many hospitals, medical providers and care centers understand the importance of the mind, body and spirit connection and either offer these services or can connect you to someone that can. Ask about them at a visit to your provider.
An aside note: Be aware that just like snake oil salesmen providing “sure fire cures, “the spirituality movement abounds with scam artists. If they are asking for a lot of money, a lot of your time, and/or are being unrealistic in expectations, steer clear of them.
If you grew up in a faith community, is this something that might be right for you now? Yoga, mindfulness meditation, Qigong, Tai Chi and other such practices can help to develop a sense of spirit. Some hospitals and health care centers offer such programs for low cost or for free. You can also go to the Kripalu website and take five minute yoga breaks all day long. Other sites to consider include:
Taking Care of Your Spirit from Mental Health America
Mindful Meditations from the UCLA Mindful Awareness Research Center
University of Minnesota’s “Taking Charge of Your Health,” Links for their Life Purpose and Spirituality
Thursday, February 3, 2011
New Dietary Guidelines for Americans 2010
The Dietary Guidelines for Americans, 2010, have recently been released. The short version is eat less, exercise, cut salt intake, eat more fruits and veggies, and don’t eat sodas, sugar, or solid fat. More specific recommendations include:
• Balance calories to Manage weight
• Exercise
• Reduce daily sodium intake to less than 2,300 milligrams (mg) [about a teaspoon] and further reduce intake to 1,500 mg among persons who are 51 and older and those of any age who are African American or have hypertension, diabetes, or chronic kidney disease.
• Consume less than 10 percent of calories from saturated fatty acids by replacing them with monounsaturated and polyunsaturated fatty acids.
• Consume less than 300 mg per day of dietary cholesterol.
• Keep trans fatty acid consumption as low as possible by limiting foods that contain synthetic sources of trans fats, such as partially hydrogenated oils, and by limiting other solid fats.
• Reduce the intake of calories from solid fats and added sugars.
• Limit the consumption of foods that contain refined grains, especially refined grain foods that contain solid fats, added sugars, and sodium.
• If alcohol is consumed, it should be consumed in moderation—up to one drink per day for women and two drinks per day for men—and only by adults of legal drinking age.
• Choose foods that provide more potassium, dietary fiber, calcium, and vitamin D, which are nutrients of concern in American diets. These foods include vegetables, fruits, whole grains, and milk and milk products.
• Replace protein foods that are higher in solid fats with choices that are lower in solid fats and calories and/or are sources of oils.
• Use oils to replace solid fats where possible.
• Choose a variety of protein foods, which include seafood, lean meat and poultry, eggs, beans and peas, soy products, and unsalted nuts and seeds.
• Increase the amount and variety of seafood consumed by choosing seafood in place of some meat and poultry.
• Increase vegetable and fruit intake.
• Eat a variety of vegetables, especially dark-green and red and orange vegetables and beans and peas.
• Consume at least half of all grains as whole grains. Increase whole-grain intake by replacing refined grains with whole grains.
• Increase intake of fat-free or low-fat milk and milk products, such as milk, yogurt, cheese, or fortified soy beverages.
To read more about the Guidelines:
Digesting the New Dietary Guidelines
2010 Dietary Guidelines, deconstructed
• Balance calories to Manage weight
• Exercise
• Reduce daily sodium intake to less than 2,300 milligrams (mg) [about a teaspoon] and further reduce intake to 1,500 mg among persons who are 51 and older and those of any age who are African American or have hypertension, diabetes, or chronic kidney disease.
• Consume less than 10 percent of calories from saturated fatty acids by replacing them with monounsaturated and polyunsaturated fatty acids.
• Consume less than 300 mg per day of dietary cholesterol.
• Keep trans fatty acid consumption as low as possible by limiting foods that contain synthetic sources of trans fats, such as partially hydrogenated oils, and by limiting other solid fats.
• Reduce the intake of calories from solid fats and added sugars.
• Limit the consumption of foods that contain refined grains, especially refined grain foods that contain solid fats, added sugars, and sodium.
• If alcohol is consumed, it should be consumed in moderation—up to one drink per day for women and two drinks per day for men—and only by adults of legal drinking age.
• Choose foods that provide more potassium, dietary fiber, calcium, and vitamin D, which are nutrients of concern in American diets. These foods include vegetables, fruits, whole grains, and milk and milk products.
• Replace protein foods that are higher in solid fats with choices that are lower in solid fats and calories and/or are sources of oils.
• Use oils to replace solid fats where possible.
• Choose a variety of protein foods, which include seafood, lean meat and poultry, eggs, beans and peas, soy products, and unsalted nuts and seeds.
• Increase the amount and variety of seafood consumed by choosing seafood in place of some meat and poultry.
• Increase vegetable and fruit intake.
• Eat a variety of vegetables, especially dark-green and red and orange vegetables and beans and peas.
• Consume at least half of all grains as whole grains. Increase whole-grain intake by replacing refined grains with whole grains.
• Increase intake of fat-free or low-fat milk and milk products, such as milk, yogurt, cheese, or fortified soy beverages.
To read more about the Guidelines:
Digesting the New Dietary Guidelines
2010 Dietary Guidelines, deconstructed
Wednesday, February 2, 2011
Take a Break-Paper Cut Valentine Activities
It's a very snowy day here. Schools are closed and few are venturing out. Conditions are perfect for a fire in the woodstove and an afternoon of making “cut out” Valentines.
As a child, my mother entertained us on such a day by reading “Appolonia’s Valentine” and suggesting that we try and make the Scherenschnitte, German style paper cut, Valentines included in the book. If you are not familiar with this book, it’s the story of how an Amish girl discovered that she can make a beautiful Valentine with paints versus the paper cut ones that her classmates were doing. Maybe it’s because of those hours I spent with my Mom that I’m more comfortable with scissors and paper than I am with paints, the exact opposite of Appolonia’s experience.
Below are variety of techniques for making cards, paper chains and other decorative items using paper and scissors.
Paper Cut Hearts from Martha Stewart (includes a video and templates)
Planet Pals Three Different Hearts
Heart Paper Chains
Heart Garland from Martha Stewart
Cobweb Valentine with Jocelyn
Once you are done, hang them around the house and enjoy.
As a child, my mother entertained us on such a day by reading “Appolonia’s Valentine” and suggesting that we try and make the Scherenschnitte, German style paper cut, Valentines included in the book. If you are not familiar with this book, it’s the story of how an Amish girl discovered that she can make a beautiful Valentine with paints versus the paper cut ones that her classmates were doing. Maybe it’s because of those hours I spent with my Mom that I’m more comfortable with scissors and paper than I am with paints, the exact opposite of Appolonia’s experience.
Below are variety of techniques for making cards, paper chains and other decorative items using paper and scissors.
Paper Cut Hearts from Martha Stewart (includes a video and templates)
Planet Pals Three Different Hearts
Heart Paper Chains
Heart Garland from Martha Stewart
Cobweb Valentine with Jocelyn
Once you are done, hang them around the house and enjoy.
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