A cat and a Dust buster

Last week I invited you on a journey beyond disability. When we are young we do not expect to be disabled. When we see or hear of others becoming disabled, we think it cannot happen to us. Yet, one in five working aged Americans says they have a disability. Yet we do not prepare ourselves or our children for the possibility of becoming disabled. In raising our children do we prepare them for becoming disabled without knowing it?
When I was raising my children, I sought to make them competent adults capable of living in the world that they inherited from me. Even though I had been diagnosed with the disease that will eventually take my eyesight I did not contemplate my own disability or that my kids might become disabled. Instead I tried to instill in them those values skills and ethics that I thought would serve them best. It turns out that many of those skills are what we need to successfully journey through the storm of disability.
It seems that no sooner than we are aware of past and present, we become aware of the future. We also become aware that some events in life are pleasant and others unpleasant, good or bad. It is human nature to be optimistic. Psychological studies have shown this to be true even for pessimists. Yet, we don’t prepare ourselves for the bad.
How often do you see bicyclists not wearing helmets? We all know stories of bicyclists getting severe Head injuries. All cyclists know it is easy to take a spill. Usually we just get a good scrape sometimes a broken bone. Those injuries heal, and we return to cycling. Serious head injuries are another story. So why don’t more cyclists wear helmets? Those cyclists I have asked usually talk about comfort. I know people confined to wheelchairs and the like because of head injuries. Would a cyclist think that was comfortable?
I used to cycle and still hope to return. After my eyesight became poor I continued to cycle. One day while cycling, I swerved to allow a car to pass. My front tire went off the road into a ditch. I was thrown forward onto my shoulder and probably my head. I was wearing a helmet, so the worst I received was a separated shoulder. As I look back on it I am sure the helmet saved me from a more permanent injury…
On that occasion I had prepared for a bad outcome. But do we go through life preparing ourselves for possible bad things? Early in our lives we assume bad things will not occur. Later when we focus on bad things we find ourselves depressed. Are there ways to prepare ourselves for bad events that make us happy?
In recent year’s psychologist have found many ways to do just that. In fact a whole field of psychology has developed around that. It is called positive psychology. It is exactly what life coaches have been seeking to do. These techniques have been shown to be effective when taught in schools. They reduce bullying, truancy, teen suicides and criminal behaviors.
Studies have shown that people with better social and emotional skills handle adversity better. These skills can be learned and thus our ability to whether bad events can be improved. Adults can learn these as well.
The terms emotional intelligence and social intelligence are not well defined. Emotional intelligence generally refers to the ability to sense our own and others’ emotions, to use those emotions to express ourselves and understand the emotions of others. Social intelligence goes beyond that to understand the roles and norms of the social situation. Many authors have attempted to develop tools to measure these intelligences and to teach them.
I would love to know what social and emotional skills you would like to have in your toolkit. I am It is collecting as many of these tools as possible for the book I hope to write. The book will appear in early May.
Coach Dr. Dave [MD [
PS, most cats I know would have as little as possible to do with a dust buster.
Author of the upcoming book, “Recipes for Lemonade: Dr. Dave’s Recipe for Thriving through Disability”.

Insurance and Freedom, by Paul Krugman

In today’s NY Times columnist Paul Krugman wrote “Insurance and Freedom” about how Americans are enslaved buy their “need” for health insurance.

http://www.nytimes.com/2013/04/08/opinion/krugman-insurance-and-freedom.html?nl=todaysheadlines&emc=edit_th_20130408&_r=0

I would reply that Obama Care will not free Americans, just change the way they are enslaved.

Paul,

You question if Health Insurance has enslaved Americans. I might suggest that the American Medical system has enslaved Americans. In the past thirty or so years American Medicine has gone from curing ills to “Preventing” them. It is true that the biggest improvement in health has come not from our ability to cure illnesses but in preventing them in the first place. Yet, doctors myself included has made a good living convincing people that if you lower your blood pressure, cholesterol and exercise you can prevent a heart attack or stroke. We have data showing that. However, heart attacks and strokes are still the leading causes of death for Americans. They just happen at older ages. So why does American Medicine continue the promote prevention?

American Medicine promotes prevention because it sells. It is hard to watch the evening news without seeing an ad for some sort of medication. It is usually a new and more expensive version of a current medication.  The drug companies spend millions on studies designed to show that their new drug is more effective than the older one.  Doctors make a good living prescribing and monitoring those medications. So why to doctors persist in this charade?

Doctors persist for several reasons not just the economic. We are taught that these drugs prevent deaths, but not in how to find the cost of preventing one death with method a or b. When I started in medicine decades ago, we believed that preventing PVC’s saved lives. We prescribed drugs that made our patients feel ill and dependent. We enslaved them to our care lest they drop dead of a heart arrhythmia. Then patients took charge and stopped the offending drug and felt better. Finally doc tors had the nerve to study the drugs more carefully and found that the drugs were actually killing more than they helped.  The FDA banned one of these drugs completely.

Would medicine better serve America by teaching people how to weather the storms of illness?  In the past couple of decades a new approach to psychology, called Positive Psychology has found ways to do just that. Several books are now available that document this. Some of the books have even made the NY Times best seller list.  Doctors and others can now teach people how to successfully whether the storms of life, including illness. These techniques have other benefits besides just lowering the risk for heart attacks and strokes; they can help people weather divorce, job loss and other trauma. By promoting social and emotional health we can free America from the slavery of ill-health.

David Moseman, MD, MPH, FACP (disabled)

An Invitation to Journey Beyond Disability

An Invitation

I would like to invite you on a journey with me. For some of you this journey may be very difficult. For others who have taken it before it might seem easy. In many ways it is a journey we all must take at some point in our lives. This is a journey through disability into what can be joy filled abundance beyond.

I want you to join me on this journey because it will be richer for both of us. I have made this journey several times and thus can serve as our guide. Your input and experience as we go will be a great help to both of us. We will enjoy the journey more by inviting friends to join us, so share this if you wish.

We will start out as we all do naГЇvely and innocently. The path we take contains roadblocks. We will have to find a way around over under or through these roadblocks. These roadblocks can take many forms each of us will find it takes a different form. That is why your experience will help me understand more about how to bring more people upon this journey.

After we leave the space of innocence we will find our resources tested. For me this came in the form of the loss of eyesight. Others have found the barrier to be painful or fatiguing. I have been on the other side of these illnesses. I know people who can find joy filled abundance in the life beyond. The resources you find to get you into that joy filled abundance can help others. Before we finally arrive at the joy filled abundance we will also have to traverse a new beginning. As we journey through the barrier we will not be able to return to our innocence. Until we find that joy filled abundance each of us may wish to return to the place of innocence. I hope we can enjoy the journey as well as the destination itself.

Your comments as readers of this newsletter or blog will be invaluable. So that I may help others as they take this journey, I will be trying to keep a written record of our travels. I have created a website especially for this purpose. You may sign up for this journey by subscribing for this blog. I hope to see you there in the coming weeks.

Dave Moseman, M.D.

joy

Neurophysiology of sadness

Neurophysiology of sadness

In my years as a physician, I often had to intervene in the sadness spiral.  When one has a stroke, it is sudden and unexpected. Often the first thing one knows is that they wake up in a hospital having difficulty moving.  They must depend on strangers to get out of bed and do other things. Being dependent on others makes one feel like a child. One of the markers of being an adult is the ability to care for ourselves and others.

Recovering from a stroke takes time. Time that was not planned for. This unplanned interruption of life is depressing.  Depression makes recovering from a stroke harder. The brain recovers its ability to direct the body’s movements over weeks and months. During this time muscles atrophy and joints stiffen. To prevent these complications doctors prescribe exercises. It takes effort to exercise with the therapist. Up to forty percent of stroke suffers will get depressed.  Adding an antidepressant medication to the treatment plan can speed recovery.

In our brains different things happen when we are happy or sad. Different parts of our brains are active when we are happy or sad. Our brain cells use chemicals called neurotransmitters to communicate with each other. Many sad or depressed people don’t make as much serotonin as they do when happy. The most commonly used drugs for depression; SRI’s increase the amount of serotonin available in the brain.

Images of brain blood flow show that in happy brains blood flows to the cortex or thinking parts of the brain when sad or depressed this does not happen. This partially explains why we think better when happy.

There exists evidence that your immune system also works better when we are happy. Thus happiness can keep us from being ill. Conversely, when we are ill we often feel depressed and that will lead to more illness.

A stress hormone, corticotrophin releasing factor (CTrf) can also be increased in depression.    CTrf causes increased levels of adrenalin and other adrenal hormones. Increased levels of adrenal hormones cause increased blood pressure and are associated with more deaths after heart attacks and strokes.

 

Beside medications what can you do to be happy?

We now know that we can reprogram our brains.  Several techniques are known to reverse the changes seen in unhappy brains. These techniques fall into two categories, reversing unhappy changes and strengthening happy parts of the brain.  Meditative techniques like mindfulness reverse unhappy changes.  Finding ways to enjoy and be happy can reinforce the happy brain.

Such simple things as forcing a smile change our brains. I experienced this many years ago, when I had a very stressful semester in college. I developed a spastic colon. I would get gut cramps for no apparent reason. They might double me up while walking across campus. By just smiling the cramps would stop. Eventually I dropped a troublesome course and the cramps stopped.

Music and other things are known to make our brains behave in happier ways. So when you feel stressed or sad, do something that makes you feel happy?

 

Why Joy?

Joy is more than its own reward.

Happy people are healthier.

Happy bodies fight infections better.

Happy brains think better.

We cannot always be happy. In fact life often makes us sad. Sadness can make life worse. When we are sad our faces droop. When we are sad our bodies droop. We have less interest in life and living. We might even have trouble getting out of bed.  When you see a sad person do you want to say hi, or avoid them? When others ignore you does that make you feel happier or sadder?  Thus, being sad can bring its own spiral of increasing sadness.

 

abundance-of-gifts

New Year or New Life

New Year or New Life

В Ever feel that you are embarking more on a new life than a New Year? New Year is the traditional time to reflect on the old and plan for the new, but for those of us whose life plans have come to a screeching halt, it might seem like only a New Life waits in the New Year.

Many life events can cause this, some planned and some unplanned. It is the unplanned that seem to put us most adrift. Job losses are common, but so are illnesses and traumas. Illness and trauma prevent us from using all of our past to build a new future.

The path forward is not obvious when illness and traumas force the change. That is where a coach can be most helpful. In addition to finding what you can do and where they can be used, a coach will help you find yourself. Yet, in many cases our identity is tied up in our work and our bodies. I still think I am 20 or 30 on a bad day. Never mind that both my sons are over 30.

Facing a New life is almost like we are teenagers again. We don’t know what we want to do or what really we can do.  How did we make the decision the first-time? Did the advice we got really help? Now that I know what a Life Coach can do, I wish I had used one the first time.

If we go back to school we it seems we have missed a lot in the years we have been out.  When I went to college I used punch cards to do things that my lap top does. Even phones have changed. Smart phones seem more like portable computers, than phones. Is a “blue tooth” something we should see a dentist about?

Is it realistic to embark on a whole new career at our age? Yet, how long does anyone work at one job? Can we trust our bodies to hold out for a new career? What other questions do we have? Or are they fears. We know how life plans can change. Did we do what we thought we were going to do in life so far? With the disability option we could just find a whole and curl up.

After a while curling up gets cramp. How do we go forward, and why? When our life plans get interrupted, we ask the basic questions again. Is there a purpose in life? How do we make our way forward? What did we do wrong?

Should we give up in despair or go blindly forward?

But what do we base our future upon? Our bodies are fragile; we have seen them fail us. The skills we had are not the skills that our world seems to want. And what they want are not the skills we think they need. How do we resolve these dilemmas? How did we resolve these dilemmas in college? We went with the crowd. We got jobs, married and raised families. We found joy in the little things in life. How much fun it is to watch a football game, especially when our team wins?

In our busy lives we neglected some things and emphasized others. Own we seek to restore balance to our lives. We seek to find the energy to go forward. We seek joy. How are we going to enjoy Life? Grand kids are one source. Sports are another. We all don’t have to play golf or travel.  We can still work and since that has been our identity, maybe that is what we should do.

 If these are some of the questions you ask yourself, let’s talk.

Improve your health, be grateful

Improve your health, be grateful

You may feel better when you have something to be grateful about, but did you know that finding things to be grateful for can actually improve your health? В That is people who are grateful are physically, emotionally, spiritually and socially healthier.

We all like to be around people who are grateful. They are positive and enjoy life. They find the joys in the little things of life. They tend to overlook or Passover the trials of life. Their spirit always seems to be soring.

Research has shown that people who focus on what they have to be grateful for are less depressed, and stressed.В  They fall asleep faster, sleep sounder and awaken more refreshed. This is even true for people with such painful conditions as post-polio syndrome and chronic Fatigue syndrome.

In a study of persons who survived a heart attack researchers at the University of Connecticut found that those who were grateful for their heart attack had fewer second heart attacks. В Those who were grateful for their heart attacks saw them as a warning to slow down and get their lives in balance.В В  Helping reestablish a life balance is what Life Coaches are good at.

Some would say that each of us has a gratefulness set point. That is over time our sense of gratitude does not change. Yet there are times when we feel grateful and times when we feel well, ungrateful.В  Some would say that grateful children become grateful adults. However, can ungrateful kids become grateful adults, or the opposite?

The answer is yes, we can become more grateful.  Researchers have found several techniques for increasing one’s gratitude.  Here are some you might want to try.

1. Keep a gratitude journal. at some time each day list five things you are grateful for.  Things you are not grateful for will also come up. Record them as well.  Always make sure you come up with five things, even if one is, “I am grateful that I can write this.”
2. Place visual reminders of what you are grateful for.В  If you are grateful for family keep their pictures where you can see them. Post it notes can also be used to write things you are grateful for. Put them where you will see them easily. Especially at times or places where you might feel less them grateful.
3. Improve your health, be grateful:

  • You may feel better when you have something to be grateful about, but did you know that finding things to be grateful for can actually improve your health? That is people who are grateful are physically, emotionally, spiritually and socially healthier.
  • We all like to be around people who are grateful. They are positive and enjoy life. They find the joys in the little things of life. They tend to overlook or Passover the trials of life. Their spirit always seems to be soring.

  • Research has shown that people who focus on what they have to be grateful for are less depressed, and stressed. They fall asleep faster, sleep sounder and awaken more refreshed. This is even true for people with such painful conditions as post-polio syndrome and chronic Fatigue syndrome.

  • In a study of persons who survived a heart attack researchers at the University of Connecticut found that those who were grateful for their heart attack had fewer second heart attacks. Those who were grateful for their heart attacks saw them as a warning to slow down and get their lives in balance. Helping reestablish a life balance is what Life Coaches are good at.

  • Some would say that each of us has a gratefulness set point. That is over time our sense of gratitude does not change. Yet there are times when we feel grateful and times when we feel well, ungrateful. Some would say that grateful children become grateful adults. However, can ungrateful kids become grateful adults, or the opposite?

 

The answer is yes, we can become more grateful. Researchers have found several techniques for increasing one’s gratitude. Here are some you might want to try.

 

  1. Keep a gratitude journal. at some time each day list five things you are grateful for. Things you are not grateful for will also come up. Record them as well. Always make sure you come up with five things, even if one is, “I am grateful that I can write this.”

  2. Place visual reminders of what you are grateful for. If you are grateful for family keep their pictures where you can see them. Post it notes can also be used to write things you are grateful for. Put them where you will see them easily. Especially at times or places where you might feel less them grateful.

  3. Write a thank you letter; the process of writing the letter and delivering it will help you focus on what you are thankful for. Getting the letter will bring joy to the other.

  4. Become religious; all major faiths promote gratitude. The press may not promote this aspect of religions but the Hebrew, Christian, Islam, Buddhist, and Hindu faiths all have gratitude as a central tenant of their faith. All look at life as a gift from God (or Gods).

  5. Have a partner in gratitude; just like exercising is more fun with a partner; find someone you can share your gratitude with. This makes you accountable to someone else and they might even be able to be the thing you are grateful for one day.

  6. Publicly declare that you will be grateful for things; you can do this on Facebook or other sites; if you post that you will post your Gratitude Journal there daily, your friends will come to look for it. Thus they will become your gratitude partners.

  7. Join groups or web communities that focus on Gratitude; Greatfulness.org is one such group.

  8. If you are always coming up with things to be ungrateful for, change yourself talk. This requires that you work with a coach or therapist. They might use a technique call Cognitive Behavior Therapy. They will teach you how to record the events that trigger negative self-talk. Together you will evaluate them.

В 

 

 

If you wish help in this or other aspects of your life, ask a coach. I am available for free consultations. To set up a consultation email me atВ mosemandave@gmail.comВ to find out more about me and my coaching check outwww.www.bsmk-med.com

sadness

Abundant Perspective

Abundant Perspective

As I gaze out the window on this very cold winter’s day, I see bright sun shining upon bare trees and snow. It is almost too much for the eye to bear. It is blinding. It is so Abundant and yet so simple. In the midst of so little heat there is so much energy. How can this be?

Yet is not that always the way, plenty in the midst of scarcity? Or is it a matter of perspective. When I think of winter I think of snow and cold. I think of the effort to go about my normal tasks. I think of the way in olden times people would struggle to feed themselves. Yet here in Minnesota we find an abundance of ways to enjoy the cold.

Winter is the time for Ice Castles and snow forts, of sledding and hockey, of bright winter’s mornings and clear starry nights, of gently falling snow and howling winds.

A heavy snow fall is both a blessing and a curse. It makes us pause and attend not to our agendas but that of nature. We cannot go about our normal activities. We must find the car under the piles of snow. The roads are hidden under the white. Yet it creates unique opportunities. What child does not enjoy sledding or snow ball fights. When my kids were young I would pile the snow at the end of the drive so they could make forts.

What do we need? More stuff or more appreciation for what we have?

The good times I share with my family are those we spent together. It is not the activity, but the presence we shared. Paddling a canoe, each of us dipping our paddle in and out of the water in unison. The canoe gliding gently across the water, or bouncing through the rapids and thrilling us.

Hugs and smiles give us joy. Not the presents and food that fills our stomach and soon becomes waist to fill the sewer. В These are the things that are so abundant and yet so simple.

When I see the abundance I see opportunity. I get the power to do the things that I can do and let the rest take care of itself. I am freed of burdens and empowered to act. And over time I have accomplished so much that when I look back I see the abundance and not the scarcity.

So how can I apply these reflections to my life? Might I choose to pause each morning and list the abundance I find in the world? The sun that rises each day, giving light to the world and ease to our moving. The warmth of the day that eases the nights chill. Each night as I settle myself to sleep might I recall the abundance I experienced this day?

If you wish to explore your life more or seek a coach go toВ www.www.bsmk-med.com