Countdown Reason # 7: Life Channel or Pain Channel?
Research tells us that although 70 % of our day is relatively good, 28 % of it neutral, and only about 2 % of what happens to us is actually bad, we think about that negative 2 % almost all the time; it’s what we ruminate over as we shower, drive, and fall asleep.[i] It reminds me of that old saying that we wear 2 % of our wardrobe 90 % of the time. We button ourselves up in our misery cloak a lot. I think of it this way. For most of us, two different sound tracks are playing simultaneously in our mind. I call them The Life Channel and The Pain Channel. It just depends which one we tune into — and turn up. The Life Channel is the channel on which uplifting and joyful moments play. It’s the feeling I get when I am braiding my daughter’s hair. Watching my family doubled over laughing at a bad joke at the dinner table. Holding hands with my husband, or my daughter (if she lets me) as we cross a parking lot. The feeling I get when I am staring at the snow covered trees as the sun transforms their icy branches into twinkling silver lights. Or when I am meditating, clearing the mind, focusing on nothing but my breath, and I manage (now and then) to reach that sweet spot of inner quiet, inner smiling. The aha of being half way through a yoga class, and realizing I’m in a peaceful place of well-being as I focus on every muscle and breath that goes into my downward facing dog. The joy of looking into one of my best friend’s eyes and feeling the inner love that’s exchanged in our haven’t-seen-you-in-far-too-long glance, in just an ordinary instant. The Pain Channel is where we live, however, most of the time. It blares our anger, resentment, fear. Our ruminations over what happened, how it shouldn’t have, what should be happening instead. Our self-doubt. Our regret and recrimination. Our physical pain and fear over any health issues we’re facing. Sometimes we have to be on The Pain Channel; it’s what wakes us up to deal with difficult situations, make change, take action. But we don’t need to be listening to The Pain Channel 90% of the time. We just don’t. We know The Pain Channel doesn’t feel good. We just don’t know how to shut it off. It’s powerful and seductive to get wrapped up in what’s playing on The Pain Channel, especially when we are feeling at our most vulnerable. We have to have the tools to reach out and turn The Pain Channel off — and turn The Life Channel on. THE LAST BEST CURE is about having a high-speed connection to dial up to The Life Channel, especially in those moments when we need it most. So we have a real chance at living life on the right track. [i] it’s what we ruminate over as we shower, drive, and fall asleep: Rick Hanson, Ph.D., and Richard Mendius, MD. Buddha’s Brain: the Practical Neuroscience of Happiness, Love and Wisdom. New Harbinger Publications, Oakland, CA, 2009. To see a fascinating talk given by Hanson at Google in June 2010 see http://www.youtube.com/watch?v=0EM45CpeQb4.
Countdown Reason # 8: How Did We Miss This Chronic Disease Epidemic?
How did we miss the chronic disease epidemic now facing America? And why are we so behind in meeting the needs of the 1 out of 2 adult Americans who suffer from them? I wanted to find out the answer to that question. So I reached out to Laurie Edwards, author of the upcoming book In the Kingdom of the Sick: A Social History of Chronic Illness in America (due out in April). Laurie teaches writing for the health sciences at Northeastern University. She blogs about chronic illness, health care, and writing at A Chronic Dose. I asked Laurie, “What has caused us to be so late out of the gate in meeting needs of patients with chronic illness, and in utilizing the new brain body science? Here is what Laurie had to say: “By and large, patients with chronic illness still navigate a medical system dominated by the biomedical model of disease, where patients are diagnosed, treated, and dismissed. This strategy is only effective with acute illness; after all, chronic conditions are treatable, but not curable. While many examples of a growing shift from this model exist—more centers with integrative care, or technology that allows patients and doctors to better collaborate in care, to name just a few—much work remains. Another reason we’re slower to meet the needs of those living with chronic illness is that we get hung up on a limited view of prevention – the idea of preventing illness. For many patients who face chronic conditions, prevention is more about slowing down disease progression. We need to be realistic about what the chronically ill population looks like. It is tempting to focus more exclusively on conditions like heart disease, diabetes, and lung disease when we think about chronic illness; after all, the seven most common chronic diseases are estimated to cost a staggering $1 trillion annually. But this is an incomplete picture. Some 50 million Americans live with autoimmune disease, and a disproportionate number of these patients are women. An estimated twenty-five percent of the population lives with chronic pain and again, women suffer in higher numbers than men. So many chronic conditions are “invisible illnesses” – and this invisibility shrouds the physical realities that millions of people live with daily. The gender gap also plays an important role in why chronic disease has been underacknowledged. Research shows female patients’ reports of pain are taken less seriously, treated less aggressively, and they are more likely to be characterized as emotional or psychogenic. Sex-based research into pain is one step. Already, emerging research suggests differences in the ways men and women perceive pain. Chronic illness is incredibly complex, and these complexities feed into the delay in utilizing new brain-body science. As you write in THE LAST BEST CURE, for so many patients, Western medicine has done all it can. Patients live with ongoing symptoms, try all sorts of lifestyle interventions and alternative therapies, and wonder if this is as good as it will get. While many recognize a fundamental mind-body connection, the idea that the brain itself could hold the key to healing is an enormous paradigm shift. Hopefully, science can give us more answers, and increased collaboration between patients and provides can help us put those answers into practice.” I thank Laurie for her response to my question. I think it’s spot on. We’re late to address the skyrocketing problem of chronic illness in America, for all the reasons she cites. We have much to do. I hope that THE LAST BEST CURE helps us to better understand the emerging scientific answers and to put those answers into practice.
Countdown Reason # 9: It Doesn’t Have to Be This Way
Today I was listening to NPR as I was driving. The discussion centered on new approaches to addiction — and the fact that addiction is now being classified as a “chronic brain disease.” Experts said that 22 million American’s suffer from it. (Add this to the 133 million Americans suffering from a range of other chronic diseases and the tally rises to 155 million Americans facing chronic health issues.) And guess what one of the successful new treatment strategies for this newly labeled “chronic brain disease” turns out to be? What do practitioners who treat patients with addiction feel is critical for patients if they hope to return to a state of well-being? “Manage their thoughts,” said both experts being interviewed. The phrase kept coming up: “Managing your thoughts plays a role in recovery.” Manage the negative Floating Brain. Monkey Brain. The constant chatter of worry, the laser focus on what’s wrong with whatever is happening, or wishing for something else to be happening. Nursing anger, frustration, fear, anxiety, resentment, regret. Ruminating. Getting caught in those states of mind that are linked to setting forth a toxic cocktail of inflammatory hormones and chemicals from brain to body to cell. During the NPR show there was a pause for a commercial for an upcoming discussion about another rising health condition, the “disturbing rising rates of heart problems in young people.” We know that heart conditions are related to chronic and acute stress. Listening to this I thought we just have to find a way out of this American Stress Crisis and what it’s costing us. We just have to. In my year-long journey to find a way out, to find THE LAST BEST CURE, I test drove everything I thought might help the 155 million Americans who have chronic conditions. Everything that scientists know activates the healing responses of the brain. So that we can walk away from Monkey Brain, and live with a newfound sense of well-being. I also wanted to help the 145 million who don‘t face chronic health worries — and who don’t want to. I put every skill I possess as an investigative science journalist to use in the process. And when I listen to the radio for twenty minutes in the car and hear about the range of pain we face, whether from this emotional struggle or that health challenge, I find myself feeling, very deeply in my heart, how much I want to be part of the change. I hope THE LAST BEST CURE can help pave the way for change. Because it just doesn’t have to be this way.
Countdown Reason # 10: Turtle Wushu, Anyone?
A week ago I wrote this at the end of a blog on joy, memories and the brain (see Countdown Reason # 19: Why Emotional Memories of Joy Matter so Much): “I’m going to think of how to make a joy memory today. I’ll let you know how that works out on an icy, windy Friday evening in a house with with two tired working parents at the end of the week and two teenagers.” I promised I would let you know how that went. Confession. It didn’t happen that Friday night. We unexpectedly had a house full of 14-year-old girls (who happen to be naturals at making joy happen). And then the week flew by in a blur of activities, work, events, homework, doctor’s appointments, and all that jazz. But this evening things were comparatively quiet and I asked my daughter if she’d help me get “the guys” (her dad and brother) to join us in a game of Turtle Wushu. We’d come across a video of it online and when we watched it we couldn’t stop laughing. Laughter is really great for our cells, and laughter is joyful. And a joyful state of mind activates what scientists call the “positive floating brain;” those juicy good chemicals that set out from the brain and travel through our organs and cells, helping to protect us from inflammation. Moreover, it protects us from the “negative floating brain,” that state of Monkey Mind — where our inner chatter raps on about what’s going wrong, what we have to get done, what we’re angry or frustrated about, the things we’re afraid of — causing our brain to send forth a constant slow drip of inflammatory hormones and chemicals. Okay, here is the video (short at 1:42) on how to play: Turtle Wushu. (We used small crackers instead of plastic turtles. It was even more fun because the dogs “played” too in hopes of getting the spoils.) If you have teenagers it can be hard to find a game that everyone wants to play, but we were “all in” at our house for Turtle Wushu. A half hour of chasing, turning, sly maneuvers around the kitchen island, sock sliding across the floor and whirling around the breakfast table, and we were laughing pretty hard. Later, I caught my son and husband playing “Wushu” in the kitchen, just the two of them, laughing. I got “Wushu-ed” a LOT (aka I kept losing!) so the dogs really stuck by my heels in hopes of getting those flying crackers. But I got something better — a silly and wild half hour with my family, away from homework, dishes, laundry, tomorrow’s to-do list, taxes (argh), and Monkey Brain. And that felt like winning.
Countdown Reason # 11: How This Journey Began
Sneak Preview! Here is the first half of the introduction to THE LAST BEST CURE, for those who had trouble reading the preview on my Penguin author page. It tells you about the place I found myself in when this journey began…. Introduction This book began with my own sudden lockdown into the world of the chronically ill a little more than a decade ago. One day in 2001 I was pulling my daughter in a red wagon to the neighborhood pool to swim my evening mile in the lap lane. The next day I was paralyzed, unable to use my arms or legs, in Johns Hopkins Hospital with Guillain-Barre Syndrome, a disease similar to multiple sclerosis, but with more sudden onset and a wider array of possible outcomes. I slowly regained my ability to walk, drive, and tie my children’s shoes only to fall paralyzed with GBS again in 2005. The second recovery was harder, more tenuous. Although with miracle drugs and half a year of grueling physical therapy I could get down the steps and to my mailbox again, I still dealt with the neurological fallout of having had GBS twice — numb feet and hands, muscle spasms, poor reflexes and a flu-like lethargy that no amount of sleep could cure. Over the years other diagnoses unrelated to GBS had also thickened my chart: thyroiditis, more nerve damage, a clotting disorder, low red and white blood cell counts, bowel problems, slipped discs, and fevers of unknown origin. Every few months I’d end up back in crisis mode. My team of specialists – some of the best on the planet — pulled miracles out of thin air for me time and again. A pacemaker made my heart tick, and a small white pill kicked my thyroid into action each morning. Infusions of other peoples’ healthy immune fighter proteins, or antibodies — pooled from a thousand donors in a product known as immunoglobulin — replaced my faulty ones, and kept them from turning against me. The pattern was familiar: I would recover enough to drive, cook dinner, type stories on my computer again. And for that I felt lucky. But in the span of a decade I’d gone from being a healthy working mom who could swim 40 laps and stay up until two a.m. decorating a toddler’s birthday cake to being a revolving-door hospital patient – perpetually worried, exhausted, and often in pain. Above everything, I longed for a normal, ordinary life; to play hide and seek or jump in the ocean waves with my kids again, to go for a brisk morning swim with my husband. My team of specialists had pulled off miracle after miracle to keep me alive, but there was one cure they couldn’t offer me: they couldn’t give me back my capacity for joy. I felt robbed of joy. And there was no Rx for that. Something had been taken something from me, and I wanted it back. Meanwhile, the moments of everyday life that mattered most were spinning past. Life seemed to be increasing its speed while my own energy sputtered out. My best years with my children were almost behind me. My son was already in high school, my daughter nearly a teen. Soon, they would be gone. These were supposed to be my most productive and creative work years. And yet I was too tired and in too much pain to enjoy, keep up with it all, drink any of it in. I was stuck not only in my body, I felt stuck in place, held back from the full life I’d always thought I’d create for myself, for my family. It was starting to be too late to hope I’d ever have more than a half-life. A maybe life. This book was born out of that personal frustration. As a science journalist I did what I often do: searched for research trends that might give me insight as to how to solve the puzzle of my own life. For years, I’d been intrigued by the growing number of studies examining how our brain’s mental activity impacts our biology and well-being. But little of the science seemed geared to those facing chronic pain, discomfort or illness. Suddenly, however, the research had taken a quantum leap. Neurobiologists at the best research institutes in the world were finding myriad ways to peer inside the body and demonstrate how specific practices could activate robust healing responses in the brain, making us not only feel better, but creating lasting biological changes in our physical bodies and cells. One new area of mind-body medicine intrigued me in particular: the relatively new and burgeoning field called psychoneuroimmunology, or PNI. Psychoneuroimmunology is the study of the potent interaction between our psychological state of mind and our cellular and immune function. It examines the direct influence that states of mind — ranging from contentedness and well-being to joy and delight — have on the messages our brain sends to our immune system, our nerves, and our cells. In simplest terms, the science of PNI – or what I have heard a few scientists call for simplicity’s sake, PIN, or psycho-immu-neurology – is the study of how our mental and emotional state, the very way we think and act, can maximize our ability to heal — and enhance our overall physical health. Their findings were giving new credence to the idea that the mind-body connection plays a critical and even determining role in our physical condition. Moreover, research was beginning to focus specifically on helping patients with chronic conditions to relieve emotional and physical pain and suffering. Emerging data was showing that those with chronic conditions who practiced specific mind body approaches were able to move their emotional state away from anxiety and pain — and toward more joy and well being. In the process, their levels of inflammatory biomarkers and stress hormones – those linked to a range of diseases including fibromyalgia, digestive illnesses, Alzheimer’s, autoimmune disease,
Countdown Reason # 12: The Number of Kids with Chronic Conditions is Skyrocketing
I’ve written about how chronic pain is on the rise, as are rates of chronic disorders. But two new studies extend our knowledge about the prevalence of chronic conditions among Americans into an area that’s quite troubling: America’s children. One study, published in the journal PAIN found that “recurrent chronic pain is overwhelmingly prevalent in children and adolescents, with, 11% to 38% of kids reporting pain.” Study authors looked at headache, back pain, abdominal pain, muscle pain and generalized pain. Rates depended on the sort of pain being reported. For instance one in four youth reported having regular headaches. Girls generally experience more pain than boys. Which is not surprising since women suffer from more chronic conditions than men in adulthood. What is most concerning, say investigators, is this: “… prevalence rates of childhood pain have increased over the last several decades.” Stress is most certainly playing a role. The second study, published in the journal Archives of Pediatric and Adolescent Medicine found that children and teen’s chronic pain is associated with that of their parents. The more chronic pain parents experienced — especially mothers — the more their children reported chronic pain: “…clear associations were observed between maternal pain and pain in adolescents and young adults…” As adults, we need to look at managing our own sense of joy and well-being not just in terms of our own health, but that of our children. Every step we take to move past “stressed-out living” and reclaim joy in our life not only enriches us, it allows our kids to see how that’s possible. And that legacy is priceless. —– Sara King, Christine T. Chambers, Anna Huguet, Rebecca C. MacNevin, Patrick J. McGrath, Louise Parker, Amanda J. MacDonald. The epidemiology of chronic pain in children and adolescents revisited: A systematic review. PAIN, 2011; 152 (12): 2729 DOI: 10.1016/j.pain.2011.07.016 (Arch Pediatr Adolesc Med. Published online November 19, 2012. doi:10.1001/jamapediatrics.2013.428.
Countdown Reason # 13: The American Stress Crisis
A new study released today by the American Psychological Association found, after studying 2000 Americans, that the day-to-day stress the average American is living with surpasses healthy stress levels. Americans say their daily stress is at a 3.6 on a 10-point scale. Just think of that for a minute in terms of the physical “pain scale” you fill out when you go to the doctor’s. If you are experiencing physical pain that is almost a 4 out of 10 (with a 10 being as doctors say, “the worst pain you’ve ever experienced”) that’s painful. Ditto with emotional stress. Worse, for many Americans, stress levels are on the rise — 35 percent of all Americans say their stress increased this past year, and two-thirds of U.S. adults who report living with “high stress” say their stress levels have risen. Yet 53 percent of Americans say they receive little or no support for stress management from their health care providers, and that stress management is not discussed at doctors’ visits. APA CEO Norman B. Anderson, PhD. says, “Unfortunately, our country’s health system often neglects psychological and behavioral factors that are essential to managing stress and chronic diseases. In order for our nation to get healthier, and lower the rates of chronic illnesses…we need to improve how we view and treat stress and unhealthy behaviors that are contributing to the high incidence of disease in the U.S.” When it comes to stress management and wellness, says the APA report, “there is a gap between what Americans want from their health care system and what they actually get.” I’m hoping, with all my heart, that THE LAST BEST CURE will help to fill that gap. 13 days.
Countdown Reason # 14: The Autoimmune Epidemic Was Just the First Half of the Journey
THE LAST BEST CURE will be in stores, on Amazon, Indiebound, and everywhere else in two weeks. I can hardly believe it. Many of you are fans of The Autoimmune Epidemic (now in its 5th printing!). Which, as you know, talks about all the environmental stressors and toxins we encounter in our lives that add up to inflammation and illness. I call it the barrel effect. Our bodies can handle just so much in the barrel, and then, one day, there is that one more “hit” and it spills over, leading to chronic conditions too numerous to count (well, if we are counting, 133 million adults suffer from at least one chronic condition, and the numbers are skyrocketing). I wanted you to know everything researchers know about how we can decrease what’s overfilling our barrel, both by being aware, and by knowing how to eliminate what we can. After I finished writing The Autoimmune Epidemic, I encountered a great deal of emerging research on how the chronic and acute stress we feel also acts on our immune systems exactly like a toxin. How our state of mind can overflow the barrel, or, conversely, help to protect the immune system. To our bodies, it doesn’t matter if the “hit” is viral, toxic, or stress. It looks the same. Stress and anxiety can cause our “barrel” to overflow in just the same way. And so, I set out to research and write the “sequel” to The Autoimmune Epidemic. I’d talked about how to eliminate all the triggers we could to bring our immune system back to health, and why it was so important to do so. I felt I owed it to you to talk about the one thing in our “barrel” that is most under out control: reversing the inflammation-promoting agitation, fear, stress, pain and anxiety we all encounter and experience in our lives, which leaks, like a toxin, into our barrel. Thousands of researchers have been studying how to best use scientifically studied methods to do just that. And how to activate instead, the healing secrets of the brain. I would like to think my last two books form something of a health equation: The Autoimmune Epidemic + The Last Best Cure = Reclaim Your Body, Your Joy, Your Well-being, Your Life.
Countdown Reason # 15: YES, True
I don’t know why I thought of this today. Maybe because as I walked past my son’s room this morning it hit me, ping (really, I guess the word is pang), how empty his room will be when he leaves for college. Standing there, with my hand on the door, I had a sudden flashback. How when he was very little I made up a song to get him to sleep. It’s a little embarrassing but among the lines were these: “…know this is true, no matter where you go, no matter what you do, I’m going to love you your whole life through. Sometimes you’ll say I love you too much, sometimes you’ll say I don’t love you enough. But no matter where you go, no matter what you do, I’m going to love you your whole life through…” (Full disclosure here: part of the reason I wrote my own lullabies for my kids was because I really can’t sing. Really. So, I figured, if a song and the tune are mine, I never have to worry whether I’m singing it right or how off key I might be…) Sometimes when my son (or a few years later, his little sister) was tired, or cranky, or had a scraped knee, he’d give me one of those leg squeezes that toddlers give you when you’re holding them on your hip and they want you to move in a certain direction. And he’d point and say, “rocking chair!” I was happy to rock in “rocking chair” because sometimes I got tired and cranky too. And I’d sing our own personal Top 10 hit lullaby, “Know This is True.” It was a kind of mom and babe meditation. But, back to my story. My son didn’t chat a lot when he was a young toddler, though he had plenty of words. He was just… circumspect. When he started really talking he spoke in thinking-out-loud sentences. I remember once, we were in “rocking chair” and near where we then lived workmen were bulldozing a small forest for a new neighborhood. And my son put his hand on my lips and said, quietly, “Mommy I don’t like the sound the trees make when they hit the ground.” He always seemed to be listening to the world around him, as if reading a book that no one else could see. One day we were in “rocking chair” and I was singing my made up song, “…know this is true…” and he put his fingers on my lips. “Mommy, how come it’s ‘NO this is true?’ Is it YES true you’re going to love me, or NO true?” I stopped rocking. It took me a minute to understand what he was thinking in his little toddler brain. And then I got it. He didn’t understand that I was saying the word “know” instead of the word “No.” And he wanted a little clarification. No true, or yes true? I brought his face up to mine. “YES true,” I remember saying. “YES true, I’m going to love you. YES true, your whole life through.” I stood there this morning with my hand on the door of my 18-year-old son’s room, as that memory went through me in a hold-your-breath-and-you’re-back-there-again-in-the- rocking-chair whoosh. I think it came back to me, really, because of what I’ve been blogging about this week. Bless, bless, bless. Gratitude. YES true. That’s how we love the people we love. YES true, your whole life through. How many people can you bless, bless, bless today (in the grocery store, on the beltway) and say YES true to in your own living room?
Countdown Reason # 16: And Gratitude Helps with Pain
I have a good friend, a dear, dear friend, really, who I’ll call “K.” “K” suffers from an autoimmune disease. In the past five years she’s gone from daily injections of a multiple sclerosis drug that packs difficult side effects to taking no meds at all. She carries the most grateful, compassionate outlook of anyone I know. I’ve watched her devote herself over the years to exercising more, getting a three-wheeled bike when she realized a two-seater wouldn’t work and toodlling around her neighborhood, building a strong social community, and training herself to think, as she puts in, “on the better side.” I heard an interview on NPR today with an American vet from the Iraq war who just this week had two new arms transplanted onto his torso at Johns Hopkins — in a first of its kind surgery — to replace the two he lost in Iraq several years ago. He’d also lost a leg. He was amazing. The interviewer asked, “How do you feel?” He said, “I was pretty happy before the surgery, my life was pretty good, but yes, this definitely just makes me even happier.” Think about that. “I was pretty happy before.” Despite losing three limbs in the war. I suspect his transplant surgery has a good chance of succeeding. Gratitude is not only good for our relationships, it also helps with healing. Studies show it helps us to better deal with pain, suffering, illness, grief and loss. Patients who keep a positive mindset prior to even a relatively simpler surgery, such as total knee replacement surgery, and who “recognize within themselves the ability to ensure that things will be okay,” say researchers, consistently report less pain and disability after surgery and recover faster.[i] Older people who have a positive take on life are less likely to fall – suggesting that the risk of falling among the elderly is tied to one’s view of the world.[ii] There are dozens of studies like this. We know it’s true. So why is it so incredibly hard to live, as my friend “K” would say, “on the better side?” I write about that too, in The Last Best Cure. What’s getting in our way. And really, how to get out of our own way. ———– [i] Public release date: 17-Feb-2011. Healthy lifestyle, positive attitude can help improve patient outcomes. American Academy of Orthopaedic Surgeons. [ii] BMJ 2010; 341:c4165 doi: 10.1136/bmj.c4165 (Published 20 August 2010) Determinants of disparities between perceived and physiological risk of falling among elderly people: cohort study, Stephen R Lord, professor et al.