If you think sleep is merely a cozy luxury that comes at the end of a long day, think again. Sleep is an integral component of our health. In fact, this often misunderstood part of our physiological make-up may hold a much larger key to our health than we understand.

Summarizing Sleep

Sleep is a naturally recurring physical and mental state of rest during which a person becomes inactive and unaware of the environment. Sleep is characterized by suspended sensory and motor activity, total or partial unconsciousness, and the inactivity of nearly all voluntary muscles.

While we’re sleeping, most bodily functions slow down—we experience a drop in body temperature, blood pressure, and breathing rate. However, the brain stays active throughout sleep. In fact, some studies have shown that the brain is as active during sleep as it is during waking periods.

Sleep has distinctive stages throughout the night, referred to as “sleep cycles.” These cycles are characterized as non-REM and REM (rapid eye movement) sleep. Non-REM sleep consists of four stages from light dozing to deep sleep. We spend about 75% of our sleep time in the non-REM cycle. During the rest of the time, we are in REM sleep, where most dreaming occurs. The brain wave activity during REM sleep is similar to that of the waking state; however, during REM sleep, the brain blocks signals to the muscles so that they will remain immobile and dreams won’t be acted out.

Importance of Sleep

Sleep is a critical factor to maintaining health. It enables the body to rest and recharge and is also needed for important physiological processes such as hormone regulation, which affects immune function and overall health. Each stage of sleep provides different benefits to our physiological and emotional health. Some stages of sleep help us to feel rested, whereas others help us learn or make memories.

Some describe sleep as an opportunity for the brain to perform “housekeeping” tasks, such as organizing long-term memory, integrating new information, and repairing and renewing cells and tissues.

Sleep is essential to our emotional and physical wellbeing. It is a time during which the body can rest and the mind can sort things out.

Consequences of Sleep Deprivation

The average person needs six to eight hours of sleep per day, but most of us don’t get as much as we need. Studies have shown that lack of sleep leads to a dramatic decline in a person’s ability to perform even simple tasks.

Individuals who are sleep-deprived may experience drowsiness, irritability, lack of concentration, and impaired performance. Furthermore, sleep deprivation compromises the immune system, making it more difficult to fight off infection. Persistent sleep deprivation can result in significant mood swings and erratic behavior.

Sleep deprivation can have dangerous consequences, such as car accidents.

Sleep Away

Sleep is not a waste of time. It is a vital and necessary biological function. Take care of your health by doing something that comes naturally—sleep.

(If you’re struggling with sleep, visit our sleep guide, Solving the Sleep Struggle.

Nancy Sullivan

Briefly describe your diagnosis and treatment.

I was diagnosed with triple-negative breast cancer with sentinel node involvement in February 2008. I had a lumpectomy, during which doctors removed an 8 millimeter (mm) tumor from my breast and 11 nodes—of which the sentinel node had a 2 mm spot. After magnetic resonance imaging (MRI) and computed tomography scans, multiple gated acquisition testing, and bone scans, I received four cycles of Adriamycin® (doxorubicin) and Cytoxan® (cyclophosphamide) and then received four cycles of Taxol® (paclitaxel). Following chemo I spent the entire summer enduring radiation (39 treatments in all).

What was your age and health status at the time of diagnosis?

I was diagnosed at the young age of 37 and was in what I consider good health. I ate healthfully, was not overweight, and was an avid walker.

Did you have a family history of this disease?

No.

How did your diagnosis affect your work and family life?

My work was affected only on the days that I received chemo, which was every Thursday, so I did not miss much work at all. My family life changed the most—there were moments when I wanted to curl up, but I knew that my kids needed to see that I was strong and could fight this battle. My weekends were spent resting, which was tough for them, but everyone was very patient and supportive of me. I tried not to let it affect me!

Where did you turn for emotional support following your diagnosis?

I turned to my family and many friends for support. I also relied on my kids for support; their constant hugs, their rubbing of my bald head, and their desire to make sure I always had what I needed helped me get through.

What did you learn from your cancer experience?

I learned to live for the day! Too many people talk about the what-ifs in life and forget to live and be happy in the moment. I also learned to take it all in, especially when watching my children play sports or dance on-stage. I cry more often because of the fear of missing milestones, but I really appreciate the ones that I am here for now.

What is your current health status, and how often do you receive follow-up care?

Currently, my health (knock-on-wood) is good! I follow up with my breast surgeon and my oncologist every three months and have mammograms and MRIs routinely, as well.

Do you have any tips to offer newly diagnosed patients?

My biggest tip would be to keep your eye on the prize: the end of treatment. When people offer help, take it; and when you can finally turn around and help someone yourself, do it! Laugh, smile, and appreciate life even during treatment—it’s likely that someone is watching you closely and will be inspired by your courage. Let others learn from you like I hope my children did!

6 Reasons to Skip Your Workout

Know when to say no to exercise.

We all have those mornings when we’d rather lounge around in our jammies with an extra cup of coffee than make our way to the gym. Usually, this is a bad idea, and later in the day we’ll end up regretting our decision to skip exercise. Sometimes, however, when you don’t feel like working out, your body may be communicating with you. Here are six times when you should heed the urge to relax.

1-Sleep deprivation. Sleep is vital to health and well-being. During sleep the body recharges and the brain performs “housekeeping” tasks. Sleep deprivation can have devastating effects and lead to a dramatic decline in the ability to perform simple tasks. Furthermore, it compromises the immune system. When the body is already stressed by a lack of sleep, exercise will only exacerbate the problem. If you are suffering from lack of sleep, you’re better off sleeping for an extra hour than you are exercising. Get some extra rest and be ready to hit the gym another day when you feel rested.

2-Fever. If you have a fever, exercise is a big no-no. A fever is a sign that your body is fighting an infection. You want to provide your body with the rest it needs to do this important work. Under these circumstances exercise will break you down rather than build you up. Listen to your body, rest, and drink plenty of fluids. You’ll be back in the gym in no time.

3-Injury or pain. When it comes to exercise, there is such a thing as “good” pain and “bad” pain, and you will likely know the difference. Good pain refers to the sore muscles that follow a challenging workout; bad pain refers to uncomfortable pain that lingers and feels like something is wrong. If you have an injury or a nagging ache or pain, refrain from exercise and visit the doctor instead. Exercising through an injury will only aggravate it and perhaps even lead to bigger problems.

4-Fatigue from overtraining. The fatigue that results from overexercising is different from the tiredness we feel from a late night, a long day, or chronic sleep deprivation. Overtraining leaves us feeling irritable and just plain “different.” You may experience insomnia, depression, weight gain, or a litany of other symptoms. The best indicator of overtraining is an elevated resting heart rate. If your resting heart rate is 10 percent (or more) higher than normal, your body needs rest.

5-Dizziness or nausea. If you’re feeling dizzy or nauseated, your body is already under stress and there is no reason to add exercise to the mix. Even if you don’t have a fever, if your stomach is upset or you feel queasy, you should rest. Learn to listen to your body’s signals rather than try to push through them.

6-Chronic depression or stress. Many experts recommend exercise as a coping mechanism for stress or depression, and in some cases exercise can be appropriate for these conditions. However, when cortisol is elevated and serotonin is depleted—as they are with severe and chronic stress or depression—exercise can further deplete the body and exacerbate the condition. In these cases, intense exercise should be avoided. Moderate exercise (a 30-minute gentle walk) may be appropriate, but consult your physician to be sure.

Avoid Anemia

Inadequate nutrition increases the risk of anemia in postmenopausal women.

Postmenopausal women with inadequate nutritional intake have a higher risk of developing anemia, according to the results of a new study, leading researchers to speculate that nutritional intake and quality of diet should be an important focus as women age.1

Anemia is a condition in which the body does not have enough healthy red blood cells, which are critical for transporting oxygen to tissues. Anemia is the most common blood disorder, and it often goes undiagnosed because symptoms can be vague. Most often anemia results in a general feeling of fatigue, weakness, or poor concentration. Anemia can be a serious problem, affecting overall health and the ability to work or be physically active. It is a serious concern for aging women because it can result in falls and hospitalizations.

Anemia is often linked to an iron deficiency, but this new study sheds even more light on the nutritional connection to the condition. Researchers analyzed data from 72,833 older women in the United States. They found that women with anemia consumed less protein, folate, vitamin B12, iron, vitamin C, and red meat than women without anemia. Furthermore, women who had a deficiency in more than a single nutrient had a 21 percent increased risk of anemia. That risk jumped to 44 percent with deficiencies in three nutrients. Use of multivitamins and mineral supplements was not associated with lower rates of anemia; however, age, body mass index, and smoking were associated with anemia.

The takeaway message is simple and clear: A healthy diet becomes increasingly important as we age. It’s imperative that postmenopausal women consume an adequate amount of iron, vitamin B12, and folate to minimize the risk of developing anemia. Healthy habits are the best line of defense to prevent anemia and maintain quality of life.

Reference
Thomson CA, Stanaway JD, Neuhouser ML, et al. Nutrient intake and anemia risk in the Women’s Health Initiative Observational Study. Journal of the American Dietetic Association. 2011;111(4):532-41.

Obesity Increases Risk of Early Death in Women

The risk of early death increases as obesity increases.

Obesity is a major cause of early death in women, according to the results of a study published in the British Medical Journal.1 The study found that lower-income women were more likely to be obese and at a higher risk of early death, regardless of other risk factors such as smoking.

The study included more than 3,600 women ages 45 to 64 in Scotland who were followed for 28 years. None of the women had ever smoked. Approximately 43 percent of the women were considered overweight, while 14 percent were moderately obese and 5 percent were severely obese. Lower-income women were more likely to be severely obese than those with more financial resources.

During the study period, about half of the women died, with cardiovascular disease (916 women) and cancer (487) being the most common causes of death. Severely obese women had the highest death rates, whereas women who were not obese had relatively low death rates, regardless of socioeconomic status.

The researchers found that women who had never smoked were much more likely to be overweight or obese than their smoking counterparts. Although smoking is one of the strongest risk factors of death and disease, obesity carries its own set of risks and has been associated with diabetes, heart disease, stroke, cancer, and other illnesses that increase the risk of premature death.

The researchers in this study concluded that obesity—especially severe obesity—is an important contributor to premature death. If the statistics in this study are any indication, obesity may be socially patterned and related to socioeconomic status, which could result in healthcare inequalities.

If the results of this study sound dismal, the flip side of the story is actually quite optimistic: women who don’t smoke and are not obese have the lowest mortality rates, regardless of socioeconomic status. The takeaway message is clear: prevention works. One of the best ways to stay healthy is by eating a healthy diet and exercising regularly.

Reference

1. Hart CL, Gruer L, Watt GCM. Cause specific mortality, social position, and obesity among women who had never smoked: 28-year cohort study. British Medical Journal. 2011;342:d3785.

Eat Out without the Extra Calories

Avoiding calorie overload in restaurants

The holiday season is filled with fun, vacations, and lots of socializing—which may mean more meals in restaurants and fewer meals at home. But eating out in restaurants is no excuse to load up on calories. A little caution and common sense can keep your calorie count in check without ruining the fun factor. Here’s how.

Don’t rely on a restaurant’s published calorie counts.

Many restaurants underestimate the calorie content of their meals, and some provide calorie information only for the main course, which can be misleading; you may assume that all of those side dishes are included in the final tally. Furthermore, many cooks accidentally deviate from recipes, which can result in a higher calorie count. So, even if the restaurant provides calorie information, trust your common sense regarding calories and portion sizes.

Get hydrated. Drink the water, especially if you’re drinking wine or other alcoholic beverages. Fill up on water when you are seated and then alternate water and wine—drink a full glass of water for each full glass of wine. This will serve to fill you up and also reduce the amount of calorie-laden wine you drink. Staying hydrated is an added bonus.

Split an entrée. On average, restaurant portions are two to three times as big as an appropriate portion size. We often overeat in restaurants because more food is served and we’re naturally inclined to clean our plates. If you’re counting calories, share an entrée with someone in your group. Alternatively, the group could order “one fewer” and share, meaning if you have a party of six, order five entrées and share them family-style. This is a win for everyone—fewer calories and more options.

Make good choices. Many restaurants offer several preparation options. Choose grilled or steamed over sautéed or fried.

Small plates. Don’t fall into the entrée trap. Consider ordering two small plates or appetizers or choose soup and salad. Start small and see if you’re satisfied. You can always order more.

Doggy bag. Resist the urge to join the clean-plate club. Stop eating when you’re full or simply satisfied. If you don’t have the willpower for that, ask your server to bring you a box at the beginning of the meal and then immediately cut your meal in half and save the rest for later.

By Laurie Wertich

When Heather Grace started experiencing pain and numbness in her arm and neck in 1999, she never imagined that she would be living with chronic pain for the rest of her life. As a busy information technology professional, Heather spent countless hours in front of the computer, and it had taken a toll on her body. She visited several doctors and finally was diagnosed with a soft tissue injury and prescribed physical therapy (PT). “I thought that was it,” Heather explains. “I would do PT, and it would get better. Over the next year, it just got worse and worse.”

Heather’s pain intensified; she had numbness and tingling in both arms, and she was dropping things. Her head felt like it would burst. “I thought my pain was bad at the beginning, but I had no idea it could get as bad as it did,” she says. She continued to visit doctor after doctor to no avail. Finally, after more than two years, she got the magnetic resonance imaging (MRI) scan she had been begging for, and it revealed a bulging disc. “I was jumping for joy because I thought, I’m going to be better because they’re going to fix me,” Heather recalls. Unfortunately, insurance complications—Heather’s injury was a workers’ compensation claim—meant that she would have to jump through an endless series of hoops to get the treatment she needed.

“I never dreamed it would take another five years to actually get the surgery,” she says. “It was an unbearable waiting game; and even when my surgery did happen, it was years too late. It only made my pain worse.”

Today, Heather lives with intractable pain—a level of pain that most people cannot even imagine. Left untreated, her original injury led to severe nerve damage that now affects five discs in her spine. She lives with feelings of “fire” and “ice” and is sensitive to just about any change in her environment. “My pain will never go away. I will be dealing with it for the rest of my life,” Heather explains. “Until it happened to me, I didn’t even know it was possible.”

The Pain Epidemic

Heather’s story may sound extreme, but unfortunately it’s not that unusual. In fact, according to a recent report from the Institute of Medicine, chronic pain affects at least 116 million American adults.1 That’s more than the total number of people affected by heart disease, cancer, and diabetes combined. In other words, we have a chronic pain problem.

Chronic pain is a public health crisis. It costs the nation up to $635 billion per year in medical treatment and lost productivity. More importantly, it costs people—116 million of them—quality of life. Heather knows this all too well. “At one point I was actively considering suicide because I couldn’t continue living in constant, unbearable pain for much longer,” she admits.

Indeed, the impact of chronic pain on quality of life is devastating. Dr. Lynn Webster, MD, FACPM, FASAM, medical director of the Lifetree Clinical Research and Pain Clinic, says that when a patient comes to him for the first time, he tries to simply listen for at least 10 to 15 minutes. “I let them say what they have to say, and then I ask what I can do for them,” he explains. “Usually, there is a period of silence and then they say, ‘All I want is to have my life back.’”

Understanding Pain

Unfortunately, many people suffering from chronic pain cannot “have their life back”; instead they’re faced with a new life that requires them to live with pain.

Most people perceive pain as a symptom, although chronic pain is a disease in and of itself. When pain is properly treated early, many people can recover and resume their lives. Left untreated, pain can result in nerve damage that never heals—leading to chronic pain. “Rarely are we able to eliminate chronic pain,” Dr. Webster says. “There is not a cure.” Instead individuals with chronic pain must learn to change their expectations and the ways in which they live their lives.

Dr. Webster explains that the brain is a key component of the perception of pain. “Pain is literally a matter of perception,” he says. “All pain is influenced by life experiences and by the cognitive and emotional centers of the brain.

“By professional definition, chronic pain is when someone is experiencing pain persistently or intermittently for more than six months,” Dr. Webster continues. He explains that 25 percent of the population is experiencing chronic pain at any given time. Older people—those over age 65—tend to have longer periods of pain and often permanent pain that they live with for the rest of their lives.

Women and Pain

Women experience chronic pain differently than men. They tend to experience more pain than men, have a lower pain threshold, and more often suffer from conditions that cause chronic pain, such as fibromyalgia, irritable bowel syndrome, and migraines.2

The gender differences in pain experience have been extensively studied. Some research indicates that male and female brains process pain differently. For example, PET (positron emission tomography) scans have indicated that women tend to experience pain in the limbic—or emotional—area of the brain, whereas men tend to experience pain in the frontal cortex, or the intellectual processing center.3,4 This could explain why women tend to describe their pain with more emotion while men report it in a more matter-of-fact way.

Hormonal differences may also play a role in how women experience pain. Some studies indicate that estrogen levels appear to affect the experience of pain. Women tend to experience pain sooner and reach their maximum pain threshold sooner during and around menstruation, indicating that a dip in estrogen levels might make women more vulnerable to pain. There is plenty of conflicting literature on the topic, however, and researchers continue to evaluate the connection.2

Although he acknowledges that it is a generalization, Dr. Webster says that too many physicians perceive complaints from women as dramatic and overstated. “Unfortunately, many physicians tend to think women are more histrionic and blame it on social characteristics more than physical characteristics,” he explains. One way to avoid this bias is to report the pain with as little emotion as possible and be careful not to overstate it. “The one thing that discredits people is when a doctor asks them to rate their pain on a scale of 1 to 10 and they say it’s 15,” explains Dr. Webster. “Then you can’t believe what they say. It is by definition histrionic, and it biases the subsequent discussion.”

Communicating with Your Doctor

So, what is the best way to communicate pain to a doctor? Dr. Webster says it’s important to communicate directly and honestly and to provide both a quantitative and a qualitative description of the pain. In other words, women should describe the intensity level of the pain but also information about how the pain has affected their life.

Micke Brown, BSN, RN, director of communications for the American Pain Foundation (APF), has been a registered nurse for more than 30 years and has more than 15 years of experience as a pain management nurse, program coordinator, educator, and advocate. She likes the pain notebook provided by the APF because it helps patients describe their pain accurately. “It’s not just a 1-to-10 pain scale,” she explains. “That tool is designed to manage only one aspect of pain, which is intensity. There is a lot more to pain than intensity. Do you always have pain? Is it worse at different times of day? How does it interfere with your ability to work, be social, or care for your kids?”

This information helps the physician get a better sense of how the pain is affecting an individual’s ability to function—and is important for guiding treatment strategies.

Treating Pain

Treating pain is a nuanced, multifaceted process. It typically requires a combination of treatments—referred to as multimodal treatment—that may include physical therapy, biofeedback, cognitive therapy, medication, exercise, spinal manipulation, and more. Most physicians will use some combination of these strategies to create a pain management plan for a patient. In other words, treatment is not a one-size-fits-all approach. “You have to find the right ingredients to build the right recipe for the individual and attack the pain problem with many different strategies,” Brown explains.

Prescription opioids—such as hydrocodone and oxycodone—may be one component of a pain treatment plan, but they are not without controversy. The drugs can be addictive, and many physicians hesitate to prescribe them. Dr. Webster has long been an advocate for safer prescribing and consumption and has written a book titled Avoiding Opioid Abuse while Managing Pain: A Guide for Practitioners. He worries that we have lost the balance in the discussion about opioids because of the focus on abuse and addiction. “We have millions of people who benefit from these medications and whose lives are improved,” he explains. “It is a tragedy for anybody to be harmed by them, but it is also a tragedy if people are not given access to medications so that their lives can be restored.” He says that the majority of people do not need opioids, but they are helpful for some patients.

Unfortunately, there is a stigma associated with pain medication—partly the result of misinformation and imbalanced media coverage. “That is the hardest part,” Heather admits. “You’re facing this serious chronic illness, and everyone looks at you as if you’re a drug addict, a loser, and a liar. The reality is that nobody with chronic pain wants to take these medications or deal with this, but they want to be better.” For those who need them, opioids can make a huge difference in quality of life—helping people transition from suicidal despair to some semblance of “normal” life.

Seeking Help

Because chronic pain is its own disease, it helps to seek a practitioner who is well versed in treating it. Unfortunately, chronic pain is not part of the core curriculum in medical education. As a result, many primary care physicians are undereducated in pain.

Not all pain requires a specialist; however, women who don’t find help with their primary physician are encouraged to find a specialist. Dr. Webster suggests interviewing physicians. “They may need to go to several to find someone they can believe in,” he says. “A good physician in this area will be compassionate and will hear the voice of the individual.”

Brown adds that it is important to arrive prepared for that appointment. “The more information you bring with you, the better off you’re going to be,” she says.

To get the most out of an appointment with a physician, it helps to bring:

• A pain log that includes quantitative and qualitative information about the pain
• Medical records
• A history of pain treatment: what has been tried and whether it helped, hurt, or had no impact

Living with Pain

No one with chronic pain wants to hear that they just need to live with it. While the pain may be incurable, there are treatment options that can help improve quality of life. Brown says that it’s important for women to be active partners in their care. “It’s a mixture of medication management, lifestyle, movement, diet, and more,” she advises. “You may have to change how you do things, but you can’t let the pain drive your life. You have to drive your life instead.”

Heather knows this firsthand. She can’t do many of the things she used to do, but she has found strategies for coping with the pain. She has good days and bad days. Sometimes she sleeps and sometimes she doesn’t. On some days she experiences debilitating pain flares. Most importantly, she spends a lot of time advocating for the rights of people with pain by serving as a volunteer Action Network leader for the American Pain Foundation in California. “If I’m going to spend the rest of my life in pain, the least I can do is help people,” she says. “I don’t want anyone to kill themselves because they can’t get the treatment they need. I was at that crossroads.”

References

1. Relieving Pain in America: A Blueprint for Transforming, Prevention, Care, Education, and Research. Institute of Medicine of the National Academies website. Available at: http://www.iom.edu/Reports/2011/Relieving-Pain-in-America-A-Blueprint-for-Transforming-Prevention-Care-Education-Research.aspx. Accessed September 22, 2011.

2. Fillingim RB, King CD, Ribeiro-Dasilva MC, Rahim-Williams B, Riley JL 3rd. Sex, gender, and pain: a review of recent clinical and experimental findings. Journal of Pain. 2009;10(5):447-85.

3. Paulson PE, Minoshima S, Morrow TJ, Casey KL. Gender differences in pain perception and patterns of cerebral activation during noxious heat stimulation in humans. Pain. 1998;76 (1-2):223-29.

4. Naliboff BD, Berman S, Chang L, et al. Sex-related differences in IBS patients: central processing of visceral stimuli. Gastroenterology. 2003;124:1738-47.

How to Talk to Your Doctor About Your Pain

• Be direct, honest, and as unemotional as possible.
• Provide a quantitative description of the pain. For example: “On a scale of 1 to 10, it’s a level 8; and I can’t sleep more than three hours at a time.”
• Provide a qualitative description of the pain. For example: “I can’t deal with my kids without yelling at them. I feel alienated by friends and family. I can no longer do the things I love to do.”
• Ask for strategies for coping with the pain. Most chronic pain is incurable, so it’s better to say: “I need to be able to better deal with my pain” rather than “I want my pain to go away.”

When Someone You Love Is in Pain

It can be hard to understand chronic pain if you haven’t experienced it yourself, but this lack of understanding often exacerbates the pain people are feeling. “When you talk to someone and they don’t understand, it’s devastating,” explains Heather Grace. She says it’s important to provide emotional support to someone in pain. “Just remember that they were your family member, friend, or co-worker long before they had pain, and you knew them and trusted them. So, don’t change your mind about that just because you don’t understand their pain.”

Simla Somturk Wickless, MBA, CHC, CNE, is a holistic health coach and a therapeutic nutritionist who survived debilitating chronic pain and fatigue to successfully overcome fibromyalgia and other chronic health conditions. Today she guides her clients worldwide toward health. If someone you love is in pain, she suggests the following:

Listen. There is nothing you can do to change the pain, but you can help your loved one feel truly heard.

Believe them. There is a stigma associated with pain, and often people in pain are viewed as dramatic or, worse, liars. It is rare for people to fake chronic pain. If they say they are in pain, they likely are.

Ask questions. Ask your loved one to rate the pain and describe its impact. Ask him or her to describe the diagnosed condition and then research it more on your own. This will help both of you gain a better understanding of the pain—and each other.

Offer assistance. Ask how—not if—you can help. And if the answer is “No, thanks,” just be good company.

Have compassion. It can be unbearable to live with chronic pain—and even worse to feel judged for it. Empathy, kindness, and compassion can help ease suffering and build a bridge of understanding.

Bring humor and optimism. Focus conversations on positive topics the person enjoys. Laughter can take one’s mind off the pain and even serve as a temporary painkiller.

Be respectful of the unique situation. Do not push solutions on your loved one just because “it worked for so-and-so.”

Be understanding. Realize that his or her moods may be affected by the pain, and don’t take sour moods personally.

Show your unconditional love. Simple acts of kindness and love go a long way. Bring flowers or a homemade dish, offer to pick up some groceries or a good book, or give a welcome gift, such as a house-cleaning service gift certificate. Above all, just demonstrate love.

Chronic Pain Resources

The following organizations provide education, support, and other resources for individuals suffering from chronic pain:

American Pain Foundation
www.painfoundation.org

American Chronic Pain Association
www.theacpa.org

American Academy of Pain Medicine
www.painmed.org

American Pain Society
www.ampainsoc.org

National Pain Foundation
www.nationalpainfoundation.org

During chemotherapy many women experience hair thinning and hair loss. What is your recommendation for the best way a woman can camouflage spots where her hair is thinning?

Because this is such a difficult time for women both physically and mentally, I like to place more emphasis on some of their other assets. I might suggest that they play up their eyes or lips to draw attention away from what they are going through and seeing in a mirror. If they have a love for jewelry, scarves, or hats, I use this to help them create a new look that will make them feel beautiful and not place such emphasis on their hair.

As for their hair, the haircut process is so important, and it depends on each woman. I spend a lot of time talking with each client and really finding out how she feels. This helps me understand where she’s coming from so that I can give her a haircut that will not only boost her style but also make her feel good about herself.

Many women opt to wear a wig during chemotherapy treatment, which is a chance to experiment with different styles. What are a few things women should look for when choosing a new ’do?

I love the scenes from Sex and the City when Samantha is going through chemo. She wears a different wig for each scene. The color, the cut, and the style don’t matter—she is determined to look fabulous. The show’s portrayal of Samantha opened the door for many women to similarly embrace the fashion moment and not settle for just one wig. I think women should experiment and try on various styles, colors, and cuts. Feeling good about how you look is always good medicine.

Most of the time during chemotherapy women keep their hair shorter, either because they have no choice or they want to draw less attention to thinning areas. What are some fun and easy ways to style short hair?

Short hair has so many benefits and presents its own style statement, enabling women to look fresh and beautiful. It should never be looked at as a hairstyle just for women going through such a rough time. I always make my clients feel sexy and gorgeous by showing them various ways to wear their hair, along with the right styling products. My favorite way to wear short hair is naturally textured—almost as though you’ve just stepped out of bed. Wearing a hairstyle that is too stiff and structured is old-fashioned and doesn’t complement anyone. To change your style, I recommend trying hair accessories such as headbands or a thin scarf, and letting some soft wisps of hair show through.

Wigs make it easy to change your hair color on a daily basis. What colors do you think look the best on brunettes, blonds, and redheads, respectively?

There are so many color choices when it comes to wigs today, but women undergoing chemotherapy treatments need to shy away from some of the more cool tones and look toward shades that will brighten their skin tones. At times, chemo can rob a woman’s skin tone of its vibrancy, so the right wig color can help correct that.

It is all about pampering yourself and looking good so that you feel better from the inside out. Your body endures a great deal during these treatments, so any color that makes you feel or look better is the way to go when selecting a wig.

David Babaii is a world-renowned celebrity hairstylist who has had a deep passion and love for hairdressing from an early age. His imaginative hair creations quickly gained him worldwide notoriety, which allowed him to work within the world of haute couture, designers, fashion magazines, and the world’s top models. David’s work has appeared not only in the runway shows of Armani, Chanel, and Dior but on the covers of every leading fashion publication, including InStyle, Allure, Glamour, Vogue, and Harper’s Bazaar. David boasts an extensive celebrity clientele and is also a brand ambassador for Couture Colour.

The Look Good . . . Feel Better program was founded and developed in 1989 by the Personal Care Products Council Foundation, a charitable organization established by the Personal Care Products Council, the leading national trade association representing the global cosmetic and personal care products industry. The program is a collaboration of the Personal Care Products Council Foundation, the American Cancer Society, and the Professional Beauty Association/National Cosmetology Association, a national organization that includes salons, spas, distributors, manufacturers, and more than 25,000 beauty professionals. For more information about Look Good . . . Feel Better or programs available in your area, please visit www.lookgoodfeelbetter.org, call (800) 395-LOOK [5665], or contact the local American Cancer Society office.

You are what you read, according to the results of research from the University of British Columbia published in the Journal of Personality and Social Psychology. Researchers have found that media reports of good deeds inspire people to perform good deeds. In other words, good news, in its most literal sense, has the power to plant seeds for future selfless acts.

Four separate studies at the institution identified a direct link between exposure to positive media reports about Good Samaritans and a subsequent desire to emulate the behavior. These were extraordinary acts of virtue and selflessness rather than simple volunteerism or kindness towards neighbors. In other words, positive news is nice, but people are unlikely to act on it. However, stories about people who act with enormous sacrifice, often putting themselves at risk for the sake of others, are likely to inspire action. Those most affected by the media reports were those who were identified as having a strong sense of moral identity.

The takeaway? The media has the power to impact behavior—and society—by focusing on good news rather than bad news, namely acts of extraordinary sacrifice. While you wait for the mainstream media to catch on to this phenomenon, you can find good news on the web:

• Daily Good: The Daily Good provides news that inspires. (www.dailygood.org)
• Happy News: Happy News provides news intended to lift spirits and inspire lives. (www.happynews.com)
• Daryn Kagan: Daryn’s mission is to “show the world what’s possible” by sharing inspiring stories. (www.darynkagan.com)
• Good News Network: The Good News Network is the most comprehensive collection of good news on the web and is available by subscription. (www.goodnewsnetwork.com)

You know how when you track your finances, you become more aware of frivolous spending and therefore tend to spend less? The same is true with food. By tracking what we eat, we become more aware of our food choices. The result—we make better food choices and may even lose weight.

This isn’t wishful thinking. There is sound data to back it up. Researchers have found that individuals who write down everything they eat and drink lose almost twice as much weight as those who do not.[1] If this sounds tedious, don’t fret—a food journal doesn’t have to be complicated or time-consuming to be effective. It simply has to be a consistent practice that works for you.

Why Food Diaries Work

Food diaries work for two reasons: awareness and accountability. By keeping track of your meals and snacks, you build awareness about your calorie consumption and eating habits. You may believe that you consume about 2,000 calories a day, but once you start recording every meal, snack, and drink you might discover that you’re actually consuming 2,500 calories a day. This provides valuable information and insight—and an opportunity to make choices about where you can cut calories. That 500-calorie mocha suddenly becomes a lot less appealing when you realize that it adds up to one extra pound per week.

Furthermore, food journals provide accountability—whether you show it to anyone or not. The simple act of recording the data creates a system of personal accountability that can help change behavior.

How to Keep a Food Diary

Remember, a food diary need not be complicated to be effective. Develop a system you can follow. Some people choose to use a notebook, others find an excel spreadsheet to be helpful, and still others use the online tracking journals provided by services like Weight Watchers. Some tips for success:

• Track as you go. Don’t wait until the end of the day to try to recall everything you ate. Every time you consume something, record it immediately.
• Be specific. Include portion sizes and calories. Did you have a handful of chips or the entire bag?
• Be honest. You’re doing this for yourself and no one else. If you ate half a cheesecake, record it. This will help you build awareness. Plus, you’ll experience success when you see how your habits change over time.
• Be consistent. It’s tempting to skip the food journal on indulgent days or vacation. Food journals work best when they are used as a consistent practice.
• Be gentle. This is not an opportunity to berate yourself, but a chance to create lasting change. Look at your food journal as a gift you’re giving yourself because it will help you see your diet as it really is rather than how you wish it was.

Reference:

We all know the importance of saving money for a rainy day, but what is the best way to save and how do you use what you have saved? Effective saving is not as simple as depositing money into a savings account—but it doesn’t have to be complicated either.

A little intention goes a long way to create an effective savings plan that works for you. One of the most effective ways to save is to set up multiple savings accounts, each with its own specific purpose. You can create as many savings accounts as you wish, but in a perfect world there are a few basic ones that everyone would have:

Emergency fund: This is the most important savings account to create. We never know when life is going to throw us a curve ball. There are a lot of things we can’t control, but if we have some money saved up, we’ll be better able to cope when unexpected situations arise. The emergency fund should consist of 3-6 months of living expenses. The first step to becoming a savvy saver is to have a fully funded emergency fund. Once you’ve done that, you can expand your savings horizons.

Your emergency fund should be tucked away in an account that is not easily accessible. You don’t want to be able to tap into this account when you see a shiny new toy you want. Leave this money alone so it’s there if/when you need it.

Cash flow savings: The cash flow savings is for when you’re short on cash. This is a savings account that you can access when you need a little extra infusion of cash. A cash flow savings account is typically linked to your personal checking account so that you can easily transfer money when you need it. The cash flow savings provides a little extra cushion for the budget.

Periodic savings: The periodic savings account is for expenses that arise periodically, such as auto registration and repairs, insurance payments, or workshops. A periodic savings account is an excellent way to save for upcoming expenses so that you don’t have to come up with a chunk of money all at once. For example, if you pay for your auto insurance annually (which saves money) you can divide that number by 12 and sock away a little bit each month so you’re prepared when the bill arrives.

Dreams and goals savings: We all have big dreams and goals. Maybe you want to take an exotic vacation or go back to school or buy a boat. Whatever your dream, you won’t get any closer to it if all you do is dream about it. So this savings account is the place for you to take inspired action. Tuck some money into this account each month and watch it grow you closer to your goal. Before you know it, your dream will be a reality.

These four savings accounts form the foundation of a healthy savings plan. Of course, these are short-term savings accounts for the here and now. Long-term savings will include plans for retirement and end-of-life care. Some savers include other accounts such as vacation funds, college funds, or debt reduction funds. Whatever your individual needs are, you can start becoming an effective saver by creating separate accounts targeted for specific purposes.

Saving money doesn’t have to be rocket science, but it does have to be intentional. If you don’t know where you’re going, you’ll never get there. By setting clear and specific savings goals, you’ll be more likely to have the money you need for the purpose you need it and at the time you need it.

One family weighs in on the potentially loaded issue of genetic testing.

Anne Parker is, quite literally, a poster child for genetic testing. Since 1998 Anne’s family history of breast and ovarian cancer has been on display at the Tech Museum of Innovation in San Jose, California, as part of a larger exhibit on genetics. And yet, in Anne’s own close-knit Canadian family, the issue of genetic testing is fraught. For Anne’s son and his cousins, the idea of being tested for the BRCA1 mutation raises specters of fear, grief, and anxiety related to Anne’s own battles with breast and ovarian cancer and their loss of other family members to the disease. Anne’s friend, Kimberly Whitnell, describes the way this particular family is managing the issue of genetic testing.

When Anne Parker, after surviving breast cancer at age 29 and ovarian cancer at age 38, learned in 1998 that she carried the BRCA1 mutation, she began a dialogue about genetic testing with the five most important people in her life: her son (her only child), her two nephews (sons of her late sister, who died in her thirties of ovarian cancer), and her two nieces (the daughters of her brother, who learned in 1999 that he carries the predisposition to cancer). But the dialogue has been difficult. For the generation of young adults in this family touched by hereditary cancer, the suggestion of being tested for the BRCA1 mutation arouses a cascade of difficult emotions and decisions.

Over the years, as research has repeatedly shown the effectiveness of prevention and screening interventions to improve the risk of BRCA1 mutation carriers, Anne has reminded each of them of the importance of being tested. And Anne’s requests have become more fervent as the years have passed. Yet to date none of these young men and women have had the simple blood test that, in Anne’s mind, would either free them of their worries or allow them to manage a diagnosis. “Once it was confirmed that I do carry the mutation,” Anne says, “I thought they would be standing in line to be tested.”

But for this younger generation, who range in age from late twenties to midforties, it seems the issue is not as clear. “I have come to realize that you can’t underestimate the personal reasons for not being tested,” Anne says. “Today genetic testing has raised numerous issues related to the risks and the impact of being tested—there are privacy concerns, insurance issues, and employment to think of.” And though she understands the concerns, Anne remains disturbed by her family’s reluctance. “I am distressed, worried, and just a bit angry,” she says about the resistance her family has exhibited toward genetic testing. “The anguish I had to endure both physically and mentally before making the decision to be tested wasn’t just about me; I was also trying to protect other family members from going through the same suffering.”

Despite her own feelings of distress, Anne says, she has continued to encourage her family to at least be aware of their risk—to talk to their doctors, study the research, and, most important, learn about their bodies. But in talking with her family, she has come to learn that in some cases it’s information, as her youngest niece recognizes, that can be both empowering and terrifying: “Knowledge is power,” she said to Anne at one point, “but my fear of the truth makes me feel that ignorance is bliss.”

The responses from her son, her elder niece, and her two nephews have confused the issue further because they all acknowledge the benefit of testing but have been reluctant to actually go through with it. Anne’s son has said that “not to seek knowledge is lazy, if not ignorant, saying nothing of a lifetime of self-doubt.”

Her older niece, a healthcare worker, agreed that “the benefits of knowing outweigh the potential stress of hearing something you didn’t want to hear or deal with.” And her youngest nephew, now a father himself, has said that he believes that testing would be a benefit.

Despite their seeming universal acknowledgment of the positive impact of testing, only Anne’s eldest nephew—who was 17 when his mother died of ovarian cancer—has just recently agreed to be tested. He will undergo the test this year as part of his son’s school project.

Anne knows that the decision to be tested is not an easy one. There are countless situations that weigh heavily on a potential BRCA1 mutation carrier. She faced similar questions herself when she was tested: How does one protect his or her family if they are denied life and health insurance? How does a young executive dedicate his or her time to climbing the corporate ladder, knowing that a ticking time bomb could detonate any day? How does a parent tell a child that he or she has passed on a legacy that is unfathomable?

And then there are the difficult personal choices that might arise following testing. For Anne’s nieces, testing positive for the mutation could force them to make decisions they’re not prepared for at this point. They can ignore the results and trust that they will be spared the anguish that has haunted the women before them, they can select intensive screening, or they can opt for prophylactic surgery and have their breasts and/or ovaries surgically removed. But at the ages of 28 and 30, such decisions make for a cruel reality.

For the young men in the family, for whom the implications of a positive test are much less threatening, the decision to be tested appears no easier. At one time or another, each of these young adults has buried a beloved mother or an aunt, and they all have shared Anne’s pain during her three separate cancers. Perhaps it is not so surprising that the potentially lifesaving step of booking an appointment with a genetic counselor is such a complicated choice.

The struggles that Anne’s family has experienced make clear the broad range of issues and the intense emotions related to genetic testing. Though each family is unique and will handle the situation in their own way, the challenges that exist surrounding the incredible potential benefit of the test and the psychological impact of the related decisions are universal and cannot be underestimated.

By Denise King Gillingham, MSW

We all have them. They take many different forms and have various identities. They are the little voices that play repeatedly in our heads. Perhaps you have made a decision to try something new and you hear that little voice saying, “You can’t do that” or “You’re not smart enough.” Or maybe the voice is saying, “You haven’t worked hard enough for that” or “You don’t deserve this success.” Whatever the words, the message is the same: judgment and negativity.

This little voice can play a big role: it is your saboteur. Its purpose is to keep you safe by preventing you from taking excessive risks. But safety’s good, right? Not always. There are times in your life when taking a risk and initiating change are necessary. When the saboteur appears at these times, you avoid moving forward in important ways.

Below are some suggestions for saboteur management. Remember, you are in charge of your life, and being aware of your saboteur and its patterns is important for steering your life in the direction you choose.

Increase awareness of your saboteur. An easy way to remain aware of your saboteur is to keep track of the times a negative message plays its tape in your head. Keep a record of how many times the tape repeats. It is amazing how frequently we receive negative messages. Listen to the message and then replace it with a positive, self-affirming statement. For example, replace “You do not deserve your success” with “I deserve my success.”

Look for patterns. When does your saboteur appear? Often they have patterns. Some appear at the beginning of a project, whereas others appear just before you have achieved your goals. Learn when your saboteur likes to show up so that you can turn it away at the door.

Create an identity for your saboteur. What does it look like? Does it have a name? How does it dress? It can be helpful to draw a picture of your saboteur. The more you know about it, the easier it is to recognize and manage it.

Use humor. It is very difficult to be afraid of or influenced by something that you are laughing at. Acting playful when dealing with the saboteur removes some of the seriousness and lessens the power of its negative messages.

Focus on your goal from a values perspective. Let’s say you are thinking of buying a new house and your saboteur is on the scene, saying you do not deserve it. If you focus on the values involved in buying the house—like family, stability, comfort, and security—the focus shifts from the saboteur to the values that are most important to you. This is yet another way of managing your saboteur.

Just as the saboteur can take many different forms, there are many different methods for managing it. Whichever management method you choose, two things are widely applicable: a saboteur’s power is lessened by awareness, so learn as much as possible about your saboteur and its patterns and identity; and focusing on a goal that embodies your values and taking steps toward achieving it are more powerful than fear or negative messages.

Although somewhat paradoxical, it can be “safer” to make a well-planned life change than to stay in a seemingly comfortable situation. Achieving the life you want will require a degree of shifting and discomfort. Remain positive and enjoy the journey in the direction of the life you choose!

Denise King Gillingham, MSW, CPCC, is a certified co-active coach who specializes in helping people achieve enduring life change through accessing their inner wisdom. Her international practice includes clients from all walks of life. Denise received her master’s degree in social work from Columbia University and has been a mental health professional for more than 15 years. She shifted her focus from therapy to coaching in 2006. Her professional experience includes private therapy practice in Prague, Czech Republic; crisis intervention with New York University; in-patient therapy at Payne Whitney Clinic in New York City; and substance abuse counseling at Bronx VA Medical Center in New York City. She develops and conducts workshops on emotional intelligence for organizations in the United States and Europe. Contact Denise at dkgcoach@gmail.com.