IT’S A WEEK BEFORE a black-tie gala or a vacation in the Caribbean. You’ve worked hard to achieve buff arms and toned legs for the sleeveless sheaths and bathing suits you plan to wear. Then it happens: your friend trips on the gym stairs and grabs, really grabs, your bicep for support or you unwittingly bump your thigh moving a piece of furniture. How much of a bruise will erupt? How much of the damage can you offset?
A bruise, or contusion, occurs when a sudden blow or intense pressure breaks the small blood vessels beneath the skin, but not the skin itself. The capillaries leak, and blood builds up in the soft tissue. (In general, women bruise more than men, because they have more beneath-the-skin fat.) During the first day of a bruise, the area usually turns the reddish color of blood; by the end of day one or day two, iron in the blood begins to turn the bruise blue or purple; slowly it can turn green and then yellow, but often fail to completely disappear for two to three weeks.
To do ASAP: RICE, especially Ice–for as long as you can stand it up to 20 minutes every few hours for the first few days, using bags of ice or frozen peas, or ice packs . Elevate: to reduce swelling and constrict the blood vessels with the goal of discouraging blood flow to the site, which causes discoloration. Rest, if possible; mostly avoid strenuous exercise that increases the amount of blood pumping through the body, which can get trapped at the bruise site. And Compress, using anything like an Ace bandage, but don’t wrap too tightly.
For the first 48 hours, avoid anything hot like hot showers, as well as alcoholic beverages, that might cause swelling. After that, heat can help blood flow to the area to speed healing.
Expose the bruise to UV radiation in direct sunlight, at least 10 to 15 minutes a day over the next few days to speed the breakdown of bilirubin, which causes the bruise to yellow. And massage, though not if it causes pain. Rub the outer edge of the bruise with your thumb gently, using small circular motions to spur the body’s lymph system to begin dissipating the bruise.
To increase blood flowing to the skin’s surface to help heal the bruise, add witch hazel or vinegar mixed with warm water; cayenne pepper in Vaseline or crushed ginger mixed and spread over the bruised area for several hours and then removed, once a day until the bruise is gone.
Also, consume ginger, chopped up in warm water or capsules, and parsley–both have anti-inflammatory properties that help support the immune system. And, pineapple and papaya, which contain an enzyme that helps prevent the trapping of blood and fluids in the tissues.
Apply and/or consume Vitamin C–in food like oranges, broccoli and peppers, as well as supplements. Crush the pills and mix with water to create a paste: (as above) rub on, allow to dry, remove.
Take an NSAID (non-steroidal anti-inflammatory drug) such as Advil or Motrin, Aleve or Tylenol (not aspirin), which block inflammation-causing chemicals when taken at prescription doses. For Aleve, that’s two tablets twice a day. The effect of each drug is basically the same, although they work differently and an individual can often get better results with one than with the others.
And then there’s arnica, on the tips of many tongues at the sight of a bruise. Derived from a European mountain daisy, arnica is believed by many to reduce swelling and decrease pain, but its most common and traditional use is for treating bruises — by mobilizing white blood cells to the site to begin healing. In pill form, arnica is a homeopathic remedy and thus extremely diluted. A 2014 report in the Journal of the Royal Society of Medicine said its only activity was a placebo effect. Consumed in large quantities, however, it can be toxic.
Arnica as an ingredient in a large variety of gels, creams, ointments and massage oils is used by thousands of physicians and celebrities, as well as the U.S. Men’s National Soccer Team. Following a ski accident, Diane von Furstenberg tweeted: “Arnica gel is the best thing you can do for bruises,” according to the New York Times. Arnica’s beneficial effects, however, may also be traced to the massage involved in rubbing it onto the skin.
(If there is a sensation of extreme pressure around a bruise or failure to heal in about two weeks, consult a physician.)
IN CASE YOU MISSED the DHARMA Initiative on the TV show “Lost,” a new research initiative exploring brain implants to treat depression, anxiety, PTSD and even OCD appears eerily similar, funded by the DARPA (Defense Advanced Research Projects Agency) program SUBNETS (Systems-Based Neurotechnolgy for Emerging Therapies).
The DARPA research originally focused on creating super soldiers via technology that could monitor and alter brain activity, for example, to improve memory and focus or extend alert waking hours. Along the way, researchers began working to develop nerve-fiber implants for treating psychiatric problems, as well as addiction and fibromyalgia, especially among those who fought in Iraq or Afghanistan. (According to the National Institute of Mental Health, mental illness and suicide rates among the U.S. military have “spiked” over the past decade.)
“Imagine if I have a craving [for alcohol],” UC Berkeley researcher Jose Carmena told MIT Technology Review. An implant “could detect that feeling and then stimulate from inside the brain to stop it.”
“Brain implant” also refers to existing technology, including the cochlear implant–now used by more than 300,000 people worldwide–and a retinal chip, approved last year, to help with some eye impairments, as well as Deep Brain Stimulation (DBS) used to treat the symptoms of Parkinson’s Disease and epilepsy. DBS uses electrodes that are implanted in the brain and manually adjusted by clinicians on a regular basis to alter pathological signals such as those causing the tremors and slowed movements of Parkinson’s Disease. The same electrodes are now being tested to read and record those abnormal signals, with the hope of mapping the pathways of depression and anxiety that often accompany the disease.
In 2005, Helen Mayberg, neurologist at Emory University, reported using DBS to alleviate severe, treatment-resistant depression eased symptoms in 40 to 60 percent of about 150 cases. But a new device approved for researchers in 2013 that has revolutionized the field will, Mayberg told Nature magazine, “enable progress exponentially.”
Data on the brain’s abnormal activity patterns is necessary to determine where and what to stimulate for treatment. At the same time, technology is being developed with the goal of miniaturizing devices that can be attached to specific nerve fibers. (The nervous system is “incorporative,” meaning it doesn’t reject implants.) When the brain is stimulated appropriately, malfunctioning circuits can be interrupted, and the brain, because of its plasticity, can be healed.
Besides using brain implants to enhance mental focus and perception, a memory chip wired directly into the brain’s hippocampus could provide perfect recall of everything you read. And “neurocompilers” could install hours of automated mental practice inside the heads of soldiers or others, for example, golfers, to improve their swing.
The ultimate goal of DARPA’s ElectRx program is a tiny device that uses electrical impulses to both diagnose and treat inflammatory conditions throughout the body including arthritis. Although a stretch, the device has inspired comparisons to Wolverine and the Incredible Hulk–superheroes who have the ability to heal themselves.
DURING THE ALTERNATIVE 1970s, there was great enthusiasm for exercises that promised to fix faulty eyesight so that corrective lenses would no longer be necessary. While scientific evidence has not been forthcoming to support this promise, many of the exercises can provide welcome relief for eyes strained by too many hours at the computer or other close work like reading or sewing.
Exercises in the Bates Method, for example, can be easily incorporated in any daily activity. What’s important is that whenever your eyes feel strained, close them for a few seconds of rest. When walking outdoors, follow the line of curb or sidewalk with your eyes as far into the distance as you can and back again, keeping your eyes focused on whatever line you’re following. Or pick any distant outline–branches against the sky; the juncture of walls with the ceiling–and follow it closely with your eyes without moving your head; then close your eyes and try to picture the outline, then open your eyes and repeat the outlining.
Such routines, however, are unlikely to correct faulty vision, because that is caused by physical abnormalities. Both near- and far-sightedness result from “refractive errors,” created when your eyeball is too short or too long; astigmatisms occur if the cornea or lens has an irregular shape. The only true fix comes with LASIK surgery, which physically changes the shape of the cornea. (“Vision therapy,” by contrast, is a controversial “alternative” method involving both visual and mental exercises that are touted to improve how the brain interprets what it sees by correcting weaknesses in eye alignment and binocular vision.)
The most common recommendations for eye fatigue include blinking often and taking minutes-long breaks to look into the distance. For the latter, exercises like those from the Bates Method can ease the transition when you first look away from close-up work into the distance and your vision is blurry.
Another common eye relaxer is to follow a pencil held several inches in front of your face as you move it in to touch your nose and back out again. Also, roll your eyes clockwise and then counter-clockwise ten times each. My favorite is “palming:” Rub your hands together until your palms become warm, then use them to cover your eyes without applying pressure so that they are bathed in darkness and warmth.
Resting your eyes in darkness has the additional advantage of improving memory. In a recent study at the University of Edinburgh, subjects were asked to recall as many details as possible after hearing two stories. After hearing one, they were instructed to close their eyes for 10 minutes in a dark room; following another story (not always the same stories), they were distracted by a new task that involved spotting differences between pairs of images. Participants who closed their eyes remembered “many more details” of whichever story they heard, and the “striking memory boost persisted” a full week after the story-telling, according to study author Michaela Dewar. Dewar theorizes that when we first encounter new information, we are “just at a very early stage of memory formation;” further neural processes needed for the memory to be consolidated will occur automatically but only during “idle time.”
Makers of a recently-marketed eye exercise program, the “See Clearly Method,” at about $350 for a kit, have been charged with making false claims about its success in correcting vision, with an Iowa court in 2006 ordering payment into a restitution fund to compensate purchasers. The originator of this method, American Vision Institute, currently operates a website from which techniques of that method can be downloaded for $35.
But why pay when exercises like those in the Bates Method exercisesare free, and a number of eye relaxation suggestions can be found elsewhere on the web.
CONTRARY TO WHAT your mother always told you about cleaning up before visiting the doctor, do not brush your teeth or take a shower if you want to provide every possible clue to your medical condition. A serious lung abscess was diagnosed because, although the patient had none of the associated risk factors and early tests came back negative, his wife kept insisting that his breath was “different. Not bad, but it’s changed. Something is not right.”
Scent can provide tip-offs to medical conditions from cancer, in particular melanoma; infectious diseases including pneumonia and tuberculosis; schizophrenia and diabetes to more common conditions like strep, sleep apnea and GERD (gastro-esophageal reflux disease).
In the sweat, melanoma gives off an odor like gasoline, and schizophrenia is associated with a musty or sweet smell, or like overripened fruit. From the breath, diabetics can smell like acetone and rotten apples, and strep smells metallic. Because the liver and kidneys are used to clean blood, any partial shut-down due to disease can make the breath smell fishy. Although people generally aren’t aware of their own odors, sinus infections can be detected when the sufferer believes they smell a dead animal nearby. (I have searched my kitchen several times.)
The ability to identify odors varies among cultures, with English speakers, for example, less adept at naming the smell of cinnamon or ginger root compared to rain-forest foragers on the Malay Peninsula.
Artificial electronic noses offer a “fast, noninvasive and practical everyday diagnostic tool,” according to papers presented at recent medical conventions. Breath tests using the Cyranose 320 correctly identified 96 percent of patients with cancer, with a 9 percent false positive rate among non-cancer patients. Using technology that is now considered old-school (gas chromatography-mass spectrometer, which can detect tiny amounts of specific substances), profiles of patients with lung disease found levels of four organic compounds higher than normal in patients with pneumonia and lower than normal in those with cancer. First noted in the 1870s, the musty smell of schizophrenia was confirmed by GC-MS.
Less high-tech, service dogs can detect blood sugar changes in their diabetic owners and can alert them if they are about to have a seizure. Dogs have also been known to lick or bite at parts of their owner’s skin that turned out to be melanoma.
In the fancy-if-not-yet-available tech arena, surgical knives can use smell to determine whether they are cutting through healthy or cancerous tissue, and robots can detect explosives via the smell, recoil at the smell of a person’s breath and detect explosives.
And then there’s the Alzheimer’s disease smell test: Put a little peanut butter on a spoon and compare the distance at which you can smell the peanut butter, first from the left nostril with the right nostril blocked, and then from the right nostril. If the point at which you first detect the odor from your left nostril is six centimeters or more farther away from you than it is from the point detected by the right nostril, you can begin to worry.
IN THE RISK/BENEFIT equation, antibacterial soaps are on the verge of losing the battle once and for all. Early in 2014, the FDA took the new position that manufacturers have until 2016 to demonstrate that their antimicrobial products are both safe and more effective than conventional soap and water, or else these products must be taken off the shelves. Meanwhile experts from such varied places as the World Health Organization and Smithsonian Magazine have already concluded that the risks aren’t worth it.
For most antibacterial soaps, the active ingredient is triclosan, which is touted to inhibit the growth of bacteria and other microbes on the skin, as described in MyLittleBird’s story on antiperspirants. Evidence from more than 40 years of FDA research plus many independent studies, however, shows that, despite killing slightly more bacteria than conventional soap, soaps with triclosan do not lead to clinical benefits: they do not reduce infection rates due to the transmission of respiratory and gastrointestinal germs. In Smithsonian magazine, Joseph Stromberg writes, “We’re here to tell you” to stop using antibacterial soap. Among the risks of triclosan, which is also used in acne cream and toothpaste, is the creation of antibiotic-resistant bacteria, such as the life-threatening MRSA. Also, in animal studies, triclosan acts as an “endocrine disruptor,” interfering with regulation of thyroid hormones leading to problems such as infertility, early puberty, obesity and cancer. Finally, triclosan has been shown to interfere with muscle contractions in human cells.
The Mayo Clinic recently stated that there isn’t enough evidence yet to recommend avoiding triclosan, but notes that research has “raised questions about whether triclosan might be hazardous to human health.” Antibacterial soaps also “are usually the most damaging” at stripping moisture from your skin, according to a Mayo Clinic report.
Purell doesn’t contain triclosan but relies instead on alcohol, also rough on dry skin. And while Purell kills both bacteria and viruses, it doesn’t remove anything else like dirt. Outside of hospitals, the Centers for Disease Control and Prevention recommends old-fashioned soap and water, not necessarily hot water, and scrubbing for about 30 seconds to get clean.
A New York Times article titled “The Horror of Handshakes” describes a British study comparing the amount of E.coli transmitted by strong handshakes, weak handshakes, high-fives and fist bumps. The researchers found twice as many bacteria transmitted by strong handshakes as high-fives, and fist bumps were best. A recent editorial in the Journal of the American Medical Association advised banning handshakes in medical facilities.
On the other hand, as reader Stephen Gins responding to the New York Times article points out, “Touch is fundamental to our natures and plays important roles in child-rearing, mating, social bonding, etc…. The transfer of microorganisms in handshakes is simply a consequence of our living in a world of complex biology…A lack of physical contact is more damaging to individuals of our species than the incidental exchange of omnipresent bacteria.”
THE GOAL OF LEARNING new breathing patterns is to break our unconscious ones, which tend to be “tense, shallow and erratic,” yoga therapist Kate Holcombe writes in Yoga Journal. The use of breathing patterns practiced in yoga, known as pranayama, have an immediate goal of focused concentration; the ultimate goal is to experience “clearer perception and a greater connection with your true self,” Holcombe explains.
By practicing these breathing patterns, “you can reduce all of the mental noise – the agitation, distractions and self-doubt – that prevents you from connecting with … your true self,” she says. When you’re connected with your true self, it becomes easier to see what choices or decisions might be right or wrong for you.
Pranayama means to control and expand the vital life force or prana, which can be damped down by stress and fatigue, causing us to take quick, shallow breaths that provide insufficient oxygen. To practice pranayama, begin by lying on your back with one hand on your upper chest and one on your lower ribs. Then breathe. If the hand on your chest moves, or the hand on your ribs doesn’t move at all, you are an inefficient shallow breather.
Diaphragmatic breathing allows you to breathe more fully and more consciously. Lying on your back with one palm on your abdomen, breathe comfortably for a few moments noticing the quality of your breath, Holcombe writes. “Gradually begin to make your breathing as relaxed and smooth as possible, introducing a slight pause after each in-breath and outbreath.” Holcombe suggests consciously expanding the abdomen when inhaling and contracting it when exhaling.
Of dozens of pranayama patterns, the “cooling breath” can improve focus, especially during drowsy moments of your day. For this breathing pattern, sit in a chair or on the floor with your spine “naturally erect.” Open your mouth slightly with your tongue just behind the teeth, inhale letting the air wash over your tongue as your raise your chin toward the ceiling. Close your mouth and exhale through your nose as you lower your chin back to a neutral position.
The “long exhale” or 1:2 breathing practice can help calm you before bed or any time of day, but should be avoided first thing in the morning unless you feel anxious. “The relaxing effects of the practice tend to make it more difficult to get up and go on with your day,” Holcombe points out. “Exhalation that is only slightly longer than the inhalation can induce a calming effect.”
Begin by lying down with one palm on your abdomen and take a few relaxed breaths counting the length of each inhalation and exhalation. If the inhalation is longer, gradually increase the length of your exhalation by one to two seconds every few breaths, gently and without strain, until the exhalation is two times the length of the inhalation. If your inhalation is four seconds “comfortably,” the exhalation should last no more than eight seconds. “Don’t push yourself beyond your capacity,” Holcombe warns. “If you do, you’ll likely activate the… stress response and feel agitated rather than calm.”
The breathing pattern called “ujjayi” or “ocean breath” is most often used as part of a yoga practice rather than by itself. The goal is to build energy, provide a rhythm and meditative quality to the practice and help practitioners “stay present.” Inhalation and exhalation are both done through the nose, with the ocean or rushing sound created by moving air through the narrow throat passage. In stage one, a normal inhalation is followed by a longer, slower exhalation; in stage two, a long, slow inhalation is followed by a normal exhalation.
Among more forceful or complex breathing patterns, “skull shining breath” or “breath of fire” can cleanse the sinuses and improve lung function. It involves taking one deep inhale through the nose and then exhaling in short powerful bursts, about one a second for 10 seconds, and repeat three times. (Because this breathing can increase heart rate, those with high blood pressure or other heart conditions should consult their doctor first.) “Alternate-nostril breathing,” which can clear the mind and reduce stress, is a complex pattern also best learned from a qualified instructor.
In fact, any new breathing pattern will be learned more correctly and with better practice guidelines from someone experienced in pranayama. If my Iyengar yoga class, which has been meeting for more than 10 years, is any indication, repeated practice – with the instructor reminding us to “stand, breathe in, lean forward, breathe out” – is crucial to mastering breathing patterns. It’s also crucial to incorporating them into yoga poses or any movements you want to do while breathing well but not having to concentrate completely on the breath.
For more on how inhaling and exhaling correctly can benefit your state of mind, read Just Breathe.
SIMPLY PAYING ATTENTION to your breath for a few minutes can soothe your nerves and over time lead to better mental health. Specific breathing patterns have been shown to treat symptoms from nausea to allergies and anxiety, facilitate other treatments like psychotherapy and improve your feelings about yourself.
For me, the best all-around pattern is “mindful breathing” (see posts on mindfulness and meditation). Simply pay attention to your breath as you inhale, taking in fresh air from the outside world; and as you exhale, releasing any toxins from your body. While sitting or standing, mindful breathing can calm your mind, help you relax and get you ready for the next activity. Done lying down, it’s a surefire way to fall asleep for a quick mid-afternoon nap or for the entire night.
Healthy participants in a German study were instructed to pay attention to breathing without letting their minds wander during 18-minute periods. Those who could “sustain mindful contact with their breathing” reported fewer symptoms of depression, including negative thinking and rumination. Dysfunctional rumination is a “central risk factor for depression,” says study author Jan Burg. Some participants who at first had a hard time keeping their minds from wandering became more adept with practice. “Once you have the hang of it, even a few minutes of mindful breathing can help you become more calm and collected,” according to Tori Rodriguez in Scientific American Mind.
In Japanese research, subjects learned simply to breathe deeply into their abdomens. After doing this for 20 minutes, they experienced fewer negative feelings as well as increased levels of the neurotransmitter serotonin in their blood and of oxygenated hemoglobin levels in their prefrontal cortex, an area associated with attention, according to Rodriguez.
“Increased bonding, connectedness and capacity to feel love” are benefits of “coherent breathing,” according to the pattern’s developers, New York psychiatrists Richard P. Brown and Patricia L. Gerbag. To do coherent breathing, count six seconds for the inhalation and six for the exhalation, for a total of five complete breaths per minute. You can find CDs and apps that provide chimes to help time the breaths at Coherence.com, Heart Rate+ and on Amazon.
Coherent breathing affects the vagus nerve, the main pathway in the brain of the parasympathetic nervous system (PNS), which helps us relax and rest by slowing the heart rate, constricting the pupils of the eyes, etc. (As one component of the autonomic nervous system, which is responsible for involuntary activity that regulates the body’s organs, the PNS is complementary to the sympathetic nervous system, which revs us up for fight or flight.) Activating the vagus nerve is best known as the “relaxation response.”
Before each breath, Drs. Brown and Gerbag suggest moving your shoulders up and then easing them down. As you inhale, gently round your shoulders up, and then gently back down as you exhale. Because the vagus nerve regulates emotions involved in empathy, gut instincts and perception, according to Dr. Brown, “you need it to have a good time.”
“You can consciously tap the power of your vagus nerve to create inner calm on demand,” writes Christopher Bergland in Psychology Today. Deep diaphragmatic breathing with a long, slow exhale “is key to stimulating the vagal nerve.” Anxiety before giving a speech or having blood drawn can be exacerbated by a fight-or-flight reaction: “all the symptoms of performance anxiety — racing heart, sweaty palms, dry mouth, upset stomach, shakiness — are the result of your vagus nerve disengaging,” Bergland writes.
Good vagal tone in well-conditioned athletes is due to aerobic breathing and linked to slower heart rate, lower blood pressure and psychological well-being, according to Bergland. Poor vagal tone, on the other hand, is linked to “inflammation, negative moods, loneliness and heart attacks.” Most of the nerve fibers in the vagus nerve serve to communicate information from the body’s organs to the brain, Bergland points out, so that when people say ‘trust your gut’ they are …saying, ‘trust your vagus nerve,’ that is, the emotional intuitions that the gut is sending to your brain.”
To activate the vagus nerve, breathe more slowly, breathe more deeply from the belly and exhale longer than you inhale, advises Stanley Guan’s health website. A useful tip: “Exhaling through your mouth instead of your nose makes breathing a conscious process” rather than an unconscious one. Studies on Tibetan monks have shown that deep breathing improved memory, lowered blood pressure, boosted the immune system and could fight depression.
Just as breathing exercises have been used by cancer patients to shift their focus away from pain, it can be used when pain is anticipated, such as when blood is about to be drawn. “Pain imagery breathing” is one technique suggested by Leslie Goldman’s “Benefits of Breathing Breath Exercises” on the Oprah website. Pain causes us to hold our breath, which can lead to the release of cortisol, the stress hormone, and can in turn contribute to inflammation which makes the pain worse.
To breathe using this technique, close your eyes, picture your body relaxing. Take a deep breath with air going into your belly and “visualize oxygen filling any areas of tension with comfort and calm. Then picture the pain leaving with each exhalation,” advises Chicago psychologist Michael Merrill. “The longer you exhale, the more you stimulate the vagus nerve…telling it you’re in a safe environment.”
“Grounding Breathing,” used for chemotherapy patients and pregnant women, can ease nausea by suppressing the gag reflex. To try it, “visualize walking barefoot down a long stone staircase. Inhale slowly through the nose for four counts while focusing on how cool the stones feel. Then exhale for eight to 10 counts through pursed lips as you imagine taking a step down,” Goldman suggests.
YOU START TO FEEL nauseated. You can’t believe it.
Was it something you ate? A friend who was sick?
Turns out it doesn’t matter. Ahead is at least one bad night followed by several iffy days. For stomach upset caused either by a virus or by bacteria from food, doctors label it “gastroenteritis,” meaning irritated and inflamed stomach and intestines. Most people have an easier time saying “stomach bug.” The virus Rx is more important for those around you: Once it hits, you’ve already been contagious for several days, and can be altogether for up to two weeks.
Both possibilities, virus and bacteria, can take several days to make you sick, so don’t blame your friend’s garlicky “bachelor pasta” from the night before. And since symptoms of both can last up to 10 days, don’t plan another fun food night right away. (Having just emerged from a bout, I have now studied everything I wish I’d known during the days I felt too terrible to turn on a computer.)
What to do? In the acute stage, first try Coca-Cola. While some experts advise room temperature as well as stirring to get rid of the fizz, cold and carbonated can taste delicious. (I have never liked syrupy soft drinks, but that icy red can appeared like an oasis in the desert of my recent agony.) When Coke fails, if you’re lucky enough to have a Rx anti-emetic on hand, they work like magic. Ondansetron (Zofran) is an easy name to keep in mind, but others work well, too. Lacking one of these, Pepto-Bismol is surprisingly helpful with both nausea and vomiting. And once the acute stage passes, both Pepto-Bismol and Pepcid help counter the unseemly gases that emerge in what can only be called belching.
Then there’s diet. Move slowly, one day at a time. Remember: Your stomach is irritated and tender. Determined to be well again, I tried a large bowl of cereal with milk and was set back days of unpleasantness. And no treats. No ice cream, no cookies, salad, no meat. On the other hand, real danger can result from dehydration, so consuming liquids is imperative.
The first thing to try is sucking ice cubes, followed by clear liquids in small sips. Only then can you dig out the exciting white Rice and Applesauce. Make Toast. Ask a friend to bring Bananas if you can stomach them. (This is the BRAT diet, designed to ease your body back to normal eating.) When you’re still in the desert of unpleasantness if not agony, a steaming bowl of Uncle Ben’s can look quite appetizing. To spruce up applesauce, add a side of saltines. Other possible stomach soothers: peppermint and ginger, starting with tea and progressing to crystallized ginger, pickled ginger (comes with sushi) and, could it be, ginger cookies? Trader Joe’s Triple Ginger Snaps exploded with exciting flavor like they never had before. The following day consider eggs, cooked vegetables and chicken–small amounts eaten more frequently can work better than one larger serving. The last to return: fatty or spicy foods, caffeine, alcohol and dairy–which is why that bowl of cereal was a truly terrible idea.
The goal is to relax, especially the stomach. To fight the bug and repair the damage, your body needs to rest. This becomes obvious when any exertion from a traffic jam, to a work deadline, to an intense movie or a demanding book can make the nausea much worse very quickly. Choose carefully. For me, the maximum possible stressor was “Orange Is the New Black,” fortunately streamable for hours on end but not a good idea on a suffering stomach. Approaching the end of Week 1, I still moved more slowly and ate carefully. But even before adding the saltines, I emailed my doctor for more Ondansetron, hoping against hope I would not need it again any time soon.
MEDITATION HAS TWO groups of adherents: those who are naturally enticed by the possibilities of health, calm and compassion; and the rest of us, who resist meditation until driven by a specific need, often stress-related, to give it a try.
Meditation is hard to explain to resisters, which included me for most of my life, despite being aware of increasing evidence for its multitude of health benefits — even after new evidence about the brain’s neuroplasticity showed that permanent brain changes in response to the experience of meditation insure that these benefits will endure.
PAIN: Volunteers at Wake Forest University who practiced mindfulness meditations 20 minutes daily for four days changed their response to pain, which was caused by a hot plate of metal held against their calves. The unpleasantness was reduced by 57 percent and the intensity by 40 percent. Brain scans showed that activity in the specific region of the cortex linked to the affected calf had diminished by so much it was barely detectable; conversely, activity increased in regions of the brain that modulate — and can reduce pain sensations.
IMMUNITY: At the University of Wisconsin-Madison, 150 participants over age 50 — 80 percent women — were randomly assigned to one of three groups. For eight weeks, two groups did either mindfulness meditation training or brisk daily exercise, while a control group did neither. Compared to the controls, the meditators missed 76 percent fewer days of work and the exercisers missed 48 percent fewer — for both groups, the severity of colds and flu was decreased.
DEPRESSION AND ANXIETY: In an overview of 47 studies involving a total of 3,515 participants, mindfulness meditation helped manage both — although not always better than exercise. In one study of depression, mindfulness reduced by 47 percent the risk of relapse in patients who had experienced three or more bouts of depression.
COMPASSION: At Northeastern University, of 20 people took a mindfulness meditation class, 50 percent gave up their seats to a woman on crutches compared to 16 percent of non-meditators. Meditation is “fast becoming a fashionable tool for improving your mind” said study leader Professor David DeSteno, to improve leadership, productivity and individual performance (on SATs, at work) — though he notes that these attributes are often thought to conflict with compassion.
Over the past two decades, I was advised by several medical professionals that mindfulness and meditation could allay mild PTSD left over from my childhood, which sometimes made me anxious or jumpy. After hearing the same advice the third or fourth time, I felt stupid ignoring it once again. I purchased a workbook for “Mindfulness-Based Stress Reduction” (MBSR) that comes with a CD—but abandoned both after one or two efforts.
Next, I signed up for the MBSR course, which has been offered since its development more than 30 years ago at the University of Massachusetts Medical Center by Jon Kabat-Zinn, who calls his program: Buddhist meditation but secular, “without the Buddhism.” To date, this course has helped tens of thousands, mostly people in high-risk, high-stress professions like firefighters and soldiers. Knowing that many of my classmates had enrolled for medical reasons made me feel I was among fellow skeptics.
MBSR classes typically meet for eight sessions of two and a half hours each, plus six hours one weekend day. My course, offered through the Insight Meditation Community of Washington, cost almost $500. Both the time and the money helped motivate me to get to class and to do my homework: daily meditation. (For those who cannot imagine devoting eight weeks or $500 to meditating, the Wake Forest volunteers experienced less pain after practicing mindfulness meditation for only 20 minutes a day over four days.)
What made these meditations doable for me was practicing in class, maybe because of doing it with a group, plus the CD that came with the class workbook — the same one I had purchased previously. The CD’s 21 guided meditations vary in length, from short ones under four minutes to longer ones of 30 or longer. I have not yet made it to the tracks of over 45 minutes. The CD also includes various kinds of meditation: sitting, lying, standing, yoga, breathing and one called the “body scan.”
Mindfulness meditation encourages focus on the breath — in and out — and attention to everything that arises, from a sore back to annoying thoughts. (For sitting meditations, you can choose any mode you want, including a chair.) You are encouraged to notice each thought, and then to notice how quickly each one passes by. Chronic depression sufferers are helped by allowing the stream of negative thoughts to flow quickly in and then quickly out of consciousness. Focus and attention — to breath and thoughts, also sometimes to sounds, sensations and movement — make this meditation different from most other kinds that focus on getting rid of extraneous thoughts and clearing the mind.
Not until after about five or six weeks had passed did I begin to feel a difference, around the time of our six-hour “all-day.” For me, a plan for all-day anything, with a group of people, mostly in one room, sounds unbearable. Maybe because we were discouraged from chatting, the hours passed calmly and quickly. At the lunch break, it was suggested that we walk outdoors, remaining silent if possible. Joining this phalanx of 20 or so zombie-like adults walking the busy Saturday streets of downtown Bethesda took me to a new level of I-can-do-this.
Slowly I got better at keeping track of random items, those to pack for a trip or those I needed to bring up in unexpected phone calls from my hard-to-reach sons. Time seemed to move a little more slowly — similar to the sensation of watching an impending disaster, like a baseball heading for a glass window: the ball appears to move in slower motion and greater detail than normally. As time slowed down, I felt as if I were slowing down — just a bit — instead of racing around.
When I tired of the slightly unctuous voice on the CD, I tried sitting quietly with a timer. To my surprise, 20 minutes sped by. Although I have slacked off since the class ended, on most days I find time if only for a short meditation. My next goal: to feel I’ve earned the right to say, if only to my closest friends, “I meditate.”
GENETIC SIMILARITIES among friends revealed in recent research point to the old axiom that “friends are the family you choose.” The new study shows that your close friends may be as “related” to you as fourth cousins, or as people who share great-great-great-grandparents – in each case, you share about 1 percent of your genes.
“One percent might not sound like much to the layperson,” says Nicholas Christakis, Yale professor of sociology, evolutionary biology and medicine. Christakis and James Fowler at UC San Diego performed what’s called a “genome-wide analysis” using data from the Framingham Heart Study, the largest study to date containing both sufficient levels of genetic detail and information on who is friends with whom.
But to geneticists, 1 percent is a significant number. “Most people don’t even know who their fourth cousins are!” Christakis says. “Yet we are somehow, among a myriad of possibilities, managing to select as friends the people who resemble our kin.”
The researchers were able to use the data to compare pairs of unrelated friends against pairs of unrelated strangers because the study involved a relatively homogenous population of people with European ancestors, so that the only difference between them was social relationships. In addition, the study authors developed a “friendship score,” which can be used to predict who will be friends based on their genes just as well as who will become obese or schizophrenic.
Evolutionary advantages result from shared attributes among friends, or “functional kinship,” as the study authors label these friendships. “In the simplest terms: if your friend feels cold when you do and builds a fire, you both benefit,” according to the Science Daily article on the study. Also, some traits, such as the ability to speak, work only if your friend has them, too, creating a sort of “social network effect.”
Friends are least similar in genes that control immunity. Differences in immunity, also found in studies on spouses, bestow “fairly straightforward evolutionary advantages,” according to Fowler and Christakis: Having close connections with people who are able to withstand different bugs reduces interpersonal spread.
Conversely, friends are most similar in genes controlling the sense of smell, although the reason for this is unclear. Perhaps our sense of smell draws us to similar environments: People who like the scent of coffee, for example, might be more likely to spend time in cafes together. Perhaps, as with pheromones, scent attracts us to our friends as well as our sexual partners.
Or there may be a connection to the ways in which smell triggers memories. The olfactory nerve is close to both the amygdala, the area of the brain connected to emotion and emotional memory, and the hippocampus, which helps control memory. To identify a scent, these areas help you connect it to visual input that occurred at the time you first smelled it. (There is some suggestion that by studying information in the presence of certain scents, you can increase the intensity and clarity of the remembered information when you smell that scent again.) Sharing the kind and intensity of memories makes for good friendships.
Finally, the genetic friends research “lends support to the view of human beings as ‘metagenomic,’” according to Christakis, so that “our fitness depends not only on our genetic constitutions but also on the genetic constitutions of our friends.”
WE SIT TOO MUCH. Even in summertime, we sit on the beach, at outdoor cafes, to watch tennis or sunsets, while working and most of all, when traveling. “Yoga for Travelers: the ‘Sitting Disease’” headlines the “Yoga Today” section of the summer Pathways, D.C.’s alternative health publication. Traveling is exhausting because, counterintuitively, there’s so much sitting involved.
And year-round, there’s always inertia: the more we sit, the more we sit… Standing up every 20 minutes is more effective at counteracting the harmful effects of sitting than taking a long walk, notes NASA researcher Joan Vernikos. A common recommendation is to set an alarm on your phone or watch for 20 minutes, so that you can be sure to stand up often enough.
“Sitting is the new smoking” seems to be the slogan of 2014. “Sitting disease” is now commonly used within the medical community “when referring to metabolic syndrome and the ill-effects of an overly sedentary lifestyle,” according to the website Juststand.org.
On Juststand.org, Mayo Clinic experts weigh in: “For most people who sit most of the day, their risk of heart attack is about the same as smoking,” says cardiologist Martha Grogan. Also, “Today, our bodies are breaking down from obesity, high blood pressure, diabetes, cancer, depression and the cascade of health ills and everyday malaise that come from what scientists have named sitting disease,” writes endocrinologist James Levine.
Sitting reduces the pressure of gravity on your body compared to standing. NASA studies show that a completely gravity-free environment accelerates the aging process by a factor of ten, but the gravity loss when you sit can make a difference. Sitting has been linked to so many health risks that, according to a 2010 American Cancer Society study, sitting shortens your lifespan regardless of all the physical activity you do when not sitting.
That study, which followed almost 70,000 women from 1993 to 2006, found that inactive women who sit more than six hours a day were 94 percent more likely to die during the course of the study than physically active women who sit less than three hours a day. Research at Vanderbilt University found that the average American spends about 55 percent of their waking hours or 7.7 hours per day in “sedentary behaviors like sitting.”
The gyrotonics instructor who has been most helpful as a physical therapist/personal trainer to me as well as to many of my friends, Nathan Martin, says that even the fittest among us (for example, people who take more than one exercise class a day) suffer from too much sitting. Martin sees “many more younger people today with old people’s problems” because they spend too much time sitting, due to the proliferation of technology. He points to the irony that yoga was invented to get people physically able to sit for long periods in the Buddha pose, but that you need to be physically active in order to get to the point where you can sit like that without pain. Sitting too much weakens our hamstrings and pelvis to the point that everything from our necks to our feet is thrown off kilter, he has found.
Bess Abrahams, co-author of “Airplane Yoga,” has a few tips for airplane travel: Always take the aisle seat; do heel and toe raises, alternating your weight from one foot to the other any time you get the chance to stand, and do “standing thigh stretches,” pulling your foot up behind your rear end, in the bathroom or anywhere.
On driving trips, Yoga Today author Claudia Neuman lists her favorite “yoga poses to do at rest stops.” The most doable: a “half downward dog against the car.” For the driver behind the wheel, Neuman recommends neck stretches, gently moving your head from side to side, shoulder rolls, conscious breathing and chanting. (For the last one, I prefer loud singing to combat drowsiness while driving.)
And then there’s workplace sitting. Nathan Martin advises using a standing desk as much of the time as possible. Among the five most popular models of these desks, according to one poll, is the DIY option — piling up boxes or books to create a higher desk — very appealing because you can try out the concept at various heights and locations in your house or workspace before taking the expensive plunge.
Having set up several piles in my house, I use them for downtime activities like newspaper reading and Words with Friends. But I haven’t yet mastered the art of sparing any of my attention, needed for actual work, for staying upright. True believers like Martin keep reminding me to try.
THERE’S MORE TO spending a day by the sea than meets the eye. For thousands of years, humans have flocked to the ocean seeking the respiratory benefits of crisp, salty air. But a trip to the beach isn’t the only way to achieve the soothing effects of a sea breeze.
Bethesda is now home to a salt cave, the first of its kind in Maryland and the D.C.-metropolitan area.
Upon entering the cool, dark room made entirely of salt, seven other cave-goers and I were invited to choose a spot. The options — a zero-gravity lounge chair draped with a soft blanket or a yoga mat on the ground. Both seemed equally inviting for my sore back, so, feet crunching over a floor made entirely of coarse Himalayan salt crystals, I tried both.
For the next three-quarters of an hour, I experienced the subtle yet noticeable change in air quality as I focused on my breathing, stretched my muscles and cleared my head.
“One 45-minute session is equivalent to three days by the sea,” says Janine Narayadu, owner of Bethesda Salt Cave at 4709 Montgomery Lane. “Himalayan salt is comprised of 84 different trace elements and minerals — the same number found within our bodies. That’s why humans are drawn to the sea.”
A practice dating back to ancient Greece, salt inhalation therapy is surging in popularity. Cavernous rooms that circulate pure salt-filled air are popping up in metropolitan cities across the world, and those seeking to ward off the ill effects of pollution, pollen and other irritants have embraced the therapeutic practice.
Narayadu, a licensed massage therapist, said she had her first salt cave experience in Asheville, N.C.
“I was worn down,” she said. “The long hours I’d been working as I was building my practice had made me physically ill. My husband took me on vacation and encouraged me to try the cave. I noticed the effects immediately.”
Convinced that if she wanted to regularly reap the benefits of salt inhalation therapy, she’d have to build her own cave, Narayadu spent two years researching the concept and talking to her clients.
“The response that I received from the community was so overwhelming that I realized there was really a need for it,” she says. “I was even able to raise some money crowdfunding through IndieGoGo.”
So Narayadu got busy. She found an FDA-approved Himalayan salt provider, secured a location with substantial structural integrity and hired someone who could verify the authenticity of all 32 tons of Himalayan salt as it left Pakistan at the Port of Karachi. The salt arrived in March.
“We lined up 10 men who carried it in rock by rock and then stacked them like stone masons,” she says. “It has to be 100 percent natural and safe, so we secured the salt rocks that make up the walls with metal braces.”
Narayadu emphasizes that the salt cave is not a medical facility and they make no medical claims. But breathing in the air is said to foster good sleep, alleviate symptoms of allergies and asthma, relieve hypertension, stress and even cure hangovers.
“We are not here to offer medical advice or to negate doctors’ advice; it’s just an alternative option,” she says.
The organic, antimicrobial agents of the salt air provide the same benefits regardless of age. Children are welcome to sit in on a reserved session and family memberships are available. Children under three are free.
“We won’t dim the lights when kids come along, but they can sit with a shovel and bucket and play with the salt. Eventually my goal is to have a room just for children.”
Heavy smokers or people suffering from Chronic Obstructive Pulmonary Disease, better known as COPD, must disclose such information before reserving a session, as they will not be permitted to sit in the same room as non-smokers. However, they can reserve their own session and the salt levels are adjusted to proper treatment levels.
D.C. resident Diane Dompka shared her first salt cave experience with a few girlfriends.
“I was intrigued, and impressed by the experience,” Domka said. “I definitely felt the energy of the salt in the body.”
Soon to come is a water feature that Narayadu says both enhances the relaxation experience and encourages further salt growth.
A 45-minute salt-therapy session is $45 for adults, $25 for seniors and $15 for children ages 4-17.
Before or after a session, choose one of their professional therapists, who specialize in Swedish, hot stone and reflexology, to work out the kinks and enhance the experience. Other spa services include face and body waxing and brow tinting.
A MEDICAL ANOMALY with unknown causes and no symptoms led me to “gait therapy.” (Peripheral neuropathy, probably caused by Lyme disease, caused numbness, actually an absence of symptoms, which my doctor thought I should tackle.) “Gait therapy” led to me balance.
First, the sobriety walk. I have often wondered, if my car was stopped for any reason and I was asked to walk the line, what would I do? I never mastered that heel-to-toe walk without weaving and stumbling. The first day of gait therapy, I was told not just to walk the line, but to close my eyes while doing so. I wove and stumbled before completing one step.
Turns out that balance is one of those things you should make an effort to keep or even improve, starting in your 30s if possible. But any time is better than not at all.
So, no more leaning on staircase bannisters or on armrests when rising from chairs, I get that. What gait therapy didn’t teach me was what support to use instead, which I eventually learned elsewhere – hamstrings, glutes, stomach muscles. Those still need a lot of work.
To maintain balance, the brain’s cerebellum coordinates information from three of the body’s systems — the visual, the proprioceptive (receptors in joints and muscles that orient you in relation to other objects) and the vestibular (inner ear). Over time, people rely more on the visual system, which operates more slowly than the vestibular system, causing people to feel shaky, begin to distrust their balance and become more sedentary, leading to less use of sensory information and worsening balance.
Daily adjustments such as using stairs and chairs without holding onto something make a difference. Also practice getting up from a chair 10 times in a row, first with your feet in a wide stance, then with your feet together. And walk on uneven surfaces such as grass. Between crumbling sidewalks and broken escalators, D.C. offers many opportunities to work on balance.
Practice standing on one leg while waiting in the checkout line, for the microwave. At home, stand on one leg on a thick pillow (or Bosu ball), then raise the opposite arm straight out in front, then add swinging the opposite leg back and forth. Also standing on one leg, swing the other leg back and forth and side to side. Do these things with your eyes closed to lessen your reliance on the visual system. Also, do these using a stretchy band around a fixed object so that your moving leg pulls against the band in each direction.
In my gait therapy sessions, I spent a lot of time on the sobriety test walk: heel to toes, eyes open, then eyes closed. I also practiced standing still, one foot directly in front of the other, heel touching toes, for 30 seconds, and then switch feet. Then do both with eyes closed. If you have a 2-by-4 board handy, try walking that, heel to toe. After many sessions with practicing in between, I could walk the line 20 steps, pretty well, with my eyes closed; eyes open, I was a master.
Yoga can improve balance because it increases flexibility and integrates movements that strengthen different muscles, Dr. Arlene Schmid at Colorado State University told The Wall Street Journal.
Strength training can help prepare your muscles to react if your balance is thrown off, as well as stabilizing joints and maintaining bone density, according to Lenny Bernstein in The Washington Post.
“Balance” on Wikipedia lists 12 uses, of which only one, “equilibrioception,” is the “physiological sense of balance.” Others include a mathematical puzzle, “one of the wine-tasting descriptors” and the name of a Moody Blues song from their 1970 album “A Question of Balance.”
For the average Moody Blues listener, however, the early 1970s were not a time of “working out,” nor jogging, nor strength training and never balance exercises. Even in the 21st century, who in their 30s worries about balance when they are still putting on their shoes while standing up? Now there’s a goal.
COPING WITH BAD MEMORIES that interfere with daily life is a hot topic, whether the memories concern traumatic stress or mere misery. During one week this May, major articles on the subject appeared in two top publications but covered opposing camps. A story in The New Yorker focused on approaches to interfering with or erasing the memory, while The New York Times Magazine described psychomotor therapy to plumb the emotions attached to it. Research is underway in both areas, with no certainty yet about which will prove more effective in the long run.
In the process of recalling an old memory, it is possible to change that memory in order to eliminate the fear attached to it, explained McGill University psychology professor Karim Nader in The New Yorker article. The very act of remembering makes memory vulnerable to change.
Exposure therapy, which has been widely practiced in the United States to help with Post-Traumatic Stress Disorder (PTSD) as well as with phobias and addiction, involves recreating the trigger (for vomiting phobias, it might be videos of vomiting; for addiction, the place or people connected with the desire or its pleasurable relief) in the presence of a positive experience, often simply the absence of a negative one. The old memory becomes “reconsolidated” with the new experience, and thereby separated from the fears or other negative effects of the original experience.
Nader first tested his theory on rats using a drug that interfered with recall. Rats were trained to connect a tone with fear of being shocked. Two weeks later, within four hours of hearing the tone without receiving the shock, they were given a drug that erased their fear. At Mt. Sinai Hospital in New York, psychologist Daniela Schiller tested Nader’s results on people using a behavioral method called “extinction training,” similar to exposure therapy. People were trained to associate a picture of a colored square with the fear of being shocked, and afterwards were shown the picture minus any shock several times in a row. Timing was crucial: people who were shown the square with no shock, and then shown it again within ten minutes were able to forget the fear completely. But people who saw the square with no shock, and then didn’t see it again for several hours remained fearful.
Early research showing that memories can be manipulated came from Elizabeth Loftus, now at the University of California at Irvine. Loftus gave subjects a journal that described three detailed events of their childhood, based on interviews with friends and family, along with one fictitious event. Later, one fourth of the subjects recalled the fictitious event as true, and some added “remarkable detail,” leading Loftus to conclude that memory “works a bit more like a Wikipedia page…You can go in there and change it, but so can other people.”
In both the U.S. and China, reconsolidation has worked very well with drug abusers, the idea being that “you cannot be addicted to a desire that you don’t remember,” according to The New Yorker.
Proponents of the alternative “psychomotor” techniques are vehemently opposed to exposure and extinction therapy, as well as to the similar and also popular, Cognitive Behavior Therapy (CBT). Exposure therapy works less than half the time, and even then doesn’t provide true relief, Boston psychiatrist Bessel Van der Kolk told The New York Times. Van der Kolk prefers what is often referred to as the Pesso-Boyden method, named for its founders.
This method involves recreating the original trauma in a group setting by arranging for others to play the roles of the people who were originally involved. To help a soldier who suffered from PTSD after seeing a mother weep over her son whom he had just shot, participants played the role of the mother, of the son and of others involved. The rest of the group watched and acknowledged the soldier’s emotions to validate them and to provide a new sense of security to the soldier.
Van der Kolk believes psychomotor therapy works because, he told the Times, “Trauma has nothing whatsoever to do with cognition…it has to do with your body being reset to interpret the world as a dangerous place.” His contention is supported in part by the number of physical ailments, including headaches, fatigue and digestive troubles, that plague PTSD sufferers. Van der Kolk also believes in using other body-centered methods such as yoga, acupressure and Eye Movement Desensitivation and Reprocessing (EMDR). In the latter, using a moving light, vibrations or the therapist’s wiggling finger during the sufferer’s retrieval of the memory helps them process the scene so that it is no longer traumatic.
Psychomotor therapy, however, is hard to find outside of a few centers, whereas exposure therapy and CBT are much more widely available from therapists in the D.C. area, who specialize in these or at “anxiety” treatment centers.
Should you always do what your doctor says to do? / iStock photo
RECENTLY I HAD a barely perceptible symptom, but one that’s on the list for potential risk, which led my doctor to send me for a CT scan. What showed up was the tiniest mark on my lung, probably scarring from a teenage bout with pneumonia – something that would have never been seen without a CT scan, and was so small that it was probably of no significance.
BUT once the doctor had seen this, he felt obliged to require another CT scan a year later to make sure it hadn’t grown. I complied. There was no change. Then he told me he really wanted one more to be sure. At that point, I began checking out radiation risks.
A CT (computerized tomography) scan uses many 2-D x-ray images taken from different angles as the x-ray tube rotates around the patient’s body to create a single 3-D image. The rotating x-ray tube causes an overall higher dose of ionizing radiation to be absorbed by the irradiated parts of the body. Thus, a CT scan of the chest measures 7 to 8 mSv (milliseverts) versus .1 for a single chest x-ray. (Bone scans measure 4 mSv; mammograms, .7 mSv; and dental x-rays, .01)
Compared to the MRI — which uses magnets and radio waves, not x-rays — CT scans are better for looking at cancer, pneumonia and bleeding in the brain; broken bones and vertebrae; and lungs and organs in the chest cavity. Because CT scans show organ tear and injury more quickly, they are better for use on accident victims.
But with every CT scan and x-ray, added to the “natural background” radiation acquired daily, an individual’s lifetime “accumulated radiation dose” gets higher. Higher lifetime doses are linked to increased risk of cancer, more so for those who received x-rays at a younger age and more so for women.
My full-body scan measured 12 mSv. Although full-body scans are useful for patients already diagnosed with cancer, the National Cancer Institute recommends against using full body scans on those with no symptoms: “Most abnormal findings from this procedure do not indicate a serious health problem, but the tests that must be done to follow up and rule out a problem can be expensive, inconvenient and uncomfortable.”
And the risk of “false positive” results – that is, showing something that is never going to amount to anything – from full-body scans is “very high,” according to Roshini Rajapaksa, M.D., medical editor of Health magazine. My “focused” chest CT scan the following year measured 8 mSv, which, added to the full-body scan, brought me up to 20 mSv for diagnostic tests, not counting mammograms and bone scans.
No one seems to know exact numbers for quantifying risk, i.e., for deciding when to balk.
In the absence of symptoms or a diagnosed medical condition, I questioned the need for a second CT scan. When the second one showed no change and he recommended I have one more, I said yes again, because I believe in following your doctor’s advice.
After that one showed no change, he actually recommended a fourth CT scan. At that point, I became suspicious: Was the doctor merely covering himself instead of watching out for my radiation risks? That time I said no, to which he said, “okay, but just so you know, that my advice is to have one more.” I wished I’d balked sooner.
YEARS AGO, A FRIEND’S article for The Washington Post called the D.C. area “Therapyland,” because of the abundance of local options. Nevertheless, when my high school friend Marjory who lives in Montana visits her in-laws here a few times a year, she brings me cutting-edge mind/body alternatives from a different source, YouTube.
Hot from Marjory’s June trip comes the YouTube physical therapy phenom Eric Goodman with his Foundation Training, which soothed her husband’s bad back pain for the first time in years. Marjory’s own latest enthusiasm was for Brene (pronounced like Renee) Brown, self-described “author and vulnerability researcher,” whom I had heard about in passing from local friends but never investigated. [Disclaimer: I almost never watch YouTube or TED talks even when close friends send links, because I’m usually toggling between over-due work or hard-core procrastination on Words With Friends.)
Thinking physical fixes are usually quicker, I started with Foundation Training. I chose Goodman’s longest one for better comparison to the Brene Brown videos, which are all about 20 minutes. The 11:59 Foundation Training, at last count with 414,153 views, however, was far too advanced, so back to the 4:41 length “Better Posture in 4 Minutes.” The best aspects are that it’s short and free; the worst, that it’s still difficult. Then there’s “Prone Decompression” at 4:16, which at first looks easier because you’re lying down, is also short and free, but is almost impossible for me to do. Of course, turns out that if you really want Goodman’s system to work, you are encouraged to purchase the video, for $60, and to devote time every day to the exercises. So no quick fix. Also, checking with a local movement therapist, I learned that having a professional help you do the exercises correctly makes an enormous difference.
On to the mental and emotional, for which I chose Brene Brown’s talk, “The Power of Vulnerability,” at 20:50, with 2,329, 830 views to date. Although she has done her share of edgy emotional experiences from past-life regressions to EST, my friend Marjory said of Brown, “I feel like we’re all so armored and defended and that being vulnerable is truly a place of power.”
Despite the length of her talks, Brene Brown is enjoyable to watch because she moves quickly through topics, speaks matter of factly and keeps returning to her years as a researcher as the source of her ideas. Some ideas that struck me: people who feel worthy have a strong sense of love and belonging; and the rest of us try to combat not feeling worthy enough by pleasing and performing for others. She had one “trick” I liked called the “spinning ring:” when she’s asked to do something like bake dozens of cookies for her child’s class party, she spins the ring on her finger to take time for reflection before answering. The reflecting mostly concerns how resentful she will feel if she says yes, a resentment that will heat up around midnight when she is still baking those cookies.
Of course, as with Goodman, to really learn from Brown’s ideas requires a much greater commitment. My D.C. friend Serena, who took the 12-week online course ($129) which includes weekly art projects, felt that “some of her insights have been incredibly valuable for me.” Among the take-aways: to distinguish between when I am comforting myself and when I am merely numbing myself – which, Brown points out, we do with mindless activities like eating. Another: to avoid shame, which comes from feeling that we are flawed, and is driven by a desire to look good for others, instead look for a place where we truly belong and are accepted for who we are.
Although I haven’t signed up for long-term versions of either, I do appreciate knowing Goodman and Brown are there when I need them, just a few clicks away. And I look forward to Marjory’s upcoming visits for catching future waves of online gurus.
AMONG MY WOMEN FRIENDS who are night owls, one is especially adept at taking financial risks and profiting from them. The rest of us who like staying up late, though, are notably hesitant about anything risky regarding money. The difference, reflected in several studies, may be due to the “stress hormone” cortisol.
Women who are night owls tend to be risk takers and unmarried, according to researchers at the University of Chicago. Female night owls have higher levels of cortisol than other women, closer to the levels of most men. And, according to Dutch researchers, slightly elevated cortisol in women is related to improved decision-making performance, as measured by the Iowa Gambling Task (IGT); whereas in men, the greater the elevation, the poorer the performance.
Cortisol rises in moments of high physical stress as well as in situations of uncertainty, releasing glucose and fatty acids into the blood to prepare the body for fight or flight. Cortisol levels in night-owl women are chronically elevated, and may be more so in night-owl women who are already stressed, either from past or more immediate causes.
Those people with higher cortisol levels have high metabolism, high energy and arousability, according to Dario Maestripieri, professor of Comparative Human Development at the University of Chicago. There is some evidence, he said, that high-achieving, successful people have high cortisol levels.
From an evolutionary point of view, night owl-traits might have evolved to facilitate short-term mating, which for Maestripieri’s research are “sexual interactions that occur outside of committed monogamous relationships.” He cited research showing that night owls of both sexes are more likely to be single or in short-term relationships. (Male night owls reported twice as many sexual partners as male early birds.)
In Maestripieri’s initial study, which measured aversion to financial risk in 500 students, men were more willing to take financial risks than women. In a further study of 200 students, Maestripieri compared levels of cortisol and testosterone before and after students took a computerized test that measured their financial risk aversion. The students also described their willingness to take risks as well as their sleep patterns. The results showed that night-owl women had cortisol levels higher than other women and comparable to the levels in all men, both night owls and early risers.
In the Dutch study at the University of Utrecht, women whose cortisol levels were slightly elevated in response to stress had improved performance on decision-making and risk-taking. But among “high-cortisol responders,” women had poorer performance, closer to that of men with elevated levels. High cortisol-responders of both sexes were more sensitive to immediate rewards, according to these researchers. They concluded that “acutely elevated levels of cortisol are associated with euphoria and reward-like properties related to sensation-seeking behavior.”
In a British study, artificially altering cortisol levels for 20 men and 16 women by administering hydrocortisone raised levels about 70 percent, similar to those previously measured in stressed traders in the City of London. They found that “while initial spikes of cortisol had little effect on behavior, chronically high and sustained levels as seen in the traders led to a dramatic drop in participants’ willingness to take risks.” The researchers noted their concern that “subterranean shifts in risk appetite” could unduly affect the judgment of these traders. Also that chemical adversity to financial risk may occur unexpectedly in people taking anti-inflammatory medications such as prednisone.
While I probably will never get the chance to measure cortisol levels in my night-owl friends, I suspect that the more successful risk-taker has slightly elevated cortisol levels, while the rest of us may have higher levels maybe because we are generally more stressed.
For everyone, the point is to be as aware as possible of how stressed you are when making important decisions, especially those involving risk. If you are an early bird with low stress, low cortisol levels might influence your thinking to make you more conservative. A laid-back night owl might be more likely to take well-thought out risks. And anyone under extreme stress, especially night owls, might make conservative decisions, based not on careful reasoning but because of the cortisol streaming through their veins.
BLOOD PRESSURE, while clearly a concern for some, still confounds medical experts. And everyone should pay attention when the thermometer starts rising in the summer heat.
My blood pressure, which hovers around 90/60, has always been considered a sign of good health in the United States, but if I were in Germany, for example, it would be deemed too low and worthy of treatment. When I was in the middle of minor surgery in Brussels, where I lived for several years, suddenly medical personnel began racing around and pulling equipment off the walls as if my heart had just stopped. When my husband mentioned that my blood pressure is usually low, the activity died down and the room became silent except for one quiet “Oh.” The procedure proceeded as planned.
Early this year, U.S. physicians once again changed the blood pressure levels considered healthy. Despite several such changes and an enormous amount of research, however, no one is entirely sure what levels are “safe,” whether “unsafe” levels really cause the problems they are accused of causing, and whether the drugs that purport to lower the levels do a good job.
First, the acceptable levels. Blood pressure is the force of blood against the blood vessel walls. High blood pressure, or hypertension, makes the heart work harder to pump the blood, and too much stress on the heart and arteries can damage them over time. Hypertension contributes to hardening of the arteries and the development of heart failure, and creates a higher risk for heart attack, stroke and kidney disease.
In January, 2014, the highest level deemed safe for the systolic reading, the upper number in the equation, which is the pressure measured when the heart contracts to pump blood, was increased from 140 to 150mmHg (millimeters of mercury). What has been considered the “healthy” goal of less than 120/80 was also questioned, because there is little evidence of any health risks below 140. (The lower number is the diastolic pressure, measured when the heart is at rest.)
Because blood pressure usually rises with age, doctors used to add 100 to the patient’s age, making 160 an acceptable upper systolic limit for a 60 year-old. (In the U.S., those 60 years old and over take the majority of anti-hypertensive drugs.) By the late 1960s, the system was deemed too casual, and the number 160/100 was applied to every age group. The next change occurred in 1997 when the safe level was lowered to 140/90. The Joint National Committee (JNC), which makes these decisions, is composed of leading cardiologists and experts on hypertension.
There is also the issue of timing: Blood-pressure readings are highest in the morning. They can also vary from one arm to the other. For some people, “white-coat hypertension” occurs when simply being at the doctor’s office, before the pressure is measured, causes the systolic level to rise by as much as 30 mmHg. People who have this experience can do their own monitoring at home, which works best using spygmometers (blood pressure monitors) that fit around the upper arm, not the finger or wrist.
Hypertension, considered a silent killer because there are no symptoms, affects one in every three American adults, according to the American Heart Association. About 95 percent of those with high blood pressure have “essential hypertension,” meaning there is no known cause. Most of them are “salt sensitive,” so that any added salt increases their blood pressure. People living in the north of Japan eat more salt and have the highest incidence of hypertension of anyone elsewhere in the world.
For high readings, doctors often prescribe medications, although evidence for their efficacy is “only moderate,” says the JNC. And one of these, beta-blockers, has recently been shown to cause stroke and hypotension (low blood pressure) in surgical patients who are hospitalized. Research on African-Americans has shown that antihypertensive medications should be started right after getting a high reading. But for everyone else, the preferable recommendations are the usual: more exercise, less processed foods, more exercise, less salt, etc.
In the absence of a good spygmometer, one thing that can separate the low from the high in terms of blood pressure is the hot tub. Those who feel lightheaded, dizzy or exhausted after getting out may have low or high pressure. But those who feel this way while still in the tub definitely have low pressure caused by a myriad of factors: less gravity means the heart has less difficulty pumping blood; heat makes your blood vessels dilate, creating less resistance to the heart’s pumping; and lower fluid volume is caused by dehydration as a result of sweating. Mental and physical relaxation also play a role.
When outdoor temperatures rise, blood pressure can decrease during the day and increase at night. In very hot weather, the heart has to work harder to pump blood to your skin’s surface to assist with sweating to cool the body. (Blood pressure can also rise in cold weather when blood vessels constrict and the heart has to work harder to push blood through the veins and arteries.) Tips to avoid blood-pressure changes in the heat include wearing lightweight and light-color clothing, staying hydrated, and, surprisingly, paying attention to your feet: most people sweat the most inside shoes, so well-ventilated footwear and wicking socks can be helpful.
People with low blood pressure can also nod off more easily, for example, during long drives or at evening cultural events – or at least that was my father’s excuse when we both fell asleep at the opera.
THERE’S MORE TO spending a day by the sea than meets the eye. For thousands of years, humans have flocked to the ocean seeking the respiratory benefits of crisp, salty air. But a trip to the beach isn’t the only way to achieve the soothing effects of a sea breeze.
