Silencing the Stress

Lord, help us.  With the election, the economy, the business, the finances, the job, the world turmoil, and the senseless violence that permeates our culture, we are in need of some nurturing.  It seems the normal holiday stress pales in comparison to the struggles and the losses so many have to endure.  Just how are we to cope with the physical and mental stressors that we are so beset with?  How can we process the grief that comes with loss of those so precious?

The Stress Response

The acute stress of trauma, be it a threat, or sudden loss, causes a tremendous surge of the “fight or flight” hormone called adrenalin and following that is the stress hormone called cortisol.  Cortisol, made by the adrenal gland, is a good hormone in that it helps us carry the body through times of stress, such as infection or physical trauma.  It maintains blood sugar and blood pressure and helps squelch acute inflammation.  The effects of cortisol are life saving, but sometimes the stressor is so strong that it messes up the body’s ability to mobilize cortisol in a normal and healthy manner.  This is often the case in people that have been diagnosed with post-traumatic stress disorder or PTSD.

Chronic stress, such as that which comes with the day in and day out of our hectic lifestyles, can put the adrenal response on “simmer” and lead to a continuing low level alert.  Persistently elevated cortisol levels will causes breakdown of healthy muscle and bone while promoting high blood sugar and fat gain around the midsection, and will change brain chemistry leaving us feeling irritated, depressed and fatigued.  Furthermore, cortisol can wreak havoc throughout the body and is linked to most of the diseases we are dying from, including cancer, heart disease and diabetes.

Clearly cortisol is a bad thing if it is called into action all the time.  And to make matters worse, this long-term stimulation of the adrenal gland can also cause it to burn out and lead to adrenal fatigue, which is chronic fatigue combined with an impaired ability to respond to normal stressors. 

Grieving

With loss and grieving there is no way to avoid the stress response, only work through it, which may take months or years.  For many, the stress is so great that it will leave a footprint forever upon the body and soul.  Anyone losing a dear friend or family member knows the deep inescapable grief that takes hold.  How we ever manage to get through these times is a testament to our strength, our spirit and our faith. 

The universal stages of mourning are experienced by all and were first described by Elisabeth Kubler-Ross in her 1969 book “On Death and Dying.”  Denial is the first reaction to overwhelming emotional shock of loss and it carries us through the first wave of grief.  As denial wears off and reality sets in, anger arises, from deep inside where the emotional core of hurt resides.  

The third stage is a reaction to the need to regain control in the face of helplessness and vulnerability.  Called bargaining, this is our attempt to postpone the inevitable reality of loss.  “What if” or “what could I have done” thoughts intermingle with pleas of “if only I could undo what has been done”.

Depression is the stage of sadness and regret.  Reassurance from those close can be critical for healing.  A quiet internal struggle must take place in which one begins to say goodbye to a loved one.  This leads to the final stage of grieving, acceptance. 

When working with patients going through the grieving process I always imagine it like being in a fog.  Initially there is no light, only a thick fog of sadness.  As time processes the emotions, the fog lifts a bit, letting in some normal light.  Eventually the fog clears enough for them to move forward in their “normal” life, but the fog often always present.  At best, they are able to move around the fog and find meaning in life.

Not everyone goes through all the stages of grieving, or in the exact order, and not everyone reaches the final stage of acceptance.  There is no time-line for the grieving process.  But throughout each stage, a common thread of hope appears.  As long as there is life, there is hope, and as long as there is hope, there is life.

Stress Remedy

So we come equipped with this marvelous emergency stress response system that allows us to fight for our life or run for our life - this innate hormone system gave primitive-man the energy to “fight the saber-toothed tiger”.  In today’s complex world it seems we are always “fighting imaginary tigers” or “running from imaginary bears”.

For many of us, the best stress remedy is to simply divert our attention from a constant stream of worry to a more positive place.  This might mean simply turning off the TV or the Internet and going for a walk.  Taking 2 minutes to sit quietly and do some deep breathing is a powerful cortisol lowering technique.  Meditation, prayer, yoga, tai chi, exercise, hobbies, supportive relationships, all help lower cortisol.  Focused activity is proven to lower cortisol and the stress response - so focus.

Seeking help with grieving is good for most people, although the process is different for everyone and some need more introspective and quiet “alone time”.  As friends and family of one who is grieving we need simply remind our loved one that we are there, with reassurance, or just a hug.  For those experiencing the loss, reach out to those friends and family and let them share a tiny bit of the burden with you.  Professional counseling is something I’ve found helpful for many patients as well as myself during times of stress or loss.

Things such as poor diet, lack of good sleep, chronic infections, allergies and toxic chemical exposures are other things that will trigger the stress response and eventually push the adrenal gland into fatigue.  Address the issues you have control over.  Nourish the body with healthy food so that it will be strong.  Rest the body with plenty of good sleep so that it may heal and be resilient.  Deal with stress or grief “head on” but then let it go for a bit and refresh the mind and the spirit.  If you feel like stress is taking control then focus on the tools at hand to manage stress.  Get medical help if the stressors seem to be beyond your control.

During what should be a festive holiday season, remember those who are grieving.  I pray for a “silent night” for them.  Put aside petty concerns and focus on blessings.  Don’t let stressors win – don’t let them keep you from enjoying the beauty that surrounds.  Hold your loved ones close, savor the friendships and the times that nurture, and remember the important things in life aren’t things...

FREE Seminars

“HCG Weight Loss”

Wednesday, January 16^th, 6pm at the IMC

“Low Thyroid:  Misunderstood, Misdiagnosed, Missed”

Monday, January 21^st, 6pm at the IMC

RSVP at 245-6911

Bio

Scott Rollins, MD, is Board Certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine.  He specializes in Bioidentical Hormone Replacement for men and women, thyroid and adrenal disorders, fibromyalgia, weight loss and other complex medical conditions.  He is founder and medical director of the Integrative Medicine Center of Western Colorado (www.imcwc.com).  Call 245-6911 for an appointment or more information.

My Christmas Music Perscription

  If laughter is the best medicine, then I’d like to think music is a close second.  Not having the opportunity to study music as a child, I discovered around the age of 18 that I actually play music by ear, which is a blessing and a curse.  I must confess that my love for music, specifically playing the piano, borders on problematic.  Most days if I’m running behind I can blame it on the irresistible gravitational pull of that glorious black and white keyed beast that lives in our living room.  When the evening workout is skipped, again the piano is impugned.  If the jazz bars would have me and I could pay the bills, I’m afraid medicine might become my hobby.

Listening to music is equally appealing.  Mozart helps the infant brain grow and the college student score higher in math.  Whether it’s Beatles or Stones, Rock or Country, Jazz or Classical, music can lift the spirit, infuse the soul and send us flying.  Have you ever seen someone singing in the car, smiling, oblivious to the hubbub around them?  Or, how about after your first breakup, when somehow every song on the radio seemed perplexingly written just for you. 

The Christmas season brings with it some of our favorite music, and to my wife’s delight, my children and I start practicing around September.  Not that we need the practice, but it’s a good excuse to cover up our sentiment.  The classics, so jazzy and light, so uplifting and spiritual – aaah, there’s a reason they are classics.  Being a music buff, I’d like to share some little known history of a few Holiday favorites.

Austrian Catholic priest Joseph Mohr penned one of the most beloved and well-known songs, ‘Silent Night’, in 1818.  The church pipe organ had broken and Franz Gruber hastily composed the music for a tenor, a bass and two guitars.  That same night it was heard for the first time at Midnight Mass.  The song quickly became a favorite around Austria, then the world, and it was the 1850s before the anonymous composers knew of its success.

“Gloria in Excelsis Deo” was called from peak to peak on Christmas Eve by shepherds in the south of France, announcing the birth of Christ.  The song, “Angels We Have Heard on High” was first published in a carol collection that dates 1855.

“Joy to the World”, penned in 1719 by English hymnist and cleric Isaac Watts was based on Psalm 98 in the Old Testament.  The “Carol of the Bells” was originally a Ukrainian folk song intended to be sung a-capella, celebrating the joyous bounty of the season. 

           

“Adeste Fideles” was written in France around 1750 by British exile John Francis Wade, and a century later British clergyman Frederick Oakeley turned out the English version, “O Come, All Ye Faithful”.  He translated the song because he felt if congregations had good literary texts to sing, they would sing well.

Modern day composers, such as Johny Marks who wrote “Rockin’ Around the Christmas Tree”, “A Holly Jolly Christmas” and “Rudolph the Red-Nosed Reindeer”, provided the songs for legendary singers like Nat King Cole and Bing Crosby, who made the Christmas songs into classics.  Judy Garland made “Have Yourself a Merry Little Christmas” famous in the 1944 film Meet Me in St Louis.  Gene Autry wrote “Here Comes Santa Claus” and his singing made “Frosty the Snowman” a huge hit in 1951. 

           

Even the great geniuses of American musical theater, Rodgers and Hammerstein, gave us some great Christmas tunes with “My Favorite Things”, from the 1959 Sound of Music.  In the stage version, Maria sings a duet with her Mother Superior in the covenant, listing the many things in her life she could not give up as a nun – whiskers on kittens, brown paper packages tied up with string….

           

When it comes to Christmas recordings, here are some of our family favorites:  A Very Special Acoustic Christmas by assorted artists, My Kind of Christmas by Christina Aguliera, Go Tell it on the Mountain by The Blind Boys of Alabama, When My Heart Finds Christmas by Harry Connick, Jr, Yule B’ Swingin’ by assorted artists, and of course the timeless classic of all classics, The Christmas Song by Nat King Cole.

           

George Frideric Handel composed the oratorio, “Messiah” in 1741, and the “Hallelujah” chorus is perhaps one of the most celebrated works of the Christmas season.  There is a story told about this chorus... that Handel's assistant walked in to Handel's room after shouting to him for several minutes with no response.  The assistant reportedly found him in tears, and when asked what was wrong, Handel held up the score to this movement and said, "I thought I saw the face of God."

           

My prescription for the holiday season is to ‘eat, drink, and be merry’ – eat rich but healthy, drink in moderation, and merrily enjoy the simple beauty of the songs that celebrate the reason for the season.

FREE Seminars

“HCG Weight Loss”

Wednesday, January 16^th, 6pm at the IMC

“Low Thyroid:  Misunderstood, Misdiagnosed, Missed”

Monday, January 21^st, 6pm at the IMC

RSVP at 245-6911

Bio

Scott Rollins, MD, is Board Certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine.  He specializes in Bioidentical Hormone Replacement for men and women, thyroid and adrenal disorders, fibromyalgia, weight loss and other complex medical conditions.  He is founder and medical director of the Integrative Medicine Center of Western Colorado (www.imcwc.com).  Call 245-6911 for an appointment or more information.

Making Great Health a Habit

                                                                                 Are we indeed “creatures of habit” and if so is that a bad thing?  Habits rule our behavior as much as choice, yet free will and making the right choices creates good habits. The biggest challenge for all of us in pursuit of great health lies in making choices that lead to healthy habits.  Or put another way, doing the simple things every day that add up over time to promote health.

In guiding patients to great health I encourage them to consider the “keys” for great health.  The keys include attitude, diet, exercise, sleep, stress management, digestive health, detoxification, supplements and hormone balance.  The first 5 keys are primarily up to the patient to implement and as such rely on consistent efforts.  Just how can we build those great health habits?

Health, like so many things, does not rely on a secret key that suddenly unlocks the pathway to success.  We can’t have instant success, instant loyalty or trust, instant weight loss, or instant health.  Success starts with a desire, a vision, and a plan.  Success happens due to effort and perseverance.  Success is achieved with everyday decisions that will compound over time to produce results. 

Attitude means making the easy decisions every day that add up to great health.  It is just as easy not to do the right thing, as it is to do the right thing.  Eating that greasy cheeseburger and fries with a super-size soda is an easy choice – one that is not likely to kill you today, but compounded over time it will.  Just as easy is to eat something healthy.  Skipping exercise, again, is easy.  So is making the choice to exercise.  Great health starts with having the right attitude, determined to make the right choices – without the right attitude then you may as well stop reading now.

So we make the decision to have the right attitude... now to make the right choices and that’s where habits come in.  And here is where is gets hard.  Often great habits involve making changes and change brings stress to our brain.  We don’t do so well with change.  One problem is we try to change too much too fast or change is so overwhelming we can’t imagine how to make it happen.

“The journey of a thousand miles begins with the first step”, wrote Chinese Taoist philosopher and founder of Taoism over 2000 years ago in his book "Tao Te Ching" or "The Book of the Way".  And so it is with change – what seems impossible is usually possible but one has to start somewhere. 

Many years ago as a house painter I encountered what I called the “overwhelming paralysis” of wondering where to start and how in the world I was going to finish painting some giant house all by myself.  I quickly learned to quit thinking and start painting.  Just pick a corner, preferably in the shade, focus on a small area, and start.  A week later it was done.  After a while what once seemed overwhelming was routine.  It was a habit.

Same thing happened the first week of medical school – overwhelming paralysis.  How in the world could any human being ever get through all the material we were expected to read, never-mind remember it well enough to pass a test!  I quickly reminded myself that many before me had managed to pull it off so I had faith I would be able to “get ‘er done” and just started reading.  That started the habit of getting up at 5am to study – still do, 7 days a week, and most of my columns are written early in the morning.  Old habit.

Tips for developing great habits

Kaizen is a Japanese term that means “improvement” or “change for the better”.  It is a process that is embedded into the culture and leads to changes in everything from healthcare to industry.  A continuous process of analyzing, rethinking, and making changes that lead to improvements in health or improvements in production.  The key is that Kaizen emphasizes small but continuous changes.  Again... SMALL changes.

Robert Maurer, PhD and author of “One Small Step Can Change Your Life:  The Kaizen Way”, explains that small continuous changes are what adds up to success in the long term.  Successful fortune 500 companies get to the top by making small, steady, and well thought out improvements.  Weight loss may happen by first eating only one bite less with each meal, then later two bites less.  Starting an exercise program might begin with simply walking around the block and each day going just a little bit further.  This is the Kaizen way.

How do we incorporate Kaizen into our health habits?  Pick one the 5 keys and start.  Choose an area you know you need to do better with.  Make one small change.  Tomorrow do it again.  When you have that change established you have created a new habit.  It feels good.  Make another small change.  Pick another key to health and start with yet another small change.

Getting help with establishing good habits is always a great idea.  This might mean finding a buddy to exercise with.  When the weather is cold, my wife is usually the one that encourages me to leave the warm fire and get bundled up for our morning walk.  And of course once I’m out there I’m glad to keep the habit going!  Have lunch with the co-worker that appreciates good healthy food and encourages you to eat smart. 

Get a Health Coach

Working with a health coach is an easy and affordable way to help you establish goals and stick with them.  Coaches are trained to analyze each individual’s strengths and weaknesses and turn health goals into achievements.  I recommend and refer to our health coach regularly because I see it work to help patients establish great health habits.

Health coaches differ from the traditional medical paradigm in which we doctors give information to the patient and expect them to implement that information.  Coaches guide patients toward their health goals by focusing on behavioral changes.  This involves setting goals, identifying obstacles that interfere with goals, and providing the support necessary to make changes.  Coaching empowers patients to help write their own prescription for great health and holds patients accountable for implementing their plan.

My upcoming seminar is called “Keys to Great Health” and is free to the public.  I review the basics of the key elements for great health.  The first element is attitude.  The hardest thing we, as physicians, do is to get patients to have great health habits.  A great health plan starts with that “first step”.  Your first step might be coming to my seminar... Kaizen!

FREE Seminar

“Keys to Great Health”

Monday, December 10^th, 6pm at the IMC

RSVP at 245-6911

Bio

Scott Rollins, MD, is Board Certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine.  He specializes in Bioidentical Hormone Replacement, thyroid and adrenal disorders, fibromyalgia and other complex medical conditions.  He is founder and medical director of the Integrative Medicine Center of Western Colorado (www.imcwc.com) and Bellezza Laser Aesthetics (www.bellezzalaser.com).  Call (970) 245-6911 for an appointment or more information.