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Saturday, October 3, 2020

Why doctors should talk about the weather!


Sick? Click the boxes; tell the computer all; what symptoms do you have? Computers can fold in labs and other studies and spit out logical next steps. So, do we even need doctors?  Surely, after recent experiences with the medical profession, I wish we didn't.  

And I fear I'm not alone.That some of you or your loved ones can relate -- and have been talked to callously -- or thoughtlessly -- or examined more like hunks of meat than fellow humans swirling around the universe right along with the medical professionals.  

Before I go on, let me be clear. Of course, there are wonderful amazing medical humans! I have friends who surely are. I try hard to be one. And so, so many heroically braved Covid exposure to take care of us! And even on the lousy recent medical visit, I met thoughtful thorough medical folks - a nurse cracking jokes and a medical administrator telling me about her three-year-old granddaughter -- all while meticulously doing their jobs.

I am talking about the others -- who act distant. Cool. Cold. Are too spare in their explanations. Those without a social smile and who seem to have forgotten -- when we face illness, we need humans, albeit highly educated humans -- but humans nonetheless -- to guide us. 

A brilliant teacher of mine, Harvard's Dr. Paula Rauch, once said that family members facing horrific illness tend to feel like they are in empty metal drums alone; no one can hear; it is cold and hard in there; words and cries reverberate. But doctors can help -- by sharing that others have travelled this road -- by saying we will stay alongside.

The excuse for docs too often is not enough time. They have boxes to click. Malpractice to avoid. Patients piling up. Nope. Truth is, it takes only thoughtful seconds to make patients feel recognized as fellow humans. All you have to do is a couple of these:

  1. SMILE and look at the patient as you walk in. 
    1. Really. No matter how bad your day is.  
  2. SAY SOMETHING BORING and universal right off the bat!  
    1. "Nice to meet you. What a freezing fall day we're getting today, huh?" Or,  "How about that rainstorm! Sure hope you didn't get soaked coming in." And so on.
    2. Or if you loathe weather, branch out! "Traffic was brutal this morning for me, how about you?"  "I'd love a coffee about now, how about you? Wish I could offer one."  Anything. 
    3. Be awkward. That's fine. Whether it falls flat or not. You tried; you are joining the patient in being human, rather than leaving her or him alone with a very human illness.  
  3. APOLOGIZE to the patient.  
    1. I.e. acknowledge briefly the lousy winds of fate that brought him or her in today.  
      1. "I'm sorry you are dealing with this." 
  4.  JOIN the patient on his or her journey.  
    1. Let the patient know that you will be there. 
      1. Something like: "I'll help you deal with this."  Or, "No worries, I'll help you figure this out". 
      2. Or if you can't.  "I'll help you get the right specialist to take this on."
  5. And for extra credit.  
    1. Do NOT share scary information before doing a painful procedure, if possible.
      1. Fear increases pain. 
    2. Have a patient get DRESSED before sharing less than awesome news.
      1. Seems a minimal defense to allow a person -- a layer of reliable fabric between him or her and doom, rather than that famously flapping, hopelessly humiliatingly thin hospital gown.
And please share this post. Because we all need doctors some day.  And too often, it's sooner than we think.  
 

Monday, September 28, 2020

Fats?




Even as a physician passionate about the role of nutrition for mental and physical health, I have to admit, I've sometimes been baffled over the years about the what/where/whens of eating fat, especially amidst all of the passionate opinions.  (People seem to have stronger feelings about fat than just about anything, well, except politics, of course, especially these days.)

So to start your week on a good note (not politics), enjoy this linked to lovely little clear as day summary of the subject, hopefully as you eat a nice walnut and avocado topped and olive oil drizzled salad.

Or, if you just want my quick bottom line, here you go. The better for us unsaturated fats have at least one double or triple bond in their chemical formula and tend to be liquid at room temperature, famously like olive oil of the Mediterranean diet.  While the totally single bonded saturated fats are probably far less good for us, like cheese (sigh) and butter.  While, key point, the partially hydrogenated oils (where food companies add hydrogen to unsaturated fats to make them more saturated and more solid and more shelf stable) are trans fats and are the WORST.  And while in 2018 the FDA determined partially hydrogenated oils were unsafe and demanded they be taken out of foods, a bunch of countries haven't yet done this according to The World Health Organization (WHO).  So, especially if you happen to hang out in one of those countries, please read your labels! Or, easy peasy -- avoiding processed food can help! And is wise for health anyway, of course.

So please eat well. And have a lovely week folks.

Saturday, September 26, 2020

Houseplants for anxiety and depression?




Catchy title, right?  Admittedly, that's just my somewhat outlandish take.  

However, I'm talking plants for a potentially exciting reason.  Some long have dreamed that enriched oxygen might increase oxygen diffusion into the brain and boost the sometimes lazy function of mitochondria (the cell powerhouses) in those with some sorts of mental illness.  

And looks like, they might have a point.  In a pilot, double-blind, placebo-controlled study, Dr. R. Belmaker gave 51 adults with mild-moderate depression either enriched oxygen air (35%) or regular old (21% oxygen) air (as a placebo) for 7 hours nights for one month.  And incredibly enough, those given oxygen-enriched air felt better, as seen by a drop in their Hamilton depression test, especially the anxiety and cognitive sub scales.

Wow.  Could this offer a side effect free way to help folks?  Let's hope!  However, we need to see this published. (I can only find the results on reports of the virtual congress of the European College of Neuropsychopharmacology.)  And we need more and bigger studies to better prove both efficacy and safety before shopping for our very own oxygen tanks.

However, in the meantime, why not invest in a plethora of houseplants? While admittedly it might take hundreds of plants to make a meaningful difference in air oxygen content, I'm happy to have another reason to invest in plants to beautify -- and oxygen-enrich -- my home!  Truth is, plants make us feel good anyway. Yes, there seriously are studies showing they benefit us.  Not like we really needed a study to know that anyway, I think.

I'm off to the garden store. Take care out there.

Tuesday, September 8, 2020

Art in a pandemic!

Alrighty, another non-vaguely-scientific post, but rather a rant. Pandemic days do bring out my rants, it seems.  I'll keep it short though, no worries. Bottom line, in these dark days of unrest and pandemic, we need art more than ever! There even is research supporting the good art does mental health.  Sadly, with theatre, concert halls and museums closed, this may seem irrelevant. Art can seem mighty hard to access. 

But is it really? Or could there be a plus side to pandemic? A lemonade out of lemons thing? Is more art being posted online and becoming available to the world free and easy than ever before?  Even musical theatre emerges increasingly online (my bias -- one of the most soul nurturing forms of art out there). The original and amazing star of Come from Away and friends, singing their hearts out at this link for example!  Or have you made time to watch the rightly famous Hamilton on Disney Plus? And those are just for starters.  


Find art. It's out there.  Enjoy! And have a lovely day out there.

Eat your veggies (and fruits) for happiness!

I can't help but link to my fav nutritional guru yet again... Who makes clear we should eat 7 or more servings of fruit a day and 8 or more servings of vegetables a day, to not only improve our happiness and sense of wellbeing that day, but the next day, too!  So so a famous mother saying is proved right yet again.  Eat your veggies! (And fruits!) And have a super day out there!

Monday, August 17, 2020

Got Depression? Measure it!

Hey any depressed folks out there, do your psychiatrist and yourself a helpful favor.  Every time you meet with your doc, first print a PHQ-9 Form out, fill it out (including date) and bring it along; or in these pandemic times, mail it to her or him.  This form can help track progress in fighting depression, so can help guide treatment decisions.

And I hope you feel better soon!

Friday, July 31, 2020

Intro to Nutritional Psychiatry

Vegetables, Vegetable Basket, Harvest
Happy end of July to you.  Here's a LINK to a nice little overview of some key concepts from the amazing, lovely, fantastic field of nutritional psychiatry.  Food can help us feel a little better. Why not tap into that? 

Enjoy. And have a super weekend.

Saturday, July 25, 2020

Do

Person, Woman, Cleaning, Tidying
This is not a medical post. Nope. You get a break from vitamins and veggies for the day.  This is just sharing an idea that is helping me, and so perhaps could be of use to a few more out there?  I'm talking about generous behaviors today, but I'll skip the science of it. Yep, there is a science to it. There are studies that show generous behavior makes us happy. Even preschoolers know this according to one study.

Today I'm blabbing opinion. Because I need to vent. Who does not need to vent? The world is going downhill!  2020 is dreadful! Pandemic. Violence. Politics. Mean spewing from all directions. We all want to gripe. Don't we? This group is ruining the world! Those folks over there are too! Can you believe these guys? That's the gist of so many of our conversations these days. Right? 

But how is that working for you? For me? For any of us? Uplifting? Inspiring? Motivating? Not so much, I think.

So my soapbox to my poor long-lectured-to family over breakfast. I asked, what if we try to stop judging others? Like those with different pandemic attitudes? Different politics? 

And, what if, any time we judge, we take a look at ourselves? Far from an original thought. The glass houses thing has been around for a while. Not brilliant, but I thought it's an approach that might be especially helpful right now. I suggested to my family: Every time we get judgey, what if we consider, what did I DO for others today? Did I step up? Can I? Is there something I can do this very minute? 

Voltaire pointed out we should tend our own gardens back in what, the 1700s? Perhaps it's time to listen? To focus on doing some good in our own little worlds? 

So, after today's griping, I did my best to walk this walk, my husband joining in. We shoveled up trash on our street, weeded the alley (yes we did), and sent a food basket to an older friend. Nothing huge. Nothing different from what so many generous souls do every single day. (Actually so many do far, far more!)  

But enough to stop my griping. To stop that ineffectual feeling at a frightening political pandemic moment. I can't fix the world, of course. But these bitty extra steps beyond my norm, I can do. 



Monday, July 20, 2020

Go dietary vitamin B6 for the brain! Woo hoo!



Hello vitamin B6, a super cool chemical compound (actually there are multiple forms with various names but let's keep things simple) that helps with all sorts of bodily processes! These include such key moves as helping with food metabolism, creating blood cells, and ... drumroll... creating neurotransmitters!  Yes, vitamin B6 is key in making those lovely little neurotransmitter chemicals that let brain cells talk to each other and so literally form our thoughts! B6 works as a so-called co-enzyme (that helps the enzyme) to help to make serotonin and norepinephrine -- the same stuff so many of our antidepressant and anti-anxiety medications work to increase! 

But sadly studies don't show vitamin B6 supplements especially helpful for mental health.  Our reliable Cochrane Review did not find it helpful for thinking or mood. And, a 2011 review from Norway concluded that there isn't the data to adequately know whether vitamin B6 supplementation is helpful for anxiety.  

However, a 2017 review from Australia did find a whiff of support for vitamin B6 combined with magnesium alleviating PMS anxiety, and B6 supplementation alone helping anxiety in older women.  And, a 2018 study did find combining B6 with magnesium was more effective than magnesium supplementation alone for the severely anxious.

Still, bottom line, there's not data to support using B6 supplements, I think, unless your doc tells you to for a specific medical reason -- like a B6 deficiency.   For the rest of us, though, could it still make sense to eat loads in our diet?  After all our bodies can't make B6. That's part of the definition of vitamins.  They're organic essential little chemicals that our bodies needs a little of but can NOT make.  And, good news, a diet rich in B6 doesn't look problematic.  The National Institute of Health says: "High intakes of vitamin B6 from food sources have not been reported to cause adverse effects". Being water soluble, the body can get rid of excess vitamin B6. (Unlike the fat soluble vitamins that are stored in our fat, liver and muscle and hard to get rid of.)

So, yep, I'm going to pile up the plates of those I love with the healthy, happy, whole food, fiber rich, dietary sources of vitamin B6 -- items that are healthy anyway!
  • 1 cup of chickpeas that has 1.1mg of B6!
  • 1 cup of boiled potatoes for another 0.4mg of B6!
  • 1 cup of raw tofu for another 0.2mg of B6!
  • 1 banana for 0.4mg of B6!
Just eating the above combo would give 2.1mg of vitamin B6 -- more than the RDA minimal recommendations of 1.3mg for adults age 19-50.   

So, yes, this is a long-winded way to get me back on the same soap box. Vitamin B6 offers yet another logical reason to prioritize eating maximally healthfully and thoughtfully -- for our brains, as well as our bodies!  Take care out there!

Tuesday, June 9, 2020

Alcohol and the Brain

While I'm still too overwhelmed by pandemic chaos to blog in my usual wordy way, here's a useful -- if not lovely -- image for you.  Serves as an effective reminder that lifestyle matters.  It's worth watching the alcohol consumption. Also serves as reminder to be extra generous and gentle to those with Alzheimer's, I think. Take care out there!

Wednesday, March 4, 2020

Helping stressed out kids!

The ever brilliant Dr. Kastner offers up a nice concise summary of how to help kids with stress!  Enjoy here.

Sunday, February 2, 2020

3 (or 2?!) ingredient banana and oats cookies!

Wow, Clean and Delicious strikes again, offering a health-packed banana and oats cookie recipe using only mushed ripe banana mixed with oats and chocolate chips (I leave these out). Spoon cookie sized blobs onto a cookie sheet and pop into a 350 degree oven for 15 min.  Or first add a spoonful of omega three rich flaxseeds or chia seeds or anti-inflammatory cinnamon to kick up the health benefit even further.

Bottom line, Clean and Delicious recipes have found a new fan here.  Enjoy!

Saturday, February 1, 2020

No bake peanut butter oat bars!

Love these healthy recipes that even a non-cook -- i.e. me -- can manage. So, here you go, no bake peanut butter oat bars. Mix rolled oats, peanut butter, a dollop of maple syrup (or I sub in date syrup) and chopped cranberries, pat the mixture into a parchment lined pan and refrigerate a good hour before cutting and serving. Or, enjoy the full recipe with actual amounts here, for those of you who do that measuring thing. All thanks to my new favorite recipe source, Clean and Delicious. By the way, I hate to state the obvious, but use no sugar and no oil added and unprocessed ingredients here, and everywhere, to maximize healthiness. Enjoy.


Sunday, January 19, 2020

Exercise for depression!

For you neurobiology-loving folks, here's a lovely summary slide on the brain benefits from exercise, thanks to Medscape.  A nice reminder to get moving today, and most days. Here you go. Enjoy:



Lean into anxiety, and other key CBT concepts made simple!

Although I absolutely don't agree with everything this Norwegian therapist chats about on You Tube, he has published a load of videos that make key cognitive behavioral concepts simple and accessible to all, especially for those struggling with anxiety.  Worth a listen! Enjoy!


Sunday, January 12, 2020

Write down three good things that happened today!


This evening, and every evening, write down three good things that happened today and their causes. Nice job. You've taken a research supported step towards being happier.  Enjoy!



Monday, January 6, 2020

Do NOT take supplements willy-nilly!

Wow, a great reminder not to take supplements carelessly. Ack. Today's Forbes article powerfully communicates a recent study finding that a variety of supplements taken during chemotherapy for breast cancer can INCREASE risk of recurrence and even death. SIGH.  Be careful out there. Read the article.  And, as always, more than ever, try to get your healthy vitamins and minerals and omega threes from a meticulous diet!  And discuss every supplement you take with all of your doctors, especially those of you on chemotherapy it seems!


What is Wellness Anyway?

"The state of being in good health, especially as an actively pursued goal."