 For some, the holidays are a time for gathering, joy, cheer, family, friends, peace and togetherness. For others, the holidays are instead filled with isolation, stress, depression, family turmoil, heartache, and loneliness. And maybe for the majority of us, it is a combination of the above.
During this season of thanksgiving, it can sometimes be difficult to maintain an attitude of gratitude. Some may feel it is only obtainable when all is going well. According to Robert A. Emmons, Ph.D (noted to be the world’s leading scientific expert on gratitude and a professor of psychology at the University of California, Davis, and the founding editor-in-chief of The Journal of Positive Psychology), one of the five myths about gratitude is that it isn’t possible or appropriate in the midst of adversity or suffering. “Some argue that it’s impossible to be grateful in the midst of suffering. When life is going well, when there’s abundance—sure, then we can be grateful. But what about when we’re facing hard times? I believe not only is gratitude possible in those circumstances—it’s vital to helping us get through them. When faced with adversity, gratitude helps us see the big picture and not feel overwhelmed by the setbacks we’re facing in the moment. And as I’ve suggested above, that attitude of gratitude can actually motivate us to tackle the challenges before us. Without a doubt, it can be hard to take this grateful perspective, but research suggests it is possible, and it is worth it.” https://greatergood.berkeley.edu/profile/robert_emmons#articles Gratitude has been studied in patients after heart attacks. Gratitude at 2 weeks after a heart attack was associated with a higher self-reported adherence to medical recommendations (diet, exercise, medication adherence, stress reduction) and improved emotional well-being 6 months later. It was concluded that gratitude may help recovery from a heart attack and that interventions promoting this positive construct could help improve adherence and well-being. https://www.ncbi.nlm.nih.gov/pubmed/27796252 In another study of asymptomatic heart failure patients, gratitude journaling decreased lab results related to heart failure morbidity such as inflammation. https://www.ncbi.nlm.nih.gov/pubmed/27187845 Here is a TED talk I recently watched which involves a physician and her journey with gratitude while caring for a son with an incurable and terminal illness. Can you apply her experience to your own life’s situations? - https://www.youtube.com/watch?v=HHTmiHB6aXk&feature=youtu.be&list=PL9wE6J5iLNROCZYibeUCT9vWStvOc6EOZhttp%3A%2F%2Fyoutu.be%2FHHTmiHB6aXk%3Flist%3DPL9wE6J5iLNROCZYibeUCT9vWStvOc6EOZ But how can I develop more gratitude? I recommend a review of the following article by Dr. Emmons titled 10 Ways to Become More Grateful - https://greatergood.berkeley.edu/article/item/ten_ways_to_become_more_grateful1 Lastly, how can I be better prepared for the upcoming holiday season (and any “season” of life)? I often recommend guided imagery, which is a form of meditation, as a way to practice mindfulness. By reconnecting with ourselves and being present for a short period of time, we can be better prepared for the stressors and challenges of life. To see if guided imagery is right for you, try listening to guided imagery audio for free on this Kaiser Permanente website - https://healthy.kaiserpermanente.org/health/care/!ut/p/a0/FchBDoMgEADAt_iAzYZEYfFmhH6hhdsGiZIIGELt99seZ9DjC33hO-3cUy18_uxCLD22md9bqnCnLVZ8okd_Nd4zoysVAocj_o9bT-GM6IzVap2MBamlBCGsgEWPBohoUkKp8UErXjnTZxmGL2IKPpI!/ If you find these audio sessions helpful and would like more, I recommend resources from the following website - https://www.healthjourneys.com “Gratitude unlocks the fullness of life. It turns what we have into enough, and more. It turns denial into acceptance, chaos to order, confusion to clarity. It can turn a meal into a feast, a house into a home, a stranger into a friend. It turns problems into gifts, failures into successes, the unexpected into perfect timing, and mistakes into important events. It can turn an existence into a real life, and disconnected situations into important and beneficial lessons. Gratitude makes sense of our past, brings peace for today, and creates a vision for tomorrow. Gratitude makes things right.” Melody Beattie Dr. Charles Willnauer
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 Below is a great article by Dr. Mark Hyman, MD regarding the many benefits and tips on sleep. I'm off to get my 8+ hours now. ZZZZZZzzzzzzzzzzzz....... Dr. V YOU CAN LOSE WEIGHT without changing what you eat or doing one minute of exercise! It’s a bold claim. And don’t get me wrong: Nutrition and exercise are important! But there’s another key to weight loss – and most people don’t even know about it. It’s sleep. In fact, besides eating whole foods and moving your body, getting enough sleep is the most important thing you can do for your health. On the flip side, sleep deprivation makes you fat – AND leads to depression, pain, heart disease, diabetes, and much more. That’s why in today’s blog I want to talk about the impact sleep has on your health and give you 19 tips you can use to get a good night’s rest and enjoy all the health benefits sleep has to offer. Let’s start by talking about a rather serious sleep condition called sleep apnea. The Dangers of Sleep Apnea Sleep apnea is a condition where your sleep is interrupted all night because your airway closes and your body startles you awake so you don’t suffocate. This is a very common and extremely under-diagnosed problem. It affects 18 million Americans and most are NOT treated for it. Let me tell you about one of my patients who was in that same predicament. He was so tired that he had to stand up at his computer to work during the day so he wouldn’t fall asleep! His wife reported hearing his horrible snoring and gasping episodes at night. He would fall right asleep as soon as he sat down to watch TV at night. Most frightening, he had fallen asleep at the wheel when driving. Then he came to see me. When we got his sleep apnea diagnosed (with a sleep study in a sleep lab) and got him treated with a device to keep his airway open at night, he lost 50 pounds, his blood pressure turned to normal – and he got his life back. But people with sleep apnea are not the only ones in trouble. It is estimated that 70 percent of Americans are sleep deprived. The era of Starbucks has been surpassed by an era of prescription stimulants to keep people awake and functioning, like dexadrine and Ritalin – otherwise known as “speed” or amphetamines. Surprisingly, I see an increasing number of patients prescribed these “uppers” by their psychiatrist because coffee is not enough to keep them energetic. It seems we believe that if you can’t do ten things at once, something must be wrong with you. But this is preposterous. Your biological rhythms keep you healthy and produce cyclic pulses of healing and repair hormones, including melatonin and growth hormone. When those rhythms are disturbed by inadequate or insufficient sleep, disease and breakdown get the upper hand. It is estimated that 70 percent of Americans are sleep deprived. We evolved along with the rhythms of day and night. They signal a whole cascade of hormonal and neurochemical reactions that keep us healthy by repairing our DNA, building tissues and muscle, and regulating weight and mood chemicals. The advent of the light bulb changed all that. When you are sleep deprived, your cortisol rises – and so do all its harmful effects, including brain damage and dementia, weight gain, diabetes, heart attacks, high blood pressure, depression, osteoporosis, depressed immunity, and more. The reality is that most of us need at least eight hours of restful sleep a night. But meeting this goal has become more and more difficult. Partially because good sleep is not something that just happens (unless you are a baby or teenager). There are clearly defined things that interfere with or support healthy sleep. Here is what you need to do: 19 Tips to Improve Sleep First, you have to prioritize sleep! I used to think that “MD” stood for “medical deity” and meant I didn’t have to follow the same sleep rules as every other human being. I stayed up late working long shifts in the emergency room, ignoring the demands of my body to rest. It wasn’t until I learned that shift work (like I did in when I worked in the emergency room) leads to a shortened life expectancy that I quit. Unfortunately, our lives are infiltrated with stimuli – and we keep stimulated until the moment we get into bed. This is not the way to get restful sleep. Frankly, it’s no wonder we can’t sleep well when we eat late dinners, answer emails, surf the Internet, or do work, and then get right into bed and watch the evening news about all the disaster, pain, and suffering in the world. Instead we must take a little “holiday” in the two hours before bed. Creating a sleep ritual – a special set of little things you do before bed to help ready your system physically and psychologically for sleep – can guide your body into a deep, healing sleep. We all live with a little bit of post-traumatic stress syndrome (or, I should say, traumatic stress syndrome, because for many of us there is nothing “post” about it). Much research has been done on the effects of stress and traumatic experiences and images on sleep. If you follow my guidelines for restoring normal sleep below, your post-traumatic stress may become a thing of the past. Here’s how restore your natural sleep rhythm. It may take weeks or months, but using these tools in a coordinated way will eventually reset your biological rhythms:
Sleep Testing: What You Need to Know There are many medical sleep disorders, the most common (and most under-diagnosed) is sleep apnea. If you experience excessive daytime sleepiness, fatigue, snoring, and have been seen to stop breathing in the middle of the night by your spouse or partner, then you could be one of the many people with undiagnosed sleep apnea. People with sleep apnea have a higher risk of high blood pressure, heart disease, and sudden death, so diagnosing and treating it is imperative. High blood pressure is a clue, because half of all people with high blood pressure have undiagnosed sleep apnea. Get an overnight sleep study done in a sleep lab. It may the best thing you ever do for yourself. It might just save your life! And remember – don’t skimp on sleep! It is one of the most powerful healing treatments available if you want to achieve lifelong vibrant health. For more on sleep, I recommend The Promise of Sleep by William C. Dement MD, PhD (Random House, 1999). To your good health, Mark Hyman, MD www.drhyman.com Dr. Vannaman is a Board Certified Family Medicine Doctor in Kansas City who believes that trusting relationships and quality conversations are essential to providing outstanding primary care to one and all. Sign up today!  Hippocrates was on to the root of something (no pun intended) when he made his famous quote, "Let food be thy medicine and medicine be thy food." Another well-known author and food-writer, Michael Pollan made an equally poignant statement in the opening of his book, In Defense of Food: an eater's manifesto, when he declares "the secret" revealed in all his years of research and writing about food and health.
Eat food. Not too much. Mostly plants. His book then goes on to describe the transition of Americans going from thinking about food in the way of, well, FOOD to thinking about food in the way of "nutrients". He describes how in order to avoid angering the meat and dairy industries by suggesting people cut back on those foods, governmental agencies instead advised Americans to "decrease their intake of saturated fats". Gradually over time, we became increasingly obsessed with the labels on the boxes with their nice tables of nutritional information. Calories, fat grams, carbohydrates, fiber, vitamins, etc were all there to be counted and compared. Personally, I know many people who shy away from eating fresh fruits and vegetables because there isn't a label describing their exact nutritional data. Unfortunately, in our attempts to eat healthier, we exchange common sense for the current professional advice of the time. In John Harvey Kellogg's day, protein was the enemy, which led to his zeal for vegetarianism and regular enemas at his Battle Creek Sanitarium (side note: if you are one for satire, check out the 1994 movie "The Road to Wellville"). More recently fats have been the enemy, particularly in regards to cardiovascular disease, however these assumptions have been repeatedly challenged and now, "the lipid hypothesis is quietly melting away...(as we) come to the unavoidable conclusion that the emperors of nutrition have no clothes and we'll never listen to them again." writes Michael Pollan (In Defense of Food, chapter 5). Meanwhile, Dr. Atkins and others proclaim that carbohydrates are the true enemy and many people (celiac or not) are delving into the gluten-free mantra. I agree that many people feel better on a gluten-free diet, but I am skeptical whether this is because they are avoiding gluten per se, or all the other low-quality carbohydrates found in processed foods. By now, if you're like me, you've made yourself dizzy in trying to follow all these rules. So, what now? Again, I think Michael Pollan sums it up nicely: Michael Pollan's 7 Rules for Eating:
#6 is my favorite...and the topic of another blog... To your health! Dr. V Dr. Vannaman is a Board Certified Family Medicine Doctor in Kansas City who believes that trusting relationships and quality conversations are essential to providing outstanding primary care to one and all. Sign up today!  As summer turns to fall, the nights get cooler, the leaves start to change, we start getting out our cozy sweaters and...BAM! cold and flu season starts ramping up. What can start out as a mildly irritating illness can turn down right miserable. So, how do you know if this is something that needs a doctor's visit vs a little TLC? Rest, fluids and over the counter medication for symptom relief vs a prescription or antibiotic? Read on for some clarification on some common misconceptions and TIPS on how to stay well.
Green snot means you need an antibiotic. FALSE Any time you have increased mucous production, especially if it sits around in your sinuses for awhile, it will turn from its usual clear to yellow or green. This does not indicate a bacteria is necessarily the cause. I feel miserable. I must have the flu. Maybe... "The flu" is a specific infection caused by the influenza virus (typically A or B). The flu changes some each year, sometimes a little, sometimes a lot, which is why a flu vaccine is recommended each year. If you have a cough and a runny nose, it's probably one of the many viruses that causes the common cold. If you have the above, PLUS, fever, muscle aches and feel like you've been hit by a bus...then you probably have the flu. The "stomach flu" is a thing. FALSE I grew up calling any vomiting or diarrhea illness "the stomach flu" too, but this is a tragic misnomer. If you have vomiting and diarrhea, you probably have some sort of food poisoning (bacterial cause) or viral gastroenteritis, but it's not any type of "flu". Antibiotics can help any serious infection. FALSE So, this one has a 2-part answer... 1. Antibiotics only kill bacteria, so anything caused by a virus will NOT be helped by an antibiotic. It may cause a rash or give you a yeast infection, but it won't cure your virus. 2. When antibiotics are used inappropriately (such as for a virus), we worsen antibiotic-resistant epidemic, which as it sounds, is BAD news. This creates "super bugs" that are harder to treat and often lands people in the hospital to get expensive, IV antibiotics to kill off these bacteria that were once susceptible to simple, inexpensive antibiotics. When my cold goes to my chest, I always need an antibiotic. FALSE Bronchitis can be very serious, causing chest tightness, productive cough and shortness of breath which may require prescription medication such as an inhaler or cough suppressant. There is a very common misconception that bronchitis, or a "chest cold", requires an antibiotic, however, the vast majority of the time, bronchitis is a viral infection caused by the same viruses that cause the common cold. A good history and careful physical exam can help determine if the bronchitis is caused by a virus or bacteria, but sometimes an X-ray or blood test is needed as well. If you are at high risk for infection (diabetic, immune deficiency, COPD or chronic bronchitis sufferers), an antibiotic may be given since they often don't present with typical symptoms and the risk of serious complication in this group is much higher. Viral infections are not as serious as bacterial infections. FALSE Viral infections, including those that cause the common cold and influenza (the flu) can make you super miserable with high fevers and muscle cramps that will make you want to curl up in bed and beg for spring to arrive. Even some types of meningitis (a scary infection of the spinal fluid surrounding your brain) are viral and can present very similarly to bacterial infections. Usually, a good history, physical exam and possibly blood tests can help distinguish between a viral and bacterial infection. If your illness is determined to be viral, this just means that an antibiotic won't do any good, NOT that your symptoms aren't serious. Instead, we need to focus on treating the symptoms, supporting your body's own immune system (which may require a hospital stay if severe) and waiting for your body to fight off the virus. If I don't need an antibiotic, there is nothing that will help me feel better. FALSE! There are lots of things that can help ease the symptoms that come along with the cold or flu. Ibuprofen or Tylenol can help ease muscle aches, sore throats, headache and fever. Saline nasal spray/rinse can help keep sinuses clear and that mucous moving along so it doesn't settle in and cause sinus infections (mostly adults) or ear infections (mostly kids). Humidifiers can help with congestion and nighttime cough. Vicks vapor rub on the chest, neck or feet can help with congestion and cough. Lemon and honey "tea" can soothe a sore throat. You'll also find tons of over-the-counter medication promising to help with symptoms, but read the labels carefully, avoid over-dosing on medication when taking more than one combo medicine and avoid these entirely in kiddos under age 4 - they don't tend to work and have caused serious side effects in children. When in doubt, ask your doctor or pharmacist. The cough from bronchitis only lasts a few days. FALSE I really hate to say it, but the average cough for VIRAL bronchitis lasts up to 3 or 4 WEEKS! Boo. This is important to realize as most people assume that a cough that lasts this long MUST require an antibiotic. But as we've discussed above, unless you are having other worsening symptoms, you just have to keep on with the chicken noodle soup and ride it out. I don't need a flu shot because I've never gotten the flu. FALSE You've probably never been hit by a bus, but I'll bet you still look both ways before crossing the street. In fact, we feel so strongly that the flu vaccine is important that we offer the flu vaccine FREE for all members over 6 months of age of our clinic. I'll let the CDC answer the rest of the most common flu shot questions. TIPS ON HOW TO SURVIVE COLD AND FLU SEASON These may sound familiar to what your grandma used to say... 1. Get plenty of rest 2. Drink plenty of fluids - we're talking water, green tea, etc. 3. Wash your hands frequently 4. Cough/sneeze into your elbow - and teach your kiddos to do the same 5. Get plenty of vitamin C - think strawberries, orange juice, bell peppers or a supplement 6. Get your flu shot early - it takes 2 weeks for your immune system to ramp up 7. Relax, find time for yourself and de-stress - stress causes increased cortisol levels which weakens your immune system. We offer weekly meditation classes at clinic, check out our newsletter or call for details. What other questions do YOU have about the cold and flu season? What's your best go-to treatment? Personally, I'm a big fan of chicken noodle soup, foot rubs and Vicks Vapor Rub smeared under my nose. Feel free to share your questions or comments below. Wishing you a happy and healthy fall! Dr. V Kylie Vannaman MD is a Board Certified Family Medicine Doctor in Kansas City who believes that trusting relationships and quality conversations are essential to providing outstanding primary care to one and all. Sign up today! |
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