Soulful Sundays: Once a week I will have an installment that speaks to my spirituality, because, as I’ve said, to me, spiritual wellness, is essential to complete wellness. Because I am Christian, my spirituality is heavily based on my relationship with the Trinity and the Christian Bible. If reading about God, Jesus, or the Spirit will offend your sensibilities, these posts aren’t for you–be advised
13 I do set my bow in the cloud, and it shall be for a token of a covenant between me and the earth.
Gen 9:13 KJV
I was riding in the car, thinking about a particularly difficult situation. In fact, many would call it impossible, or hopeless. I had my eyes closed, and I was talking to God, asking Him to make this situation better, and to strengthen me and prepare me if He decided not to, and I opened my eyes and saw the picture I’ve loaded to today’s blog…a rainbow. Not taking up the sky—not overwhelming. If I wasn’t looking, I would have missed it. If I had kept my eyes closed longer, I would have missed it. At first, the parallel to the scripture lost on me, I tried to snap a picture, thinking that my oldest would really want to see this partial rainbow. And then, the significance of what I was seeing hit me. The symbol of a covenant. A promise. What the rainbow can represent to those who believe. God’s first promise, and His every promise. For me in that moment, that tiny rainbow, in that great big sky–that almost invisible hope, in all that impossibility—it gave me so much peace.
You see guys, I didn’t get to write last week. There’s a reason. A great one. I took a trip to see a physical therapist who has changed the course of my headaches. I’m about 70% better. I may have to take my abortive therapy tomorrow, because I’ve simply overdone it the past few days, but where I’d been taking this medication every day to every other day, I have gone 11 days without taking it. For the first time in over 6 months, I went 11 days migraine free. I am so amazingly and abundantly grateful to God! It’s amazing!
And that’s just the beginning of what He’s been doing for me
in the past 3-4 months. He is simply AWESOME. AMAZING. So I’m sitting in the
car, talking to Him about this situation, and there is this tiny symbol of his
covenant with Noah, in the great big sky, and if I had waited just 2-3 more
seconds, I’d have missed it, and I’m so moved, because I’m almost certain He’s
just told me to be quiet and trust Him more. To hush, and stop thinking so
hard, and do what He says, and that even if He’s got to destroy some things I
think I need, He’s got me. Peace, be still.
But Jesus looked at them and said, “With man this is impossible, but with God all things are possible.”
Soulful Sundays: Once a week I will have an installment that speaks to my spirituality, because, as I’ve said, to me, spiritual wellness, is essential to complete wellness. Because I am Christian, my spirituality is heavily based on my relationship with the Trinity and the Christian Bible. If reading about God, Jesus, or the Spirit will offend your sensibilities, these posts aren’t for you–be advised.
Do not judge, or you too will be judged. 2For in the same way you judge others, you will be judged, and with the measure you use, it will be measured to you. 3“Why do you look at the speck of sawdust in your brother’s eye and pay no attention to the plank in your own eye? 4How can you say to your brother, ‘Let me take the speck out of your eye,’ when all the time there is a plank in your own eye? 5You hypocrite, first take the plank out of your own eye, and then you will see clearly to remove the speck from your brother’s eye.
Matt 7:1-5 NIV
This verse is resonating
with me this week. So often we see what others need to change, how others have
wronged us, how others should grow. I have praised God in these migraines—one thing
He has shown me is who is in my corner, and who is not. He has helped me walk
away from situations that were not for me. He has helped me grow in ways I didn’t
know possible. I praise Him in that. However, in all that, I am constantly
praying that I am not guilty of the above—that I do not find myself flawed in
someway that I am blind to due to a plank in my eye.
It’s very much like how
at the beginning of all this, I sat and told my patients to take care of
themselves, take time for self-care, while literally running myself into the
ground and ignoring my own advice. In fact, my taking the time off work, at my physician’s
and admin’s advice, was because I wanted to be able to look my patients in the
eye, and know that I had done the very thing I encouraged them to do, day in
and day out. And today, it’s with a different conviction, but zero judgment,
that I encourage my patients to self-care when necessary.
So this week, I am
challenging us all, me first, make sure you are appropriately reflecting on
yourself. Make sure you are leading growth by example. Make sure you are being
the Christ you want to see in others before you ask it of them. Let’s not be so
arrogant that we think we have it all figured out—that’s the beginning of the
end.
Houston
fall and spring is some of my favorite weather. Last week, we had one of those
perfect days where it was 70 degrees and almost no humidity. So after arguing
my older son outside, we finally spent some time as a family, riding very
underused bikes, enjoying the perfect weather, and each other.
The little one was on the red tricycle my best friend bought for my older one when almost 5 years ago (I really need to Marie Kondo my life, but it worked out this time), and he took great joy in calling attention to the difference between his red and his brother’s orange.
I love this view!!!
It
was one of those afternoons you hope will live on forever. In fact, after
arguing about how he didn’t want to go outside, the older one didn’t want to
come back inside…so I didn’t make him. I let him ride to his heart’s
content…because how many days do we get like this in Houston?
Then we did something we don’t normally do. We came inside, and watched Planet Earth II on Netflix and ate microwaved popcorn from a great big bowl. It was a wonderful day.
Sooooo many calories!! At least we had already burned some off outside.
More
importantly, I took the time to enjoy my family. To slow down and savor the
moments with them. To soak them in. In this fast-paced world, we’ve got to do
that more often.
The
most important therapy right now is symptomatic. I am not a fan of combined
formulations, because I prefer to target my specific symptom set, and I
generally will just deal with the achiness and omit the Tylenol/acetaminophen
or Advil/Motrin/ibuprofen that’s typically always a part of the combo meds.
Also, the antihistamine in combination medications are typically short acting,
and wear off in the middle of the night, resulting in waking halfway through
the night feeling miserably, or having to dose every 4 hours. It’s just a lot.
I prefer things that can be dosed once or twice a day. However, you can also
use this as a way to make sure your combo med is treating all your symptoms.
Pseudophedrine/Sudafed
(decongestant, but dries—shouldn’t be used if you have high blood pressure)
For post nasal drip and congestion:
Fluticasone/Flonase
Nasonex/mometasone
Pseudophedrine/Sudafed
(decongestant, but dries—shouldn’t be used if you have high blood pressure)
Saline
irrigation with something like Nettipot, Arm & Hammer Simply Saline or a
store brand irrigation
Chest congestion:
Mucinex/guaifenasin
(Will
not help dry up, but will help it come up, which is very important! You do not
want that mucus blocking the airways and growing bacteria)
Vick’s
VapoRub
Cough:
Generally,
during the acute phase of illness, cough is protective. You want to cough mucus
up, and I don’t like to suppress cough until I know the cough is residual. The
goal is to decrease the mucus and decrease the need for the body to cough.
Also, Vick’s VapoRub, cough drops, and lots of warm fluids.
Muscle aches/ Headache:
Ibuprofen/Advil/Motrin
Tylenol/acetaminophen
Sore throat:
Ibuprofen/Advil/Motrin
Tylenol/acetaminophen
Salt
Water Gargles
Lozenges
Other Notes
Vitamin C, Zinc, and Elderberry may all have roles in shortening viral illness. I recommend my patients add them to their regimen if they have no metabolic (liver, bone, or kidney) issues.
REST
is so important in healing. Try to get as much rest as possible to prevent
developing a secondary bacterial infection. When I give the above instructions
it’s my goal to prevent the need for an antibiotic prescription.
The overwhelming majority of calls I get, wanting to be seen for waking up “sick,” or “coming down with something” are some variation of a normal viral illness This is the typical time frame:
Day 1-2: feeling a little off. You may be more tired than normal. Maybe your throat is more scratchy, nose is more itchy, but it’s really easy to miss if you’re busy, or there is some other explanation.
Day 3: I’m normally called on this day. Today you feel pretty bad and you have known you haven’t felt like yourself for a couple of days. You are starting to really have the common symptoms, may be feeling a little achy, but less so than the flu, and you have some more intense fatigue today. Now is when you definitely have some sort of runny nose or congestion or sore throat or cough–something to let you know you’re sick.
Day 4: Today is definitely worse. Honestly, no matter what I do on day 3, it’s going to be worse. You feel like crap. There’s mucus everywhere. Sorry.
Day 5: If we do everything right, this is the day the systemic symptoms should start to improve (meaning if you ran a fever, it should stop, you should have fewer body aches, be a little less tired, etc), but if it’s going to move into your chest, it will start to do so today if it hasn’t already.
Day 6 and beyond: you will be coughing but you should be improving overall. If you get worse systemically at this point, it’s time to call your doctor. You likely need an antibiotic. However, remember, the cough can hang around for a while and be QUITE annoying.
Prevention:
How
do we prevent the common cold? Wash your hands. Wipe down your surfaces. Eat a
healthy diet. Get plenty of rest. Pay attention to your body. What I have found
is that if I can catch myself in day 1 or 2 when I’m just feeling more run
down, I can keep myself from really hitting the sick of day 3 if I 1. Rest, 2.
High dose C, 3. Zinc lozenges, 4. Elderberry Syrup. I can’t find any evidence
to say that this works for everyone. It works for me.
Treatment:
You missed
your window of prevention and you’re in day 3? Ride it out. There is no
medicine that’s going to kill a virus. That being said, vitamin c, zinc, and
elderberry are very promising for shortening the duration of a viral illness,
again assuming no kidney, liver, or metabolism issues (so make sure you check
with your personal doctor before use). I also tend strongly advocate for
treating your symptoms, because untreated mucus symptoms are the biggest cause
of bacterial infections in my completely subjective opinion. I like to be able
to prevent the need for antibiotics, so I give my patients the run-down on what
to use to dry it up and keep what’s in there rinsed out or flowing out. See the
post here. Mainly with a virus, you gotta just suck it up, and ride it out. Get
some REST!! As a society, we highly undervalue it, and it’s so important to our
recovery. And remember, the annoying cough can last for up to 1 month, but it
shouldn’t be associated with fever, chills, night sweats, or shortness of
breath. And generally, your docs may have a prescription up their sleeves for
this annoying cough if you ask.
Secondary
Bacterial Infections
Understand
that it will normally take 10-14 days for a bacterial infection to develop
after a common cold if it’s going to happen. ENT studies have shown it takes at
least 14 days for bacterial sinus infections to develop, so even if you’re have
classic sinus infection symptoms, it’s likely from a non-bacterial cause if
it’s prior to 14 days. It just takes that long for enough bacteria to grow to
be causing an infection. Before this, you likely don’t need antibiotics unless
you have some kind of special risk factor.
At this point, I normally want to see my patients. I want to make sure you aren’t more sick than you think, and I want to localize the infection to make sure I pick the best antibiotic for your infection. All antibiotics are not created equal, so please don’t use the last antibiotics you had for the infection you might have right now unless you’ve received the okay from your physician.
With both of these, you generally are much sicker than with the common cold. You may be running fevers, but you definitely feel like you should be in bed, and generally, aren’t going to be able to ignore your body for long. They are typically accompanied with severe body aches and headache. If you think you have one of the above, it’s normally best to contact your doctor.
Influenza
In most cases, influenza is fast and severe (although if you’re vaccinated, it can really change the way it presents if you still catch it). You think you may be getting sick, and by the end of the day, you think you’re maybe dying…lol. There are typically body aches, runny nose or post nasal drip, sinus congestion, cough, and chest congestion. There’s also frequently gastrointestinal symptoms like nausea, vomiting or diarrhea. Fever is typical, but the absence of fever doesn’t mean you don’t have the flu.
Normally,
you get sick within 2-3 days of exposure to flu.
For the best way to prevent the flu, and for loads more information, see this blog post.
Treatment:
For certain populations, not all, antiviral medications are recommended. These
medications are recommended within a certain timeframe (usually within 48-72
hours of symptom onset) so contact your doctor as soon as possible if you’re
suspecting flu.
In
my research on my favorite advice for common cold therapies, I found out that
elderberry may just have activity against influenza. If you have a healthy
liver and kidneys, it may be worth adding to your treatment regimen if you’re
recovering from flu.
Strep
Strep throat can accompany other infections, but generally, pure strep throat is not associated with the other symptoms of an upper respiratory illness. Fever, sore throat, headache are the mainstays of this illness. Having cervical lymphadenopathy (swollen glands in the neck) makes it more likely, but this can happen with the other illnesses as well.
Generally,
you feel as bad with strep as you do with the flu…one of the main times that
i figured out I had the flu was when I said to myself “I haven’t felt this bad
since I had strep.” So yeah, you feel horribly.
However, it’s not common in adults. Typically you will have been exposed to younger children in order to be at risk. You will need to be swabbed, but also, make sure that whoever is swabbing looks at your throat. I will normally treat if the throat looks like classic strep, (it does have a very classic appearance) or if there is known exposure and the symptoms are super classic, since the rapid test is not 100% accurate.
Treatment is generally with amoxicillin of some sort. If you’re allergic, a cephalosporin, clindamycin or azithromycin will do.
Soulful Sundays: Once a week I will have an installment that speaks to my spirituality, because, as I’ve said, to me, spiritual wellness, is essential to complete wellness. Because I am Christian, my spirituality is heavily based on my relationship with the Trinity and the Christian Bible. If reading about God, Jesus, or the Spirit will offend your sensibilities, these posts aren’t for you–be advised
“Or know ye not that your body is a temple of the Holy Spirit which is in you, which ye have from God? And ye are not your own; for ye were bought with a price: glorify God therefore in your body.”
1 Corinthians 6: 19-20 KJV
I just got home today from a conference surrounded by my
colleagues in internal medicine, learning about updates in the field, wellness,
resiliency, and networking. And so, of course, this, one of my favorite
passages, resonates with me today. Because I find that we often forget…I often
forget…that my body, this thing that I sometimes neglect in the name of serving
others, houses the Spirit.
So let’s talk about that. Let’s talk about what that means.
When the Israelites were privileged to have God in their
presence, they were instructed to build a tabernacle. It was holy, and sacred.
They had specific instructions for its care, and for who could enter, and how
they could enter.
Through the perfect sacrifice of Jesus, Christians are privileged
to have access to this relationship 24/7, in our own bodies. It means our
bodies are sacred places. It means our wellness is a sacred thing—after all, we
only get one physical temple. Yes, it will age. It will become ill. It will
meet hardships. But we are also given the responsibility to treat it with the
respect and honor of the temple that houses the Spirit.
Growing up, I always heard this read to teach against tattoos,
sexual immorality, etc. But as a physician and someone who is learning more and
more what it truly means to live well, I truly feel we’ve done this verse a
disservice, and that treating our bodies with respect is so much deeper than this.
Eat well. Stop putting so much fast food, processed food,
sugar and excess into our bodies that we constantly feel sluggish.
Exercise. Renew energy and build strength through movement.
Rest. Stop burning the candle at both ends and sit down long
enough to hear God’s voice and direction in our lives.
Draw boundaries. Learn to say no to the things that aren’t
serving His purpose in our lives or allowing us time to ensure we are caring
for ourselves.
Give the Spirit a home that is strong, resilient, and ready
to serve.
I know I’m still learning. I’m a work in progress. But it’s
so important to remember that caring for this body is important as we are
stewards of all we’ve been given, and health is such an important blessing! Let’s
not take it for granted.
One of my fave shots of me and bestie1 getting it in.
But
I’ve been exercising every day for the past X months, and I still haven’t lost
weight…
I
can’t tell you how many times I’ve heard that line in my office.
Or
the response to the question “What are you doing for exercise?” that for some
reason is immediately answered with their weight loss efforts, or how they know
they should lose weight.
PEOPLE!! Exercise has lots of benefits—some of them have to do with weight, BUT
that’s not all of it.
First,
let’s talk about what exercise does for weight. Weight loss is 80% diet, 20% exercise.
So, you can expect a small amount of weight loss from exercise if you have been
completely sedentary, but don’t expect a great deal. What you can expect is
weight stabilization. What we find in patients who have been successful in
weight loss and kept that weight off for a substantial amount of time (years)
is that they are exercising regularly. In addition, I tell my patients, the exercise
is COSMETIC. It’s what’s going to help your body look like you want it to look,
regardless of whether the scale changes. But for me, these are all extremely
superficial to why I am asking people to exercise. Below are just some of the
many reasons I like to encourage my patients to GET MOVING!!
In fact, this infographic highlights many of the benefits, from improving bone health to improving sexual health, including some of the things mentioned above.
My active and youthful octogenarians swear by exercise, and swear it helps keep them youthful, active, and they have less achyness when they are exercising regularly.
I
encourage exercise at every age. I prescribe it first for almost every chronic ailment.
You will hear me mention it often. And it doesn’t have to be much depending on
what benefit you are going for.
I actually recently read this article that cited a study that showed that only 7 minutes of jogging daily can cut your risk of heart attack and stroke nearly in half, and adds to your life. I’m huge on circuit training and HIIT training to maximize your time when it comes to burning fat and building muscle—and these workout generally can provide major results in minimal time. But honestly, I encourage people to move in ways they enjoy, swimming, dancing, biking—whatever makes you happy, and is something you will sustain, is something you should do. If you hate walking on a treadmill—don’t buy one. Stop using the heat of the Houston summer as the reason you don’t work out—it’s hot EVERY SUMMER! Come up with a work around.
MOVE!
Not to lose weight either. Just because it’s good for you.
Soulful Sundays: Once a week I will have an installment that speaks to my spirituality, because, as I’ve said, to me, spiritual wellness, is essential to complete wellness. Because I am Christian, my spirituality is heavily based on my relationship with the Trinity and the Christian Bible. If reading about God, Jesus, or the Spirit will offend your sensibilities, these posts aren’t for you–be advised
“for by grace have you been saved through faith; and that not of yourselves, it is the gift of God; not of works, that no man should glory”
Ephesians 2:8-9
So I have a confession. I’ve made it before somewhere on
this site. I’m a recovering perfectionist. And much like a recovering alcoholic,
I must admit, I realize this will always be a problem I will struggle against.
I realized a long time ago that we all have our struggles.
For some, it’s lying, some stealing, some pride…you get it. My struggles: trust
and perfectionism. They will lifelong be the things I struggle against, and I’m
pretty sure they go hand in hand.
When I had to leave my job in July for the first four weeks
due to the severity of my migraines, I sat in front of my administrator and
told her, I simply wanted to make sure to learn whatever I was supposed to
learn from this. And I began to study. And that study immediately took headfirst
into major work on my perfectionism and doing away with it.
The Bible’s call to be perfect is speaking about a
completeness that can only come through God, and recognition of his
sufficiency. It does not come through striving to be everything to everyone,
never making a mistake, never sweating, never asking for help.
I feel like this is going to be such a journey—In fact, I’m
sitting here, knowing that there is way too much to type on this topic, knowing
that I’m too tired, but wanting to finish because it’s Sunday, and I’m supposed
to post something—I made a rule! I’m laughing at myself. So actually, I’m going
to close on this here. I’m going to stop. Because I can’t really do this topic
justice at this time of night, with this level of exhaustion. What’s funny, is I
have known since about 10am what this post should be about today. Funny how the
Lord works. Funny how he needs you to hear your own words sometimes.
So we’ll end on this: I felt I was reading my soul when I
read these words in one of the books I decided to read. “I’m done trying to be
everything to everyone, trying to prove a point to the world. I will not chase
this impossible standard. I’ll hold myself to a standard of grace, not
perfection.” The book is Grace, Not
Perfection by Emily Ley, and I truly found some good points in it. The
first few chapters, and this quote, definitely needed revisiting as I enter my fourth
week of work, and I feel the familiar tingle of the super woman syndrome calling
to me.
I read the article in The New York Times Parenting column and thought it was quite interesting. The Giving Tree was one of my son’s favorite books because he was particularly fond of trees. But I hated this book. And I felt he was too young for me to fully articulate why. The most I said was, “the boy isn’t a very good friend to the tree, and it makes me sad.” He was 4 or 5 at the time.
We don’t read it very often anymore for that reason, but now, I don’t think I’ll mind. This article, entitled “We Need to Talk About ‘The Giving Tree'” has given me some very good discussion points, and quite honestly, they’re good for young and old alike, and it inspired a train of thought PERFECT for my first post on wellness.
In
The Giving Tree, a little boy befriends a tree. The tree loves the little boy
and gives him whatever he asks, just for the boy to leave for long periods,
grow, and return downtrodden, looking for his “friend” to give him something to
fix his next problem.
The
tree had no healthy boundaries, and gave him whatever he asked, only to be left
at the end, with nothing, but a stump to show for this “friendship.”
I saw a parallel in life, right in my office. I have people in front of me all the time, not following their health care regimen, not finding time to eat right, exercise, check their blood sugar or blood pressure because they are taking care of a family member, over too many church ministries, bogged down at work…you name it, I’ve heard it.
My
“patient non-adherence” problem is generally filled with a story about how this
person has put themselves on the back burner for so many others. NO.
BOUNDARIES. It’s what the giving tree did. And she gave until she was only a
stump, with nothing left to give, and the boy had everything.
Many times we talk about self-care, we think, spa day, massage, etc. I read this piece a while back that shared my opinion that self-care is so much more and defined true self-care as building a life from which you don’t need escape. That requires excellent skill in setting boundaries.
Here are some wonderful quotes from the article that are great take-aways:
“Self-sacrifice is not sustainable, and it isn’t healthy either. Research shows that people who care about others and neglect themselves are more likely to become anxious and depressed.”
— Adam Grant and Allison Sweet Grant
“Generosity is not about sacrificing yourself for others — it’s about helping others without harming yourself. It’s not about giving to takers — it is giving in ways that nurture more givers. It’s not about dropping everything any time someone needs you — it is prioritizing your needs along with theirs.”
–Adam Grant and Allison Sweet Grant
I
thought I was very good at boundaries. And I was okay at it, but I’ve learned
that for people I really care about, I have a hard time sticking to my guns. I
really rely on their respect for me, and that’s a mistake—we must be comfortable
with requiring that respect regardless of whether it is offered.
And actually, let’s take it a step further. Not only did this tree give everything, but it asked for nothing. This is where I have the MOST room for growth: asking for, and receiving, help from others. It’s essential to wellness. Not only does it allow others to express love for you, it allows your tank to be filled in ways you truly need but can’t provide yourself. It is also a practice in humility. It strengthens relationships, because, when we’re honest, there’s a bit of power that comes from always being the helper, never the helped. The closeness that comes from the vulnerability of you allowing someone to help you can really strengthen the bond of friendship (I think I learned this from Brene Brown).
But it’s not just me. These same patients, horrible at boundaries, tend to be givers who need to be convinced to accept help from others. Who either have a hard time humbling themselves enough to receive, a hard time realizing their worthy of the very same help they are wasting away giving others—or some combination of the two.
So,
in my inaugural wellness blog post, I choose not to necessarily focus on
exercise, or healthy eating, or meditation. But to focus on boundaries and vulnerability.
Because the balance between these two things are essential to formulating the
inner peace that is required to live well, and I always say, true health starts
with mental and spiritual health.
P.S. For more information on these topics, I highly recommend Brene Brown, who is the vulnerability guru. See links to her books on amazon below (I am making NO MONEY FROM THIS—I JUST LOVE HER STUFF):
