Uplifts and Downdrafts

I have worked in the person-centered field of mental health care.  Due to this experience and my own personal life, I have often found taking care of ourselves falls by the side of the road.  Life is so very demanding - and when we care for others it can seem almost selfish to take care of ourselves... to say - No, this is time I must have for myself.

However, there is truth in the statement "you cannot take care of others until and unless you first take care of yourself".  If you have nothing left, then you have nothing left to give.

There is also truth in the statements I often hear, "I have to work to pay bills.  Just how am I supposed to 'take time' to take care of me?" or "Taking care of Jane Doe/John Doe is 24/7 - there is just no time left".

How then, do we reconcile these statements?

I suggest we change the playing field.  This is how:  Stop trying to find big blocks of time.  Instead look for and rejoice in the small minutes that you can use to replenish yourself.

Allow me to provide a few examples:

I may not be able to change the fact that I must work.  I cannot change that I have often worked a 50 hour work-week in order to accomplish all necessary tasks.

• But I CAN make the environment pleasant through full-spectrum lighting, arranging my office to my personal comfort, and ergonomics with my desk, computer and chair.
• I CAN set playlists to which I listen as I work through the day.  
• I DID order glasses with blue-coat on them to reduce glare from computer screens (I spend a lot of time looking at computers as I read through documents about services provided).  
• I CAN make sure that at least twice per week, I am home early enough to cook dinner, eat leisurely, and spend time with my son.  
• I DO leave paperwork and concerns at the office.
• I TURN OFF my phone in the evening when I am ready to start settling down for bed (Do not disturb functions on smartphone are absolutely wonderful!).  
• I DO practice 1 or 3 or 5 minute moments of closing my eyes and simply breathing.
• I DO use desk and office stretches to keep my body from stiffening if I am sitting for a long period of time. 
• I TAKE BREAKS every 45 minutes to change what I am doing - perhaps I will move to file paperwork instead of spending 2 hours straight at the computer.  Perhaps I will contact clients or clinicians and use the phone time to pace a bit around the office.

For many, work may be one aspect of our lives.  For others, it may not be.  However, everyone has a home life of some sort.  We can each increase our wellness by ensuring we make things as pleasant and beneficial as possible.  How?  For me: 

Media

• I turn off the computer in the evenings.  It does not benefit me to stay up late chatting with friends or playing Farmville or other games.
• I turn of the TV (mine only has a DVD player attached to it - I do not have TV channels.)
• I got rid of TV channels.  I do not stream shows online, either.  I am much happier not spending hours of my life watching television shows.  I am less negative not watching the nightly news.
• I DO listen to NPR in the morning on the way to work - this makes my world a larger place.  I listen to NPR sometimes in the afternoons at home or on the way home.

Pets

• I play with Inky and Chai (our dogs).  There is something soothing in interacting with furbabies.  For me, having a dog settles me and gives me an anchor in this busy world.  Cuddles with a dog makes so many things less overwhelming.

Sleep

• I make sure I get enough sleep.  If I do not have 8 hours of sleep, I come to the end of myself before the end of the day.  This is not good for anyone.
• I meditate 15 minutes each morning and each evening. 
• Meditation does not have to be the "clear your mind and go "ohmmmm" type thing so many people think it must be.  
• For me, I spent 15 minutes noticing and naming all that I sense.  There is no judgement.  My mind never stops; but in allowing myself to be still and through channeling my mind to notice what I am experiencing, I can step outside of the rush and so can rest.  
• I have noticed over the last 18 months of doing this that my anxiety levels have decreased over 45% based on mood trackers.  
• I have also noticed I fall asleep faster and my sleep quality has increased dramatically.  I used to need 12 hours of sleep.  Now, I am rested and well with 8 hours (although I do sleep in on weekends and get 9-10 hours).
• I use my CPAP machine.  Sleep disorders result in chronic sleep deprivation.  This has multiple impacts on mood, physical health, ability to function, mental health, etc.  Simply put - if you have a sleep disorder you do not address you are shortening your life and reducing the quality of your life.  
• I sleep in the dark.  Lights can interfere with the production of melatonin.  

Organization

• I attend to household tasks each day so my home is a haven, a refuge, where I can rest and replenish.
• When I come home, I try to ensure that I put things into their place.  This reduces the amount of time it takes me to clean my house.
• I try to keep dishes done each day, which increases the hygiene of my home, reduces chances of having bugs, and makes living here pleasant.  
• There is something anxiety provoking to me to walk into a kitchen with dirty dishes in the morning.  
• Conversely there is something calming about being able to make breakfast and lunch in a kitchen that is both clean and organized.
• I plan ahead.  I do the majority of my cooking on the weekend.  That way, during the week, I can make quick and nutritious meals without much time or cleaning.

Introverts and Extroverts.

• I am an introvert.  There is often confusion about what an introvert is and is not.  Robbie Gongaware, one of the most impactful mentors in my life, explained introverts and extroverts like this:  An introvert is someone who builds up energy in solitude.  An extrovert is someone who builds energy in the companionship of others.  Neither introverts or extroverts should always be solitary or in company.  For each type of person, balance is essential.  However, for each type of person, what makes balance is different. 
• I have found that I am happiest when I have some dedicated solitude built into my day as well as some dedicated time to interact with others.  When I spend too much time in solitude, my world becomes a smaller place.  When I spend too much time with others, I have no energy and become very frazzled. 
• Once a month or so, I deliberately take an entire day to be alone.  This is the time I set my mind free and simply surf the flow of thoughts.  This is when I am most creative and when I generate the ideas I work on bringing into reality over the rest of the month.  I create new recipes and then have the pleasure over the month of trying them out.  I seek new experiences I might want to try.  And, I review the previous month to determine what I want to change over the next month.  I find this time invaluable and a great source of strength. 

Friends

• I have many friends.  A good proportion of these are online friends from various interest and support groups.  Some of the online friends are ones who became friends in "face-to-face life" and then have moved beyond visiting range.  
• I have local face-to-face friends.  I do not interact with these friends as often as I should based on society's standards... but that is part of the introvert balance I have spoken of above.  I touch base with them regularly.  And, I get together with people a couple times per month.
• I understand the difference between friend and acquaintance.  Often I have found that people get their feelings hurt when expectations of an acquaintance exceed the bounds of the acquaintanceship.  
• For caregivers, the tendency is to do "too much" for others.  When this tendency intrudes upon friendships, it creates imbalance and slowly destroys the friendship.  I have found it important to be willing to ask friends for assistance - EVEN WHEN I CAN DO IT MYSELF.  When I was trying to do everything, the unspoken message was that I was "more capable" than my friends.  Now, that I ensure I honor my friends' ability to be capable, I find I am much less stressed and my friendships are stronger.  It was never necessary that I do everything myself.  By doing so, I denied my friends the chance to provide caring and to demonstrate strength and ability.  I have learned to be less arrogant, which has reduced my stress.
• It is okay to say "no".  People who are caregivers often have a difficult time saying no.  After all, if someone asks then he or she must "need help".  This is not the case.  Sometimes people do need help.  Sometimes, the request is instead an offer to spend time with the person.  On occasion, the request is manipulation.  It is important to be able to parse the difference between these, to determine WHY the request is being made, and then to honestly evaluate if this is something you can do and that you are willing to do.  It is essential to not become the martyr who accedes to all requests and resents the time filling those requests take.

Uplifts and Downdrafts

• I have found it helpful to create lists of the short things I can do to renew myself ... as well as a list of things to limit as those items "drain my batteries".  For example, I love a cup of hot tea, looking at flowers, or cuddling my dogs.  These are some uplifts.  On the other hand, dealing with inaccurate bills, interacting with a few select people, or doing dishes are things I find unpleasant and prefer to avoid.  Therefore, when these tasks need doing (and dishes are a daily thing), I ensure to pack uplifts around the unpleasant to buffer out the stress of unpleasantness.  I change the environment to reduce impact of unpleasantness - an example would be listening to favored music while washing dishes.  Another would be steeping aromatic tea while doing dishes to have a cup of hot tea afterwards.
• A previous entry on this blog, April 23, 2103, Box of Joy, discusses how to create a system for uplifts using index cards.  If you are not used to taking time to experience uplifts, this may be something helpful to you.

Exercise

• For me, this is perhaps the most difficult part of wellness.  I have chronic illnesses which sometimes limit my ability to be very active.  However, when you realize that exercise is simply another word for movement, then the whole frame of thinking changes. 
• How many ways can you move your body?  Some days, I find myself doing stretches while soaking in a tub of hot water with Epsom salts.  Other days, I may be hiking.  There are days when I walk with my dogs out in the back yard.  And there are days I dance around my house while taking care of cleaning and dusting.  Instead of thinking "ugh, I have to get some exercise", try thinking "how am I going to move around a bit today...  What will be joyful?"
• If you have chronic structural or systemic issues (osteoarthritis, fibromyalgia, lupus, etc.), try for just a COUPLE MORE MINUTES of moving than the day before.  The biggest problem with "starting exercise" for people with these type of challenges is the doing-too-much-and-so-cause-too-much-pain-to-continue.  And, often it is because on the "good days" there is such need to "get things done" that overdoing becomes a cycle.  Insanity is doing the same thing and expecting different results.  So, maybe changing things up a bit would create a different result.  Pacing works!!

Vitamins and Nutrition

• If you have allergies or dietary restrictions it is very important to make sure you are getting adequate nutrients and vitamins.  For example, due to my allergy to corn, I do not eat any iodized salt (corn-based substance used to attach iodine to salt).  My hair started falling out.  I did some research and talked with others who are allergic to corn.  Figured maybe it was an iodine issue.  I purchased kelp supplements and started taking them.  My hair stopped falling out and is starting to grow back in.
• YOU KNOW YOUR BODY.  Please do not assume that someone with a degree or a license knows more about you than you do.  You are the expert on you.  Many diseases and disorders have YEARS of typical search for answers before diagnosis.  Some conditions are misunderstood or mislabeled due to multiple factors - including societal bias. Homosexuality was once consider a mental illness.  African Americans die of heart disease more often than Caucasians due to treatment disparity.  Socioeconomic status is often tied to outcome for medical and mental health treatment. 
• So, please, develop confidence in your ability to determine what is normal for your body and what is not... and be willing to persist until your providers listen, do your own research, talk with others - but with the awareness that what works for them may not work for you, take charge of your own health  and wellness.  The joke goes that the chicken is involved in breakfast, the pig is committed.  It is very true that no one is more committed in your health and wellness than you are.  Your providers are involved.  You are committed.
• Eat as well as you can.  I will not go into the arguments about GMO, organic, or other food issues.  Instead, I will simply suggest that the healthiest way to eat is to balance your meals between types of foods (dairy, meat, veggies, fruits, grains, other), pay attention to portions (you eat less if you use a smaller plate), get enough liquids (water is best), and reduce as much as possible the more processed foods.  My personal opinion is the closer it is to something grown (whole food - which means the less processed the item is) the healthier it is for you.
• Learn to cook.  Pretty much any item you cook is healthier than that same item bought in a package.  Often, it tastes better as well!
• Avoid, as much as possible, things (notice I did not call those items "foods") high in preservatives, trans fat, and sugar or sugar substitutes.
• Fad diets are fads because they do not have enough foundation in science, nutrition, or common sense to remain in use over time.  DIFFERENT DIETS (eating plans) WORK FOR DIFFERENT PEOPLE.  I do well when I eat a diet low in carbohydrates.  I feel sick when I eat too many carbohydrates.  However, the same eating plan that works for me, sends my sister into serial episodes of hypoglycemia.  So, if a diet does not "work" for you, modify it until it does or try a different eating plan.
• Dietitians - For some people, they can be invaluable.  For me, with the allergies I have and the extensive prevalence of corn derivatives in America, several dietitians provided advice which was dangerous to me.  "This item is safe for you."  Uhm, no, it was not.  So, as with all experts, please make sure that you blend the information provided with the truths your body experiences.  Consultation with experts, did however, provide me with new ideas to trial to new avenues of information to research.

Wellness has so many components more than what were discussed here.  Spirituality, purpose of life, continuing education, etc.  I hope that each person reading this explores the different aspects of wellness and then spends the time required to develop a plan of uplifts and wellness to keep his or her batteries filled.  :)

Wellness, reactions, and the whole-body thing.

Wellness, reactions, and the whole-body thing.

Been thinking about this since the other day’s discussion in a group to which I belong.  Thought I would try to make some sense of it all to myself and see what you all think.

Background:

I have anaphylactic reactions to airborne wheat and corn (and corn derivatives).  I have reactions spanning from not much to hives to swelling, migraines, numbness, cognitive problems, and so on to other types of exposures and to multiple other substances.  Therefore, I am grain-free and avoid lots of other substances/foods.  I am not the most sensitive of people, unless we are talking airborne, and then I might be considered sensitive.  To date, IF I avoid the other allergens as much as possible, I have been able to not have to compound my medications.  I can usually SMELL when something is going to be bad for me – not-safe-for-me items make it feel like I have spider webs drawing through my head (like walking through one in the forest).

Situation:

I can eat Raspberries.  I have local farmers who have u-pick farms and who are at the farmer’s market.  These are, at least were until Monday, were safe-for-me.   I was at a local grocery store which was having an AWESOME sale on raspberries.  I sniffed them and they “smelled good”.  So, I got a pack, and carefully separated the top berries from the ones touching the soaker pad (which is most always not-safe).  I ate FIVE berries.  This was about 2:00 PM.  (Note to new people – just because THIS item is safe from THIS source, does not mean that THIS item is safe from THAT source).

The first one did not taste as good as it should have.  The next one was a bit less luscious than the first.  By berry 5 my tongue was numb, my lips were starting to swell a little, my inner cheeks were swelling a bit.  Please note, my throat WAS NOT swelling.  Also, my fingers where I had touched the berries were bright red and tingly.  Reaction started about 2:05 PM.

I immediately took quercetin and benedryl at doses approved for me by my allergist.  I dropped 1 epipen into my pocket and put the other on the table.  I notified my son, who is 18 and was getting ready to head out, that I needed him to stay in-house as I was reacting.  Were he not available, I would have notified one of my neighbors.  If no one was available, I would have headed to ER by ambulance as I did not know how far this reaction would go.

I continued to monitor the situation, reporting at 15 minute intervals to my son, who had also notified my parents and who then reported to them as needed.  The swelling remained minor.  My inside mouth tissues felt sunburned and hurt, but my throat did not swell.  I was able to continue to think, although my emotions were all over the place.  I could breathe without difficulty.  My blood pressure went rather high (a typical allergic reaction for me). 

I did a nebulizer treatment to ensure that my lungs had as much support as possible (30 minutes into reaction).  I continued to alternate quercetin (odd hours) and benedryl (even hours) through the evening.  By hour 4, my blood pressure was 180/140.  By midnight, my blood pressure was 220/170.  By 3 AM (the next morning), blood pressure had dropped back to 180/130.  By 5 AM, it was down to 160/110. 

Asthma started to kick in about 10 PM that night.  I started to do nebulizer treatments every 6 hours.  The asthma was very mild compared to other reactions.

So – thoughts on all this.

The reaction was triggered by the berries, something on the berries, or something else.  It was a specific item making my body have a specific reaction.  Medication was needed to control the reaction and to support my body as it went through the reaction.  Without the medication, the reaction would have been MUCH worse. 

And to be clear, this WAS a mild anaphylactic reaction – if I had not had multiple anaphylactic reactions and if I had not KNOWN the local ER would increase my exposure to allergens, I would have been in the ER.  If it had been just a little worse, I would have been in the ER.  If people had not been available to stay with me, I would have been in the ER.

So, how does wellness come into play?

Well, I believe that a body is a system.  I believe there is complex interplay between all the factors and domains of our life.  Things that had increased my risk of reaction included the high pollen count (see full bucket theory a little bit further down), a previous fairly serious reaction about 10 days prior, lack of sleep the 3 or 4 nights before Monday, and stress over loss of job/having to fight the loss of job.  These all had taxed my body and reduced the amount of available resources to cope with the reaction.

What reduced my risk of reactions?  I avoid as much as I possibly can within my own home.  Most of my food is safe-for-me (of course, as illustrated I can make some really boneheaded choices on food as well)!!  I have a basic safe-to-eat diet for when reacting in order to reduce rebound reactions.  I meditate 15 minutes 2 x each day.  I have a wonderful support system.  I have a good medical support team – so I know I can handle situations.

Side-note – Bucket Theory.

I seem to be a bucket type of person.  Think of an empty bucket – each allergen exposure is a “drop” or perhaps a LOT of drops, into the bucket.  The fuller the bucket gets, the less space there is for more allergens.  Eventually, the bucket fills up.  The NEXT exposure, no matter how little or how much, is the one that tips the bucket over.  And that is the one that I experience as a HUGE reaction. 

How does the bucket relate?

So, the environmental pollens were drops.  The medications I take daily are drops.  The raspberries – for whatever reason, were the exposure which overflowed the bucket.  What I do not know at this point is if raspberries are a flood of exposure (like airborne wheat) which is going to overflow the bucket every time, if it was just THOSE raspberries, or if it was a contaminant on those raspberries.  I guarantee I will trial my were-safe-for-me raspberries VERY, VERY carefully the next time I eat them… which will be a while!

Side-note 2 – Moving Target

For me, my reactions are like a moving target.  I seem to randomly develop new allergens (most recent ones are cloves (asthma, migraine) and black pepper (ana to airborne).  I also do not have replicable reactions for the more mild of my allergens – I might immediately start vomiting on day, develop hives another day, or have an asthma attack the third.  Airborne wheat is ALWAYS an ana reaction involving lungs and swelling of throat/mouth.  Airborne corn usually is like wheat, but on a really empty bucket, I can get away with a blinding (literally shuts down my vision) 2 day migraine.  Airborne corn derivatives vary. 

How does the moving target relate?

So, it is very hard to say if I am exposed to this thing then this specific reaction will occur.  That makes it hard to plan around things – so I have learned to plan for about the worst 75% of the time reactions.  This seems to work best for me.  It also helps to paint a picture for my friends and family that the reactions are not always spectacularly visible, but that the chance of a bad reaction is always there.  We sometimes joke – “Do you feel lucky, punk?  Well do you?”….

Ok, so what about wellness?

I think that the more you can do to help your body be healthy all contributes to emptying the bucket.  The meditation I do each day has shown that it reduces my blood pressure…  I meditated during the reaction, which I do believe kept my blood pressure from going higher.  It would drop my blood pressure 10-20 points on top and 10 on bottom each time I did 15 minutes.  But, I am not good enough to meditate for hours.  

 If I had not been as worn out physically and emotionally, it may be that the reaction would not have been as much – NOTE – this does not mean the reaction would not have happened.

The things I had done to be healthy, I believe supported my body through the reaction, and hopefully reduced the intensity of the reaction.  Being aware of what was happening and being able to cognitively talk myself through it (and know what to expect in a broad sense) allowed me to remain calm.  I think remaining calm made it so anxiety neurochemicals and physical reactions did not intensify or the reaction by further taxing my body (in other words, so my body could put all energy to fighting the reaction).  A lot of the way I think about my body is derived from dynamic systems theory, a rudimentary understanding of/interest in neuroscience, and various other concepts.

So, I rather consider wellness practices – whatever ones work for you – to be under the heading of things to increase physical resiliency.  These are things that can help you keep your bucket emptier – provided you do the structural work of avoiding allergens in all ways possible!  Wellness practices do not, at least in my opinion, take the place of medication, medical protocols/advice, and avoidance of allergens.  Wellness practices do provide one more tool in the fight to maintain the quality of life you want to maintain.

To summarize, my allergy life plan looks rather like this –

1.        AVOID EXPOSURE TO ALL THAT CAN BE AVOIDED

2.       Keep medications on hand and work with your medical team. 

3.       Make sure support groups are informed

4.       Increase wellness in all ways possible (eustress)

5.       Reduce negative stress (distress) in all ways possible.

6.       Plan that there will be reactions – and know what to do in each type/situation

7.       Don’t make impulsive decisions (I blew that one this time!!)

8.       Stay current on the research and information – science is still in the middle ages when it comes to the whole of the human body.