Author: Pat

Is it a psychiatric illness or a drug-induced psychosis?

First, what is psychosis? Psychosis is a term used to describe when a person interprets or perceives reality in a different way than those around them. Psychosis may be a symptom of mental illness, but that is not always the case. Nobody knows exactly what causes psychosis.

May 11, 2022

Observations

Suzi visited her mom, Val Thursday after work. Suzi checks in on her about twice a week. Val is 70, active with high cholesterol, high blood pressure. arthritis, and mild depression. Val takes her medication regularly and as directed. Suzi notices that her mom is not quite herself. Val cannot follow the conversation and does not seem to be able to concentrate.

The first thing Suzi thinks is, an UTI. Possible dehydration. They go to the Dr., but the urine test comes back clean. No infection and her electrolytes are all in the normal range. Hmm. Now what? Nobody seems to know what to do next, but wait and see.

It is now a week later and Val is not better and in fact she is a little worse. She cannot remember if she has taken her meds or not. She is unsure of what has happened over the last three days. Suzi is getting more and more concerned. This is not normal and her mom has never been this way before. Suzi wonders if her mom is developing dementia, Alzheimer’s disease or mild cognitive impairment.

In this particular case, her physician looked at her medications and had a consult with her pharmacist. They determined that most likely it was her blood pressure medication and/or her arthritis medication. Outside chance it could be anti-depressant med, but not likely. They began a withdrawal of HBP medication and started a different one. Val was some better, but not back to normal. It was not her arthritis medication; it was her anti-depressant medication. She was slowly weaned off of that and they did a wait-and-see approach to see if she needed to be on an anti-depressant anymore. Her mind cleared and she was back to her normal self.

While this case was a success, many more are not. No one thinks to check the medications. Why? Well, their thought processes go along these lines – She has been on these meds for three years or more. It came on suddenly, it must be a UTI or dehydration or she does indeed have the beginnings of mild cognitive impairment or a dementia.

Medications are not without risks and problems over time. As we age, our metabolization and kidney function decrease. We cannot clear meds as quickly or as easily as we once did. You know when your loved one is “not right.” You may not know what it is, but you know that something is wrong. Push for answers, never accept it is “just old age,” dementia, or other assumptions. Blood tests and urine tests need to be done. Medications need to be checked. Hydration and nutrition need to be addressed. We want to rule out any fixable problems.

Psychosis can be:

  • Due to stressful life experiences or trauma
  • Part of a neurological condition such as dementia. Alzheimer’s disease, or Parkinson’s disease
  • Triggered due to a brain injury
  • Medication side effects
  • Effects of illicit or illegal drugs such as marijuana or cannabis
  • Effects of alcohol withdrawal
  • Triggered by menopause
  • Triggered during times of severe stress or anxiety

As you can see, it is not black and white. Many things can trigger a psychosis. By the way, marijuana is not the gateway drug to addiction. Trauma is the gateway to addiction. The self-medication, whether it is alcohol, marijuana, cocaine, hydrocodone, heroin, etc., becomes the problem due to another problem. We have to deal with the primary problems first! Yeah, I know, we chased a rabbit there.

We don’t think about medications as causing a psychosis or a psychotic episode, but they sure can. Too often, we assume that it is a mental health issue. Maybe it is, but, we need to find out and rule out other fixable causes.

Understand that some classes of drugs can cause psychosis.

Classes of meds that may cause psychosis:

  • Muscle relaxants
  • Antihistamines
  • Antidepressants
  • Cardiovascular medications
  • Antihypertensive medications
  • Analgesics
  • Anticonvulsants
  • Antiparkinsonian medications
  • Chemotherapy agents
  • Corticosteroids
  • Stimulants

From the list above, you can see that the possibility is real that the psychosis is from a medication and not mental illness. Alcohol abuse or misuse is another inducer of psychosis.

Drug-induced psychosis usually only lasts until the medication/drug has cleared the body. Depending on the drug, the metabolization and clearing may take from 1 day to several weeks (if it is from a stimulant medication).

A healthcare professional needs to be contacted. They can decide where the safest place to “come-off” the medication will be. Drugs can affect different people in different ways. What causes a psychotic episode in one person may not cause a psychotic episode in another person. Genetics plays a part. Life experiences play a part. Pre-disposition to mental illness plays a part. Remember, mental health disorders can cause substance use or misuse on its own. The mental health disorder can be exacerbated or intensified by medication use, abuse or misuse, but it is not caused by the meds.

We should note that schizophrenia is not caused by drug use, abuse or mis-use. It may trigger schizophrenia symptoms in those people susceptible to schizophrenia.

Common signs and symptoms of psychosis includes:

Hallucinations – when you see, hear, feel or taste things that other people don’t

  • Hearing voices or sounds that others don’t
  • Seeing things that others do not see
  • Tasting things when you haven’t had or eaten anything
  • Feeling someone touching you who is not there
  • Smelling things which other people cannot smell

Delusions – unusual beliefs that other people in your “community” do not share, even though they feel real to you

You may worry:

  • That you are being followed by secret agents or members of the public
  • People are out to get you or to kill you (may be strangers or people that you know)
  • That a chip has been implanted in your brain to monitor your thoughts
  • That your food or water is being poisoned
  • That you are a powerful person or God

Cognitive impairments – these relate to mental action (learning, remembering, functioning)

  • Problems concentrating
  • Memory problems
  • Difficulties understanding new information
  • Having a difficult time making decisions

Alcohol, amphetamines, phencyclidine (PCP), cocaine, and hallucinogens are among the most common causes of drug-induced psychosis. Symptoms of drug psychosis include:

  • Paranoia and terror
  • Hallucinations. A person might see, smell, or hear things that aren’t there.
  • Delusions. A person may adopt demonstrably false beliefs, such as that a demon is pursuing them.
  • Dangerous behavior. A person might attempt to fly, harm themselves because a voice told them to do so, or become a danger to others. Some people who experience psychosis become aggressive.
  • Disconnection from other people or from reality. A person may appear catatonic or totally withdrawn.

Drug-related psychosis is distinct from other forms of psychosis in a few ways:

  • It appears while under the influence of or withdrawing from a drug.
  • It comes on suddenly.
  • It is typically more intense than other forms of psychosis.

Illicit/Illegal Drugs that most commonly cause substance-induced psychosis:

Methamphetamine

Cocaine

Marijuana

LSY

Peyote

Mushrooms

Ketamine (this is a Rx drug, but is used illicitly)

PCP

Ecstasy

This overview is so that you know and understand that medications can cause psychotic episodes. What signs and symptoms to look for? Contact your healthcare provider for withdrawal and monitoring needs.

Pat

Another drug problem … medication overload

Too much medication, too many medications, overprescribing, inappropriate prescribing, & the body’s decline in metabolization and excretion. Whew! It is a lot, isn’t it?

May 4, 2022

Medications will not fix everything. Medications are not without risks. Over-the-counter medications are not always safe. Vitamins, supplements, herbs, or essential oils are not without risks and they are not always safe either.

I am on the lookout for unnecessary medications or potentially inappropriate use of medications. I look for appropriate medication usage and benefits vs risks treatment regimens. Just because a medication may help, does not mean it should be used because the risks or side effects will be worse than the treatment. Treatment may be indicated, but it will not be beneficial. A medication may no longer be necessary. Medication is not necessary at all.

We have to get over this, “a pill for every ill,” kind of thinking. Let’s be honest, a lot of folks want “my rights” or “my choices,” but they do not want the responsibilities that come along with those things. It is each of our responsibilities to take care of our bodies, as best we can. Eating better, drinking our water, doing physical activity, taking care of our mental health, and even sleeping well. Progress over perfection. Be consistent. Then if you need meds, take only what you need in the lowest amount you need.

Medication overload isn’t really talked about very much. When 750 people aged 65+ are admitted to the hospital Every Day, due to medication problems … that is significant. Not all of these folks survive. 7,000 people die every year due to preventable adverse drug events. It is unknown how many dies, due to worsening of their current diagnoses.

If you are 65+ and are on 5 or more medications, you are at risk of an adverse drug event.

Possible side effects of overmedication include:

  • Mental health concerns
  • Addiction
  • Substance misuse or abuse disorders
  • Drug reactions that are dangerous
  • Adverse side effects
  • Increase in physical health problems

Common signs of overmedication include:

  • Fatigue and energy depletion
  • Pressure in the abdomen
  • Aches and pains in the body
  • Problems with balance and motor skills
  • Fatalities and falls
  • Rashes and flushing of the skin on a regular basis
  • Weight gain or loss that is not clarified
  • Mood swings are frequent, and there is a lack of personal hygiene.
  • Concentration problems
  • Impairment of memory
  • Confusion or cloudiness of mind
  • Delayed decision-making
  • Inability to think rationally
  • Psychosis, hallucinations, and delusions
  • Symptoms of withdrawal when not using

How can we decrease medication overload?

Take time to discuss medications during office visits. Find out what is still necessary and needed. Find out what can be stopped or tapered off. Work with your physician. Discuss the benefits vs harm and what are the alternatives.

Be open to the possibility that your medications are hurting you rather than helping you. Maybe, you feel so bad, not because of your diagnoses, but because of some of your medications.

You are the one inside your body and you are the expert on how you feel and how you are really doing. Consider, just consider, that taking less medication (in number or dosage) may benefit you. It is worth a conversation with your health care provider and worth a try to deprescribe some meds.

Pat

Manage your energy, not your time!

Promises of a better life, an easier life, if you will only use the XYZ method of time management. You are convinced that if you knew and could master the trick of managing your time to be more and more productive, your life will be better.

April 27, 20222

How many phrases pull you in to the “That would make my life better and easier?” Probably, quite a few. Why? Because, we are dealing with crap that is standing in our way of our lives being better and easier.

We see the ads, we see the promises, and we even search for solutions. Of course, we are leery, we have either bought or done things before that did not work for us. Still, we search. Why? Because, we want better. Something is out there to help us; it just has to be.

What if we have thought about time all wrong? Maybe, we have only been managing deadlines, this whole time? Use a planner, they say. Planners and date books are great for solid meeting times, appointments or deadlines. There are list makers and there are fly-by-the-seat-of-your-pants kinds of people. I am a list-maker, but I have learned to leave space for spontaneous goings-on. Changes, reschedules, opportunities, missed out times, it is all good. Time marches on no matter what we do or don’t do. Our energy on the other hand, is finite. It does run out. We do need to rest and recharge.

When doing a physical activity that does not require a lot of focused attention to detail, we get tired. We rest, get cleaned up and we are ready to go again. When doing mental activities that take a lot of focused attention to detail, we have about three hours a day before that energy is zapped. Sorry, but a short rest and shower will not fix this energy depletion. The brain must rest, from processing information. Daydreaming is a nice way to rest the brain. Letting your thoughts wander is great too.

What can you do to rest your brain? 

  1. Go for a walk
  2. Take a nap between 10 minutes up to an hour
  3. Take a shower, leisurely
  4. Play sports
  5. Stretch
  6. Go outside
  7. Journal
  8. Color or Draw
  9. Watch animals play
  10. Listen to music

Find what works for you. If you know that you will be having to process a lot of information, learn when you perform at your best. You may already know that you can only be detail oriented for an hour and a half at a time. Great, you have two of those blocks per day.

Depending on how detail oriented I need to be or how much research that I need to do, I know that I have about three hours a day for that intensity. After that, I will need to do other tasks that do not take as much effort and energy. My best times are usually from 11:30 am – 1:30 pm and from 2 pm – 4:00 pm. If I have reading and research to do, I protect that time frame so that I will be at my best to work on my clients needs.  I check email once in the morning and once in the late afternoon. I scan the news in the morning and late afternoon. I check Twitter and facebook mid-day and late afternoon. I have this routine and I don’t waste any brain energy trying to figure out what I am going to do or not do next. Routines and habits help you conserve brain energy.

We can all go down rabbit holes at any time. We learn to catch ourselves doing that, course correct and go forward. Mindless scrolling, is a rabbit hole. If you are having trouble with that, set a timer for 10 minutes. Do something else. Read. Journal. Chores. Plan for the next day. Walk. Daydream.

Learning to calm yourself benefits your brain too. When you focus on the problem or issue, you get stuck because you cannot think about it in any other way. By taking a break, getting away, playing or being fully present in the moment, you can rest and let your brain work in the background. Who knows, it may come up with a brilliant new way to look at the situation or find even better options.

New perspectives. New ways to think about brain energy. New ways to plan your day. Give them a try for two weeks and see how you are doing. Make adjustments, you may be surprised at how much better you feel and how much easier your tasks become. You get to do your most intense work when it is best for you, your brain and your body.

Pat

Conflicting thoughts and how to decide what is best for you.

Conflicts inside our mind

We all have them, the mixed feeling or conflicting thoughts. What does it do to us? How do they make us feel? They stress us out. They make us tired both emotionally and physically. We stay paralyzed because we don’t want to make a wrong decision. It hurts us worse to make a wrong decision than it does to make a potentially right decision.

April 20, 2022

Internal conflict is the experience of having opposing psychological beliefs, desires, impulses or feelings.

A few examples:

  1. You feel frustrated and angry at the health care system (doctors, hospitals, insurance companies) but, yet, you need them.
  2. You are disappointed in the lack of communication but you are unsure how to fix it.
  3. You are not sure that your loved one has the financial resources that they will need to have the best care possible for them, yet, you are not sure how much, if any, you can contribute.
  4. To be an advocate, you need good, science-based information that works for you and your needs.
  5. The frustration of unmet clinical concerns (diagnoses, treatment plans, home needs).
  6. Our inner child emerges and is ready for battle.
  7. Our compassion and losing the ability to be compassionate.
  8. Our Ego gets bruised and then we act out instead of seeking to find the best solution.
  9. Conflict with yourself – taking care of yourself along with taking care of your loved one.
  10. Unresolved family issues rear their ugly head.
  11. And many more…

What is causing this inner agitation? Ruminating thoughts? Troubling thoughts? Feeling like the thoughts are in control? You experience this out of control feeling and you just keep spinning your wheels. There is an element of fear. In fact, the “fear” of something is always at hand.

When your mind is relieved of the stress, those feelings of conflict and turmoil will disappear. Our minds want to be in a state of calm. We like it when things are copasetic. So, how do we get there?

Your thoughts and not always true. Identify what thoughts are causing the distress. Do you have competing or conflicting thoughts? Get your paper and pen out. Write the competing thoughts down. Under them, write down the good points about each of them. We are looking for win/win ideas. Now you have to change hats to be the mediator. As a mediator you are looking for the best options for RIGHT NOW. There will be give and take. Get rid of the “either – or” mindset, look for a “both – and” mindset.

Have you figured out that the biggest problem is between your WANT and REALITY? Yes, it sucks, but more times than not that is what the conflict is about. Does that mean we give up? Of course not. Making things the best they can be under the parameters that we have is our goal. Rarely, do we have a perfect reality anyway so we know that we can course correct and move forward. We are made for challenges. Take the limits off of your thinking. Let’s try and see.

You are the one in control of your thoughts and your feelings. No one else. That is powerful. That is an “in control of me” empowering feeling. You have to be the one to learn how to handle your strong emotions and feelings. Drill down deep, what are they trying to tell you? Yes, they do have a message. They are ALWAYS trying to keep you safe. They will always raise a ruckus. It is your job to listen, step back and figure out what is real and what is not real. Are you safe, right now? Is this an old trigger? Is this a pattern? I know we just chased a squirrel her.

Back on task.

What does the evidence say to you?

What does the logic say to you?

Reasoning is a powerful tool for the mind. To be able to reason well, we need correct and true information. Three trusted sources is sufficient for you to make a well-reasoned decision. A trusted source is NOT ‘they said and I heard.”

Remember, we buy with emotion and justify with logic. Sometimes, we keep looking for sources to help us justify the way that we want. We keep searching until we find what we WANT it to be.

Be careful about how you are searching for information. Do you want the facts or do you want the biased information that will support what you want? When you know the facts and your options, you will actually feel much better about your decision. You will know that you have done everything possible to get the best information available at the time to help you make a decision. It doesn’t mean that it will be easy. It doesn’t mean that you won’t wonder? It doesn’t mean that you won’t make a mistake. We are human, we will probably always wonder. But those are just thoughts. They are not reality. The reality is that you did the best you could with the best information that you had at the time. Very few decisions are final. Oops, that did not work as well for us, so, you make adjustments and move forward. Progress over perfection.

Write these things down and answer them:

I am concerned about ____________________________________________________

I am afraid that _____________________________________________is going to happen.

Write down all the possible outcomes that you are thinking about.

Make 3 columns – Thoughts that reinforce Negative outcomes, Thoughts that make the situation stay the same, Thoughts that are Growth/Goal oriented realistic outcomes

Try to focus on the thoughts that are growth/goal oriented realistic outcomes. These thoughts are the motivators to help you take action.

Consider what you really want. What are your life values?

We want balance between our head and our hearts. When it is out of balance we have inner conflict. You are having trouble or confusion between accepting and aligning your belief with what is being presented to you. Accept the duality. Sometimes, you need to be still and breathe, just deep breathe. Allow your thoughts to calm down so you can think more rationally. Think about your life values and the principles that you live your life with. Decisions are hard. If you have no good decision, then which decision will you least regret making?

Pat

When to take a rest day.

How caregiving is like working out, rest days are important.

April 13, 2022

Why is it okay to take a rest day or two from working out but, it is not okay to take a rest day from care giving or helping your loved one? Think about that. We have the research and the information about listening to our bodies. That rest days are just as important as workout days. That if you cannot mentally concentrate on a lifting day, you are better off skipping that workout. If you push through your chances of injury are greatly increased. Then what? You got it… you will have to take four to six weeks off to heal.

Helping out a loved one is the same kind of thing. Sometimes it is mentally exhausting and sometimes it is physically exhausting. You know that you need a break, but will you take a break? Will you push through? For how long? At what cost to you and your own health?

These are things that all of us need to think about. The problem is that we don’t think about these things. We just jump in and do. That is great, if it is for a short time. The problems arise after we have been helping for a longer period of time. Three to six months is what I consider a longer period of time. At about 18 to 24 months burnout has begun, if you have not gotten help or taken time outs.  

I get it. It is hard when you are in the big middle of things to think about what would be best for all involved. You get in to survival mode and you just do. Some of us don’t want to think about what would be best for us and for out loved one. Thinking is hard and it takes a lot of energy when you are learning new things or doing new things. Remember, you only have about three hours of focused energy per day to use. When are your good hours? When are you able to concentrate and work on detailed projects the best? The rest of the day, you can do the things that do not take as much mental energy or focus.

Developing habits are good for us. They decrease the expenditure of mental energy. Basically, when we have habits, we do them and we do not have to waste any mental energy or focus to think about the “who, what, when, where, why” things. We just do. We have already learned. Some folks call it discipline and others call it a routine.

As with most of us, the most aggravating thing is trying to figure out where to go for dinner. How much time and energy is wasted on this simple act? We ask each other, “Where would you like to go?” The reply is usually, “I don’t care, where do you want to go?” Yes, you know what is coming next. “How about the Roadhouse, you ask?” Wait for it …. The reply is … “I don’t want to go there.” Here comes the hard part … do you say this or just think it? “Obviously, you do care. So, where do you want to go?” The back and forth continues, until finally a place is chosen. How do you feel after this discussion? Tired? A little miffed? Wondering why it is a chore to pick a place to eat? Sometimes, you can give them three options and they still do not like any of them. But, they don’t have any options to give you. Why is that? Sorry about that, I digressed.

How does the rest of your evening go? If both of you can let it go, the evening will probably be okay. If one or both of you do not let it go, then chances are you will not be having pleasant conversation the rest of the evening.

I wonder how much better and easier it would be if one of us said, from the beginning, “I would like to go to the Roadhouse, do you want to go?” The other person can say yes or offer another suggestion. Then the suggestion could be taken or not and they can go or stay at home. Shoot, one person gets to pick this time and next time the other person gets to pick.

We are trying to get a consensus, but sometimes that is not possible. The same thing happens when you are a helper or care giver. You may or may not get a consensus. A “good enough” decision has to be made. NOT perfect. Progress, not perfection is what we are after.

If you do not have habits or routine, try this for two weeks and see how you do and how you feel. Plan your breakfast every day. It does not matter if you eat at home or go and pick something up. Figure out what it will be the night before. Pick out your clothes and shoes the night before. Stick to this routine for two weeks.

Hopefully, you will find that having a routine frees your mental energy for other things. What day or days do you clean the house? Do laundry? Change the sheets? Workout? Run or walk? Schedule them like an appointment, until they become a habit. When they become a habit, the less focused mental energy you will use and will have that energy to do other things. Learning to manage your energy is much more efficient than managing time.

Which of these fits you today?

8 SIGNS YOU NEED A REST DAY

1. YOUR RESTING HEARTRATE IS ELEVATED

2. YOU FEEL TIRED

3. YOU’RE MOODY

4. YOU FEEL SICK

5. YOU’RE ALWAYS SORE

6. YOU’VE HAD A FEW BAD WORKOUTS IN A ROW

7. NOTICE YOU’RE NOT GETTING ANY STRONGER

8. YOU FEEL THAT YOU NEED A REST DAY

From Tough Mudder https://toughmudder.com/blog/no-excuses/signs-need-a-rest-day/

14 Signs you need a rest day from being a helper or care giver

  1. Feeling “trapped” or hopeless
  2. Losing patience or compassion for your loved one
  3. Overreacting to small accidents
  4. Resenting or neglecting your loved one
  5. Withdrawing from your personal hobbies and friendships
  6. Oversleeping or not sleeping enough
  7. Overeating, not eating enough, or eating a lot of high-sugar foods
  8. Having health problems
  9. Abusing drugs or alcohol
  10. Having thoughts of suicide
  11. Making mistakes
  12. You are irritable
  13. Signs and symptoms of depression
  14. You feel exhausted most of the time

I can’t say it any better than Daily Caring has said it in their article.

6 WAYS TO MAKE IT EASIER FOR CAREGIVERS TO TAKE A BREAK

1. Accept that you’ll feel guilty
Guilt is a normal part of caregiving simply because you care – it’s never going to disappear. 

Don’t let this stop you from getting the caregiving help you need.

Taking regular breaks is the best way to maintain your overall health and your ability to provide care.

Besides, how good would you feel if you never took any breaks and your health declined to the point where you could no longer care for your older adult? 

It doesn’t do them any good if you’re not physically or mentally well enough to be their caregiver.

2. Don’t ask your older adult for permission
This isn’t a decision that your older adult gets to make. 

Many older adults refuse outside help because they’re uncomfortable with the idea. 

And someone with dementia doesn’t have the cognitive ability to make a rational decision.

When seniors refuse, they’re not thinking of your needs and are often not considering their own true needs either. 

That’s why you need to make the decision, regardless of how they feel about it.

All that matters is that they’re safe and well cared for when you’re not there.

3. Start before you really need it (if possible)
It may take some time to find the right person to help and for them to learn the caregiving routines. 

That’s why it’s helpful to find help before you really need it.

When you’re putting together a team of family, friends, and volunteers, it can be less stressful if you have some time to get the team in place and work out the details.

To make the transition easier, you could have someone come and shadow you until they learn the ropes and can be left alone with your older adult. 

Or, you could have someone come for a short time in the beginning and gradually increase their time as everyone adjusts to the new situation.

4. Combine paid services with help from friends, family, and volunteers
Hiring caregiving help can be expensive. But even if the cost is high, maintaining or improving your health is worth it.

Being open to different sources of help also lowers the cost of taking regular breaks. 

Ask family or friends for help and seek out local volunteer programs that offer companionship services.

Then supplement those hours with paid help as needed.

5. Check in to know that your older adult is well-cared-for
You might be afraid or nervous to leave your older adult with a stranger or a family member with limited experience. 

To give you greater peace of mind, use simple, discreet ways to keep an eye on them and make sure they’re treating your older adult well.

You could sometimes come back early as a surprise check-in to see what’s been happening. 

Or while you’re out, call occasionally to hear how things are going. 

Another good move is to ask the caregiver to take notes so you’ll know what happened while you were out.

6. Be creative when introducing the hired caregiver
Nobody wants to be told that they’re getting a babysitter. 

If your older adult is very resistant to outside help, be sensitive and creative when introducing them to the household. 

A careful approach is especially important to prevent seniors with Alzheimer’s or dementia from reacting with fear or anxiety.

For example, you could introduce the person as your helper around the house and have them help you with meal prep, light housekeeping, and simple care tasks. 

After a few of these visits, it will seem normal that they’re around and it will be easier for you to leave to “run errands.”

You could also position it as doing that person a favor. Perhaps you could say that this person is in need of extra income, so you’re helping them out with a few hours of work here and there.

If family or friends are helping, you could say that they wanted to visit and spend some time catching up. When they become regular visitors, you can start popping out to “run errands.”

By DailyCaring Editorial Team

Pat

How to make stress work for you?

April 6, 2022

Let’s start with a definition of stress.

Stress: a state of mental or emotional strain or tension resulting from adverse or very demanding circumstances.

Now, notice that it does not say anything about negative or positive stress. Have you ever even wondered about that? Some may think that all stress is negative. Not true. Positive stress happens, too. Positive stress (Eustress) or good stress is the type of stress response that we feel when we are excited.

Stressors are thoughts or challenges. They can be positive or negative. Stress and how it affects you depends on your mindset.

What Is Stress Mindset?

Again, it’s how you view stress, what it means to you.

  • Is it a threat – something that will negatively affect your emotional state, your performance (physical and mental), even your health?
  • Or is it a challenge that lifts you to a higher level of energy and performance? (i.e. the stress response is helping you cope.)

Why Stress Mindset Matters

A negative stress mindset views stress as harmful, a threat – and therefore something to be avoided, averted, maybe even suppressed. Negative consequences are:

  • You’ll avoid challenges and opportunities for growth and development (as with a fixed mindset).
  • Trying to avoid stress, and in particular trying to suppress the body’s stress response, actually amplifies it and makes the feeling of stress and anxiety worse, and probably longer lasting.
  • You can get locked into a state of chronic stress response, which is actually harmful (unlike short bursts of stress) – your stress mindset becomes self-fulfilling.

A positive stress mindset means stress is a challenge to be embraced, moving you to perform better. The stress response is your body’s mobilizing energy to help you meet the challenge. It feels like excitement, not anxiety. In other words, although there is still a physical stress response, it doesn’t feel like stress at all.

I stole, I mean, borrowed this from Stress Resilient Mind

Distress Stressors:

  • Financial crises
  • Solo caregiving
  • Death of a loved one
  • Relationship problems
  • Illness or Injury
  • Abuse
  • Feeling neglected
  • Worrying about someone else
  • Work problems
  • Deadlines

What happens to the body during stress?

The body’s autonomic nervous system controls your heart rate, breathing, vision changes and more. Its built-in stress response, the “fight-or-flight response,” helps the body face stressful situations.

When a person has long-term (chronic) stress, continued activation of the stress response causes wear and tear on the body. Physical, emotional and behavioral symptoms develop.

Physical symptoms:

  • Aches (headaches, body aches, etc.)
  • Pains (lower back pain, neck pain, etc.)
  • Chest pain or heart racing
  • Trouble sleeping
  • Exhaustion
  • Dizziness
  • Muscle tension
  • Jaw clenching
  • Stomach problems
  • Weaker immune system
  • Trouble with or lack of interest in sex

Emotional or Mental symptoms:

  • Anxiety
  • Irritability
  • Sadness
  • Depression
  • Panic attacks

Stress is subjective and cannot be measured with tests. Only the person experiencing the stress gets to determine how severe it is! That being said, we can look at the physical and mental symptoms you are having and we can also assess whether you are handling the stress with healthy or unhealthy behaviors.

Negative Stress:

Examples of unhealthy behaviors:

  • Alcohol misuse – drinking too much and/or too often
  • Medication misuse – taking a medication for other than its intended purposes
  • Food misuse – overeating, excessive eating of sweets, eating disorders
  • Smoking
  • Gambling
  • Shopping

Examples of healthy behaviors:

  • Deep breathe for 3-5 minutes four to six times a day
  • Eat for nutrition
  • Hydrate with water and other non-caffeinated beverages
  • Walk or run regularly – four to five times a week for 20 minutes at a time
  • Practice relaxation techniques
  • Mindfulness meditation
  • Sleep enough
  • Make time for your hobby
  • Talk therapy
  • Re-framing the situation
  • Journaling for 10 minutes each day
  • Setting realistic goals

Find your own personal mantra:

  • I did not cause this and I cannot fix this.
  • I cannot control the outcome; all I can do is to do my best.
  • I cannot change this situation and no amount of worrying will change the situation.
  • It is okay that the situation is not okay, I am moving forward and doing my best.
  • I can control how I react now, and that is all I can or have to control.
  • It is okay that I did not get it all done today, I have accomplished a lot today.
  • Things are not too good today, but I have adapted.
  • Let it go = let it be just as it is, right now

Create your own saying or mantra. One that is empowering and meaningful to you.

Sometimes stress is telling you to pay attention, something needs to change around here. Something is out of whack. Look at it. Is there a fix? Yes. Great, do it and move forward. Is there a fix? No. Great, let it be and move forward.

I know, I know. It is not normal to let things be and move forward. We all have to understand that our problems arise when we refuse to believe that what is happening cannot be fixed and we don’t like it! It is the internal struggle that is wearing us out. How much better off would we be, if we would accept things the way that they are, right now? It does not mean that we don’t try to make things better. It does not mean that we don’t move forward. We adapt. We reassess.

Re-frame the situation. How in the hell do you re-frame the situation? Start by noticing “stinking thinking.” Get ready to write some things. No, you cannot just think about them. That is part of the problem, you are in your head too much. Get the paper and pen or pencil.

  1. Write down your thoughts. (What is causing the anxiety?)
  2. Fact-check your thoughts. (Are they true? What is the proof?)

Truth is on a spectrum, it takes in to account your experiences, life stories and belief system. Facts are facts. They are true everywhere and for everyone.

 3.When you are really feeling stuck, ask, “Is this helpful?

4. What would you say to a close friend that is having the same thoughts are you are?

5. What is realistic, not positive? Finding a positive thought about a negative situation is not realistic. You don’t have to put a positive spin on it.

6. Screw “the bright side,” find “the meaning.” Get out of the “all-or-none” type of thinking. It doesn’t have to be an “either/or” situation, it can be a “both/and,” type of situation.

7. What is the next right action to take?

8. Try this for a week or two. Give it time or work or fail. Then reassess, make a plan and try again.

Reframing is not the best way to deal with every situation, but it sure can be a helpful tool. Use reframing to take an alternate view of the situation.

What are your skills and traits? Identify your strengths. Identify the areas that you are not so good at to find out either what you need to learn or you will learn that you need to let someone else handle the job.

If you are using all of your energy focusing on the negative, then you will have little to no energy left to find any good in the situation or to look for possible solutions. Use your energy wisely, you only have so much focused energy to use every day (about 3 hours).

Positive Stress:

Some stress can be good for you. How do you know if it is good stress?

Positive Stress Characteristics:

  • Focuses Energy
  • Motivates you
  • Within our coping abilities
  • Feels exciting
  • Improves performance
  • Short-term (you will still have physiological changes to your body)
  • Challenges for learning, growth and achievement
  • Sense of purpose

Positive Stressors:

  • New relationship
  • Wedding
  • Upcoming holidays
  • Retirement
  • Vacation
  • Pregnancy
  • Taking on a new project at work
  • Physical conditioning
  • Learning something new
  • Buying a home
  • Graduating
  • New job
  • Self-care

Positive stress is key for developing resilience. That is what we are all after. The ability to handle whatever happens both good and bad. To get back to the point that we know we are going to be okay.

Pat

The Best Way to Treat Migraines

March 30, 2022

The best way to treat migraines is to find the combination of therapy that works best for you. Whether that is a cocktail of prescription meds and OTC meds or an infusion cocktail or meds and exercise along with stretching, etc.

If there was one best way, you would be pain free and I would be rich.

You are different than someone else. Your triggers are different. Your needs are different. Go ahead, get mad and frustrated. It is maddening and very frustrating. Now, it is time to get to work. Railing against the pain will only make it worse.

What if you could lessen the pain considerably AND decrease the number of attacks? I am up for that, are you? We are going to be realistic. Nobody likes reality when they are in intense pain, and the goal will be to decrease that intensity. You get to choose. You can keep on going as you have been or you can make changes that will help you over time.

Will you choose to be disciplined in your treatment plan to reach your goal? It is simple, but it will not be easy. It will take some trial and error. What are your three goals? You get to pick what is important to you and your needs. Make them personal. Make them things you want to accomplish for yourself. These are the things that will keep you focused when you are not seeing much, if any, improvement at the beginning. It will be a long haul. You have probably been dealing with the attacks and intense pain for many years, so what is 6 more months?

Being open to the possibility that you can lessen the pain. Being open to the possibility that your attack days will decrease considerably. Why is your belief and thought process so important in this area? If you don’t really believe that you can actually be better and feel better, you will not stick with the plan. Barriers and failures will occur. Realize that, and get back on track. You messed up. You didn’t do what you had planned. Admit to yourself that you messed up. No excuses and no beating yourself up. Get back on track and move forward.

As we move forward, always check with your healthcare provider before trying OTC meds, supplements and adjunctive therapies.

About 40% of folks do not respond to prescription triptans. So, for them it is like taking water … they get no relief, but they sure do get that increased heart rate.

It is usually 3 or 4 things together that make the difference. You job is to find those 3 or 4 things that work for you. Here is where it can be difficult as you have to do those things for 3 months before deciding if it is helping you or not. Remember, it is a process. A wanted process that will help you to get better and feel better.

If you have never done so, start a daily journal or diary. A spiral bound notebook is fine. You want to address the following:

  • Date
  • Morning – food and drink
  • Mid-morning – food and drink
  • Lunch – food and drink
  • Mid-afternoon – food and drink
  • Dinner – food and drink
  • Evening – food and drink
  • (noting the times will be helpful)
  • Overall mood – address morning, mid-day and evening and any significant stressors
  • Exercise – what, when and how long?
  • Headache today – Y or N
  • If, Yes –      what time began?
    • Notable weather (barometric pressure increase/decrease)
  • Medications taken – how much and when?
  • Relief – Y or N (maybe not gone, but much improved)
  • Symptoms prior to headache
  • Symptoms during headache
  • Time headache is gone
  • List your known triggers that may have precipitated this attack
  • Describe your body sensations – muscle tightness, teary eyes, numbness, tingling, nausea, etc.

Headache Treatments and how much they did or did not help

          Ex. Ice pack, Heat, Meds, Stretching, Trigger point release, etc.

Anything else that is particular to you.

We are looking for patterns. Not all migraines have patterns, but for those that do, we can work towards modifying or eliminating triggers. Triggers don’t cause migraine, but they set off the processes that cause the migraine.

It is best to fill this out on an ongoing basis. There are probably apps that will help you do this if you don’t want to do the writing. This is your research. This is your unique information. This is what can best help you to get better. For those of you that need help in finding your pattern and plans of action, contact me to see if we are a good fit to work together. pat@EmpoweringHealthOptions.com and place Migraine in the subject line.

I do recommend that a person with migraine see a neurologist that specializes in treating migraine. You have to work with your health care provider. It is a team approach.

Things that you can try to see if they help:

  • Gel Ice pack – use for 20 minutes on your neck, shoulders or back area
    • Some folks like to place it on their eyes
  • Far Infrared heat – Migun mini wrap or mat (there are other manufacturers)
    • You can use far infrared heat for hours. It is to relax tight muscles.
  • Watch out for Medication Overuse Headaches – they are most common in folks that use OTC pain relief products multiple times per day (3 or 4 doses) and multiple days in a row (3 or 4). This is also known as a rebound headache.
  • Deep breathing exercises – Slow, deep breath in through your nose for a count of 4   and breathe out through pursed lips for a count of 6. Make that belly rise. Do this five times. You may be a little light headed. You can do this exercise 3-4 times a day.
  • Acupuncture
  • Massage (weekly or every other week)

SEEDS for migraine control – these are things that you can control to help ease migraines

S – Sleep – be consistent with your sleep schedule, even on your off days. Go to bed and get up at the same time. You may want to consider a sleep study test, especially if you have morning headaches or insomnia. You may or may not have sleep apnea, but there are other sleep disorders that may be impacting you.

Maybe you will benefit from a neck contour pillow? Roll up a towel and place it in the bottom of your pillow. Yes, scrunch your pillow up above the roll. You want to relax your neck muscles.

E – Exercise – Yep, off ass and on feet. Walk or run three or four days a week. Work up to 30 – 40 minutes. Start out with 5 minutes and walk three times a day. Consistency is the key here. You can actually do your breathing exercises while walking/running. Add weight training 2-3 times per week. Yoga, Tai chi or stretching three times a week. Start slow and build up. Find what you enjoy doing. If you think it is a chore, you won’t be consistent. You don’t have to love it, but you do have to like it enough to keep doing it. Maybe, you will like the benefits after it is over.

E – Eat – Foods and hydration are important. Regular meals and consistent hydration are important for overall good health. Eat for nutrition. Drink about half of your body weight in ounces of water every day. I know, most all liquids count, but do your water, too. If you weigh 160 lbs. then drink about 80 ounces of water throughout the day. A bottle of water is16.9 ounces. That comes out to 4.7 bottles of water per day. So, do 4 bottles of water per day and your other liquids. I would suggest a higher protein and a little lower carb diet plan. A heart healthy plan, an anti-inflammatory plan, the Mediterranean diet plan. Find one that works for you. It is a lifestyle change. Change takes time, discipline and planning.

D – Diary – Take the time to invest in yourself. Look at what is going on in your life with work, family and friends. What does your body feel like? How is your emotional state? How is your spiritual state? Make notes about your day, your health, your eating, your hydration and your exercise. We are looking for patterns, if they exist.

S – Stress – It can be good stress or bad stress, but it is all stress. Do something that you enjoy doing. Turn off the computer and your phone at 8:00 pm. Take a break, read, watch tv, talk, etc. Mindfulness meditation is a great tool to help decrease your stress. Journaling for 15 minutes a day to let everything on your mind get out. Practicing gratitude every day will decrease your stress. Write down three things you are grateful for each day. No, they cannot be the same three things each day.

Non-prescription supplements:

You do need to talk with your healthcare provider before stating these.

Riboflavin (B2) – 400mg per day

Magnesium – 400 mg per day (up to a maximum of 600mg per day)

Co-Enzyme- Q10 – 150 mg per day

These are the only three that have shown some promise in migraine therapy treatment. We still do not have any hard proof.

OTC Pain relievers:

Brand or Product name                      Active ingredients per tab/cap

Aleve®                                              naproxen sodium 220 mg

Advil®                                              ibuprofen 200mg

Bayer®                                             aspirin (ASA) 325 mg enteric coated

Anacin®                                            aspirin 400 mg and caffeine 32 mg

Excedrin® Migraine                          aspirin 250 mg, acetaminophen 250 mg,

                                                          caffeine 65 mg     

Excedrin® Tension headache             acetaminophen 500 mg, caffeine 65 mg

Tylenol® Regular strength                 acetaminophen 325 mg

Tylenol® Extra strength                     acetaminophen 500mg

Tylenol® 8 HR Arthritis Pain             acetaminophen 650 mg

Motrin® IB                                       ibuprofen 200 mg

Sudafed®                                          pseudoephedrine 30 mg (have to sign for at

                                                          pharmacy)

Sudafed® PE                                     phenylephrine 10 mg

Maybe you have found that taking two generic Excedrin® migraine, one 30 mg tab of pseudoephedrine and a prescription muscle relaxer works for you. Maybe you need a triptan or prescription preventives or a cocktail infusion. Maybe your migraine meds leave you out of sorts for two or three days later. Let’s find the best non-medication ways that will help you. Only take the medications that you need, they are not without risks.

There are many prescription medications to try. Hang-on, you may need to try quite a few to see what works for you. For those of you that have been unable to find a medication that works for you, give the non-medication adjuvant therapies a try.

Pat

What I wish you knew about migraines

It isn’t just a severe headache. Info for those that don’t know.

March 23, 2022

Migraines not only affect the person that has them, it also affects their loved ones. Everyone’s emotional health and well-being are affected. Irritation, negative feelings and sometimes anger shows up. That is normal. The problems arise when we don’t deal with the irritation, negative feelings and anger appropriately.

Look, the person that has migraines does not want to have them. They are sometimes debilitating and their quality-of-life sucks. Remember, it is not just a severe headache, it is a brain disorder. I have been on both sides of this issue. I have only had three debilitating migraines in my life. I also have had many migraines that were annoyances and I have had some that you cannot think clearly for hours. When you can’t think clearly, it takes about four times as long to work on a project than it normally does. Sometimes, you can push through and sometimes you can’t. Sometimes, medications work and sometimes they don’t.

I know what most of my triggers are and I can do a pre-emptive strike with over-the-counter and prescription meds when I feel the familiar pain beginning.  I call it, the cocktail. I usually only have to take the cocktail once and the pain decreases to where I can function almost normally. The great thing about the cocktail, I use less medication overall. My migraines are acute. If they were chronic, then I would have to take preventative measures all of the time. Preventative measures include prescription medications, supplements, massage, running, walking, stretching, etc. As you can see, there are many things that may help with preventative measures. You have to find the group of things that will work for you. We will talk more about treatments and prevention next time.

I am thankful that I do not have chronic migraines. For those that do, I can empathize with you. I can also empathize with your family. It is hard on the family when you have plans and then a debilitating migraine flares-up. The plans go out the window or the one that is having the migraine flare-up is left at home. It sucks.

If someone is having a severe migraine, they probably should not be left alone. They should be watched. Why? Because they usually cannot get liquids or crackers safely on their own. A person that is having a severe migraine may be having neurological deficit problems and they could even have a stroke. If a person gets to status migrainosus (severe pain, lasting 3 days or more) they can have a stroke. They usually need to be in the hospital at this stage with a neurologist monitoring their condition.

As you can see, migraine is not just a bad headache. It takes the whole family working together to help get a handle on calming down migraine. Learning and understanding what a migraine disorder is and the ways in which each of you can help makes it much less stressful on all involved.

Eating nutritionally better, regular exercise, staying hydrated, learning more effective ways to deal with stress will help all involved. Help lighten the load at home for the one that has migraines. Be supportive. Ask how you can help them. Don’t be an ass. This is hard when you have been dealing with migraines for a while. During an attack is not the time to go through all the preventive measures “they should be doing.” Learning their own preventive measures takes time.

For those that have migraine flare-ups. Are you actively doing anything to try and find ways to decrease your attacks? Are you open to trying two or three things for 3 months to see if they help? Some of you have hurt for so long, that you don’t feel like you have the energy to find things that help. Maybe, you need help in getting plans of action that are unique to you and your needs.

**Shameless plug – I help with these types of plans. – Shameless plug over.**

If you have given up, I hope that you reconsider. Will you be open to the possibility that you can be helped? That you can get better and feel better? Yes, it will take time and effort on your part. You deserve to have fun and a good quality of life. If you are looking for an end to all the flare-ups and pain, that is not realistic, at this point in time. A decrease in migraine days and a decrease in the severity of pain is possible.

I encourage you to share this with others. Especially those that do not understand what happens during a migraine attack. My goal for this article is to help others better understand what a person that has migraines goes through.

Headache Types – Migraine, Non-migraine and Mixed

There are many types of headaches, about 150 different types. First, we have to figure out if the headache is a primary headache or a secondary headache. A primary headache has no known underlying cause. A secondary headache is the result of another condition. The other conditions are things like, inflammation, bacterial or viral infections, a trauma to the head or neck, sinusitis, etc.

Examples of the most common primary headaches:

  • Cluster headache
  • Migraine (with and without aura)
  • Tension headache (medically known as tension-type headache)
  • Trigeminal autonomic cephalalgia (TAC), including cluster headache and paroxysmal hemicrania
  • Silent migraine
  • Basilar migraine
  • Abdominal
  • Ocular
  • Vestibular
  • Status Migrainosus – ongoing pain lasting for more than 3 days

Examples of the most common secondary headaches related to another medical condition:

  • Disease of blood vessels in the brain
  • Head injury
  • High blood pressure (hypertension)
  • Infection
  • Medication overuse
  • Sinus congestion
  • Trauma
  • Tumor
  • Hangover
  • Menstrual
  • Exertional

There is a mixed type of headache, a migraine and a tension type headache that happen at the same time. Some call it a mixed tension migraine.

A migraine can occur in four different phases. Not everyone will experience every phase.

Premonitory phase – also known as the prodrome phase

Non-painful symptoms that may occur a few hours of a few days Before the headache arrives.

  • Unexplained mood changes
  • Food cravings
  • Neck stiffness
  • Increased yawning
  • Diarrhea or Constipation
  • Increased sensitivity to light, sound, or smells

Aura phase – sensory disturbances that may occur before or during an attack

Visual auras may occur in one or both eyes

  • flashing lights
  • zig-zagging lines
  • blurred vision
  • blind spots that expand over time

Sensory auras cause numbness or tingling that starts in the arm and radiates to the face.

Motor auras cause problems in the person’s ability to think clearly and communicate verbally.

  • slurred or jumbled speech
  • difficulty understanding what others say
  • difficulty writing words or sentences
  • having trouble thinking clearly

Headache phase – pain ranges from mild to sever (not everyone will have a headache, but they may have all of the other symptoms such as nausea, vomiting, off balance, etc.

Postdrome phase – happens after the headache subsides and lasting a few hours to a few days

  • exhaustion
  • confusion
  • generally feeling like crap

Migraine Triggers:

  • stress
  • lack of sleep or jet lag
  • hunger or dehydration
  • foods
  • additives
  • alcohol
  • caffeine
  • medication overuse
  • smells
  • lights and sounds
  • weather
  • female hormones
  • physical activity

Unusual signs and symptoms of migraine:

  • Body chills
  • Phantom smells
  • Brain fog
  • Insomnia
  • Stuffy or Runny nose
  • Watery eyes
  • Your skin or hair hurts – Allodynia – pain from things that do not normally hurt
  • Hiccups
  • Ringing in your ears
  • Double vision
  • Trouble hearing or understanding what others are saying
  • Sparks of light in vision

The Complete Headache Chart

TypeSymptomsPrecipitating FactorsTreatmentPrevention
  Hangover Headaches  Migraine‐like symptoms of throbbing pain and nausea not localized to one side.Alcohol, which causes dilation and irritation of the blood vessels of the brain and surrounding tissue.Liquids (including broth). Consumption of fructose (honey, tomato juice are good sources) to help burn alcohol.  Drink alcohol only in moderation.
  Caffeine‐ Withdrawal HeadachesThrobbing headache caused by rebound dilation of the blood vessels, occurring multiple days after consumption of large quantities of caffeine.    Caffeine.  In extreme cases, treat by terminating caffeine consumption.    Avoiding excess use of caffeine.
        Exertion HeadachesGeneralized head pain of short duration (minutes to 1 hour) during or following physical exertion (running, jumping, or sexual intercourse), or passive exertion (sneezing, coughing, moving one’s bowels, etc.).  10% caused by organic diseases (aneurysms, tumors, or bloodvessel malformation). 90% are related to migraine or cluster headaches.Cause must be accurately determined. Most commonly treated with aspirin, indomethacin, or propranolol. Extensive testing is necessary to determine the headache cause. Surgery to correct organic disease is occasionally indicated.      Alternative forms of exercise. Avoid jarring exercises.
    Post‐Traumatic HeadachesLocalized or generalized pain, can mimic migraine or tension‐type headache symptoms. Headaches usually occur on daily basis and are frequently resistant to treatment.  Pain can occur after relatively minor traumas. Cause of pain is often difficult to diagnose.    Possible treatment by use of antiinflammatory drugs, propranolol, or biofeedback.    Standard precautions against trauma.
    Hunger HeadachesPain strikes just before mealtime. Caused by muscle tension, low blood sugar, and rebound dilation of the blood vessels, oversleeping or missing a meal.    Strenuous dieting or skipping meals.  Regular, nourishing meals containing adequate protein and complex carbohydrates.    Same as treatment.
  Temporomandibul ar Joint (TMJ) HeadachesA muscle‐contraction type of pain, sometimes accompanied by a painful “clicking” sound on opening the jaw. Infrequent cause of headache.  Caused by malocclusion (poor bite), stress, and jaw clenching.  Relaxation, biofeedback, use of bite plate. In extreme cases, correction of malocclusion.    Same as treatment.
      Tic Douloureux HeadachesShort, jab like pain in trigger areas found in the face around the mouth or jaw. Frequency and longevity of pain varies. Relatively rare disease of the neural impulses; more common in women after age 55.  Cause unknown. Pain from chewing, cold air, touching face. If under age 55, may result from neurological disease, such as MS.      Anticonvulsants and muscle relaxants. Neurosurgery.      None.
  Fever HeadachesGeneralized head pain that develops with fever. Caused by swelling of the blood vessels of the head.  Caused by infection.  Aspirin, acetaminophen, NSAIDs, antibiotics.  None.
      Arthritis HeadachesPain at the back of head or neck. Intensifies on movement. Caused by inflammation of the blood vessels of the head or bony changes in the structures of the neck.    Cause of pain is unknown.    Anti‐inflammatory drugs, muscle relaxants.      None.
Eyestrain HeadachesUsually frontal, bilateral pain, directly related to eyestrain. Rare cause of headache.Muscle imbalance. Uncorrected vision, astigmatism.  Correction of vision.  Same as treatment.
      Temporal ArteritisA boring, burning, or jabbing pain caused by inflammation of the temporal arteries. Pain, often around ear, on chewing. Weight loss, eyesight problems. Rarely affects people under 50.    Cause is unknown. May be due to immune disorder.    Steroids after diagnosis. Confirmed by biopsy.      None.
      Tumor HeadachePain progressively worsens, projectile vomiting, possible visual disturbances speech or personality changes; problems with equilibrium, gait, or coordination; seizures. Extremely rare condition.      Cause of tumor is usually unknown.    If discovered early, treat with surgery or newer radiological methods.      None.
      Tension‐Type Headaches    Dull, non‐throbbing pain, frequently bilateral, associated with tightness of scalp or neck. Degree of severity remains constant.      Emotional stress. Hidden depression.Rest, aspirin, acetaminophen, ibuprofen, naproxen sodium, combinations of analgesics with caffeine, ice packs, muscle relaxants. Antidepressants if appropriate, biofeedback, psychotherapy. If necessary, temporary use of stronger prescription analgesics.    Avoidance of stress. Use of biofeedback, relaxation techniques or antidepressant medication.
      Migraine without Aura    Severe, one‐sided throbbing pain, often accompanied by nausea, vomiting, cold hands, sensitivity to sound and light.Certain foods, the Pill or menopausal hormones, excessive hunger, changes in altitude, weather, lights, excessive smoking, and emotional stress. Hereditary component.Ice packs; isometheptene mucate, combination products containing caffeine, ergotamine, DHE injectable and nasal spray, 5‐HT agonists; analgesics or medications, which constrict the blood vessels. For prolonged attacks steroids may be helpful.Biofeedback, betablockers (propranolol, timolol), anti‐convulsant (divalproex sodium). Calcium blockers and NSAIDs may prevent or treat migraine headaches.
      Migraine with AuraSimilar to migraine without aura, except warning symptoms develop. May include visual disturbances, numbness in arm or leg. Warning symptoms subside within one‐half hour, followed by severe pain.      Same as migraine without aura.  At earliest onset of symptoms, treat using biofeedback, ergotamine, dihydroergotamine or a 5‐HT agonist. Once pain has begun, treatment is identical to migraine without aura.    Prevent with same techniques as migraine without aura.
          Cluster HeadachesExcruciating pain in vicinity of eye. Tearing of eye, nose congestion, flushing of face. Pain frequently develops during sleep and may last for several hours. Attacks occur every day for weeks/month, then disappear for up to a year. 80% of cluster patients are male, most ages 20‐50.        Alcoholic beverages, excessive smoking.      Oxygen, ergotamine, sumatriptan or intranasal application of local anesthetic agent.      Use of steroids, ergotamine, calcium channel blockers and lithium.
      Menstrual Headaches    Migraine‐type pain that occurs shortly before, during, or immediately after menstruation or at mid‐cycle (at time of ovulation).      Variances in estrogen levels.        Same treatment as migraine.Small doses of vasoconstrictors and/or anti‐inflammatory drugs before and during menstrual period may prevent headaches. Hysterectomy does not cure menstrual headaches.
  Hypertension HeadachesGeneralized or “hairband” type pain, most severe in the morning. Diminishes throughout day.Severe hypertension: over 200 systolic and 110 diastolic.  Treat with appropriate blood pressure medication.  To prevent, keep blood pressure under control.
          AneurysmSymptoms may mimic frequent migraine or cluster headaches, caused by balloon‐like weakness or bulge in blood‐vessel wall. May rupture (stroke) or allow blood to leak slowly resulting in a sudden, unbearable headache, double vision, rigid neck. Individual rapidly becomes unconscious.          Congenital tendency. Extreme hypertension.          If aneurysm is discovered early, treat with surgery.          To prevent, keep blood pressure under control.
            Sinus HeadachesGnawing pain over nasal area, often increasing in severity throughout day. Caused by acute infection, usually with fever, producing blockage of sinus ducts and preventing normal drainage. Sinus headaches are rare. Migraine and cluster headaches are often misdiagnosed as sinus in origin.      Infection, nasal polyps, anatomical deformities, such as a deviated septum, that block the sinus ducts.          Treat with antibiotics, decongestants, surgical drainage if necessary.            None.
  Allergy Headaches  Generalized headache. Nasal congestion, watery eyes.Seasonal allergens, such as pollen, molds. Allergies to food are not usually a factor.Antihistamine medication; topical, nasal cortisone related sprays or desensitization injections.  None.

Source: http://www.headaches.org/press/NHF_Press_Kits/Press_Kits_‐_The_Complete_Headache_Chart

Sometimes the dang chart does not completely transmit correctly, so you can use the link above.

Pat

Describing a migraine to a non-migraine person & Which Time is best, Standard or Daylight-Saving?

You get a “two fer” today.

03/16/2022

A migraine is NOT just a bad headache. Did you know that there are people in the world that have never had any type of headache? I have met a few. I could not believe that there were people that had never had any type of headache. Well, I had to talk to them and explore further. Sure enough, they had never had any type of headache. One thing that I learned is that it is very difficult to explain a pain that they have never experienced, so that they can understand that pain.

Pain is subjective.. It depends on the type of pain and the person experiencing the pain. Why is it so hard to explain? I think one of the reasons is that we need a base reference. What are the different types of pain you have experienced? Tension headache, broken arm, broken leg, broken toe, kidney stone, childbirth, arthroscopic surgery, major surgery, heart attack, arthritis flare-up, etc.

Even if someone has the same kind of injury, the pain may still be different than yours. I know. It is crazy, isn’t it? What if we learn how to better state the pain we are experiencing and how to help others understand what a migraine is? They may never understand the pain you experience, but let’s try to help them understand what a migraine is and what a migraine is not.

Here is the definition of a migraine by the National Institute of Neurological Disorders and Stroke. “The pain of a migraine headache is often described as an intense pulsing or throbbing pain in one area of the head. However, it is much more; the International Headache Society diagnoses a migraine by its pain and number of attacks (at least 5, lasting 4-72 hours if untreated), and additional symptoms including nausea and/or vomiting, or sensitivity to both light and sound. Migraine is three times more common in women than in men and affects more than 10 percent of people worldwide. Roughly one-third of affected individuals can predict the onset of a migraine because it is preceded by an “aura,” visual disturbances that appear as flashing lights, zig-zag lines or a temporary loss of vision. People with migraine tend to have recurring attacks triggered by a number of different factors, including stress, anxiety, hormonal changes, bright or flashing lights, lack of food or sleep, and dietary substances.  Migraine in some women may relate to changes in hormones and hormonal levels during their menstrual cycle.  For many years, scientists believed that migraines were linked to the dilation and constriction of blood vessels in the head. Investigators now believe that migraine has a genetic cause.”

Look at that. Does that look like just a bad headache? No! It is a brain disorder. It can cause a stroke. It can be debilitating for hours, days and sometimes months.

Look at this information from the Cleveland Clinic. “A migraine is much more than a bad headache. This neurological disease can cause debilitating throbbing pain that can leave you in bed for days! Movement, light, sound and other triggers may cause symptoms like pain, tiredness, nausea, visual disturbances, numbness and tingling, irritability, difficulty speaking, temporary loss of vision and many more.

What’s a migraine? What does a migraine feel like?

A migraine is a common neurological disease that causes a variety of symptoms, most notably a throbbing, pulsing headache on one side of your head. Your migraine will likely get worse with physical activity, lights, sounds or smells. It may last at least four hours or even days. About 12% of Americans have this genetic disorder. Research shows that it’s the sixth most disabling disease in the world.

What are the types of headaches? What type of headache is a migraine?

There are over 150 types of headaches, divided into two categories: primary headaches and secondary headaches. A migraine is a primary headache, meaning that it isn’t caused by a different medical condition. Primary headache disorders are clinical diagnoses, meaning there’s no blood test or imaging study to diagnose it. A secondary headache is a symptom of another health issue.”

https://my.clevelandclinic.org/health/diseases/5005-migraine-headaches

Learning to describe your pain more effectively.

THE FOUR MAJOR TYPES OF PAIN:

  1. Nociceptive Pain: Typically, the result of tissue injury. Common types of nociceptive pain are arthritis pain, mechanical back pain, or post-surgical pain.
  2. Inflammatory Pain: An abnormal inflammation caused by an inappropriate response by the body’s immune system. Conditions in this category include gout and rheumatoid arthritis.
  3. Neuropathic Pain: Pain caused by nerve irritation. This includes conditions such as neuropathy, radicular pain, and trigeminal neuralgia.
  4. Functional Pain: Pain without obvious origin, but can cause pain. Examples of such conditions are fibromyalgia and irritable bowel syndrome.

Words used to describe pain.

  • pressure
  • aching
  • squeezing
  • cramping
  • burning
  • freezing
  • numbness
  • tingling
  • shooting
  • stabbing
  • electric shocks (jolts)
  • burning
  • sharp
  • dull
  • intense
  • aching
  • cramping
  • shooting
  • stabbing
  • gnawing
  • gripping
  • pressure
  • heavy
  • tender
  • prickly
  • stinging
  • pounding
  • pulsating
  • throbbing
  • sick (associated with nausea)
  • tightness
  • vise-like
  • jabbing
  • lightning bolts
  • constant
  • constant with jabs

Keep a record. Clues are very valuable.

Date

Time (how long did it last)

Where is the pain located?

Are there triggers? List them.

How quickly does the headache develop? (Suddenly, over time, starts low and increases, etc.) Describe the start. You may have to think back before the pain started, what was going on?

Is there a family history of migraines or headaches?

What do you take? What works? What does not work?

Can you recognize some of the lesser-known symptoms of a migraine? The things that may happen before the pain begins.

  • Intense throbbing or dull aching pain on one side of your head or both sides.
  • Pain that worsens with physical activity.
  • Nausea or vomiting.
  • Changes in how you see, including blurred vision or blind spots.
  • Being bothered by light, noise, or odors.
  • Feeling tired and/or confused.
  • Stopped-up nose.
  • Feeling cold or sweaty.
  • Stiff or tender neck.
  • Lightheadedness.
  • Tender scalp.

We should talk about the different types of migraines and medication overuse headaches next time.

Next is the time change debate.

Time Change Stuff

Everybody has an opinion. Especially the two weekends a year we change our clocks. Most of us are out of sorts for a week or two. The “reasons” that are used to change the time twice a year are plentiful and are usually exaggerated or down right wrong.

We aren’t gaining any daylight. The amount of daylight is still the same, our time of day has changed. I am a night owl, but I think that I would prefer the Standard Time to be the one we stay with. Settle down, you can have your say later and I hope that you do. It is much more interesting when we can have a discussion.

When I was younger, I would ask why do we do this? I was told it was to help the farmers and conserve energy. The very next questions was, you guessed it, “how?” So, we would have more time in the evening to do hay. Since most of my family had other jobs during the day and did the farming chores after work and on the weekends, that made sense to me. As for the energy conserving … well, that did not get a good explanation. We stayed out until dark-thirty so I guess we didn’t have to use as much electricity for air conditioning. I know now that there isn’t a good explanation. We no longer use coal to heat. We have much better light bulbs now. It is much better to set the thermostat and leave it alone.

What happens if the change to Daylight-Saving Time is made permanent? I guess we need to decide if that hour of daylight is better for us to use in the morning or the evening. Our circadian rhythm is closer to Standard Time. It seems as though it is better health wise for us to stay on Standard Time. Kids catching the bus would benefit more from Standard Time. When it is dark out, I don’t want to get up and I know that it is harder to get the kids up. It is hard to get them to bed when it is daylight outside and they have school the next day. Even if you can get them in bed, they don’t go to sleep. They are getting a double whammy. They lose out on sleep time and they are hard to get up in the morning while it is still dark outside.

Maybe the farmers want more light in the mornings. It is really hot outside after two or three.

Now I hear that Congress is getting ready to get in to the time change game. This may be interesting. It looks like our representatives are leaning towards Daylight-Saving Time. If it passes then Hawaii and Arizona will have to change their clocks. Whichever group has the best lobby will probably win.

I do like the idea of never having to change our clocks forward and back. I prefer us to be on Standard Time for health reasons and kids that have to get up early and catch a bus. For the parents that have to get them to bed, it will be easier on you to get them to bed when it is dark outside.

Yes, I do know that Daylight-Saving Time gives us more daylight in the evening to be active or “do stuff.” Is that one hour in the evening worth all the other issues we will have to deal with?

I don’t know 100% which is best, but I am leaning towards Standard Time. If Daylight-Saving Time is picked, then we will make the best of it, do some studies over 10 years and see. Just pick one!

And your thoughts?

Pat

If it isn’t visible, it isn’t happening and other bull$%^!

If it hasn’t happened to them, they have no idea what is going on. But, a lot of them have an opinion about how you are; how you should or should not feel. Even if they have experienced it, it may not be the same as how you experience it.

March 9, 2022

We are all different. Our life experiences are different. Our pain tolerance is different. Our bodies are different. Sure, they are comparable, but they are not exact. We metabolize foods and medications differently or not at all. So many variables affect our immune system. So many things affect the inflammation inside of our bodies.

Biological processes are variable. Cultural traits are different. Genetic make-ups are different. We all have special qualities. We have our own body type.

When did healthy become based on appearance?

You can be really thin and be very unhealthy. You can be overweight and be really healthy. People of all shapes, sizes, weights, can either be healthy or unhealthy. You are in your body 24/7 how do you feel and what is going on with you? Is your body nourished with the foods that it needs? I am not talking about stress eating or emotional behaviors, just plain old giving your body what it needs to function at its highest level. Food, hydration, rest, activity and sleep are all important for a healthy body.

What happens when a body has an autoimmune disorder? An autoimmune disorder is a condition when your own immune system mistakenly attacks your body. It destroys healthy body tissue by mistake.

How would you think a person might feel while all of this is going on inside their body? They have pain, tiredness, fatigue, nausea, rashes, headaches, dizziness and more depending on what disease they have. They feel these things, All-of-the-time, because they have these things all-of-the-time. It would be rare for them to not to feel bad because their body is under attack.

My hope is that these folks are working with their doctors and other health care providers to find out what works best for them and their needs. To have the best quality of life possible. I only want folks to take the medications that they need. To use other means to help manage their conditions. Nutrition, hydration, strengthening, mindfulness-based stress reduction meditation, stretching, rest and activity. It takes all of these things plus medications to improve quality of life.

I get it. It is hard to do all of these things, work full-time, have a family life, friends, etc. Don’t look at it as giving things up. Look at it as caring for yourself to improve your energy and strength so you can spend more time with those that you love and do the things that you enjoy doing. Your friends and family can do all of those things with you, except, take your medication. It is probably easier to have a work-out buddy to keep you engaged and committed to the routine. That is the key anyway. It will become a routine and then a habit. Once it is a habit, you no longer have to use a lot of brain energy to figure out all the particulars.

Living with a chronic disease is hard. It is hard on the person that has it and it is hard on those that love them. It sucks to make plans and then they get cancelled because of a flare-up or a bad day. Once or twice, you can usually get over it, but more than that, it begins taking a toll on all involved.

No body wants to make plans because they get cancelled. A wall begins to build up. Everybody is pissed and nobody is talking to nobody about the elephant in the room. Maybe, it is because you don’t want each other to feel bad? Maybe, it’s because, you know that sometimes shit happens and you have to adjust.

It is great to realize all of that. You must also talk with each other about it. How you see things, how it makes you feel and what you want. You aren’t really mad at each other; you are mad at the situation. If you are mad at each other, I suggest you go and get counseling now. It does not matter if it is a partner relationship or a friend relationship, you do need help in navigating these issues.

Too often, only the medical side is addressed. No body wants to deal with the messy part of a chronic illness. The parts that leave families strained and sometimes broken. You have to deal with the messy parts. Once you do and you have a workable plan, it can make all the difference in your relationships. It is not easy, but the results are worth it. In my business, I deal with the medical side and most parts of the messy side. If you need a therapist, I will recommend that.

Learning and understanding what is truly going on with a person that has a chronic illness is eye opening. Being able to modify plans or activities will improve relationships. You want them at their best, so what are you going to do to help them get to their best?  Can you relate to what they are experiencing?

Pain is subjective. We all have different tolerances and what may be a 10 (the absolute worst pain you have ever had) may be a 3 or 4 (mild to moderate) to me. I am sure you have heard people state that they have had a kidney stone and it was the worst pain possible. It has to be worse than having a baby. Why? Because you “say so?”  Because the pain you experienced was the worst pain in your life does not mean that it was worse than the pain of childbirth. Some of you mom’s that have had both can speak to this. I have heard a few moms say that childbirth pain was the worst and I have heard a few moms say that the kidney stone pain was worse.

Here comes a rabbit chasing. No one needs to suffer from uncontrolled pain. I understand that all pain cannot be eliminated and that is not really the goal of treating chronic pain. We treat chronic pain to help those with that type of pain to live the best quality of life possible. An active life. A fulfilling life. Managing the pain to a tolerable level is the goal. Treating chronic pain takes a multi-prong approach. Medication alone will not provide the relief needed. Strength training is one way to reduce pain. Running or walking is another way to reduce pain. Eating for nutritional needs, is yet, another way to reduce pain. Hydrating every day is another way to reduce the pain. It is all connected. Yes, I know there are many different types of pain. Thus, the multi-prong approach. I don’t believe in cookie cutter approaches to treating pain. People are different, their pain is different, their tolerances are different, medications work for some, but do not work for others. It is very easy to get frustrated when every thing that you try does not work. I use a combination approach with my clients and that seems to work better for pain relief and pain control. It will take effort, some fine tuning to the plans to get the right combination that works for you, but it will be worth it. Rabbit chasing over, for now.

After a while, folks just give up. The one with the chronic illness and the one without the chronic illness, just give up. If your loved one has a chronic illness, help them to become they best they can be. Encourage them to take back control of their life. Help them to focus on the solutions and not the freaking problems. What can they do? What can they improve? What will it take to help them? You can’t make them, but you can encourage them, believe in them and help them when they ask. You can’t do it for them and they do get to decide what they will or won’t do.

To the one without the chronic illness, you need to take a look at your beliefs about the one that has the chronic illness. This may get ugly. Do you understand what they go through every day? Do you understand that they feel like they let everybody down? Do you understand your part in not being able to go and do? Are you becoming an enabler to their lack of action or lack of participating in activities? There are other things, but you get the idea.

Don’t give up! There are things to try. There are things that will make your life easier. Get ready to look forward to activities again. Yes, you have to think about getting ready. You have to reason it out in your mind. The negatives will come rushing at you. All of the “you have tried this and it didn’t work,” thoughts will flood your mind. It may not have worked then, but it is possible that it will work now by doing “x,y and z.” If you are not open to the possibility that things can get better and actually be better, then they won’t.

Who do you need to add to your health care team? Me? A sports psychologist? A nutritionist? A therapist/psychologist? A trainer? A workout partner? A deal with my anger and other emotions therapist?

An autoimmune disorder may cause destruction of body tissue, may cause an abnormal growth of an organ, or even cause changes in organ function. The areas most often targeted are blood vessels, connective tissue, joints, muscles, your skin, red blood cells, your thyroid or your pancreas and other endocrine glands.

Very few of these disorders can be seen. It is all happening inside the body.

Here are some of the most notable autoimmune disorders:

Next time, we will touch on other non-visible health conditions such as migraine, depression, heart disease, etc.

Pat

How the senses change in dementia…

No, they are not just being difficult.

March 2, 2022

Your loved one is having an unexpected reaction to the food they are eating. They stop eating, declaring that it has no taste. They become very apprehensive while walking through a door into a restaurant. They are nervous and are becoming more and more irritated. They cannot seem to judge how to sit down in the seat. They seem so distracted that they cannot read the menu or decide what to order.

These things and more are due to the brain not being able to process the sensory inputs correctly or in a timely manner. Their sense of taste and smell have lessened or may even become non-existent. When areas are too dark, they are unable to differentiate the floor from the walls, tables or chairs. Their depth perception is way off and maybe they begin to sway more and even fall more. Noisy places can send them over the edge. Too much sensory information overload can cause a meltdown and unwanted lashing out behaviors. The talking, the music, the televisions may be too much for them to handle.

You probably will not be able to calm them down and so it is best to remove them from the situation. They cannot follow the conversation with all of the distractions. They will become disoriented more easily and their balance will be affected as well.

Why is this sensory overload happening? It could be an auditory processing disorder. That can be tested by an audiologist. In mild cognitive impairment, any dementia, including Alzheimer’s disease too much “noise” can strain the brain and make it work harder. Our brains only have so much focused energy to use during the day and an impaired brain, has way less energy to use. If they expend all their energy on the “noise” issue they have no energy left to work on anything else. They may be able to hear well, but they cannot process/interpret the sensory input. By the way, hearing also affects balance.

Sight/Vision issues:

  • Lack of depth perception
  • Decrease in ability to detect movement in the room
  • Decrease in ability to see colors
  • Problems recognizing people, faces or things
  • Shadows and light can mess with their minds and what they think they are seeing   .
  • They may be able to see, but are unable to interpret what they are seeing.
  • Things may appear blurry.
  • They may no longer have peripheral vision.
  • They will need more light to see.

Smell issues:

  • Sense of smell decreases
  • They can no longer smell smoke, odors, foods that may be spoiled.

Taste issues:

  • Sensitivity to taste declines in dementias.
  • The last taste to go is the sweet taste.
  • They will add a lot of salt, if the salt shaker is visible.
  • It is perfectly fine to use other spices to help them “taste” their food.
  • When the sense of smell goes, taste goes too.

Touch issues:

  • They may be unable to tell when things are hot. You might want to decrease the hot water heater temperature.
  • They may not know when they have cut themselves with a knife.
  • They may not be able to tell the difference in hot water and cold water on their body.

Hearing issues:

We talked a little about that in our example above.

  • A person with dementia may have normal hearing, but they will probably be unable to process the information correctly. Remember, we hear with our brains.
  • Competing noises are very distracting. Even if it is normal to you, a person with a dementia cannot filter out the extraneous noises.
  • Are the batteries in their hearing aids good? Are their hearing aids working?
  • Do they need to be checked by an audiologist? NOT, a hearing aid specialist.
  • They need a quiet setting. Low music is usually fine. TV is not good and needs to be turned off, while they are eating and talking.

Impaired movement issues:

  • They may take shorter steps.
  • They may drift to one side.
  • They may shuffle their feet.
  • They may slow way down as they walk.

Balance issues:

  • It becomes harder to judge distances and they may bump in to things.
  • They struggle or can no longer negotiate stairs.
  • Balance and coordination may be off and so they trip or fall more easily.

Stiffness/Shaking issues:

  • The muscles can become more rigid which makes it more difficult to move.
  • The muscles can become tighter and restrict movements.
  • The muscles can waste away from inactivity and malnutrition.

Coughing/Choking issues:

  • The ability to chew and swallow may become compromised and even lost.
  • It becomes easier for them to aspirate and a pneumonia set up in their lungs.

A person with a dementia is actually having brain failure. The brain can no longer receive, process, interpret and react to sensory signals appropriately. What is so frustrating is that sometimes our loved ones are “all there and with it,” other times, they cannot do anything. No rhyme or reason. Some days and moments are good and other days & moments suck.

Pat

What is your resistance costing you?

What happens when things do not go smoothly? What happens when things do not go our way? Stress levels rise.

February 23, 2022

Think about the turmoil in your life. The things that are stressing you out. The things that you are just uncertain about or confused about what to do next. Some of you need to take a few deep breaths right now.

Breathe in deeply through your nose for a count of 5 and exhale through pursed lips of a count of 6. Do this 5 times. Now, you can settle down and focus. You realize that “it” is not happening, right now and you are okay. Why would I want you to be able to focus? Why would I want you to realize that you are okay?

Because things run together. They get intertwined and become a big mess with you in the middle of the situation. You cannot think straight when you are in the big middle of a mess. Most of us do not like messes. We like it when things go smoothly and we especially like it when things go our way.

What happens when things do not go smoothly? What happens when things do not go our way? Stress levels rise. Reactions take priority over a plan. WTF, gets said multiple times. Dammit and shit are said a lot too. You may or may not say them out loud, but you sure are thinking them. It is okay, it can be a stress reliever and give you enough time for your thinking brain to catch up to your reacting brain. I know, friggin’ amygdala.

We have heard the phrase, what we resist, persists. Carl Jung is apparently the one who first stated this principle. Resistance is what stops us from getting things done. We use excuses, justifications, procrastination, perfectionism and even the voice in our head that is telling us that we aren’t good enough or we don’t have enough time. It also tells us other things, but you get the idea. Sometimes, you have to tell that inner critic to shut up.

We have resistance because we are afraid of something. We have resistance because we need to make some kind of change. We do not like change. It is hard and it takes energy to change. Resistance will always rear its ugly head when there is something that will need our energy and attention. We would be better if we learned to “let go” or let things be, just as they are. No judgement allowed. The goal is accepting things, just as they are, right now. If you keep resisting, then all of your focus and energy is going to something that you do not want.

Learn to refocus your energy and focus on what you DO want. You don’t give up. You won’t give up. It is not in your nature. Persistence is a good thing, especially if you are a helper or care giver.

Recognize your resistance triggers and when they will show up. Be curious about them. We all have them. The question becomes, will we give up or will we move forward? Visualize the success in your mind. Set your personal goals. That is all you have control over, anyway. Decide how you will act during a tough time. Maybe, you will need to take 5 – 10 minutes to gather your thoughts and figure out the next best step. No, not the whole plan. Just the next step.

When you find yourself in the middle of a crap storm, look around, take inventory. Is anyone in mortal danger? Is any one about to die? If not, then you have time to take a few minutes to see how best to proceed. I know you want the pain to stop. We all do. That is part of the resistance, we do not like change or the unknown it takes energy and time.

Some signs you may be in a resistant mode:

  1. You procrastinate
  2. You are too busy
  3. You are impatient
  4. You forget things
  5. You are not organized
  6. You feel stuck or paralyzed
  7. You are very impatient
  8. You can’t or won’t make a decision
  9. You find a reason Not to act
  10. You complain a lot
  11. You become defensive
  12. You look for limitations and barriers
  13. You avoid people or change

Antidotes to resistance:

  1. Acceptance of how things are, right now
  2. Observe and acknowledge how you are feeling
  3. Let go of blame or judgement
  4. Move – walk, run, work out, hike
  5. Take the next step forward

You may have to start with accepting that you are not ready to accept what is. We resist because we don’t want to deal with “it.” We are fearful of the outcome. We may know intellectually what the outcome may be, but we are not emotionally ready for the outcome. It won’t go away. Get comfortable with being uncomfortable. Feeling out of control is another trigger.

Find the lesson. There is always a lesson that we are supposed to learn. A lesson about ourselves. A lesson about our loved ones. A lesson about trust. We do have a choice. We can choose acceptance and move forward. It won’t be easy, but you can do it. Acceptance never means giving up. It means finding new ways to have the best quality of life possible for you and your loved ones.

I am more of a “see where we are and what needs to be done,” kind of care giver. I don’t deny the facts, but I sure won’t give up either. We can no longer do it this way, so what about trying the other way?  Focus on your realistic goals and options. You only have so much energy every day, don’t waste it on things that are not changeable or cannot be changed.

You don’t have to be okay with the “thing” that you are accepting. It doesn’t even mean that you feel good or peaceful about it. It requires courage to face the reality of “what is, right now.” Maybe, the word acknowledging is better than acceptance in some situations. It is okay to hate it and not know what to do. Use a person to be your sounding board so you can work through scenarios. Ask for input or suggestions, realizing that you get to choose to use that information or not.

Are you ready to make some kind of change?

  1. Identify your “want” in the change (not the should)
  2. Give yourself time to prepare for change
  3. Visualize your life during the change and after the change
  4. Prepare for set-backs and moving forward again
  5. Be kind to yourself and acknowledge all of your victories (both large and small)
  6. Create an action plan (Empowering Health Options does this, too)

Pat

Has your life been hijacked by responsibilities outside of your control?

How do you feel about that? Okay, now, how do you feel about how you feel? Whew! That in itself is enough to make your head explode, isn’t it?

February 16, 2022

I learned a new phrase today, as I was doing some research on dealing with feelings, and I came across “meta-emotions.” I have never heard of that term before. I was thinking about my own experiences of how I felt about the frustration and anger that I felt when my life was hijacked. I did berate myself for feeling that way. How could I feel that way? I love my mama and I will do anything that I can for her. The frustration and anger was never about her. It was about the situation.

Meta-emotions can be classified into four types: negative-negative (e.g., feeling embarrassed about feeling sad), negative-positive (e.g., feeling guilty about feeling happy), positive-positive (e.g., feeling hopeful about feeling relieved), and positive-negative (e.g., feeling pleased about feeling angry).

I could not make things better. I could not fix this so we did not have to deal with all of this crap. I wish that I could tell you that I adapted well. I did not. I made it much harder than it had to be on myself. I sure learned the hard way, that I would have been better off if I had learned to accept things as they were & adapt to the ever-changing situation.

Nope, just stuff it all down. Deep down, inside. Soldier on. That will work for a while, but not forever. It will come out. It will come up in screwy ways. You won’t even know why you are feeling like you feel. It may years down the road. You can’t figure out why your emotions are all over the place. Maybe, if you got still and curious you could figure it out? Talk therapy is a much quicker way to figure it out.

I think everyone needs to do some talk therapy. Shoot, three or four sessions may be all that you need. Therapists will give you the tools you need to figure some of this “emotions” stuff out. You will also be taught how to deal with it in an appropriate manner. In other words, you won’t have to show your ass.

You won’t have to keep beating yourself up for feeling bad about feeling bad. If you are a helper or care giver you have probably dealt with all kinds of emotions. I use feelings and emotions interchangeably sometimes because I won’t slow down and figure out which one it is. Here is my attempt at understanding the difference. Emotions are neurological reactions to external stimuli. They are instinctive and we are not usually conscious of them. That friggin’ amygdala, again. It really is trying to keep us safe. We have to help it, by realizing when we are in danger and when we are really NOT in danger. Feelings are the reactions to the emotions.

  1. Something triggers you
  2. You have an automated response (your fear emotion, anger or whatever the emotion, is being sent out through your body)
  3. That lasts about 90 seconds and then that part is over
  4. What happens next, is up to you. Will you cling to that emotion or will you interpret the situation as not life threatening, reassess and move forward?
  5. Realize that how you think and how you feel directly impacts how your body reacts. This is the point where you take a breath or three and separate yourself from the experience to observe it, be objective and be curious about how you feel. No judgement allowed.

How do you manage difficult emotions?

Can you reinterpret what you experienced? Can you look for the good in the bad? Sometimes, we have to sit with that uncomfortable emotion. We have to feel it to process it. That is not fun. The upside is that we can learn from it and we don’t have to always have the negative emotions when we are triggered. We can learn. “Whatever you resist will persist.” I have no idea who said that first, but I have heard it a lot.

Emotions may not signal danger, but they may signal that you need to make a change.

Care givers have many, if not all of these emotions at one time or another. See if you can relate?

  1. Guilt
  2. Resentment
  3. Anger
  4. Frustration
  5. Worry
  6. Loneliness
  7. Defensiveness
  8. Grief

Questions to ask yourself when you feel certain emotions arise:

  1. Is what happened unexpected?
  2. Is what happened enjoyable?
  3. Is what happened going to make it easier or harder for me to get what I want?
  4. Can I control it?
  5. Will I be able to cope with what happened?
  6. Does what happened match with what I think is right or wrong?
  7. Is what happened my fault or someone else’s?

(I borrowed these questions, but I cannot find my cite link.)

What are the positives of negative emotions?

Sadness or grief may make you pay more attention to details?

Anxiety or stress may encourage you to find new ways to deal with situations.

Anger or frustration may make you see that it is time for help or another set of eyes on a situation or problem.

Guilt may help us to figure out what is ours to deal with and what is not ours to deal with.

Negative emotions may be what you need to motivate you to make a change.

**Any time that you deal with your emotions, you will get tired and feel drained. It is very exhausting, but it is worth it in the long run. **

Pat

Are there any positive benefits to being a family helper or care giver?

Sandwich generation

February 2, 2022

So often we talk about the stressors and negative consequences of helping a loved one. But, what about the positive things that can happen? There actually are some benefits.

Care giving is full of ups and downs. Every day may be different. Different is not always a bad thing. You may even have more pleasant days than bad days. I know, some of you are thinking that pleasant days are not what you experience. I get it, not everything is going to be pleasant.

Think back to a rough day. One where it took you three hours to get them dressed and fed. Maybe, it was a day that they did not recognize you and they balked at every turn. It gets emotionally draining. We tend to remember all the problems and struggles that we deal with. Why? I am sure our amygdala has something to do with it. LOL. Look, we remember it because it messed with our plans. We hit a resistance or barrier of some kind. Did we shift our focus or try another way or even try again later? Nope. We pushed through and made it happen. What was left in our wake? Wasted time. Hurt feelings. Frustration. We just reinforced all of the negative feelings. We forgot to focus on the small victories. They can still get dressed and they can still eat. They can still get out. Your unmet expectations are what really caused the “problems.”

While we are focusing on a dementia or Alzheimer’s related issue today, it could be any chronic health condition that causes a decline in our loved one. A physical decline and/or a mental decline happens in a lot of other diagnoses.

I wish that I could tell you there are predictable patterns. It all depends on what area(s) of the brain are affected. Their brain is failing. You may experience a problem with the bathing issues and someone else may be dealing with the 500 questions a day issue (the same 500 questions). Maybe, they are still quite mobile and wander off, repeatedly. You must realize that all of these behaviors are UNCONTROLLABLE for folks with dementia. Alzheimer’s is the most common dementia. Analyze your own response to the frustration. See what you can modify or change to make the process go more smoothly. If you find yourself getting more and more frustrated, it is past time for you to take a break.

Next time, focus on what they can do. See what they can do for themselves, even if it takes longer. What would you consider a success, taking their limitations or bad days in to account? Go in with a smile and a warm fuzzy feeling in your attitude. They will pick up on that. Spend a few minutes talking with them. Touching them gently on the arm or shoulder. Use the phrase, “we are going to _____________ now.” One thing at a time. One arm at a time. Speak to them and tell them what “we” are doing in a calm, loving voice. Take a break, if they need to. You will still complete the tasks much easier and faster if they are helping and not fighting you. How ever long you think it should take … multiply that by 4. That is your timetable.

It will be in the small things that you will see what you have accomplished. Their calmness and trust will be so amazing. Even if they are no longer verbal, they sense emotions and do it quite well. They may look at you and not know your name or maybe not even who you are. But, they know that you are someone that cares about them, that loves them because they sense it.

You have a purpose. To help someone that you love have the best quality of life possible for them.  It feels good to have a purpose. It feels good to help someone that you love. They have helped you and now you get to help them.

You being there is important. None of us want to be alone. Your time, effort and attention provides comfort to them. I hope that brings you comfort and joy.

You find yourself talking with them. For the first time, in a long time, you are having a real conversation. Telling and listening to stories.

You will be changed by this experience. Maybe you figure out what you want and what you do not want when you reach their age. Maybe you see the things that you need to take care of now, so your kids won’t have to struggle to find the information needed.

You probably will never receive an award for being a helper or care giver to your loved one. You may never even be appreciated. You may never be acknowledged for what you do or what you have sacrificed.  Did you really do it for the accolades? Probably not, but some people do.

What if you haven’t been close and they need you now? Could this be a time of mending fences? Could this be a time of moving forward? What about resolving old hurts or negative feelings?

Care giving can teach you a big lesson about control. As in, you are not in control and you cannot control the outcomes. That, sucks! It is a lesson that we all need to learn. We can do our best. We can make plans. We can implement the plans. But, we have no control over the outcome.

Your own kids are watching you. They are watching how you act towards your mom, dad, spouse or partner. They are listening to what you say. They are observing what you do and how you handle problems or stressful situations. You are modeling for them what to do and how to act. Your attitude towards your loved one may very well become their attitude towards you when you need their help.

Even with all of the positives of helping a loved one … we all need to take breaks to rest and recharge.

Pat

p.s. Share this blog with your friends.

Almost half of caregivers will not ask for help. Why?

January 26, 2022

At first, it did not take too much time or effort to help them. Your mom needed a little help with running errands and doctor appointments. Your dad needed some help with cleaning the gutters or getting the oil changed. Your wife needed help getting to her hair and nails appointment. Your husband needed help with mowing the lawn and going to the barber. Nothing major and it didn’t take too much time or effort to help them.

As the months fly by, more and more is required of you. More of your time. More of your effort. More of you moving your schedule around. At about the 18 months mark, you are getting a little tired. You are beginning to feel more and more frustrated. You have had to miss work. You have missed your kids school functions. You have missed your kids’ ballgames. You look up and realize that you have not seen your best friend in months. You have not been out to eat in a long time.

Your body is aching. You are tired. You realize that you have not been doing your favorite activities that keep you in shape or keep your stress level down. Walking, running, swimming, weight lifting, yoga, playing cards, gardening, reading, etc. You try to think back to when that all stopped. Maybe you remember, maybe you don’t because it was a slow process.

When was the last time I saw __________________? When was the last time that I had any fun? When was the last time that I spent a weekend with my husband, partner or family? When was the last time that I spent time with my wife or partner to reconnect? Hell, when was the last time that I had time to myself to do what I wanted to do?

About the 18 months to 2-year mark, you usually need help. Sometimes, things are going well and you just need a break. Sometimes, things are not going well at all and you don’t know what to do to make things better. This is usually the time that I am called in and we troubleshoot, create plans of action and get the support system up and running.

Everyone needs a support system. It would be best to gather all of those folks at the beginning. Why? Because, eventually you are going to need them, their talents and their help. Don’t wait until there is a crisis to figure out who is good at what. Don’t wait until there is a crisis to find out who is willing to provide hands-on help and who is willing to provide other services such as running errands, doing the laundry, cooking meals, mowing the lawn, cleaning the house, etc.

If you ask people to do what is uncomfortable for them to do, they will do one of two things. One, they will decline to help. Two, they will do it, but they will resent it and will find ways to never have to do it again. Not everyone can or should provide the hands-on care. Maybe they are comfortable with hands-on care up to a point. Find out what that stopping point is! Mine is the toileting and bathing habits. I am not too good at sitting with them for long periods of time either, I preferred to get out and about with mama and she preferred that too. I used to beat myself up for not being able to do the toileting and bathing things. I certainly loved and cared for my mama. I wanted her to have her needs met and have the best possible care. I had to realize my strengths and my weaknesses. I had to understand that it was not about me, it was about what she needed and who could best provide those things.

I can do any of the medical stuff but, I cannot do the toileting or the bathing stuff. Isn’t that strange? Looking back, I had medical know-how and training, but I never had training for daily care. Maybe, that would have made a difference. In my case, I don’t think so. I do believe care givers need to be trained in helping with the activities of daily living. You can hurt your loved one or yourself if you do things incorrectly. Care giving is hard work. It is physically demanding. It is emotionally draining. It is mentally taxing.

We sure do it though, don’t we? Even if you provide hired help or see to your loved one’s care, you are a care giver. Even if you are hours away or states away and you see that their needs are met, you are a care giver. We see ourselves as helpers and not as care givers, but we are care givers. Why is that important? Because, being a care giver has health consequences for us. Being a helper or a care giver impacts our entire family.

Asking for help is necessary for good care. It is good for the care receiver and it is good for the care giver. Why do you need to ask for help? Because at the beginning, folks did ask you how they could help you. You didn’t really need the help then. They would keep asking for about a year and then they would stop asking. Why? It wasn’t because they no longer wanted to help. It was because, every time they asked, you said no. So, they stopped asking. They figured, if you needed help, you would let them know. You needed help, but you did not let them know. You are so busy. You are stressed. Take a breather. Be open to the possibility that others are willing to help. You make that call and state what you need. Yes, state what you need. Be specific. If they can, they will. If they can’t, they won’t. Call the next person and state what you need. For example, I need mom to be taken to the hair dresser on Thursday at noon, to the grocery store after that and stay with her until 4:00. Not, can you help me with mom on Thursday?

By stating what you need, you have given them the opportunity to see what needs to be done and if they can make it happen. Maybe, they can do all of it, maybe they can do the hair dresser and grocery store. It is much easier to decide if you know what will be expected of you and the time frame. It is always the unknown or ambiguous that will cause us to hesitate and probably say no. Another example is that you need someone to sit with your mom for 6 hours on Saturday. Don’t ask if they can sit/stay with her for 6 hours. They will freak out. They don’t know what to do with her for 6 hours. Give them some activities to do. Lunch out, if possible. Watch a movie, play cards or a board game.

Use “I” statements. I need a break to take care of my stuff. I want you to _______. Try your best not to use “You” statements. That is a fight or hurt feelings just waiting to happen. The word “you” gets everybody’s back up and on the defense.

Maybe you do need them to sit with a loved one who is unable to do much of anything anymore. You still need to tell them how to be helpful. Give her 2 oz. of water to drink every hour or so. Tell them that she will need to be prompted to drink. Tell them when and what to feed her. Tell them what medications they need to take and when.  Let them know her schedule, TV shows, nap time, etc. Let them know that they need to check on her every hour and that they can watch TV, watch a movie or do their work. Maybe, they need to hold her hand or just be in the same room with her.

 Tell them what to expect. Sure, you know, but they do not know. They want to help and they want to do it right. It would also be helpful to give them a phone number of someone else to call, if they have questions. NOT your number, someone else’s number. You are taking a break.

Look, the more you have prepared them, the more likely it will be a success for all involved. The more successful it is, the more likely it is that they will help you again. Win-win-win. You win. Your loved one wins. The helper has helped you and feels good about that because they care about you.

The helper will not do it exactly like you do it and that is okay. There are always more ways to do things. Don’t be a micro-manager. You trust them to stay with your loved one so trust them to handle the tasks.

Why is it so hard to ask for help?

  • You are having difficulty trusting someone else to do the job “right.”
  • You won’t let go of the need to control things
  • Guilt over leaving the person in someone else’s care
  • Worry over the quality of care if you are not there from day to day overseeing everything
  • You may be too overwhelmed to ask for help
  • You think that you are being selfish if you put your needs first
  • I promised my father that I would always take care of my mother
  • I am responsible for my parent’s health
  • If I do it right, I will get the love, attention and respect that I deserve
  • You feel inadequate if you ask for help
  • My loved one refuses to let anyone else help & guilt trips me
  • My siblings are jockeying for power

Change your mindset

Realize that asking for help is smart. It is not selfish. If you burnout, who will be there to help care for your loved one? Give yourself permission to enjoy your own life. Realize the importance of taking care of your own health (physically, emotionally and mentally.) Understand that a break is essential and not a luxury. While this is easier said than done, turn off your care giving mind. A few hours of reconnecting with others, a dinner out, a long hot bath and sleeping in your own bed, can do wonders.

Asking for help is necessary for both you and the care receiver. See, it is not all about you.

Some tools/tips to help you ask for help:

  • Have a list of people to call
  • Have a list of needs/projects to be handled
  • Consider the person’s strengths when asking
  • Ask different people, do not use the same person each time
  • Pick the best time to ask for help
  • Be prepared for refusals
  • Understand their hesitancy
  • Don’t take it personally, when someone you have asked cannot help, this time
  • Be assertive, but don’t be an ass

Our emotions exist for a reason. They let us know when something is out of whack or off kilter. Learn from them. Don’t push them down, don’t ignore them, learn from them. Even if you push them down, they will come out in other ways. If you are providing care for a loved one you will experience many different emotions. Emotions are not wrong or bad, they just are. Be curious about them, ask why you are having this emotion or feeling? No judging! Maybe some of your emotions are telling you that you need to make a change in your care giving situation. You have probably begun the grieving process. You are experiencing an increase in stress. That it is time for you to ask for help. It is time to be assertive.

  • Who are the 5 people you will contact?
  • What will be on your list of chores/projects?
  • What days and times will you need a break?

Write it down. When will you complete these lists? Write it down. When will you start making these calls to get people on board? Write it down.

What gets written down, gets done.

Pat