All Saints' Health Ministries Cares for You!

These are previous blog posts on current, relevant topics from our former Health Ministries Coordinator, Patrice Al-Shatti when she served parishioners of all ages and stages in her previous role at All Saints'. See her current blog as Deacon in "We Are Called."
 

Archive of 2014-2016 Health Ministries Articles

August 26, 2018 Goodbye, For the Moment


I came to All Saints’ in August 2012 during the most tumultuous time in my life. This community helped me heal and nurtured within me a renewed hunger for the spiritual life. In 2014, I became Health Ministries Coordinator after my friend Marta Smith moved on to other roles, and in 2016, I collaborated with others to start the All Saints’ Creative Community and our gallery program, which has perhaps enabled some of you to own artwork created by your friends and neighbors.


I also spent the last two years walking the path of discernment for the ordained deaconate. Some of you were on my discernment committee. Some of you have been praying for me. Some of you have been friends and confidantes as I navigated this interesting journey. All of you have inspired me. Those of you who trusted me with your pain and sought my advice regarding difficult personal and family matters; those of you who attended small group programs like Transitions or Mindful Eating, trusting that there might be something of value there for you; those of you on Prayer Team who helped me see my broken places so that God could fill them. I feel like you are family.


 

Now my deacon academy journey is calling me to another parish for six months to serve a required internship starting September 1st. As I disengage from my various roles at All Saints', I do so with bittersweet knowledge that this community has woven itself into my heart and that taking leave is hard. Longtime parishioner and experienced nurse Jane Irvine will take over as your new Health Ministries Coordinator, and artists Stephanie Cambio and Mary Boehm will coordinate the gallery program. I will be at St. Augustine’s in Tempe until the end of February, and my ordination, God willing, will be June 1, 2019 at Trinity Cathedral. I’ll be back in church at the beginning of March

as I await ordination, finish deacon academy, and prepare to join the Reverend Jim Bade in service to the parish, the Church, and the world.


Thank you so much for welcoming my contributions to our community, for your encouragement, and for the many expressions of support. This change is both exciting and sad for me, but I contemplate the future with wonder, seeing the work God has accomplished in my life. As Matsuo Basho, 17th Century Japanese poet, once said, “Every day is a journey, and the journey itself is home.”


August 12, 2018  The High Cost of Loneliness


In our culture loneliness gets little respect. We are the independent thinkers and lone rangers. People are more likely to talk to their doctors about depression than loneliness because there is such a stigma attached to it. But it is a killer on par with heart disease and cancer and hundreds of studies connect chronic loneliness with chronic disease and early death because our bodies interpret loneliness as a physical threat.


When people develop such deep loneliness that they feel hopelessly alienated from others, have faulty thought patterns that tell them they are a burden, and somehow become fearless about pain and death, loneliness leads to suicide. The alienation can happen while surrounded by loved ones or it can grow over years because the person chronically ignores the internal sensor that urges him or her to seek support and, therefore, has no support.


Men complete 4 suicides for every 1 completed by a woman and white men account for 7 of 10. Middle aged white men are most at risk and for every one person who completes a suicide, 25 attempt it. In Arizona someone dies by suicide every 7 hours. By any measure, it’s a bigger problem than one would think.




If you care about someone who is struggling with loneliness, who seems depressed, who isolates himself or has suffered a big loss, please listen for despair. People think about suicide for a long time before they do it and it’s not true that asking someone about these thoughts will make them come true. Ask “What’s the worst thing you’re thinking about or feeling these days?” If they talk suicide, ask if they have a specific plan and a specific way to implement the plan. Someone who has the means (my car) and a plan (driving off the overpass) is at very high risk. Call our local hotline at 480 784-1500 with the person you care about. For immediate support, before or after a suicide attempt, the Crisis Response Network, 602 222-9444, is a local organization that can send a team out to intervene.


These aren’t hypothetical problems that hit a few and it happens more often than you’d think. It happened to my family. We can all look for signs that someone is struggling. Let’s remove the stigma from loneliness so that we don’t need to deal with the stigma of suicide. No one is an island. God made us to love and serve each other.



July 29, 2018  The Heat is On


For me it’s the birds. When the weather turns really hot and I have to close up the house for four months, I really miss the sound of the birds. Is reverse Seasonal Affective Disorder (SAD) a thing? Researchers have long known that our moods can plummet in the winter but they are now finding that we may have these problems in the summer too, especially when sealed up indoors for long stretches of time. Interestingly, researchers have also found that we get crankier and more aggressive in hot weather. There are statistics showing that domestic violence, crime, and war escalates during periods of excessively high temperatures. Brian Lickel, the author of one study noted that “It makes people more prone to anger, it makes people more frustrated, and it makes decision making more impulsive.”


Our hot weather has other consequences also. As we age we are less sensitive to physical signals that we are thirsty or overheated, so older people are more prone to heat related illness, or simply live with thermostats that are set too high for their wellbeing. Children can ignore physical signals to rest or hydrate because they’re having fun and every Phoenix parent dreads the boredom that covers desert kids like a blanket once we get into the depths of 110 degree days. The city streets are half empty and although it’s a relief to beat the traffic, we might have the vague feeling that other people in other places are having great summers in the outdoors while we are being burned by our steering wheels. Back to the cranky and frustrated thing.

 


In any case, the desert’s tough time of year calls for all our patience, creativity, and resiliency. It’s quite true that pleasant weather makes for a better mood and time outdoors is important to our mental health. What can you do, as we pass the halfway mark of summer, to make life as rich as possible, despite the heat? Check on older friends and relatives and make sure the house is cool and they are getting out periodically. Parents, nurture your social ties and find ways to bring informal groups of kids together for casual, rather than programmed, indoor activity. Be patient with your loved ones. Get away to somewhere cooler here and there to soak up pleasant weather and reset your mental thermostat. And have heart. The Fall is coming. Every day is bringing it closer.


July 15, 2018  Coming Home

 

I’ve just spent three weeks traveling, am on an airplane as I write this, and am desperate for home, for the calm of my house, full of plants, and art, and my favorite things. I yearn for the nearness of friends and my grown children, and for the routines and responsibilities that make my life secure and fulfilling.

It’s a sweet feeling, isn’t it?

 

Home didn’t always mean this. It used to be a place of stress and a stage for managing at least one painful relationship. It used to be second shift, a physically arduous duty that kept me breathless. I remember several times in my adult life when I literally wanted to run away from home— once when my oldest child was newborn, and the second after my mother died in old age. Something about transitions makes a hard home almost unbearable maybe.

 

 

What does home mean to you? If it’s less than welcoming, this may be some sort of canary in the coal mine, an early signal that something in your live may not be alright. Like me, have you ever had moments, or days, or months, when you wanted to flee? If so, it’s perhaps best to give that some thought. If you cannot be yourself at home, where will you do it? If home is such a financial burden that it keeps you up at night, how can that be OK? If home feels cluttered, or demanding, or depressing, what small steps can you take to find space, and light, and calm? If home is home to a walk-on-eggshells relationship, know that it is harming your health every day through the subtle effects of chronically elevated stress hormones. If you feel burdened by endless work at home, or walk into the emptiness of loneliness, both of these dynamics also have a negative physical impact on your health and longevity.

 

You deserve a home that nurtures and pleases you, one that you long to return to. Jesus is our ultimate home and prayer is the place to find Him. Spend a little time seeking His will for your life in this area and maybe talk to someone skilled at helping you problem solve if any of these challenges feel familiar. Home should be where the heart is. We all have a right to this simple joy.

 

June 17, 2018 Getting Loose


In the last twelve hours I’ve had an instructive encounter with an 18” long baby bull snake. It was caught in a glue trap in my garage. After recovering from the initial “yuck” response, and with the phone coaching of an animal loving family member, I made several attempts to save it and went to bed with the heavy knowledge that I would likely need to give it a quick demise this morning with the end of a shovel. Ugh. But dousing the trap with cooking oil did the trick and it was gone this morning, back into the desert.


The whole episode reminds me of a concept I learned recently called radical acceptance. The more that poor snake struggled, the more of its body got caught up in the sticky trap. Radical acceptance is a mental tactic taught in dialectical behavior therapy to help people get a grip on anxiety by relaxing into situations rather than fighting them. The idea is this— when you’re in an untenable situation and cannot go around it, but must just bear it, you simply tolerate it. “Let it be so.” Pain is for the living and sometimes the path out of hell is, unfortunately, through misery. Whatever your particular pain,  remember that there are limitations on the future for everyone.


 


We can practice radical acceptance daily in small ways. Traffic backed up? Let it be so. Your spouse is ignoring you.. again? Let it be so. Your arthritis or back pain is acting up? Let it be so. If we can build tolerance for life’s daily annoyances we will build strength to handle the big ticket stressors when they come along. Like the snake, when we face those crucible moments thrashing around, we are likely to just get more stuck. When we can’t control the situation we still, in the worst of times, can control our response.


The lovely irony is that in doing this, in staying a little more calm and detached, we make it more likely that we can ultimately escape like my little friend, more likely that we won’t suffer the effects of chronic stress along with the impact of the presenting problem, and more likely that we will, in that time of darkness, hear the whisper of the Holy Spirit guiding us because God is in the crisis with us, and has the power to free all his creatures, great and small.


May 27, 2018  Enough


I’ve struggled lately with the concept of enough. I’m a bit of a fashion lover and I found a “life changing” clothing rental website lately, signed up, and my fashionista tendencies are in overdrive. To the point where I’m starting to wonder about my priorities. Blazers and handbags shouldn’t exactly by on anyone’s top ten list of important life issues. A friend of mine wonders what is enough wine and a loved one struggles with enough pets. At three dogs, two fish tanks and a new chinchilla named Gus they may have just arrived.


In America, we have so much. So much stuff, so much freedom of choice, and so many advertisers telling us the ways in which we don’t measure up. What is your enough question? In what area of your life are you high jacked by your desires? Because that’s what it is, I think. When I’m planning for my next dress I’m not writing, making art, reading, or taking care of business. I’m high jacked by hedonic adaptation. The last (name the “enough” in your own life) was awesome, but I’m kind of tired of it, or I miss doing it, or I’m itching to plan for a new one. But I’m thinking about it. A lot.


 

There is more than 7 square feet of self-storage space in the US for every, man, woman and child in the country so we clearly have more stuff than we can house. We eat almost 25% more calories in a day than we did in 1960 and the average American man weighs fifteen pounds more than he did twenty years ago. We devote more than ten hours a day to screen time and we owe $931 billion on our credit cards. On many measures we’ve gone from enough to too much.


The problem with all this is that it keeps us from maintaining a state of quiet gratitude. Every desire is an “open file” in your mind, taking bandwidth from other things. Unfulfilled desires seed frustration and take over your experience of the present moment. An active gratitude practice can increase your baseline happiness set point and turn what we already have, finally, into enough. The things in the world are here for our enjoyment, but maybe they shouldn’t morph into the sources of our life’s joy. A quiet mind comes with the practice of gratitude and a great new dress may be momentary fun, but less is usually enough, and enough, known in the soul, can be a delight.


May 13, 2018 Take Care of Your Skin


May is skin cancer awareness month and Arizonans know that we are especially vulnerable. Arizona is close to the sun (high altitude), close to the equator (low latitude), and has a warm climate, which has us wearing our shorts and tank tops much of the time. High altitude and low latitude mean less atmospheric protection from ultraviolet radiation, the part of the sun’s rays that damage and age the skin.


In general, 1 in 5 Americans will be diagnosed with some type of skin cancer in their lives. The American Academy of Dermatology notes that there are four types of skin conditions we should be concerned about. Actinic keratoses are precancerous dry and scaly patches or spots that occur on areas that get a lot of sun exposure, like our forearms. These appear most frequently on people over 40 and those with fair skin. Basal cell cancers are frequently diagnosed, especially as we age, and look like flesh-colored, pearl-like bumps or pinkish patches of skin. They need to be removed because they can spread to surrounding areas. Squamous cell skin cancers look like red firm bumps, scaly patches, or a sore that heals and then re-opens. They form on skin that gets frequent sun exposure and must be removed as they can grow deep into the skin and cause damage and disfigurement.


 

Melanoma is the deadliest form of skins cancer and the Centers for Disease Control states that 20.6 people out of 100,000 are diagnosed in Arizona annually. That’s about 1460 residents, 75% of them being men. Look for ABCDE: an asymmetrical mole with an uneven border, that is more than one color, is probably wider in diameter than a pencil eraser, and is evolving over time.


We live in a high risk environment and the best preventive measure for most of us is an annual full body skin check with a dermatologist. The Academy of Dermatologists also has a detection tool we can use at home as a first step. You will find it here: https://www.aad.org/public/spot-skin-cancer/learn-about-skin-cancer/detect/body-mole-map. Take a good look at your skin once in a while and encourage your loved ones to do the same. Avoid sunburn, use sunscreen, and seek the shade this summer. Not only will these

measures reduce your risk, they will help prevent wrinkles and age spots and keep people guessing your age.


April 15, 2018   A Season for Change


In this season of resurrection it seems appropriate to think about all things new. Are there changes you wanted to make in your life this year and never got around to? I was struck today by a new study from researchers at the University of California, Irvine. People who have negative emotional reactions to the small stresses of life and tend to mull them over until the next day are more likely to report health problems and physical limitations ten years later compared to peers who were able to move on, emotionally. Put another away, when we can’t let it go, it hurts us.


If you have a role or obligation in your life that causes you chronic ongoing stress, maybe it’s time, this Eastertide, to consider making your own transformation. These reactions are messages that we shouldn’t ignore. What is the cost of removing yourself from a situation since the cost of staying may be your future health? 


If you can’t leave, what can you do to control the thoughts that generate stress? Our emotions are the product of our thoughts, so start to be aware of what you say in your head and challenge how much of it is actually realistic and accurate.


 

And build pleasant activities into your day that challenge your intellect, creativity, or need for connection. We lean into screen time when we are tired or have free time and too much research indicates that it’s not good for us. Pleasant activities will give your mind something positive to focus on and make it easier to shift gears from the hard stuff.


Periodically, it’s time to examine our lives and consider how short and precious they are. Don’t spend time in worry that will only shorten your life. Try these tricks instead:


- If you have an important change you think you should make, see a counselor.


- If you’re not exercising routinely, figure out how to add that into your life. The endorphins generated by exercise counter stress and improve mood and sleep.


- If you want to build a particular positive activity into your life, but can’t seem to get started or stick with it, create a grid of boxes, one for each day of the week, one row of boxes for each activity, and check off a box when you do it. It’s great to see your chart fill up with meaningful experiences that build resilience and well-being.

March 4, 2018  Intro to Dementia, Part II


Someone once said that you lose your loved long before their body finally goes when they have dementia and that the hardest loss of all is to take care of someone who literally doesn't know you. That seems as though it must be the case. I worked with family members trying to take care of an elder at home for decades, and the most challenging situations involved dementing illnesses.


From the early days, when someone's personality starts to change in odd ways and they just seem forgetful, to the end, when the brain actually forgets to swallow and breathe, theses diseases are heartbreaking for loved ones. Luckily, there are a few resources and strategies to help so let's whip out the dementia caregiver's toolbox. 


- The Alzheimer's Association is a wealth of support, from information about the various diseases to support groups for caregivers. They have an especially helpful care consultation service, https://www.alz.org/dsw/in_my_community_15608.asp, that can assess needs and offer strategies and resources and it is free of charge.

 

- They also have early stage programs, for those at the beginning of the journey, and a medic alert program for patients who are at risk of wandering. If you live alone with a dementia patient it's also a good idea to have a bracelet made up for yourself, indicating that you have someone at home with dementia, should you unexpectedly go to the hospital.


- Coach Broyle's Playbook. This awesome little volume is all about managing challenging behaviors and was written by a man who cared for his wife. It can be downloaded digitally here, http://www.smaaa.org/documents/cs/fcg/AlzheimersPlaybook.pdf, and purchased as a hard copy on Amazon here, https://www.amazon.com/Coach-Broyles-Playbook-

Alzheimers-Caregivers/dp/B000NLBQ4A.


- In Phoenix, Hospice of the Valley offers a Palliative Care for Dementia Program, https://www.hov.org/our-care/dementia-care/palliative-care-for-dementia/, that offers support at home for families at any stage of the illness. It is a fee for service program but offers sliding scale and grant funding in specific situations of need.


- Lastly, I also encourage all caregivers to set up a regular schedule of personal respite, either through friends, family members, private duty agencies, the use of adult day health care programs, or formal caregiver respite programs. You can find out more about the last two options by contacting the Area Agency on Aging Senior Helpline at 602-264-4357.


February 25, 2018  Intro to Dementia, Part I


On March 4th we are privileged to learn more about the experience of dementia from Episcopal priest Rev. Tracey Lind, who was diagnosed with dementia in 2016. In preparation, I share a two-part series about dementing illnesses and the caregiving challenges they present. Today's column is focusing on the diseases themselves. Next week we will talk about caregiving and resources.


Dementia is a catch all phrase that describes a number of different diseases that have common features. All dementias cause cognitive decline in some form. It is often in the form of memory loss, but can also look like problems with language, body movement, or forgetting people, places or things. Dementia impairs social and work functioning, and progresses over a period of years. Dementia is often a terminal illness, meaning that the person will ultimately die of the disease.


Alzheimer's Disease accounts for 50-70% of all dementias and its' greatest risk factors are advanced age, family history, and genetics. After age 65 our risk of developing Alzheimer's Disease doubles every five years until it is about 50% at age 85. Research at the Mayo Clinic indicates that the disease can't be prevented, but that you may be able lower your risk by reducing your risk of heart disease.




Other forms include Lewy Body Dementia, which shares symptoms of both Parkinson's Disease and Alzheimer's. Vascular Dementia is often seen in combination with Alzheimer's  and is a deterioration of cognitive functioning caused by reduced blood flow to the brain, often in the context of someone having "mini-strokes". Frontotemporal Dementia is a little different and is usually diagnosed at younger ages. Its main features are changes in behavior and problems with language.


Getting a diagnosis of a dementing illness can be a long process and I always encourage families to get a wholistic assessment. In my opinion, the best place to do that in Phoenix is the Banner Alzheimer's Institute. Rather than seeing one neurologist, a patient sees a multidisciplinary team of nurses, doctors, therapists, and social workers, and services are provided both in the home and at the clinic. 


Getting a good diagnosis is the first step to getting a treatment plan and, maybe, getting on a medication that can slow the disease process. Getting a diagnosis also demands that the family and the impaired person are willing to face scary changes in behavior and memory and name them for what they are. Sometimes this comes easily and sometimes it's really hard, but it is the first step.


February 11, 2018 Your Brain On Centering Prayer


You have a health treat in store for you this Lenten season. Centering prayer will be the focus of our Thursday evenings together. Centering prayer helps us enter into a state of contemplative prayer which opens us to connection with God beyond words, but it also is a form of meditative practice that has powerful health benefits, even if we only consider what it does for our brains.


According to the National Center for Complementary and Integrative Medicine, meditative practices increase the number of folds in the outer layer of the brain. This process (called gyrification) may increase the brain’s ability to process information. It also seems to affect the amygdala, the part of the brain that generates the fight or flight response and initiates stress and negative emotions. Meditative practices seem to decrease activity in the amygdala during times of stress so that we become more stress

resilient.


The prefrontal cortex is the part of the brain that supervises complex behaviors, like planning, and greatly contributes to our personalities. Meditative practices keep this structure from thinning over time and it is this thinning that is the hallmark of age related cognitive decline.


 

Our two hippocampi help us form new memories and they tend to shrink from the long term effects of stress hormones like cortisol. One study at Massachusetts General Hospital, a national center for the study of mindfulness practices, found that meditative practices actually increase the concentration of brain tissue in the left hippocampus. These same researchers found benefits to parts of the brain associated with creativity, the ability to maintain perspective on a situation, and capacity for

empathy.


One of the most striking benefits of meditative practice is related to the pain matrix, the complex neurological network that feeds our perception of pain. In 2017, researchers looked at 30 different studies of the impact of meditative practice on pain perception, depression symptoms, and quality of life, and found, across hundreds of patients, that it somewhat improved all these factors, without the side effects of drugs or the complications of surgery.


God is so good. A simple practice like centering prayer can not only bring us into communion with Him that is beyond conversation, it has enormous benefits for our bodies, for we are truly mind-body-spirit, as elegantly designed by the ultimate artist. Join us, this Lent, to learn centering prayer, and move through Easter with a new habit that will build your wellness for the rest of the year.


January 28, 2018  When is Too Much Too Much?


At least 134 countries have laws setting the maximum work week. The U.S. doesn't and 85% of American men, and 66% of women, work more than 40 hours. And according to the Bureau of Labor Statistics, the average productivity per American worker has increased a whopping 400% since 1950.


In the midst of all this productive chaos it's important to have some sort of control over your day, otherwise you're ripe for stressed related illness and burnout. Quaker author Palmer Palmer talks about becoming your true self and how difficult that is when we are driven by the "oughts" of our situation, with little insight into our own limits and potential. We just do the next thing because we are afraid to do anything else. Afraid of seeming to be less than Superman. Afraid of disappointing a supervisor. Afraid of even losing our jobs.


But there is no real excellence to be had in that scenario, and definitely none of the job satisfaction that makes work a blessing. We must find ways to prioritize the meaningful parts of our jobs. Stephen Covey advocates that there are four kinds of tasks: not important and not urgent, not important and yet urgent, important and not urgent, and both important and urgent. We spend time in one of four ways and way too much of it is going to the urgent, yet unimportant. Ironically our greatest reward is in the important yet not urgent stuff because it's the big picture work.


 



Researcher Cal Newport, in his book “Deep Work,” is concerned that email is a habit that sucks time away from meaningful work, which usually requires the ability to sit down and think quietly for a good stretch. He advocates finding ways to limit or contain email and finding ways to limit your availability to others, even if that includes simply closing the door to your work space periodically.


Both of these authors have helpful advice to offer the time starved but I'd add that we need to find ways to approach our managers with our needs. To quantify, in some way, how we are spending the time they pay us for, noting how much of it goes to the unimportant, and how little is left for the big picture. We need their help to prioritize and delegate so that they get the best from us. And we need to feel that we can take these risks because our value as human beings isn't in being Superman employees, but rather in being precious children of God, who do not endlessly need to prove our worth. And that would be a relief indeed.


January 14, 2018  Welcoming Cold and Flu Season


Is it just me or does it seem like everyone is sick these days? I'm nursing a minor runny nose but a lot of people seem to really be suffering. If you agree, it's not your imagination. The Centers for Disease Control announced that this is the worst flu season since a 2009 H1N1 pandemic and Arizona is listed as one of 26 states with high influenza-like illness activity. Currently 11% of all physician visits in Arizona are for these types of symptoms. Complicating things, the current flu vaccine is only about 32% effective against the most active strain of flu this year (H3N2).


So what are the differences between an ordinary cold and a flu illness, and when should you should take yourself to the doctor, since a lot of sick people hang out there, and there are so many better things to do? The CDC tells us that "flu and the common cold are both respiratory illnesses but they are caused by different viruses. Because these two types of illnesses have similar symptoms, it can be difficult to tell the difference between them based on symptoms alone. In general, the flu is worse than the common cold, and symptoms are more common and intense. Colds are usually milder than the flu. People with colds are more likely to have a runny or stuffy nose. Colds generally do not result in serious health problems, such as pneumonia, bacterial infections, or hospitalizations. Flu can have very serious associated complications." https://www.cdc.gov/flu/about/qa/coldflu.htm.





If you have a persistent fever, painful swallowing, persistent coughing over two or three weeks, persistent nasal congestion with headaches for more than a week, it's probably time to check in with your doctor. If you, or an ill loved one, experience severe chest pain, severe headache unrelieved by treatment, dizziness, confusion, shortness of breath, or persistent vomiting, you may need to get immediate attention.


In general, colds and flu are spread mainly by droplets made when people with flu cough, sneeze or talk. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. To avoid this, try to stay away from sick people and stay home if you are sick. It's also is important to wash hands often with soap and water for at least 20 seconds frequently when you're out and about. If soap and water are not available, use an alcohol-based hand rub. Stay well and stay warm. Our brief winter is upon us.


December 26, 2017  A Fresh Start in 2018


This morning I received two completed unexpected checks in the mail that added up to a substantial amount of money. What a surprise. What do you do with an unexpected gift? As I thought about it, it occurred to me that health is somewhat the same way, a gift that is often unearned and unexpected. As we face the turn of a new year I encourage us to take a fresh look at ourselves, because our well-being is truly a gift from God that we take for granted until it either really saves the day, or fails us.


Unlike my checks, it's not going to show up at your doorstep one day in a crisp white envelope. It was gifted at your birth and has required your tending all these years. How's your stewardship been in 2017? Are you physically well but emotionally and cognitively stressed? Is your body giving you nagging instructions that something is amiss but you haven't taken the time to check it out, or are afraid to do so? Are you struggling with ongoing health problems and feeling discouraged? Do you take it all for granted and practice the eat, drink and be merry method of health maintenance? Are your struggles psychological? Depression, anxiety, chronic loneliness. And talking about

loneliness, are you too busy to maintain robust social ties? Facebook does not count here as social contact. Research tells us that you ignore your social well-being at the risk of your emotional and physical health and that social media use doesn't substitute for real life relationships.






With so much new and contradictory health news being announced every day it can be easy to shrug your shoulders and ignore what we already know in our bones. Eat real, whole foods, not the processed stuff. Find an exercise routine that works for you. Work on your sleeping habits. See your doctor when you need to. Don't put it off as sometimes time matters. Be involved with other people. We need each other. See a counselor if you are distressed in a way that affects your functioning. Take your medicines.


As we turn a new calendar, for a new year, take a look at your wellness challenges and set some reasonable goals. No matter what your age or stage in life, we can always live with greater well-being. I wish you a glorious 2018 that is full of God's grace and good health.


December 10, 2017 Too Busy for Advent?


The other day I needed to find two volunteers to help with a project. Three days later I was still batting zero. Everyone who usually says "Sure!" Was saying "I'm SO busy!" There's something about this season that brings out the frantically overcommitted in us. I guess we just can't imagine adding shopping, wrapping, feasting, travel, decorating, etc.. to the usual juggle, but somehow we manage to do it every year. 


But it's also Advent 1 this week. We are literally waiting in darkness for the Light of God to appear. Are we breathing? Are we awake and in a state of expectation? Or are we ramping up the holiday anxieties? Can we de-prioritize some of the usual busyness and make time for a bit of a seasonal sabbatical? Managing stress when we are overloaded often, and to our distress, sometimes simply requires us to do less. Drop. Delegate. Defer. Consider how important that activity really is. You only have so much time in a day and Jesus is coming. What's the best way to use this one precious day? We don't want to just add holiday responsibilities to the top of the pile because that's a recipe for a chronic cortisol and adrenaline spike, and those stress hormones are bad for everything from our weight to our immune functioning. 



I encourage you to practice a little energy conservation this Advent season. How do you really want to spend the hours in your day given the fact that our Savior is soon to be born? We cannot do it all. But we can make time for what's important. We can say "no" from time to time. And we can give our minds and bodies a bit of quiet here and there to rest into the miracle that is to come. Here are a few tips and have a blessed Christmas!


  • Exercise your sense of humor and laugh.
  • Roll with it. Sometimes things don't go right. It will be OK.
  • Workout to flush tension away.
  • Try to eat more good stuff than bad stuff.
  • Make it a priority to sit in quiet for a few minutes a day.
  • Make time for your loved ones and the things that make you happy.


November 16, 2017  Teaching our Children to Delay Gratification


As we look forward in anticipation to sitting down next week to an enormous and luscious Thanksgiving meal, I'd like to reflect on the ability to delay gratification as a key skill our children must learn for successful living. Current research talks about "inhibitory control" or "cognitive control" and defines it as the ability to resist a strong inclination to do one thing, and instead do what is most appropriate or needed at the moment.


In general, we need to be able to resist the first impulse, and do the thing that we are required to do, or the thing that is more polite. We need to stay on task despite boredom or temptation, and we need to be able to control attention enough, despite distraction, to get things accomplished. 


In children this plays out as the ability to stay off the video games until homework is done, eat a healthy afternoon snack instead of a whole bag of cookies, or refrain from taking the attractive toy of a playmate by force. The ability to inhibit a strong behavioral inclination is enormously important and helps create self-discipline, social politeness, and focused attention. A 2011

long term study of 1000 children found that cognitive control was a better predictor of financial success and good health at age 30 than either IQ or the wealth of their childhood families. How do we help our children learn this skill? We start early and are consistent in requiring that they practice, as practice is the thing that strengthens all human habits.


 


-As parents we create an environment in which self-control is consistently rewarded and impulsivity is not.


- We support young children with timely reminders and tell them the rules of an activity before they start it.


- We encourage stop and go play activities like old fashioned red light-green light.


- With older kids, we help them focus on tackling challenges and learning from failures rather than just successful skill acquisition.


- We help kids develop their attention skills and expand working memory. Anything that requires a child to pay attention to new information and repeat it back will be useful.


- As parents, we serve as emotional intelligence coaches and make cognitive control as important as good grades and nice manners.


- We model self-discipline as our actions speak so much louder than our words.


November 5, 2017  Health Insurance: It's that Time of Year Again


Open enrollment! Most employer sponsored health insurance plans are wrapping up, the Healthcare Marketplace (ObamaCare) is opening up, and Medicare open enrollment is in full swing. So let's look at your coverage.

If you are covered under an employer, I encourage you to sign up for the best plan you can afford as we never know our health future. You compare the costs of plans by multiplying the premiums times twelve and adding the total annual out of pocket maximum. You also review the copay structure. Most of the time copays are not counted as part of your annual out of pocket maximum. The higher they are, and the more services that include a copay, the higher your costs in a healthcare emergency. And mostly, make sure to review the information provided by your employer. Plans change and if you don't make an active choice, you may be enrolled in a plan that you don't want.


If you're on Medicare you probably know that I suggest straight Medicare, a drug plan, and a supplement versus a Medicare Advantage plan (Medicare Part C). The Medicare Advantage plans are cheap because they limit your benefits and network. This may work when you're healthy but it's impossible to know when that will change. If you can, sign up for a Plan F Medicare supplement, which covers charges above Medicare assignment, and a Part D drug plan through www.Medicare.gov or with their assistance by phone, 1-800-633-4227.


 

The Affordable Care Act insurance marketplace is definitely alive, if not completely well, is designed for people who have no other access to coverage, and open enrollment is open from November 1st to December 15th. That is a much shorter sign up period than in the past so be aware, and if you are on a Marketplace plan, you need to review your coverage/premium. Healthnet is the insurer in Maricopa County and the coverage is very good. 


Prices are unknown at this writing but if you are a single person making between $11,880-$47,520, a household of two making between $16,020 and $64,080, or a household of four with income between $24,300 and $97,200 you are likely eligible for a subsidy to lower your premiums. Here is a calculator to enter your specific situation: https://www.kff.org/interactive/subsidy-calculator/.


If you earn less than the lowest amounts I note above, which is 100% of the federal poverty level, you are likely eligible for Medicaid as Arizona accepted the Medicaid expansion a few years ago. Go to www.healthearizonaplus.gov on a desktop computer (versus a mobile device) to apply. 

October 8, 2017 The Art of Attention


The artists of All Saints' send us a message this month, "Look closely, there is beauty to be seen." Their exhibit in St. Barbara, titled “Sacred Spaces,” is a visual meditation on our church campus and I challenge you to identify where in the church each of these images originates, because our artists found beauty in objects that we walk past every week. What is it that allows an artist to see when others don't? Honestly, it's simply trained attention. The ability to slow down, observe, and see the beautiful heart of something.


How strong are your observational skills? There is a movement these days called attention training, closely linked to mindfulness, and its goal is to encourage us slow down and literally smell the roses. We have finite time and energy and our always on technological networking burdens us with the need to run two parallel lives all the time. As physician Amit Sood says in his book, “The Mayo Clinic Guide to Stress-free Living,” we "exist only superficially on this side of the screen."


 

We need to create moments in our day when the multitasking busyness stops and we can wake our brains up to the novelty all around us. Novelty is the appreciation of uniqueness - in a flower, a person, a dish you are washing. Each one is special and transient. So how do we really "see" rather than rush blindly through our days, because it is in really seeing that we really live?


When you are involved in a task, try to calm the chatter in your head and really feel, see, smell, and hear what you are doing, in that moment. Can you greet your loved ones at the end of the day as if you're seeing them for the first time after a long trip? Can you give them the same attention you give to your smartphone? Can you look at a common object and identify its uniqueness? When you are out and about, what are you smelling, what are you hearing? Try to amplify your sensor for novelty by accepting things as they are and turning down the mental chatter. Exodus 14:14 tells us that "God will fight for you, you have only to stand still." If that is the case, we can let

go a little and try to be present, knowing that everything and everyone is only on loan to us. They are worth our attention.


September 10, 2017 The Warrior Metaphor


When someone has a serious illness, our can-do spirit is usually expressed in the encouragement to fight it, and beat it. No matter what "it" is or how long the odds. I saw this up close and personal through many years of counseling families facing cancer and a recent blog post on Web MD caught my eye as the world sends this message to our senior senator, now diagnosed with a fatal glioblastoma, http://blogs.webmd.com/breaking-news/2017/07/dont-tell-john-mccain-to-fight-his-cancer.html


It seems like helpful advice, but what it actually does is give someone the strong message that truth telling is not something that should happen, and that terrible doubts and fears need to stay right where they are-- locked inside. I've seems families build walls by keeping fears hidden because each person is "protecting" the other. And we often believe that saying something will make it so- so we don't speak bad outcomes into existence by talking about them. A variant of this that was always difficult for me was when patients either received, or generated, the message that God was going to heal them if only they believed strongly enough in the healing. I was never sure what to think of that as the same God made us all mortal. 

 


If you know and care about someone with a serious illness, here is my advice.


- Have courage and be willing to talk about and listen to the really hard stuff.


- Ask the person this question: "What are you most afraid of?" And listen to the answer. Don't negate it, explain it away, or tell them that they're wrong.


- When they tell you their worst fear, ask them what it is about this fear that most disturbs them. People are mostly worried about dying, but we vary in the way this fear is operationalized. Some people worry about the well-being of their loved ones, for instance, and some people worry about the legacy they are leaving. Some worry about dying in pain. If you can have an honest conversation, you may find that you can actually help in some small way to connect them to resources to address these fears.


Although we are born alone and die alone, the journey should not be lonely. The way to be the warrior when someone you care about is really sick, is to valiantly be with them in the truth, and love them fearlessly.

August 27, 2017 Time To Get Energized


We can feel Autumn in the early morning air now, and are on a timer for the return of our snowbirds. Pretty soon the kids will be back in school, Fall activities will start, the roads will get crowded, and the Holidays will start lining up in front of us to be planned for and celebrated. It's time to get busy again after the slow heat of summer.


Let's take a lesson from the professionals who practice occupational therapy and apply some energy conservation strategies to our lives. Energy conservation is focused on the practice of being more mindful in the way you use your energy so that you have more of it for the things that matter to you.


You prioritize. Decide what has to be done in a given day but prioritize the list. If you don't have time to do it all, drop, defer, or delegate low priority items.


You plan. Think about how you will sequence the things you have to do. When is your best energy time of day? Put your most important task there. Do tasks that are geographically close to each other at the same time. Do tasks that require you to think when you are best cognitively and save simple busywork for later.


You pace yourself. Does the whole task have to be done at once? If not, break it down into manageable subtasks to do over time. How can you build time for rest into your day?


You modify. Can a task be done differently so that it uses less energy? Can it be simplified? Are there tools or products that would make it easier or faster?

 





Plug energy leaks. An energy leak is anything that is slowly draining your tank without contributing to your output. Pain is an energy leak because it causes alterations in posture, movement patterns, sleep, and even breathing patterns. Any change in the body's alignment causes compensatory changes in other parts of the body, which require more energy. Poor body mechanics, how we move through space, lift and carry, or change position, affects our center of gravity. Anything that alters this requires compensatory energy. Alterations in the way you walk are obvious energy leaks. For instance, research has shown that when people are in casts or braces, they need 15% more energy. Altered breathing patterns are huge energy leaks because an inadequately oxygenated body can't perform normally. And poorly designed task spaces are always energy leaks. Counters that are too high or too low, desk chairs that are uncomfortable.


So plug your leaks, practice planning, pacing, and prioritizing, and go out there and have an amazing Fall. So much to see, do, and experience as we move into Phoenix's beautiful weather. Be well!

 

July 30, 2017   When A Family Member Is Hospitalized


Caring for a hospitalized loved one is extremely challenging. Hospitals are high tech places that are difficult to navigate and it can seem, at times, as though no one is either listening or in charge. Since most of us are likely to find ourselves in this role at some point, let's review helpful strategies for managing.


Your most important tool is your loved one's health care power of attorney. Either bring this to the hospital or have your loved one complete it at admissions. The person listed as agent for healthcare decisions should be, ideally, someone who can navigate the hospital system and is physically present. The National Family Caregiver's Association strongly encourages family members to also have their loved one's Living Will (a statement of end-of-life wishes). It's never fun to contemplate worst case scenarios but it is extremely helpful if your documents are capable of addressing all possibilities.


Get to know your hospital social worker. Almost every hospital unit has a medical social worker assigned to patients in order to address family concerns, plan for discharge needs, help with resources, and steer families through short term crises. It is extremely helpful if you meet this person early and routinely spend time with him or her.


 


The doctor in charge of your loved one's care is usually a hospitalist, a physician whose expertise is the overall management of a hospitalized patient, sort of like a primary care doctor. This is also an important person to speak with routinely and is often called the "attending" physician.

The specialists who see your loved one will come in and out as their schedules permit. Thus, you may often see them either very early or quite late. If you need to visit with any particular doctor, your nurse will usually know the time of day she comes around, and you can plan your hospital visits accordingly.


Follow your gut, but don't let your emotions overwhelm you. It's an odd balance, in a way. If you feel that something is wrong, it often is because no one knows your loved one like you do and unusual side effects and medical errors happen all the time. But it's also true that you can become so upset that you don't process the advice you're being given, and don't make sound decisions. That's why it is very helpful to manage the situation with other loved ones. In general, strive to understand that every healthcare choice has opportunities and risks, and that, at the end of it all, God's loving presence is with you.


May 28, 2017  Summer Savvy


Snowbirds have mostly flown the coup and the high heat will make itself at home until October. So let's revisit summer safety recommendations. We all know to drink a lot of water, refrain from exercising outside in the middle hours of the day, and not lock children or pets into our cars.


Here are a few of the finer points, however. There is heat exhaustion, and then there's heat stroke. One is a warning and the other is life threatening. The first signs that you might be getting overheated are muscle cramps, heavy sweating, and feeling weak, faint, or nauseous. Get out of the sun asap, rest, and rehydrate if you ever feel this way.


If you are older, or have an older loved one, realize that the body doesn't recognize swings in temperature as well, and that medicines and chronic health problems can impair the body's ability to adjust. I did many summer home visits over the years where my patient's household thermostat was set at 89 degrees and the person said that they felt comfortable. In these circumstances, however, the body is getting overheated and we don't even recognize it. If you have frail older relatives, check on them more frequently in the summer, have the A/C serviced, and be aware of their household routines.







Infants and children can also struggle more when it's hot, and they may not understand and properly interpret the symptoms of heat stress. In kids we also need to be alert to frequent or severe sunburn. According to the Skin Cancer Foundation, one or more blistering sunburns in childhood doubles the risk of melanoma later in life.


If you work or spend a lot of time outdoors, for fun or for employment, build up your tolerance to the heat through acclimatization, slowly increasing the amount of time outside. Wear light loose clothing, take frequent rest and water breaks, don't work alone, and limit midday exposure.


One last risk to be aware of is our own special version of seasonal affective disorder. When we are sealed inside for months at a time with limited exposure to nature, it can be hard emotionally, not unlike winter in cold weather climates. Take a vacation, or take a few day trips to the cool of northern Arizona. It is a priceless mood lifter and can give you the boost you need to see it through until Fall.


May 7, 2017   Give Thanks in all Circumstances


"You're blessed when you're content with just who you are- no more, no less. That's the moment you find yourselves proud owners of everything that can't be bought." This contemporary translation of Matthew 5:5 complements our Eastertide message of joy. Joy comes when we are grateful and there is no joy without it.


Gratitude happens when you realize that you've been given something of value, that the sharing required effort from the giver, that it was shared intentionally, and that it was shared without any agenda designed to create indebtedness. In this light, all of nature, every breath we take, every bite of food we eat, all these things should create in us a constant stream of joy because God didn't have to do any of it, and He created us, our world, and everything and everyone in it simply because he loved Humankind.




What keeps us from living into this joy? Two things come to mind, hedonic adaptation, and our tendency toward unhelpful self-talk. Hedonic adaption is the interesting dynamic whereby we get used to good things. The first bite of homemade ice cream is amazing, the tenth we barely notice. How long are you thrilled by your new car? Or new shoes? We continually strive for more because our brains can't maintain a high level of focus and excitement. We adapt and the cool thing is no longer novel. But this striving keeps us from appreciating what we have. Notice the well made pen you carry, or friend who calls you, and think a grateful thought. It will bring you joy.


And as you move through life consider rethinking your approach when your plans are thwarted by circumstances or other people. We tend to know what we want, when we want it, and we get frustrated, blame ourselves, or blame others when things don't work out. Parker Palmer, in his lovely little book "Let your Life Speaks" offers an antedote to this type of self-defeating thinking with the concept "way closed". Sometimes the way in life opens up to us, and we take that as God's sign to walk on through. But sometimes the way closes. Isn't this also God's sign and isn't that as loud a message as the opened door? If we can remember this, we will more gracefully accept our limits, manage stress, walk with a light heart, and live joyfully.

April 2, 2017   Prescription Medication Savvy


Last Sunday, pharmacist Dennis McCallister, RPh, who sits on the Arizona State Pharmacy Board, graced us with a discussion about medicines and answered many questions. I’d like to follow up with a few additional thoughts about prescription drugs.


Reduce your medication costs:


· Have access to your drug formulary, the list of medicines your insurance company approves of, and the prices for each, often expressed as “tiers”, i.e. Tier 1, 2, and 3. These documents can usually be found on your health insurer’s website.


· When you get a new medicine, ask the cost BEFORE you fill it. You may be able to substitute a generic, go back to your doctor for a cheaper medication, or find a coupon for the drug online. Search for a coupon by using the drug name, i.e. “Invokana discount coupon.” Many new, expensive drugs have coupons available online that can lower the price considerably. If this doesn’t work, start an unfamiliar medicine by asking for a “partial fill,” such as one week, to see if you can tolerate it. Nothing is more annoying that an expensive medicine you can’t take.


· Dennis noted that generics are usually made by the same companies that make name brand drugs and are just as effective. Try them.


· www.needymeds.org is a clearinghouse for information about drug discount programs, coupons, and patient assistant programs where one can obtain free or deeply discounted medicines if you meet specific insurance and income criteria.

 

 

Manage them wisely:


· If you have food sensitivities, check the inert ingredients in unfamiliar medicines online at www.drugs.com or www.rxlist.com, or by asking the pharmacist to check for you.


· Use a medi-set container if there is any possibly that you will forget. These are the little plastic containers with sections for each day of the week. Keep it somewhere you will see it every morning or evening. I have used one for years and cannot count the number of times it reminded me that I had forgotten my medicine.


Find a way to be OK with it.


· I have often seen patients become annoyed, angry, or depressed when they learn that they must start a new medicine, particularly long-term therapies. It’s hard to acknowledge that the body is changing, and hard to admit to it needs help. And some people worry quite a bit about possible side effects, or just note that they “hate” medication. Aging is part of living, and eventually most of us need help in this area. So, try to choose to be grateful that these medicines are now available to us, and live the healthiest life you can to minimize your need for them.

 

March 5, 2017


Delayed Gratification


With Lent upon us it seems an appropriate time to think about delayed gratification. Delayed gratification is related to self-control, and it's worth reflecting upon whether or not you feel that this is a personal strength, and is something you focus on if you're a parent. If not, consider spending time in the holy season of Lent to build these muscles. For children, research confirms that self-control is a critical psychological skill. It's a basic aspect of emotional intelligence and is taught through activities that require children to tolerate, and even value, delayed gratification. A child's capacity for self-control is partly biological, and partly a result of socialization within the family, and children who exhibit self-control perform better in school, and ultimately in life because they aren't at the whim of every desire and impulse.

In adulthood, it's tough to fight years of habit, as well as brain biology, but we can tweak our capacity to tolerate frustration. It just might be harder for some people than others. Here are two behaviors to consider if you want to improve your ability to delay the good stuff until you're done with the important things.


 

Distract yourself


When struggling with an impulse, replace tempting thoughts with those that support your new habit. If possible, physically remove yourself from the situation, or at least keep the object of temptation out of sight. Then, distract yourself with enjoyable activities.


Reframe Your Thinking


Think twice about the object of temptation by remembering the practical parts of an experience instead of just the sensory aspects, which tend to get us into trouble. For instance, if you want to eat a bowl of ice cream instead of a bowl of yogurt, focus on how much it's going to raise your blood sugar instead of how great that first bite will taste. In a related vein, think about the longer term negative consequences instead of the momentary experience. Today's bowl of ice cream may taste great for a minute, and send that endorphin fueled sugar high rushing to your brain, but pretty soon you're feel tired, and guilty, and unsuccessful in controlling your sweet tooth.

It's best to start young with good habits at delaying gratification, but even those of us with a lot of missed opportunities, and ice cream, under our belts have room to grow. Wishing you a Holy Lent.


March 19, 2017   Tell Me Yes, Tell Me No


In the past six months or so I've said "yes" a lot, and lately find myself running up against my limits - maybe. I'm tired too much and thinking about all the projects I've committed to leads to anxiety as often as it generates excitement. And it's possible that my attention to quality is starting to fray. Quantity over quality. Can you relate?


Our culture glorifies busyness, and busy people are successful people, so we all run the race. Who do you give a job to? The busy person, of course. But busyness also, oddly, separates us from each other in a tangible way. We email instead of call, and text instead of email, and post it on Facebook for maximum distribution in minimum time. And we protect our friends' and neighbors' space and privacy, because they're probably busy too. All this focus on production instead of relationships is a uniquely American quandary, but it has the potential to lead to deep isolation, where we are hyper-productive but lonely, as well as tired. The thing I find most fascinating when I visit Europe is that the folks occupying tables in cafes for hours at a time don't seem to share our internal clock, always tick ticking. Do we drive ourselves to distraction in order to feel valued? In order to look successful? Or are we afraid of what we'll feel when we stop?




On the other hand it's easy to see that checking out and refusing to participate beyond the basic requirements of work and life also creates circumstances that are ripe for loneliness and lack of meaning. Although we value the "outsider" as a folk hero, nobody wants to be outside the warmth of the human hearth, really.


Maybe the answer is a version of Goldilocks and the Three Bears. Busy enough. Saying "yes" to community and caring, to using our gifts and building relationships that are real and meet the very basic human need for belonging, but not driven to exhaustion by the more is better philosophy. Maybe part of a Holy Lent can be finding your "just right" place. I'm going to be thinking about that this season. Maybe we can find each other and share the insights we arrive at once we figure out when to say "yes" and when to say "maybe later." 


02.05.2017 Supporting the Suicide Survivor


Every year in the United States, 33,000 people take their own lives. According to Harvard University, every one of these deaths leaves an estimated six or more "suicide survivors" — people who've lost someone they care about deeply and are left struggling to understand. That's almost 200,000 by my count, so it's very likely that you know one. You may even be one, and with the rise in suicide frequency in our country, the count is only likely to climb. So let me lay out a few of the issues and resources related to this phenomenon, and trust that you will share the information, as is your generous tendency.


Suicide loss isn't like other types of bereavement because so much anger and guilt are wrapped into the experience. Loss survivors have complex needs that aren't easily met by the traditional grief support network. So what can you do if you know someone in this situation? First, set a tone that it's always OK to talk. Some people won't or can't, so your friend's support system has likely gotten smaller. Second, ask questions, then listen. Pry a little when your friend seems down or you haven't heard from them for a while. Be persistently present. Third, try not to give advice but remind your friend of their genuine strengths. Fourth, know a few resources and help them connect with them. Sometimes they don't have energy for the first step, even when they know they need to take it.




Here are those resources:

-American Association of Suicidology, Survivors of Suicide (SOS) Handbook, a concise 32 page handbook to guide a survivor through the first months. http://www.suicidology.org/Portals/14/docs/Survivors/Loss%20Survivors/SOS_handbook.pdf


-American Association of Suicidology, Survivors of Suicide Support Group Directory, a way to find a local support group.

http://www.suicidology.org/suicide-survivors/sos-directory


For women impacted by the suicide death of a spouse, I have created FindingUp, https://www.findingup.com, a source for education and insight. FindingUp includes the resources listed above, as well as everything a woman would need to consider in the path back to health and wholeness. It includes coping strategies, resources, and examples from my own experience, as I am one of the 200,000. Like any terrible loss, this is survivable, but having community, and love, and faith, are key assets in the struggle. So reach out. Someone out there needs you.

January 22, 2017 Taking on a Taboo: Part I


Statistically speaking, it's really likely that somewhere in your circle of acquaintances, you know someone who lost a loved one to suicide. Suicide used to be considered a problem just for angst ridden teenagers or lonely elderly men but things are different. In the last fifteen years, the suicide rate among people in their 40s, 50s, and 60s has surged, creating what physicians call a silent epidemic. Did you know that suicide is the third leading cause of death in men in their 30s, or that 29% of all suicides in the US are in white men ages 45-64?


Most people don't, and it's a scary knowledge gap because we, as a community, are the first line of defense when someone is feeling despondent to the point of death. So, what are the risk factors for suicide? According to the American Foundation for Suicide Prevention (AFSP) they are health conditions like depression, anxiety, substance abuse, chronic pain, or chronic or severe medical problems, environmental factors like stresssful life conditions, dysfunctional relationships, access to lethal means, or surviving another person's suicide, and historic factors, like previous suicide attempts or a family history of suicide.



The warning signs that someone may be thinking about suicide are focused around talk, behavior, and mood. A suicidal person may talk about being a burden to others, feeling trapped, having no reason to live, or even admit that they are thinking about suicide. They exhibit specific behaviors too, like withdrawing from social activities, drinking more, acting aggressively, or sleeping too much or too little. They usually also have a depressed, anxious, or angry mood.


If you're worried about someone, remember the acronym QPR. It stands for question, persuade, and refer. You start by just asking, "Are you thinking about killing yourself?" It's an awkward question, for sure, but most people are honest in their answers and this can literally save a life. If they say yes, we may be able to lovingly talk to them about these feelings and encourage them to get help. And then refer them to it. The suicide hotline is a great place to start and locally that number is 480-784-1500. Nationally it is 1 800-273-8255.


If we know a suicide loss survivor, they need your love, support, and prayers over many months or years. I will talk about that challenge in my next column, and encourage you to share this information across your social network because we never know where need resides.


January 5, 2017  Do You Believe In Resolutions?


Someone asked me lately what my New Years' resolution was, and I had to admit that I never make them. Saying you're going to do something is

never a recipe for change, so I've tended to just decide on a certain behavior change and create weekly, trackable mini-goals to help make it happen. When or if it didn't work out I wasn't really invested in the goal, so I moved on to other goals. Whether or not you made a New Years' resolution, or just look at January as a fresh start, here are three behaviors to reflect on: should I have more of this in my life? These three habits alone would go a long way toward improving your overall wellness in 2017.


1. Scripture. Participating on the RenewalWorks evaluation team helped me to understand that the best way the grow spiritually is to weave the Bible into my daily life. Is it a growing opportunity for you, too? We cannot grow closer to God if His Word isn't comforting our spirits and guiding our actions.


2. Build your social support network. Make at least one good friend this year, someone with whom you share your thoughts and feelings. In adulthood, we tend to lean on the same friends we've known for years. The problem there is that people move, and die, and if we aren't bringing new people into our circle, we are in a state of net loss, year by year. There is overwhelming data that strong social support is a foundational element of good physical and mental health, and it is so much more important than you may think. And spouses can't be your only support. For men, this is especially critical. Statistically, men suffer more suicide, substance abuse, and mental and physical dysfunction than women, and researchers track a lot of it back to poor social support.

 



3. Try to watch your self-talk. "I'm such an idiot." "He did it just to annoy me." "I am never going to get a raise." What we say inside our heads is often poisonously unhelpful. If someone else talked to us the way we talk to ourselves, we'd sure be angry. So when you find unpleasant emotions arising, turn inward and observe your self-talk. It's likely unrealistic, unfounded, and unhelpful. Working on self-talk is the very best non pharmaceutical way to improve mental health, according to research.


Three powerful behavior changes. Three paths to wellness. So what are you going to do this week to make a small change? Happy New Year!


November 22, 2016  Just Do It


A turbulent election is behind us and next year we have new leadership and the uncertainty that goes with that. Let's take a cue from the equally important fact that our national day of thanks is this week and consider that it may be a wonderful moment to focus on gratitude. Gratitude represents our thankfulness for every experience because they all help us grow, sometimes materially, but sometimes spiritually and emotionally.


1 Thessalonians 5:18 is a beautiful verse that tells us to "give thanks in all circumstances; for this is the will of God in Christ Jesus for you". When life is great, that's easy to do, but when our circumstances are trying, or our emotions distraught, it's a much bigger challenge.


For a lot of reasons aside from the spiritual, it's really useful to develop a practice of gratitude. First, the mind is constantly struggling with unfulfilled desires. We never have enough time, enough shoes, or enough hair and Amazon.com is always beckoning. But the perception of "enough" is relative because there's always something more to want. When we nurture contentment through the practice of gratitude, we calm the mind and clear the way for actual happiness. And there is a lot of research that connects gratitude to happiness versus acquiring- status, position, possessions.



Gratitude also has a positive impact on health because it facilitates a state of physiological relaxation rather than stressed out frustration. From instance, researchers at University of California Davis found that nurturing an attitude of gratitude helps immune functioning, reduces blood pressure, and improves sleep. It's always a lovely revelation to me that behaviors that God calls us to invariably are good for our bodies.


So how can we do this, especially in moments when we may not be feeling so grateful? I think it boils down to building good habits. Every day add prayers of thanks to your personal reflection time. Practice saying thank you frequently to other people. Be grateful for the mundane because life could be so much harder. And use gratitude to harness your hurts. Make a habit of looking back and seeing how the strength you had to bring forth to manage hard times may have changed you in some way that now makes you a more authentic version of yourself. As the saying goes, there are two ways to look at your life. One is as though nothing is a miracle. The other is as though everything is.


October 30, 2016 Let’s Talk about Open Enrollment


As health insurance open enrollment winds down for employers, and gets started for the Healthcare Marketplace and Medicare, I’d love to share a few tips about these choices.


• Don’t choose a plan based on your or your family’s current health status. Consider the worst-case scenario and plan from there. In my opinion, this is the number one mistake people make. They purchase coverage that is adequate only if they stay healthy because it’s cheaper. But it’s an inaccurate kind of math to look at your current medical costs, and decide that it’s cheaper to choose less coverage or go without all together because it doesn’t take into account the fact that things can change.


• If you’re looking for an individual insurance plan, this is a challenging time indeed. Healthcare.gov is currently open to preview options and there is only one plan available in Maricopa County, offered by Healthnet. Please talk to a private insurance broker about other options if your physicians aren’t contracted with this plan. Whatever you purchase, please make sure that it covers the Affordable Care Act’s ten essential services.


• If you’re on Medicare make sure you have a Part D prescription drug plan and explore whether or not you can purchase one at this time if you don’t.

• If you are faced with a high deductible plan, learn about gap coverage. Gap coverage is offered through insurance brokers, and some employers. For a modest premium, it can provide insurance coverage for your deductible and is a good option for some.





• If you’re on a Medicare C, or Medicare Advantage plan, consider how easy or difficult it has been for you to access specialists, see the providers you want to see, and your general customer service experience. Although these plans are cheaper, they do have much tighter provider networks and some of the most prestigious medical institutions in the state don’t take these plans. If you’re considering a switch to to straight Medicare, you’ll need to purchase a Part D drug plan and a Part B supplement, and now would be the time to make the move.


Resources:

AARP Law: Choosing a Health Plan

http://healthlawanswers.aarp.org/en/facts/choosing-health-care-plan-coverage-cost-compare


Medicare: Your Medicare Choices

https://www.medicare.gov/sign-up-change-plans/decide-how-to-get-medicare/your-medicare-coverage-choices.html


Healthcare Marketplace: Getting Coverage for 2017

https://www.healthcare.gov/get-coverage/


NPR: Would You Like Some Insurance With Your Insurance?

http://www.npr.org/sections/health-shots/2016/09/13/493695824/would-you-like-some-insurance-with-your-insurance


October 16, 2016 When it’s Not Okay


If you're not familiar with it, #notokay is a Twitter and Facebook page started by Canadian writer Kelly Oxford to highlight the problem of sexual assault in the wake of last week's political news. Her recent online invitation for women to share their first experience of sexual assault had staggering results. 27 million people visited or responded on her Twitter page in a few days, reporting victimization, often as young as twelve.


The Rape, Abuse & Incest National Network (RAINN) notes that 63,000 children a year are victims of sexual assault and most are between 12-17 years old. And one of every six American women experience sexual violence of some sort. I'm not even sure if statistics are captured regarding the rate of sexual harassment. Many stories with #notokay hashtags described behavior that creates hostile school and work environments, but never gets reported. Does my experience, as a young woman, of having a male manager slip in between me and my desk and sit on it to flirt, which positioned my eyes inches away from his belt buckle, fit? I don't know…




What I do know is that it all starts with our kids, and us. Are we teaching our girls, before they reach adolescence, about appropriate and inappropriate touch? Are we teaching them to recognize sexual harassment before we think they will need that information? Many women's stories included a thread of shame, or fear that kept them from telling anyone. Are we teaching our girls in clear language that it is never their fault if someone touches them in a way that makes them embarrassed or scared and that we need to know if it happens? Pretending that they are too young, or that we can keep them safe, only makes them more vulnerable.


And are we teaching our boys to respect girls and women, really? I'm not sure if "locker room talk" is really as crude as it seems, since I've never been in those conversations, but you men do know. Please think about what you've heard and prepare your sons to manage themselves. One college-aged male blogger recently reminded readers of Martin Luther King's assertion that allowing injustice anywhere is a threat to justice everywhere. We must coach our sons to have compassion for girls and women as real people and have ways to respond to disrespectful peer-to-peer conversations. Because talking about women in a degrading way has a direct relationship on how women are treated in our society. And it's just not what Jesus would do.


October 2, 2016  Happy Feast of St Francis of Assisi! 


In honor of the occasion, let's talk about dogs. (Sorry cat lovers.) The special chemistry between dogs and humans goes back at least 100,000 years. They were the first domestic animal with which we developed a close association and scientists believe we helped each other survive and evolve. Dogs acted as our alarm systems, trackers, hunting aides, heating pads, babysitters, and playmates. In exchange, we provided them with food and security.


Dogs have a uncanny ability to predict what their owners will do, can often read human body language, and are attuned to our emotional states. And people are reasonably good at understanding dog body language, also. Researchers at Walden University in Florida found that owners recognized a happy expression on their dog's face about 88% of the time. No wonder that at least 40% of owners identify their dog as a family member rather than "just" a pet.


Pets, especially dogs, seem to be good for our health. "Dogs make people feel good," says Dr. Brian Hare of Duke University's cognitive neuroscience department. Research has shown that when we interact with dogs, oxytocin levels increase in both species. Dr. Hare notes that "dogs have somehow


hijacked the oxytocin bonding pathway, so that just by making eye contact, or playing and hugging our dog, the oxytocin in both us and our dogs goes up." (http://www.heraldtribune.com/news/20160927/pet-theory-researchers-find-more-ways-our-animals-can-keep-us-healthy) This a pretty amazing considering the idea that oxytocin plays a key evolutionary role in parent-child bonding among most mammals, including people. It's this rise in oxytocin levels that accounts for why our stress levels, anxiety levels, and heart rates go down when we interact with our dogs.


Dogs are used in therapeutic capacities in courtrooms, exam study halls, hospitals, nursing homes, hospice homes, classrooms, and airports. They have been shown to be therapeutic for people with chronic pain conditions, both married couples and single people living alone, those at risk for heart attack, people facing emotional struggles such as depression, and many other circumstances. The research goes on for miles.


So dog owners rejoice. Your furry friend is an asset for your health, and for those of you like me, who haven't yet taken the leap, remember that All Saints will be hosting a huge adoption event on Saturday September 29th. Who knows, your fur-ever friend may be waiting for you.

September 15, 2016  Know Thyself

I've spoken several times in this column about emotional intelligence, that priceless ability to identify and manage our emotions, as well as respond in a measured way to the emotions of others, and one of the cornerstones of emotional intelligence is self-awareness. We cannot manage anything without awareness of it, right? And without awareness, there is no way to pursue a path of holistic wellness. So too it is with our congregation. As a body, if we are not self-aware, how can we be physically, emotionally, and spiritually healthy?

This week we roll out RenewalWorks, a very special opportunity to gauge our wellness as a community through the vehicle of self-awareness. I joined the RenewalWorks team because as a social worker and your Health Ministries Coordinator, I saw it as our opportunity to increase our communal emotional and spiritual awareness. What an exciting thing!

 


How can we take focused, action oriented, and informed steps into our future if we are unaware of where we are now? I just don't see how it's possible. So in order to know ourselves, we move through the RenewalWorks process and there is a whole team of volunteers from the community, from all walks of life, who have stepped forward to give their time to review and analyze the data we receive from the program after the survey is over. It will be completely anonymous aggregate information about us as a whole, and your RenewalWorks team is excited to crack it open and identify our strengths and challenges. What programs do you need? What supports? What's going well and what's not? We will not know unless you tell us.

So your part in this journey to self-awareness is to fill out the survey because the plans developed will only be as reliable as the information they are based on. Know thyself and health and healing come. And we all have a part in this body's journey in wellness. Yours will come in the form of an email link. The next step is up to you.

September 1, 2016  Knit One, Purl Two

I recently read an article about the health benefits of knitting. Really. Turns out that time spent in crafting activities that are intellectually challenging, require hand-eye coordination and manual dexterity, produce something we can be proud of, and involve repetitive actions really do us a world of good.

The studies involving knitting, specifically, are impressive. It helped young women with eating disorders improve clinically, induced calm behaviors amongst incarcerated prisoners, alleviated depression, helped people with chronic pain conditions focus less on physical sensations, reduced dementing illnesses in the elderly, and improved the likelihood that smokers could successfully quit cigarettes.

Last April, the Yarn Craft Council even created a “Stitch Away Stress” campaign in honor of National Stress Awareness Month. Dr. Herbert Benson, a pioneer in integrative medicine and author of “The Relaxation Response,” confirmed that the repetitive action of needlework can put us in the same relaxed state as meditation and yoga. Once you get beyond the initial learning curve, which can definitely be frustrating, knitting and crocheting can lower heart rate and blood pressure and reduce blood levels of cortisol, one of the primary stress hormones that build up in our bodies as we face the fight or flight response in reaction to life's daily trials.




And all kinds of people are figuring this out. Needle crafts are popular. It now seems that about a third of younger women knit, as do more men and even children. In fact, if you check out menwhoknit.com, you'll see that men are knitting socks for amputee friends, organizing scarf exchanges, and making hats for premature babies to take their minds off worries related to their own premature infant sons and daughters. It's terrific! We all need more healthy and productive ways to handle the stresses of life, build caring relationships, and make an impact on the world. Sometimes knitting needles are just what the doctor ordered. Sound intriguing? A great place to start might be our own Prayer Shawl ministry. And if you practice a needlecraft activity that soothes your soul and creates beautiful objects to share with others, please teach a child in your life how to do what you do. Pass it on. These simple practices, and there are so many of them, are the little joys that lead to lasting health and happiness.

August 17, 2016  Coming your way . . . The All Saints’ Creative Community

Have you noticed the call for artists over the past few weeks? All Saints’ has an exciting new way to connect coming your way, the All Saints’ Creative Community. We envision a space in the life of the church where those who are interested in the visual arts can find each other, grow their skills, work for the benefit of the larger community, and just have fun. Art and spirituality are natural partners and All Saints’ already has a long history of excelling artistically. What might this connection group look like? Well, we might have access to workshops by visiting artists, host an exhibit and sale to benefit a specific ministry, share our work with each to receive support and feedback, study art and spirituality together, host an art focused meet-up in the community, etc. We envision the group as a loose roster of members who share this interest in the arts, but do not plan specific routine obligations like group meetings. However, we also see the group as shepherding it own programs and activities, so the specifics are wide open.

 


Why am I involved? Well, I’m a later life art student, learning classical drawing and painting, and know that God has healed me through the arts in so many ways. And maybe this project is a natural extension of All Saints’ Health Ministries Program because research has definitively proven the therapeutic effect of arts participation.

So if you are a student, amateur, or professional artist, spending one hour a month or forty hours a week on your craft, make money from it or spend money to do it, we want you! Please email me at palshatti@allsaints.org, let me know what you enjoy doing, and I will add you to the growing All Saints’ Creative Community group in Realm, the platform through which we will organize communication and activities.