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 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." 

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.

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.


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.


AARP Law: Choosing a Health Plan


Medicare: Your Medicare Choices


Healthcare Marketplace: Getting Coverage for 2017


NPR: 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.