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LIVING WITH SPINAL CORD INJURY: BECOMING AN ADVOCATE FOR YOURSELF

July 22nd, 2011
Although we sometimes wish that other people could read our minds and go to bat for us, in reality no one knows our needs and desires better than we do. While you are in the rehabilitation center, the professionals who work there serve as your advocates. When you leave, you have to become your own advocate.
What does “advocating” mean? Basically it means standing up for yourself and communicating the importance of your needs to those who can meet them or who can help you achieve your goals. To advocate effectively, you must believe yourself worthy of having your needs met.
Different people have different levels of comfort in speaking for themselves, and we’re generally more comfortable doing so in some situations than in others. An extrovert may find communicating easy, while an introvert might find it intimidating. Comfort levels are also affected by the amount of stress in our lives.
Gwen, an attorney, was usually quite competent in dealing with situations that involved gaining entry using her wheelchair. One Saturday night she went to the movies with a couple of friends. Arriving at the theater, they waited in line in the freezing cold to buy tickets. They eventually got their tickets and entered the theater, only to be met by the manager, who told them that Gwen wouldn’t be able to see the movie because it was on the second level and the theater had no elevator. Gwen, who’d had a stressful week litigating a case and caring for her aging mother, burst into tears. This was the proverbial “straw that broke the camel’s back,” she thought.
In another time and place, Gwen would have handled the situation with her usual professional demeanor, imparting information with a sense of humor. Her experience at the movie theater illustrates how emotions change, depending on what is happening in our lives. When advocating for yourself, give yourself some slack. Don’t expect to be “perfect” in being educational and understanding in every situation.
When you have the emotional resources, what sorts of skills do you need to be your own advocate? Most people agree that an advocacy tool kit should contain the following elements:
1.   Identify the problem
2.   Identify the desired solution
3.   Identify various ways to reach the solution
Each step requires clear thinking, the ability to articulate, and the willingness to hear other people’s ideas, appreciate them, and incorporate compromises if necessary.
How do you learn to advocate for yourself? First, be informed; know what you are talking about.
Second, learn assertiveness and advocacy skills. Programs that teach advocacy skills are most likely sponsored by your local Office for Persons with Disabilities or Commission for Women. You can also learn these skills through mainstream organizations that teach public speaking.
Some rehabilitation programs provide social skills training, and many community colleges and mental health facilities offer assertiveness training classes for the general public. On a very practical level, you can learn from watching how other people with spinal cord injury gain the attention they need to achieve their goals.
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MINDFULNESS: THE KEY TO THE MINDFUL-EATING PROGRAM

July 14th, 2011
The fundamental concept underlying my treatment program is mindfulness. Many people are not aware of this term or what it means. If you have heard of it, you probably associate it with meditation and stress management. In fact, Dr. Jon Kabat-Zinn of the University of Massachusetts Medical Center pioneered its well-known use with patients suffering from stress-related medical problems such as hypertension, cancer, and cardiovascular disease.
Mindfulness is not a new idea. It is an ancient concept that is the central component of meditation. Mindfulness is a state of mind that will help you gain control over your emotions, thoughts, and behavior. It will put you back in charge of your eating.
Mindfulness is awareness. It is not simply paying attention but a deep, focused awareness of yourself and your surroundings on a moment-to-moment basis. It is paying attention, on purpose.
Most of our eating occurs automatically, without real awareness. This is true whether you are eating low-calorie, nutritious foods or two candy bars. I mentioned earlier that when people binge they often do so in a robotlike, “spaced-out” manner. This state of mind is the exact opposite of mindfulness and one that is designed to keep you feeling out of control. Food is in charge, not you. Together, we can put a stop to this and put you back in control of your eating and your life.
Mindfulness will provide you with the opportunity to change your relationship with food and, eventually, your dependence on food. You will learn to heighten your awareness of every aspect of your life as it relates to food and eating. We will be applying mindfulness to your thoughts and emotions associated with food as well as to your hunger and appetite. To stop binge eating you must first become mindful of your automatic reactions related to food.
*63\358\8*

IS IDEAL MARRIAGE ATTAINABLE?

July 2nd, 2011
To many persons the marriage ideal we have set up will seem beyond the range of possibility for most human beings. And, judging by existing conditions, they are right about it. Probably from one-third to one-half of all men and women who marry find themselves unhappy sooner or later, not to mention those who are simply moderately contented.3 The present divorce rate—about one divorce for every six marriages—while regarded by some as appallingly high, really paints too bright a picture of the marital situation. There are a number of factors that conspire to make divorce statistics inadequate as an index of marital unhap-piness. Religious prohibitions, of course, deter many from dissolving marriage. Moral sentiment is probably even a greater force in holding unhappy couples together. Many persons who consider themselves thoroughly emancipated and by every rational standard know that they should live at opposite poles of the earth rather than under the same roof find almost insuperable mental barriers standing in the way of their freedom. Economic necessities, in rural districts especially, and everywhere in those age groups in which it is difficult for a woman to support herself, cause many to endure their unhappiness with stoic resignation. Added to these influences are the expense and the perjury required by our laws to enable a couple to obtain a divorce, and the vicious system by which parasitical young women may be granted alimony though not rendered by matrimony incapable of earning a living for themselves. The difficulty, too, of establishing new social contacts, which either or both of the divorced couple must face, is also a potent factor in keeping incompatible men and women together. And we have not yet even mentioned children, whose interests make separation a very serious matter, and justly so. Finally, we cannot judge the success of marriage altogether by the reports of the participants, for it is a part of the conscious or unconscious personality-defense of persons who have to make the best of a bad proposition, to try to believe or assert that they are happy.
*107\275\8*

SYMPTOMS OF MENOPAUSE: VAGINAL CHANGES

June 27th, 2011
As the level of oestrogen falls, the walls of the vagina become thinner, and the blood flow to this area is restricted, causing a lack of lubrication. Doctors describe this as vaginal atrophy, which actually means wasting away, becoming useless. It’s a nasty term, guaranteed to make any woman feel she is about to become a dried-up husk. In fact it’s a real case of ‘use it or lose it’.
Although the vagina does not expand so much, it is still quite large enough to accommodate an erect penis. But the thinning of the vagina can encourage bacterial infections such as cystitis. Staying sexually active is a must. Regular sex or masturbation stimulates the blood flow into the vaginal area, reducing dryness. The muscle contractions during orgasm promote the health of the vagina.
Your waterworks are also affected by vaginal changes. The lining walls of the bladder and urethra (the tube linking the bladder to the outside) shrink and become thinner and drier and can become more liable to infection if they crack and split. You may feel the need to urinate more frequently, or find you leak a bit when you sneeze, cough or laugh. The good news is that there are plenty of natural ways to deal with these symptoms.
*7/101/5*

WEIGHT LOSS: THE THREE MACRONUTRIENTS: FAT

June 13th, 2011
For the past few decades, we’ve been bombarded with the message “Fat is bad food!” Every women’s magazine, every sports magazine, every men’s magazine, every health magazine includes at least one article or advertisement about how the consumption of fat will subtract years from your life by causing degenerative disease, including heart disease, cancer, stroke, diabetes. To listen to the experts, you would think fat isn’t an essential part of the human diet.
We’ve already learned that it’s no accident that nature distributed fat abundantly throughout the food chain. Fat is an extremely beneficial food. For example, fat is used to build hormones, some of which regulate blood pressure, heart rate, vascular dilation, blood clotting, immune response, and the central nervous system. Fat makes up a substantial part of the cell membrane of over three trillion cells, making the cell wall permeable so that nutrients can get into the cell and waste materials can be excreted from the cell, and rigid so that the shape holds firm against the pressure of the surrounding environment. Along with protein, fat acts as a receptor on the cell wall to invite nutrients and hormones into the cell.
Fat keeps the skin soft and supple and helps to avoid premature wrinkling of the skin. Fat is an excellent energy source, particularly for the heart. And fat keeps the metabolism running fast!
We need fat in our diets. The problem comes when we eat far too much of the wrong types of fats.
An important rule of thumb I personally follow is that I never eat anything that has been put together in a chemist’s lab, including new food artifacts like the “fat substitute” Olestra. These substances are toxic. They do not build the type of long-term, vibrant health I want for my body. They do not perform all those important functions listed above. On top of that, they taste bad!
The types of fats you want to include in your diet are the raw, unprocessed vegetable oils like extra-virgin olive oil, avocado oil, and the oils from nuts and seeds. You need to include the fats found in fatty fish like mackerel, salmon, and halibut. These oils are extremely beneficial in protecting the heart and nourishing the nervous system. I encourage all my clients to include at least two to four tablespoons of raw oils in their diets each day by making salad dressings from olive oil, by using flaxseed oil in their morning protein drink, and by eating vegetables that are rich in essential fats (avocados and nuts and seeds, such as sesame, almond, and other nut products). Flaxseed oil is a nutritious oil from flax that can be purchased from your local health food store. Be sure to keep it refrigerated. It oxidizes rapidly if not preserved carefully.
You will need to include about half the amount of fat as your protein requirement, gram for gram. For example, if you require fifty-five grams of protein per day, you will wish to enjoy about twenty-five to thirty grams of fat. If you require seventy-five grams of protein, increase that amount to about thirty-five to forty grams of fat. Don’t worry too much about the fat content of the diet. If you are eating whole, natural foods, the fat will balance itself out without your help. Just restrict yourself to the healthy fats described above. Potato chips, ice cream, and deep-fried chicken must not be included!
*57\319\2*

SKIN DISEASES: SCLERODERMA, SEBACEOUS CYSTS AND SEBORRHEA

June 3rd, 2011
Scleroderma
A hardened and thickened condition of the skin. It may affect the whole body and include the hands. It is sometimes described as a hide-bound condition, and may interfere with the easy movements of parts like the chest. It is generally supposed to be related to the nervous and the glandular systems, and only health-building measures will help to ameliorate the condition.
Sebaceous Cysts
These may form in the glands, which are distended with their own secretions. They are usually often found on the scalp, but they occur in other parts as well. Commonly known as wens, they may become quite unsightly, and, if they cannot be reduced by local measures -heat, etc. -surgical removal should be considered.
Seborrhea
Alteration in the quantity and quality of the secretion of the sebaceous glands. This often takes place in connection with dermatitis and other skin infections. It is generally related to nervous and digestive troubles, and may run on for a long time if the sufferer is unable to take a change and put aside the stresses of his daily life. It can be very troublesome when it affects the parts of the skin covered with hair, as, for instance, the scalp, and it may lead to deterioration in the hair growth. A strict regimen, more change and relaxation are the first things to be considered, and its course is usually dependent upon the efforts that can be made in this manner.
*32/154/5*

VITAMINS AND MINERALS: VITAMIN B3 (NIACIN) & VITAMIN B4 (CHOLINE)

May 22nd, 2011
Vitamin B3 (Niacin)
Functions:   Health of all cells, essential for digestion (works with enzymes); needed for healthy skin; nerves and sex hormones; cleans out toxins; helps circulation; helpful in allergies and sugar and alcohol cravings
Sources:
Causes of Deficiency:
Deficiency Signs and Symptoms:
Wholegrains, lean meat, liver, poultry, fish, nuts, pulses
Dirty colon, disorders of liver and colon, alcoholism, stress, lack of
Dry lips, fissured tongue, wind, Irritable Bowel Syndrome, anxiety, depression, high blood cholesterol, hardening of the arteries, skin sensitive to sunlight or friction. Severe deficiency: pellagra (rough skin)
Note: This is a very useful supplement for people who are always cold, for chilblains, and as a tranquillizer. There is often a harmless skin prickling or flush after taking it. This does not last long and is good for the circulation. The synthetic vitamin B3 (nicotinamide) does not have this effect; it is also less sedating, and because of this might be more helpful if you are depressed.
Vitamin B4 (Choline)
Functions
Sources:
Causes of Deficiency:
Health of nerves is the main effect; one of the most important messengers in the brain; also necessary for vitamin B4 to work; helps in the breakdown of fat
Egg yolk, liver, brewer’s yeast, wholegrains, lethicin (which has no tranquillizing effect because it contains phosphorus which is a stimulant)
Poor diet
Deficiency Signs and Symptoms: Dizziness, visual problems, nervousness.
*138\326\8*

LOWERED VITALITY – A CAUSE OF CANCER

May 16th, 2011
The primary and ultimate cause of cancer, however, is lowered vitality and a breakdown of the body’s own defense mechanism against the physical, chemical, emotional and environmental stresses. This condition is brought about by an unnatural mode of living, over-feeding, over-excitement of the nerves through stimulants, or by medicaments for a long time. Many well-known biologists and naturopaths believe that a faulty diet is the root cause of cancer. Investigations indicate that the cancer incidence is in direct proportion to the amount of animal protein, particularly meat, in the diet.
It has been observed in the nutritional field for centuries, that people who live according to natural methods and follow natural laws in eating and living habits, do not get cancer. On the contrary, people who follow methods of modern nutrition on an increasing scale become prone to degenerative diseases, including cancer, in a relatively short time.
In later medical history, the best known cancer-free people were the Hunzas, who live on the slopes of the Himalayan mountains and who use only foods grown organically in their own country. They do not take imported foods. The same is true for the Ethiopians. They also have natural agriculture and simple living habits, which seems to prove that this type of agriculture keeps people free of cancer and most degenerative diseases.
*25/355/5*

NATURAL HISTORY OF TYPE 1 DIABETES: EFFECT OF INTENSIVE MANAGEMENT – WEIGHT

May 3rd, 2011
In the DCCT, intensively treated patients gained an average of 4.75 kg more than conventionally treated patients (p < 0.0001 ). This finding represented an excessive increase in BMI of 1.5 kg/m2 in men and 1.8 kg/m2 in women. Weight gain was most rapid in the first year of therapy. By year 9 of the study, BMIs had increased >5 kg/m2 in 35% of women and 28% of men, whereas comparable figures in the conventionally treated women and men were approximately 13% and 4%.
Waist-to-hip ratio did not differ between treatment groups. However, intensively treated DCCT subjects who were in the highest quartile of weight gain had increased waist-hip ratios and BMIs, associated with a slightly higher blood pressure and a relatively atherogenic lipid profile. These patients may be predisposed to the insulin resistance syndrome, and their tendency for abdominal obesity may have been exposed by intensive insulin therapy. Long-term follow-up of these patients in EDIC will be of great interest.
Among patients without major weight gain, those on intensive therapy had a greater fat-free mass with no difference in adiposity. Although the benefits of intensive management on microvascular complications in type 1 diabetes are clear, improved understanding of the causes of weight gain and methods to control it are needed.
*33\357\8*

SPINAL CORD INJURY: HOW CAN MY FAMILY HELP DURING THE ACUTE HOSPITAL PHASE?

April 30th, 2011
In the initial stages of your hospitalization, how can you and your family take some control of the situation? Here are some suggestions for how family members can assume responsibility for supporting you (and each other) and for seeing that you get the best care.
1.   Form your own family team, with each member responsible for information and input about a certain aspect of your care. For instance, one member could be with you each morning to talk with the doctors on their rounds. Another member could talk with rehabilitation centers about the second stage of your recovery, to get the information necessary for making the best decision.
2.   Ask questions until you really understand procedures, medications, and any side effects of treatments and medications. This is how you’ll become an informed consumer and a partner in the decision-making for your care.
3.   Ask family members to accompany you to therapies to observe, assist, and give you feedback. They can reinforce your progress and will also be better prepared to help you with exercises when you return home.
4. Advocate for your own care. If your voice is not heard, ask family members to speak up for you.
5. Ask family members to listen to you and understand your observations and needs. And listen to your family. This will keep you attuned to one another’s emotional states so that you can support each other when needed.
6.   If you have questions or concerns that are not being answered or addressed to your satisfaction, request a meeting with the physician. In a rehabilitation hospital or in an acute care setting that uses a team approach to patient care, you can request a Case Conference. This is a meeting that pulls together all the medical personnel involved in your care. You and your family will be included in the conference so that you can hear the different strategies being integrated to form the core of your care. Carefully consider every aspect of your care or prognosis so that you can ask just the right questions.
*25/156/5*

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