Mindful Recovery #1

Being more mindful during this second hip-joint-replacement surgery is proving very interesting. There is something to be said for having been through the process once already; to say nothing of being able to select my surgeon, hospital, type of anesthesia, and even date of surgery. I believe all of that conspired to reduce the anxiety that typically goes along with this type of major procedure—seeing as the entire body is part of the subconscious mind. Not only did I purposefully engage in specific preparatory exercises for three months immediately pre-operatively, I spent 10-15 minutes each day visualizing different aspects of the process, reminding my body of what would be happening and instructing it in how I wanted it to behave. Based on the old axiom that the proof of the pudding is in the eating, it’s been fun to identify positive differences between the two experiences.

1. My body was much more relaxed during initiation of the spinal anesthetic, allowing the CRNA to “get in” more easily.

2. I was able to lift my right leg and foot up off the floor to a height of about four inches on day one post-op, which didn’t happen until day four post-op last time.

3. My brain could joke in advance about some of the procedures, which while it may have disconcerted some of the staff certainly released dopamine and endorphins as I laughed at my own descriptions.

Meanwhile, in my conscious mind . . .

Brain and Intuitive Grammar

Studies have shown that the brain is intuitively good at some things. Grammar, for example. According to Daniel Kahneman, author of “Thinking, Fast and Slow” and winner of the nobel prize in economics, the human brain appears to be a good intuitive grammarian. Any normal baby brain born on this planet is able to learn any of the languages and dialogues that are spoken on this planet. By the age of four, children conform to the rules of grammar of their native language(s)—effortlessly—even though they have no idea that grammar rules even exist. They also pick up the inflections or dialects or speech styles of their immediate environment, which may differ based on the locale or section of the country even though the basic “language” is the same. A couple years ago I visited Nova Scotia where the Acadians (French-speaking individuals) lived. More recently I visited New Orleans where the Cajuns lived (slang for Acadians who migrated from Nova Scotia to South Louisiana in the 18th century). Watch for examples of dialects or speech styles in upcoming blogs.

Snacking, Grazing, and the Brain

Do you tend to snack and graze? If so, you may be ingesting far more calories than you think and packing around more “fat” than you need can negatively impact your brain function. Grazing and snacking involve habits and habits can be altered. According to Susan Bowerman, RD, assistant director of the UCLA Center for Human Nutrition, there are no snacks that burn fat. There are some snacks that can help to increase metabolism and that are much lower in fat and sugar than others, however: snacks that are 200 calories or less and that contain around 10 grams of protein and 5 grams of fiber. Here are examples:

• An apple or ½ an avocado with 6-8 raw or dry roasted almonds

• An apple or ½ an avocado with 2 ounces of 1% cottage cheese

• Three ounces of light tuna with 6 whole wheat crackers

• A mixture of 1 diced pear, ¼ cup diced walnuts, and 2 ounces of 1% cottage cheese on 2 pieces of sour dough toast

• One teaspoon of natural almond butter on 2 pieces of sour dough toast and covered with unsweetened applesauce

Develop new habits. Eat slowly, chew well, stay hydrated with water, and tell your brain you feel satisfied with these healthier snacks.

Grief and Gratitute

No doubt many of you have been watching and listening to updates about the Boston marathon act of terrorism and the Texas fertilizer explosion--as have I. Even for individuals who were not on either site or who knew no one in either arena, there can be a level of horror and grief, if not outright despair about "What is the world coming to?" It can feel like that when incident compounds incident. It is important to take a brain-balanced look at this, however. First, evil has been part of the human condition for the life of recorded history. Goodness, heroism, and self-lessness have, as well. While I will forever regret the loss of life and the families who are changed by injury or death, the individuals at fault would like us to get stuck on the sadness, to become frightened of life and living, and to become overly isolated and defensive. It is my brain's opinion that even the individuals who had life cut short wouldn't want this. Even as we do everything in our power to help the FBI find these individuals and bring them to justice on behalf of those who were injuried or killed, let us remain hopeful and advisably alert--courageously living life to its fullness. As Diane Sawyer put it, "Courage is fear that has said its prayers." Let us live in a state of gratitute.

Brain-Body Communication

The healing process continues to amaze me. Every day I notice ways in which my body is not only healing but also trying to make me aware of what is happening. For example, it may be a bruise that is slightly lighter in color or edema that is smaller in size or a muscle that screamed during rehab yesterday and is only shouting today or a range of motion that is just a bit expanded or a reduced need for pain medication. I read an article a while back that suggested your brain and body appreciate knowing that you not only recognize what they are doing but also like to hear you say "thank you." That was a new concept. For years I've thumped my thymus gland every morning and thanked it for keeping my immune system healthy. But thank my brain and body for healing? Hmmm. I decided I'd try it. After rehab this morning I said aloud:  "I really appreciate the way you are helping me recover from surgery. Thank you for showing me some progress every day, which helps me stay focused and positive. Life is good and my health is excellent." I'm gaining an expanded appreciation of the exponential progress that a coordinated team effort can make. Me, my brain, and my body.

Friend-To-Friend Communications

What does a friend say to a friend who is under the weather? A newly released book entitled “How to Be a Friend to a Friend Who is Sick” included some helpful suggestions. The author, interviewed on television recently, indicated three specific communication tips for these situations. I’m very fortunate to have friends who actually use some of these with me. Maybe they’d already read the book or perhaps they’re just naturally gifted. I know I’ll be communicating a bit differently from here on out. 

• Do you want company now or not? (It takes energy to interact with visitors no matter how much you love them. Sometimes “company” via phone or text or email is perfect and saves your friends a trip for just a few minutes of visit. A choice is good. It’s a gift! Close friends called a couple of days ago and offered to drive out from the city for a visit if I was up to it. Exhausted from rehab, I asked if we could just chat on the phone for a bit. It was wonderful to know they would not be offended. People who genuinely love you are all about doing what works for you.)
• Tell me what to bring and when to leave. (Friends called to say they were bringing me a food basket and asked what I wanted in it. “You can tell us what you want and get what you like or you can risk liking only some of the contents.” I said what I wanted—and got it. Great option! We had a fun visit and I didn’t even need to tell them that it was time for them to leave so I could do my next rehab session. They left before I was tired. Great perception!)
• Tell me what’s helpful and what’s not. (Every person has things he/she prefers to do versus those that it would be helpful for others to do. Be clear about what you need and want and be willing to state that. In my case, offering to do my hair is unhelpful, so is suggesting having oil rubbed on my feet. Picking up my mail, on the other hand, is beyond helpful! Most good friends would rather do what’s helpful to you instead of guessing!)

What To Say?

What are helpful (versus unhelpful) things to say to friends who are under the weather, having an off day, or downright ill? Most people have struggled with what to say at some time or another. Many have been recipients of unhelpful comments. Letty Catlin Pogrelbin recently released a book entitled “How to Be a Friend to a Friend Who is Sick.” It is filled with suggestions of what to say and what to avoid saying. Perhaps I found it unusually interesting because of my recent hip-joint replacement surgery. Whenever I’m on the opposite side of health care (a patient rather than a provider), there is always something to learn—especially from well-wishers and visitors. It can be tempting to think you know what the person you are calling or visiting needs and yet the most comfort you can offer is more likely related to what the person perceives he/she needs or wants. For example, “Tell me how I can help,” may be more effective than saying, “Let me do such and such for you.” Rather than asking, “How are you?” try, “What are you feeling today?” That leaves the door open to answer “fine, okay, fair-to-middlin’, improving, none of your business,” or whatever, rather than the person sensing any obligation to rehearse diagnosis and treatment options. Small things. Yes. But good things often come in small packages.