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Here is the latest Podcast from Jerry Cahill, where he talks to ME about nutrition….go figure!
Jerry Cahill\'s Cystic Fibrosis Podcast

What is the Right Career?

How is a career choice related to wellness?  First, when I write about wellness with CF, I am not simply talking about physical health and wellness, but also emotional well being…a sense of contentment and fulfillment.  Many things are related to this sense of wellbeing, and fortunately, most have little to do with physical health.

I’ve been reading and thinking a lot about happiness lately.  If you’ve read my column before, you probably know that I find the field of positive psychology fascinating.  Essentially, it is the study of what causes people to be happy and to live rich and fulfilling lives.  Happiness is a popular topic these days.  You see happiness “secrets” revealed on book and magazine covers, on PBS specials, on happiness blogs, websites…you name it.

My purpose is to mine the field of positive psychology and happiness research to come up with scientifically validated ways to improve the subjective wellbeing of people with chronic illness, and of course, cystic fibrosis is a perfect example.

So what does this have to do with career choice?

The research tells us that one of the most important elements of living a good, fulfilling life, is the ability to use your strengths in a manner that serves a purpose that is larger than yourself…one that you believe in deeply and that aligns with your core values.  Those people for whom work is a calling feel the most fulfilled.  And there is a strong positive correlation between happiness and using your strengths every day.  Wouldn’t it be awesome if you could do that and get paid?  You can…and you should strive to do just that.

We all have strengths, and I’m sure you have a very good idea of what your particular strengths are.  It has only been a recent discovery that people who are the happiest immerse themselves in using their strengths rather than using their finite amount of time and energy to “shore up” their weaknesses.  I believe that the very first thing to take into account when deciding a career path is “What are you good at?”  Notice, I didn’t say, “What do you think you can handle, given CF?”

If you want to try a fun and often revealing exercise, take the VIA Signature Strengths Survey at http://www.authentichappiness.org.  This is a series of 240 multiple-choice questions (it takes 45 minutes or so), and when you are done, you will immediately see which are your top five (or Signature) Strengths.   I thought I knew what my results would be, and I was close, but there were some that completely blew me away.  You will also get an interesting perspective on your own strengths by asking those that know you well what qualities they most admire in you.  Finally, make your own list of things you love to do and that you know you do well.  Try to narrow this down into five or six things in which you take great pride and satisfaction.  Combining all of these methods together will give you a very accurate map of the kind of career you will find most fulfilling.   It will be the one(s) where you see the need and the opportunity for these strengths at every turn.

Looking back to my decision to go to medical school to ultimately “cure cystic fibrosis,” I realize that I could have used this advice.  When one thinks of a good researcher, strengths like the capacity to love and be loved, humor, zest, curiosity and love of learning, and hope/optimism/future mindedness (my top five) are not the ones that first come to mind.   A great researcher would show strengths like industry, diligence, critical thinking, caution, judgment, ingenuity, and leadership (not even close to my top five).  While my passion was in the right place (curing CF), my strengths were not suited well to this career decision.

Now, this didn’t turn out all bad.  I loved going to medical school.  My love of learning and curiosity strengths were force-fed every day for 10 years of training.  I got to tell great pathology jokes.  But let’s just say that sitting around diagnosing cancer (after the intellectual thrill of figuring it out) did nothing for my zest, my hope and my optimism.  And who loves their pathologist?  Was I happy?  Not so much.  When it came time to retire to take care of my children and myself, I went through a slight existential crisis (well if I’m not a doctor, then who am I?), but then settled into post-physician existence quite happily.

Now I am entrenched in career number two, coaching and training wellness to people, who, like myself, live in less than perfect bodies that often require care and attention above and beyond the norm.  I use my strengths in a much more effective an ongoing way, and I am appreciated for them more than I ever was sitting at my microscope.  And, I care deeply about the meaning and usefulness of my work.  I feel that I am doing what I “should” be doing.  Given that I have always had a passion for fitness, nutrition and stress management, I get a kick out of sharing this with other people, and love learning even more about these topics.  This leads to a sense of fulfillment and contentment that I didn’t feel as a surgical pathologist.

So what can you learn from this story?  First, it pays to learn your strengths and give them serious consideration when choosing your career.  The same goes for following your passions, and figuring out a way to merge your core values with your daily job.  But finally, what you can learn from this story is that sometimes, despite your best intention, your “dream” job takes awhile to manifest.

You may decide on one path, and find out later that it doesn’t work out as well as you had hoped.  Or, you may love what you do for a time, and then physical challenges may force you to be more attentive to your own health needs than that particular job allows.  All of this happens…to everyone, really.  When you are first deciding on a career, in your early twenties, it may seem like you only get one chance, and you can’t afford to mess it up.

You might be making yourself crazy by thinking, I can do this now, but what if I get sick?  Sure, be practical.  You probably shouldn’t become a firefighter!  But why paralyze yourself by imagining what may happen in the future?

Barack Obama said something in his inaugural address that stuck me (actually, most of what he said struck me…but this I remember).  He said he rejected the notion that as a nation, we couldn’t both follow our values and be safe.  To paraphrase him, I reject the notion that as people with cystic fibrosis, we can’t both follow our passions and be well.

Your career is obviously a very personal choice…one that you will live with day in and day out.  Most people you talk to will give you practical advice:  Think about your health.  How stressed will you be?  Will you be able to care for yourself appropriately?  How healthy are you now?  What can you do now?

These are obviously important to consider.  But remember also to consider the following:  What are your strengths?  What are your values?  Is it more important to you to work your tail off doing what you love, or to work at a less stressful job so that you can place more energy and attention on your own health and family?  These aren’t right or wrong questions.  They are just questions…to which only you know the answers.

Do You Ever Have One Of Those CF Days?

There’s been a bit of a lull in my series on shaking up your CF child’s exercise routine.  But, I have good reason.  I promise, I’ll return…as soon as….it works.

How to Shake Up Your CF Kid’s Exercise

Ok, first of all, I want to say that I don’t normally use the phrase “CF kid.”  Your child is not a “CF kid,” nor am I a “CF adult.”  I am an adult.  CF is one of my challenges…as is coming up with good titles for blog posts. It just didn’t sound right to say “How to shake up your child who deals with CF’s exercise program.”

That said, the purpose of this blog is to talk about living well with chronic illness, and of course, CF is the illness I know the most about.  Self care obviously contributes to wellness with regard to any illness.  But in CF, self care goes to new levels…new extremes.  It may seem to someone who has CF, or to a parent of a child with CF, that to be fully compliant with your doctor would take most of your waking hours.

It’s true…and  this is in part why I stopped working in the real world.  The wasn’t enough time!

So when you hear about the need to add daily exercise to a very long and complex regimen, it stands to reason that the first thought is, “Oh yeah…right…I have time for that!”

However, exercise and it’s importance to health with this disease is so important that I feel an entire series of articles is warranted.  I think that the best way to spread the word is to target first the parents of children with CF, because the earlier an exercise routine is established, the better.  My goals for this series are to first present the reasons WHY exercise is important and why it needs to be established early in life.  Then I will talk about different ways to encourage exercise as your child grows through different stages of both physical and emotional development.  Then I will cover how motivation changes as a child grows older, and how to optimize the methods you use to encourage exercise as motivations change.  Finally, I will discuss the challenges that seem to cloud the way and how they change as a kid moves from toddlerhood to transition to college. Hopefully, I will then present some ideas to work around these obstacles.

Why Should Your Child Start Exercising Today

I have written about the benefits of exercise before, but I don’t mind doing it again.  It is very clear that fitness levels correlate with survival in cystic fibrosis.  This was first shown in 1992 by Drs. Nixon and Orenstein (Nixon PA, et al.  N Engl J Med 1992;327:1785‐8).    No proof of a causal relationship was evident then, but the correlation was intriguing.  Since then, it has been shown that maximal exercise capacity correlates with survival, just as FEV1 does.  In fact, in Europe, routine exercise studies are done in addition to  pulmonary function testing to follow the course of the disease.
It makes sense, really.  Look at the “CFTR-able” population.  Fitness correlates with survival because it lowers the risk of so many health hazards (diabetes, obesity, hypertension, hypercholesterolemia, and several cancers, to name a few).  It also enhances immunity and acts as a buffer to the ill effects of chronic stress.  We don’t know the exact reasons why it helps in CF, but we have some eduacated guesses.

For one thing, and a very important thing at that, exercise promotes weight gain in children with CF.  We are a weird group indeed.  For most of the world, exercise is prescribed to help lose weight.  We even have reality shows based on this concept (The Biggest Loser). But for children with CF, exercise increases the appetite, and as long as good, high energy density food is around, weight is put on!  As I’m sure any parent of a child with CF knows, lung function shows a strong correlation with weight and BMI.  Lungs just work better when kids are closer to their ideal BMI.  Exercise is one tool to use to get them there.

Exercise also is an excellent form of airway clearance.  In fact, we know that exercise combined with a standard method of airway clearance such as the Vest, flutter, or chest PT is better than either one alone.  Is the Vest good?  Yes.  Is it better to do both the Vest and exercise?  Yes.  Can I do just one method?  Not if you want optimal clearance of mucus.

It is even starting to be more clear why exercise helps with mucus clearance.  At the most recent NACFC, I heard a talk given by Stephanie Dwyer from Australia, who has shown in an elegantly designed study that exercise decreases viscoelasticity (stickiness) of CF sputum.  In addition,  her subjects described a subjective improvement in ease of expectoration (coughing up) sputum following 20 minutes of exercise biking.  This is likely due to both decreased “stickiness” as well as increased air flow rates through the lungs.

Dwyer offered as explanation an interesting study done in 2001 (Hebestreit) which suggested that exercise partially inhibited the excess sodium absorption through the ENAC channel, which lead to more water present in the airways following exercise.  Remember, in CF there is both hyposecretion of chloride and hyperabsorption of sodium, a double whammy leading to very dehydrated conditions in the airways, as water follows salt concentration through passive secretion.  No (or little) sodium and chloride in the lumen of an airway….no water secretion….leading to very little airway surface liquid and sticky sputum.

Another reason to exercise early in life (and keep it up) is that exercise leads to better self-esteem and an overall sense of well-being.  As kids with CF enter adolescence, body consciousness becomes a huge issue.  Think back to your teenage years as a “normal” kid who didn’t really have much to deal with other than raging hormones and acne.  Add to it digestive issues, delayed puberty, a weird sounding cough, having to take fists full of pills, needing to go home early to do treatments, strange looking fingernails and, missing a lot of school, and did I mention the digestive issues?
Clearly, if there is anyway to improve on body image and self-esteem, all efforts should be made to incorporate it into the life of a child with CF.  I say start early, because if a pattern has already developed by the adolescent years, they will be ahead of the game when *%&# hits the fan.

Another issue that can to rear it’s ugly head in adolescence is depression.  Kids with CF are not necessarily at an increased risk for this until the teenage years, when body image issues come up as well as questions arise about the future.  The full implications of their disease may not be apparent to them until this time, when they are old enough to read for themselves about CF and what comes with it in adulthood.

Luckily, we have a tool to fight depression that is completely safe, and has been described by Dr. John Ratey in his book, “Spark:  The Revolutionary New Science of Exercise and the Brain,” as like taking just the right dose of ritalin and prozac…without any medications.  And it’s free.  It turns out that exercise has a profound impact on neurochemical changes in the brain.  It can help with not just depression (in many cases as well as an SSRI without the side effects), but also anxiety and with the ill effects of chronic stress.  But wait….there’s more!  It also helps your child learn and improves memory!  I highly recomment Spark to all my clients….and to you, too.  It will not just motivate you to add exercise to your child’s routine, but to yours as well!

In the next post, I will discuss different ways to encourage your child to exercise as they move from toddlers to pre-adolescence, to teenage years and beyond.

The Wellness Recovery Package

As a nation, we are in deep doo-doo.  Jobs are disappearing in droves.  People are losing their homes, their health care, their confidence in the “American Dream.”  It’s a tough time, no doubt.  At a time of crisis like this, the worst thing we could do is to ignore the fact that this is an extreme test of our stress resilience factor.  While clearly, some people are hurting more than others, the uncertainty we all face is stressful.

We will get through this, of course.  Despite all of our hand wringing, the universe will unfold and we will survive.  The question is, will we come out stronger and wiser, or will we be a collective frazzled mess.

I’m a fan of the stronger, wiser option.  One way to do that, is to use this opportunity to improve upon those things in our lives over which we have control.  We don’t have a lot to say about freeing up the credit market, but we can dump our own “toxic assets” by dropping a few pounds and getting closer to our ideal weight.  We may not be able to do much about our home’s dropping value, but we can focus instead on the value that those we love bring to our lives.  The obvious greed of Wall Street may make us mad as hell, but instead of letting it eat at our gastric lining, we can make use of that energy and hit a heavy bag with abandon.

As our President gives press conferences and leads town hall meetings delineating his Economic Recovery Plan designed to lead us out of this mess, I would like to propose my own “Wellness Recovery Plan.”

To use the same rhetorical tool as our President uses, I will describe my Plan as a combination of three things….a “three-legged stool,” if you will.  This is a very simple plan consisting of three things…three actions…to take each day, that together will work to improve your physical, mental and spiritual wellness.  I promise that if you do these three things consistently every day as we all work to get out of the economic hole we are in, you will emerge as our country will,  stronger and healthier.

The Plan is to take ONE step each day in each of three Initiatives:

1) The Movement Initiative
2) The Eat This, Not That Initiative
3) The Wealth Appreciation Initiative

The Movement Initiative

Every day until this crisis ends, make one choice in favor of movement.  This may be a choice to walk instead of drive.  It may be to stand and stretch during commercials instead of sitting numb as marketers feverishly peddle their junk food.  It may be a choice of stairs over the elevator.  The point is to, at least once a day, make a clear choice to do the healthier thing.

This doesn’t need to be a big deal.  It doesn’t have to be overwhelming.  I’m not asking you to train for a marathon.  These are small, easily accomplished tasks.  As you look for ways to make this choice each day, you will naturally become more conscious of how to be more active without even trying.  It will work….but only if you do it.

The Eat This, Not That Initiative

You can probably guess this one.  Again, it is a very small choice that I am asking you to make, every day.  We all know what the better choice is when we are faced with a nutritional quandary.  It is usually pretty obvious, but if you really are unsure, there are books out there to help (Eat This, Not That).  It may look like eating an apple instead of chips…or a drink of water instead of that Coke…or munching on a bowl of whole grain cereal at night instead of ice cream.  It could be as simple as drinking skim milk instead of whole milk.  If you make just one decision in the direction of better nutrition each day, by the end of this crisis you will be healthier, possibly lighter, and definitely more enlightened about how much control you really do have over your health.

The Wealth Appreciation Initiative

So your 401K doesn’t look so great right now.  It is depressing, but it is what it is.  You can focus on that and be bummed out and angry.  The result:  You will be bummed out, angry, and less wealthy than you were a year ago.

Option two:  You can focus on the wealth that exists in your life right now that cannot be taken away.  The result:   You will still be less financially wealthy than you were last year, but your emotional wealth will grow exponentially.

Take time every day to take an honest inventory of your true wealth.  This includes the important people in your life, the dogs who love you, the home you live in, the amount of material wealth that is in your life, especially when you think about the millions and millions of people around the world who have so much less.  We may think we have it bad…but compared to the rest of the world, we are still quite well off.  As you start focusing on what is good in your life, what isn’t so great takes on less importance.  It also simply feels a lot better.

That’s it!  It is a very simple plan.  It pales in complexity next to what the Senate and House must wrangle over this week.  But it will work.  And it is one way to take charge, right now, when life seems so out of control.

CF and Time

I am researching for a talk I will give to a CF Education Day in a couple of weeks, and found this article that I wrote three years ago.  The talk is going to be about exercise, of course, and how to find both time and motivation to move when you live with CF.  But re-reading this made me slow down a bit (hard to do on Prednisone), and remember what this time thing is all about.  I hope you enjoy: CF and Time As a fellow anatomic pathologist, I fully respect Dr. Dorothy Anderson’s description and naming of the constellation of signs and symptoms that we now call Cystic Fibrosis back in 1938.  Her observations marked the beginning of several decades of medical research, the outcome of which allows me  to sit at my computer at age 45 and write this. But for now, I would like to think way, way outside the box, and ask a question posed by one of my favorite spiritual teachers, Eckhart Tolle.  Does chronic disease really exist?  Does CF really exist? In “The Power of Now”, Tolle differentiates your “life” from your “life situation”.  He speaks of your “life” as this very ”moment”, as opposed to your “life situation”, which is comprised of the circumstances or conditions of your life.  As such, your life situation is your “story”, which has a beginning, middle, and eventually, an end.  It exists on the horizontal axis of time.  However, there is a part of each of us that is unchanged over time and exists outside of time.  Think back to that day you learned to ride a bicycle.  Or think of throwing that high school graduation hat into the air with a big cheer.  Or perhaps, think to the moment when you said, “I do”….  In each of these situations, there was an awareness of what was happening, and that same awareness, unchanged, is aware that you are reading this page now.  That awareness is what Tolle would call “life”, and it does not exist in time.  It is NOW.  It does not change, because it lies on a “vertical” axis, with no past and no future. Try not be offended by this (many of us are very attached to our CF), but imagine for a moment the possibility that CF is part of your “story”, existing on the horizontal axis of time.  At some point you were diagnosed.  In other words, a combination of sounds emitted from your doctor’s mouth (copied from the sounds Dr. Anderson decided best described this disease) was suddenly ascribed to YOU.  Those sounds became part of “who you were”.  The beginning of your CF story may have been when you were a baby, or later, but part of your identity was now as a “sufferer of” CF. The story then continued, with a different trajectory for each of us.  For some of us, the story has already ended. Your story isn’t just CF, of course.  There is the story of what you do for a living, how your body has grown and changed, what you have learned over time, who you know, who is in your family, how many dogs you have loved and lost….If you think about it honestly, whenever you ask yourself the question “Who am I?”, the answer is usually just more of the story.  “I am a lawyer”, you say.  Then who were you before you got your JD?  “I am a father and husband”.  Who were you before you were married?  “I am sick” really means the physical part of “you” is not completely healthy at this point on the horizontal axis of time.  Yes, your body has weird and unusual chloride channels lining its epithelium.  But is your brain “sick”?  Is your heart “sick”?  Are your bones intact?  Can you see?  Are you breathing? Can you love? “I” (the author) am a 45-year-old female “sufferer” of CF, retired physician, mother of two, partner, wellness coach, friend, daughter, sister…  Yeeeees, but other than being “female”, all of that has been variable throughout my life (and as I understand it, even being female could be changed, if I wished…).   Who was I when I was 9 months old, and had no language yet? But, you argue, my brain is the same…!  No it isn’t.  Neuronal pathways are always changing; cells are dying; plaques and tangles are forming (at least, in our “old survivor” brains).  I’m sure you’ve heard that all of your cells are dying off and regenerating constantly. Nothing is constant on the horizontal axis of time.  The “life story” is ongoing, and ever changing, just as the body is. Do you see the point of this tirade?  A part of you, and I would argue, the ”real” you, is the observer of your story, or as Tolle would say, “the awareness” within which your story unfolds.  Does that “awareness” have CF?  NO!  The body in which the “awareness” resides has CF!  So does CF really exist?  Only in time!  Only in the content of your life, the content that always changes and that describes you, but is NOT you.  The content is your life story, but is not your LIFE.  The real you is life itself, and that life is now, this moment.  “CF,” then, in this moment, is really reduced to what you are actually experiencing now.  Maybe that is a cough.  Maybe it is rapid breathing.  Perhaps it is pain in your joints as you walk.  Or, possibly, in THIS MOMENT, it is nothing at all. “Wow,” you say, “Julie has completely lost it!”  But if it sounds kind of interesting to explore the idea of “this moment” where CF possibly doesn’t even exist, maybe you are asking, “How do I get there?” I’m glad you asked.  This is the cool part.  Tolle describes “portals” into the NOW.  Entering these portals is sort of like a meditation, yet it is not meditation in the way we usually think of it.  I don’t know about you, but when I focus on my breath, I do NOT enter a state of bliss!  These portals are much easier to use. One portal, my personal favorite, is to become aware of the “inner body”.  Another way to describe the inner body is your “life force”, or “life energy”.  To do this, you simple sit or lie in a comfortable place, close your eyes, and ask yourself without moving it or looking at it, “Is there life in my left hand?”  This may take a few moments.  You probably will be tempted to move your hand, but don’t.  Just sit or lie in stillness and find out, “How do I know that my left hand is there…without looking at it or moving it?”  After awhile you become aware of the energy of your hand.  That is your “inner body”.  When you become aware of it in one hand, you then move your attention to the other hand.  Then, when you can feel it there, you try to feel it in both hands at once.  After that, you get adventurous, and move to your feet, and up your legs, to your torso, then arms, then neck and head.  With some practice, you can soon, at will, become aware of the “inner body” within your entire “outer body” (the one you can see and move). Here’s the catch:  the only way to feel this “inner body” is in the NOW.  You can’t do it if you are remembering the past, or worrying about or anticipating something in the future.  You can only feel your inner body in THIS MOMENT.  This technique essentially forces you into the “NOW,” the vertical, timeless dimension called awareness.  In this space, I would argue that there IS NO CF.   There may be a cough (see if you can maintain awareness of this life energy while you cough), but the energy is separate from the cough… from the body… from your thinking mind.  It’s wild. If you get really into it, you can practice this awareness throughout the day.  You can do it during a treatment.  You can practice while folding clothes, or while walking, or while in a particularly unpleasant conversation with an ex-partner.  The more you practice, of course, the easier it becomes. There are other portals, of course.  But this is getting way too long.  I would be happy to share my experiences with them (all very legal!).  Just give me a call or email.  Until next time: BE FIT…BE STRONG…BE WELL!

How to Make the Most Out of Vest Time!

I don’t really know anyone who actually enjoys doing their Vest.  In fact, if baffles me, because it is probably the most passive of all the requisite treatments those of us with CF are asked (told) to do, but most people hate it.  They put it off…they rationalize…they ignore it…some actually hide it!  One client told me this week that she actually had the Vest on, and wore it around the house for a few hours, psychologically unable to hook up.

I think a study should be done, frankly.

But, short of that, I have come up with a list of “sure-fire” ways to spice up your Vest time.  Beware, you may actually find that you want to schedule in an extra session!

Here is it:  The Top Ten Ways to Make Vesting Fun!

1) This is the most obvious.  Television.  You are hooked up to a machine and can’t move.  There is nothing else to do…if EVER there is an excuse for mindless TV, it is now.  These days, with technology on our side, we even have the advantage of Tivo (or some knockoff), so we can actually schedule a show that we truly want to see as a carrot to bring us over to the dreaded machine.  Not only that, but in case the rest of your neighborhood doesn’t have your similar taste in shows, now there are wireless headphones  to strap on (one more thing to get tangled up in).
2) Audiobooks.  I know.  Reading while vibrating at 14 hertz is not a pleasant nor relaxing activity.  However, your sense of hearing is not likely to be upset by the shaking (as long as you can hear over the roar).  Here is another case for headphones,
3) Enjoying a mindful cup of coffee of tea.  Again…you’re not going anywhere.  Why not fill up (not too full) a cup of your favorite morning drink, and just completely experience the pleasure of taste (another sense that is immune to shaking).
4) Take pleasure in another sense that can’t be destroyed by loud, shaking sounds…your sense of imagination.  Vesting is a good time to try some guided imagery.  Guided imagery audios can be found online or in bookstores, and cover anything from learning how to relax, to improving confidence, to perfecting your golf swing.  A favorite one of mine, given the setting, is to imagine that I am receiving the World’s greatest massage on a beach somewhere in Hawaii.  In this case, I am not guided by a tape, but by my own imagination.
5) Surf the internet.  Join the 21st century.  There is ALWAYS something to read or look at online.  For fun, sign up to StumbleUpon.  Here you can create a profile describing your likes and interests, and cool websites are just generated for your pleasure at the click of the mouse.  If you like it, give it a thumbs up rating, and you get more like it.  If you don’t, thumbs down….they won’t send you to another one like it.  It is WAY fun, and easy to kill hours on!  It’s amazing how, after a few times playing with it, the site knows you and your likes like the back of it’s….whatever is at the back of a web program.
6) Meditation intervals.  I say “intervals” because I’ve tried…it’s really hard to meditate while shaking for the whole 20-30 minutes…especially if you are simultaneously nebulizing.  But what is NOT so hard is to do short periods of meditation-–say a minute or two–– and then relax and think about whatever for a few minutes.  Repeat this a few times and time is up before you know it.  Most people think “they can’t meditate”…like it is a skill or something.  It’s not.  It is simply a way of paying attention, on purpose, to something.  An easy thing to meditate on is your breath.  It is always there.  All you do is watch is and pay attention to how it travels in and out of your body…without forcing anything.  Just watching it.
7) One of my favorites:  Pet a dog.  Here is one of my favorites.  This is Jaxon.  He loves my Vest, and comes running when he hears it turn on.  Do you know why?  Because he knows I am cornered for 20 minutes, and have nothing better to do than to pet him.
Hug a kid and make funny noises as you talk to them.  This used to be a hoot when the boys were younger.  Now they look at me like I’ve lost my mind.
9) ChiGong mindful stretching.  Lately, I have been doing a 20 minute Chi Gong routine during my Vest treatments.  It’s great, because I work on my flexibility and relax at the same time.  All of the exercises are VERY easy…really they are just stretches….and can be done while I’m teathered to the machine 3 feet away.  It is too difficult to explain them, so look for my “Chi Gong” Vest workout in a TouTube video coming your way soon.
10) Write blog posts.  Or better yet, comment to mine, and let me know how YOU pass the time!

Five Steps to Re-Energize

Sometimes it is easy to get bogged down on a project.  You let it “sit,” so you can think about it awhile, and before you know it, three other things have come up that need your attention, and your “big idea” starts gathering dust.

At least, that is how it often works for me.

This blog is a great example, but there have been others.  It has been a challenge to post lately.  Tom died.  Christmas happened.  I got sick.  I got busy.  Life happened.  Writing took a back seat.   In addition to writing, half-marathon training programs, book ideas, and piano lessons are also residing in the back seat.  Now don’t get me wrong…my motto for life in general––I get knocked down…but I get up again––applies to projects as well as it does to my health.  Usually I come back.  Like now, for example.

So I thought a good article to write might be one about just this:  How do you pick up where you left off, before life got in the way?  I’ve come up with a 5-step “Get Up Again” action plan to use when approaching that stack that is growing on your desk.

STEP ONE:  This is the most important one.   Get off your back already!  Unless you live alone, have no friends, have no other responsibilities, have only one interest, and generally have no life, things come up!  Life happens, and you get knocked off course now and then.  For most people I know, this is when the nasty little nagging voice speaks up.  “You are such a loser…!  Why aren’t you working on this?  You had such grand plans…such great ideas…Right.  What a lazy (%&#*!

First off, this is a true waste of energy and time.  It is, of course, much more efficient to use that energy in getting back up on the horse, to mix metaphors.  Everyone gets pulled off course, now and then.

STEP TWO:  Find your motivation!  If you are spinning your wheels, you need to get a grip on something, right?  The traction is found within something called motivation.  What lights your fire?  As much as possible, you need to recreate the energy you had when you began the project.  That’s a tall order, I know.  If I had the secret to that, I would be a bazillionairre.

Why did you want to do this project in the first place???  There must have been a really good reason.  The trick is to remember it. And get back into it!  Read about it again.  Read about how others have done or are doing what you want to do.  Talk to people about your idea.  Enlist their ideas…their help.

STEP THREE:  Set one goal.  This is obvious, but it is so overlooked.  You need a finish line.  It doesn’t have to be far away, but it needs to be a bit of a stretch for you.  It needs to be time-based and measurable.  You also need to really want it!  You need to be excited.  It helps to read the goal several times a day, imagining the feeling you will have when it is accomplished.  I know what you are thinking..”One goal?  But I have at least twenty to get back to!”  This may be true, but just pick one for now.  Just a little bit of traction goes a long way.

The most important aspect of setting a goal (to me) is setting a reward.  Seriously.  You need a carrot AND a stick.  If you are like me, the stick is taken care of.  It’s that voice in your head yelling all of the time.  The carrot is, of course, the reward you pick to give yourself when you’ve crossed that finish line.  Make the reward appropriate to the effort you need to put in to accomplishing the goal.  If you’re going to train for three months to run a 5K, give yourself something worth three months of hard training!

So let’s say, for instance, you had initiated a great workout program.  You were committed.  You had worked out all the details…and then…poof.  What program?

There are two ways to deal with this.  The usual way (for many) is to tell yourself you “don’t have it in you” to stick to a program, and then give up until the next time something wakes up your motivation again.

The second (better) way, is to get off your own back, remember your motivation, set a new and smaller goal (perhaps to just start to walk for 20 minutes a day)…add a carrot…and take STEP FOUR.

STEP FOUR:  Take a small step…every day.  Small is the important element here, especially at first.  The reason for this is that you will build on small successes.  If you do what you set out to do every day, then even if those action items are small, your confidence in yourself grows bigger and bigger.  Soon, you’ll start challenging yourself with larger daily action items without feeling overwhelmed.

STEP FIVE:  Stick to it until you can celebrate your achievement!  Your motivation may wax and wane a bit (have you noticed this?).  That’s ok…that’s just what it does.  If you have a day where you feel completely unmotivated, then make your daily action be to read about your goal.  Google it.  Find success stories.  Get your mojo back!  Tomorrow is a new day, and likely, you will feel more like playing.

Top Ten Ways I Thrive (yes, even in this economy)

I was recently asked to list my top five to ten strategies for “thriving.”  Given the body I inhabit, I picked ten.  Here they are:
1)  (I bet this is a unique top pick)  GREAT DRUGS…legitimate ones, of course.  I would literally be dead were it not for biotechnology and the pharmaceutical industry.  Daily inhaled and oral medications keep me breathing and digesting with the best, and I am thankful for that every day.  My willingness to accept the need for them, and to follow a diligent routine has to be my top strategy.
2)  A sense of purpose.  This has come to me late(r) in life, but is rapidly rising to the top of the list of things that keep me going.  I now understand (I think) why my soul picked this particular body to reside in this time around.  It was a mystery for awhile why I went to an elite medical school, only to retire after 5 years of practice.   Then why, of all things, I became  a certified personal trainer?  And then, a wellness coach?  Huh?  I thought the idea was to go into medical research and somehow help to cure CF…
Now, every day I coach people like myself to incorporate exercise into their routines just as it is becoming a medical certainty that exercise is VERY important for people with CF.  Because of my MD, I am asked to speak and write about this topic.  I am passionate about the importance of exercise in keeping myself healthy, and have been told that I am a “beacon of light” for the CF community.  Now that is a sense of purpose.
3)  A sense of humor.  One of my signature strengths is humor, and it is a good thing!
4)  My two sons, who have revealed within me a depth of love and feeling I never would have known.  They keep me going.  They keep me attentive to caring for myself…because they need me.  They keep me laughing…and screaming (it’s good for the lungs).  They, amazingly, are capable of both warming every cell in my body and driving me crazy at the same time.
5) Connection with others.  The love and support of my partner, my family and my friends, specifically, provides an immeasurable amount of fuel to keep me going when times are not so great.
6) Faith.  This is a hard one to describe, as I am far from religious.  My faith is centered on a felt sense of trust that I am connected to a greater whole, one that was there before I was born and that will be there when I am gone.  When I am lucky and can let go of my brain for awhile (in meditation), I don’t feel separate from this greater whole at all.  That keeps me going.
7) Movement!  When I don’t exercise every single day, I feel like I am letting myself down.  My dedication to pushing my body is what brings me to age 48 in pretty good shape (for someone with my genotype).  Of this, I am certain.  Certainly, I don’t do now what I did in my 20’s.  But, as I’ve said countless times before: I ran until I had to jog.  I jogged until I had to jog/walk (now).  When I can’t do that anymore, I’ll walk fast.  Then…I’ll just walk.  If there comes a time when I can’t walk, , I’ll roll (but I’ll push myself!).
Sleep!  I love to sleep, and sleep loves me.  I don’t function well without 8 hours…at least.  Sometimes I take 2 hour naps in the afternoon, and I refuse to feel bad about it.  I know my body…it is worthless when it needs sleep.  I acknowledge that it needs more sleep than the average body.  When I lose sight of this, I remember the constant battle that takes place in my lungs, and then happily surrender.  This probably should have gone up there after the drug thing.
9) The unending quantity of information on the web makes lifelong learning as easy as finding the on switch.  Since ‘love of learning” is another SS,  I’m never bored.
10) Dogs…I collect them (six today).  I know…you are probably scratching your head, but if there is one thing that keeps me in the moment, it is a dog.

What keeps you going?

Irrefutable Evidence of a Universal Plan

I have had a massive left-sided sinus infection for a few days now.  Misery does not even come close to the right descriptive for what I have felt.  Thoughts of ripping out my watering, throbbing, burning, itching left eye, and scooping out the offensive obstruction were persistent.  Competing with them were images of just finding the nearest guillotine and taking care of it, once and for all.

Today is a new day.  I feel better, and for that, I am extremely grateful (in addition to Theraflu and brandy).  While showering this morning, I was able to find the underlying message in my recent illness.

As I always do now, I was mentally thumbing through my NOTDEADYET acronym, looking for new and exiting ways to use this tool in my upcoming day. The letter that stood out today was “E:  Envision the Opportunity“…found within your illness.  Here is why:

Yesterday, in my extreme desperation, I purchased a product new to me, called “Sudacare.”  This is an effervescent tablet containing lavender, mint, eucalyptus, menthol and camphor…which, when it dissolves in water, creates a veritable Drano-mist for the nose.  The idea is that you place this tablet on the floor of your shower, and take a long, hot time breathing the fumes.

You would think this would be quite evident to your sense of smell while showering with such a tablet, no?

So, I kept looking at this thing, shrinking on my shower floor, wondering when I would smell it.  Was it defective?  I smelled NOTHING.  Then it dawned on me…perhaps I was defective?

I then proceeded to sniff the shampoo, the conditioner, the Ivory soap (the smell of which reminds me of childhood vacations), the refrigerator contents, and alas…Cisco’s breath.  Nothing.

I believe the medical term is “anosmia.”  I currently have absolutely no sense of smell.  It’s a very disconcerting thing, really, because it also affects my sense of taste.  But I digress.

Here was my realization from this morning’s shower.
As often happens on days that I oversleep and am rushing to get the kids fed, lunches made, and get off to school on time, the sewer backed up.  Just at the moment when I could delay no longer, and excused myself to convene with my dogs in MY bathroom, my son shouted from the OTHER bathroom, “Mom, the toilet is flooding!”

Sure enough.  I had to use the emergency trick a nice plumber had taught me to stop the water from rising.  One more millimeter would have been disastrous.  Knowing the probable answer, I went outside to look at the cleanout (this is a recurrent issue at our house…. it has to do with roots––that’s all I know).

You guessed it.  There was not simply water and tissue backing up out of the hole in the cement, created by the cap being blown off by the pressure…There was so much more.  And it wasn’t just in the hole.  No, it was all over the driveway…spilling into the street.  I will not try to describe the disgust I felt.  Griffin summed it up best:

“GROSS!!!!  LET’S GET OUT OF HERE!”

Suddenly, I didn’t have to do anything to rush them out the door.

And the irrefutable evidence is this:

I smelled nothing.

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