Now it is time to move on to Step Two, which is all about improving mobility.  Mobility is becoming one of my favorite subjects lately, and I have been working diligently to improve my own.  It is not a complex subject; mobility is simply the ability to move.  As it relates to exercise, mobility is about the ability of every joint in your body to move through its natural range of motion.  Now, there are many, many joints in your body…somewhere between the mid 200’s to mid 300’s (the definition of “joint” is a bit fuzzy).  Most of those don’t need a lot of your attention. But before you stress your body with exercise, it is good to circulate a bit of synovial fluid (the stuff that lubricates joints) and wake up the millions of mechanoreceptors that live around your major joints…especially the ones you plan on taxing during your workout.

I have many tight and not so smoothly moving areas that I like to focus on, but the one area I’d like to talk about at length here, because I am certain that we all share this issue, is the thoracic spine.

Think about your posture.  Adults with CF very commonly have poor posture, and most of us with poor posture know that it is a problem.  The causes of the problem are many.  First, we are getting older, and with age comes increasing reinforcement of poor movement patterns.  The body adapts perfectly to what is asked of it.  If you start slumping your shoulders when you sit at the computer, or drive, or breathe, the body decides this is the position it is to always assume. Second, with age comes bone loss (especially in CF), which can lead to osteoporosis and subsequent hunching of the upper spine (technically called kyphosis).  Finally, as breathing mechanics change with increasing lung disease, there is consequential structural alteration of the thoracic cavity that worsens kyphosis.

Why is this?  Because the body tries to offset or balance the  increased hunching (kyphosis) of the thoracic spine with an over-pronounced swayback of the lumbar spine, also known as lordosis.  This leads to pelvic and hip problems, and the result is a mess. Sounds bad, right?  It is, and the worst part is that all of this leads to a very common problem in adults with CF, back pain.  The picture below illustrates this problem.

The thoracic spine is actually supposed to be very flexible.  It is supposed to flex, to extend and to rotate.  In contrast, the lumbar spine is designed more for stability and less for flexibility.  Sadly, most people have this backwards, and tend to use the lumbar spine more than the thoracic and hips for bending and rotating.  This often leads to pain, and commonly to injury.  Because the thoracic spine in CF tends to be even more “frozen” in place because of the above-mentioned issues, pain is extremely common.

But wait, there’s more.  Pain is bad enough, but what is worse is that the combination of poor posture and pain leads to inhibited airway clearance, less expansion of lung tissue and deteriorating lung function. Stiff and unmoving thoracic vertebrae also increase the work of breathing (isn’t it hard enough?).  None of this is good.  Not good at all.

But here is the good news:  Some of the postural problems in CF can be corrected.  Those having to do with muscle  and soft tissue tightness are reversible!  Stiff joints can be mobilized with specific exercises and soft tissues can be stretched to allow for normal alignment and movement.

This is why at least 10 minutes of your workout should be spent waking up and moving your thoracic spine.  If you are like me, you literally need to teach your brain exactly where this part of your back is, and how to move it because of something called sensory-motor amnesia.  This is exactly what it sounds like:  When you don’t move a body part much, the brain 1) forgets where it is, and 2) forgets how to move it.

I’m Convinced.  What Should I Do?

First, take a breath and don’t panic.  Then, check with your doctor and make sure these are safe for you, especially if you have osteoporosis. Next, to get a rough assessment of the amount of kyphosis in your upper spine, do this test.

Lie down on your back with your feet on the floor, knees bent to about 90 degrees.  Now press your low back into the ground and keep it there as you do the following:  bring your arms up and over your head, keeping them straight with your biceps muscles close to your ears.  Don’t move into pain, but see if you can bring your wrists and back of hands to the ground above your head.  If you have normal thoracic mobility, this is a breeze.  If you can’t, you are like me and have some pretty stiff and sticky thoracic vertebrae.  The following exercises are for you.  If you can, and want to keep it this way, the following exercises are for you.

1)Spend quality time with your double tennis ball contraption (link) every day…before your workout as I discussed in the previous article, and also throughout the day, especially if you sit at a desk a lot.  If you are bigger and have more muscle mass, you might graduate to double lacrosse balls.  This is not in my future.

2) Roll your upper back with a foam roller.  As you do this, bring your hands behind your head and keep your elbows close together (this gets your shoulder blades out of the way).  Slowly roll up and down the spine, stopping at the neck above, and the lowest rib below.  Try to “curl” yourself around the roll by aiming the top of your head to the ground.  If you have tight spots that are slightly uncomfortable, spend some time there.

3) Get on hands and knees and push your butt slightly back toward your heels.  Now take one hand (for example, the right) and place it behind your head by bending your elbow.  Now, keeping your butt back, rotate your spine by reaching the right (bent) elbow toward your left knee.  Come back up and do this several times, slowly.  Repeat on the other side.

4) Stay on hands and knees, but  this time sit all the way back onto your heels.  Take right hand again behind your head, and now rotate it up, toward the ceiling, trying to open your chest to the ceiling as well.  Don’t move your butt–this is keeping the lumbar from moving, thus isolating the upper back.  Repeat on the other side.

The sensory-motor amnesia problem is a bit more complicated, but can also be remedied with some drills taken from a system called Z-health.  I am currently immersed in learning Z-health and will write more about it in future posts, but these are some basic exercises that will begin waking up and mobilizing the spine.  Try them and then retest with the “raising the hands over the head” exercise.  My bet is that it will improve.  I don’t start my workout until I can do this without discomfort (but it has taken awhile to get there).  Start slowly, but be persistent and patient.  Your spine and lungs (and posture) will thank you.

Related Posts:

• Step Four of Perfect Workout: Movement Preparation
• First Sick and Happy Video!
• Step Three of Perfect Workout: Corrective Exercises
• Step One of Perfect Workout: Rolling
• The Perfect Workout

If you are interested in the class, more information can be found, as well as a direct registration page, here:

Related Posts:

• Almost Six Months Later….
• Sick and Happy Takes on New Meaning
• Engage Fully in Life
• Step Five of the Perfect Workout: Strength Training

I’ve been there.

But then, 13 years ago, in the midst of one of the more stressful periods in my life, I signed up for a class called Mindfulness-Based Stress Reduction (MBSR).  It was an eight-week class that met weekly for two hours, and included one all day “retreat” toward the end of the class, where we practiced in silence what we had been working on over the previous weeks.  This was one of the best decisions of my life, and meditation has become one of the most effective tools I have as I continue to live a full and happy life with cystic fibrosis.

This class made such an impact on me, that I have now learned how to teach it.  The reason I took the time and spent the money for this training is that I want to teach others with CF how this simple practice can make a difficult and sometimes complicated life just a bit easier to handle.

I took the class (twice) in person (both times in hospitals), and co-taught another eight-week session with my mentor in a hospital in San Jose.  Why meditate in hospitals, you might ask?

Actually, the MBSR program originated at the Stress Reduction Clinic, which was founded in 1979 at the University of Massachusetts Medical Center by Jon Kabat-Zinn. Now, it exists in over 250 medical centers across this country as well as in numerous locations internationally.  Consistently, graduates of the program report:

• Coping more effectively with both short- and long-term stress
• Greater self-respect, energy, and enthusiasm for life
• Lasting improvements in physical and psychological well-being

You know that having cystic fibrosis does not define you. Yet, it can be hard to find yourself in the midst of treatments, medications, doctor visits, hospital stays, and constant concern over that magic number, the FEV1. Having a chronic illness like cystic fibrosis is stressful.  This is just a fact of life.

What is often forgotten is that there is much more that is right about us than is wrong! Using the techniques taught in Mindfulness-Based Stress Reduction, we can develop skills that will help us stay afloat in times of chaos, and get more in touch with aspects of ourselves that are untouched by problems with an epithelial chloride channel!

Common Questions

What is Mindfulness?

Mindfulness is simply purposefully paying attention to what is happening in the present moment, without judgment. The present moment is where life unfolds, and it is only here where choice is possible. By cultivating the practice of mindfulness, you can begin to see where you tend to be on “autopilot,” and learn to use compassion and courage to make conscious choices about how you allow life to unfold, rather than feeling completely out of control. Mindfulness practice is ideal for cultivating greater awareness of the interconnection of mind and body, as well as of the ways our unconscious thoughts, feelings, and behaviors can undermine emotional and physical health.

I can’t focus on my breath…How can I meditate?

The good news is that the leader of the class (me) also has CF and understands this dilemma.  There are other ways to use mindfulness to better cope with stress.  One does not need to focus on the breath.  There are many other ways to anchor the mind.  Breath is just a very easy one to teach, and it’s always there.  Because I understand that attention to the breath can provoke anxiety, we will explore other ideas.

I can’t go to a class.  I have a multi-resistant bug. Or, the corollary:  I don’t want to get multi-resistant bug.

The best news yet:  This class takes place in a virtual classroom.  All you need to attend is a computer with Internet access.  If you would like to be able to speak (and this is encouraged), a computer headset is recommended.

What are the details?

This class will be an 8-week intensive training in mindfulness based on ancient healing practices. In addition to the weekly classes, there will be one full day retreat scheduled toward the end of the course.  The price of the course is $350, but no one will be turned away for lack of ability to pay.  If you would like a scholarship, please contact Julie Desch at Julie@newdaywell.org.

Registration can be completed here.

The mind and body are linked. We know this now through innumerable well-designed scientific studies, and we are learning more every day about how this works. Don’t kid yourself into thinking that you have no input into your health simply because your disease is genetic.  When you learn the practice of mindfulness, you begin to experience exactly what this means, and with that understanding, you can begin to see some wiggle-room around unhealthy habits of the body and mind.

Give it a try by registering now

Class description

Class schedule

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Related Posts:

• Mindfulness-Based Stress Reduction for People With Cystic Fibrosis
• Inner Strength
• Engage Fully in Life
• Step Four of Perfect Workout: Movement Preparation
• Step Two of The Perfect Workout: Just Move It

Rule Number One that I hear myself telling people who are bummed out about their illness, whatever it is, is to remember, “there is more right with you than wrong with you.“

And that’s true, right?  Think about it, by some miracle you are here on this earth, breathing, most likely able to walk around, enjoy food, listen to good music, pet your dog, watch Survivor…

Why is that?  Because most of the 100 trillion cells in the body, each of which are probably performing thousands of events per second, are actually doing their jobs perfectly well right now.  If not; well, you would not likely be reading this.

Now I’m not preaching here.  I am mostly writing this for my own edification, because I just learned that I am now infected with MRSA in my lungs.  I really can’t convey in words what happened in my consciousness when I learned of this last week.  Maybe you know the feeling that really bad news carries with it.  The sinking feeling in the pit of the stomach, the tight chest and throat, the heart racing and the blood draining from seemingly everywhere…  Sh_t!

Then the anger, and the self-pity arrive.  Sh_t (again)!  Why me, why now?  This is a REALLY bad time for this.  I’ve got plans, Universe!

And then, the tears.

So, now I’m officially a CF Pariah.  Gown, glove and mask everyone…here comes Julie.  Man, I’m pissed.  And of course, really what I am is scared.  What does this mean?  Is my CF going to get worse?  Will the freakin IV’s even work this time?

So, I allowed this to go on for a couple of hours.  Then, I was better.  Then, it came back with a full and serious vengeance over several days.  And now, finally, I’ve decided to respond instead of reacting.  Or at least…to try.

The first thing that came to my mind was to write the post I was going to write before the fateful telephone call.  It seemed to me that writing about having a “positive exacerbation” could only be credible if it were to be created during an exacerbation.

So, even though this is a slightly unusual (for me) situation, it is most certainly a “CF adverse event” and just as certainly would be best handled with a positive attitude.

Here are a few things I do to make my three weeks of IV’s…my “home vacation:”

1) First, since I can’t exercise strenuously, I don’t.  I legitimately and compassionately stop pushing myself.  A gentle walk every day that I feel like it is about as hard as I’ll push these days.  After the port goes in and the PICC comes out today, my arms will be free at last, free at last.  So as I feel stronger…I’m back to those kettlebells!  Have I told you about my favorite new exercise?  Something else to post about.

2) I have incredible friends who have been incredibly kind.  I will appreciate them every day, in some way.  By telling them what they mean to me, I will add positive energy to their world and mine.

3) Sometimes it takes a real blow to the illusion of stability to wake me up.  This has been a great one.  I will resolve to appreciate what is good in my life.  The best way I’ve done that in the past is to keep a gratitude journal, and vow to write in it every night three good things that happened that day.

4) I have a post that I have been writing in my head for weeks now about the growing importance of meditation in my life.  I have been trying to figure out how to stress this without sounding like a preacher…hence the silence about meditation.  But it has been SO key for me this last week, that I will write this post.  It will be the next one.  I will pour my soul into it, for both myself and for those two or three readers I have:-).

So if you like this plan, or if you have some suggestions, or if you’d like to share how you deal with your own “operation exacerbation,” please leave a comment!

Related Posts:

• My Weekend at the RKC
• Rant
• Step Five of the Perfect Workout: Strength Training
• Step Three of Perfect Workout: Corrective Exercises
• Step One of Perfect Workout: Rolling

Here, for example, are a few random things I hadn’t planned on:

1) Hot flashes and menopause:  Isn’t it weird that every time I put on my therapy Vest, I have a hot flash?  I don’t think they were designed with this in mind.

2) Wearing hand me down jeans that used to belong to my son:  It’s true.  My 12 year old son is now giving me his outgrown jeans…and they are too big.  I’m trying to grow into them.

3) Forgetting whether or not I have actually done pretty important things:  Did I take that pill?  Did I inhale Advair?  ”Honey, did you see me inhale this?”  This is truly frightening.

4) Wondering with fear and fascination what will happen if I actually outlive my disability payment:  I don’t think the insurance company was expecting this either.

5) Not being able to see whether the needle is actually going to hit the tip of the  Colistin vial:  Are they making that bulls-eye smaller, or is it just me?

6) Getting so used to the ringing in my ears, that is seems like part of the radio background:  Oh, the years and years of tobramycin….

7) Routinely wondering if it is possible to lose one’s colon down the toilet:  Ok, this is a bit graphic.  I don’t know what the magic number of hours logged will be, but at some point, don’t you think gravity is going to win?

8)  Getting too “old” to run (read: low back and knee pains):  I thought the lungs were supposed to go first.

9) Making more cracking and moaning sounds getting out of bed in the am than my 16 yr old border collie as we hobble to the kitchen to make coffee.

10) Wondering if I might outlive yet another dog:  I don’t know which to wish for.

11) Living long enough that those foolish years of laying out in the sun on aluminum foil  lathered in baby oil has resulted in my wrinkles having wrinkles:  Who knew that shins could get wrinkled?

12) Needing a screening colonoscopy:  Of course, if we wait long enough (see 7 above), we can probably just examine it directly:-)

Related Posts:

• Step Four of Perfect Workout: Movement Preparation
• Step Two of The Perfect Workout: Just Move It
• The Perfect Workout
• CF Wellness Boot Camp – Introduction
• Almost Six Months Later….

But in this case, it is!  Resistance training is not difficult to do.  You don’t need to join a gym.  There is no requirement for fancy equipment or expensive clothing.  While a routine does take a little bit of time, you will begin to see and feel significant results in as little as 20 minutes 2 or (ideally) 3 sessions per week.  You could multitask, and do your routine while watching Scrubs reruns.  How simple is that?

Your own body weight can provide all the resistance you want or need, or if you are so inclined, you can purchase some very reasonably priced resistance tubing to use in your living room.

Here’s the trick.  Don’t fall for the fitness magazine articles that suggest complex moves, or drop sets, or supersets, or unbelievably crazy-sets.  Pick exercises that target multiple muscle groups like squats, lunges, front and side plank, or good old fashioned push-ups, and just start doing them!  Here is why you should start today:

Reason 1) Resistance training is a friend of your metabolism.  Why is this?  As you begin to overload your muscles beyond what they are used to, you injure them slightly (don’t go for major injury…that doesn’t do any good at all).  You cause little tiny microtears in the muscle fibers, and this is why you are sore one or two days later.  But this is good news, because as your muscle fibers heal, they become stronger and bigger.  You add muscle mass, and over time, this increases your metabolic rate.

How does that work?  Body fat doesn’t do much.  It just sits there and looks back at you in the
mirror.  It doesn’t use up much energy.  Heck, it doesn’t even need much of a blood supply since it requires so little maintenance.  As a result, it burns very few calories.

On the other hand, muscle is very active.  It requires food (glucose and amino acids) and burns tons of calories by just being there.  Clearly, if you want to be a lean, mean, calorie burning machine, you want as much muscle as you can get.

Reason 2) Muscle, because it requires glucose and amino acids, is very sensitive to insulin.  Insulin opens the doorway to  to the little muscle cells, so glucose and amino acids can get in.  If you are insulin resistant, as in Type II diabetes  (and possibly CFRD), lifting weights will increase your insulin sensitivity as you build muscle mass.  A finely tuned insulin sensitivity mechanism is required for a stable blood glucose level, which leads to good health.

Reason 3) This is a big one for me, and maybe you can relate.  Building muscle and feeling and being strong physically is one area of my life where having cystic fibrosis doesn’t even matter!  My lungs may not be the best in the gym, but I will take on any woman my age in a push up or pull up contest!  This is a very empowering feeling…I have at least a modicum of control over my body which is otherwise at the mercy of my lung status.  Now, some days my lungs even interfere with my time at the gym, and that is OK.  I know that when I recover, I will be back, strutting around the gym with the big boys, knowing that my muscle fibers are no different than theirs:-)

If you have an illness other than CF, lifting may just provide the same benefit.  Lifting weights is a very black or white thing to do.  You do it and you see and feel results in as little as two or three weeks.  You have control of this.  It may not feel like you have control of much else, sometimes.  But you do have control over this.
Reason 4) More and more studies are showing that well-designed resistance training programs in post-treatment management of cancer patients and survivors are beneficial in improving health status and quality of life.   This is true in other chronic diseases as well.  Weight training is anabolic, meaning it builds up the body.  Often, treatment for illness is catabolic, or breaks down the body (think steroids or chemotherapy).  While these treatments are necessary, we can counter their bad side effect of breaking down tissue by weight training.

Reason 5) Weight training is fun!  Ok, maybe I’m in the minority thinking this, but stand by this statement.  When you get over the initial “I have no clue what I’m doing,” and move through the “Oh my God this huts,” you begin to see improvement!  And this is fun!

Are you ready to begin?  I’m starting a YouTube channel where I will teach easy, and very modifiable exercises that anyone can start doing today.  Check it out, and subscribe today!

Related Posts:

• How to Structure Your Weight Lifting Routine
• Step Five of the Perfect Workout: Strength Training
• Step Four of Perfect Workout: Movement Preparation
• Step Three of Perfect Workout: Corrective Exercises
• Step Two of The Perfect Workout: Just Move It

This current illness has prompted several ideas for blog posts, although up until now, I haven’t had the energy to act on the ideas.  One topic that comes up frequently when I deal with my cystic fibrosis and it’s ever-present ups and downs is what my mind does with the very simple information that my body is not perfect.

Do you have ANTs?  By ANTs, I mean automatic negative thoughts.  Do you remember the last time you watched a colony of ants, as the workers stream in perfect lines to and from the ant colony with the single goal of procuring food and whatever else an ant needs to live a good ant life.  Perfect, tiny little single file lines of ants, determined to stay in line and do what is expected for an ant to do.

This is the way unhelpful thoughts travel in your brain.  They are a series of repetitive synapses that have traveled the same neuronal pathways in your brain so many times that they have worn grooves in the sand of your brain.  Now, they are automatic, as are their emotional and behavioral consequences.  So it is very appropriate for the acronym for “automatic negative thoughts” to be A.N.T.  I’ve read that humans have about 50,000 to 70,000 thoughts per day, and that 90% of them are repeats.  We think the same things, over and over and over.  It reminds me of that ant in a single file line, doing exactly what the ant in front of him/her (probably him I guess) does, without question.

Here are some examples of my ANTs:  “This disease sucks.  You just got through two months of P90X, only to have to stop!  You’ll never get through this 3 month program.  IV”s again?  I  (sometimes I’m “you” and sometimes I’m “I”  If you lived in my brain, you would have me committed.) already had 3 weeks of IV’s just a few months ago…My CF is progressing.  My lung function probably stinks right now…God, what if it doesn’t come back.  What if I am now on that downhill slope?  Oh man, I am coughing so hard…what if I start to bleed and never stop?  No one is here to help if I have massive hemoptysis…what would I do?  WHAT?  103 pounds…oh no… You’re disappearing.  How can you be losing so much weight?  What does THAT mean?  Do you now have to deal with CFRD and insulin, too?  That would really suck.  You know Julie, that CFRD usually means worsening of CF.  The good days are over.  Your luck has run out….” and on and on and on

They are automatic.  I don’t try to think them.  They just happen.  And they’ve happened before.  It doesn’t seem to matter to my brain that it is thinking useless, negative thoughts that it has already informed me of a million times, thank you.  They keep on coming.  I’ve tried to stop them..but that definitely does NOT work!  You can’t successfully tell yourself not to think something.  Just try…right now, try to NOT think of a pink elephant lying belly up in your living room.  See?  You can’t do it.  Just by imagining what you don’t want to think, you think it.

But I’ve learned a trick in dealing with these thoughts.  It’s come with practicing mindfulness, which simply means being aware of what is happening while it is happening.  In other words, I’m watching my thoughts.  And at the same time, I am watching what my body feels in response to these thoughts.  It’s not pretty.  What I see is a direct connection between negative thoughts and bad feelings.  “Duh,” you say.  “That’s a no-brainer!”  Exactly.  These processes occur below the level of your “brain,” or consciousness.  But when you become conscious of them, something pretty cool happens.  It turns out that you can’t be fully conscious of something you are doing that is harming you, and continue doing it.  When you directly experience the fact that negative thoughts lead to bad feelings, you will appreciate that you have direct control of how you feel.  All you need to do is decide to think alternative, more positive thoughts.

So instead of, “Your lung function probably sucks right now!” I can gently decide (consciously) to change the thought to, “Yes, my lungs are a bit under the weather now…..and that is why I am taking care of them by resting and infusing wonder drugs.  Thank God I have health insurance and access to  great health care!”  The ANT will try to take over, and I will have to be very alert for this, as the grooves run deep.  But as long as I catch them, I can always substitute a life and health affirming thought for the negative one.  Over time, the affirming thought grooves will deepen and the negative grooves will smooth over from disuse.

Try to catch your ANTs.  Remember, don’t try to force them away (remember the elephant).  When you catch and ANT, replace him with an affirming thought that carries with it positive feelings.  Is this Pollyanna, New Age garble thinking?  I don’t know.  But would you rather feel bad, anxious, worried and depressed, or hopeful and grateful for what is good in your life?  Which feelings do you think are healthier overall and better for you?  Does being depressed and worried help you in any way at all?  Will it change the outcome?  I would argue that being optimistic and grateful can change the outcome…for the better.  So why not give it a try?

Some Other Articles You May Enjoy

• How To Fit Exercise In
• A GIANT LEAP FORWARD?
• Exercise for Preschoolers and Elementary School Children With CF
• Chest Opening Stretches
• Shame on You, Wally Koala

I have recently taken on a new challenge.  I love challenges!  THis morning I was sent an email link to the most fantastic site, called the 29 Day Giving Challenge.  It was started by a young woman with multiple sclerosis, who found happiness (check out her video on the home page) and abundance through the simple act of giving a small gift to someone else every day for 29 days in a row.  This has erupted into a huge movement of giving by thousands of people across the world!  Imagine.

So today is Day 1.  I just joined the Global Giving Village, as one of the 29 Day Giving Challenge member suggested.  I think I’ll update my giving here, to keep me honest.

You know, having CF is no picnic.  But when I check out these organizations and what they do, it reminds me first, that I really have so much to be grateful for, and second, that the quickest way to happiness is to give to others.  Of this, I am certain.

Now….off to the pharmacy for the third time this week!

Some Other Articles You May Enjoy

• From Outside the World Of CF Research
• Posture For the Sick and Happy
• CF Wellness Boot Camp – Introduction
• The Pros and Cons of Working Out at a Gym
• Tonic and Me: Traversing the Winter From Hell

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.

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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.

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