School is starting up again, and while it’s an exciting time it can also mean extra stress for students and their parents! Helping adults and kids calm the mind at bedtime is key to good, restorative sleep. Try this technique of progressive muscle relaxation. It’s good for all ages!
My kids are getting ready for school this week, as many are. This year they will be in 1st grade and pre-kindergarten. I am struck by the courage they have inside as they face this transition. Shopping among the back to school isle at Target today, I noted that every mom was heads down reading off their phones to check off the list of supplies requested for another year. Much has changed since you bought a trapper keeper, a pencil holder and a ream of three-hole punched paper and considered yourself prepared. My daughter is convinced her new teacher is “her favorite” and is counting the days to see her friends again. My son is still not in complete realization that he will be changing schools. He makes the transition to the elementary school setting this year and big days are ahead.
A few new clothes ease the transition between our summer vacation and brave new world. I can see and feel the excitement in them, laced with the nervousness that we all have during times of change. I observed some of the same this past week in the first Osteopathic manipulation lab I taught at Rocky Vista. The new first year medical students are getting to know each other, asking the usual, “Where did you go to undergrad?” Everyone is settling in. Nervous. Anticipating. Change abounding.
Facing these transitions truly does require courage. Courage, “the ability to do something that frightens one” according to Google, or per Merriam Webster “mental or moral strength to venture, persevere and withstand danger, fear or difficulty.”
Is courage mental and emotional? Is our ability to flex with change endogenous – natural and inborn? Do we learn to cope with change from our environment – how we observe those around us that teach by modeling? It is the age old question: Nature or Nurture?
I am certain, it is a bit of both. Our neurotransmitters strongly influence how we respond to the stressors around us. In testing neurotransmitters over the past few years, a newer approach to holistic mental health, I see there are subtle, but real variations. Some have more of our calming neurotransmitters – serotonin, gaba. Too little of these players can cause a tendency toward depression or anxiety. Others have an excess in the excitatory neurotransmitters – glutamine, dopamine, norepinephrine and epinephrine. Too much of team excitatory puts your body always on edge, like fight or flight – ready to jump at any moment.
Of course, there are many things that impact neurotransmitters from your parents to their parents, and their parents, etc. Traumas or joys of early childhood impact brain chemistry. Drugs, alcohol and even smoking can change things from a moment to moment basis, and even long term. And some of neurotransmitter balance is simply, “how you are.”
Luckily, there are the things you can do to control how you feed into this system. Eating a diet high in health proteins and amino acids increasing the building blocks available for your nervous system. Sleeping adequately and with good quality has tremendous impact on your brain. Even breathing shifts our mental and emotional state. Meditation and exercise impact your mind. Being aware of “cognitive distortions” can help you figure out how to work with the neurotransmitter make up that you have at this moment, with this stress and in this situation. That is a skill that takes practice, but it can become stronger that even the genes you were given.
Learning, modeling and teaching coping skills is essential if you are a parent. If you are a parent to no one other than yourself, understanding how you cope with stress remains and important. I often ask patients, “How do you cope with stress? What are your healthy and your unhealthy coping skills?” We all know that we have both. In times of stress and transition, how can you parent yourself to get outside and move your body instead of go home and distance the worries with wine or chocolate? Now there is a time and place for everything, so don’t give me a reputation for being that doctor that recommends against wine and chocolate. We all need anti-oxidants after all!
We can learn from our children. We can watch them as they approach the new year with nervous excitement and calm courage. We can talk about healthy ways of working with being anxious to start new things, meet new people and push ourselves. We can acknowledge the bravery we see. We can remind our each other that it is normal to go into school with a belly of butterflies and a mind full of mixed emotions. This goes for moms and dads too!
Here’s a few tips for all of us as we transition from the fun of summer to the discipline, structure and routine of fall.
Cheers to another school year. And to fall, the arrival of cool weather, the change of leaves and, of course, football…
Amrito Cross Spirit Coach, Yoga and Meditation teacher joins Dr Brie for Mindful Mondays this week from beautiful Lake Tahoe, CA. Watch our Facebook Live to learn:
Bringing mindfulness into the work life balance equation can help with day to day transitions from home to work and vice versa.
Watch our Mindful Monday Facebook Live to learn:
In honor of bike to work this Wednesday, June 27th, today for Mindful Mondays we are highlighting applying mindfulness to your exercise routine.
Join us for answers to the questions:
It is always with you.
It is an easy tool to help harness your own physiology.
Lets take a moment to practice working with breath intentionally.
Watch Dr Brie's first Mindful Monday on Facebook and get a new technique you can use every day to bring mindfulness with you anywhere you go.
Controlled breathing has been shown to:
For more information on the breathing technique used in this video visit Dr Weil's website here.
You may remember the NABD list from the holidays. Not. A. Big. Deal. That is a big term in our house with two small kids and two busy adults. Triaging what is and is not a big deal is a daily practice.
It is important to know, however, that there are B.D.s as well. Big. Deal. This past week the Big Deal was being stranded on the side of i-70 with my two small kids and a flat tire. It put a few things in perspective.
Isn’t it funny how there are warning signs that we know in our heart of hearts? We know we need to listen, but we often don’t until the yellow warning becomes the red brick wall of life that stops you in your tracks.
What is a B.D.? Your health. You know this as soon as you don’t have it present any more. When your health gets buried under disease.
This was what I loved about hospital work. There are a lot of people when their health is done with yellow warnings they end up in the emergency room. If you have been privy to a night in the hospital, you know there is a lot of time for reflection. As a physician, if I would dare ask, I would hear that there were warning signs along the way. Patients would tell me, “I knew my blood pressure was a little too high” “I knew I needed to start working out again” or “I could tell something wasn’t right”.
My car gave me a warning sign too. I was busy shuffling kids around after work and getting them to gymnastics. I did not pay attention to the warning signs. I kept pushing. I am really good at pushing through. Sometimes, I am forced to listen.
Driving on i-70 at full speed going to gymnastics the tire went flat completely. Luckily, I was close to the side and was able to get off the freeway safely. As is typical with three years olds, my son was in the middle of having a fit about going to gymnastics (ah, children). Sitting in the car inches from the slow lane the trucks and cars seemed anything but slow. I turned around and was serious with my kids. We were in a Big Deal situation.
To make a long story short, I got the kids safely onto a frontage road. Three wonderful people came to our aid and we got the tired changed and headed home. After the experience (and then getting back on a busy freeway), I got off at the next exit and pulled into an apartment complex. I parked the car and crawled in the back with my kids. We hugged and cried and laughed and hugged and cried and laughed. We put on our favorite song and drove home.
Life is great at giving us second chances when we don’t listen. Our bodies, minds and spirits are amazingly resilient and when we forget to take care of ourselves we can often get up, brush our selves off, and try again.
I always feel like I have a lot of work to do. I love doctoring. I enjoy running my business and teaching. I love being a mom and a wife. Sometimes these jobs have demands that conflict with each other and somehow, the easiest person to get lost in the shuffle is me.
After the B.D. this past week, we came home and I played baseball with my son in the back yard. I walked “toddler pace” with my kids to school and giggled with them as we tried to outrun the falling snow under the tress. Fiona termed these “popcorn trees” as the ice and snow rained down on us and jumped back up from the sidewalk. I watched as my son just sat and stared, eye to eye with a vibrant pink blossom. I resisted the urge to tell him to “hurry up” or that we “had to go”. We were both captured in the moment.
It is spring. What garden needs tending? Your mind? Your body? Your spirit?
It is time to wake up from the winter doldrums. To shift the habits we have formed in the rut of winter’s snow and mud. Time to ask, “What needs my attention today?”
Life is not about being perfect and every day doing every thing. Its not about mediating daily and exercising 5 days a week, eating 5 fruits and 5 vegetables, spending time with family, getting work done, sleeping enough AND…..
If we can pay attention long enough to the small, inner voice we might hear a totally different story. We might hear: “Slow down, take it easy, play”. Today might be blend of doing one of the things we know we need to do for ourselves and giving ourselves permission to let go of “the list” itself.
Isn’t it time we started to pay attention to what our health— body mind and spirit— thinks is a Big Deal and what is Not A Big Deal?
Today I finished teaching for the semester at the Rocky Vista Osteopathic Medical school where I’m an Assistant Professor. I teach first-year medical students and the final exam is a pass fail test called “competency testing” where they diagnose and treat each other while the other faculty and I observe. For the students, it’s a nerve racking experience. For me, it’s an osteopathic marathon.
Many of you see students in the clinic. You may wonder who they are and how they got there. Perhaps you are not sure what really makes D.O.s different from M.D.s, especially if you have not had an osteopathic treatment. So here’s a little story on how an Osteopath is born.
First, we take a bright college student who took a lot of tests and did well enough to get into medical school. Then we teach them how to feel and think.
Here’s what we taught the students at Rocky Vista in their first year in the department of Osteopathic Principles and Practice:
Today, after ten short months in the classroom, the students amazed me. Competency testing can be challenging for the students who internalize the idea that they must be perfect at everything (like I did in med school) or for the ones that blow off true osteopathy. But under the layers of nerves were students who were really feeling and changing the physiology of their classmates. Bones moved, ligaments relaxed, muscles that were too tight let go. Next year the students will learn advanced techniques and start treating more and more clinically. This year we helped them to build a foundation.
It’s true, only about 20% of the students will graduate as Osteopaths and go on to use the manual skills they have learned. But in their 4th year I can tell they still have their placatory skills. I know they will be better surgeons because they can feel still feel fascia and understand functional anatomy. They ask deep questions when taking a medical history because they understand that looking at the whole person is part of what our founder, A.T. Still D.O., called “a rational approach to treatment”.
I wish more of our Doctors of Osteopathy (D.O.s) could keep these skills honed through training and clinical practice. It is a clinical skill like any other that some are innately good at and others have to practice a lot to do well. I wish our medical system fostered the students to keep looking at the body this way. That is why you see students in our office on rotation. We want to teach them to look at people always as a good doctor will and see not just body - but mind and spirit. Dr Lisa is my “adopted D.O.” colleague—and friend—because she sees the whole person in context of their life. She considers stress, nutrition and exercise in her approach. A Doctor certainly doesn’t need to be a D.O. to think holistically.
Thanks for being a part of teaching every day you let a medical student tag along with your visit. You can always say “no, not today”. When it is ok to say yes, know that you are part of shaping a future Osteopath who might one day write a blog that incorporates all of our tenets without even realizing it until the end. It was the tenets of Osteopathic Medicine that attracted me to the profession when I was 19. Nearly 20 years later I believe in Osteopathy even more than ever. Congratulations future Osteopaths of 2021. Welcome to second year.
The Tenets of Osteopathic Medicine
The Tenets of Osteopathic Medicine express the underlying philosophy of osteopathic medicine and were approved by the AOA House of Delegates as policy.
In the summer of 2009 Dr Lisa Nguyen and I headed up to the mountains on our residency retreat weekend. We had car pooled together and we were listening to 1980s music on the radio. I was singing along. She was not. We had just met, fresh out of medical school headed to Swedish Hospital together to start a career in family medicine. On our drive up we shared our journey. It was then that I learned that, as many doctors do, Dr Lisa had gone straight through from undergraduate school to medical school and how now landed in the middle of residency in her mid 20s. I, on the other hand, had a more wandering course taking a year and a half off between college and med school to travel, study botanical medicine and live on the beach.
After two years in residency, Dr Lisa and I were both voted into the leadership position by our peers and faculty at Swedish called Chief Resident. In the life cycle of a medical path there are many stages: college, MCAT (big test), med school with two years of course work and two years of clinical work. (this is the stage that the students you encounter at our office are in).
Then there is this computerized match program that decides your "entire life", or where you will spend your residency years, the most intensive part of your training. That is where Dr Lisa and I fatefully met. For family medicine doctors this part is three years and the first year is called your internship (queue memories of Grey's Anatomy season one).
The next transition seems like the "end" but it is really the beginning. Going into practice is perhaps the biggest leap you take as a medical professional. No longer within the safety of your training cocoon, now you are a big doctor on your own and your wings are not yet developed. Dr Lisa and I decided to take that last leap together when we opened Whole Family Health at Belmar for HealthONE right after we graduated.
When HealthONE decided to close our practice, Dr Lisa was left with a decision: keep going on the medical treadmill to the next job or take the break she hadn't had since....summer vacation in college? She was just getting married, without any kids or pets, and she decided it was time. Dr Lisa started by studying medical acupuncture the summer before her big trip. Then, in January of 2017 she went to China for three months learning more about acupuncture by practicing it. This started the sabbatical year that brought Dr Lisa and her husband around the globe. They included a bike ride from Lisbon to Budapest, with a culinary exploration in each town. By the end, they had made a small footprint on nearly every continent.
After she spent a few months working in Oregon last fall, Dr Lisa and I got together and started talking about working together again. I am elated to say that once she got back, we made it happen.
This week, Dr Lisa Nguyen will start seeing patients at Direct Osteopathic Primary Care. She will expand our clinic availability by adding appointment time on Tuesdays, Wednesdays and Fridays. Dr Lisa will add to our services with acupuncture treatments for $55 for members and $70 for non members. In fact, for your first three treatments as a member you get $10 off per treatment so try it! If you stay tuned, you'll notice other exciting membership perks we have in the works. Read a special message from Dr. Lisa here.
I am honored and blessed that my best friend, and my favorite medical professional, is joining us. I know you will find the compassion, easy going demeanor, and intelligence of Dr Lisa to be a perfect fit for DOPC. Now is the time to send a friend or a family member to join us! In fact, at our last practice that is exactly what I did when I sent my parents to Dr Lisa! We can now double our capacity and continue to make Direct Osteopathic the place where doctors get to be doctors (instead of corporate automatons) and patients get good care (the old fashioned way, by partnering with a provider they trust).
Refer a friend and get $20 off your next invoice with us.
Cheers to growth and expansion this Spring,
Some how it is December 2017. In a typical weekday evening at home, I am reminded why this time of year has the uncanny ability to fill your heart with cheer….and boil it over with overwhelm and stress.
I was home later than I wanted to be. Unable to wrap up completely at work, doing the best I can to meet the needs of here and now and today. As always. I walk in. My kids are cute, hungry, 3 and 5 years old. They go from adorable to hangry monsters within the first 20 minutes of my arrival. I had wanted to make the gingerbread man due at school with my daughter. She is in Kindergarten and helping her with her projects is a precious experience, one I consciously try to fit in my schedule as busy as it can be. She starts gluing and using glitter (of course) on the kitchen table and for a moment I am startled by the rapid sequence of mess making that ensues. I go to say something and then catch myself. I remember, this is on the N.A.B.D. list. Not A Big Deal.
We started the NABD list when my son turned 3. Three is precious, and terribly challenging. My son can be the worlds cutest human and then a beast within seconds. When the threenager collided with the emotional mood swings of a kindergartener we coined the term. I have said countless times in the last six months…
“Honey, there are BDs (Big Deals) and NABDs which one is this?” That is right, NABD. Not A Big Deal. Almost always.
As I sit to join the gingerbread project it becomes apparent that food must appear immediately in front of the 3 year old. But the window was missed and now he is in his room having a fit. I am whisked to cooking. To be fair, I am lucky and this is not my typical role. My husband is a phenomenal cook. I will forever be the mom that just “made food.” Healthy, yes. Tasty, not always. But my husband is working late tonight. I cook fast and furiously and have tacos on the table in no time. Phew. We can all eat and relax. We talk about the good things and the challenges of our day.
The glitter is moved to the appropriate art table and we dive in. There is glitter everywhere now, a little on each surface and the floor. Gingerbread man turns out beautiful. Turns out this is a BD (Big Deal), doing art with your child. I am amazed at the calm it brings me to come into the moment and glue the fine details when she needs my help. Then the 3 year old gets wind of the glitter project and more glitter goes everywhere. Of course. Not A Big Deal.
I am reminded of the book, “Don’t Sweat the Small Stuff” by Richard Carlson. I never read it but always wished I had. I felt I learned it all in the title. I probably missed some key elements since I just figured out the N.A.B.D. list and the book was published in 1997. Yes, that was 20 years ago.
My husband comes home. The dog, who is a hundred pound eight year old fur baby wags his tail vigorously in a very cute fashion. He also happens to whack the closest child cup that spills milk across the entire room. Couch, floor, art table. Luckily not the precious gingerbread man was safe, having moved to a higher surface for stabilization and drying. For a moment I look at the mess and think, “Are you kidding me?” Then I remind myself. Spilled milk. And you know what they say about spilled milk? Not worth crying over. Not A Big Deal.
It is the holidays, officially. What can you let go of? What can get crossed off the infinite “List” of “to do” so that you can have some more moments “to be”? In giving ourselves permission to add to our N.A.B.D. list we make room for the things that are a B.D.
Let the Big Deals sink in. If it is Not A Big Deal, let it go.