HOW DO WE KNOW WHO WE ARE?

I recently watched Julianne Moore's moving and beautiful performance in "Still Alice."  She portrayed the rapid progression of dementia symptoms in a 50 year old woman.  In the movie, she talked about how devastating it was to lose her memory and to lose her memories.  She felt that in many ways, her memories defined who she was.  What does define who we are?  Is it our memories? Is it our experiences?  Is it our relationships?  Is it who we love? 

Our experiences seem to be important to how we view ourselves. These experiences also seem to be shaped by our relationships with others and with ourselves.  So, to take away these experiences could leave us feeling empty.  But, does having dementia mean we lose these experiences?  Or, are we still who we are even without our memories. We don't seem to think about our memories when we go about our daily routines, having new experiences with people we are with. In fact, if we are thinking about the past (memories?) then we can miss the opportunity to have a new experience that will add to our sense of ourselves.  

So, is it possible to still know ourselves even if we are losing our immediate and short term memory?  Do we store our experiences in a way that we can hold on to them even when our memory goes?  If so, then the problem with memory loss may be our reactions to the loss and the reactions of others who we are with. So, does the stress that our reactions create really undo us when we lose memory?  Even if this is true, how in the world would we be able to not react with stress?  

Research studies continue to correlate stress with an increased risk for memory problems (dementia).  So we should avoid stress!  Of course.  That is why I focus so much in these blogs on how to control (eliminate?) stress.

MODERN DAY PROPHETS

Recently I was watching a replay on public television of "Fifty Years of Peter, Paul and Mary" and I was very moved by their performances as I had been years ago.  As I listened with tears flowing I felt that I was being reminded of what life is about...the beauty of this earth, the beauty in each of us and how we are meant to be together, all of us.  Peter, Paul and Mary seemed to be telling us through their performances that we are all tied together by love!  Music and songs can be powerful reminders of what is important in life.  I guess mostly about how important relationships to other people are. I think that most of us know that and yet very frequently things happen and we end up feeling isolated or alienated from others.  It is easy to feel that we need to protect ourselves from other people because they don't believe what we believe, or that we feel that we are different in some way that seems important.  Sometimes stress will cause us to isolate more and also to see more people as wrong and like they are the enemy.  In my more than thirty years of helping people to be less stressed, I have never seen it helpful for anyone to isolate themselves or judge and criticize others. Inevitably this increases their stress level and depressed feelings.  This has been true even if someone feels a part of a group that is judging and criticizing others.  It still separates us from others and this leads to feeling stressed and depressed.

So, how do we avoid this isolation and this judging and criticizing others?  We can learn to recognize when we are being critical or judgemental and stop ourselves or at least try to defer this to a later time in the day that we have set aside for being critical and judgemental. This deferring the criticism and judgemental attitude to a later specified time can work if we have clearly set a goal of stopping this and are trying to reduce it this way.

We could all try this and we might find ourselves influencing others in a very positive way.  Would that mean that we would be like modern day prophets?

SYMPATHY VERSUS EMPATHY

I was listening to someone talk about how they respond 'sympathetically" to customers and as I listened to her describing being sympathetic, I realized that she was not listening to the other person but reacting to what she was hearing. I believe that being sympathetic means that we respond personally based on our own reaction to what's been said. This seems to make sympathy more about our reaction to others and not about what other people are experiencing. So, sympathy is not really about listening to others even though having someone listening to them is what seems helpful for people who are struggling with emotional pain.  

However, many of my patients have expressed feeling like they were "not helping at all" when they "only" were able to listen when they were with friends or family who were grieving a loss.  Often we feel that we are not being helpful if all we are doing is listening. However, it can feel stressful to listen to someone who is experiencing emotional pain.  Maybe it is this stress that we feel listening to others who are experiencing emotional pain that leads us to offer sympathy.  So we don't have to listen any more in order to relieve our own feelings of stress.  

WHAT MAKES US BLESSED?

Recently I was reading a poem by Mary Oliver and I felt moved by her words: "Sometimes I need / only to stand / wherever I am / to be blessed."  So, does that mean that we can be blessed wherever we are standing? What does it mean to be blessed?  What does "stand" mean?  

Thinking of "stand," I remembered a song by Susan Ashton called "Stand."  Years ago my oldest daughter suggested that I listen to it as it had inspired her.  The song describes "standing for what we believe and the love we have received and then we won't be alone."  Then we can resist "the voices of doubt as we listen from inside out."  I love that...listening from inside out.  So, does "stand" mean to be grateful for the love that we have received and to be true to what we believe? If we do this then are we blessed? Are we blessed when we know what we have been given and also choose to honor what we believe?  Is it that simple, that hard?

So, all we really need to do is stand, wherever we are, and we will be blessed! If we realize that we are blessed will that help us to stop worrying about the past and the future?  It would seem so. Why don't we all "stand" and see what happens.

WHY OUR DOCTOR'S NEED TO TREAT EACH OF US AS UNIQUE HUMAN BEINGS

The simple response to that statement is because we are unique. Even identical twins are not really identical but each has unique features compared to their twin. So why is this important for our doctor's to consider? Well our uniqueness means that we may not fit within a statistically derived range on blood tests or even on physical parameters like blood pressure or heart rate. Even the odds of illnesses may not apply to any one of us just as the likelihood of side-effects may also not fit us.  Since nearly all the parameters that doctor's use to evaluate us and our health are based on statistical averages, this guarantees that what is normal for some of us will be outside the normal ranges as approximately 5 to 25 percent of us will fall outside this range.  In addition, it is helpful to know what our values are when we are doing well and do not have any symptoms as this will show what our normal values are. This is a problem as many of these lab tests are not part of wellness screening.  As an example, TSH [thyroid stimulating hormone] tells you how much hormone your thyroid is producing, based on how much TSH is required.  If you do not have TSH values from when you were healthy, then it is harder to interpret whether your recent TSH value is normal for you or not.  My point is that a statistical averarage may not be your average. The good news is that hypothyroidism is a clinical condition that is diagnosed by symptoms you are having and is not diagnosed by your TSH level.  The bad news is that the TSH value is often used to decide if your thyroid is ok, no matter what clinical symptoms you have.  

What can you do? You can be an active participant in your health care. In fact, if you are not an active participant in your health care then you are much less likely to receive good health care. Doctor's need your input to provide good care.  So what does being "an active participant in your health care" mean? 

I'd recommend that you: 

Be aware of how you feel [healthy or not and why not] and identify specific ways that you do not feel right [what symptoms you may have];

Keep an uptodate list of everything that you take, including supplements and specific diets; 

Check on possible interactions between all the things that you take as your doctor mayl not have time to check on this;

Check the internet and other sources of medical information such as at the library to learn more about what the ways that you do not feel right might mean and about illnesses that you already know about;

At your Doctor's appointment, share with your Doctor how you are feeling, what you have learned about your symptoms and possible diagnoses, as well as treatments. Also, bring copies of information that you have found;

Decide with your Doctor what your diagnoses might be and the steps that you can take to help you to feel better;

Also, decide on a time frame for when you can expect to feel better and when you should contact your Doctor if you are not feeling better;

Thank your Doctor for working with you to help you to feel better;

In a couple weeks, call your Doctor's office and let them know how you are doing.;

Finally, be sure to follow-up with your Doctor at the time that you and your Doctor had decided was a good time to call and give an update.

Remember to be grateful that you are in charge of your health!