Resources for health care professionals
Today’s tip is a resource sent to us by Dr. Dana Foradori, a former faculty member at TCH. It is a “padlet” of wellness resources for health care professionals:
Keeping Well in COVID: Resources for Healthcare Professionals
Breathe
I used to hate when my parents would tell me to breathe when I was upset as a kid. It felt so basic and banal. Then I got to graduate school and read the research on how deep, rhythmic breathing is the fastest way to activate the parasympathetic nervous system, the system that shuts down our fight-flight stress response. I guess my parents were on to something. There are lots of ways you can use your breath to calm your nervous system. One approach is to breathe in for four counts, hold your breath for two counts, and breathe out for six counts. Repeat this for ten cycles.
Coping by developing unhealthy habits
Be careful of coping with stress by developing unhealthy habits, such as excessive alcohol consumption. We have turned to comfort food, online shopping and the occasional libation during this stressful time. And while the occasional cocktail, and virtual happy hour with friends can be incredibly beneficial, beware of drinking to excess as a means of coping with the unknown. Not only are there long-term health consequences but, in the short-term, alcohol can actually make anxiety and sleep issues worse – the exact opposite of what we all need right now!
The National Institute on Alcohol Abuse and Alcoholism recommends no more than 4 drinks in a single day for men and no more than 3 drinks in a single day for women. How often are you over the recommended limit?
Get some sun
Just because some of us are not leaving the house for work doesn’t mean we shouldn’t be leaving the house. Even standing by an open window is better than nothing. Many studies have demonstrated that exposure to sunshine can elevate mood. Sunshine boosts vitamin D production, which increases our immunity and helps prevent depression. Try to get at least 15 minutes of sunshine a day.
Stay active
Sneak in activity throughout the day. Believe it or not, the little bursts of activity you can incorporate throughout the day really add up! For every half hour you sit at your desk, try to get up and take a quick lap around your workplace or at least stand up and do a few stretches. Or, try one of these simple exercises you can do at your desk without anyone noticing. If available, a standing desk is a great option to use for a few hours of the day to strengthen your legs, core, glutes, and back.
Track your activity. Activity trackers like a pedometer or a Fitbit go a long way in showing you how active you are. If you have an iPhone, you already have one built in with the health app. It just might inspire you to get up and move a little more throughout the day!
Make exercise part of your schedule. At the beginning of the week, decide when you want to exercise and plan everything else around that. This may mean adjusting your sleep schedule or making a commitment to work out right after work (no matter what!). Even if it seems inconvenient, keep your goals in mind, and know that a commitment to your health is worth it.
Work towards reducing your stress level
No matter how much we feel we are in control, our physiologic stress response is activated. It is prudent to develop a clear plan that prioritizes our self-care:
- Practicing good sleep hygiene;
- Eating well (some are fortunate to have some time to cook meals);
- Setting aside time for daily exercise (a 30-minute walk outside is refreshing and will lower your stress level); and
- Adopting a stress-reducing practice: either a short 3-minute breathing exercise, listening to music, or simply being in nature for even 15 minutes.
Take the stairs
At all Texas Children’s Hospital campuses, staff are now encouraged to use the stairs. While this will free up the elevators for patients and families, it also has at least 5 important health benefits:
- It engages multiple muscles. Stair-climbing exercises engage more muscles than walking, jogging, or running on flat terrain. Moving on flat ground engages your leg muscles, while stair climbing also works out your glutes and provides a more thorough workout for your quads and hamstrings.
- It improves balance. Whether you’re climbing actual stairs or working out on a stair-climbing device, you’ll have to engage the stabilizing muscles in your foot and ankle and the peroneal tendons to maintain balance.
- It’s an efficient, low-impact cardio workout. Because you have to engage more muscle groups and exert yourself more than if you were on flat ground, stair climbing is an effective and time-efficient cardio workout.
- It boosts overall fitness. Adhering to a stair climbing regimen improves overall fitness in healthy, sedentary adults. Climbing stairs over a period of three to 12 minutes intermittently was superior to working out continually for improving blood sugar control in people with insulin resistance. Also, climbing stairs helps you burn more calories every minute as compared to jogging.
- It lowers mortality risk. One study involving more than 8,000 men between ages 65 and 71 found an association between climbing a higher number of floors and lower mortality from all causes.
The joy of movement
The runner’s high is often held up as a lure for reluctant exercisers, described in terms that can strain credulity. But this side effect is not exclusive to running. Bliss can be found in any sustained physical activity, whether that’s hiking, swimming, cycling, dancing or yoga. However, the high emerges only after a significant effort. It seems to be the brain’s way of rewarding you for working hard. Why does such a reward exist?
The latest theory about the runner’s high makes a bold claim: Our ability to experience it is linked to our earliest ancestors’ lives as hunters, scavengers and foragers. Researchers like biologist Dennis Bramble and paleoanthropologist Daniel Lieberman have hypothesized that the neurochemical state which makes running gratifying may have originally served as a reward to keep early humans hunting and gathering. There’s no objective measure of performance you must achieve, no pace or distance you need to reach that determines whether you experience an exercise-induced euphoria – you just have to do something that is moderately difficult for you and stick with it for at least 20 minutes. That’s because the runner’s high isn’t a running high; it’s a persistence high.
Persistence is key to experiencing a high while exercising, but maybe that’s not the best way to think about it. We don’t persist so we can get a neurochemical reward; the high is built into our biology so that we can persist. Natural selection has endowed us with a way to chase our goals and keep going even when it’s hard. For many, the experience of persevering is part of what gives movement meaning and what makes the experience rewarding. This is the less heralded but perhaps most lasting side effect of the persistence high: You get to experience yourself as someone who digs in and keeps going when things get tough.
A runner’s high does the opposite: It helps us bond. Many people have told me they use running as an opportunity to connect with friends or loved ones. I’ve heard from people who rely on a daily workout to be more caring parents or partners. As one runner notes, “My family will sometimes send me out running, as they know that I will come back a much better person.” One study found that on days when people exercise, they report more positive interactions with friends and family. When spouses exercise together, both partners report more closeness later that day, including feeling loved and supported. This includes the runner’s high but it also includes social pleasures, like sharing, cooperating, playing and bonding. In this way, regular exercise may lower your threshold for feeling connected to others – allowing for more spontaneous feelings of closeness, companionship and belonging, whether with family, friends or strangers. At first glance, the runner’s high seems an unlikely antidote to social isolation. Yet the neurobiological reward that kept our ancestors from starving may now save us from a more pressing modern need: loneliness.
Excerpted with permission from the new book The Joy of Movement: How Exercise Helps Us Find Happiness, Hope, Connection, and Courage by Kelly McGonigal. Published by Avery, an imprint of Penguin Random House, LLC. Copyright © 2020 by Kelly McGonigal.
Meditation may be good for the heart
Today’s wellness tip is the article Meditation May Be Good for the Heart by Nicholas Bakalar.
Meditation may be linked to a lower risk for cardiovascular disease, a new study suggests.
Researchers used data from a national survey conducted annually by the Centers for Disease Control and Prevention, identifying all patients with high cholesterol, hypertension, diabetes, stroke and coronary artery disease and any who reported that they meditated. Of 61,267 people in the survey, there were 5,851 who participated in some form of meditation. The study is in the American Journal of Cardiology.
After controlling for age, sex, B.M.I., marital status, smoking, sleep duration and depression, they found that meditating was associated with a 35 percent lower risk of high cholesterol, a 14 percent lower risk of high blood pressure, a 30 percent lower risk of diabetes, a 24 percent lower risk of stroke and a 49 percent lower risk of coronary artery disease.
The lead author, Dr. Chayakrit Krittanawong of the Baylor College of Medicine, said the reduction in stress that meditation can provide could at least partially explain the result. But he cautioned that the study is observational, and that clinical trials would be needed to determine the mechanism that explains the association. He added that the study did not distinguish between the many different kinds of meditation.
Still, he said, “I believe that any kind of meditation would have benefits for cardiovascular disease risk reduction.”
Stress Resets
Today’s wellness tip is Part 1 of a two-part excerpt from “Five-Minute Coronavirus Stress Resets“ by Dr. Jenny Taitz.
In this emotional equivalent to an ultramarathon, it’s key to have some stress-reducing strategies available that work quickly and efficiently to help you hit the reset button. Pushing away feelings is like trying to force a beach ball underwater: They will pop back up. Instead, notice and normalize difficult emotions.
These strategies can help lower the intensity of overwhelming emotions, allowing you to recalibrate to better deal with challenges you face.
Try Music Medicine
Focusing on relaxing sounds reduces stress. In research spearheaded by Dr. Veena Graff preoperative patients were assigned either to music medicine — listening to Marconi Union’s “Weightless“ — or prescribed a benzodiazepine. Remarkably, serene music proved nearly as effective in easing patients’ jitters as the medication option, with no side effects. To honor your unique taste, explore different options and create a playlist that you find comforting when you need a break. Keep in mind that research on inducing varying mood states concludes that we can improve our experience with a more uplifting soundtrack.
Cool Off
Dr. Marsha Linehan popularized an exercise in dialectical behavior therapy to regulate intense emotions that involves immediately lowering your body temperature by creating a mini plunge pool for your face. This activates your body’s dive response, a reflex that happens when you cool your nostrils while holding your breath, dampening your physiological and emotional intensity. To do it, fill a large bowl with ice water, set a timer for 15 to 30 seconds, take a deep breath and hold your breath while dipping your face into the water. While this isn’t conventionally relaxing, it will slow your heart rate, allowing blood to flow more easily to your brain.
By practicing managing your emotions, you’ll experience a sense of freedom in your life. See Part 2 in next week’s newsletter for three more strategies.
Stress Resets
Today’s wellness tip is Part 2 of a two-part excerpt from “Five-Minute Coronavirus Stress Resets“ by Dr. Jenny Taitz.
Pushing away feelings is like trying to force a beach ball underwater: They will pop back up. Instead, notice and normalize difficult emotions. These strategies can help lower the intensity of overwhelming emotions, allowing you to recalibrate to better deal with challenges you face. See Part 1 in the August 14th newsletter for two more strategies.
Pace Your Breathing
In “The Healing Power of the Breath,” Drs. Richard Brown and Patricia Gerbarg offer a range of exercises to promote resilience. One of my favorites: Slow your breathing down to six breaths a minute by consciously inhaling and exhaling (to practice this timing, you can use a secondhand and inhale for five seconds, exhale for five seconds, and repeat four times, or try a guided recording). Paced breathing offers a host of physiological benefits, like reducing your blood pressure, which helps promote a sense of tranquility.
Practice ‘Anchoring’
Our interpretations of events supercharge the intensity of our emotions. But mindfulness is a nice remedy for anxiety. One brief way to enter the moment is known as “anchoring.” Start by physically centering yourself by digging your heels into the floor — this evokes a feeling of being grounded in reality. Then take a moment to observe: What am I thinking? Feeling in my body? Doing? Then ask yourself: Is my response: A) Helpful? B) Aligned with my values now? Or C) Related to future worries or a past problem?
Hyperventilate
If you struggle with physical sensations of anxiety, like muscle tension and feeling like you can’t get enough air, a counterintuitive yet important way to manage is to practice bringing on those sensations in more quiet moments to improve how you tolerate stressful ones. In a recent therapy group I led on Zoom, my clients prepared to try this by ordering thin coffee straws. I set my timer for a minute as they pinched their noses and tried to breathe only through the straw. We also worked on replicating the other sensations they associated with fear, like muscle tension, dizziness and shortness of breath. We held a plank, spun in circles and ran in place. Some people were surprised that the practice experience was worse than the anxiety they normally felt. Others found it was similar, which felt liberating — they didn’t have to wait for the feelings to catch them off guard — and instead could purposefully habituate themselves to them.
Now I hope you create your own plan with the strategies above. By practicing managing your emotions, you’ll experience a sense of freedom in your life.
Sneak in some exercise
Today’s wellness tip is an excerpt from “Sneak In Some Exercise“ by Kelly DiNardo.
Move while you wait. Use the time it takes to brew coffee, warm up lunch or boil water to squeeze in mini-workouts. Rotate through 10 reps of each of these until the microwave dings.
Kitchen counter push-ups: Stand facing the counter and place your hands on the edge just slightly wider than shoulder width. Keep your arms straight and step your feet back so your body forms a plank. Keep the heels lifted, abdominal muscles engaged and back straight. Inhale and bend your elbows out to the side as you lower your chest to the counter. Exhale as you push back up.
Side lunges: Stand with your feet shoulder-width apart and toes pointing forward. Take a wide step out to the right as you press your hips back while keeping the left leg straight and both soles of the feet on the ground. Push yourself back to the starting position and lunge to the left.
Standing bicycle crunches: Stand tall with feet slightly wider than your hips. Interlace your hands and place them behind your head with elbows wide. Raise your right knee up as high as you can as you simultaneously twist your torso to the right and draw your left elbow to the lifted knee. Alternate between sides.
Multitask your muscles. Find moments throughout the day to incorporate movement into more mundane tasks.
Toothbrush squats: Use this two-minute morning routine to wake up your lower body by squatting while you brush your teeth. Stand with your feet shoulder-width apart. Keep your chest up, bend your knees and push your hips back until the back of your thighs are parallel with the floor. Pause so you’re not using momentum to push back up. Then, drive through your heels and press back up to standing.
Dishwashing lifts: While standing at the sink, add in calf raises to tone the lower legs and glute muscles. Lift your heels and come up onto the balls of your feet as high as you can. Squeeze your glute muscles at the top and lower your heels.
Toothbrush rolls: Foot massage improves circulation, decreases stress and releases endorphins, all of which promotes better sleep. Use your before-bed brush to roll out the feet. Place a tennis or similar ball under the ball of your foot. Put as much weight on it as you can tolerate, and roll the ball back and forth the length of your foot several times.
Walk while you talk. When it’s appropriate, take that work call outside for a walk. Start by asking if it’s OK to walk while you talk, and let them know they may hear some background noise. Be sure to use earbuds or headphones.
Zoom and move. When appropriate, turn off the video and sneak in a short desk workout or stretch.
The prayer: Sit upright with both feet flat on the floor. Bring your hands together in a prayer position in front of your chest. Push your hands together as actively as you can for 30 to 60 seconds and release.
Wall sit: Stand with your back against a wall. Walk your feet out and slide your body down until your hips are level with your knees and your knees are at a 90-degree angle. Hold for 30 to 60 seconds and release.
Standing hamstring curls: Stand in front of your desk and lightly hold onto the edge for support. Shift your weight onto your left leg, bend your right knee and bring your heel to your butt. Lower the foot. Repeat 10 times and switch legs.
Exercise
Today’s wellness tip is an excerpt from “Exercise May Make It Easier to Bounce Back From Stress“ by Gretchen Reynolds.
“Exercise makes it easier to bounce back from too much stress, according to a fascinating new study with mice. It finds that regular exercise increases the levels of a chemical in the animals’ brains that helps them remain psychologically resilient and plucky, even when their lives seem suddenly strange, intimidating and filled with threats. The study involved mice, but it is likely to have implications for our species, too, as we face the stress and discombobulation of the ongoing pandemic and today’s political and social disruptions. Stress can, of course, be our ally. Emergencies and perils require immediate responses, and stress results in a fast, helpful flood of hormones and other chemicals that prime our bodies to act. Exercise seems to build and amplify stress resilience. But regular exercise is so good for us, anyway, that deploying it now to potentially help us deal with today’s uncertainties and worries just makes good sense.”