The Critical Importance of Being Your Own Advocate

Own your health

As I experiment with different subject matter to decide on the topics that I like to write about and share here, one of them that keeps bubbling to the surface is self-care.

As my wife and I go through our early 50’s with our two college-age kids, it’s becoming crystal clear to me how critically important it is to take care of your physical and mental health no matter what age you are. Poor decisions made today about your health will most certainly come back to haunt you years down the road.

What I want to touch on here ties directly into the heart of self-care, and that’s the fact that you must be your own advocate in all of your health matters. Nobody else is going to do it for you, and in our complex healthcare system it’s more important now than ever before that you’re aware of your full set of options in any given situation.

By using the word “advocate”, I mean that it’s important to:

  • Communicate: Develop the skills and communication methods to define what your problems are and explain them clearly to medical professionals. People can’t offer the right help without the clearest explanation possible of what your problem is. Perhaps start by writing down your questions and the history of your problem (including any relevant dates) so you don’t forget things when you need to speak with someone about it. Having things written down is a stepping stone to an effective and thorough discussion. Also focus on listening and interpreting what’s being said. Don’t accept something that you don’t understand and move on from it because that will ripple through the rest of the conversation.
  • Research: Use trustworthy and reputable internet research tools to further understand and self-educate about your problem. Learn what it is, why it might be happening, what might be done about it, and whether or not it’s something you can improve on your own or something for which you need professional help. Corroborate what you learn across different websites and experts, and dig incrementally deeper to separate fact from fiction. Do this before or after you speak with your doctor, but definitely put the effort into it. I often start with general heath websites like WebMD, Healthline, Mayo Clinic, or Harvard Health and then work my way into specific sites dedicated to a problem I might have, for example the American Heart Association for cardiac topics. Etc…
  • Know the system: Understand who the best people are to help you with your problem and how to find them. Or maybe you can help yourself without them and avoid the need for the healthcare system altogether. If you need a doctor, start by asking your Primary Care Physician for referrals. You can also use a site like Castle Connolly Top Doctors to explore further. Just make sure that if you use a physician search or ranking site that you understand how they make their selections and do their rankings. You can also ask friends you trust about their experiences and recommendations.
  • Question: Ask as many questions as you need to understand your situation, write down the answers, and note who was involved in the conversation and when. Don’t just accept a prescribed path as the only one for you. I’ve been given conflicting advice by physicians on a number of occasions, and you shouldn’t just walk away from those situations without trying to understand why they made their recommendations and how they differ from one another.
  • Persist: Relentlessly drive toward a solution to your problem. There are often several ways to pursue a health solution, and many don’t involve immediately turning to medications. One might not work, but another will. Understand your options, because we all want to stay off medications for as long as possible in life. Stand up for yourself when you feel that finding your solution is going off course. You are in control of your health.

Why is this important?

In just the past five years or so, I’ve seen many examples myself and also through the stories of friends and family of how poorly various health situations were handled by the medical community and sometimes the patients themselves. I’m sure you’ve experienced the same thing. We would like to believe that we go to doctors who are knowledgeable, cutting edge, and whose opinions we can trust. Fortunately, in many cases this is true. Sadly, in some cases it’s not.

To be clear, this is not an indictment of the entire medical establishment. I have no problem with the majority of medical professionals I deal with. This is just a simple message that no doctor knows everything, some let their biases determine a treatment path that might not be optimal for you, and sometimes they’re just wrong.

Here are two quick examples…

Scenario 1:

My friend’s elderly father with Parkinson’s disease recently suffered a fall and hit his head. He went to the hospital, was treated for a few days until he seemed stable, and eventually returned home. As often happens with the elderly after an accident, things just didn’t seem quite right with him after that. One thing led to another and eventually he had to return to the hospital with various issues, one of which was breathing difficulty. He was diagnosed with pneumonia. He was treated but his condition continued to worsen to the point where my friend was told there was nothing else that could be done for his father and that he should be moved to hospice care.

He was moved to a rehabilitation facility where hospice care was offered and my friend was told that his Dad had just a short time left. I recommended to him to say what he wanted to say to his Dad now because this might be his last chance, which he did and was very glad he was able to have a semi-lucid discussion with his Dad before he possibly passed away.

In hospice care, a new doctor stopped in to evaluate the situation and decided quickly that more help was possible, and put the father on an IV for a few days. He eventually improved to the point where he was able to sit up, interact with people, and eat pureed food. Eventually he improved enough that he went home! He needs extensive mobility assistance at home, but he is there and he is alive.

So he went from fall + injury, to hospital, to hospice, to near death, to re-diagnosis + treatment….and then to home?! Wow! Talk about a roller coaster ride. Makes you wonder what was going on in that hospital and with the initial set of doctors that sent him down a path toward death when the option of saving him was so quickly picked up by another doctor in a different facility. Terrible situation…

Scenario 2:

Another example is my own experience with trying to solve several problems I’m having with my feet.

Do you know what size shoe you should be wearing? I bet your answer is “Of course I do”. My answer was the same. I was wrong, and I’ve since learned that many adults are possibly wearing the wrong size and/or width shoes and might be causing irreparable harm to their feet.

I have the good fortune to be in a high quality medical group for the past 20+ years that has grown over time in our region to include many doctors and specialties under their umbrella in almost every area you would normally need. I don’t think I’ve gone outside of our medical group once in the past 20 years because the doctors have always worked well with me, given solid advice with explanations as to what was going on, etc. Great situation! Unfortunately, I’ve learned that this doesn’t always protect me from poor or incomplete advice because it lurks even in places we consider trusted.

The first podiatrist I went to about my problems within my medical group wanted to do an MRI imaging test of my foot using an injected contrasting agent though an IV to make the MRI image clearer. I’ve read some bad things about contrasting agents and I didn’t want to use it during the test unless absolutely necessary, so I asked to do the MRI without it because I learned before the test that contrasting wasn’t really needed to diagnose my suspected problem. He refused. I left and never went back. He was stubborn about listening to my concerns and wanted to do things his way despite evidence showing it wasn’t necessary for my particular situation.

The second podiatrist gave me a thorough exam, started targeting the same possible causes as the first podiatrist, and recommended some actions to try to solve the problem (including an MRI without using contrast, imagine that?!). None of his solutions seemed to work with my somewhat chronic problems, and indeed one of the solutions about using orthotic inserts in my shoes may have caused a further problem because he didn’t give me proper instructions for how to acclimate my foot to the orthotic over the period of a week instead of just suddenly using them in my shoes all day, every day.

Seeing how this was going, I decided to further research the problems these podiatrists were diagnosing me with, and I do indeed have all of them. But here’s the crazy part….All of my problems are primarily caused by incorrect footwear. In my case I was erroneously wearing the wrong size sneakers over a long period of time.

When you were a young kid and you went to purchase new shoes, they would always measure your feet in the store with that metal device with the sliders on it called a Brannock device. That’s how you were assured of proper fit as your foot grew like crazy in your younger years.

As an adult, when is the last time you measured your feet with a Brannock device? Exactly. I don’t either. My foot stopped growing around the age of 20 and I’ve been generally buying the same size shoes for the past 30 years. I buy shoes that feel “good enough”, and move on without giving it a second thought. Until I developed foot problems…

When I discovered how much feet actually change over the years once past the age of about 30, and that all of my problems are typically caused by incorrectly fitting shoes, I realized that neither of the podiatrists I went to even bothered to measure my feet! What??? They jumped right into diagnosing me and offering solutions without first measuring my feet and then asking the most basic question that a podiatrist should ask, which is: What size and type of shoe are you wearing? It never even dawned on me at the time how stupid this was, and I willingly went down their path without pausing to assess the situation.

Using the philosophy mentioned above about being my own advocate, I’ve learned more about feet and shoes in the past three weeks than I ever thought I needed to know. In fact, everyone should know these things. I used a Brannock device to measure my feet properly, was surprised to find that I had both my size and width wrong, and I’ve since purchased the right size shoes. My wife needs to do the same. Interestingly, I’ve also learned that many common athletic sneakers are shaped incorrectly and contribute to the problems many people have, so I’ve switched to what’s called a natural shape shoe (I have some photos below to demonstrate how absurd that situation is).

Since getting the new type of sneakers in the right size, the discomfort from my chronic conditions is somewhat easing. I’m hoping that it continues to do so to the point where it’s not such a big distraction to my everyday life.

Improve your outcomes

So what is the point of the two stories above? The answer is simple: Be an advocate for yourself.

In the case of my friend’s father, they were basically in a situation where they were guided to follow the advice of a single doctor without being offered a second opinion, and only saved him by the happenstance of another doctor giving him one final check at a different facility.

The difficult takeaway from that is that in those dire circumstances, perhaps we should all consider a second opinion before final decisions are made. When I think back about some of the decisions our family made in my father’s elder years, the takeaway would probably be the same because he had some clunker doctors for sure (one of which was eventually terminated from the retirement community where my Dad lived).

In my situation, the point is that what I was hearing and seeing didn’t make sense to me. When I educated myself about all of the involved topics, I found that I was likely diagnosed correctly and the solutions offered were mostly right, but they had absolutely no chance of helping me because of the basic fact that I was wearing the wrong size shoes. Zero chance.

So the overall message of this article is about owning your health and the possibility of achieving better outcomes. Don’t blindly turn yourself over to the medical system and assume they’ll make all the right decisions, because they might not or might be following a “one size fits all” approach that’s not right for you.

Learn, ask questions, get answers. In my experience over the years, I’ve found that doctors have appreciated and commented positively about the effort that I put into understanding my conditions and options. It enables them to better help me and have a more complete discussion when they know that I understand the problem, the possible options, and that I can work with them to make appropriate decisions.

I hope the information in this article (and the photos below) are helpful. Be your own advocate and own your health!

Bonus: Want to help your feet? Here are some photos as food for thought…

I mentioned above that a common problem that shoes have is simply using the wrong shape. Driven by the desired appearance of the shoe, marketing needs, or whatever…many companies design their shoes to have a curve in them in the toe box area that jams your small 3rd, 4th, and 5th (pinkie) toes up against each other inside the shoe. They also force your big toe inward when it should be straight. These things lead to your toes flexing unnaturally and your bones rubbing against the nerves in your feet to create painful conditions like Morton’s Neuroma, metatarsalgia, numbness or tingling, and many other problems.

The types of sneakers that I’ve been wearing my whole life have this exact type of design, and when researching my problems I made the decision to buy natural shape sneakers instead. The relief from eliminating that inward toe box curve in my old shoe’s design was nearly immediate. My toes felt like they had room to spread and move with a less crowded feeling in the toe box area of the shoe, and my feet were more comfortable all day long.

Here are two photos that show the differences…

This first photo below shoes the two shoes. The typical athletic shoe is on the left and the natural shaped shoe is on the right. You can notice the leftward curve in the toe box area of the shoe on the left. Not good… The natural shape shoe is basically straight ahead from back to front.

The second photo below shows the insoles of these two shoes which I took out of the sneakers for this photo, and it demonstrates the difference more dramatically. My old athletic insole is on the left, in the middle is the insole from the new natural shape shoe, and finally on the right is a custom orthotic molded from my foot. Is your foot shaped like the insole on the far left or the one in the middle? My guess is the one in the middle. You can see that the natural shape insole and the custom orthotic are the same straight ahead shape.

See where this is going? Typical athletic shoes probably aren’t doing your feet many favors, and many other types of shoes have the same design problem.

If you have foot problems and you want to explore shoes that might help you, check out HealthyFeetStore.com. There’s a good search tool on their site that lets you specify your problem and then it matches you to shoes that might help you. To be clear, I have no affiliation to their site and I didn’t even buy anything from them, I’m just putting the link here because their ‘problem-to-shoe’ matching search tool was helpful to point me in the right direction. I actually ended up buying my new shoes directly from the New Balance website.

Happy shopping and healing!

What to do when stress breaks you – Part 2

Relaxing is hard. I mean truly relaxing, where your mind is calm and freed from its rush of thoughts so you can disconnect from everything around you and focus on the moment you’re in without distraction. Remember that thought, we’ll come back to it.

The need to move on…..but how?

In Part 1 of this article series I wrote about how a few generally stressful years in a row (and one terrible year in particular) brought me to my brink with stress, and how I ended up in the hospital because of it. In Part 2 here, I’ll focus on how I brought myself back from that brink using some initial tactical steps to get my days under control and reduce mental overhead. The final Part 3 article will focus on strategic steps that I took for long term overall health and well-being, and the sometimes surprising results of those steps.

To be clear I’m not a doctor, therapist, or licensed in anything that qualifies me to offer medical advice, so you won’t find me doing that here. What I am is an average guy who’s logical, organized, pragmatic, and has a lot of common sense. When I have a problem I learn about the things associated with it, pull together facts and concepts that I can relate to, and then put that knowledge to use solving the problem. I’m open-minded to new ideas, and that open-mindedness was the key to me beating stress.

I don’t want to over-simplify the conditions of stress and anxiety. They’re both complicated beasts that can cause a myriad of health problems, and they often land people in doctor or therapist offices. My particular situation was somewhat straight forward to resolve once I set my mind to it and stuck with my approaches, but your mileage may vary with basic stress management techniques. At some point you might need to investigate professional help if you can’t ease your situation by yourself. But regardless of whether basic techniques work or you need something more advanced, the key point is not to ignore stress because it’s an insidious thing to live with.

My tactical steps for immediate help

I saw two basic problems that I had to tackle right out of the gate. First, over a long period of time my average day had morphed into a zoo of personal and work activity that was simply too much to handle. I was rarely achieving the goals that I set for any given day and this created a lot of mental churning and angst because I’m normally a very organized person at home and work. Second, there were a lot of negative and energy-draining activities occurring without a lot of positives to counteract them. This quite frankly became a big downer over time, and both of these scenarios were sinking me.

It’s important to note that I didn’t de-stress and ease my mind overnight. It took many months of sticking to the following approaches to feel better in a holistic way. But I did it, and maybe some of these things will help you as well.

With the above statements made, below are the tactical steps I started with. Some might work for you, others might not, but remember that open-mindedness I mentioned? Try to absorb what’s here without judgement. If you see an idea that you want to explore further, try it. If something doesn’t click with you, then just pass it by. Make the concepts work for you…

1) “Houston, we have a problem”… so make a list!

The first thing I did was acknowledge to myself that I was in over my head with stress. Something was wrong, I knew it, and I had to do something about it. The morning after my hospital visit, I sat alone for a long time and thought about how I got to the point of being so stressed out. How did I get bogged down by a conspiracy of topics to the point that it affected my physical health? My mind was swirling on the topic without focus until I decided to make a list of the things that were bothering me.

Some topics immediately came to mind (my Dad dying), but other things were much more subtle like an endless to-do list, home projects that I saw unfinished every day when I walked around the house, a friend causing angst, etc. Those items and many more weighed on me to varying degrees, and if you think about it you probably have things just like them in your life as well.

Stress is insidious. It’s like rust. It eats away at you like rust does to metal, and before you know it you’re crumbling. These items on my list, both large and small, were overtly (and sometimes more subtly) eating away at me and contributing to my overall stress picture until I snapped.

This list-making process requires soul searching and honesty, there’s no getting around that. I found that nothing can go unexamined because stressors can creep in from many paths in life. Look at your daily activities, your work, the people you spend time with, the things you do throughout the day, time you might be wasting that could be spent better elsewhere, etc. Real…honest…examination. If you’re not willing to be honest with yourself about what you really think and feel, then this process will fail. Write down each item and why it bothers you.

Well, let me tell you, I had quite the list when I was done! It took me a few days of off and on again work and coming at it from different viewpoints to get it completed, but a strange thing happened when I finished. I looked at the list and breathed a sigh of relief. My mindset had already started to shift more positive because there it was, staring me right in the face. There on my list were the major contributors to my high stress level. Amen!

For me this was a difficult but crucial first step because it helped me to qualify and quantify my situation. It put meaning and guardrails around it. It was a starting point in an otherwise swirling and concerning situation. And from there I went on…

2) Focus on what you can control, and learn to let the rest go

When I looked at my list I started to see commonality between some of the items, and two high level buckets emerged quickly: 1) Things that I have control over, and 2) Things that I don’t.

People generally like to control as much of what goes on in their lives as possible, and I think that’s human nature. Who wants to live in a constant state of reactive chaos, right? You try to resolve things, put some order on things, move forward, and lead your version of a normal life. That’s great, until you try controlling things that are out of your control. All that does is create friction and stress in your life, “rope burn” if you will.

You have to control what you can control, and you have to let go of what you can’t control because when you try and control something that you actually have no control over, that’s called rope burn.

Travis Eliot

Here’s a story about how this type of rope burn eventually wore me down…

After my Dad died, I was the family member responsible for handling his estate and dissolving it equally between me and my three sisters. He had a lot of different accounts at many different financial institutions. Each one had a Beneficiary Services department and specific processes for how they handled the closing of accounts. Each day was a process of endless phone calls, paperwork, signing, scanning, and mailing documents. More phone calls, more waits, etc. I’m sure you can imagine…

The process really started to grate on me after a while because with every phone call I would get more and more frustrated at the long time things were taking and the incompetence of some of the people I was dealing with. Side note: It’s scary that some of these people manage money, because I found in some cases that I knew more about certain topics than they did and I’m certainly no expert.

My stress level spiraled upward with these daily frustrations until one comment from an agent at a bank snapped me out of my thought pattern. She said “The paperwork you prepared was excellent and it will make this arduous process go much smoother. I’ll take care of this and get back to you”. A few days later, she did get back to me and SHE actually thanked ME for the perfect paperwork that I submitted. The process was completed, there was no aggravation, and my stress level started to come down for this one particular situation.

The critical takeaway for me from that scenario was: You can only do what you can do, and you can only control what you can control. Sometimes the rest is up to someone else to complete and you must accept that. It is what it is.

Think about how many ways that thought can apply throughout your day, whether it’s in your personal or business life. Every day we deal with various types of situations and try to control outcomes that are at least partially out of our control at some point along their path. You have to realize when these times are occurring and let them go.

I adjusted the way I dealt with every financial institution after that. I made sure the paperwork I submitted was perfect, that it was done on time, and that it made it to the right person. Then I accepted the fact that I had done my part of the process, I had controlled what I could control and did the best I could with it. Now I had to turn it over to someone else to do their part without micro-managing it.

With this approach my expectations were more realistic and the small wins started to come, one after the other. And you know what? Everything worked out fine in the end. It took a lot longer than I wanted for sure, but it all got done and my stress levels were noticeably reduced bit by bit along the way.

The exact same thought process can be applied to people. In your daily interactions with people, at some point their reactions and subsequent actions are out of your control, and you must accept that for the sake of your own sanity. Any parent who has tried to help their child can relate to this. You can give your children all of the solid advice in the world, but at some point it’s completely up to them to internalize it, find any value in it that works for them, and then act on it if they choose. It can be frustrating and stressful watching a proven piece of advice go unheeded when you know it will help them, but it is what it is. You have done your best.

3) Make your daily to-do list realistic, and set up the following day for success

I’m a heavy user of the lists and the Reminders app on my iPhone and Mac. I have four different lists of reminders for different purposes, but it wasn’t always like that. I used to have just one long list of reminders.

When you’re extremely busy and find yourself in a situation when you have to fit as much as you can into the usable day, there’s nothing more stressful than reviewing your to-do list and seeing 65 things on it. All that’s saying to you is “You will never finish all of these things today.” That creates subtle subconscious stress all day long. It’s more rope burn. I used to scroll up and down my list to find the highest priority items that needed attention each day, and the rest just stayed there staring at me until I eventually got around to them another day. Another week. Or never.

That situation had to end. Instead, I created lists for Today, House, Monthly and Miscellaneous. When I bucketed the tasks it was easier to see how things naturally segmented themselves and priorities became clearer. For example, I have many tasks that fall into that Monthly bucket. Why was I scrolling through them every day if they only needed to be done…once per month?!

When I look at my plans at night for the following day, I have a pretty good idea of how much free time I’ll have throughout that day. At that point, I review my to-do lists and I pull only the top priority items into my Today list that I want or need to achieve that following day. Sometimes it’s one item, other times it’s five. It depends on how much free time I have and how complex the tasks are.

You have to be ruthless with what makes it onto the Today list. Keeping it low volume and achievable sets the tone for the whole day that will come with the morning. When that’s done, I turn out the lights and fall asleep with a clear, organized mind knowing (for the most part) what the next day will bring with regard to work. I rest easier doing this the night before instead of figuring it out in the morning. It allows me to start my mornings much more peacefully because I don’t feel that morning rush to get things organized anymore.

In reality you’ll still have just as many to-do’s as you did before. However, when they’re managed in this way you don’t have the subconscious stress of staring down an endless list of things you know you can’t finish in a day or don’t need to be focusing on at all that particular day. You’ve chunked the list into realistic and achievable goals.

Bonus tip: Keep your calendar realistic in the same way as managing your to-do’s. Set up your day so that you have some blocks of time to rest, process the events of the day as they’re unfolding, and get ready for the next thing you have to do. Don’t eat breakfast or lunch while working. Avoid back to back appointments. And for sure, don’t double-book yourself on your own calendar! It’s literally impossible to be in two places at the same time, yet I’m amazed at the number of people who double or even triple book themselves in the same time slot. It makes zero sense and only creates stress to see that mess staring back at you.

4) Focus on the small wins and they will add up to big wins

We’ve all got busy and challenging lives. Sometimes you run into a string of days, weeks, or even months that just don’t go well. I had a lot of bad days in 2019, which I mentioned in Part 1. It’s easy to get into a cycle of feeling like things are just going wrong and there’s not much light at the end of the tunnel.

I found success in re-framing that situation. Things go wrong during the day, but things go right as well. I started focusing more of my attention on the things that were going right and adding up the small wins throughout the day that made me feel good. The things that made me smile or laugh. When I focused on the good parts of the day, my mindset started to shift to the more positive side. I still had the problems, I still had the to-do’s, work, etc, but I took those wins during the day and banked them.

By doing this, I found that at the end of the day I was no longer focused as much on what went wrong and what I didn’t get done. Instead I was focused on what I did get done and the things that made me feel good. Over time this approach put a blanket of peace on the end of the day. I found that when I framed my day with a good start (using #3 above) and a positive end that things started to smooth out overall. Some peace was coming at last…

5) Move!

I originally titled this item “Get some exercise”, but then I realized that this is something different and much simpler than that. It’s really just about moving yourself and giving your body and mind some activity and a few minutes to refresh and reset periodically throughout the day. Some people experience barriers to entry with starting an exercise program, but there are no barriers to simply moving and refreshing your perspective.

I typically work from home as an IT Manager, but these same principles apply to an office as well. When I get bogged down with work and personal tasks, I realized that I was stuck at my desk or in one room of the house for hours on end. This can get to be a bit much when it happens over the course of many months, so this suggestion is simply about recognizing when that’s happening and counteracting it by getting some motion into your day. Move to a new room to do whatever you’re doing, go outside for a little break to catch some sun and hear the sounds of the outdoors wherever you live or work. It does wonders for your mind and body to just…move!

I live near wooded areas, so when I go outside for a few minutes I can smell the grass and fresh air. I hear the birds singing, the wind blowing through the trees, and the sun has a chance to hit my face. I can walk around the yard or neighborhood to get my blood flowing. It’s well documented how much this helps your well-being and I highly suggest trying to work these small mental and physical breaks into your day. It makes a huge difference. It’s precisely why many companies are restructuring their environments to provide employees with these opportunities for breaks. Apple, for example, has taken it to an extreme with their amazing new Apple Park office in California that pushes their employees toward nature literally in every direction they turn.

This need to move is also the essence of why fitness devices like the Apple Watch and Fitbit have reminders to stand, move, exercise, and take breaks several times throughout the day to do some deep breathing exercises. Science clearly shows the benefit of doing these things, it’s not just an opinion or marketing tricks. That’s why these devices try to motivate you with daily goals, activity rings to close, and visual reminders of your progress. They’re all forms of motivation to get you moving. (Anyone who owns an Apple Watch recognizes that little tri-colored ring above…Did you close your rings today?) 😉

6) Do nothing

To the opposite of #5 above, try this one as well. Sit still. It’s OK sometimes. Let your mind wander and maybe let it go down a rabbit hole to satisfy your curiosity for a while. Stop worrying about always making progress with everything. It can wait.

This is a critical thing I needed to remember while I was trying to de-stress and get myself back on track because I’m typically not one to sit still for long. The combination of having a lot to do for my job, many chores, and also making time for my hobbies and other fun things put me on a treadmill of always doing something. I forgot to just stop once in a while to take a breath. Read a book. Watch a movie. Watch the grass grow. Take a short nap. It’s all OK.

Don’t hurry. Don’t worry. And be sure to smell the flowers along the way.

Walter Hagen, from his autobiography. This is the phrase that later morphed into “Stop and smell the roses” some time during the 1960’s

I think modern culture is so fast paced that people begin to think that by sitting still, enjoying the moment, or doing something just for the sake of doing it that they’re wasting time and letting life pass them by. I would argue the exact opposite. I think that when we rush around like maniacs that life passes us by much faster. We need to remember how to savor the moments, and stop to smell the roses.

Takeaways

The content above is a lot to process, so let’s summarize the takeaways from this second article:

  1. Identify your stress points. Dig deep, be honest with yourself.
  2. Focus on what you can control, and learn to let the rest go.
  3. Manage to-do lists and calendars realistically, and set your next day up for success.
  4. Focus on small wins that add up to bigger wins.
  5. Move!
  6. It’s OK to do nothing sometimes.

These were the immediate tactical steps that I took to calm my days and bring some peace of mind. Having chaotic, emotional, always-on days was the primary cause of many of the items that I listed out in #1 above. It’s just not sustainable.

If you’re feeling that your days are not quite yours anymore, I encourage you to try some variety of the ideas above to throw a rope around things and calm them down. There are many websites about creating effective to-do lists, managing your day in a mindful way, 7-minute exercise routines to get some motion into your day, etc. The ideas presented here are meant to be seeds for further investigation if you see value in them. Google is your exploration friend!

Last but not least

Remember what I said in the beginning about relaxing and how hard it can be to really let go? Using the tips above can help you frame your day better and remove some of your daily stressors so that you can start moving toward regularly getting some chances to relax. It takes time, but slowly and surely things will catch on. The final installment in this series will focus on the strategic long term stress-reducing steps I took that could be classified as lifestyle or wellness changes. These are the things that brought me sustainable peace, and with that peace came a better ability to truly relax. Stay tuned for more…

What to do when stress breaks you – Part 1

Part 1: A relaxing evening turns into an unexpected trip

It was 9:45 pm on January 23, 2020, and my wife and I were relaxing with some TV at the end of a busy day.  She left the room to do some things and I suddenly started to feel tired, so I got up to brush my teeth and change into pajamas for the rest of the night.

Strange feelings came over me shortly after I entered the bathroom.  There was an irregular pounding heartbeat in my upper chest, feeling like it was up close to my neck.  A different kind of shorter and shallower breathing involuntarily swept over me.  Adding to these uncomfortable feelings was a sudden wave of anxiety, which was strange because I’m not prone to those types of feelings at all. I suppose it might be akin to a panic attack, but I’ve never had one so I can’t be sure.  

I quickly finished brushing my teeth (because you can’t not finish, right???), left the bathroom to sit down, and figured out what was happening.  I used my Apple Watch’s ECG function to confirm what I suspected, and I was correct. The 30-second test on the watch detected an abnormal heart rhythm called atrial fibrillation (AFib)

When your heart beats properly, you’re not even aware that it’s there because it pulses along steadily and quietly doing its job in the background of your life.  But you clearly feel it when it’s not working right, and it’s alarming. The realization causes your anxiety level to immediately skyrocket precisely because…it’s a heart incident!  This is your ticker, and if something goes wrong with it then you’re often in big trouble if you can’t get help fast enough.  The sudden and involuntary auto-anxiety that washes over you causes your body’s systems to flood your bloodstream with adrenaline and stress hormones like cortisol. Additionally your blood vessels constrict, heart rate and blood pressure increase, and your breathing rate accelerates.  The regulatory systems in your body feed off each other in a red-alert escalation.  

My Apple Watch indicated that my heart rate was up at 145, while doing nothing except sitting on the bed. Normally in that situation my heart rate would be around 60. I used the ECG function again to see how my heart rhythm looked, and when I reviewed the result on my iPhone it was ugly. It was an erratic irregular pattern with odd peaks and valleys, again indicating AFib. So at least I knew what I was dealing with, and I knew it was dangerous, so this clearly got my attention.

My normal (sinus) heart rhythm, as recorded by my Apple Watch. Perfect peaks, spacing, and valleys.
My abnormal heart rhythm of January 23 showing the temporary atrial fibrillation (AFib), as recorded by my Apple Watch. Notice the irregular spacing between peaks and the different profiles in the valleys.

I sat for a few minutes hoping for it to clear up, but it didn’t.  Things seemed to be getting worse and then came some shortness of breath when I stood up, so at that point I suggested to my wife that we should go to the hospital emergency room. My anxiety at that point was becoming uncontrollable, yet I was somehow strangely calm overall. The two are opposing feelings, yet somehow they were co-existing in that moment. I’ve never felt anything like it.

My wife drove to the hospital since it’s only twenty minutes from our house. Despite the situation, I didn’t see the necessity of calling an ambulance and waiting for transportation. It was probably a lot faster to just leave immediately and get there ourselves.

The hospital and emergency room were luckily quiet at that time of night, and I breezed right into one of the ER side rooms.  This was occurring shortly before COVID surfaced, so there was no commotion at all. They hooked me up to an EKG, blood oxygen meter, gave me aspirin and Diltiazem to settle my heart, drew blood for at least three dozen types of blood work, and took chest x-rays. Then I waited, and the stress level grew.

After several hours of monitoring and check-ins with the doctors where they explained each step of what they were doing and looking for, the decision was eventually made to release me. I left the hospital still experiencing minor AFib, but I was told to get some rest with the hope that things would settle down by morning under the medication.  With AFib still occurring at that point, my thought was “Should I really be going home already?” but the doctors said it was safe.  Appointments were made to follow up with my primary care physician and a cardiologist the following day.  

The three hours in the hospital ER were billed to me at almost $10,000, but luckily because of good insurance I “only” had to pay slightly over $1,000.  The entire experience gave me much to think about, and it started me down a year-long “reset” where I gave a lot of thought to some of the things happening in my life and how I approached them, and how I viewed and responded to sometimes difficult aspects of the world around me.  I’ll explain my reset process in a series of articles, of which this is the first.

How did I get to this point?

The year 2019 was not a good one in our house and my stress levels were through the roof the entire year, especially from November wrapping into January 2020. The years prior were a little rough too, but were less intense overall.

My Mom died in 2014 after a long, difficult, and sometimes odd health decline. In the years that followed, the family (Dad, sisters, me) went through the sad and difficult process of moving Dad out of the two-story ranch house in New York where we all grew up, and in which he was hoping to spend the rest of his life. The house was rapidly outstripping his mobility and it simply wasn’t safe anymore. He knew this as well as we did, so we eventually made the decision for him to move into a very nice senior living community with the hope that he would engage in the community there and with people his own age to find some commonality to support him. My sister lived just fifteen minutes away and was able to help and visit frequently, but sadly the scenario of him getting involved in the community never worked out and he was never truly happy there.

By 2019, Dad was experiencing rapidly declining health after a series of physical setbacks and surgeries.  There were household problems in my own home, our kids had many challenging things happening (some good, some bad), and then Dad passed away at 94 years old in August 2019.  I spent the latter half of that year working with the kids to resolve their topics and prepare them for college while also dealing with my grieving process and working with lawyers, bankers, insurance, and tax people to handle my Dad’s estate.  One of his final wishes was for me to ensure that everything was handled correctly for me and my sisters, and it was a ton of confusing work that will continue into 2021 when all is said and done.  This was all occurring while maintaining my full time job. It was a lot, for sure, and the breaking point under the stress of it all was approaching fast.

Stress + more stress = breaking point

I’m a pragmatic, logical, and persistent person.  Give me a problem and some facts, and I’ll doggedly figure it out and get it resolved.  The issue with 2019 was that life was overwhelming me from all directions at once with nothing but problems, worry, stress, and sadness.  We all have those types of years, and 2019 was mine.  It piled up on me, and I kept a lot of it inside just trying to “get the job done” so I could get to easier and better times ahead after I had solved all of the problems.

When you get that stressed out, other aspects of your life suffer greatly.  In my particular case, one example of how it hit me is that all of my creative energy went out the window because I just didn’t feel like pursuing my hobbies and there was little time to do so anyway.  The energy was sucked right out of me by everything else going on.  That only happened one other time in my life back in 2012, and I briefly mentioned it here.  It’s a completely draining, negative, cyclical experience that I vowed not to let happen again, but circumstances in 2019 conspired against me and I found myself back in the same scenario as in 2012.  There were other impacts on me as well, but that’s one of the easiest to explain here.

The thing I didn’t realize is how the stress from all of this was mounting up over several years, not just 2019. It was taking hold over a large span of time, and I just kept going forward no matter what to “get things done”, in a way hearkening back to the old British adage during World War II of “Keep Calm and Carry On”. That approach doesn’t address the root cause of the stress though, it just perpetuates it cyclically and endlessly.  

The thing to realize about stress is that it’s like rust eating away at a piece of metal. It takes hold a little bit at a time, spot by spot, until it overruns the metal and causes its surface to erode and become weak. If left unattended, the rust will engulf the metal and eventually cause it to fail.

Stress does the exact same thing to your mind and body as rust does to metal. It eats away at you on every surface, negatively affecting so many different aspects of your health that I’ve found it incredible to learn about it over the past year. Some of the impacts are to your body’s internal systems like your heart, organs, bones, etc. Other impacts are easily visible on the outside like poorer looking hair, eyes that look dim and sullen, skin problems, poor posture, etc. For some insight of what uncontrolled stress can do to you, reference this article from Healthline or this one from WebMD. There are many articles just like those that spell it out, just search on your favorite trusted/reputable source for medical information and you’ll find plenty of eye opening research.

As my understanding grew, I felt compelled to share my experience here with the hope that readers can relate to this story and take action in their own lives to “stop the stress-rust”. I had a specific set of circumstances generating my stress, and yours are certainly different. The stress might be coming from ten sources, or it might only be coming from one. Regardless, stress is stress, and it should be addressed.

Recognize and respond

Once you become overwhelmingly aware that there’s a problem in your life or with your health, as I did through my emergency room experience, how do you get past it?  How do you begin to “reset”?

The first step is the same as what you’ve heard about other personal challenges that might occur in your life: You must understand and admit that you have a problem.

So that’s where I began. The morning after the hospital incident, I was sitting alone in a quiet room thinking about the experience and about the ramifications for my life and my family’s life if things didn’t go well for me that night. I thought about the complexities of the past few years, the passing of my parents, my wife and kids and our future, and then the epiphany hit me like a bat to the head. I said to myself “I can’t go on like this. I have to fix this.” And thus my journey to reset myself began right in that moment…

That’s the beginning of this story. In Part 2 of this series, I’ll focus on the specific steps that I took to get started with my de-stressing process. I’ll explain how I calmed my mind and daily life, and how I proceeded through 2020 resolving and/or modifying one thing at a time until I was feeling better. It’s a mindful and iterative process of soul-searching and adjusting in which you must be brutally honest with yourself about…everything. For sure though, it’s something that you can definitely do for yourself if you consistently focus energy on it over a sustained period of time.

Stay tuned for more, and if you think this series of articles might help someone you know, please forward this link to them so they can follow along too. Thanks!

Wear a face mask correctly for the most benefit

Wearing masks wrong puts you and others at greater risk

Correct positioning of a face mask.
Image from the Centers for Disease Control

I haven’t written a lot about COVID-19, and I don’t really plan to. I’m trying to remain positive and move forward throughout the crisis, so the articles I’m drafting to post here are about other things that are uplifting to me. But I’ll make a short exception here.

We’re five months into COVID-19 at this point, and I still see people wearing face masks incorrectly every day in the media. I figure now is as good a time as any to write a quick post about it.

If even one person reads this post and realizes that they’re wearing their mask incorrectly or they learn the importance of masks from the linked BBC article below, then it has done its job.

Ironically, the people who are wearing masks wrong are actually trying to do some good. They put the mask on in the first place, right? Unfortunately because the masks sometimes don’t come with instructions (or the person made their own mask), maybe they just don’t have the fit concept quite right.

For details on how and why everyone wearing masks helps the overall COVID-19 situation, check out this thorough BBC article.

I read the NY Times often and generally find it to be a good source of content except for the occasional errant fact here and there, which most media sources have these days. Today they published an article that’s an example of something that should have been caught and corrected before publishing. The article was about the good work a delivery person is doing in their community, but every picture of the worker in the article showed her using a face mask that’s only covering her mouth and chin. Her nose is uncovered.

While I most certainly commend the worker in the article for what she’s doing and also for making the effort to wear a mask (both of which are good things!), the Times should not have used photos showing incorrect usage of protective equipment. The article will be seen by many people who might now erroneously conclude this is an acceptable way to wear a mask. I saw similar photos in articles from two other reputable sources this weekend as well.

What simple steps could have been used to correct this situation?

  • Companies large and small should issue employee communications about how to wear masks correctly.
  • The photographer who took the pictures should have helped the woman and informed her that she was wearing the mask incorrectly. She then could have put it on properly before the photos were taken.
  • Media editors should prevent photos showing improper use of protective equipment from being used in their stories.

Working together we can help correct misinformation that circulates about personal safety during COVID-19. Everyone has to do their part to help the bigger picture, so I’ll do my small part here.

Proper fit

To see how to wear a mask correctly, refer to the CDC image above and check out the photos below showing the right and wrong ways.

You should adjust the fit of your mask so that it completely covers your nose, mouth, and chin area. Anything else is wrong and therefore less effective.

CORRECT fit with nose, mouth, and chin area covered.
Incorrect fit, the nose is uncovered.
Incorrect fit, the chin area is uncovered.
Incorrect fit, and if you can’t see why then just don’t go outside. 🙂

Sum it up

Obviously the last photo above is just a bit of comic relief to an otherwise serious topic. Proper fit of your mask will help you and everyone around you stay a degree safer in these difficult times, and we should take whatever edge we can get. In many countries where masks are typically worn during illness, these practices are already part of their cultural and societal norms so they’re well aware of how to wear them properly. However, for those people less familiar with masks because this is new to them, hopefully this refresher helps.

Be safe everyone!