Welcome! I decided to create this website after spending 5 long, frustrating years searching for the answers I needed to address my complicated health issues. During this process, I found a significant lack of helpful, reliable, and accurate information online to help guide me to the right doctors and to the answers I needed.
Prior to becoming ill in 2011, I worked as a physician specializing in the care of patients with musculoskeletal injuries, Fibromyalgia, Chronic Fatigue Syndrome/Myalgic Encephalomyelitis, neck and back pain, and autoimmune related joint disease.
Though I learned a great deal about illness in my medical practice, being a patient gave me a new perspective. I now truly understand the frustration, loneliness, sadness, and anger often associated with the search for answers when dealing with complex medical issues.
As my health improved, it became clear to me that I needed to use my experience to create a platform to provide education, resources, tools, and inspiration for those struggling with challenging health issues.
One of my goals with this website is to help you navigate the often confusing world of healthcare. Some of the topics I will be generally covering are:
How to find compassionate, caring, and knowledgeable healthcare providers
How to prepare for your medical appointments
How to organize your thoughts to better explain your symptoms
Important questions to ask your doctor
How to be your own advocate without alienating your healthcare providers
Besides providing information about how to connect with the appropriate healthcare providers and ways to maximize the care you are receiving, I will also be sharing insight on how to more effectively manage illness, including:
Potential nutritional and environmental aspects that could be making your illness worse
Balancing traditional medicine and complementary medicine
How to understand the cycle of illness and why food, stress, and sleep affect it
Another goal is to provide you with tools and resources to help create a more joyful life despite dealing with the challenges of illness. Some of the topics will include:
Inspirational stories from those learning to manage their complex health issues
Tips for creating joyful moments in spite of your health struggles
As you can see, there is a lot of information I want to share with you. Each article I publish will provide practical strategies to help you create a healthier and happier life. Now let’s get started!
Disclaimer: The information contained on this site is intended for educational purposes ONLY and is not a substitute for advice, diagnosis, or treatment by your physician. It is not meant to cover all possible precautions, drug interactions, circumstances, or adverse effects. You should seek prompt medical care for any health issues and consult your doctor before taking supplements or making a change to your medications, diet, or exercise regimen. Read our full disclaimer.
Neck pain has been one of the most common medical issues I’ve seen in my clinics over the years, only second to low back pain. In the thousands of people I’ve treated, two factors almost always contribute to neck pain, no matter how abnormal the x-ray or MRI: (1) abnormal spinal alignment, and (2) poor muscle mechanics. Fortunately, these two issues can be managed easily with proper activity modification, stretching, and strengthening exercises.
How Abnormal Spinal Alignment and Poor Muscle Mechanics Contribute To Neck Pain
One of the key factors in managing your neck pain is learning how to keep your spine in a neutral position. A neutral spine begins with the position of your feet. When standing, your hips should be aligned with your ankles, shoulders aligned with your hips, and ears aligned with your shoulders (see the illustration below).
Your head should not be tilted backward or far forward (a slight forward tilt is fine). Your head/chin should not protrude forward. Your shoulders should be relaxed and not rounded in a slouching position or elevated in a tensed position.
Photo Source: Shutterstock
A neutral spinal alignment triggers contraction of the muscles that do not fatigue easily and rarely contribute to pain. If your spine is not in a proper alignment, the muscles that are activated are ones that fatigue easily, leading to muscle pain, cramps, soreness, stiffness, tightness, and even headaches.
Changing How You Do These 8 Activities Could Reduce or Even Eliminate Your Neck Pain
The activities you do every day can play a big part in your neck pain. Small changes to your spinal alignment (posture) and muscle mechanics could make a huge difference in your neck pain and quality of life.
Sitting
Photo Source: Shutterstock, By Inspiring
If your low back is not properly supported while sitting, your upper back tends to slouch which is a common cause of neck, shoulder, and upper back pain.
Solution
Use a supportive chair that has lumbar and mid-back support (a lumbar cushion may be needed)
Sit with your hips as far back on the chair as possible
Keep your shoulders down, back, and relaxed (not slouched or tensed)
If using a chair with a headrest, make sure it does not tilt your head forward or backward
Center your chair so you avoid turning your head to the side for an extended period of time
When your TV is placed above a fireplace or high on a wall, you usually have to tilt your head backward to view it.
When watching TV, you should be able to sit with your chin parallel to the floor or even tilted slightly downward. Your eyes should be able to comfortably view the entire TV in this position.
Solution
Lower the position of your TV so you can view it easily without tilting your head backward
Center the TV in front of your viewing area
Sit with your hips as far back as possible on the couch/chair to avoid slouching
Sit upright with the low back and mid-back supported (a lumbar cushion may be helpful)
Keep your shoulders down, back, and relaxed (not slouched or tensed)
EXTRA TIP FOR THOSE WITH CHRONIC ILLNESS: It can be very tiring to sit for extended periods of time when you have a chronic illness. Sitting with pillows supporting your arms and a pillow supporting your head can help reduce fatigue.
Using a Computer
Photo Source: Thinkstock
Your eyes are most comfortable when looking slightly downward at a computer screen. If your computer screen is positioned too high, your neck will tilt backward and can cause eye strain, neck pain, upper back pain, and shoulder pain.
If your shoulders are not supported in a relaxed position, your muscles will fatigue quickly which can trigger upper back, shoulder, and neck pain, as well as headaches.
Solution
Monitor Position
Position the top of the monitor slightly below your line of eyesight (even lower if wearing bifocals)
Keep your head in a neutral position with your chin parallel to the floor or slightly tilted downward
Center the monitor in front of you, so your neck is not turned for an extended period of time
Keyboard and Mouse Position
Adjust the keyboard height so that your shoulders are relaxed, your elbows are at an approximately 90-degree angle, and your wrists and hands are in line with the keyboard
Keep the computer mouse as close to your body as possible so your shoulders stay relaxed (consider using an ergonomic keyboard which is tilted in the middle to allow a more natural position of your wrists)
Chair Position
Use a supportive chair that has lumbar and mid-back support (a lumbar cushion may be needed)
Sit with your hips as far back on the chair as possible
Position your hips in line with or slightly higher than your knees
If your feet do not touch the ground comfortably, consider using a footrest
Keep your shoulders down, back, and relaxed (not slouched or tensed)
In addition to the above tips, if you are using a laptop, make these additional modifications:
Use a laptop stand so the screen is properly placed slightly below eye level
You may need to use a separate keyboard to keep your shoulders relaxed
Sleeping
Photo Source: Shutterstock
Neck pain is common if the spine is not in a neutral position while sleeping. Your neck/head should not tilt upward, downward, or to the side.
Solution
Your mattress should support your entire spine and keep it in a neutral position (click here to learn more)
Make sure your pillow completely fills the gap between your neck and the mattress to support your neck and keep it in a neutral position (click here to learn more)
You may need additional cushions to keep your entire spine in a neutral position (see the illustration above)
Avoid sleeping on your stomach because it flattens the natural curve of the spine and puts additional strain on your neck and back
Most of us don’t realize how poor our posture is while using our phones, tablets, etc. Because we use these devices often, they are a common contributor to neck, shoulder, and upper back pain.
Solution
Be mindful of your neck position
Do not tilt your head to the side, backward, or too far forward
Keep your shoulders down, back, and relaxed (not slouched or tensed)
Consider a headset or other hands-free option if needed
EXTRA TIP FOR THOSE WITH CHRONIC ILLNESS: It can be easier to keep your spine neutral if you talk on the phone while lying down with a pillow supporting the arm holding the phone. This position also makes talking on the phone less tiring.
Washing and Drying Your Hair
Photo Source: Shutterstock, By AnastasiaSonne
It is common for those of us with long hair to wrap our hair up into a towel to help it dry. If you use a regular bath towel, this is often too heavy for those with neck issues. Also, if you use a blow-dryer, you may have to tighten and elevate the shoulders to carry the weight of the dryer.
When squeezing the shampoo/conditioner bottle, if your hand is facing downward, there is a natural tendency for the elbow to lift away from the body and the shoulder to elevate which contributes to neck and shoulder pain. You can avoid this issue by squeezing these bottles with the palm facing upward.
Consider buying a lightweight blow dryer and be mindful of your arm position while using it
When washing or blow-drying your hair, be mindful of how long you let your head stay in one particular position (any position for too long, other than neutral, can cause pain)
When squeezing shampoo/conditioner bottles, make sure your palm is facing upward to prevent activation of the shoulder muscles
EXTRA TIP FOR THOSE WITH CHRONIC ILLNESS: Washing hair can be one of the hardest things to do for those with chronic illness. Using a shower chair can help reduce fatigue from this activity.
Driving
Photo Source: Thinkstock
It is very common when driving to tighten and elevate the shoulders, especially if feeling stressed. This position causes significant strain on your neck and upper back muscles.
Solution
Consider the use of a lumbar cushion to better support the spine
Sit with your hips as far back on the car seat as possible
Keep your shoulders down, back, and relaxed (not slouched or tensed)
Carrying a Briefcase, Backpack, Packages, or Purse
Photo Source: Shutterstock, By Andrii Bezvershenko
There is a natural tendency for the body to tilt towards the object being carried, especially if it is heavy. This puts stress on your spine and on the shoulder carrying the object.
Solution
Try to keep your spine centered despite the uneven weight you are carrying
Consider regularly switching the briefcase, package, or purse from side to side
If carrying multiple packages, evenly disperse them between both of your hands
If using a backpack, place both straps over both shoulders, instead of one strap over one shoulder
Keep your shoulders down, back, and relaxed (not slouched or tensed)
Summary
You probably noticed three key recommendations repeated throughout this article. They are essential to understanding how to reduce your neck pain through using neutral spinal alignment and good muscle mechanics.
The position of your low back and mid back affects the position of your upper back, shoulders, and neck.
Be mindful of your spinal alignment. Keep your neck in line with the rest of your spine (neutral alignment), your ears in line with your shoulders, and your chin parallel to the floor or slightly tilted downward.
Avoid slouching or tensing your shoulders by keeping them in a relaxed, down, and back position.
You can teach your body to make these changes automatically by being mindful of your body position and making the appropriate changes to reduce stress on the back, neck, and shoulders. In time, the proper muscles will get used to being activated, and maintaining these positions will get easier and easier.
[If you have difficulty making these changes on your own, consider working with a Physical Therapist who specializes in spine care.]
My family was plunged into the long, unending, mind-bending rabbit hole of chronic Lyme disease in the fall of 2012. As soon as we entered, we knew that nothing – and I do mean nothing — would ever be the same.
This Rabbit Hole Called Chronic Lyme Disease
Looking back at my son’s health history, he began to show signs of this disease in his last semester at college. Some emotional dysregulation (for a guy who is always calm and grounded). Outsized anxiety. Rapid hair loss. But we explained it away as situational –– a stressful transition from campus life to adult life in NYC.
Now, of course, I know better.
I now know that his immune system was compromised back then, accounting for those early, subtle signs. He could have been bitten by a Lyme-carrying tick in college. Or he could have been bitten during his teen years at camp. We’ll never know. In fact, the majority of chronic Lyme sufferers never see the tick that bites them.
For years now, I’ve been his research partner on this medical odyssey, learning, seeking, and trying to make some sense of his condition. Years into this rabbit hole of research and misinformation and medical conundrums, we continue to work side by side to help him fully recover his health.
Why is it that we had to figure it out on our own?
That’s easy to answer. Because mainstream medicine, for forty years, has chosen to believe that there is no such thing as chronic Lyme disease. As their rhetoric goes, ‘Lyme disease is nothing more than a nuisance condition that can be treated easily with a few weeks of antibiotics. And then, you’re good as new.’
Nothing – and again I do mean nothing – could be further from the truth.
Lessons Learned from Chronic Lyme Disease
What I’ve learned in the years that have followed, in the co-navigation of my son’s medical odyssey, in all the research I did for my newly published book Lyme Madness, in my daily work as a global activist for this cause, only one thing is certain. That what most of our doctors know about Lyme disease is driven by a forty-year foundation of falsehoods.
What I’ve learned is so multi-layered, complex, overwhelming, and headshaking that it became the driving force behind my book. I wanted to spread this message far and wide so that others wouldn’t have to suffer as my son did. And not feel so alone.
What I know for sure:
Chronic Lyme disease is EASY to catch, DIFFICULT to diagnose, and VERY DIFFICULT (and costly) to treat.
It is often a ‘do-it-yourself disease’ (as coined by Kris Newby of Under Our Skin documentary fame), requiring you to be your own neurologist, microbiologist, rheumatologist, cardiologist, nephrologist, internist, researcher, sleuth, and more.
Doctors who ‘believe’ in chronic Lyme disease and are willing and able to support this community are difficult to find. But they are out there and for that, we’re very grateful.
Chronic Lyme disease sufferers are victimized every day…in so many ways
by the disease itself
by doctors who turn their backs
by loved ones who roll their eyes and walk away
by insurers who refuse to provide coverage
by the CDC and IDSA who together say that chronic Lyme does not exist
How to Adopt a Mindset of Strength and Empowerment
Lyme sufferers don’t want to remain victims. Who really does? What they want is for someone to listen, to care, to understand, to offer viable solutions, to help them get better. As human beings, we are wired to thrive, not merely survive.
So how does a Lyme sufferer relinquish a victim mindset and adopt one of strength and empowerment when struggling with a disease that affects mood and cognition, and wreaks havoc in so many ways? How does someone live every day experiencing pain, disease, and suffering, and not let their anger and outrage destroy them?
It’s not easy. But finding space for hope and comfort is necessary.
Seek out a medical professional who actually ‘gets it’ and cares. Granted, these doctors can be hard to find, but they are out there – they do exist.
Ask your loved ones to read or watch a good resource or two on what it feels like to have chronic Lyme so they can step into your shoes for just a moment.
Know that as much as there are seemingly immovable obstacles preventing you from getting well; there are new ideas, research, and protocols being pursued to help you find relief.
Realize there is tremendous power in connection. Dr. Edward Hallowell calls it a big dose of Vitamin ‘C’ — a vital prescription that can open your heart and deepen your soul. Find ways to connect with others who ‘get it’ so you will feel less alone. The loneliness and isolation of living with chronic Lyme can sometimes be as painful as the disease itself. Look for ‘in-person’ and/or ‘on-line’ support groups with people who are there to help you, who are open to sharing and supporting your pain and suffering.
My way of coping, of staying ‘sane’ these past several years has been to write Lyme Madness. It has provided my son and me with the power of connection and community with other Lyme sufferers. It has helped us find a way out of this rabbit hole, together, so we can graciously carry the grief that persists.
Don’t let the multiple layers of chronic Lyme disease keep you from finding the support and care you need. Support, care, and connection are your human rights and can be yours in places you haven’t yet discovered.
Keep looking for the light in the darkness. Believe it or not, it’s always there.
Photo Source: ThinkStock
Disclaimer: The information contained on this site is intended for educational purposes ONLY and is not a substitute for advice, diagnosis, or treatment by your physician. It is not meant to cover all possible precautions, drug interactions, circumstances, or adverse effects. You should seek prompt medical care for any health issues and consult your doctor before taking supplements or making a change to your medications, diet, or exercise regimen. The views and opinions expressed in this article are those of the author and do not necessarily reflect those of Mastering Health & Happiness or Amy Stenehjem, M.D. Read our full disclaimer.
Lyme disease is an infection caused by Borrelia burgdorferi, a corkscrew-shaped bacteria called a spirochete (pronounced spy-ro–keet). Lyme disease is transmitted to humans through the bite of a tick carrying the bacteria.
Lyme disease is surrounded by misinformation and lack of understanding, both in the medical community and in the general population. An undiagnosed or undertreated infection can result in chronic, debilitating symptoms.
The purpose of this article is to dispel common myths about Lyme disease and to spread awareness of this serious and misunderstood illness.
Lyme Disease: 13 Common Myths
Myth #1: Lyme Disease is Rare
According to the Centers for Disease Control and Prevention (CDC), Lyme disease is the fastest growing Vector-Borne Disease in the United States.1 The CDC estimates 329,000 new cases of Lyme disease are diagnosed each year, 10 times more than previously thought. 23
Image Source: Bay Area Lyme Foundation
Myth #2: Lyme Disease is Only an East Coast Problem
“The recent confluence of environmental, ecological, sociological, and human demographic factors has created a near ‘perfect storm’ leading to more ticks in more places throughout North America.”
In the last ten years, ticks carrying Lyme disease have been reported in all 50 states, with the highest numbers in Connecticut, Rhode Island, Maryland, New Jersey, Massachusetts, New York, New Hampshire, Pennsylvania, Maine, Delaware, Virginia, Vermont, Wisconsin, and Minnesota.456
Myth #3: You Can Only Get Lyme Disease in a Wooded Area
You don’t need to be hiking in the woods to contract Lyme disease. Ticks can be found wherever there is grass or vegetation, including your backyard. Though the adult tick’s preferred host is deer, the immature nymph tick, responsible for the majority of cases of Lyme disease in humans, feeds on a wide range of small animals, including mice, birds, and squirrels.7
For example, the map below illustrates the tick-borne disease risk in the counties of Minnesota. Notice, there is a moderate to high risk of infection within the city limits of Minneapolis/St. Paul.
Myth #4: You Can Only Get Lyme Disease in the Summer
The adult stage deer tick actually begins its feeding activity around the first frost, and will latch onto any larger host (cat, dog, or human) whenever the temperature is near or above freezing. 89
Myth #5: You Will Know if You Have Been Bitten By a Tick
According to the International Lyme and Associated Disease Society (ILADS), fewer than 50% of patients with Lyme disease recall a tick bite. Research from Georgia Southern University revealed only 4% of those infected were aware of a tick bite.10
A bite often goes unnoticed due to the pain killers secreted in the tick’s saliva and the tiny size of the nymph tick, which is no bigger than a poppy seed.
Picture of a Nymph Tick, Image Source: LymeDisease.org
Myth #6: Everyone Infected Gets the Telltale Bull’s-Eye Rash
According to the CDC, a rash only occurs in approximately 70-80% of those infected, and even fewer have the classic bull’s-eye rash, erythema migrans (EM).1112 A 2010 study in Maine revealed only 43% of Lyme patients exhibited the bull’s-eye rash. 13
It is important to note that there are many different types of rashes that can be seen with Lyme disease. These rashes can be mistaken for spider bites or skin infections.
Example of the classic bull’s-eye rash, Image Source: CDC
Myth #7: Doctors Agree on How to Diagnosis and Treat Lyme Disease
“The Lyme disease infection rate is growing. So is the battle over how to treat it.”
There is significant controversy regarding Lyme disease. Two medical societies hold widely different views on the disease, making it difficult for patients to receive the medical care they deserve. 14
One medical society, the International Lyme and Associated Diseases Society (ILADS), regards Lyme disease as often difficult to diagnose and treat. In contrast, the Infectious Diseases Society of America (IDSA), regards Lyme disease as relatively rare and easy to cure. This group also denies the existence of chronic Lyme disease.
If you have symptoms of Lyme disease, it is important you consult a Lyme disease specialist (called a Lyme Literate Medical Doctor or LLMD). Recognize that opinions on how to diagnose and treat Lyme disease vary widely even among LLMDs, so it is worth getting a second or even a third opinion to find the Lyme specialist who best fits your needs.
Myth #8: Traditional Lyme Disease Testing is 100% Accurate
There are many different types (species and strains) of the Borrelia bacteria which may be missed with mainstream testing.15 Also, Borrelia has the ability to change its physical characteristics which can make it invisible to the immune system, unresponsive to treatment, and undetectable on diagnostic tests.
The current mainstream testing for Lyme disease can miss more than 35% of those infected.16 Because of the inaccuracy of Lyme testing, diagnosis should not be based on testing alone. Lyme disease is a clinical diagnosis which should be based on your medical history, symptoms, and exposure to ticks.
Myth #9: Lyme Disease is Easy to Diagnose
Similar to its “cousin” Syphilis, Lyme disease is called “The Great Imitator,” because it can mimic many other diseases. Those with Lyme disease can be misdiagnosed with a variety of conditions including Chronic Fatigue Syndrome, Fibromyalgia, autoimmune disease, depression, anxiety, and neuropathy.
In addition to the Lyme bacteria, ticks can carry other bacteria, viruses, and parasites. These separate infections, called co-infections (contracted from the same tick bite), can cause a variety of symptoms, making diagnosis even harder to obtain.
Myth #10: Traditional Antibiotic Treatment Cures Lyme Disease
Persistent or recurrent symptoms of Lyme disease have been reported in up to 40–50% of patients on the typical 2-4 week course of antibiotic treatment. 17
Lyme disease may linger because of “persister cells,” that manage to survive a short course of antibiotic treatment by going into a dormant state or by masking their presence.18192021222324
Myth #11: Treatment for Lyme Disease is Always the Same
No single treatment protocol works for everyone. Lyme disease and its related co-infections can react with the body in various ways. Treatment options should always be discussed in depth with a LLMD.
Myth #12: Chronic Lyme Disease Does Not Exist
If Lyme disease is not diagnosed and treated early, the Lyme bacteria can spread, become harder to detect, and prove less susceptible to antibiotic treatments. Weeks, months, or even years later, symptoms may develop, including severe fatigue, headaches, cognitive dysfunction, and pain. 2526282930313233343536373839404142434445464748
“The bacterium at the root of Lyme disease, Borrelia burgdorferi, is an organism with a remarkable ability to mask its presence so that it won’t be attacked by the human immune system.”
Even though Lyme disease is the fastest growing Vector-Borne Disease in the United States, it is significantly underfunded relative to other comparable and less common illnesses.4950
Image Source: Bay Area Lyme Foundation
Summary
Lyme disease is a misunderstood epidemic surrounded by controversy within the medical community, making it very difficult for those infected to find proper treatment. This has led to a widespread, alarming rate of very sick people struggling with an undiagnosed debilitating disease.
There is a dire need for further research to help explain the complexities of this very complicated disease and to develop accurate and universal screening tests for all stages of Lyme disease and its associated co-infections.
Physicians should be willing to treat their patients’ symptoms rather than relying strictly on unreliable diagnostic tests and outdated medical guidelines.
“While great strides have been made in understanding and treating Lyme, little about the disease has ever been simple or straightforward.”
Disclaimer: The information contained on this site is intended for educational purposes ONLY and is not a substitute for advice, diagnosis, or treatment by your physician. It is not meant to cover all possible precautions, drug interactions, circumstances, or adverse effects. You should seek prompt medical care for any health issues and consult your doctor before taking supplements or making a change to your medications, diet, or exercise regimen. Read our full disclaimer.
Learning to cope with chronic illness has been very difficult. Nothing in my life prior to 2011 prepared me for this experience. I have learned a lot, and am continuing to learn. These strategies have helped me live a more joyful life despite being faced with many challenges.
Be Kind To Yourself
First of all, be kind to yourself. It is important to realize having a chronic illness does not mean you are weak or deserve to be sick. You are special and important. Your value is not measured by your health, intelligence, appearance, or energy level.
Don’t blame yourself for flare-ups of your symptoms. It takes time to understand your body and to learn how to best manage your illness.
Create a list of relaxing activities you enjoy. Include activities you can perform with very little physical and mental effort.
Each day, try to make time for at least one of these activities. This will help you refocus your mind on something positive and give you a break from the daily frustrations of your illness.
Here are few ideas:
listen to your favorite music
listen to a book on tape
do some gentle stretches, yoga, tai chi, or qi gong
It is important you realize you are not alone and others understand your situation. Many churches, hospitals, and community centers have support groups for those dealing with chronic illness. Also, my husband and I found Facebook support groups to be extremely helpful.
Consider talking with a counselor. You don’t have to be depressed or anxious to find benefit from a therapist. Ask your health care provider for a recommendation or visit Psychology Today.
Let others help you. If you do not know someone who can help, contact your local church or community center to find services that may be available in your area. Also, your doctor can determine if you qualify for a home health aide or other helpful services.
Stop Comparing Yourself To Others
It can be difficult to watch people living what appear to be full and vibrant lives, while you are learning to cope with a chronic illness. Remember, we never really know what burdens are carried by those around us. Comparing yourself to others is a waste of time and will yield nothing positive.
“Comparison is the thief of joy.”
-Theodore Roosevelt
Learn To Pace Yourself
One of the key factors in learning to cope with chronic illness is understanding how to pace yourself. Those with chronic illness have a limited amount of energy available each day, and it takes time to figure out what and how often certain activities can be tolerated. [I recommend you take a moment to read Christine Miserandino’s personal story, Spoon Theory, a wonderful article for those with chronic illness.]
Disclaimer: The information contained on this site is intended for educational purposes ONLY and is not a substitute for advice, diagnosis, or treatment by your physician. It is not meant to cover all possible precautions, drug interactions, circumstances, or adverse effects. You should seek prompt medical care for any health issues and consult your doctor before taking supplements or making a change to your medications, diet, or exercise regimen. Read our full disclaimer.
Chronic illness and poor sleep go hand in hand. Many people with chronic illness suffer from debilitating fatigue. To make matters worse, they often sleep poorly and do not get the restorative sleep their bodies require.
Also, poor sleep has been linked to the development of a number of chronic diseases and conditions (including diabetes, cardiovascular disease, obesity, and depression) and should be addressed no matter your health status. 4144546474951
Common Causes of Poor Sleep
A Disruptive Sleep Environment
A deep, restorative sleep is best achieved in a cool, dark, and quiet environment. You can create this setting by doing the following:
Most people sleep best in a cool room with temperatures set between 60 and 72 degrees Fahrenheit. (According to the National Sleep Foundation, the ideal bedroom temperature is around 65 degrees.) If your significant other prefers a warmer sleep environment, there are specialized pillow cases, bedding, and fans that can keep you cool while not disrupting his/her sleep.
Some people experience extreme swings in body temperature at night and do best if they have multiple blankets nearby which can be easily added or removed throughout the night.
If you experience night sweats, consider using bedding and clothing that wick away moisture from your skin.
It is best to sleep in a dark room. This is particularly important for those with chronic illness who require naps during the day. A dark room can be achieved with block-out shades and/or curtains. If these are not available, an eye mask can be helpful.
It is important your sleep environment is free from disruptive sounds. A white noise sound machine or a fan can help reduce disruptive sounds. I use a Marpac Dohm DS Sound Machine which is the Official Sound Conditioner of the National Sleep Foundation. It is customizable and allows you to change the intensity and tone of the sound.
Poor Bedroom Ventilation
Fresh air with adequate oxygen is needed for restorative sleep. You can improve the quality of the air you breathe while sleeping by doing the following:
Try every day to open a bedroom window for a few minutes and/or use a fan to circulate fresh air.
Don’t sleep with bedding covering your mouth/nose which can create a collection of exhaled air which is not healthy to rebreathe.
An Overstimulated Brain
Your brain produces hormones to help regulate your sleep-wake cycle (circadian rhythm). These hormones tell your brain to stay awake and are triggered by anxiety, stimulants, physical and emotional stress, and exposure to sunlight and artificial light.
Artificial blue light emitted from laptops, tablets, and cell phones simulates sunlight and can confuse your brain into thinking nighttime is daytime. 52535455
Consider running a diffuser with calming essential oils (e.g. lavender) 30-60 minutes before going to bed. 5758
Drink warm milk or herbal tea about an hour before going to bed
Take a warm bath before going to bed
Retraining your sleep-wake cycle
Use blue light reducing software on your electronics. Or better yet, turn off your electronics at least an hour before going to bed. (Install f.lux on computers and Windows/Android devices. Use Night Shift on Apple devices.)
Use low-watt light bulbs in your bedroom.
Stick to a regular sleep schedule as much as possible. This can train your brain into a regular sleep rhythm.
Most of us with chronic illness get very little sunlight. Try to expose yourself to sunlight 15-20 minutes every day. This is most helpful if done in the morning because it tells your brain it is daytime and time to wake up.
If you have difficulty waking up in the morning, consider trying a sunrise alarm clock. 59
Avoiding foods, drinks, and chemicals that stimulate the brain
Avoid caffeine, alcohol, nicotine, and other chemicals that interfere with sleep. Many people with chronic illness are ultrasensitive to caffeine and even drinking a small amount in the morning can affect sleep at night.
Limit sugar intake, especially in the few hours before bedtime.
Avoid eating large meals before going to bed. However, a small bedtime snack consisting of a healthy fat and a carbohydrate can help prevent a blood sugar drop and early morning awakening. (Tip from my favorite nutritionists at Nutritional Weight and Wellness.)
Pain can make it difficult to fall asleep and stay asleep. Also, poor sleep can make the body more sensitive to pain, creating a vicious cycle. One of the best ways to reduce pain at night is to make sure your body is properly supported by your mattress and pillow(s). You can properly support your spine and joints by doing the following:
Using a supportive mattress
Mattresses with obvious dips and defects are usually not supportive enough for your body and likely indicate it’s time for a new mattress. Most experts say a mattress’s lifespan is 7-10 years.
In general, most people prefer a medium-firm mattress. Lying on your back with a pillow under the knees is usually the most comfortable position. If you have severe low back pain, consider placing another small pillow under your low back.
If you do a lot of side-lying and have hip, knee, shoulder, or elbow pain, consider adding padding on top of your mattress and use a body pillow between your legs and arms to keep your spine from rotating. You may also benefit from a small pillow under your waist.
Some people, especially those with disc-related low back pain, feel most comfortable sleeping on the stomach, on a firmer mattress with a low-profile pillow under the abdomen. (Otherwise, I don’t recommend sleeping on your stomach because it flattens the natural curve of the spine and puts additional strain on your back and neck muscles.)
When purchasing a new mattress, make sure you try out various mattresses at the store, and confirm the return policy allows for at least a 30-day trial period.
Making sure your pillow supports your neck
Even if you don’t have neck pain, a supportive pillow is a must. The pillow should keep your head in alignment with your spine (see illustration). You don’t want a pillow that is too big or too flat.
If you sleep on your side, your pillow should fill the gap between your mattress, head, neck, and shoulders. Check out this helpful guide: pillows for side-sleepers.
If you sleep on your back, you should sleep on a thinner pillow with extra padding on the lower third of the pillow to fill the gap between your neck and the mattress.
Those with neck pain should avoid stomach sleeping.
When purchasing a new pillow, make sure you are able to return it if it does not work for you.
Important Note: Some people with chronic illness are sensitive to the chemicals released by new products (off-gassing). If this is a concern for you, make sure to ask about this issue before purchasing a new mattress or pillow.
Photo Source: Shutterstock
An Undiagnosed Medical Issue Causing Poor Sleep
If the above tips aren’t helpful, you should schedule an appointment with your doctor to discuss your sleep. Some medications can disrupt your sleep and the dosing schedule may need to be modified by your doctor. Also, there are medical conditions (i.g. Obstructive Sleep Apnea, Restless Legs Syndrome, REM sleep disorder, thyroid disease, allergies with post-nasal drip, lung disease, heartburn, indigestion, hormonal changes) that can interfere with sleep. Your doctor may refer you to a sleep specialist who can perform a sleep study to identify the cause of your poor sleep.
Summary:
These practical tips can help improve the quality of your sleep so your body has more time to repair itself and restore depleted energy levels.
Disclaimer: The information contained on this site is intended for educational purposes ONLY and is not a substitute for advice, diagnosis, or treatment by your physician. It is not meant to cover all possible precautions, drug interactions, circumstances, or adverse effects. You should seek prompt medical care for any health issues and consult your doctor before taking supplements or making a change to your medications, diet, or exercise regimen. Read our full disclaimer.
The brain and gut appear to communicate with each other in various ways including the enteric nervous system (ENS), often called the “second brain” or gut-brain axis.
Important research shows an unhealthy gut and decreased numbers of good gut bacteria may have a direct impact on your overall health.
Protecting the lining of the intestinal tract and increasing the number of healthy bacteria in your gut could improve your health and well-being.
In the 1700s, Jean-Jacques Rousseau, the acclaimed French philosopher and writer, recognized the possible link between digestion and overall health, defining happiness as “a good bank account, a good cook, and a good digestion.”
“ALL DISEASE BEGINS IN THE GUT.”
-HIPPOCRATES
Good Bacteria: The Link Between Your Digestion and Overall Health?
Your digestive tract is home to billions of good bacteria which help prevent the overgrowth of harmful organisms such as bad bacteria, yeast, and parasites.
For years it has been well understood that the good bacteria in your digestive system help your body digest food and absorb nutrients.
Promising research reveals that decreased amounts of good gut bacteria may contribute to health issues ranging from inflammation606162
The brain and gut appear to communicate with each other in various ways including the enteric nervous system (ENS), often called the “second brain” or gut-brain axis. 63
When the number of good gut bacteria decreases, there are, according to research, signals sent from the gut to the brain which could affect brain function. 646566
Jay Pasricha, M.D., director of the Johns Hopkins Center for Neurogastroenterology, states, “For decades, researchers and doctors thought that anxiety and depression contributed to these [gastrointestinal] problems. But our studies and others show that it may also be the other way around.”
“Our two brains ‘talk’ to each other, so therapies that help one may help the other,”
-Jay Pasricha, M.D
Good Bacteria and A “Leaky Gut”
It is well known the lining of the intestinal tract (mucosa) can be damaged by irritants including NSAIDS (nonsteroidal anti-inflammatory drugs, i.g. ibuprofen and naproxen) and alcohol.
Some doctors also think it can be damaged by artificial sweeteners, processed foods, refined sugar, foods that commonly produce sensitivities (including gluten, dairy, and soy), and antibiotics which can disrupt the balance of good gut bacteria. 676869
When the intestinal mucosa is damaged, foreign substances may be able to enter the body and produce an inflammatory reaction. Good gut bacteria may help protect and repair the intestinal lining, preventing this abnormal immune response. 70
Specific Health Connections:
In the past few years, there has been a great deal of promising research showing a connection between decreased amounts of good gut bacteria and poor health. Here are a few of the areas being researched:
Mood
A large amount of the mood-altering neurotransmitter serotonin is located in the intestinal tract. Good gut bacteria likely plays a role in the production of this very important substance. 717273
Research out of Oxford shows supplements designed to boost the numbers of healthy gut bacteria may improve anxiety levels by changing the way information is processed. 74
Obesity and Appetite
Good gut bacteria may play an important role in the regulation of appetite and sensitivity to insulin which controls where fat is deposited in the body. 75767778
Immune Function
Gastrointestinal immune cells are likely a vital part of the body’s immune system. It appears that good bacteria interact with the immune system, providing signals to promote the normal development and function of immune cells. 79808182
Ground-breaking research suggests that important cells in the control of inflammation, naturalkiller T cells, are regulated by the good bacteria in the gut and the two-way communication between the body and the gut neurons, aided by good gut bacteria, likely plays a large part in preventing chronic inflammation. 83
Possible Ways To Increase Good Gut Bacteria and Improve Your Digestion:
[Before implementing any of these options, discuss them with your doctor to determine if they are appropriate for you.]
Add fermented foods to your diet. These promote the growth of good bacteria (includes plain yogurt/kefir with live and active cultures, sauerkraut, and kimchi).
Eat foods that act as a “prebiotic”- nondigestible foods that help healthy bacteria grow in the digestive system, such as asparagus, garlic, cabbage, beans, artichokes, legumes, onions, and bananas.
Remove or at least reduce those foods and substances that are contributing to irritation of the lining of the gut.
Take a probiotic. Probiotics provide live strains of good gut bacteria. Extra caution should be taken with children, the elderly, women who are pregnant or nursing, postoperative patients, and those with a compromised immune system (there have been reports of serious infections in these patients taking probiotics), and in those at risk for a blood clot, stroke, or heart attack. Also, some probiotics contain gluten.
Add zinc-rich foods to your diet. Good sources of zinc include beef, eggs, beans, and nuts. 8485
Consider starting a fish oil supplement which can reduce inflammation and may help heal the lining of the intestinal tract. 86 Because fish oil can reduce the body’s ability to clot normally, those taking any anticoagulant drugs, such as Coumadin (warfarin), who have had a hemorrhagic stroke, have a bleeding disorder, or are scheduled for surgery should not take fish oil, unless recommended by their physician. Also, those with a fish allergy should not take this supplement. Those with a soy allergy should look for a brand without soy. *Some people notice GI upset when first starting fish oil. This often gets better if you temporarily reduce the dosage, store the bottle in the freezer, and take it with meals. If GI issues continue, discuss this with your doctor.*
Summary:
There is exciting research that suggests a link between your digestion and overall health. Low levels of good gut bacteria may be associated with a number of medical issues, including obesity, anxiety, depression, allergies, asthma, autoimmune disease, and more.
Preventing damage to the lining of your intestinal tract and taking steps to increase the levels of good bacteria in your gut could make a difference in your overall health and wellbeing.
Disclaimer: The information contained on this site is intended for educational purposes ONLY and is not a substitute for advice, diagnosis, or treatment by your physician. It is not meant to cover all possible precautions, drug interactions, circumstances, or adverse effects. You should seek prompt medical care for any health issues and consult your doctor before taking supplements or making a change to your medications, diet, or exercise regimen. Read our full disclaimer.
Wouldn’t it be nice to feel optimism rather than frustration from doctor appointments? Being both a physician and a patient has provided me with insight into why medical appointments sometimes go poorly for patients and what steps can be taken to improve the outcome of these doctor visits.
The Reality of Modern Medicine
Most physicians work in a clinic setting and with insurance regulations that restrict the amount of time they have available for each appointment which poses significant challenges for doctors caring for patients with complex medical issues.
As a patient, there are a few things you can do to optimize the time you have available with your doctor which will give him/her more time to analyze your symptoms, create a treatment plan, and answer your questions.
If you feel too ill to work through the suggestions below, consider sharing this article with a friend or family member who can help.
How To Reduce Frustration From Doctor Appointments
Schedule Your Appointment At The Optimal Time
To avoid long wait times, ask for the first appointment of the day or the first appointment after the doctor’s lunchtime.
Doctor appointments can be extremely tiring for those with chronic illness. Make sure you schedule plenty of rest before and after the appointment.
Create A Current Medication List
The time needed for your nurse to review your medications can sometimes use up a portion of your medical appointment.An updated list will speed up this process.
This list should include:
the name of each medication (including over-the-counter medications/supplements)
the dose of the medication (often written in milligrams “mg” or micrograms “mcg” on your bottle)
how many pills of the medication you take each time
when/how often you take this medication each day
For example; “Zyrtec 10mg, one pill, every morning” (which equals 1 pill a day) or “Ibuprofen 200mg, two pills, twice a day” (which equals 4 pills a day).
Bring your medication list to all of your doctor appointments. If this is your first appointment with a particular doctor, it is a good idea to actually bring your bottles of medications for verification.
If changes are made by your doctor, make sure to update your medication list. For example, draw a line through any discontinued medication(s) and document the stop date(s).
Keep an updated medication list in your purse/billfold for emergencies.
Outline Your Symptoms
It is very important to prepare for each appointment by taking the time to outline your symptoms. This will help you answer your doctor’s questions with precise and accurate informationwhich in turn provides him/her with the information needed to more quickly get to the bottom of your medical issues.
A few days before your appointment, write down your answers to the questions below and review them the day of your appointment.
Use your own language when describing your symptoms. For example, if you feel dizziness, describe this sensation in your own words rather than using the word “vertigo” because vertigo may not be what you are actually experiencing.
Questions To Answer:
What are your main symptoms?
Which two or three of these symptoms are the most bothersome?
How do they affect your daily life? Work? Hobbies? Be specific.
For each of your symptoms, ask yourself these questions:
Approximately when did it start? Did it precede any other symptoms?
Can you think of anything that may have triggered it?
Has this symptom changed over time or since your last appointment?
How often does this symptom occur?
Does it appear to be associated with any other symptoms?
Is it constant or intermittent?
Is there anything that makes it better or worse?
If you have pain/discomfort, ask yourself these questions:
Where is it located? Does it travel to a different body part? (It is often helpful to point to the location of your pain during your appointment so your doctor can see exactly where it is located.)
Approximately when did it start?
Can you think of anything that may have triggered it?
Has it changed over time or since your last appointment?
How often does it occur?
Is it associated with any other symptoms?
Is it constant or intermittent?
Is there anything that makes it better or worse?
How severe is your pain? Be honest, and don’t minimize or exaggerate it. On a scale of 1-10, “0” is no pain and “10” is the worst pain you could ever imagine.
What type of pain are you experiencing? Here are a few examples:
Aching Pain (often a constant pain that may feel deep in your tissues, such as a toothache)
Dull Pain (often a constant pain which is not as severe as an ache)
Throbbing Pain (often a fairly constant pain that feels deep in your tissues and seems to almost have a heartbeat-like frequency to the pain)
Sharp/Stabbing Pain (an intermittent type of pain that feels like a sharp, quick, stab-like sensation and can be severe)
Cramping Pain (a pain that may come and go in waves and may feel like a squeezing sensation, such as abdominal, muscle, or menstrual cramps)
Burning Pain (often feels like a hot, searing type of pain)
Radiating Pain (a shooting, traveling pain which may be associated with tingling and/or numbness)
Pins and Needles (similar to the discomfort noticed when your leg “wakes up” after being “asleep”)
Have these symptoms/pain been previously evaluated by a doctor?
What tests were performed and what were the results? (bring a copy of the test results if possible)
What was the diagnosis? (bring a copy of the doctor’s note with the diagnosis if possible)
What treatments were prescribed? Did they help?
If you are attending a follow-up appointment, make sure to thoughtfully analyze how your symptoms may have changed since your last visit. Even if your symptoms have only slightly improved, it is important that your doctor is aware of this change which may indicate you are on the right path and more time or a more aggressive treatment is required.
Write Down Your Questions
Write down your questions, in order of priority. This will ensure your most important questions get answered. (Sometimes a follow-up appointment is needed to address additional questions.)
Make sure to write down a quick summary of your doctor’s answers to your questions so you can more easily remember them at a later date. Even better, bring a friend or family member to your appointments to take notes.
Do Not Diagnosis Yourself
Do not diagnosis yourself prior to your appointment.This may affect your ability to thoughtfully interpret and summarize your symptomsfor your doctor.
If there is a diagnosis you are concerned about, share this with your doctor. You can state something like this, “One of the things I have been worried about is _________. Do you have any concerns that this could be going on?”
Arrive Early For Your Appointment
Make sure you arrive 15-20 minutes early for your appointment (even if your doctor runs late). This provides enough time to fill out any clinic paperwork, review your answers to the symptom questions above, and for the nurse to “room” you (review your medication list and obtain your vital signs).
Make Sure You Understand Your Doctor’s Recommendations
Ask questions if you don’t understand something your doctor is recommending.
It can be helpful to repeat to the doctor (in your own words) what you think he/she is recommending. For example, you could say “Can I repeat what I think you are recommending to make sure I am understanding you correctly?” Then repeat to the doctor your interpretation of his/her recommendations. This will help to make sure you are both on the same page.
If any tests are ordered make sure you understand exactly how you will be notified of the results. In my opinion, it is best if you are notified by phone if there are any abnormalities/concerns. You should also receive a copy of the test result in the mail (even if the result is normal). Bring this copy to your next appointment so you can review the result with your doctor and confirm there is nothing more to address.
If a new medication is recommended, ask the following:
What condition(s) is it used for and what are you hoping it will do for me?
How do I take this medication? How much? How often? For how long?
Are there any side-effects I should be aware of? What do I do if I notice any of these side-effects?
Is this a type of medication that can be stopped abruptly or does it have to be tapered off?
Are there any potential interactions with this medication and my other medications?
Will any labs or other tests be needed in the future to monitor my body’s response to the medication? If so, how often?
At the end of your appointment, find out when your doctor wants to follow up with you and be sure to make that appointment before leaving the clinic.
Also, find out what symptoms or changes in symptoms would warrant a follow-up with your doctor earlier than scheduled.
Summary:
Most physicians work in a clinic setting and with insurance regulations that restrict the amount of time they have available for each patient appointment.
These seven tips can help optimize the time you have available with your doctor which will provide your doctor with more time to get to the bottom of your symptoms, create a treatment plan, and answer your questions.
Disclaimer: The information contained on this site is intended for educational purposes ONLY and is not a substitute for advice, diagnosis, or treatment by your physician. It is not meant to cover all possible precautions, drug interactions, circumstances, or adverse effects. You should seek prompt medical care for any health issues and consult your doctor before taking supplements or making a change to your medications, diet, or exercise regimen. Read our full disclaimer.
One of the most important things you can do to help your body function at its best is to avoid unhealthy foods; instead, eat foods that help your body reduce inflammation and provide proper nutrition.
There are many foods that may seem healthy, but if eaten incorrectly or in some cases consumed at all, only provide your body with unnecessary calories, sugar, and unhealthy fats.
Even though granola looks healthy, it is usually loaded with sugar and calories. Also, the serving size for granola is usually less than you would imagine, so your bowl of granola may actually equal 2-3 servings and 2-3x the sugar and calories.
A Better Option: Look for granola with whole grains, no artificial ingredients, and 7 grams or less of sugar per serving. Be mindful of the portion size and instead of pouring yourself a bowl of granola, use a small handful on top of plain yogurt or fresh fruit.
An Extra Tip: Sugar is one of the most unhealthy ingredients found in our modern-day diet. Research shows that it likely contributes to many health problems. The American Heart Association recommends limiting added sugar to no more than 24 grams per day for women and 36 grams per day for men.
Most nut and coconut milks have added sugar. Many companies also use a common food additive called carrageenan to create a creamier texture. Carrageenan can be found in many health foods and is thought to be associated with digestive problems, inflammation, and even autoimmune disease.
A Better Option: Look for unsweetened nut/coconut milks. Avoid all products containing carrageenan.
Recently, yogurt has been advertised as a “must eat” for those trying to eat healthier. Even though flavored yogurts have protein, calcium, and other nutrients, they are far from healthy due to their high sugar content.
A Better Option: Opt for plain, unflavored yogurt and add some fresh fruit or a drizzle of honey for added flavor.
(4) Multi-Grain and Wheat Bread
Photo Source: Graphic Stock
Many varieties of multi-grain or wheat bread are made of refined flours (also called bleached, unbleached enriched wheat flour, or all-purpose flour) which are stripped of their nutrients during processing.
“Now that trans fats are largely out of the food supply,” says David Ludwig, M.D., Ph.D., director of the New Balance Foundation Obesity Prevention Center at Children’s Hospital in Boston, “refined carbohydrates, including refined grain products, are the single most harmful influence in the American diet today.”
A Better Option: When buying bread, look for the words “whole grain” or “whole wheat” in the ingredient list. These grains are not stripped of their nutrients.
An Extra Tip: When you make the switch to whole grains, take it slow at first and drink extra water to help your body adjust to the increased fiber.
(5) Sports Drinks
Photo Source: Graphic Stock
Originally, sports drinks were created for elite athletes. They contain added sugar and electrolytes, which the average person doesn’t need in most situations. Also, some sports drinks are marketed as supplements, which means they are not regulated by the FDA.
A Better Option: Stick to water as your beverage of choice for hydration, unless you have special hydration requirements for your health (i.e. Postural Orthostatic Tachycardia Syndrome). If so, ask your doctor for his/her recommendations.
(6) Fruit Juice
Photo Source: Graphic Stock
While fruit juice has some vitamins, it also has lots of calories and sugar. Fruit in its whole form has healthy fiber and nutrients that are lost during the manufacturing process.
A Better Option: Instead of drinking store-bought juice, eat fresh fruit or make your own juice using whole fruits and a good juicing blender.
(7) Salads
Photo Source: Graphic Stock
Salads are often loaded with unhealthy foods including cheese and croutons. Also, salad dressings usually contain hidden fats, calories, sugars, and artificial ingredients.
A Better Option: Avoid calorie and fat-loaded extras, as well as creamy dressings. Don’t drown your veggies in dressing; only use enough to add extra flavor.
An Extra Tip: When dining out, always ask for your dressing “on the side” so you are in control of the calories, fat, and sugar you add to your salad.
(8) Diet Soft Drinks
Photo Source: DollarPhotoClub
Diet soda is one of the worst culprits when it comes to unhealthy foods disguised as diet/health foods. It is filled with artificial chemicals and sweeteners and has absolutely no nutritional value.
Research shows diet soft drink users tend to gain weight rather than lose weight. There is also growing research showing a connection with the artificial sweeteners (including Aspartame, Saccharin, and Sucralose) in diet soda and illnesses including autoimmune disease.
A Better Option: If you are craving a carbonated beverage, opt for sparkling water and if needed, add a small amount of 100% fruit juice for extra flavor.
Dried fruit seems like a healthy snack, but companies often add sugar to sweeten their products and chemicals like sulfur dioxide to preserve freshness.
A Better Option: Eat unsweetened dried fruit without added chemicals. Also, pay attention to serving size. Fruit shrinks when it dries, so the same amount of calories and sugar comes in a much smaller portion size.
(10) Smoothies
Photo Source: Graphic Stock
Store-bought smoothies regularly include fruit juice, ice cream, frozen yogurt, or sherbet which add sugar and calories. Also, they often come in disproportionately large sizes which usually equals a high-calorie treat. In the liquid form, fruits and vegetables are usually not as satisfying which may lead you to consume more calories.
A Better Option: Stick with fresh fruit and veggies or make your own smoothies with a blender using healthier ingredients: filtered water, unsweetened nut or coconut milks (without carrageenan), fresh or frozen fruit, fresh spinach, carrots, cucumbers, avocados, beets, dates, fresh mint, unsweetened nut butters, plain yogurt, honey (in limited amounts), flax seeds, chia seeds, unsweetened cocoa powder, nutmeg, ginger, cardamom, cinnamon, etc.
(11) Sushi
Photo Source: Graphic Stock
Sushi rolls have lots of sugar, fat, and calories in part due to the fact that traditional sushi rice is made with sugar. Sushi rolls often contain mayonnaise, cream cheese, and fried ingredients (tempura). Also, fish commonly utilized in sushi, like albacore tuna and swordfish, are among the ocean’s worst for mercury contamination.
A Better Option: Sashimi (fish without rice) is the healthiest option. If you can’t give up sushi rolls, stay away from those with mayonnaise, cream cheese, and/or tempura (also referred to as “crunchy” or “crunch”). Also, some restaurants provide the healthier option of brown rice instead of white rice.
If you are gluten-free, don’t order imitation crab, and opt for gluten-free soy sauce, if available. Also, limit the amount of soy sauce used due to its high sodium content.
Those with a weakened immune system, women who are pregnant or may become pregnant, as well as breastfeeding mothers, and parents of young children, should discuss fish/seafood/shellfish intake with their physician and avoid raw or undercooked fish/seafood/shellfish.
It can be difficult to avoid eating unhealthy foods, especially when the foods you eat are often advertised as health foods. However, you can make a difference in your health by using this list to make modifications in the way you eat the foods you already enjoy and to eliminate those foods that do not provide you with nutritional value.
Disclaimer: The information contained on this site is intended for educational purposes ONLY and is not a substitute for advice, diagnosis, or treatment by your physician. It is not meant to cover all possible precautions, drug interactions, circumstances, or adverse effects. You should seek prompt medical care for any health issues and consult your doctor before taking supplements or making a change to your medications, diet, or exercise regimen. Read our full disclaimer.
I’ve written this article to help educate those who want to learn about chronic illness. It is written from my perspective, that of a doctor who treated patients with chronic illness for many years, and who spent years of my life bedbound due to illness.
I want to spread awareness so that friends, family, employers, coworkers, and healthcare professionals can better understand chronic illness. My hope is that an increase in awareness will help strengthen relationships, reduce misunderstandings, and improve support systems for those with chronic illness.
About Chronic Illness
Chronic illness is a disease, condition, or injury that can last years or a lifetime and is typically not curable, though in some cases it may go into remission. It can vary in its severity, with some people able to work and live active or seemingly “normal” lives, while others are very sick and may even be homebound or bedbound.
Many people with chronic illness have an invisible chronic illness. The severity of their symptoms is not clearly noticeable, which may lead to a lack of understanding and support from doctors, family, friends, and coworkers.
Are you able to tell by looking at the picture below that this person has a chronic illness? What symptoms is she experiencing? How much pain does she have?
This is my friend Tanya. She has had Rheumatoid Arthritis (RA), a chronic illness attacking primarily the joints, for 15 years. RA has caused her two surgeries, daily joint pain in her hands, shoulders, elbows, and feet and permanent damage in her hands and feet that impacts her ability to grasp objects and walk without pain. Her pain level ranges from a 3 on “good” days to a 9 on “bad” days. You can learn more about her story and how she is determined to help others thrive with chronic illness by checking out her blog, Mom’s Small Victories.)
“I’m not making it up. If I wanted to fake an illness, I would choose something that people would believe!”
In all my years as a doctor treating patients with chronic illness, I never saw a patient who enjoyed feeling ill. I saw the opposite: patients who were once very active, desperately trying to find answers and treatment for their overwhelming symptoms.
(2) Many Doctors Don’t Understand Chronic Illness
For years, doctors were under the misperception that some chronic illnesses were caused by depression or anxiety and the only treatment available for these patients was psychiatric care.
Despite medical evidence disproving this perception, some doctors are “set in their ways” and do not truly understand chronic illness or how to appropriately address it. Therefore, patients often have to spend precious time searching for a doctor who understands their illness and provides appropriate treatment options while their symptoms potentially worsen.
(3) Being Unable To Work Is NOT a Vacation
Those who are not able to work due to chronic illness are not “on vacation.” They are, instead, struggling every day to do simple tasks: getting out of bed, getting dressed, making a meal, bathing, etc. They are often homebound, too sick to leave their homes except for doctor appointments.
Have you ever been stuck indoors for a couple of days due to bad weather or a temporary health issue? Remember feeling annoyed with the inability to leave your home and be active? Now imagine not being able to leave your home for weeks or months at a time. Frustrating, right?
(4) Chronic Illness Can Trigger Many Emotions
Chronic illness itself can change the biochemical makeup of the mood control center in the brain. In addition, frustrations such as the following can affect a person’s mood and lead to depression and/or anxiety:
the wait/search for a diagnosis
inability to work and feel productive
change in family dynamics
loss of social interactions and isolation
financial stress
the struggle to deal with symptoms and perform simple daily tasks
Those with chronic illness often feel a great loss. It is not unusual to experience some or all of the stages of grief (i.e. denial, anger, bargaining, depression, acceptance). They grieve for the life they once lived. They grieve for the life they must endure now. They grieve for the life they dreamed of having.
Many people with chronic illness also feel very isolated. Even though they crave social interactions, their symptoms make it very difficult and at times impossible to talk on the phone or type an email or FB post.
“It is debilitating and lonely to look fine on the outside and be broken on the inside.”
-Heather A.
(5) The Symptoms of Chronic Illness Are Very Complex
The symptoms experienced by those with chronic illness vary depending on the illness; however, many people experience some or all of the following symptoms: extreme fatigue, pain, headaches, brain fog, nausea, and/or dizziness.
It is not unusual for the symptoms of chronic illness to wax and wane over time (sometimes even from hour to hour), so planning activities ahead of time can be very difficult. A “good day” for those with chronic illness would likely be considered a sick day for most others.
(6) Chronic Illness Fatigue Is Much More Than Being Tired
Fatigue is a common symptom in chronic illness and in many cases it is severe, often debilitating. It can be easily triggered by simple daily activities or by more elaborate events such as holidays. Those with chronic illness will often have to “pay the price” for engaging in an activity and then require days, weeks, or even months of recovery.
Those with chronic illness may need to rest often and may have to cancel events at the last minute. This does not mean they are lazy or trying to avoid activities. Once fatigue kicks in, there is no other option other than to rest. It’s as if the body “hits a wall” and can’t go further, no matter what. To better understand the fatigue and limited energy of a person with chronic illness, read this helpful article about the spoon theory.
Have you ever been stuck in bed for a few days from a really bad infection, surgery, or hospitalization? Think back to how that felt. You could barely get out of bed and simple tasks were exhausting. Now consider feeling that way every day, all day, for months or years.
(7) Pain Is a Common Symptom In Those With Chronic Illness
Those with chronic illness often experience severe pain, including headaches, joint pain, muscle pain, nerve pain, back pain, and/or neck pain. Studies show those with chronic illness can have real physiological and neurochemical abnormalities that may make pain more severe, noticeable, and widespread.
(8) Brain Fog Is Extremely Frustrating
Brain fog is frustrating because it is a difficult symptom to describe so that others understand its impact. Brain fog is a cognitive dysfunction common in chronic illness, which can include issues with word finding, concentration, and recall. Those with brain fog often know what they want to say, but can’t find the thoughts or words to communicate effectively.
(9) There Is a Greater Risk of Dangerous Infections
The immune system in those with chronic illness may be overactive and instead of attacking infections, the chronic illness immune system wastes time and energy fighting the body’s own organs, joints, nerves, and/or muscles. Many people with chronic illness are on medicines to suppress their overactive immune systems and consequently, need to avoid being around sick people. A minor cold in a healthy person could progress to a dangerous infection in someone with chronic illness.
(10) Certain Foods Can Aggravate Symptoms
Certain foods may aggravate the symptoms of those with chronic illness. Common culprits are gluten, dairy, sugar, soy, yeast, alcohol, and processed foods. These trigger foods increase inflammation which can cause a significant increase in symptoms which may last for hours or days (sometimes weeks).
Because so many of these trigger foods are in our diet, it is often difficult to pinpoint which foods aggravate symptoms and staying away from favorite foods can be a challenge.
Certain smells and fumes including perfumes, colognes, cleaning agents, and smoke can trigger headaches, brain fog, nausea, and other symptoms in those with chronic illness. Also, some of the medicines used to treat chronic illnesses are low-dose versions of chemotherapy drugs. The sensitivity is similar to that seen in those who are pregnant or on chemotherapy and have a sensitivity to smells.
(12) It Takes a Lot of Effort to Manage Chronic Illness
Those with chronic illness have to be very regimented to make sure they get adequate rest, avoid trigger foods, take medications at the correct times, and avoid flares. It is understandable that sometimes they just want to feel “normal” and eat some pizza or stay up late, even if they know they will “pay for it later.”
Summary
Despite struggling with grief, isolation, and often debilitating symptoms, those with chronic illness (and their caregivers) “warrior on.” They fight daily to be able to understand their bodies and to do things others take for granted. They are often surrounded by a society that does not understand their challenges, and therefore, is unable to provide adequate support.
You can make a big difference in the lives of those with chronic illness by learning more about their symptoms and approaching them with compassion and support. Gaining an understanding of chronic illness will help make these conditions less “invisible.” This is why it is so important you are taking the time to read this article. Thank you!
“Nobody likes to be so sick or in pain that they are unable to work, shop, cook, clean or go to an activity, even if it only for a couple of days. In view of that, let us be sensitive to people who are sick or in pain for weeks, months or even years at a time.”
Disclaimer: The information contained on this site is intended for educational purposes ONLY and is not a substitute for advice, diagnosis, or treatment by your physician. It is not meant to cover all possible precautions, drug interactions, circumstances, or adverse effects. You should seek prompt medical care for any health issues and consult your doctor before taking supplements or making a change to your medications, diet, or exercise regimen. Read our full disclaimer.
Amy Stenehjem, M.D. works as a Health Consultant, using her unique perspective as a physician who spent years bedbound due to illness. She uses this insight to help her clients find the answers they need to improve their health and live a more active, joyful life.
Dr. Stenehjem works with clients, from all over the United States, experiencing any level of illness. Her work has been featured on the Huffington Post and The Mighty.
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