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  • Are You Stressed? How to Cope



    Breathing exercises are an excellent way to release the tension and give self a sense of calmness. Short and long term physical and emotional health can be improved with breathing techniques. In addition to relaxation, breathing exercise can help prevent fatigue and improve overall health.

    In an article on Onlymyhealth.com, there are simple breathing techniques that you can follow. Read the entire article here

    Here are a few other stress relieving techniques that may help busy medical students:

    1) Visualization: Picture yourself getting an 'A' on the exam or finishing that paper. These techniques help you calm down and prepare for success. 
    In one notable study that appeared in the North American Journal of Psychology in 2007, athletes who mentally practiced a hip-flexor exercise had strength gains that were almost as significant as those in people who actually did the exercise (five times a week for 15 minutes) on a weight machine.

    2) Exercise: You've heard this a thousand times but it's true. Exercise helps boost the production of your brain's feel-good neurotransmitters, called endorphins. So take a walk, go to a yoga class, grab a friend and play tennis!

    3) Take a nap: Or at least make sure you get enough sleep at night. 

    4) Go to a comedy club or listen to a joke: According to the Mayo Clinic, a good laugh has great short-term effects. When you start to laugh, it doesn't just lighten your load mentally, it actually induces physical changes in your body. Long term, negative thoughts manifest into chemical reactions that can affect your body by bringing more stress into your system and decreasing your immunity. In contrast, positive thoughts actually release neuropeptides that help fight stress and potentially more-serious illnesses.

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  • A poem to inspire you

    Let this poem by physican and poet William Carlos Williams (September 17, 1883 – March 4, 1963) remind you that you have a wonderfully creative left brain as well!

    Young Sycamore
    I must tell you
    this young tree
    whose round and firm trunk
    between the wet

    pavement and the gutter
    (where water
    is trickling) rises
    bodily

    into the air with
    one undulant
    thrust half its height-
    and then

    dividing and waning
    sending out
    young branches on
    all sides-

    hung with cocoons
    it thins
    till nothing is left of it
    but two

    eccentric knotted
    twigs
    bending forward
    hornlike at the top


    Source: Allpoetry.com

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  • Overnight Oatmeal



    By Melina Benson
    Chair, AMSA Wellness and Student Life 

    I can't tell you how many times I tell patients to eat breakfast, just loud enough to cover my own empty-belly growls. What a hypocrite, right?

    We all know that eating a breakfast with protein improves concentration, curbs cravings for snacks high in fat and sugar (ahem, obligatory tray of doughnuts in the center of the table during rounds), and correlates with a healthy BMI.

    But oh, how hard it is to get up in the morning and put something together! It is so much easier to opt for an overpriced breakfast bar, many of which are packed with sugar, fake fiber and carry a heavy caloric load.

    Here's at least one remedy: Overnight Oatmeal. I believe there is something psychologically satisfying to starting a task that takes time to create itself. I'm thinking along the lines of gardening, brewing your own beer, or marinating meat or vegetables. When I leave a delicious oat mixture to soak overnight, it always helps me get out of bed in the morning.

    To make Banana Berry Overnight Oats:
    1. Mash 1/2 banana into 1 cup low fat cow's, almond or soy milk in a microwave-safe mug or jar
    2. Add 1/2 cup quick-cook oats.
    3. Add 1/4 cup dried fruits, frozen or fresh berries
    4. Dash vanilla extract
    5. Dash salt
    6. Mix it up, cover with cellophane, leave in fridge.
    7. The next morning, microwave for 2 minutes and enjoy!

    Other options: add 1 tsp honey or agave nectar, chia seeds, ground flax or nuts. Sprinkle with cinnamon and nutmeg. Be creative!

    For more overnight oats recipes, check out: theyummylife.com/Refrigerator_Oatmeal

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  • How Mindfulness is Changing My Life



    By Caitlin McFarland, 
    Webinar Coordinator, AMSA Wellness & Student Life Action Committee

    You are not the voice in your head.

    This line from The Untethered Soul, by Michael A. Singer has been with me for the past month. I am a person prone to low self confidence and am intensely critical of my work, my choices and myself. While these tendencies have spurred me onto excellence in my professional life as a research technician, once I started medical school, an atmosphere of high competition and intense evaluation, the neurotic self criticism that worked for me in the past has, at times, become over-the-top and debilitating. The invitation to take a step back and reevaluate my critical “self talk” did not come a moment too soon as I immerse myself in studying for Step 1.

    In the tradition of mindfulness and meditation, Singer, a longtime practitioner of yoga and meditation, encourages the reader to recognize that there is a running dialogue in their minds at all times and to view themselves as separate from the dialogue: In short, to view themselves as the ear to that dialogue rather than the mouth. Throughout the book, Singer gradually offers the reader tools to become more objective about the constant inner commentary and to observe themselves labeling experiences as “positive” or “negative”, recognizing that the labels we give experiences are drawn from our past experiences. Among these tools is simply “self-observation”; stilling yourself and listening to the mental chatter, paying attention to it and more importantly, paying attention to what it is saying.

    I have tried to practice this for the past week since I started reading Singer’s book and caught myself catastrophizing a low score on a practice qbank question block (“I haven’t learned anything- how will I ever pass the boards?”). This kind of mental statement is perhaps my way of motivating myself to shape up and hit the books, but in the moment I felt paralyzed and hopeless. If the assertion that I haven’t learned anything in medical school, shouldn’t I give up now?

    The point is that what we tell ourselves is not always true. If I had a friend who told me some of the things I tell myself, they would be out the door ASAP!

    So my Wellness Wednesday challenge to you this week is to take a moment to really “hear” what you are telling yourself. Then reflect on it. Question it. If you, like me, are your own worst critic, this awareness might be the first step toward getting out of your own way.

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  • Medical Students and Mental Health



    We’ve talked a lot about coping with stress on Wellness Wednesdays. The AAMC recently published an article that uses some startling numbers to give credence to our assumption that you all are stressed! They note that while the mental health profiles of students entering medical school are similar to those of college students, many end up dealing with a mental illness during their four years. To make things worse, the most depressed among us are the least likely to reach out for help given the stigma.

    Another factoid gleaned from a 2005 NEJM article was that the suicide rates among physicians is higher than the general population: 40% higher for males, and 130% higher for females.

    The AAMC highlights three medical schools that are countering this known phenomenon with school-wide curricular implementations from year one. Read on to find out what Creighton, St. Louis, and Vanderbilt University Schools of Medicine are doing as a service to their students. Could this work at your school?

    To hear more, join us next Monday for the first day of Health Equity Week of Action (HEWA). At noon on Monday, January 20th, Michael Kavan, PhD, will lead a webinar to discuss mental health issues among medical and pre-medical students! Log on here

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  • 10 Uses for Canned Pumpkin by The Foodie Physician


    Now that Thanksgiving is over, and with another month of holiday parties ahead, you may have noticed the silos of canned pumpkin lining the aisles of grocery stores. I don't know about you, but I am always tempted to purchase these with zero plans of what to make. Maybe because it's packed with fiber, Vitamin C and beta carotene. But more likely because it's a cheap and unadulterated source of veggie!

    This week I bring you a list of ideas for using that versatile pumpkin so you can make what little cooking you can motivate yourself to do last until Winter Break. The list is courtesy of Sonali, founder of thefoodiephysician.com. For details on each idea, go to the link below.

    1. Smoothies
    2. Soup
    3. Pasta
    4. Pudding
    5. Muffins
    6. Risotto
    7. Latte
    8. Mashed Potatoes
    9. Cheesecake
    10. Chili

    Find out more here: www.thefoodiephysician.com/2013/11/dining-with-doc-10-easy-ways-to-use.html.

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  • Meditation: For the Physical, Spiritual and Mental Well-being


    A study has been done in what happens to human physiology when they experience relentless focus and a high expectation to maintain professionalism and enthusiasm for learning in the setting of sleep deprivation. It’s called a 6-week rotation in General Surgery. Having just finished my own, I’d like to take a moment to reflect on what plan I could write to help my colleagues reduce the overall stress of the experience.

    Considering I’m not allowed to write for drugs yet, I’d like to propose another strategy. An hour of meditation each day would certainly make the world of medicine a better place, but that would require a 25-hour day since we’re already booked. Instead, let’s start with taking the in-between moments and converting them into mini mindfulness sessions:

    1. When you are watching a resident type into a computer, or waiting for a lecture to start, or walking between patients’ rooms, take three deep breaths. If this isn’t enough to steal away your thoughts, count the seconds inhaling and exhaling. Try to make your exhale longer. If you are still distracted, imagine the seconds flashing before your eyes in different colors. There! You gave your mind a break from its process.

    2. If you can sneak away into a hallway or bathroom for a few minutes, pop in headphones and listen to a song! I know you have your Smartphone with you.

    3. Stretch, and mentally repeat the phrase: “I am [inhale] / at peace [exhale].”

    The goal of these sessions is multifaceted: physical, spiritual, mental well-being. The most compelling, I suspect, for my audience is the physical. You are attempting to reverse the stress response for a short time and bring your heart rate, blood pressure, and muscle tone down. Eventually the goal is to teach yourself to perform what is expected of you at a lower stress level, so that you get to the point at which you complete eliminate your need for sleep and food at all. Kidding. But you will likely feel better by the end of the day, and have more energy to expend when you get home to exercise, cook your own food, or study effectively! Use yourself as an experiment and try mini mindfulness out this week.

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  • Need Help With a Sleep Schedule?

    As someone who has struggled with keeping a consistent sleep schedule for as long as I can remember, I want to share with all of you a website that offers some helpful advice on how to improve sleep hygiene. One could argue that getting enough sleep is incompatible with medical school, but there are easy ways that all of us can improve the quality and quantity of sleep that we get to improve our mood, energy level, and productivity.

    http://healthysleep.med.harvard.edu/healthy/getting/overcoming/tips 

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  • 7 Common Myths of Losing Weight



    The New England Journal of Medicine may not be the first source you would think to look at for the latest in diet tips. The renown evidence-based journal, however, made quite a stir with its recent article debunking 7 common myths of losing weight after an extensive literature search for supporting findings and clinical expert opinions.

    The study, conducted by physicians as well as dieticians, was funded by NIH. 

    Myth: Having sex burns a ton of calories. 
    Fact: According to this study, the average person will burn only 21 calories - only 14 more than if they were watching TV!

    Myth: If you want to succeed, set reasonable, attainable goals. 
    Fact: Bigger goals = bigger results. People who set more ambitious goals often lose more weight. 

    Want to read more - check out the entire study here

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  • Life Saving 101

    By Richard Pinckney MD, MPH 
    University of Vermont College of Medicine


    “HELP!” “HELP!!” You look around to find the person calling in distress and see a swimmer struggling to stay afloat. As the lifeguard on duty, it’s time for you to spring into action. What will you do?

    When confronted with analogous scenarios many physicians do one of two things: some say the equivalent of, “Wait right there, I’ll be back with help!;” while others simply dive into the treacherous waters without a thought. Lifeguards would caution us that the swimmer may not be above water by the time help arrives, and diving in risks getting pulled under by the victim.

    Though doctors are not often called upon to rescue someone that is drowning, they are often faced with patients who feel like they are drowning in their own emotions and pain. Rather than hungering for air, these patients are often equally desperate for controlled substances like benzodiazepines and opiates that they believe will bring them some reprieve from their suffering. Patients are told, “Wait right here, I will get some help,” as physicians frequently feel unprepared to manage these situations and resort to making referrals which are often times ineffective. Likewise simply diving into the murky waters with the patient and providing controlled substances can be a treacherous way to proceed. How can physicians be prepared to address this challenge? Lifeguard training offers us three important lessons that may help us: Stay alert, learn to swim, and use life preservers.

    Stay Alert

    Just as lifeguards must train themselves to be constantly vigilant in scanning the horizon, so too must we work to keep attentive to the potential of suffering in our patients. It is too easy to be distracted with our medical to-do list of activities. When our brain is completely focused on making a diagnosis, checking the allergy list, and making sure immunizations are up-to-date, we may overlook the subtle currents of emotion that may signal the potential for decompensation. Cultivating mindfulness can serve as a way to ensure you are in tune with the patient’s emotional wellbeing.

    Learn to swim

    It seems obvious that a lifeguard should be a good swimmer, yet when it comes to emotional coping skills, many physicians are doing the doggie paddle. Like most Americans, they were never taught about evidence-based skills such as Cognitive Behavioral Therapy (CBT) and Mindfulness-Based Stress Reduction (MBSR). Ironically medical schools and residencies use more of a sink or swim approach to teaching emotional coping rather than offering swim classes. Trainees are immersed in an extremely stressful environment with no real training as to how to handle the emotional complexities of the experience. There are very few medical training programs in the United States that offer structured training in stress management. As a result, many students and physicians resort to using less effective coping strategies that don’t allow them to reach their full potential as human beings and physicians.

    Learning to become more effective at navigating our own emotional waters also allows us to become more buoyant in the presence of another person’s suffering. As a result, we can be more conscious in our approach to caring for their needs, teach them how to swim as well, and develop a plan that is in a patient’s long-term best interests.

    Use a life preserver

    If a lifeguard can save a life without getting wet, that is always the preferable approach. Life preservers, poles, and other tools allow lifeguards to safely reach out to others while staying well grounded.

    Communication skills are the tool we can use reach out to our patients who are suffering. There are a wealth of such tools in the world of psychology that have demonstrated their value in research and clinical experience. Reflective listening and motivational interviewing are several examples of ways we can throw a lifeline to those in need. Through these tools we can express our empathy and compassion effectively, support patients, and engage them in a healthy path to recovery. As a result, patients will rely less on controlled substances to make themselves feel better, and use strategies that will lead them to happier and more productive lives.

    Take the plunge

    Just as lifeguards can train themselves to be more effective at saving drowning swimmers, physicians can learn critical skills for helping patients with emotional suffering. Though many medical schools do not offer such training, the tremendous success of MBSR, CBT, and motivational interviewing has created a plethora of workshops and self-study materials for physicians to supplement their traditional biomedical training. The specialists that teach these programs are incredibly excited to have medical students and physicians attend, and in fact, some of these programs are designed specifically for medical professionals. So jump in and try some of these skills!

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