We are celebrating Mother's day today and during the week. It is a time to reflect on what it means to be a mother and what our mothers mean to us. I have two daughters and both of them are great blessings to me. They are wonderful and accomplished in their young lives. They taught me numerous things about bugs, boys, friendships, skinned knees and broken hearts. I have lived through their eyes and laughed through their hearts. The child who taught me most about being a mom though is the one I never held. He died when I was in my second trimester. He died the way he came--silently, but yet he left a lasting place in my heart. He taught me so much about my expectations of having a baby and how he really did belong to me, his mom. No one grieved his death the way I did nor did anyone celebrate his existence as much. I took care to eat the right foods, listen to "healthy music", and protect his fragile existence. When he died I felt responsible. I went over everything even though the doctor reassured me that his death was a "random fluke".

        This baby taught me about how a mom prepares her dream for this new life. How this new life is part of her from the moment it becomes apparent that she is carrying another life. How a mother's concern for her child takes precedence over every other matter. There is no escape for a mom when it comes to her children. She can never totally abandon the child without haunting feelings or a nagging sensation to go to them. When a mother loses a child she usually describes it as losing a body part; something as significant as a leg, arm, heart, or soul. It happens so quickly within the pregnancy. Before we are aware of it we are already bonded to this little being.

         If you feel like you haven't talked to your mom or expressed your love for her this is an excellent time to do that. You can do it with a card, a phone call, even an email. The important thing is to do it. Your mom doesn't care how it comes to her; she only cares that you know how much she loved you and how she would give up anything to have you in her arms. Every mom needs to know they did a good job raising you. Every mom went through the process of giving you life through her body. A mom is a mom until she dies. Rationalize it, deny it, or intellectualize it, no one will ever love you like your mom! Happy Mother's day to your mom!

MJo

        We saw the news report and heard about it on the radio. We read about it online and in the newspapers; we will continue to hear about it until we all do something about preventing it. Suicide is the 11th highest cause of death in the United States. It kills 31,000 people each year and severely inflicts injuries on another 425,000 each year. April is the most popular month for suicide in the United States. We see people out of work or losing their homes and then resort to killing themselves and many times their whole family, co-workers, or even complete strangers. How does this happen? What is wrong with these people? Who are these people? They are you and I.

       The profile of someone who turns to suicide is complicated. Many times it is someone we would have never suspected. Often the person has one of these issues: clinical depression, bipolar disorder, schizophrenia, postpartum depression, alcohol or drug abuse, PTSD, and chronic pain. Usually when you are in the midst of one of these disorders you also have a chemical imbalance which prevents you from thinking clearly. You may convince yourself that the world is better off without you and many times you make that call for others as well. You may feel like you need to save others and to kill them would be better. You have confused ending your pain with ending your life.
What can you do if you know someone you love is struggling and you worry about them committing suicide?

       Step I. Don't ignore it. You cannot talk someone into suicide and bringing it up won't make someone act on it if they aren't feeling like it. In fact it may have the opposite effect. Once you ask someone you may begin a dialogue with them where they begin to feel safer and more willing to discuss their pain or problems with you. Remind your friend that you care about them and will not abandon them no matter how long it may take.

        Step II. Make a doctor's appointment for the person right away. Many times thyroid imbalances or serious illnesses can form a severe depression which may lead to your loved one wanting to end their life. It may be something as simple as getting on an appropriate medication for the person to begin to feel better and no longer be suicidal.
Step III. Invest in a good counselor. Sometimes problems are so shameful or difficult that your loved one cannot talk with a family member or close friend about it. A third party provides an environment as well as expertise at helping a person trust and be vulnerable with them. Once the problem is out in the open it will be much easier to deal with. Very few problems eliminate themselves immediately. It takes time and patience to work through difficult issues.

         Step IV. Have your loved one sign a contract with you that they will not kill themselves. Although this sounds too simple or outdated it is one of the single best tools we have in regards to preventing suicide. A good rule of thumb is to keep it simple and have them read it back to you. Ask them if they will commit to you that they will not attempt or complete an act of suicide without checking with you first. Understand that thoughts of suicide are feelings and feelings come and go. Your loved one may feel suicidal today but not tomorrow. Work toward keeping your loved one safe one day at a time.

        Never forget that when someone is contemplating suicide they are also looking for weapons. Remove all guns and other weapons from the immediate area. If we all become more aware we can help to prevent this deadly decision.

MJo

         This week I was asked to comment on a new movie coming out. The title of the movie is "I love you, Man". The movie plot consists of a couple getting married only to discover the groom has no best man. This presents a dilemma and the bride-to-be encourages her fiancé to go out and find a best friend to be his best man.

           The movie is a comedy but actually has a serious question. What is male bonding and is it necessary? Most guys have best friends, they have "boy's night out" and they bond by going to sport events, fishing, drinking beer, playing music, etc. Women usually are supportive of their husbands having best friends until it gets too wild or their husbands begin choosing their buddies over their wives and families. I've talked to guys about these relationships. Men report them to be very important and healthy to their well being. Guys need other guys to communicate because men's and women's style of communication is so different. Men aren't as vulnerable with each other and they talk about different things then what they discuss with their girlfriends or wives. They do activities together and may spend whole day fishing without words. They are not responsible to other guys as they are to their wives and girlfriends so these relationships are less stressful. Men don't analyze and think about what they say to each other. They communicate more directly so the pressure to keep going over things they said to each other is unnecessary.

How does a guy find a guy friend?

1. Hang out where guys hang out. The gym, sport stores, hardware stores, book stores, and sports café.
2. Ask your girlfriend or wife to invite other couples over. That way you can have dinner with the guy before you invite him to join you for a fishing trip, or a golf game.
3. Have a cook-out. Guys love to get into cooking over a pit in the back yard.
4. Start taking you car apart in the drive way. Every guy in the neighborhood will come by to see what you need help with (I happened upon this one by accident...my car fell apart in the driveway).
5. Plan a camping trip with a group of guys from work. It's good to get away from all of your family responsibilities every once in awhile.

          It is a well known fact that people who have many social connections live longer. Women have networks of friends established and this is one of the healthiest aspects of being a woman. Men need that too. Friends make your blood pressure lower and lower stress. It is more difficult for guys because they worry about being judged. Don't let what others think prevents you from doing what is very healthy for you. Find a best friend now...in fact find a couple of guys you can talk with or play a game of tennis with. Your body, mind and relationships with your wife and children may all benefit. Have a great week!!!

MJo

 

       This is the final blog to the relationship series and perhaps the most difficult. Most of the patients I worked with who have had weight loss surgery struggle with the following steps. It may be because these steps are the most difficult for us even without surgery. It also may be that the marriage or relationship was so broken prior to surgery that it seems hopeless. I usually advise patients not to make changes for at least 18 months after surgery, especially in your relationship status. You can anticipate many changes in yourself this first 18 months and if you work the following steps it may help you restore and begin to mend your relationship.

      Once again...the first step is to remember to "slow down". This is a process that takes time. You are changing in your looks, in your attitude, and in your energy level. Don't make changes too quickly and step back from time to time and reflect.

Step one: Listen

• When a spouse, family member or friend expresses concern regarding your personality changes listen to them and try not to get defensive. They may have valid points. When one person changes (you) everyone else around you has to change also. Make sure your behavior changes are positive ones (getting into fights with people who use to bully or ignore you is not a positive change).

Step two: Empathy

• Even though you may feel proud and great about yourself after surgery remember responses from others is unpredictable. Don't judge or value yourself according to other's judgments or comments. You didn't have the surgery to please anyone else except yourself; always keep a sense of who you are. Your losing weight makes everyone close to you contemplate their own body image. Be understanding with others, and remember what it felt like to not like your body image.

Step three: Allow those close to you time

• Give your loved ones time to get to know the "new you". If they treated you without respect in the past don't expect them to treat you differently now. You may need to set new boundaries with them. Some people who love us can never show it. This is a good time to learn to walk away from "toxic" relationships or hurtful words. You can love someone but chose not to be with them.

Step four: Assert yourself

• Asserting yourself is not getting angry or hostile. It is being able to say "No" gently but firmly. It is being able to stick up for your own values without feeling guilty. You have a purpose to your life and only you can fulfill that purpose. You must be able to defend your purpose and know that this is okay and, in fact, necessary. You don't have to use mean or ugly words-you just need to be firm about how far and to what extent you are willing to put yourself out for another. In other words: be sure to make boundaries. Also make sure that within your boundaries there is ample space for you to feel safe and able to grow toward a better you!

Have a great week!!

MJo

 

Step 1: Take your Time

Get clear on the nutritional aspects of your new lifestyle and begin to exercise lightly. Begin to focus on caring for you. If you have children give them small tasks they can do to help you get your energy back. Never rely on your children to care for you and do your "chores". You need to get moving and begin to take responsibility for this new direction you have decided to take.

Step 2: Be Considerate of your Friends, Family and Spouse

Your change may threaten your family and they aren't real sure how you are going act. They knew how to support you in the past but they may not be sure how to support this more confident, outgoing you. Accept compliments but don't let yourself dwell on them. People are reacting to how you look. Don't take it too seriously, but make sure you acknowledge it.

Step 3: Keep your Conversations Diverse

Try not to talk too much about your weight loss success (they may see this as being self focused). Instead inquire about their interests and goals. Show concern and enthusiasm for what's going with friends, family and your spouse.

Step 4: Include your Spouse/Significant Other in New Activities

Remember all the things you couldn't do, but wanted to and take them up now. Bring your whole family into the fun! Everyone can pick one new activity to try a week. It can be a three legged race or a game of sand volleyball. It doesn't matter what you do-just do activities and laugh.

Step 5: Compliment your Spouse/Significant Other

Take the focus off of you and put it on your partner. Tell them what their support has meant to you. Try writing them a letter "25 things I love about you". Include what they did to help lift you up when you were down.

Many of my patients complain after surgery that they are noticing things they don't like about their spouse. It is difficult because as we change physically we may project some of the "old tapes" that sabotaged us in the past on to our spouses. This is a slippery slope to engage in and it usually ends with you falling in a mess. Better to focus on what you do love about your spouse and look for those things. If your marriage is troubled before surgery it is likely it will not improve after surgery. Hurt is held in and resentment is not easily let go. Better to invest in counseling prior to and after surgery to ensure its health and continued support for years to come. A broken family is just that...broken. Relationships don't just die; they are neglected and neither partner wants to risk the pain for possible growth. Be a risk taker and grow.

MJo

This week in clinic I spoke to several patients who told me they are "binge eaters". My first question was of course "How do you know?". One of the patients told me that she had consumed about 8 boxes of crackers and could not stop. She made a run to the grocery store at 10 p.m. to pick up her favorite crackers. The other patient told me she had eaten over 5 packages of frosted oreos. I was amazed. Who could eat that much and wouldn't you get awfully sick? A binge eating episode typically lasts around two hours, but some people binge on and off all day long. Binge eaters often eat even when they're not hungry and continue eating long after they're full. They may also gorge themselves as fast as they can while barely registering what they're eating or tasting. Are you thinking you may be a binge eater? Well here are a few of the features according to the binge eating website:

• Frequent episodes of uncontrollable binge eating
• Feeling extremely distressed or upset during or after binging
• No regular attempts to "make up" for the binges through vomiting, fasting, or over-exercising.

People with binge eating disorder struggle with feelings of guilt, disgust, and depression. They worry about what the compulsive eating will do to their bodies and beat themselves up for their lack of self-control. They desperately want to stop binge eating, but they feel like they can't. According to the National Institutes of Health, 2 percent of all U.S. adults suffer from compulsive overeating, which makes binge eating disorder more common than bulimia or anorexia. Unlike other eating disorders, which primarily occur in women, binge eating disorder also affects a significant number of men. Binge eating usually begins in late adolescence or early adulthood, often after a major diet. But most people don't seek help until much later when weight gain from their binge eating is causing health problems.

• When I see patients with binge eating issues I usually ask them these questions first.
• Do you think about food all the time?
• Do you eat in secret?
• Do you eat until you feel sick?
• Do you eat to escape from worries or to comfort yourself?
• Do you feel disgusted or ashamed after eating?
• Do you feel powerless to stop eating, even though you want to?

The more of these questions you answer yes to the more serious your binge eating may be. How do you stop binge eating? Well the first thing you must do to stop it is to admit it. Once you can admit it, you would be wise to meet with a counselor and a dietitian. Usually the three of you can put together a plan to help you stop binging. Here are some quick and easy tips to get you started on Saying "no" to binging:

1. Eat regular meals throughout the day. Try not to get "overly hungry".
2. Take time to nurture yourself daily. These are self rewards. Never use food as a reward. Have a list of things to do when you want to eat such as call a friend, get a manicure, get a massage, go to the bookstore, knit something, play an instrument, go outside for a walk, get your hands dirty in the garden, etc...
3. When you have a problem write it down. Talk to a friend about it. Google parts of the problem to help come up with ideas for solving it. Keep a diary and look at what you did in the past to solve problems like this one (most problems are repetitive).
4. Become aware of situations that will put you in a awkward situation. Don't put yourself in a bakery if you love pastries and muffins. This is not being a good caretaker of YOU.
5. When you want to use the "fix of food" set the time and wait for ten minutes.
6. Gargle with mouthwash, brush your teeth, think of a ugly scene like lard in your blood and clogging your heart. Whatever it takes to not eat that "trigger food".
7. Remind yourself that you are the "boss" of you. That you can get through this and that it will go away if you just breathe and change your scenery.

We all have weaknesses and problems in some area of our lives. Just because you binge eat doesn't mean you have to stay a binge eater. You may find you are out of control with one meal, but that doesn't mean you have to stay out of control for the next one. A binge lasts two hours, so how about if we say "the third hour is the magic hour". The third hour we get back on track and binge no more. You can do this! Start today!

MJo

Some things are so vivid in my mind. I grew up in a small house (less than 1,700 sq. feet) in Northern Wisconsin with eight brothers and sisters. We were poor; my mother was a school teacher and my father a laborer. I was number six of nine children. I was witty and challenging to my parents, but they taught us humility and obedience. I don't remember a time I didn't feel sorry for them-their lot in life and how they did their best to love and care for all of us. Each Thanksgiving my mother would make hot dogs. I remember asking her why we didn't have turkey like everyone else and she told me not to question what I didn't understand. Now I realize hot dogs were cheap; she could buy them in the summer and freeze them. Since we never had them any other time they were exotic. The first Thanksgiving that we had turkey was when our priest, Father John, brought one to our home. My mother was flabbergasted. She hated accepting charity, but she didn't want to disappoint the priest. It took her and my father to roast it, and all of us kids just sit in the kitchen and watched her fix it. We couldn't believe our good fortune. I have since become a vegetarian, but I can tell you I have never tasted such a great turkey.

My mother died in 2002. One of my best memories was listening to her talk about that big turkey. Such a novel event for her and she was so grateful. This gratefulness made her strong. She used this memory when times were bad and reminded us of the goodness of others. She used this memory when she felt "unappreciated" by others. This one simple act of someone's kindness affected my whole family.

There is a connection between appreciation and happiness. When you appreciate another person you value them and you also give hope to everyone around you. The appreciated person feels grateful and happy and you feel fortunate that this person is in your life. Most of us don't work for money, we work for appreciation. Why not start appreciating now? Have you told others how much you appreciate them? When is the last time you hugged your husband and told him you appreciated the way he treated you and your children?

Are you a student? Have you thanked your teachers who have made a difference? Maybe you are a professional, have you thanked your secretaries and co-workers? Blue collar workers-have you thanked your boss or anyone that helps clear your path so you can do your job? Have you thought about who you appreciate? Appreciation is one of the few gifts we can give each other and it comes right back to you. Make a memory. Tell someone how much you appreciate them and then watch their eyes. Don't forget that look in their eyes. Make it your memory to use when times are difficult or life is cruel.

Blessings to you in this season of Thanksgiving! I am grateful that I can write each week and I appreciate the comments you make. You inspire me, and I want to do more for you.

Everywhere you go you hear about the crisis on Wall Street. It doesn't stop at Wall Street, in fact it is coming home with us; like it or not this is going to "trickle down" to us. Perhaps the most vulnerable group in a recession is the Baby Boomer generation. They have two dependency burdens since they are old enough to have children but young enough to having living parents who they are responsible for (financially and physically).
Most of the Baby Boomers have lost a lot of money in stocks, retirement funds, and other investment varieties. Many have had to foreclose on their dream homes. So how do we get through this to see the light at the end of the tunnel? First you have to go through the grief.

Kubler-Ross described 5 stages of grief:

* Denial : this isn't happening
* Anger: The damn government (blaming is common)
* Bargaining: maybe if we give them some money the problem will go away (the bail-out).
* Depression: I feel so let down by my country's government.
* Acceptance: this is the reality. We are here, and now we have to work to solve it.

Ways to live with the economy and maintain control:

1. Do not panic. If you take your money out there will be a penalty and it will worsen the situation.

2. Sit down with your family and come up with at least three expenses you can cut back on as a family (this will build family cohesion).

3. As a family or couple try to engage in a healthy life style. One way we can all cut back and become healthier is if we eat more dinners together at home. It is expensive to go out and eat...and never as healthy.

4. Set small realistic goals. For example everyone can begin saving now for a vacation planned in the spring or summer. You can begin now to set up college funds, or guide your child with applying for scholarships.

5. Manage your anxiety or depression with medications from your doctor if necessary. If you don't have medical insurance there are programs that can help you find resources to assist you with your emotional needs. Ignoring that you have a problem is a problem.

6. It is never too late to learn new coping skills. The great thing about a crisis of any kind is it forces us to make changes. 10 minutes of meditation and prayer is a great place to start.

7. Be creative with entertaining at home. A big family expense is going out. It may be cheaper to have friends over for dinner, or creating pot-lucks with families. Everyone relaxes, talks, and shares how they feel about issues. This is healing and inexpensive.

Most healing happens when we work together. People need other people. Reach out and invite someone to share the experience; it will make it less scary if you know others feel like you do.

This week our part of the world (Southeast Texas) went through a life altering crisis/opportunity. We had a huge hurricane (Ike was his name) sweep into our gulf and take with him power, homes, phones, Internet, and peoples' livelihood. As you can imagine, we are now all struggling to make sense of it and reestablish structure. This presents difficult challenges, but also provides us with a huge opportunity.

How do we want to go forward? How do we deal with the present (some of our neighbors lost everything, many have no power, and the media predicts a difficult four more weeks of recovery)? I think the opportunity lies in what we can give to each other. How do we take the focus off of ourselves and give it to everyone else? We know that when people feel loved and cared for they adjust better to the present circumstance.

Here are some ideas of what "survivors" have in common

1) Survivors have friends and family who will stand by them and give them a sense of hope. (If you know of someone who is downhearted remind them that you are here with them and not going anywhere).

2) Survivors do not deceive themselves. They realistically understand what they lost and what this loss means to them. (If you are contacted to help someone deal with the crisis, don't sugarcoat it. Help them by listening and validating what they are feeling).

3) Survivors learn to forgive themselves for their mistakes and for surviving. (If you are the only home who has a home standing...it is okay to be thankful. It is also an opportunity for you to share your shelter with others' who lost theirs).

4) Survivors learn to accept their own good qualities. (It is okay to be proud of what you are doing for others at a time like this. Just make sure you "walk the walk as well as talk the talk"). Survivors continue to give themselves a reason to carry on. (We all need a reason to live. If you are a survivor you may need to remind another person what their living means to you).

We are all in this together. It is in each other we find our reason to carry on and in each other the mirror that reflects back to us who and what we stand for.