Stressipedia

The Source for Health and Stress News You Can Use

About The Joy Of Stress

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About “The Joy of Stress”:

The Joy of Stress was written originally over three decades ago, and has proven to have lasting and universal appeal.  The concept was started as an information piece for specific questions asked by my patients.  In the course of a busy practice of family medicine and emergency care, I was asked by my patients to simplify the complicated steps to deal with their particular problems.   I heard myself repeating  verbal lists  for management of obesity, high blood pressure, low back pain etc.  However, verbal “core dumps” are very poorly retained (or, worse yet, misremembered), and I would inevitably have to repeat them at intervals.  Initially, I thought I should write these down, and started handing out printed action-items for some of the more common conditions.  Strress was the most common basis for most medical visits, so that was the starting point.  To this was quickly added obesity, high  blood pressure, elevated levels of blood sugar or cholesterol, and pain management.  As I catalogued each new subject brought up by the next patient, the pamphlet idea soon grew to a book. 

The manuscript for the book was turned down by all publishers, as I was an unknown young doctor in the countryside north of Toronto.    I had never written professionally, and knew nothing of editing, illustrating, marketing, and printing.  However, I did know that stress is not always bad, and indeed is a needed ingredient to success.   Mortgaging everything to self-publish, it was indeed a great joy to see the book enter the Canadian Best-Sellers list, rising to number one for over three months. 

The American edition

 

 

 

 

 

 

 

was then picked up by a real publisher, and translations were done in dozens of countries.  Some of these are shown below.

Since then, I have travelled the world as a professional speaker, yet always remained in active practice.  My millennial patients suggested blogs, which now form the basis of www.stressipedia.com.  Along the way, I also rewrote the entire book;  “The Joy of Stress”, now available on Amazon in print or as an e-book. 

 

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Static Tension: The Non-Sports injury

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Sports injuries are usually not subtle.  Tension in the underlying tissues results from acute acceleration or deceleration movements.  For example, we see this with a check into the boards,

 a tackle from the side,

 or a crash over the handlebars.

 

 

  Some sports injuries are a lot less dramatic, yet still involve movement.  We see this in stress fractures, plantar fasciitis and shin splints in runners,

 

 

 or in the gradual disc degeneration in spines of  motorcycle racers.

 

But one of the much more frequent injuries I see in my office today is the NON-sports injury, caused by the complete LACK of movement.  Otherwise known as STATIC TENSION, the condition can best be illustrated by trying to freeze like a statue, with  two hand-weights held out to the horizon.

Even if the weights are small, this position can cause acute pains if the muscles don't move for extended times.  

Yet today, we freeze our muscles for long hours at our desks.  Even with no weights in our hands, we tense our muscles, ready to pounce on the next stroke on a keyboard. 

 This static tension produces similar results to sports injuries, such as sore shoulder tips, necks, upper and lower back muscles, stiff knees, and leg cramps.

At a cellular level, here’s how it works.   Each cell in our body needs circulation, to provide incoming food and oxygen, and to carry off the waste products of metabolism.  Our muscles get this circulation only BETWEEN beats of contraction/relaxation.  Normally, this works fine, as the human body was designed for hunting and gathering, moving all our waking hours. 

However, the modern work place has replaced movement with stasis.  With legs folded tight under our chairs, our necks craned forward, our shoulder-tips raised, and our knuckles white, we freeze our muscles in the name of progress.  Trouble is, when the work day is over and we try to stand up, it gets pretty ugly. 

Our legs betray us, our heads can hardly swivel to look for oncoming traffic, and we continue to wear our shoulders as ear-rings.  The muscles have been effectively starved of circulation for hours, and respond with expected results.  

So when you are at a work station, remember to be kind to your muscle cells.  Ease up that static tension, and move at least a few times an hour, to allow precious food and oxygen to fuel your cells again.  It could be a simple shoulder-roll, a pulling together of the shoulder blades, or standing up to twist your torso to the left and right a couple of times.  It could be as easy as straightening one leg at a time under the table during a meeting, or as subtle as rising up on your heels when you are standing in conversation or at a work station.  When you do get away from work itself, make a point of climbing stairs, walking quickly, or pursuing any active movement, from dance to tennis, or from yoga to gym work.

In any event, stop letting your work station give you the non-sports injuries of static tension.  Your muscles will definitely serve you a lot better.

 

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Work Stress and Heart Disease

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Are you under a lot of stress at work? Well, if you are not handling it well, it could be making you more at risk for heart disease.

An image of someone stressed-out at work

First, let’s set the record straight. We are all under some stress, and most people at work are under a lot of it. But just because you have a stressful job, such as an air traffic controller, police officer, or computer worker, does not mean your health need suffer. Many such people thrive on their pressures, and indeed wither into death or senility within a few short years of idle retirement. But if you are not handling these job stresses well, then indeed there is cause for concern.

A recently published study in the Journal of the American Medical Association looked at over two hundred men, aged 30 to 60 years. About one in five suffered job stress, such as impending mergers, trouble with a bad boss, and economic factors. These highly stressed individuals were three times as likely to have high blood pressure as their peers. Even more alarmingly, all men aged thirty to forty with high stress jobs had a clinically significant thickening of the heart's left ventricle. This means that there is something happening inside your body when you have chronic job stress, and rather than responding by passively adopting bad habits, it is critical for you to take control.

People with highly stressful jobs but little real control over decision making are running a 23% increased risk of a heart attack, according to authoritative research.

Many people in today's world, where the pace of life is fast and money is tight, may consider themselves stressed at work, but the definition used by authors of the study in the Lancet medical journal is precise. They considered job strain to involve high demands on the individual and little freedom to make his or her own decisions about how and when to do the work.

This sort of stress is to be found among all sorts of people, holding down all sorts of jobs on both high and low salaries, said one of the authors of the study, Professor Andrew Steptoe of the department of epidemiology and public health at University College London.

"It is the coupling [of high demand and low control] that is problematic," he said. "It is more common in low income jobs where people are doing the same thing again and again, such as assembly line work, but it is across the whole social spectrum.

When one has high job stress, the tendency is to pay less attention to good nutrition, learning skills of relaxation and exercise, and more inclination to talk shop all through one's spare time hours. It may very well be that it is these choices, and not the job itself, that account for most of the associated heart disease. If you are in a stressful job, you owe it to yourself to fight back with ‘active participation’. Eat good foods, exercise regularly, develop skills of relaxation, and focus on other interests in your spare time to get your mind off work.

Given that 1 in 3 Americans suffers from heart problems, managing work-related stress is key. Here are some recommendations from the American Heart Association:

  • Practice positive self-talk: Instead of telling yourself, “everything is going wrong,” think, “I can handle things if I take one step at a time.”
  • Identify emergency stress stoppers that work for you: For example, count to 10 before you speak or go for a walk.
  • Find pleasure in simple activities: Try to do at least one thing a day that you enjoy, like listening to music or meeting friends for lunch.
  • Take time to relax daily: Calm tension in your mind and body through yoga or meditation.

 

Most of all, ask yourself if you really like the job in the first place, or are just in a rut. If you no longer enjoy your work, be flexible enough to consider planning for a change, for the sake of your heart. The most stressful job in the world is after all the one for which you are not suited.


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Traveling Stress and Economy Class Syndrome (Deep Vein Thrombosis)

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We always knew that economy class wasn't the most comfortable way to travel and can be quite stressful. But now it turns out that, if you're not careful, it can even be harmful to your health on long journeys.

An image of tomatoes

Three distinguished scientists, Drs. Cruikshank, Gorlin, and Jennet have called the condition the Economy Class Syndrome, otherwise known as E.C.S. I call it leg lag. The underlying medical condition is deep vein thrombosis. The symptoms can appear several weeks after flights as short as three hours, and can-in extremis-lead to death. We do not yet know what causes deep vein thrombosis, but it obviously has something to do with the cramped leg-room in the economy class seats. Economy or charter class seats, also known euphemistically as hospitality class seats, have only half the leg room of first class seats. Yet economy class passengers, on average, have just as many legs as their first-class co-travelers. The longer the journey, the greater the risk is of a blood clot forming in the leg, which could then end up in the lung, with potentially fatal complications.

What is Deep Vein Thrombosis?

A deep vein thrombosis is a blood clot in a deep vein. A clot inside a blood vessel is called a thrombosis. Deep vein thrombosis predominantly occur in the legs and may have no symptoms. The non-specific signs of  deep vein thrombosis include pain, swelling, redness, warmness, and engorged superficial veins in the leg. A  deep vein thrombosis may go away naturally, but the most serious complication is when a blood clot dislodges (embolizes) and travels to the lungs to become a life-threatening pulmonary embolism.

In 2011,  The sudden death of rapper Heavy D was due to a pulmonary embolism caused by deep vein thrombosis, a Los Angeles coroner has decided.  His weight, heart disease and a recent transcontinental jet flight were cited as contributing factors to deep vein thrombosis.

In another example, tennis star Serena Williams appeared on the Today Show March 9, 2011 and gave host Matt Lauer additional details about her recent health scare. Williams was  being treated for a pulmonary embolism which resulted from a deep vein thrombosis. The Grand Slam tennis champ had two surgeries on her foot and she apparently was in a cast for 10 weeks, followed by 10 with an orthopedic boot on her leg. She also was doing a lot of flying during that time as well.

Why is this a potential problem when traveling?

The only way blood can circulate freely from the legs back to the heart is through the pumping action of the leg muscles in motion. The blood in these veins returns most easily when it is not thickened: unfortunately three factors on a plane conspire to turn our blood into sludge. At altitude, the humidity on a passenger jet is drier than the Sahara desert, causing the body to dehydrate. Alcohol also dehydrates the body, as does salty food. To make matters worse, most planes on this continent carry no bottled water for the passengers. The soda water and tonic water both have considerable quantities of salt and sugar, respectively, and thus neither solves the dehydration problem.

What is at stake here is a lot more serious than the minor nuisance of not being able to get back into your shoes after you have taken them off during the flight. In 1986 a three-year study carried out at Heathrow Airport found that 18% of 61 sudden deaths among long-distance passengers were due to blood clots in the lungs, which had originated as deep vein thrombosis in the legs. But this doesn't mean that we all have to win the lottery to be able to fly long distances safely in first class. Now that you know the dangers, you can take some simple steps to avoid the pitfalls of having a  deep vein thrombosis develop in your legs while flying.

Here's an action tip:
Fight leg-lag, otherwise known as Economy Class Syndrome (deep vein thrombosis), by taking the following precautions:

  • Make sure you wear loose clothing. Girdles, tight belts, garters, and executive socks are out. Support hosiery, on the other hand, provides some protection against deep vein thrombosis.
  • Drink lots of water, even if you have to bring your own bottles on board.
  • Avoid alcohol in flight; also avoid sugared drinks and excessively sweet foods.
  • Get some exercise. If you have a bit of time on your hands in the airport building, do a few laps of the concourse instead of sitting in the cafeteria or lounge. If you are held at the gate, choose to stand rather than sit. Once on the plane, Stretch your legs by walking the aisles, or standing out of the way at the back of the plane for at least a few minutes every hour. If you are stuck sitting in your seat try compressing and releasing your calf muscles
  • Don't smoke, as this further impairs the circulation of blood in the body.

Deep vein thrombosis while traveling in cramped quarters (think economy class on a 14 hour flight from San Francisco to Hong Kong) should be a concern to all travelers. If you take control, you can enjoy any flight, and arrive in complete safety.

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Adding More Food Fiber To Your Diet May Reduce Your Blood Pressure

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It has long been believed that medical diseases can often be a result of our western diet. Well, it turns out that we now have an even better reason to eat fiber, not just for our bowels, but for our hearts.

An image of blood pressure being taken

We've long heard the expression "you are what you eat". Well, as we are gathering greater scientific knowledge, it turns out that this saying is truer than we imagined. A new study done in Sweden by Dr. Kieth Eliasson of Stockholm's Karolinska Hospital, recruited 63 mild hypertensives with a mean diastolic blood pressure of more than 99.6 mm of Hg. The normal level is about ten points lower, anything up to 90. For the next three months, each volunteer would receive a 7 gram dose of tablets, while their blood pressures were monitored.

One half of the group was given tablets containing mixed dietary food fiber, the other was given identical pills containing placebo. Because blood pressure normally changes with different moods and activities, researchers took several daily readings from each volunteer. Blood pressures were measured at rest, during mental stress (using the Stroop test), and during physical stress (using the cold pressor test). Readings were also taken to assess levels of cholesterol, insulin, glucose, and triglycerides in the blood.

The findings were consistent, and dramatic. The group taking food with fiber lowered their blood pressure, by an average of 5%, and also reduced their levels of cholesterol, glucose, insulin and triglycerides in the blood stream.

Here's an action tip:
The best route to health is not always through drugs, even though that has been our medical tradition. If you have high blood pressure, or for that matter even if you don't but want to help prevent it, try eating more food fiber in your diet. The next time you see your doctor for a blood pressure check, ask him or her for more dietary advice.

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Herbal Remedies for Aches and Pains

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Lets face it, many people are over-medicated, either from over the counter products or from prescription drugs, and many of their complaints could have been better handled with grandmother's old fashioned herbal remedies. An image of useful herbs But that does not mean that drugs from factories are bad, while drugs from plants are safe.

Plants can produce very potent drugs, some of which are the raw materials for medicines such as digitalis, morphine, aspirin, and quinine. When taken in their raw form, it can be a tricky thing to get the dosages right.

 

Much has been written and claimed about herbs, but here are a few guidelines. The following herbs can be very helpful:

 
  • Aloe gel from the inner leaves of the aloe plant whose derivatives are natural herbal remedies for the pain of burns, including sunburns.
  • Chamomile tea can relieve indigestion, and act as a mild sedative.
  • Feverfew tea is said to help colds, flu, and migraine-headaches.
  • Gingerroot tea can counter motion sickness.
  • Peppermint and spearmint tea can help heartburn, indigestion, and cold symptoms.
  • Raspberry leaf tea can help alleviate diarrhea and menstrual cramps.

With all of these, as with most medicines, there can be individual allergic reactions. However, others are not herbal remedies at all, and are downright hostile. Calamus and coltsfoot and Sassafras contain suspected carcinogens. Ginseng and licorice, when taken in large amounts, can raise blood pressure, and in the case of licorice, cause fluid retention. Goldenseal and senna can both cause miscarriage and severe stomach pains, and can be fatal in large doses.

Here's an action tip:
Just because a herbal remedy is marketed as natural, organic, or herbal doesn't mean it is free from side effects. Check with your doctor to see if your herbal remedies are appropriate for you, especially if you are on prescription medications or are pregnant or breastfeeding, and don't give them to children.

Because herbal medicines can be so powerful, they deserve all the respect you would give prescription drugs.

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Stress and your Blood Pressure: How to Read the Numbers!

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One of the top ten ways that stress can influence your health is via your blood pressure.I commonly have patients present with a surprisingly elevated pressure, and suggest that we consider the context before rushing to medicate. This is just one example of silent signals that your doctor can help you identify, as we discussed in another post.
 
WHAT IS BLOOD PRESSURE?
Blood pressure is expressed in mm of mercury, in a “fraction” format, eg 120/80.This is not really a fraction, just a listing of two pressures; the upper number reflects the pressure inside the heart during contraction, while the lower number measures the resting pressure between beats.
 
WHAT SHOULD THE NUMBERS BE?
In young athletes, the pressures might be around 120/80. As we age, we can easily cope with ten more mm on each number.With exercise or anxiety the upper number will rise as the heart beats faster.The lower number should stay below 90.
 
IF MY NUMBERS ARE HIGH DO I NEED MEDICATION IMMEDIATELY?
Usually not.A single episode of an elevated set of numbers usually means the patient is anxious about seeing the doctor (white coat hypertension), and this simply indicates that more data is needed.Your pressures are going to increase with exercise, stress, anger, frustration, and overeating.They can be lowered with rest, meditation, deep breathing exercises, and eating a good diet.Because medication is often a lifetime option (never without some chance of side-effects) I always suggest a BP diary so the patient can show me the range of highs and lows during a couple of weeks.
 
HOW DO BLOOD PRESSURE CUFFS WORK?
By encircling the limb, the inflated balloon compresses the underlying artery, shutting off all blood supply. With the stethoscope (or built-in microphone) listening over the artery beyond the blockage, the pressurein the balloon is slowly released.When the first sounds are heard (always at the rate of the pulse) the upper or systolic BP number is known.When the beats become inaudible as the pressure keeps dropping, then the lower diastolic BP number is known.One of the limitations of the upper arm cuff is that it takes a lot more pressure to squeeze the underlying artery in the arm if the muscles are toned from recent weight lifting, for example, or if the whole arm is encased in layers of fat, as in the morbidly obese.
ARE CUFFS IN DRUG STORES ANY GOOD?
Usually they are pretty accurate.The only limitation is that you have to be walking by the store to get the reading, so we are missing many of the rest of the highs and lows of your day.Also, some do not have super-sized cuffs to get around an extra large arm.
 
ARE HOME BP CUFFS ANY GOOD?
Actually yes, and, due to the absence of white coats, these numbers are usually more accurate than those taken in our medical offices.If you can, try one of the new wrist units, as the arm cuffs are not as accurate.
 
NOW THAT I HAVE MY RANGE OF PRESSURES, WHAT’S NEXT?
Take your readings along to your doctor for assessment.Also take along a diary of your food intake and exercise output.In the case of obesity, a proper weight loss can often take the spike out of the blood pressure, and obviate the need for any drugs.In the case of extremely high pressures, your doctor may have no choice but to start you on medications.In general, eat good natural foods, and stay away from “white death”, ie white sugar, flour, and salt.If you have weight to lose, then please get serious about doing so.We find that bringing our obese patients in for a weekly “health check” works wonders; we have our nurse record the weight and BP readings each week. I don’t need to see the patient unless their numbers are climbing!A good example of audience participation, this results in an impressive number of cases being able to get back to safe BP numbers, and dodge the drugs entirely.If not, then a carefully monitored course of medications can make life a lot easier.
Here is some extra reading you may find useful:

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Top Ten ways Stress can Hurt You

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For the past year, I have been working in active Family practice, including busy walk-in clinics, as well as my private office.  Having seen thousands of new people in these past months, it is clear that Stress is still one of the major factors in our Health Care Crisis. 

Stressed Worker

Our headlines have never been more stressful, and are all about issues that are beyond the grasp of the individual reader, even though the effects are felt by all.  For example, the gulf oil spill, the worsening economy, the jobless "recovery", and, not to forget, our two wars that are claiming more lives, more treasure, and seem to be generating more corruption from the governments we are supposed to be saving.  To paraphrase the old saying: "if it weren't for bad news, we'd have no news at all". 

But bad news preys on the human body and mind.  Especially because we are bombarded with these disasters dozens of times a day (newspapers, emails, talk radio, 24-hour TV news, cell phones, twitter etc).  Granted, stations now try to lighten up with idiotic stories, like "Skippy the Squirrel Learns to Water Ski...with film at 10".  But the omnipresence of bad energy leads to predictable results.  The following is the result of a survey of over 500 patients whose health drove them in to see me in the last three months, and asks the question "What does Stress Do to You?".  Each patient could mention more than one choice, depending on their body's responses.

Let's take a look at the Top Ten Ways that Stress Hurts:

1.  Insomnia  (71%)  From having difficulty falling asleep, to having troubles staying asleep, this was the most common complaint.  Waking up refreshed was rare.

2.  Anxiety (65%)  Bad news contaminates our conversations, our dinner hour, and our "down time" that we try to carve out of our busy days.  People are developing white knuckles on their Blackberries and I-phones, consuming the latest iterations of horrible news.

3. Depression (52%) With so little control over these stressful stories, no wonder people are depressed.  Sales of Effexor have never been higher! (note, antidepressant medications are rarely the best line of defense here, but more about that in other blogs!) 

4.  Skin reactions (acne rosacea, excema etc) (38%) Breakouts of acne, including rosacea, as well as itchy patches of excema are very common as a manifestation of stress. 

5.  Cardiac effects: racing beat, increased blood pressure.   (23%)  Many people can "hear" their heart pounding, as the internal carotid arteries pump close to the ear mechanisms.  Palpitations are often felt in the chest, and people will often break into a sweat.  Blood pressures can also rise, along with heart rates.

6. Indigestion, stomach pains. (22%)Sales of medicine for heartburn, stomache aches, and acid reflux have never been better. 

7. Change of bowel habits (constipation or diarrhea)  (22%) Some respond to stress with diarrhea, while others seize up and get constipation. 

8.  Headaches (including tension, migraines)  (20%) Lasting anywhere from a few minutes to a couple of days, headaches are a powerful reminder of the mind-body connection. 

9.  Fibromyalgia  (17%) When you have pain in a joint, it is called "arthritis".  When you have pain between the joints (in the muscles and soft tissues) it is called "fibromyalgia".  No blood tests or X-rays will pick it up, but millions of Americans know it is sure real.

10. Obesity.  (60%)  While some respond to stress by cutting down their food intake, the majority are seeking comfort with "comfort foods".  Obviously badly named!  The "white death" of white sugar and white flour contributes to our epidemic of obesity, especially in our children.

While the Prescription Drug Cartel wants us to all believe that each of the above symptoms is caused by the Lack of a Brand-Name Drug, there are a host of ways to defend ourselves before reaching for a prescription pad.  We will discuss each of these in upcoming articles!

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