Stress is insidious and tenacious, and can fracture many things very effectively, material and immaterial alike.
Mood. Confidence. Mind.
Chemistry. Memory. Time.
Will. Power. Karma.
We all have the capacity for both acute and chronic stress. Acute stress is transient and useful: it triggers excitement, energy, the “fight or flight” response for self-preservation, and quickly sharpens mental focus. Chronic stress is self-destructive and serves no physiologic advantage or practical purpose. Unlike acute stress, chronic stress isn’t transient; rather, it is repetitive and lasting, sometimes starting in childhood. Both stresses release the stress hormones adrenaline, cortisol, and glucocorticoids, all beneficial in the immediate term, but toxic chemistry longterm.
Physical damage, namely, atherosclerosis, coronary artery disease, a weakened immune system, and brain cell destruction in the hippocampus that impairs memory and learning, are all effects of longterm swimming in chronic stress hormones. Further damage from chronic stress includes dulling of the senses, chronic fatigue, apathy, pain, suffering, and severe reactive depression, a longterm result of chronic stress depleting dopamine, a neurotransmitter that many anti-depressants and some pain medicines work to increase.
“At the slightest stress, people seem to divide themselves into antagonistic groups.” Isaac Asimov
I felt sick and exhausted again when I awoke this morning.
I feel ill, weak, and nauseated sitting on my bike.
Maybe I should just go back to bed.
Should I even try to ride right now?
What if I puke, if I’m too weak to ride back home, if I burn too many calories that can’t be replaced by merely attempting to eat while nauseated?
Will I ever feel good again?
Let It Go
When I realize I’m again looped in worry thoughts, I usually remember to “let it go” and focus on what I actually know: I’m a bad lad sitting on a sick bike, the secret trail is ahead, and my pain isn’t that much worse than usual. Stating this, the worry loop often weakens and I slowly become aware of the present, of resplendent trail and forest,
the brisk touch of wind on my skin, and the lively feel of my bike transporting me. Again, I recall that I can live only in the present, which I regard as the always current sum of my past, my personal history, one I hold close as calibrated compass and personal guide.
Q: So, what besides anxiolytic medicine can be used to reduce or minimize chronic stress?
A: Practicing Stress Fracturing ~
Meditation practice works to instill calm hopefulness and well-being: it is a path to inner peace, fostering healthy self-dialogue and decreasing feelings of ill will toward self and others, but most importantly, it can decrease one’s suffering from stress and pain. Meditation also paves the way to a safe ‘place’ one can build and revisit.
Recall something from the past that you regret or makes you sad. For me, losing my health and career makes me very sad. While minding such a memory, let go the memory as you think only of following your breath. With practice, commanding “let it go” will replace unpleasant, painful memories with what is actually in the present, like the gentle flow of your breath, sea mist on your skin, the call of a sea lion. Try to focus on the sad memory with your eyes closed, then “let it go” as you look out and focus on what comes immediately into your awareness: colors, sounds, smells, temperature, sensations, anything you sense in the present.
Think of an event or possible occurrence in the future that is stressful. My future stressor is worsening pain and health. Again, hold the stressful thought in mind and “let it go” as you shift your awareness to your breathing. Then, being aware of the breath, begin gentle In Out Breathing and settle into a peaceful, comfortable rhythm. When your mind starts to wonder or thoughts float back in, notice the wondering, the floating thoughts and let them go, returning your awareness to the rhythm of your breathing. By letting go of your thoughts of future stressors and replacing them with peaceful In Out Breathing in the present, you can realize a decrease in mental suffering, and possibly a decrease in physical suffering as well.
Since 2001, I’ve borrowed and adapted these practices from many teachers of mindfulness meditation and Buddhism. I intensified my study of meditation when I became ill in 2005, and continue to practice fracturing stress as it continues to fracture me, but with less tenacity and power as time goes by.
Breathing in I calm my body
Breathing out I smile
I adapted a version that works better for me:
Breathing in I calm my body
Breathing out I calm my mind
In . . . Out . . .
Here are three of Thich Nhat Hanh’s straightforward exercises for fracturing stress:
1. Half-smile while listening to music, focusing on the rhythm, mood, and tones of the song. Follow your In Out breath and allow mind and body to relax in the melodious present.
2. Mindfulness over tea (coffee for me). While making tea, move deliberately to be mindful of each movement. Feel the weight of kettle and warmth of cup in your hands. Smell the fragrance with mindful In Out breathing, breathing more calmly and deeply when your mind wonders from the present.
3. Ask, “am I sure?” Hanh uses this question to inquire if each thought or action is a source of stress and suffering. “I’ll never get better. Am I sure?” “I can’t be productive anymore. Am I sure?” Asking am I sure promotes the letting go of presumptions and allows one to focus on the world as it is.
By using “let it go” practice and Thich Nhat Hanh’s mindfulness practices, I’ve reduced my stress markedly, which has improved, at least, my mental health. What happens mentally is that these practices allow me to hold stress thoughts more lightly and to shorten the wait for them to pass on through. Over time, mindfulness skills can become second-nature and easier to summon when needed. There was a period of a few years when my physical pain was too big an obstacle for unaided meditation. The remedy was listening to guided mindfulness meditations and body scans, which gave my mind something passive to do: just allowing the guide’s voice to fill my mind instead of mentally working against pain to focus on thoughts or body sensations. Through the many recorded guided meditations, I’ve refined my practice of mindfulness meditation and the body scan, an excellent mindfulness stress reducer (and a subject requiring its own post).
Recently, I had a chance to thoroughly test this updated practice of Let It Go. I went to get lenses for my reading glasses after an eye exam a few weeks before. I was feeling ill, and the 25 minute car ride didn’t help my nausea. After 15 minutes in the waiting room, I was eventually told that I needed a prescription from the eye doctor for the lenses. A flood of bitterness about the doctor omitting the required prescription weeks earlier from my previous exam and irritation over having to return for another exam on another day had my head and body swimming in stress. I sat down, closed my eyes, took a few In Out breaths and deliberately thought, “let it go” several times. The words triggered my awareness to focus on the present and calmly sift out the grievances and aggravation enough to think of asking if I could be examined for the prescription now to save further delay and another difficult trip. While the nurse worked on getting a walk-in appointment with any of the 8 staff physicians, I maintained my let it go focus while looking at interesting glasses,
I know that stressful thoughts can’t be eliminated and will return, but I also know that suffering them can be relieved somewhat by returning my awareness to the present if I let it go. I also know that stress is information, a lightening quick barometer of my thoughts as emotions and sensations, and a glacial undercurrent of my worn worry loops.
Weather varies, climate holds steady. I’m off to study climate and ignore the weatherman.
My phone’s calendar alarm sounded again this morning, this time to remind me that today is the 2 year anniversary of the creation of my ileostomy. Again, I set event alarms like this to remind me of what I’ve gone through, how far I’ve come, and that, like storm clouds, my body and mind are ever-changing.
My phone’s calendar alarm sounded this morning, reminding me that today is the 5th year anniversary of the insertion of my PICC, a peripherally inserted central catheter, or PIC line. Continue reading
Unable to work since January 2006, I’ve discovered fully what it means not to work when you truly can’t, when unemployment isn’t a choice, but an unchosen constraint that brings on devastating consequences independent of tremendous economic loss. Continue reading
Today, I resurrected and doctored my Turner mountain bike, which has been hibernating since its last trek in the biking mecca of Sedona, AZ, November 10, 2008. How do I recall the exact day? Can’t forget — the following morning I was stabbed in the left flank while sleeping. I startled awake in excruciating pain, forcing my contracting eyelids open to see the perpetrator. I urgently scanned the room while reaching for my flank to feel the bloody knife (or red-hot poker). I felt nothing, saw nothing, then realized I was having my first kidney stone attack! My eyes rolled back in my head in utter disbelief as another sharply expanding wave of pain and nausea took over. The clock displayed 4 a.m., so Danusia was beyond my door, down the hall, asleep. So, for the next 45 minutes, in a cold sweat, I closed my eyes and focused on breathing deeply through the repeating waves of attacks. After an eon and hundreds of shallow gasps, I heard Danusia moving around. I speed dialed her, and next thing, found myself in the Sedona Urgent Care ER.
I posted the following to my Facebook 3/14/12:
My illness continues:
One’s state of physical health can have a drastic, devastating effect on one’s sense of life, hope, and happiness.
The world shrinks when I am sick–my entire universe is the room I’m in, the things right in front of me, and what I’m feeling. All I care about is getting through the immediate pain cycle (which can last hours or weeks), how to do it, and how long it’s going to take.
I understand you. I’ve lived in my body cage since 2005. My rebel body, the gatekeeper, lets me out occasionally, teasing me with abandon. I’m used to that by now and simply try to take full advantage of the sweet freedoms as they come. Of course, being a prisoner, my freedom is always limited to the yard, which has a surrounding barbed fence and stationed guards with orders to shoot dissidents on sight. After mustering the courage to wander into the yard, I cowered there, afraid to move or venture farther – paralyzed. I had no confidence in my weak and 45 lbs underweight pain body, and I certainly didn’t want anyone seeing what the strong, athletic Cary had decayed to. Then it struck me: cowering in fear and immobility was only limiting my life even more. So I stood up shaking and took another step, then another, slowly moving out of the cold shade into the warm, forgotten sun. When I realized what I had accomplished, I simply stopped giving a damn what anyone thought of me or what they saw in me, because what I saw was progress, my health maturing from a choice, my choice. Confidence and self-esteem began to take root, grounding me in the present and leaving very little room to worry about the past or future. That was an empowering turning point of discovery, of understanding the importance of existing in the now, regardless of how painful it can be. This new awareness narrowed my world to the essentials: that to know who you are, and all that that subsumes, you have to know where you are, and that, in reality, is in the present. There is simply no where else one can live. So like your butterfly, I must exist in the present, awareness in tune with what is happening now, again living in the day, the only place from which I can welcome the future. That, I need remind myself, is freedom.
“Ink” is putting pen to paper, an octopus defense, a nerdy stain on shirt pocket, and a tattoo. Not “the plane, the plane, boss!” Tattoo, but a permanent (as in forever, as some of us go) declaration of some vision to the world on your skin. Various cultures have practiced this art throughout history. Often, these markings proclaim identity, membership, and ideas. As I have grown, my identity, my membership, and my ideas have evolved. Endurance, survival, and wisdom can be gained from such evolution. As an undergrad dressed in Ralph Lauren attire, I would have shuddered, condescendingly, at an arm with ink. In medical school, I was purely concerned with the physiological results of tattooing, the histology, the complications. In residency and private practice, tattoos were “O.K.” on others, but NOT on me. On and on, ideas evolve. Continue reading
I have a different perspective on what makes an illness “invisible.” The phrase “invisible illness” is used so widely now that it seems to cover any disease lacking outwardly physical signs, and that makes up nearly all illnesses, excepting those that cause visible scars, skin diseases, disfigurement, or physical impairment. The phrase would regain a much more accurate meaning if narrowed to those diseases that can’t be ‘seen’ or detected by medical testing, like physical examination, blood and pathology analysis, scans, direct visualization in surgery, etc. What then would qualify as an invisible illness would be chronic pain, most mental illnesses, some auto-immune and genetic diseases, and some infections, illnesses that include a vast number of the ill, but not an inexact majority. My intent here is to give the phrase “invisible illness” true depth of meaning, and to focus its significance on those actually suffering from an invisible illness. Something to think about, and a subject I see worthy of health activists and health professionals to convene on. What do you think?
Danusia, my soulet, rescued our “kids” beginning with Coco in 2008. Her intent was to provide comfort, companionship, and just a little bit of joy during the very dark days of my illness. At first, I didn’t have any interest in having a pet. Getting well and out of pain was my only interest, my only focus–I had absolutely no energy for anything else. But when she came to my bedside and opened the box and I saw this tiny, sweet soul looking back at me, I gave in instantly. Coco was 8 weeks old, but underweight and ill, just like me. She had severe kennel cough, requiring subcutaneous antibiotics and fluids. During the first weeks of her arrival, she would sleep next to me at night and stay by my side as I rested in bed throughout the day. Time passed and she healed while still returning to my side and purring in my lap when I could sit up. She’s become even more affectionate as the years have passed, and of course, I love her more each day. What a gift Danusia gave me.
2009 arrived and I was no better, so Danusia rescued our second, presenting her as she did Coco. Milo was 12 weeks old and, unfortunately, had to be sequestered for a month due to an intestinal infection that could spread to Coco. Each morning I would make my way downstairs to Milo’s room and lie down for an hour, letting Milo tread all over my back, kneed my side, and push her head into my palm over and over, purring all the while. The time came to unite Coco and Milo, and after a few hisses and head pats, Coco took to Milo like a proud, caring mother. Danusia had given me another tremendous heartfelt gift, as I found some rare joy in observing our two “kids” form a playful, everlasting bond.
2010 came around and found me worse after more surgeries and hospitalizations, so Danusia made another rescue. This time it was a healthy, melt your heart 10 week old. Not only did Danusia and I fall fast and hard for Echo, Coco and Milo did as well. Echo was special, exhibiting behavior we had yet to witness from a kitten. She would kneed against Danusia’s side for 30 minutes, let herself be held for hours, then bound endlessly from wall to wall in rapid, thunderous flashes.
And that brings me to their names, which Danusia kindly left for me to change. Oreo became Coco, Wilbur, whom the animal shelter thought to be a boy, became our second girl Milo, and Daisy Mae became Echo, or rather, Echoplex Blaze to reflect her raucous, chaotic speed. 2012, our “kids” are all healthy, as is Danusia, and I’m feeling a bit better each day. Never could I have imagined the healing effect such gifts would bring. So I thank Danusia from my heart each time Coco, Milo, or Echo appears to comfort their “dad” . . .
As we draw closer to the bone-chilling date, October 31st, and its fearsome implications, I find myself pondering the similarities between myself and the haunting creatures of that eve. My medical conditions, treatments, and resulting side-effects can be blamed for many of these gruesome aspects, but for at least one night this month, I can embrace them as awesome. Here are the top 10 ways I see myself being transformed into a monster by my chronic illness: