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Doctors healthcare medicare Uncategorized

How mindfulness can help during Lockdown

In this article, provided by Smiling Mind, we look at how mindfulness can help during lockdown

We are living through an unprecedented and uncertain time, requiring each of us to navigate our way, as best we can, through a rapidly evolving global health crisis.

With things changing so quickly, such uncertainty and unpredictability can take a toll on our mental and physical health.

Managing our emotions and supporting each other can be challenging at the best of times. This is why, more than ever, we all need to be doing our best to regularly pause, take a breath and be proactive in looking after ourselves and others.

” Moment by moment we can make our way through”– Sharon Salzberg

We know that this isn’t always easy, and we want to support you. In this article, you will find different practical things you can do to take care of your own wellbeing, as well as support the children in your life, your colleagues, loved ones and friends.

This resource takes an evidence-based approach to offering you practical tools and techniques to help manage uncertainty, reduce anxiety and stay connected and grounded.

Mindfulness provides us with a means of cultivating greater and more objective awareness of our own emotional landscape, the emotions of others, and of external circumstance.

In doing so, it gives us more choice in how we respond to challenges we may face and the ability to more consciously choose where we place our attention.

Wherever you are in the world we sincerely hope that you and your loved ones remain safe and healthy. In the words of one of our favourite meditation teachers: “Moment by moment we can find our way though” – Sharon Salzberg.

Fear, anxiety & denial

Acknowledging that feeling fearful and anxious at a time such as this is not only normal but appropriate. Given the nature of the threat we are facing, fear and anxiety are adaptive responses as they alert us to the fact that we need to be taking appropriate action to keep ourselves and others as safe and healthy as possible.

It’s also important to recognise that fear and anxiety can quickly escalate and reach a tipping point beyond which they are no longer helpful and can affect us in negative ways. When the acute stress response, otherwise knowns as the ‘fight or flight’ response, kicks in we’re not as able to think clearly or make good decisions; we become more reactive and less responsive; and our thinking can quickly spiral, becoming increasingly negative and difficult to unhook from.

Warning signs

Mindfulness helps us get better at recognising and understanding our own personal signals that tell us we’re close to our tipping point. We can think of mindfulness as being like our own personal ‘fear and anxiety thermometer’ helping us get to know our own warning signs and recognise them as they’re kicking in.

Examples include:

  • irritability
  • losing patience
  • a sense of urgency
  • difficulty sleeping
  • inability to focus
  • catastrophic thinking
  • ruminating
  • eating or drinking more than usual.

In addition to knowing and recognising our warning signals, mindfulness gives us the opportunity to respond by taking steps to settle and soothe our nervous system, which in turn enables us to think more clearly, make better decisions and respond as opposed to react.

Beware denial

It can also be tempting to turn away from and deny the seriousness of what’s happening. Denial may be particularly appealing given the significant impact that this outbreak will have on so many people financially, emotionally or physically. While temporary distractions can be useful for giving our minds a break, on the whole denial is not a helpful approach. It can leave us vulnerable and exhausted as it may lead to not taking appropriate precautions and it’s difficult to sustain in the face of reality.

Mindfulness can help us see things more clearly, which in turn helps us strike a balance between staying informed and making sensible choices without becoming overwhelmed.

Healthy brain breaks

Giving your brain a break when you’re nearing your tipping point can be a helpful way of deactivating the acute stress (‘fight or flight’) response. Even short moments of reprieve are beneficial as they help reset enabling us to find the middle ground between overwhelm and denial. It’s in this place that we’re able to make better choices and are best placed to support ourselves and those around us.

We recommend trying out the following as often as you need to:

Move

Any kind of physical movement is a great way of releasing the build-up of excess energy that accompanies the acute stress (‘fight or flight’) response – take yourself for a walk or run outside; do some stretching, yoga or some other form of mindful movement; or crank some uplifting music and dance around the house for a few minutes.

Breathe

When you slow your breathing rate down the uncomfortable physical sensations of fear and anxiety start to subside. Try the following:

  • Stop what you’re doing, take three long, slow deep breaths.
  • Impose a rhythm on your breathing so that your out-breath becomes longer than your in-breath.
  • Try a 4-2-6 rhythm – e.g. breathe for 4 counts, hold your breath for 2 counts, and breathe out for 6 counts.
  • If that doesn’t feel comfortable, try imposing a 3-1-4 rhythm. The main thing is that your out-breath is slightly longer than your in-breath.

Ground

Connect to what is happening in this moment right now more consciously engaging your senses. Try the following:

  •  Splash cold water on your face
  • Take a hot (or cold) shower
  • Cuddle your pet
  • Smell and/or diffuse a relaxing essential oil (i.e. lavender, geranium, ylang ylang)
  • Take a moment to enjoy a cup of tea – really pay attention to the aroma and taste
  • Do one of the following short guided grounding exercises from the ‘Stress Management’ program in the Smiling Mind App.

“Staying connected to others is more important than ever”

Sleep

When we’re fearful and anxious it can be hard to sleep. Given the importance of sleep for our mental and physical wellbeing, including immunity, establishing good habits around sleep is particularly important at the moment.

Consider creating a pre-sleep routine by turning off news and screens at least an hour before going to bed. If you wake during the night and find you can’t sleep, rather than sit lay there and worry, try a meditation from the ‘Sleep’ program in the Smiling Mind App.

Connect

While social connection may be tricky during this time when many people are physical distancing, staying connected to others is more important than ever as we are wired to connect and seek comfort and care from others. We are fortunate to have so much technology at our fingertips enabling us to stay connected to family, friends and colleagues.

Try using video conferencing technology so that you can see each other, as we communicate best when we can see each other’s body language and facial expressions. Do your best to listen and interact as mindfully as you can with others – really pay attention to the people you’re interacting with.

Contribute

Contributing to the wellbeing of others helps shift our attention from ourselves onto what we can do for them. This helps us connect with others; gain a sense of agency, even if only in a small way; plus helping others also positively impacts our own wellbeing.

Consider how you might help others at this difficult time. For example, you could support a local business you value that is likely struggling at the moment or check up on an elderly friend or relative.

Create healthy habits

Mindfulness can help us create healthy habits to keep us and others as safe and healthy as possible. For example, washing your hands mindfully and taking care not to touch your face.

This article was originally published by Smiling Mind.

For general information about looking after yourself during the coronavirus outbreak, visit Beyond Blue’s dedicated page here.

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Doctors healthcare medicare Uncategorized

Social Prescribing the new prescription

A new report from the RACGP and the Consumers Health Forum of Australia (CHF). has found that the use of social prescribing is likely to counter rising chronic health problems.

RACGP President Dr Harry Nespolon said. ‘At the frontline of healthcare, GPs are best placed to employ social prescribing to help improve their patients’ health and wellbeing,’

The United Kingdom has used this apprach successfully as have other countries including promising trials in Canada and Singapore. It can help shift the balance to focusing on prevention and early intervention for patients.

We urgently need to consider our approach to healthcare in Australia, with huge challenges in rising chronic illness, mental health issues, isolation and loneliness plus the associated costs

‘Social prescribing offers an innovative solution.’

Social prescribing involves the referral of patients to non-medical activities, ranging from health and fitness programs to movie clubs and meditation.

This report follows a roundtable co-hosted by the RACGP and CHF in partnership with the National Health and Medical Research Council Partnership Centre for Health System Sustainability, and a consultation process. It recommends that social prescribing be incorporated into routine healthcare in Australia.

In a survey commissioned for the initiative, 70% of GPs said they believe referring patients to community activities, groups or services helps to improve health outcomes, but most do not have links with such services.

Some GPs are already employ social prescribing, but more resourcing and recognition is needed to implement it in a sustainable way said Dr Nespolon.

‘Social prescribing offers a huge opportunity to improve patient health and wellbeing and cut the costs of chronic disease, but it won’t happen unless everyone can access it,’ he said.

Leanne Wells, CHF Chief Executive Officer, describes social prescribing as a ‘vital development for patients’.

‘[It] can help to address the social determinants of health, such as low education and income, which can affect people’s health and wellbeing,’ she said.

‘It has become particularly important given rising rates of chronic illness, mental health issues, social isolation and loneliness, many of which cannot be treated effectively with a medical approach alone.

‘We need to find more effective ways to keep people out of hospital in order for our health system to remain stable.’

For future information please see RACGP

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Doctors

Why the relationship you have with your doctor is so important

Recently i wrote a blog on Why we still need better health care and discussed a trip I made to the hospital in severe stomach pain with nausea and sweating. The local junior Doctor after reading my medical history decided that it was probably just anxiety, he didn’t ask me any questions or run any tests. But when I fought back he reminded me that he was the Doctor and I was not, so I reminded him, that I already have a Psychiatrist and this is not anxiety, but if he would like to call my Psychiatrist at 2am to debate my mental health with him, I could provide him with the number. It was at this point in the conversation that the junior doctor looked like he wanted to throw up and stormed off, within half an hour I was getting tests done and would you believe it, it wasn’t anxiety it was appengitis, a cousin and equally debilitating relative of appendicitis.Sadly this wasn’t the first time or the last, that I would have to strongly suggest a hospital doctor debate their diagnosis with one of my treating specialists.  And that brings to me a very important point close to my heart. The relationship I have with my Doctors and why I consider them some of the most important relationships I will ever have in my life.  If you have read my blog post 15 Life Lessons From Living With Chronic Illness you will have seen a ted talk by Dr Lissa Rankin asking the question,  Is there scientific proof we can heal ourselves?  In the video Dr Rankin discusses the power of belief and how belief held strongly enough, can produce such large amounts of oxytocin and other healing chemicals from the brain that is has been known to cause ‘spontaneous remission’ of illnesses including cancer. She uses the example of religious belief but also the faith one patient had in their doctor she states in trials, patients who have been given a placebo by their doctor and then told it will cure them have been known to go into full remission as a result of the faith they have in their doctors ability to cure them. She also discusses how the power of positive thinking has been known to greatly assist in the healing process. Oncologists actively encourage cancer patients to try and remain positive and happy, because it greatly increases their chance of survival.Now I’m not about to die of cancer and I’m not advocating drinking the kool-aid in the hope of a better life, but it does stress to me the importance of the faith and the trust I have in my treating phyicians. Now of course I am not about to put my faith blindly in anyone, just ask my psychiatrist and he will tell you – well probably not because of confidentiality and all that but if he could I know he would confidently tell you, Becky hates deceit and as such I put people through their paces before I trust them and that includes him. Now granted my Psychiatrist is fucking awesome and not just because his name is Katz and we all know how much I love my cats but because he genuinely knows his shit! For 2 years despite my then Rheumatologist sticking by the fibromyalgia diagnosis, my Psych kindly supported me while encouraging me to push back on my Rhuematolgist, My Psych knew me and he knew the pain and mobility issues were not in my head and were not simply psycho-somatic or stress-induced neuralgia and he repeatedly said “i think you have psoriatic arthritis” Finally my Rheumatologist snapped at me and said ” i think i know better than your psych and if he can’t fix your pain then i think you need to find a better one” It was that disrespect by my then Rheumatologist towards a Dr he knew nothing about that finally pushed me over the edge and without knowing where to find an alternative Rhem, i asked Dr Katz if he knew anybody. Dr Miller was a professor in Rheumatology and not just any Professor either she is one of the best in Australia. She did diagnose me with Psoriatic Arthritis, she put me on meds and sure enough, i am slowly recovering. Her comment about Dr Katz “he’s one of the best Doctors i have ever known, he might be a Psychiatrist but he could teach some Rheumatologists a thing or two” sadly she retired soon after but once again Dr Katz came to the rescue and referred me to his mothers Rheumatologist and Dr Franklyn is just as wonderful and skilled as Dr Miller ever was. Similarly, when my then Cardiologist diagnosed my tachycardia as a result of meds, Dr Katz knew better, he knew that my meds do not cause my kind of tachycardia and so once again he is referring me to a peer of his. When i was having menstrual issues and my local gyno suggested that ‘women change their minds all the time about wanting kids and contraception’ Dr Katz again referred me to one of his amazing peers who fixed my issues without any disrespect, or surgery. Whilst also respecting my decision to have surgery if symptoms continued. He understood my desire not to have children at my late age (35) or with my health concerns as does Dr Katz, never has he said to me as a psychiatrist “oh Becky I think you need to reevaluate that, or I think you’re overreacting, women needs kids” and don’t get me wrong, Dr Katz is no shrinking violet, he will put a patient in their place if they need it, he is direct and outspoken when necessary but in my case, he has only ever been respectful and understanding. Because of Dr Katz, I not only have a second chance at a reasonable life, and good mental health but i have an entire medical team of highly trained doctors fighting for me so I can have a better life and you better believe they would all go to bat for me if another doctor tried to undermine me or my quality of life. But It was Dr Katz who taught me to never accept anything less than the absolute best from my Doctors and if your Doctor isn’t good enough, find one who is, because as the L’Oreal ad says “you’re worth it”And while I might not ever be in a life or death situation where my faith in Dr Katz or any of my other specialists could save my life, I am in situations every day where my confidence in all my doctors is tested but it’s because of my proven faith in them that I power through life’s challenges confident that despite the pain and discomfort I will succeed because I know my Doctors do have my back and that kind of confident positive thinking is powerful.

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Arthritis Australia Doctors healthcare medicare

Why we still need better health care in Australia

So for the record, I have psoriatic arthritis, Kyphoscoliosis, Asthma, something else I can’t spell let alone pronounce that basically means the bottom of both my lungs are permanently collapsed. There bent backward to be exact and as such the blood supply couldn’t reach them and they’ve died. I also live with C-PTSD and related PTS heart murmur that is managed monthly by an amazing psychiatrist that I would be lost without and a cardiologist as needed.But for 7 years I was diagnosed with fibromyalgia and so for 7 years I was without appropriate medication or support, which brings me to, todays rant. I Live in a Lucky country and comparatively speaking, I live with A LOT of privilege, like universal health care and disability pensions. Because I was born in Australia, I have enjoyed access to almost freehealthcaree my whole life and because I live here and qualify for a pension, I receive little less than a minimum wage here in Australia from My government so that I may live a reasonable quality of life. So let me be the first to say THANK YOU, THANK YOU, THANK YOU AUSTRALIA!!!! But despite all this privilege, I worry that it isn’t enough, that we as humans need to do more for each other, not financially but emotionally.For 7 years I was misdiagnosed not because there was a lack of evidence pointing to another cause but because of a refusal by public funded doctors to see past their own bias. For 7 years I was repeatedly shamed as a hypochondriac, despite medical evidence saying otherwise.  3 times I presented to emergency and was immediately sent for a psychiatric consult, all 3 times, there was something physically and seriously wrong with me. The first time It happened I was in Brisbane and was having a severe allergic reaction to over the counter medications interacting with my tramadol. The senior ambulance officer made the judgement call, that they would only take me to the hospital if I was willing to admit myself for a mental health evaluation. His reasoning, his mother has fibromyalgia and he knew the histrionics we played with and thus refused me any kind of medical care. Eventually, the psychiatrist did interview me and forced the hospital to treat me medically. After 32 hours in Emergency, vomiting uncontrollably, sobbing from abdominal cramps, a high temperature and shaking, the ER doc figured out, It was the over counter medication causing the issue. Not a Fibro induced histrionic episode. The next time it happened I was in Adelaide, and as it turned out, I had appendicitis but it took a forced psych evaluation and the treating psychiatrist to demand I be treated as a medical patient before the hospital ran any tests, again the Doctors on call in the ER that night, deemed my vomiting, sweating, shaking and pain to be nothing more than psychosomatic fibro related pain. The Last time it happened it was in Victoria, I was again suffering from a severe allergic reaction to medication and again they refused to treat me, they didn’t demand a psych eval this time though, they simply sent me home with an antihistamine and the advice I talk to my Psychiatrist about pain management. 24 hours later I was Back in the ER with my face closed up and my throat near closed, I had gone into a slow but potentially lethal anaphylactic shock, all of this combined with my treating Rheumatologists dismissal of my symptoms and bloodwork that forced me to go private. He repeatedly mocked and laughed at the concerned letters from my podiatrist, physiotherapist and myself that something more than fibromyalgia was going on. He told me my blood inflammation levels were so high because I was fat, he told me if I couldn’t handle the pain, then my psychiatrist wasn’t doing his job properly, and he lied blaming fibromyalgia on my rapid foot growth, and severe swelling in my neck, hands, and knees. Thankfully it was his complete disrespect of my treating psychiatrist that pushed me to my limit, I have an amazing relationship with my psychiatrist, so my rheumatologist, laughing at him, without bothering to learn who he is (my psych is literally one of the top treating psychs in VIC and an authority on psychiatry) was the end point for me. I went back to my Psychiatrist and asked him if he could refer me elsewhere, I figured birds of a feather flock together, so I knew it was a good chance that my psychiatrist’s peers would be at the top of their field too and I was right! But that costs $$$, it would cost and is still costing me a small fortune between 300 and 500 per medical visit to see my new Doctors and i would pay even more money to ensure my own going medical needs are met. Yes it means I have to drive 3 hours each way to see these specialists, but unlike my local government funded doctors, this Rheumatologist, takes my medical needs and test results seriously. Because of her, and the subsequent medication I am now on for psoriatic arthritis, my blood inflammation markers are under 50 for the first time in 7 years, I am exercising 4 times as much, I can toilet myself without medical aids, I can walk faster, I can bend again and I’m no longer sobbing in mind blowing pain every day. Because of her, I am trying to go back to school, just today I enrolled at Tafe to study online and because of this new found hope, I am actually planning a life that doesn’t revolve around disability or living on a pension. Because of her, I will one day pay taxes again, the very taxes that fund the inadequate public health system that shunned me.Why so many doctors from so many regions across Australia believe Fibromyalgia is a psychiatric condition despite being managed by Rheumatology, I will never know, I only know the public treating Rheumatologist I saw repeatedly used my exhaustion and nerve pain as a justification for his belief that all of my sufferings was psychosomatic and in my head. Why he and so many others felt compelled to give me an additional diagnosis of fibromyalgia when the existing diagnosis of C-PTSD already covers the reason for neuropathic pain and why they believe it’s ok to ignore blood tests, CT scans, xrays and reports from allied treating professional all pointing to something else in lieu of a convenient psychiatric justification.  And perhaps in that lays the answer, are our public treating doctors so overworked that they are constantly on the lookout for ways to handball patients, and it’s convenient to label someone a hypochondriac, because it means you don’t have to deal with them, at least until the treating psychiatrist demands you do that is.I don’t have any answers, sadly all I have is questions and sadness, I lost 7 years of my life, being treated like an attention seeking drama queen, all because Doctors here in Australia don’t want to deal with the diagnosis they don’t understand. Today I am rebuilding my life, but I have also lost a lot and sadly learnt that in Australia even the medical system thinks it’s ok to treat psych patients like second class citizens, time and time again I tried to help myself and repeatedly I was made to feel like I didn’t know my place. The medical doctors I saw treated me like I was worthless and didn’t matter, but it was my psychiatrist who stood by me and repeatedly told me “this pain is not in your head” it was my psychiatrist who kept me sane when the medical doctors made me feel like a hypochondriac. But that should never have had to happen in the first place, It shouldn’t be my Psychs job to ensure I get good medical care because the medical ‘system’ doesn’t believe in treating psych patients with dignity.  And this brings me to my next blog, why the relationship you have with your doctor is so important