The Wellness Chronicle
Creighton University School of Medicine
Office of Student Affairs
Volume 1, Number 3           March 11, 1998



Welcome to the third issue of the Wellness Chronicle. We have just completed a very busy time of year for our students. The M1s have "gained closure" on several units including MCB, Host Defense, Pharmacology, and Microbiology. The M2s have completed Endocrine and Reproductive, the M3s continue to "knock off" Shelf exams and to consider their Senior schedules and careers, and about half of the M4s have just completed Step 2 of the USMLE. Wow! What a Spring! The next big events include Match Day, which is March 18th, Golden Apple on April 25th, and Hooding and Graduation in May. Time sure flies when....okay, I won't say it. Nonetheless, wellness issues were certainly important during the past month and will continue to be so as we progress through the Spring. So, please take my humble advice. If you had some difficulty getting through the past month, maybe that is a sign that you need to incorporate more wellness strategies into your daily routine. If you do, you will be rewarded. If you don't, history is likely to repeat itself. Now if you're like me, and I know I am, I don't like to feel bad - unless, of course, I'm getting lots of attention for it. But seriously, if something hasn't worked for you, it is your obligation to change it. So please read this month's Chronicle closely and learn to make a difference in your life. The Wellness Chronicle is available on medicine.creighton.edu/wellness


Relax!
A Primer for Learning How to Take Control of Stress

Meditation is a tradition that has been lost in our culture. It is nothing new. In fact, other cultures have been practicing forms of meditation for thousands of years. Whereas you may be skeptical about the benefits of relaxation, they really do work. This article is a brief introduction to relaxation techniques and information on how to easily incorporate them into your life.

The mind/body field of medicine came into light in the U.S. when Herbert Benson, M.D. wrote his book The Relaxation Response, which discussed the relationship between mind and body. Dr. Benson is a Professor of Medicine at Harvard School of Medicine and has become the leading researcher in the field of behavioral medicine. Through his research and clinical work, Dr. Benson defined a bodily calm that can be used to fight the "fight or flight response."

The relaxation response has been demonstrated to result in various physiologic changes including decreases in metabolism, blood pressure, heart rate, breathing rate, and muscle tension, and increases in slow brain waves. These changes are in direct opposition to the sympathetic nervous system changes that stress induces. Regular elicitation of the relaxation response is of enormous benefit to the body. It allows the mind to tune out everyday worries and allows the body to relax, thus, reversing the internal wear and tear of stress. Research has indicated that it, in conjunction with exercise, can bring about the "runner's high" more quickly. It is also one of the best, if not the best, method to battle insomnia. It also help PMS, hypertension, and headaches - in fact, the literature suggests that relaxation and stress management techniques are more effective prophylactically than any medication for tension headaches and migraines.

The relaxation response can be brought about in a variety of ways. It can be elicited through meditation, certain types of prayer, progressive muscular relaxation, jogging, swimming, tai chi, or even knitting. The common denominator is that you: (a) repeat a word, phrase, sound, prayer, or muscular activity and (b) passively disregard everyday thoughts that come to mind, returning to your repetition as necessary.

Here is a generic technique that Benson teaches to patients:

1) Pick a focus word or short phrase that is firmly rooted in your belief system

2) Sit quietly in a comfortable position

3) Close your eyes

4) Relax your muscles

5) Breathe slowly and naturally; as you do, repeat your focus word, phrase, or prayer silently to yourself as you exhale

6) Assume a passive attitude. Don't worry about how well you are doing. When other thoughts come in mind, simply say to yourself, "Oh, well," and gently return to the repetition

7) Continue for 10-20 minutes

8) Do not stand immediately. Continue sitting quietly for a minute or so, taking in the moment and allowing other thoughts to return. Then open your eyes and sit for another minute before rising

9) Practice this technique once or twice daily

Source: Benson, Herbert (1996). Timeless Healing - The Power and Biology of Belief. New York: Scribner.


Reflections

"He who laughs -- lasts." - Wilfred Peterson

"Most men [women] are about as happy as they make up their minds to be." - Abraham Lincoln


Exercise Injuries:
Risk Factors, Prevention, and Treatment

Well, if you are like most other people, you too started out a couple of months ago with a New Year's resolution to improve your health and get back into working out. However, along the way you unfortunately may have encountered some set backs in your exercise regimen, namely injury. Below is a reference for exercise-induced injuries. Look to see if your specific problem is listed and remember to see a physician as necessary.

Problem Who's at risk? Causes Solution Prevention

Knee Cap Pain

(patellofemoral pain syndrome)



Sx: pain in front of the kneecap increases with workout

  • aerobic steppers
  • athletes involved in running & jumping
  • treadmill runners
  • Flat Feet
  • legs that rotate inward (tibial torsion
  • weak/tight leg mm.; esp. quads; gracilis, sartorius
  • knock knees
  • obesity
  • rest/ice
  • no quick fix
  • see a Dr and get a special knee brace or shoe insert to keep the patella in its grove.
    • increase strength & flexibility for legs, focus on strengthening quads to stabilize kneecap
    • run on treadmill @ slight elevation
    • D to "easier on the knee" sports (swimming, skating, cx country skiing)

    Wrist Tendinitis

    (inflammation of flexor tendons of hand/fingers)



    Sx: pain @ dorsum of wrist which increases with activity

    • rowers
    • kayakers
    • bowlers
    • golfers
    • weight lifters
    • racket sports
  • repetitive bending & straightening of the wrists. (ie. swinging a racket, throwing a ball)
  • No exercise x 7-10 days
  • Rice**
  • see Dr. if pain persists x 2 wks.
  • Increase intensity & duration slowly
  • strengthen flexor muscles of wrist.
  • Golfers Elbow/ Tennis Elbow

    (inflamation of extensor [tennis]/ flexor [golf] tendons where they attach @ Lat. [tennis] or medial [golf] aspect of elbow)



    Sx: pain over med. (golf)/ lat. (tennis) aspect of elbow, increases with rotation of wrist

    • racket sports
    • golf
  • repetitive use of forearm; especially backhand.
  • using old tennis balls
  • heavy racket
  • weak forearm mm.
  • overuse
  • swinging too hard
  • No hard surfaces
  • strengthen lower leg mm., esp. calves
  • New running/sports shoes q 6 mo.
  • Lat. Knee Pain

    (ilio-tibial band syndrome - AKA "IT Band Syn." inflam. of IT. band from repet. irritation & rubbing over band along with repeated flexion/ext. of knee during running.



    Sx: stinging sensation on lateral of knee or along entire lateral aspect of leg. Worsens during activity & when running downhill

    • runners
    • cyclists
  • excessive mileage
  • running downhill
  • running on banked surface
  • inadequate warm-up & cool-down
  • bowlegs
    • ice knee after activity
    • mileage
    • strengthen before and after activity
  • alternate running directions when on pitched surface
  • stretch especially before work-out.
  • RICE=
    • Rest until pain gone
    • Ice 20-30 min TID x 3 days
    • Compression with ace bandage, starting distally & unwrapping toward body
    • Elevation above heart to reduce swelling & inflammation

    Spirituality: Physicians Integrating Faith Into Clinical Practice

    First and foremost, it is absolutely necessary for us, as clinicians, to ask about the patient's religious and spiritual beliefs. This is very helpful in not only learning what psychological/spiritual approaches might be useful for this patient, but we can also determine if there are some religious restrictions on how this patient will allow us to treat him/her. For instance, some religions restrict us from transfusing blood products into the patient. Obviously, it would be beneficial for the clinician to have some knowledge of this before the transfusion begins. Other religious practices might be the avoidance of anesthesia or the avoidance of antibiotics. Nonetheless, it is important to understand any religious beliefs that might restrict our treatment of the patient.

    Knowing the religious beliefs of a patient can also be a distinct advantage in obtaining adherence from patients. By being flexible and even knowledgeable about a patient's particular spiritual outlook, we can implement a treatment that provides a union of the medicinal aspect with the spiritual. For instance, a patient with a Buddhist perspective might be more inclined to comply with a medication regimen if we say, "I would like for you to take this pill 3 times a day with the last pill taken just before your meditation session." By mentioning their faith as part of the treatment, we further validate our role as a knowledgeable, caring physician. Finally, by incorporating the patient's faith into part of his/her treatment, we can help provide that link to that intangible force that provides for some miraculous recoveries. Many cases have been written and spoken of that refer to patients whom should have no hope of recovery yet, the patients miraculously turn around. Oftentimes, these patients are those that are very spiritual. The very popular Deepak Chopra writes and speaks of many such cases where he felt he could do no more as a physician, but he could aid the patient emotionally and spiritually by having them perform meditations and other Eastern religious practices. Sometimes these patient would recover from metastatic cancer or serious septic disease spontaneously. Who knows what the reason is, but faith may be at least partly responsible for their recovery, but maybe it is. Maybe, we all can try to become a little more responsive to the spiritual well being of our patients when we start to practice and maybe our patients will be better off.


    Nutrition Tips to Fight Off Extra Pounds

    As you are well aware, Spring is nearly here. That means that it is time to shed some of the "extra insulation" that has accumulated over the winter months. As you look forward to Spring, the following advice about eating "good" will be helpful in your struggle against fat:

    Source: Fitness, Nutrition, and Wellness. The Internet's Fitness Resource


    The Secret to a Happy Marriage?
    Men, Just Give In

    A recent article in the Los Angeles Times quotes research conducted by John Gottman of the University of Washington who studied 130 newlywed couples for six years in an effort to find ways to predict marital success and failure.

    The best predictor of marital success was not the couple's use of active listening skills, instead, the marriages that did work well had the following thing in common: the husband was willing to give in to the wife. Gottman states: "We found that only those newlywed men who are accepting of influence from their wives are ending up in happy, stable marriages."

    "For women, those who couched their complaints in a gentle, soothing, perhaps even humorous approach to the husband were more likely to have happy marriages than those who were more belligerent," said the article.


    Wellness Council

    Rich Lichti, Emily Richardson, Reagan Yee, Emile Wakim, Kim King, Amy Kelly, Jen Dunn, Rob Cina


    Wellness Committees

    Spirituality - Tom Hansen, Christie Michels, Joann Jackson, Emily Banset, Laura Graeff

    Exercise/Fitness - Suzy McNulty, Dan Reeves, Derek Gordon, Temple Brannan, Justin Tobias, Michelle Anthony

    Nutrition - Katie Campuzano, Brian Williams, Jason Reuter, Dawn Swimm, Justin Kirven, Martin Janout

    Mental Health - Jennifer Brown, Lori Borella, David Vasconcellos, Jane McCabe, Kyle Stanosheck, Mike McGurren, Neal Osborn

    Relationships - Nancy Koster, John Schrader, Michelle Hunke-Daffer, Lynne McKeown


    News and Events

    Wellness Brown Baggers
       NutritionMarch
    Mental Health    April
    SpiritualityMay
    Golden AppleApril 25
    HoodingMay 14
    GraduationMay 16
    Religious Retreats      Contact Fr. O'Leary at 280-3189 for deatails