Occupational Therapy and Lifestyle Medicine - a match made in heaven.

Does anyone really know what an OT does? It’s always the same response when you say to someone that you are an Occupational Therapist. That kind of vague confusion of what on earth is that! Unfortunately, it is an extremely undersold and undervalued profession that has taken a seat in the back stalls for a long time. This is unfortunate because OT’s really do have the knowledge, the philosophy, the empathy and the capacity to lead the way in health care and in particular, Lifestyle Medicine. Whether this actually happens or not is out of my hands, however, I must at least attempt to provide some awareness and insights into this misunderstood and forgotten profession. Why? Because Occupational Therapy and Lifestyle Medicine is quite simply a match made in heaven, and we can all benefit.

So what is Occupational Therapy? Where did this odd profession come from? What do OT’s actually do? And why is it a perfect match for Lifestyle Medicine?

What is OT?

Do we dare to ask it? Do we dare to mention the basket weavers?

Occupational Therapy emerged as a profession during the early 1900’s and solidified following WW1 where injured service men were prescribed ‘activities’ as a way of promoting both physical, cognitive and emotional rehabilitation. These activities were very often arts and crafts or woodwork type tasks. When you step back and look at the bigger picture, it was actually an ingenious intervention! When you analyse the task of making something, let’s just say crocheting a blanket, it takes an incredible amount of skill; physically, you need postural control to be able to sit, upper limb function, fine motor control and dexterity, adequate sensation, visual acuity; cognitively you need some planning skills, attention, memory, visual perceptual skills, problem solving and then a whole heap of internal self regulation skills such as motivation, awareness and some sort of connection to the task. As you are seeing the product being made, there is a sense of achievement, of progress, creating the internal volition to keep rehabilitating. Phew!! And that’s just for a bit of crocheting!

So, you can see the premise behind giving craft or activities as a means of therapy was actually quite insightful, and as the profession emerged, OT’s moved away from a purely medical model focus towards one that considered a complex combination of social, biological and economic causes for dysfunction. It challenged the purely scientific and physical model of disease and started to use an approach that was based on holism, that occupation is essential for health, and that the environment in which we do everything impacts enormously on us.

Unfortunately, instead of being seen and promoted as a profession that was ahead of the times, was beautifully holistic, functional and integrative in its approach to treating people, we kind of got stuck in the activities of basket weaving and woodwork. Someone in their infinite wisdom thought that during a 4-year university degree which covered anatomy, physiology, neuroanatomy, psychology and social sciences, that we should also turn a bit of wood and weave a few baskets. Yep that’s right; up until very recently, you would find OT students in the ‘labs’ learning woodwork and basket weaving! Mind boggling! No wonder the perception of this top-class profession got lost in the woods.

Now that we understand where the labels and stigmas come from, we can focus on looking at the real value of the profession. As noted, the underpinning philosophy and models of practice focus very heavily on the persons ‘occupational role’ and the factors, both internal and external, cause and effect, both function and dysfunction, as evidenced in the Occupational Performance Model diagram below1. Furthermore, “the primary goal of Occupational Therapy is to enable people to participate in the activities of everyday life… in the occupations they want to, need to, or are expected to do”2.

Being able to analyse a person and a person’s lifestyle to pinpoint areas of dysfunction or disharmony is one of the greatest skills of an OT.

opma-2012.jpg

What do OT’s actually do?

How does this actually look in the year 2018? Let’s take a look at one of my patients, Jodi, who sought help due to feeling chronically fatigued and increasing weight gain. Her main occupational roles are mother and HR manager. Both are essentially ‘full time’ roles, however, it is impossible for her to meaningfully fulfil both, without literally splitting herself in half. So, the process of assessing and treating Jodi was to identify what aspects of her lifestyle needed changing in order for her to meaningfully fulfil the roles that she wants to and needs to, and therefore, get to the cause of her fatigue and weight gain.

In Jodi’s case, the three most important lifestyle ‘causes’ that needed attention were as follows:

  • Social/cultural/economic beliefs and circumstances

    Social/cultural/economic beliefs and circumstances that were influencing her decisions regarding working hours and childcare assistance. Discussions revealed her highest personal priority was that of mother, however, she felt a huge social and cultural pressure to continue longer hours of work despite the economics not being in her favour after childcare expenses etc. The outcome being a plan to reduce working hours, implement some creative and flexible work strategies that would achieve her desired outcomes and reduce childcare hours. Ongoing coaching and self reflection was paramount to the overall process of reshaping internal beliefs about her changing roles.

  • Rest schedule

    Rest schedule required some changes to support longer duration and better-quality sleep. Her whole relaxation routine prior to bedtime required a shift from overstimulating screen time on social media to low lighted activities such as reading, journaling, bathing and even talking with her partner! (That thing that seems to be a forgotten art… conversation. Face to face, even a bit of eye contact… amazing!) Imagine what that alone does for the relaxation response in the body!

  • Self maintenance routines

    Self maintenance routines, especially how to support a nourishing eating plan. Rather than just making recommendations for a healthier diet, we completed a thorough task analysis for meal planning and preparation. What was involved to actually do this beyond the obvious? This included, preparing a meal plan to match her working and family schedule, preparing a shopping list to match the meal plan, allotting time to shop, getting access to recipes, scheduling time to prepare and cook meals, the how and what of meals at work and on the run for her and her family, and, the task of getting her partner emotionally, mentally and physically on the same page as her with respect to their eating habits.

It really feels like this is not rocket science and is so simple, but the outcome for this woman was life changing. While her GP had identified mineral deficiencies and hormonal imbalances and prescribed a supplementation schedule, this treatment was only going to treat Jodi’s symptoms to a point. While she continued to live the same life, she would always end up back at the same spot of getting fatigued and gaining weight. Working with Jodi to make lifestyle changes in conjunction with addressing mineral deficiencies and hormonal imbalances, allowed a greater change and most importantly, a sustainable result.

Why is OT a perfect match for Lifestyle Medicine?

In ‘Lifestyle Medicine’, we are talking about a medical movement towards treating the embedded cause in lifestyle. In ‘Occupational Therapy’, we are talking about a profession that is fundamentally based on treating occupation. Those things that are necessary, valued and meaningful to the individual and that occupy their time; i.e. lifestyle. As proposed by Dr Garry Egger, when looking at the drivers of modern disease, we must look at “the cause of the cause”3. Factors such as that of the micro and macro environment; physical/sociocultural/political/economic determinants. It’s a paradigm shift for the main stream western medical practitioner. However, for those trained in Occupational Therapy, this is the paradigm of thinking that is second nature to us.

I feel like OT’s finally have a language for the profession that got lost in basket weaving. Lifestyle Medicine is the arena for OT’s to step into and utilise their astute clinical skills to help people learn healthy ways of living. It will take some courage for the individuals in the profession to create new and innovate roles in practices and it will take some risk for those in practice to align and integrate OT’s into their teams. It is my belief though that this risk will be totally worth it for those wanting to truly stand up and make a difference in Lifestyle Medicine.

Jacqueline Edser is a qualified Occupational Therapist, Certified Lifestyle Medicine practitioner and offers Lifestyle Medicine Coaching

References

  1. Occupational Performance Model (Australia). Draft of 2011 revision of the OPM(A). [Internet] 2014 [cited 2018 May 14]. Available from: http://www.occupationalperformance.com
  2. World Federation of Occupational Therapists (WFOT). Definition of Occupational Therapy. [Internet] 2016 [cited 2018 May 14]. Available from: http://www.wfot.org/AboutUs/AboutOccupationalTherapy/DefinitionofOccupationalTherapy.aspx
  3. Egger, G. (2017, September 15). Is obesity really the problem? A case for cleaning out the mineshaft as well as trying to resuscitate the canary (slide 27) [PowerPoint presentation]. Manly, NSW: Lifestyle Medicine Conference 2017.

How does a lifestyle medicine practitioner study for a lifestyle medicine exam?

The reality hit me about 3 hours into the 30 hour online course. What the hell have I signed up to this for? I’m a new mum with a 7 month old baby, I'm going back to work 2 days a week and I am chronically, overwhelmingly sleep deprived. When I signed up for the certification exam 6 months ago I think I had some wild crazy notion that I would be enjoying a full nights sleep & this course would be the perfect way to keep me occupied while I stayed at home looking after my bub.  Of course this bub would be soundly sleeping for a couple of hours during the day and blissfully playing by herself while I studied.  Clearly I was completely and utterly delusional and my daughter did not get this memo!  Turns out she is the ultimate 20-30 minute cat napper and basically fights going to sleep with the utter determination and stubbornness that I would normally adopt when studying for an exam!  Oh the irony!  So you can imagine me, rocking this bub to sleep, singing, bouncing, feeding, doing everything I can to cajole her into dreamy sleep, then when finally she is asleep, I don’t dare put her down in the cot because that is her cue to wake up and party…..so I somehow hold her, get my laptop computer, sit down ever so slowly on the lounge, precariously position my laptop beside me, login to the online course, hook up my headphones and then start listening to the lectures, trying to pick up where I left of last time and focus enough to take in the info.  Aaannnnd just when I’m in the flow of things…….bam she’s awake again and ready for my 100% attention!  What was I studying again…..and why?  Lifestyle medicine and how to adopt a lifestyle that promotes health and wellbeing?! This was beyond ludicrous, but I was in too deep to back out…….(i.e. I'd payed my $700 exam fee registration and my $700 odd for the compulsory course).  What on earth was I to do? 

Was I going to stress myself out, stay up late to study and suffer even more sleep deprivation?  Was I going to ditch the course and give up?  Was I going to worry about this every waking moment and add even more pressure onto myself?  Was I going to just have a crack, do the best I could and risk the embarrassment of failing the exam?  I had to make some decisions.  On reflection, the decisions I made were confirmed through the teachings of the course and it gave me confidence that even if I didn’t pass the exam, I was living and breathing lifestyle medicine.   Either way, this would help me help others….and if I didn’t pass the exam this year, there is always next.  I could handle the embarrassment if I failed because the lessons were worth it!

Here’s my top lifestyle medicine tips that got me through the study; 

1. WTW

WALK THE WALK;  no point learning all this healthy lifestyle stuff if I’m not doing it myself.  No one wants to go to a practitioner for health advice and see that they are clearly unhealthy themselves.  I used to think this meant I needed to have perfect health for my advice to be valid.  But no, I have learnt that it just means I need to be adopting the lifestyle habits that I expect my patients to adopt.  I was heartened to see in the course content, research surrounding how a physicians health and level of engagement in a healthy lifestyle effects whether they address things like overweight and exercise with their patients.  While I was studying, this meant that I needed to maintain all of the daily and weekly rituals that help me stay healthy.  Things like going for a run with my running group, getting lots of sunshine, doing a meal plan at the beginning of each week and sticking to it, shopping at the markets for fresh organic local fruit and veg….and the list goes on.  If I dropped some of those things it certainly would have made more time for study, however, the consequences are not worth it and it’s during these times of pushing harder and doing more that these habits become even more important! 

2.  PR       

PRIORITISE ROLES; our occupational roles are so vital to our sense of self & hence our emotional & physical wellbeing. This is one of the fundamental philosophies that my degree in Occupational Therapy is based on.  When people are engaged in occupational roles it gives life a purpose and it usually gives your body physical activity.  Two things which have been shown through epidemiological studies such as the Blue Zones are paramount to a healthy and long life.  The key is, how to prioritise roles when you are taking on more than one or two things.  While studying, my roles as a mum, practitioner, student & partner started to conflict quite a lot and I had to step back and look at how to make it work.  My answer was that some days, being a mum had to be my priority and I had to completely ditch the roles of student and practitioner.  At first this caused me to worry about the other roles and worry that I wasn’t getting enough study done.  However, once I learnt to accept this and roll with the ebb and flow of life, things became a lot easier and ironically, I got more done.

3.  MBSR 

(sounds like a disease doesn’t it!) MINDFULNESS BASED STRESS REDUCTION;  how much unnecessary suffering was I going to put myself through?  When I hit that realisation of “holy crap I might have got myself in too deep here”, my stress levels definitely were on the up and up.  I started to remember those awful feelings as a uni student worrying if you were going to pass an exam like your life depended on it.  Thankfully, 20 years down the track, I have a few more tools in the bag to help cope with stress and I was so glad to see that this course had a module in emotional wellness.  FINALLY we have sensible sound stress reduction practices making their way into medicine and furthermore, we have some good research showing the links of chronic stress on immune suppression and therefore chronic disease.  But equally, some good research on the benefits of mindfulness and meditation on stress reduction.  During the process of studying I certainly had to up the anti on my stress reduction practices.  The easiest one for me being abdominal breathing…….just taking moments short or long to breathe deeply into my abdomen and feel the relaxation effects.  

4.  PA  

While I would like that to mean I had a personal assistant, unfortunately such luxuries have not yet come to me…..but I wont stop wishing!  PHYSICAL ACTIVITY was an absolute key during this study process and for life in general.  It is probably the single most important aspect of maintaining my physical and emotional wellbeing and after seeing all of the research presented in the course, it is probably the single most important thing everyone can “do” in their daily life.  The best thing is that it ticks so many boxes at once in terms of the benefits for health, both mental and physical.  One of the things that stood out to me through the research presented was that physical activity had a preventative effect and a treatment effect for people despite being overweight and obese.  So, even if weight loss was not occurring, the benefits of simply being physically active were still present.  As I am only 9 months along from giving birth, my physical fitness is not what it used to be, but, I can tell you that even despite my sleep deprivation, when I get up early and go for a run I feel so much better in my mind and body!  My ultimate stress relief, feel good “pill” is my Friday morning triathlon.  Run, ocean swim and coffee!  All done with my partner, my daughter in the pram and with friends which makes it 10 fold more enjoyable and fun.  

So as I sit here writing this, I am still waiting to hear if I passed the exam.  My fears of being embarrassed if I fail are still there.  No one wants to fail an exam!  Multiple choice exams are tough.  There were questions that I definitely knew the answer to, questions that I know tricked me and questions that I thought were not reflective of the content taught.  However, I strongly feel that the information I learnt and the consolidation of knowledge was worth it, despite the outcome, because it has reinforced and enhanced my ability to prescribe lifestyle changes, particularly for those with chronic diseases such as obesity, type 2 diabetes and cardiovascular disease.  It is so encouraging to see that lifestyle is being brought to the forefront as the first line of defence against our growing epidemic of lifestyle diseases.  Lifestyle is being recognised as the CAUSE and the CURE and it will be fantastic to see more and more medical and allied health professionals using lifestyle as the prescription first, with medications as an adjunct or secondary option.   

And, if I pass then I am one of the first in Australia, and the world, to become certified to an international standard in Lifestyle Medicine.  That’s pretty cool!    

Jac Edser

Lifestyle medicine coaching - what the heck is it?

There is a global moment towards lifestyle medicine becoming the norm for treating lifestyle diseases. It makes a lot of sense that we would start to treat the cause, i.e. The lifestyles that created the problem. The main lifestyle diseases being cardiovascular disease, type 2 diabetes & obesity....but when you think about it, most injuries or illnesses are caused by lifestyle. But what the heck does that actually mean? And how does lifestyle medicine coaching help? 

We know that for those three main conditions, diet plays a major role in causing these illnesses.  When diagnosed with one of these conditions, it is often recommended that the person start changing their diet.  

In this situation, a lifestyle consultation would help you with all the practical aspects that this involves.  You might need to change your eating habits & you might even want to, but HOW. Changing what you eat involves many steps; 
 

Shopping - do you need to shop somewhere different to have access to the ingredients you need. If so where? How will this be scheduled into your week. How will you get there? What do you need to buy? How much? What brand? What size? 
 

Cooking - maybe you don't know how to cook. All well and good to say you'll cook meals for yourself that are healthy, but what if you don't know how. You might need different equipment or kitchen utensils. You might need to change things in your schedule to have time. What things are ok to pre prepare & refrigerate or freeze & what things should you prepare fresh. What spices do you need? What herbs? What meat? What things should you avoid? What needs to be in your pantry? What recipes do you use? What the hell is quinoa?!

SO MANY QUESTIONS......

Stress management - this may also be something that you need help with.  After all, a lot of our decisions on when and what to eat are fuelled by emotion and how you are feeling.  If this doesn't change it becomes very difficult to rely on will power alone and therefore this may require careful analysis and implementation of strategies to manage stressors into your lifestyle.  

You can see why people put these changes into the too hard basket, even if it has been "doctor's orders" to change dietary habits. Lifestyle medicine coaching will help you to break down these tasks and practically implement the changes into your life. You will be assisted to work out the "HOW TO" behind the what. If you need to change what you are eating, you will be guided to work out where to shop, what to buy, how much, what brands, what to avoid, kitchen items needed, how to put the ingredients into a healthy meal at a practical time of day, in a practical budget.....and make it taste good so you actually want to eat it! And then, work out how these new eating habits become the norm. Set some plans, set some goals. If there is a partner or family to consider, how do you out these changes in place and keep everyone happy. You'll also be guided to work out what to do when your not home. How to prepare so you're not opting for the fast food drive through when you're starving hungry, running late & have screaming kids in the back seat! 

Phew that's a lot to consider.  This is such an important aspect of helping people overcome lifestyle diseases.  Not only the big three mentioned above, but any kind of ill health or injury that has arisen out of the lifestyle that you have.  

Let's all get on this and move towards a healthier, happier world!!

Jac

 

 

Standing up for increased health

1st September 2014

Who would have thought that standing up could be so good for you.  And I don't mean metaphorically standing up for yourself, I mean literally standing up.  Two feet on the ground, upright posture.  

Given my field of work, I have always always promoted the benefits of moving. Just getting out of your chair and doing a stretch or walking away from your desk for 30 seconds.  I recommend it more from the point of view of maintaining good posture and preventing repetitive overload of a particular muscle group.  However, I have never fully realised the benefits of standing instead of sitting for long periods of time.  Or I should say, the simplicity of how this change can impact you so greatly.  I feel like I have just been given this golden piece of information but I also feel so dumb that I never took this so seriously before.

It’s funny how sometimes the most important thing can actually be so simple.  So simple as standing up.  

What I didn't think about before was the implications that prolonged sitting has on your general health.  Given we are living in a time where we are all on computers for longer and longer this is essential information!  There are many studies now that conclude sitting for prolonged periods leaves you more susceptible to many metabolic diseases including type II diabetes, obesity, cardiovascular disease and high blood pressure, and, actually shortens your life!!!  People who worked in jobs that were sedentary/sitting based jobs had shorter life spans than those who were in active jobs.  The impact of a sedentary lifestyle is huge.

The thing is, I used to think sedentary didn’t apply to the people who went out for a 30 minute walk or run in the morning and then sat all day.  I would have classed them as active.  But, what I am reading in the research now is that this moderate intensity exercise for short periods, does not counteract the effects of sitting all day.  We need to be doing low intensity movement throughout the day. 

So like all good “scientists”……I didn't believe the research until I tried it out on myself.  I am currently standing up at my newhome “workstation”!!  As you can see in the photo above my new workstation is the elevated kitchen bench.  And, according to my previous education I would have thought reaching up to my computer at this height would cause me all sorts of grief with my neck and shoulders because the bench is actually a bit high for me.  But, would you believe, I feel so much less soreness in my neck and shoulders than when I am sitting at my ergonomically sound desk!  

Not only that, my lower back/core constantly feels so much stronger.  I measured my heart rate sitting at my desk and it was 62 beats per minute.  Standing here, it is 80.  If you are into calorie counting and calorie burning, imagine how much more energy I am using when standing rather than sitting.  When I am thinking, rather than slouch in my chair, I tend to walk around the room.  And, somehow, I seem to be able to work better.  I can concentrate better on what I am doing.

Amy Cuddy’s research in power postures shows that “power postures” or expansive and open postures lead to lower cortisol and higher testosterone than “non-power postures” or closed postures.  This hormone profile is indicative of being disease resistant.  So maybe by standing we are also changing hormone levels and improving our immune systems!!!

So, I say let’s all stand up.  If you are in a job that requires you to sit for long periods of time, ask for a sit - stand desk.  It is certainly next on my shopping list!!

 

Jac

Adrenal Fatigue

Adrenal Fatigue

Yesterday I read Dr Libby Weaver’s article of “Rushing Women’s Syndrome” in the Huffington Post UK. and shared it on Facebook.  There were several women who commented on how they could relate to this, or, knew several other women who it related to.  And so it reminded me of how there are just so many women out there who are on the go but are struggling with exhaustion and feeling unwell. Yet, these women do not know what to do about it, because the very nature of themselves that got them into that state, (the caring, nurturing woman with career drive and passion), is the very nature that stops them from stopping and taking care of themselves.  And I don’t just mean an afternoon nap on Sunday. I mean really taking care of your emotional, physical and spiritual bodies. I mean making those life changes that are probably scary but you know deep in your gut that it’s what you need.  

And I mean getting real about the fact that you are a woman not a man! (That whole feminist thing really didn’t serve us as well as we think!) Woman are different.  We need different things.  We like different things.  We are wired differently. We operate very differently.  Time to accept it, not fight it.

Reasons for my passion

There are two reasons I speak so passionately about this.  First is that I see people all the time who are suffering from chronic physical injuries and pain, but the underlying issue is that they are adrenally exhausted.  They have undergone so much stress either from work, from their injury, from relationships or a combination of everything, and their bodies have been in that constant “flight or fight” mode.  Their adrenals have been pumping and pumping to create adrenal hormones, which is great when the tank is full.  But over time, they run out of juice.  And this juice is VITAL for function and ABSOLUTELY VITAL for healing.  Cortisol is one of these main hormones and among it’s main functions are to regulate blood sugar levels, anti-inflammatory action, immune response and regulate mood and behaviour.  Usually these people have seen multiple practitioners, sometimes had multiple surgeries and everyone has focused on the bit that hurts.  Yet the bit that hurts cant heal because there is no healing juice!   

The second reason is that I have been there.  In that dark dingy hole where you just keep powering on no matter what, thinking you are saving the world and passionately following your life’s purpose.  Yet you are deeply unhappy, you wake up feeling like absolute shit every day and then you just power on.....and on and on.  You think that if you stop the world will fall apart.  And if there is not that little bit of stress and rush you feel like something is wrong.  

Well, that was how I used to feel.  And, I ran a marathon in this state!  (there really is some truth to that saying that long distance runners are running away from something! funny thing is......you can’t run away from yourself!  Bugger!) 

The way through 

My way through all of this was to make some fairly dramatic changes to the way I was operating, and, as Dr Libby talks about in her article, I had to change the way I perceived myself.  I no longer run that program that I am not enough......not smart enough, slim enough, rich enough, nice enough, blah blah blah.....the list is endless.  Because in that state, you are ALWAYS on the go.  I had to make some fundamental changes in respecting myself enough to see that the decisions I made by myself, for myself, were actually ok.  No one else needed to approve.  If I was the only weirdo ordering gluten free, msg free, organic full fat food, then I had to be ok with that.  If I was the only one sitting on the beach meditating while everyone else was running, that was ok.  If I worked 30 hours a week instead of 70, that was definitely ok!!!  The changes in the way I was operating were all to support my adrenal system, providing time for rest and recovery and not being in a constant state of alert.  Furthermore, these changes are for life.  The more I take time to stop and listen to my body, the easier it is to know what I need.  

What about you? 

So, what can you do if you feel this relates to you?  Firstly, don’t panic.  It took a while for you to get in this state, so it will take some time to undo. Secondly, you are not alone and you don’t have to figure it all out on your own. There are some great resources out there and some great practitioners who can help and guide you.  The one’s listed below are some of the practitioner who I use and refer to.  Thirdly, I’ve put together a general list below to get you started, remembering that it is not just a physical problem with a physical solution.  A wholistic approach is essential.  

Body Intelligence - do some abdominal breathing.  Here is a link to further info, but basically, you do not need to be technical about it in the beginning.  Just breathe into your belly, as much as you can, as often as you can.  This will aid in relaxing the body and activating the parasympathetic nervous system......that part of your nervous system that helps you to rest, digest and heal. 

Movement Intelligence - is all about finding a balance.  Most people either fall into the category of exercising too much or not exercising enough.  Movement is great for your body in so many ways.  Do it frequently and do something you enjoy.  BUT, don’t push yourself to exhaustion all the time.  Think about yin and yang.  Do a bit of yang movement, like running, cycling, tennis, surfing, and then do a bit of yin movement, like stretching, walking, yoga, swim in the ocean.  Balance it out over the week. 

Nutritional Intelligence - make smart choices when it comes to your eating habits.  Start to get less of the bad stuff in and more of the good stuff in.  Try having less caffeine and less sugar in your diet to start with.  The last thing a stressed out body needs is more stimulation and toxins!  

Spiritual Intelligence - get a journal and write in it.  It doesn’t need to document what you’ve done everyday, it is there for you to write your thoughts and feelings.  To write about the things that go round and round in your head.  It is just for you.  No one else should read it unless you ask them to.  It doesn’t even need to make sense.  Writing therapy has been documented across many years as having multiple therapeutic effects in disease management and pain management.  

 WHAT ABOUT THE MEN! 

And men!  While the article listed above refers to women, this kind of adrenal fatigue does not just happen to women.  Men also suffer from this, however, there are usually different driving factors and “causes” behind it.  

This is a complex issue and this article only scrapes at the surface.  So, please do not hesitate to contact me if you would like to know more of my experiences of things that worked for me (and things that didn’t).  And, please dont give up if you have been on the merry go round with doctors and specialist and got no answers.  This is not recognised in "main stream" medicine by all doctors.  So they cannot help you with something they know nothing about!

In health,

Jac

References and resources used and highly recommended;

 

Dr Jane Chapman - Integrative Medicine Physician www.drjanechapman.com.au

 

Dr James L Wilson - “Adrenal Fatigue, The 21st Century Stress Syndrome” 2001. www.adrenalfatigue.org

 

Dr Libby Weaver - Nutritional Biochemist www.drlibby.com

 

Tracey Whitton - Restorative Yoga Practitioner www.stmt.com.au


Managing the managers

It would seem that if you are a manger, the skills that make you a great manger are the skills that make your health suffer.  Your ability to just keep going, your ability to function highly under stress and your ability to put the needs of others first for a desired outcome are great skills as a manager.  Well they are great skills for managing work and business, not so good for managing your health.  If you are a manager, you are likely to thrive on a challenge and excel when the odds are against you.  Your probably even just a little bit stubborn..........or maybe just determined to get things done the way you want them done!

I may as well confess and admit that I was exactly that as a manager......and while I was seemingly keeping it all together on the outside, I was slowly draining out and drying up every last drop of adrenalin and cortisol, and, every last drop of joy (and some would say, sanity!).

Sitting on the other side of adrenal fatigue and mental burnout, it is easy to see the errors of my ways.  However, when I was immersed in the merry go round rat wheel of staff reviews, staff wages, rosters, contractors, balance sheets, time sheets, sick days, bad hair days it was not easy at all to see the warning signs.  

Hence my motivation to put together this health mentoring program.  I’ve previously focused on healing the healers, now it is time to manage the managers!  This program has a whole new section on workplace intelligence, where we complete a virtual or in person assessment of your workstation and your workflow.  Two of the most important ingredients for productivity in the workplace.  We might even get our feng shui on!

I welcome you to check it out and contact me with any enquires.  Please chat with me if you have several people in your workplace who would like to participate, as the program can be packaged slightly differently for you.

In health,

Jac Edser

Ham and cheese meditation

 Last time I wrote, I spoke about my calling to go do the Camino de Santiago in Spain.  After years of procrastinating I finally found the courage to get on that plane and go.  I really didn’t know why I had to go there, and I didn’t know why I had to go alone.  And, the funny thing is, after 21 days straight of sleeping in a different bed, 21 days of cheese and ham for breakfast and step after step after step along the path not talking to anyone.......I still don’t really know!  

When I first came home and people were asking me, “how was your trip”, I kind of didn’t really know what to say.  It was really challenging.  I saw really nice places and met cool people.  Drank lots of nice wine. I knew it was an amazing experience, I knew I felt different and could see things differently, but how do you describe such a profound experience in words.....without sounding like a hippy jillipy!    

Essentially though, I think this is where the true lesson of my pilgrimage was.  I just needed to experience the experience.  I needed to get out of my head and into my body and just feel and see the beauty of life.  It was one long meditative experience that was not always comfortable and had far too much ham and cheese in it, however, it was the experience that I needed.  I now know that the little lessons I learnt along the way, have and will change the way I see and feel things.  My reference point has changed and above all else, it was a lesson in trusting my intuition.  

So I think this is what I can pass on as lessons I learnt from the camino, from my ham and cheese meditation; 

          1.   Experience the experience - get into your body and experience things, big and small.  Eat the ham and cheese....smell it, taste it, feel it, just for the sake of eating it.  Not because it is healthy, not because it is going to give you energy, do it just for the experience.  When we can turn our minds off and experience things through all of our senses, taste, smell, touch, hear, see, we can effect profound change, not only in our bodies, but in our external lives.  If you think about it, this is what meditation is.  Sitting and breathing.  Experiencing your breathe through your body.  (sorry now I’m getting hippy!!)

          2.  Trust your intuition - I really believe that above all else, our own trust in our intuitive selves is where the answers lie to our health and happiness.  Especially given that we are living in a time where money is the driving factor behind our medical care, we need to trust what we think is right for ourselves.  Listen to your instinct.  Your instinct will tell you when to trust the information provided and whether to trust the people providing the information.  Do what your heart is telling you to do.  If you have a nagging feeling to do something.....then do it.  And I am not talking about egocentric extravagant experiences that we feel “called” to do because everyone will think we are amazing and wonderful.  Do what your heart is genuinely yearning to do.  It will be that thing that keeps popping up no matter how many times you ignore it.  It might be something small like paint your toenails......doesn’t matter.   

The cool thing is, when you just experience the experience, that constant blah blah blah blah blah that goes on in your head slowly quietens down and it becomes much easier to hear that inner voice of intuition. 

In health and happiness, 

Jac Edser

Intuitive decisions are not always logical

When I first learnt about intuition I thought it was some amazing skill that was going to help me be a great practitioner and heal people.  I was taught to “tune in” to my intuition so that I could help people figure out their health problems when the “medical” data didn’t give the answers.   Sounded pretty fabulous and cool to me, so I went about doing everything I could to heighten this skill and use it to best serve others. 

Little did I know that developing my intuition would totally change my own life and they way I lived it!  Little did I know that it would sometimes be this really annoying nagging feeling, telling me to do things that I didn’t necessarily want to do.....like having difficult converstaions with loved ones, stopping doing a particular job even though it paid well, leaving relationships, keeping on persisting with a vision even though it consumed my life and running marathons! 

The thing I have noticed about my intuition is that it points me in a direction to do something, and I think, how on earth can that be good for me!!  And yet, time and time and time again, when I follow that inner voice, it ALWAYS works out for the best.  Solutions and opportunities arise that I never even thought were possible.

The more I do this, the more it seems like decisions that are made following your intuition or “following your heart” are not always logical.  

So that is how I have found myself booking flights to Spain to go on a pilgrimage.......all on my own.  I have had this calling to go and walk the Camino de Santiago for many years and have continually put it off because I didnt want to go by myself.  And as much as I kept logically telling myself it was too expensive and I shouldn’t go by myself, my heart has continued to push me to go.  

It is a leap of faith and it is totally and utterly out of my comfort zone.  

When I told one of my girlfriends that I had booked my flight, she said, “Noooo!!!.....you are supposed to go to India to find yourself not Spain!!!”  My reply was, “well maybe I need to go to Spain to find out I need to go to India”.  

That’s the thing with intuition, it is not always logical.  This trip is a lesson in trusting and a lesson in following that inner voice.  I am so excited and I am also so scared.  It is an adventure into the unknown.....and, as recommended by another great friend, all I am doing now is breathing into my belly and schrunching my toes.   And oh yeah, getting very very excited!

So I will be away from the clinic for the month of September and then back on deck in October with lots of stories.  Who knows, I might then be going to India?!?

I would love to hear from you of your own experiences of what happened when you listened to that inner voice?

In health,

 

Jac Edser

Breast Cancer - a sensitive issue

Everyone has a story about health and I love reading them.  We learn so much from hearing about other people’s journey’s in relation to illness and disease.  After hearing so many people’s reaction to Angelina’s decision to have a preventative double mastectomy, I feel like I want to tell my story.  It is not for any other reason than to help people take another look at the same issue.  As it is with many many women in this world, breast cancer is an issue so close to home for me.  Three years ago I nursed my best friend to her death.....she had breast cancer, she had a double mastectomy, she lived another 9 healthy years and then it metastasised into her lungs and bones.  She was a very intelligent, healthy, emotionally connected integrative medicine doctor.  She knew so much about health and it didn’t make any sense that someone who knows everything about alternative medicine, who looked so vibrant and healthy, who was very emotionally and spiritually aware and connected, could number one get the disease, and number two, die from it.  That just didnt make sense to me and it made me question everything.  It also made me realise, there is something about illness and disease that we don’t fully understand.  It is different for every person.  Even though you might be diagnosed with “breast cancer”, it is a different set of things that have caused the disease and that will allow it to either grow or go away.

Last year I got my own personal encounter that was both scary and enlightening.  I had that experience that every woman dreads of finding a lump in their breast.  When I spoke with my doctor, we both agreed that it was not surprising, given I had only just gotten through adrenal fatigue and knew that I had a whole heap of extra estrogen floating around in my body....otherwise known as estrogen dominance.  None of this worried me, I knew it was just a consequence of pushing myself too hard and going through a few years of quite a lot of emotional stress.  I was not scared until I was lying on the table having an ultrasound of my breasts and the very scary, powerful radiologist came in to give me the report on my ultrasound.  Her booming words were that the lump I had found was no issue, however, they found another lump on the other side and it was time to panic please.

What I realise now, is that if it were not for some prior knowledge, some voices of reason and a very skilled and understanding integrative medicince doctor, I would be sitting here now having had either one or two of my breasts cut off.  

I was scared and I was in absolute turmoil about what to do.  I did not want to get into the system.......mammogram, fine needle biopsy, lump removal, etc etc.  I wanted to make some informed choices.  And, I had to make decisions that were right for me with or without the approval of those close to me.  I came to realise that I could make a decision that was right for me and my body, even though others disagreed with it.  A very hard thing to do when all you want is the people around you to agree with you and prop you up.  

So I decided I would give myself 3 months.  I would do some more testing to further understand why I had excess estrogen and why I might have a lump in my breast and how I could best cultivate a healthy body, mind and spirit.  The hardest thing was, during this time I had to try not to stress out about the obvious and I had to somehow get rid of this belief I had.  Without even realising it, I had developed this belief that if I got breast cancer I would die.  Quite extreme, but it’s funny how our minds work based on our experiences.

Part of the tests I had were some genetic testing.....and of course, it showed I was in the 10% of the population who have the progesterone receptor gene that indicates increased risk of breast and ovarian cancer.  Hhhhmmmm...what now?

Wtih this information, rather than feel doomed to get breast cancer, I felt empowered to know how to further look after my health.  You see, I do not believe that your genes determine your health, it is just the blueprint for what you have got to work with.  There is such a growing field of science in epigenetics that confirms that it is our internal environment, and the signals we send our genes through our belief systems, that determines our health, not the other way around.  Although I knew, understood and believed this, I felt like I was butting up against a massive system that didn’t agree.  If I was to think this way, I had to get the system to agree?! It is such a new way of thinking, and the recent stories of Angelina Jolie show how we have such a long way to go as a society and as a medical system to integrate this knowledge.  When you think and act like I have, most people think you are a bit whack.  I have even been reluctant to tell this information to people because I don’t want other people believing that I am at high risk of breast cancer because of my genes.  I don’t want that around me.  

Now I realise, it is actually ok for people to know, because I know in my heart what really matters to me.....and if the system doesn’t agree, it actually doesn’t matter.  I know what really really matters to me and therefore, what gives me the absolute best opportunity at maintaining a healthy body.   I know that for me it is about healthy and intimate relationships, time at the beach, engaging work, running in the bush, nourishing food, red wine with friends, camping, travel, wearing nice clothes, time with my niece and nephew, dinners with my girlfriends doin weird things like angel cards and astrology.  And, this combination of “things” is totally unqiue to me and would not work for anyone else.  And that is ok.  I don’t need to explain nor justify it to anyone else.  And no one else needs to explain nor justisy to me what their set of things that really matter are.  

So after three months of turmoil, freaking out, deep soul searching, mediatating, drinking wine, juicing and some funny conversations about whether I should do some coffee enemas, I went and had another ultrasound.  This time my experience was totally different and it was calmy, cleaning and precisely explained to me that the lump identified on my previous ultrasound was a fibroadenoma.....it presented nothing like a cancerous lump and  there was absolutely nothing to worry about.  It had not changed and that was a good thing.  What the?  Why didn't I get that information 3 months ago!!  Obviously, taking a closer look at what mattered to me was the lessons I needed.

 

It is my hope that as individuals and as a society, we are able to see things differently.  That we develop a more whole way of seeing and understanding health, and we don’t blindly follow the system that surrounds us.    

After seeing my friend die, and sharing her journey, I learnt at a very deep level, that you can never ever judge anyone else for their decisions or actions, because you have absolutely no idea what they are going through.  We have absolutely no idea what Angelina has been through and it is not for me to judge or even have an opinion about her decision.  It is however important to see things for what they truly are, and not get sucked into a system that will now have women all over the world having “preventative” mastectomy’s.

 

Jac Edser  

Mystified by magnesium

I attended a seminar on Thursday night that was all about Magnesium. The guru shwami from Germany was here to enlighten us about “the Magnesium” crisis and teach us about the Magnesium Metabolic Types.  Sounded awesome, so I paid my $70 to the “natural health” company that was hosting the event, and drove to Brisbane to attend the 3 hour seminar.  It was the first time I had attended one of these seminars that was put on by one of these companies. Great value and great for my professional development.

WRONG!!!  30 minutes later, I was that really rude person who stands up in the middle of someone’s presentation and leaves the other 150 people to be brainwashed by ridiculously unfunctional, compartmentalised information. 

What I still cannot work out, is how nautral health practitioners have fallen into the hands of these large cmpanies who make products, fund research about their products, then fund people to tell you about the research that proves you must buy their product.  No other magnesium on the earth could do what this one does!  It helps everything from migraines to Alzheimers!  Given that magnesium is an ESSENTIAL mineral, and our main energy source is dependent on it, there is absolutely no surprise what so ever that increasing magnesium intake will help just about every problem in the body, whether is be cardiovacular, musculoskeletal or neurological.  I really didn’t need to sit in a room and see  all the “evidence” to support this!

I haven’t qutie worked out what was so wrong about this whole thing.......but it did not sit right with me.  It has made me lose a lot of faith in our natural therapies world.  Most of the people in the room were Naturopaths, and what astounded me, was that they were all intently listening, absorbing and taking notes on this “world class” information.  It makes me wonder if any of them are going to stop and think.........hang on a minute, I am treating a person here.  If they are using up too much magnesium because of stress, because of alcohol, becuase of excessive exercise, the solution is not to give a higher dose supplement in a different form.  The solution is not to be a scientist and make this chemical reaction change that chemical reaction.  You are not a genius because you figured out that they are magnesium deficient.  

The solution lies in being a listener, a detective and a healer to work out WHY these things are happening.  Sure, support the body short term with a supplement, but that is not the answer.  That is not the solution.  Chances are, if they are magnesium deficient, they are deficient in a whole range of other things as well anyway!  And the answer lies in the WHY.

Even in our ‘natural‘ therapies world, we are compartmentalising the body and forgetting that it operates as a whole.  I’m actually still quite mystified that someone could actually dedicate their life to reseraching one mineral.  

And the other thing.......did they forget that there is something on this planet called food!  Vegetables, nuts, seeds.....loaded with magnesium, and loaded with all the other minerals and nutirents that our bodies need in balance.  Wow......

Jac Edser

 

Occupational Therapy - an amazing profession.

You know when you get to that point when something really ticks you off and you just have to say something.  Get it off your chest and take the risk of the fall out.  Today I reached that point.  So here it comes, 14 years worth of keeping my mouth shut.  Hold on tight.

I am an Occupational Therapist and have been for the past 14 years.  I absolutely love doing what I do and I think that as an Occupational Therapist I have so much to offer.  As a profession of Occupational Therapists, we have so much to offer.  

So why do I keep seeing OT’s who are playing it small?  OT’s who don’t think they are worth anything or don’t think they have as much to offer as a physio or a chiro or a dr.  Why do I keep seeing OT’s who wont stand up and be counted? 

Dr Lissa Rankin has gained worldwide publicity and is pioneering a movement in the medical profession based on her Whole Health Cairn.  Basically it is a model of health that says everything needs to be in balance for the whole person to be healthy.  Everything matters, relationships, work, environment, family, sexuality, physical, mental and emotional health.  I am in total agreement with her, but what makes me angry is that this is what I learnt in OT101.  And every OT on this planet learns this!  It is one of the fundamental bases and philosophies of our profession.  It took Dr Rankin a complete breakdown and many years of research and clinical practice to figure this out.  She is now a genius in her field!  

Meaningful Occupation is also at the core of our understanding of health.  Our ability to assist people to gain or regain meaningful occupation is how our profession really started, and how we got called basket weavers.  In the post war time where many of our soldiers were injured, physically, mentally and emotionally, the provision of a meaningful task to occupy them was the best form of rehabilitation provided.  Now, I can tell you, that providing someone with the ability to cook a meal, dress themselves, walk down the street, return to work, knit a scarf, read a book, plant a garden, something that provides meaningful occupation, that gives them the ability to complete all activities of daily living, is the best gift you can give someone.  It fulfills so many of aspects of what constitutes whole health.  So why are we embarrassed that cooking groups are part of our therapy.  Why do we let others think we are just cooking a cake for fun with our patients, rather than letting them know the true value and meaning of the therapy?  Are we going to continue to let other professions have a great idea of doing something “functional” for therapy and treatment.  

As a profession we hide behind the curtain of “not knowing what an OT does” or “just treating the upper limb”.  We have an understanding of whole health and wellbeing like no other profession, and, it is time for us to stand up and own it.  Get back to the grass roots of our profession and utilise that fundamental philosophy that allows people to be truly healthy and functional. 

So, if you are an OT, ask yourself.  Am I playing small?  Do I feel I have something of absolute value to offer?  

Stop telling yourself you are not worth anything.  Stop telling yourself “your only an OT”.  Stop letting others restrict your thinking and put you in a box.  Don’t wait for your employer to offer you a course.  Don’t wait for someone else to offer you a job.  Go find the courses you want to do and do them.  Create the job you want and work hard to fulfill it.  And if you see another OT doing something great, support them, don’t compete with them and knock them down.

After employing OT’s, mentoring OT’s, lecturing OT’s, being president of our state association, being mentored by other OT’s, and working as an OT, I feel I am totally qualified to make these statements.  I have spent literally thousands of dollars and travelled the world to sit at the feet of masters in many disciplines of medicine in order to make myself a better OT.  I have been praised and I have been ridiculed.  The more I know the more I realise I don’t know.  I have made money and I have lost money.  The one thing I have absolute certainty in though, is my ability to use my training as an OT to really enrich the lives of those who come to me for help.  To help them function in meaningful occupations and to find ways to get the internal and external balance in all aspects of their lives.  

And there is one thing I have absolute hope for.  And that is, that every OT reading this will stand up and be counted in whatever way they can.  They will see value in our profession and together start to drive our profession to be seen and heard.   

I will do whatever it takes. 

  

Jac Edser