why?…the big C

When you least expect it, life can turn on a dime.

I currently know 2 people who are battling cancer. One, a friend’s father who is losing his fight with recurring melanoma. The other, a dear brother-in-law who learned he has follicular lymphoma…an incurable cancer.

LYMPH NODES-SPLEEN: SPLENIC INVOLVEMENT BY FOL...

LYMPH NODES-SPLEEN: SPLENIC INVOLVEMENT BY FOLLICULAR LYMPHOMA This illustration depicts the classic appearance of spleen involved by follicular lymphoma, namely the presence of discrete, miliary, small, white “pearly” nodules throughout the whole parenchyma. (Photo credit: Wikipedia)

I’m having difficulty wrapping my brain around both cases. In fact, I feel mentally claustrophobic unable to break away from the constant flow of negative thoughts.

How? A recurring question…with no answer.

There’s no definitive reason why someone is stricken with cancer.

Yes, one’s lifestyle can be scrutinized.

Do you smoke? Or do you live with smokers? You know…second-hand smoke.

Do you inhale red meat? Or feast on fast foods 24/7?

Have you harvested the minimum amount of fruits and veggies? Or are you anti-vegetarian to the point of gagging at the mere mention of…rabbit food?

Exercise? Not your cup of tea? Couch potato more your style?

Alcoholic? Drug Addict? Sex addict?

Do you believe…in God? Or do you thumb your nose every chance you get?

Are you sleep-deprived? Or stressed out all the time?

Are you selfish? Or selfless. Volunteering and getting high on altruism?

Smiley faces? Or frowney faces? What’s your reset button?

Is depression dragging you down?

And in our hysterical, political climate being a bluebird or a cardinal might infect the healthiest body with cancerous cells.

My brother-in-law is an admirable specimen. Everything in moderation…except when it comes to compassion…and hope.

He eats well, drinks in moderation, surfs and takes walks, is religious where it counts…in everyday life, has never smoked, and doesn’t hesitate to help others. I’ve no idea his political persuasion because he’s not one to grandstand.

He makes me laugh. Gigantic belly laughs. From the moment we embrace hello…the jokes fly. We are so in sync that we could be a comedic act. My daughter has often remarked how her uncle and I don’t even pause to think about our comebacks. And those who are with us can’t help but be swept along in our insane garble. Our mother-in-law was one of our biggest fans. God bless her soul…we were both huge fans of hers as well.

One look at my sister-in-law, his wife of many years..confirms their deep and abiding love.

So how does it happen? Cancer.

I’ve no idea. But I’m involving myself in my brother-in-law’s fight without being asked. I’m hanging out my shingle…“hugmamma, m.d.” I’ve already done some Googling on follicular lymphoma and texted my sister-in-law the information I found.

As I await instructions…I send my love and prayers and mountains of laughs…to a brother-in-law…

…who’s always been…like my brother…

………hugmamma.

vegetarian, “mission impossible?”

In keeping with my previous post, I’m forced to seriously consider the  health benefits of a vegetarian lifestyle. If you’ve been with me since the early days of my blog, you’ll know this isn’t a decision I make lightly. Having grown up in a household with many mouths to feed, and a widowed mom as the sole breadwinner, meat was a luxury to be sure. So as an adult who’s been able to afford better fare, all forms of meat, especially red, has been a staple the last 40 years. While my family has cut back considerably on feasting on steak, ground beef still shows up in a variety of favorite dishes, like chili, spaghetti, Salisbury steak, teriyaki meatballs. But my recent spate of digestive issues has me rethinking what I put in my mouth. It’s probably lucky for me that my body has always known when to “hit the brakes”, even when I don’t.

As a child I would frequently suffer what my mom called “bush.” She said that was what the Portuguese called a “turned ” stomach. After asking if I’d fallen down to determine the cause of my pain, she’d set about “turning” my stomach so that it would be right side up again. I wasn’t one to question when I was in agony, so I submitted to her superstitious remedies. Lying on my back, my mom would massage my stomach with rubbing alcohol. Beside myself with moaning, tears streaming down my face, it seemed to me that after a bit my stomach ache was, in fact, better. Of course I was told to rest, my mom cooing me to sleep.

Over the years, I’ve been in and out of doctor’s offices for digestive problems, having even seen a gastroenterologist in my late 20s. While the problem wasn’t in my mind, its resolution was always nebulous. The only solid fact told me by one New York physician, that took me many years to finally accept, is that I’m lactose-intolerant. How did I decide he was probably right? After gorging on ice cream, I’d get a mean belly ache, that’s how. But testing his theory once wasn’t enough. I had to re-enact that scenario again and again, until duh, I got that “light-bulb” moment. So it’s not that I’ve permanently banished jamocha almond fudge or coconut ice cream from my palate. I just satisfy myself with a taste, a kid’s size cup or cone does the trick. And therein probably lies the secret to a healthy diet, A TASTE, not a bowlful or a plateful of anything. Except if you’re like me, a taste can lead to another, and another, and before I know it, I’m in trouble.

Last night on PBS, Dr. Daniel Amen was giving a lecture on “Change Your Brain, Change Your Body,” another of his books. He said something about himself that struck a chord with me. He noticed that certain foods triggered something in his brain which made him crave “bad” foods. Sugar and salt are 2 triggers which have me running like a hamster round and round in its wheel. I noticed a long time ago, probably when I was doing Weight Watchers, that after eating a cookie, I needed to eat chips, or vice versa. As we all do, I kept myself in check for a little while. But as memory fades, so does resolve. That’s why I’m probably lucky that my metabolism goes haywire before I get myself into really dire straits.

Veggies were not a mainstay of family meals in the Hawaiian homes I visited growing up. Since everything had to be shipped into the islands at great expense, fresh produce wasn’t always affordable for lower-income households. I can remember having potatoes, carrots, and onions in stew, with very little meat. But having a separate serving of vegetables on the dinner plate is not something I remember seeing regularly. And I can’t remember that we were heavily into growing our own either. I mention all this as an excuse for not having grown up eating fruits and veggies, as we now know we all should be doing. But wasn’t the old version of the FDA’s food pyramid also to blame? I think carbs, dairy and protein were ranked higher in the old days. But no matter, this is 2011, and I’m 61.

Fruits, veggies, and grains are definitely what my body now needs to maintain my life going forward. My digestive system can no longer process refined foods, dairy products, and meats like it did in the good old days. Wish we could all learn this lesson sooner, rather than later. But the best we can do is continually remind ourselves, and hope that the message finally takes hold nationwide so that future generations will live more healthfully. We seem to be living longer thanks to scientific research, but our quality of life falls far short. Do we really want to extend the number of years we suffer from physical ailments, because we gorged on toxic food?

I sometimes wonder what my mom’s quality of life would have been like, had she the benefit of more education, not just about food, but about everything. She had to leave school after 6th grade. Thereafter, her life was just about survival. What she ate was probably not her biggest concern, but that she ate at all, and that we her children had food on our plates as well.

i have a college degree, i should know better…but i’m still human…and there are so many temptations…hugmamma.

“change your brain, change your life”

I have to credit Dr. Daniel Amen’s book Change Your Brain Change Your Life with my “detour” towards a more positive attitude. It’s the path I’ll continue to travel, as I journey “home.” With the information gleaned from the book, I’m pretty certain I’ve suffered a form of depression all of my life, and I’m sure my mom did as well. We battled our “demons”, mustering up all the courage we could gather from deep within, and relying upon the  support  of loved ones. At best, our attempts to help ourselves was haphazard. Sometimes our efforts succeeded, other times we probably “blew it.” We muddled through, with growing negativity as a constant companion. To survive, we felt compelled to sever relationships along the way, that might destroy our fragile psyches. Looking back, we were just trying to live our best lives, given the hand life had dealt us. Without a doubt, there must be many who have led similar lives.

All kinds of help is available these days, from psychiatrists to clinics to alternative health practices. There’s no quick fix for depression, nor one right way. However I am a proponent of Dr. Amen’s philosophy, for it has helped me understand the workings of my brain. And just as I take care of my body with the help of exercise, diet, chiropractic manipulation and massage therapy, I am learning to look after my mental health, thanks to Dr. Amen’s message.

Your brain is the hardware of your soul. It is the hardware of your very essence as a human being. You cannot be who you really want to be unless your brain works right. How your brain works determines how happy you are, how effective you feel, and how well you interact with others. Your brain patterns help you (or hurt you) with your marriage, parenting skills, work, and religious beliefs, along with your experience of pleasure and pain.

If you are anxious, depressed, obsessive-compulsive, prone to anger, or easily distracted, you probably believe these problems are “all in your head.” In other words, you believe your problem is purely psychological. However, research that I and others have done shows that the problems are related to the physiology of the brain–and the good news is that we have proof that you can change that physiology. You can fix what’s wrong for many problems.

Depression is a physiological illness, just like diabetes or arthritis. Living in our high-tech, fractured society, I wouldn’t be surprised if many of us suffer some form of depression, ranging from moderate to bipolar.

According to Dr. Amen’s book, my difficulty may lie within my brain’s Cingulate System. Glancing through the following checklist, I  have probably exhibited several of the symptoms, especially during the early years of my marriage. Maturity and motherhood helped me overcome some, but more recently, suggestions from Change Your Brain Change Your Life helped me to combat other symptoms, namely “excessive or senseless worrying,” “tendency to have repetitive negative thoughts,” and “tendency to predict negative outcomes.” But just as there’s no cure for arthritis, there is none for depression. Both have to be managed, which is fine with me. It’s a fact I’ve come to accept. Exercise and a reduction in sugar intake has helped lessen the arthritic pain in my lower back. And practicing Dr. Amen’s recommendations, has greatly minimized my depression.

CINGULAR SYSTEM CHECKLIST

Please read this list of behaviors and rate yourself (or the person you are evaluating) on each behavior listed. Use the following scale and place the appropriate number next to the item. Five or more symptoms marked 3 or 4 indicate a high likelihood of cingulate problems. 0=never/1=rarely/2=occasionally/3=frequently/4=very frequently

  1. Excessive or senseless worrying
  2. Being upset when things are out-of-place
  3. Tendency to be oppositional or argumentative
  4. Tendency to have repetitive negative thoughts
  5. Tendency toward compulsive behaviors
  6. Intense dislike of change
  7. Tendency to hold grudges
  8. Trouble shifting attention from subject to subject
  9. Trouble shifting behavior from task to task
  10. Difficulties seeing options in situations
  11. Tendency to hold on to own opinion and not listen to others
  12. Tendency to get locked into a course of action, whether or not it is good
  13. Being very upset unless things are done a certain way
  14. Perception by others that you worry too much
  15. Tendency to say no without first thinking about question
  16. Tendency to predict negative outcomes

GETTING UNSTUCK

The cingulate system of the brain allows us to shift our attention from thing to thing, idea to idea, issue to issue. When it is dysfunctional, we have a tendency to get locked into negative thoughts or behaviors; we have trouble seeing the options in situations. Healing this part of the mind involves training the mind to see options and new ideas. …Whenever you find your thoughts cycling (going over and over), distract yourself from them. …Sing a favorite song…Listen to music that makes you feel positive…Take a walk…Do a chore…Play with a pet…Do structured meditation…Focus on a word and do not allow any other thoughts to enter your mind (imagine a broom that sweeps out all other thoughts).

(Keeping busy has been my “default” response to low spirits. Ironing clothes is a “favorite”, a chore my mom taught me with pride, since that’s what she did at the orphanage where she worked. When I’m outdoors walking Mocha, nature’s beauty intoxicates my senses, forcing me to disengage from life’s frenzy. Indoors I get the same “high” watching a favorite Michael Jackson DVD, which gets my body pulsating to the beat. Sitting for a few minutes with one of my cat’s purring in my lap, makes me pause, enjoying the moment. And when I lay my head on my pillow at night, I thank God for all our blessings, and pray that all may live their best lives. This prayer alone has helped me fall asleep, because it stops the “ants”- automatic negative thoughts, dead in their tracks.)

Many people with cingulate problems have an automatic tendency to say no. Fight the tendency. Before answering questions or responding to requests in a negative way, take a breath and think first whether or not it is best to say no. Often it is helpful to take a deep breath, hold it for three seconds, and then take five seconds to exhale, just to get extra time before responding.

When you are stuck on a thought, it is often helpful to write it down. Writing it down helps to get it out of your head. Seeing a thought on paper makes it easier to deal with in a rational way. When repetitive thoughts cause sleeping problems, keep a pen and paper near your bed to write them down. After you write out a thought that has “gotten stuck,” generate a list of things you can do about it and things you can’t do about it. Use this simple exercise to unlock the thoughts that keep you up nights feeling tense.

(Blogging has been a God-send. It’s been cathartic in that I’ve been able to exorcise “demons” that have probably been roiling around inside my gut for too long, not only personal ones, but thoughts about the world in which I live.)  

When all of your efforts to get rid of repetitive thoughts are unsuccessful, it is often helpful to seek the counsel of others. Finding someone to discuss your worries, fears, or repetitive behaviors which can be very helpful. Often just talking about feeling stuck will open new options.

(Coffee with friends has always been a great way to share problems and gain new insights, and perhaps discover helpful suggestions, and sometimes, even answers.)

Exercise can also be very helpful in calming worries and increasing cognitive flexibility. Exercise works by increasing brain levels of l-tryptophan. L-tryptophan is a relatively small amino acid and has trouble competing against the larger amino acids to enter the brain. During exercise, more of the large amino acids are utilized to replenish muscle strength, which causes a decrease in the availability of these larger amino acids in the bloodstream. When this happens, l-tryptophan can compete more effectively to enter the brain and raise brain serotonin levels. In addition, exercise increases your energy levels and may distract you from the bad thoughts that tend to loop. I often recommend exercise for oppositional children as a way to improve their l-tryptophan levels and increase cooperation.

(Kristina’s exercise class has been a life-saver. During these last 5 or 6 years, it has been a healthy addition to my routine, not only for my physical well-being, but for my mental and emotional well-being as well. I can feel the difference in my mood and my energy level, when I’ve been remiss in my exercise routine. The same can be said for my visits to the chiropractor and massage therapist. They’re not luxuries; they’re necessities.) 

Low serotonin levels and increased cingulate activity are often associated with worrying, moodiness, emotional rigidity, and irritability. There are two ways that food can increase serotonin levels.

Foods high in carbohydrates, such as pastas, potatoes, bread, pastries, pretzels, and popcorn, increase l-tryptophan levels (the natural amino acid building block for serotonin) in the blood, resulting in more l-tryptophan being available to enter the brain, where it is converted to serotonin. The calming effect of serotonin can often be felt in thirty minutes or less by eating these foods. Cerebral serotonin levels can also be raised by eating foods rich in tryptophan, such as chicken, turkey, salmon, beef, peanut butter, eggs, green peas, potatoes, and milk. Many people unknowingly trigger cognitive inflexibility or mood problems by eating diets that are low in l-tryptophan.

For example, the high-protein, low-carbohydrate diets that I recommend for low-dopamine states (related to prefrontal cortex underactivity) often make cingular problems worse. L-tryptophan is a relatively small amino acid. When you eat a high-protein diet, the larger amino acids compete more successfully to get into the brain, causing lower levels of brain serotonin and more negative emotional reactiveness.

(Diet remains an ongoing challenge, but at least I’ve eliminated as much sugar as possible, and replaced simple carbs with complex ones, and continue to ramp up my intake of fruits and veggies. But I’m no angel; every now and then I “sin.”)

Dr. Amen also prescribes reciting the Serenity Prayer, as a way to combat repetitive negative thoughts. “The Serenity Prayer is repeated by millions of people around the world, especially those in twelve-step programs. It is a beautiful reminder that there are limits to what we can do in life and we need to respect that. Many people find it helpful to repeat this prayer every time they are bothered by repetitive negative thoughts. I recommend that you memorize at least the first (three) lines of the prayer (change it as needed to fit your own beliefs).”

God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.

Living one day at a time, enjoying one moment at a time; accepting hardship as a pathway to peace, taking as Jesus did this sinful world as it is, not as I would have it, trusting that you will make all things right if I surrender to your will; so that I may be reasonably happy in this life and supremely happy with you in the next.

-Attributed to Reinhold Niebuhr

 As we age physically and mentally, our quality of life can suffer. Money certainly helps sustain a certain lifestyle, but is it substantive if we’re unable to reap the spiritual rewards as well? I’m trying to remain as agile as possible, mentally, physically and emotionally so that I can continue to write, and enjoy life’s small pleasantries, until I no longer can. Changing my brain, has helped change my life, for the better.

our best lives, hugs for…hugmamma.

   

maui, hookipa beach park

Had brunch with my daughter at Amerigo’s on Sunday. Our waitress was a pretty blonde with a broad smile. We made small talk when she checked to see if everything was to our liking. We were both surprised to learn that we had a Maui connection. She’d just returned from visiting her brother who lives on the island, and I explained that I’d been born there. As usually happens when I mention that fact, her face brightened and her body relaxed as if we were in the islands. The server, in her late 20’s or early 30’s, said her brother is a wind surfer and has been a Maui “kamaaina”  (stranger turned local), for 17 years. He loves the lifestyle, and she wished she were back with him, enjoying the surf and tropical sun.

I was sincerely happy to learn that someone loved my island birthplace, enough to make it his home for more than a decade. Chatting with the waitress brought back fond memories of picnicking at Hookipa Beach Park, now a wind surfing mecca. I shared them with my daughter who has only visited Maui once in her 24 years. Perhaps we’re due for another trip home.

Growing up in a household with no disposable income, weekend picnics at the beach were very special. Sundays were  when we packed the trunk with brown paper sacks full of lunch fixings, like fried chicken, white rice, potato salad, chips and strawberry and orange soda pops. Piling into the car, my mom, brother, sister, and me, would drive to beaches an hour or so from our home in Wailuku.

Although not my favorite, Hookipa Beach Park managed to stir my imagination. Hiking a long, steep, hilly path down the rocky cliff-side, carrying bags while bracing against high winds, was not fun. And the blue, green ocean always seemed colder than elsewhere. Fighting to keep a toe hold in the sand while being pulled by an occasional rip tide, struggling to stand as huge waves crashed on top of me, and tripping over rocks along the sea floor, did not compare to wading in the calm, sandy, warm waters of Kalama Beach Park in Kihei.

We would often seek shelter from the whipping winds in a water cave, carved into the base of a cliff. At low-tide, the sandy cove was a child’s dream. Lying face up on the clean, washed sand, I imagined myself a Hawaiian princess of old. Pretending that our family was fleeing from those who’d overtaken our royal palace, we sought shelter in caves along Maui’s coastline. There we’d remain until the tides returned, swelling our hideout with sea water once more. Somewhere on the horizon of my pre-adolescent mind was a handsome, “hapa-hauole” (part-Hawaiian, part-Caucasian) prince, my knight-in-shining armor…

Awakened rudely by the hollers of my siblings because the water was edging its way up the sand, I knew it meant we were leaving. Yuck! Yuck! Yuck! It was always worse climbing back up the craggy cliffs, bellies full, bodies lazy, wet sand covering legs and arms. But worst of all, the end of another Sunday, meant a return to school, homework, and endless chores. It seemed forever until the following weekend and the next picnic. 

why can’t sunday, follow sunday?…hugmamma.

foreign country, home?

HGTV is one of my “go to” stations when I’m surfing the channels looking for somewhere to land. One of my favorite segments, which my husband also enjoys watching, is “House Hunters International.” Being “niele” (Hawaiian for “curious”, my family says I’m “nosey”) by nature, I want to see how other people live, especially in  foreign countries. What are their houses like? Do they reflect a totally different lifestyle, or one not unlike mine? What are prices like? Do they seem in line with what the homes offer in basics, as well as in amenities? I’ve seen HGTV shows filmed in cities like Tokyo, Hong Kong, Honolulu, Paris, Edinburgh and countries like Mexico, Portugal, Spain, Italy, England, Argentina, Costa Rica, and islands like Aruba, Jamaica, the Caymans.

Most of the locations HGTV visits seem to appeal to my exotic side. Of course viewing places I’ve not been as a traveler is like being in a candy shop, face pressed against glass cases, eyes bugging out over the contents. My latest refrain which seems ongoing is “We should retire there.” To which my husband’s reply is always “Yeah?” or “I don’t think so.” I’ve decided he has no exotic side, only a very practical one which keeps me fully grounded. If it weren’t for him, I’d have been airborne a zillion times, never landing for a breather. Of course I’m glad he never takes me seriously for then I’d have to “put my money where my mouth is.” And I’ve no “kala,” (Hawaiian for money, lots of it) to support a lifestyle of the “rich and famous.” Besides, we’re not of that class, being pretty simple in our wants and likes. I’d like a vacation home in Hawaii, and a Volkswagen bug, blue or yellow. See, pretty basic. Well, at least half my wants is…the Hawaiian home…with an ocean view.

While I’m caught up in the moment watching non-natives weighing the pros and cons of various houses in foreign locales, I’m amazed at their decision to live beyond their comfort zones. Some even retiring, lock, stock and barrel, to supposed final homes of their “golden years.” Besides needing a tremendously flexible attitude toward their adopted place of abode and its citizenry, these new residents must be prepared to live within the explicit, and implicit, laws of the land. They might find themselves adrift without a” life jacket” in a face-off with the ruling government where they’d taken up residence. Trying to cloak themselves in the American flag as U.S. citizens might be like moving a mountain, which might prove easier to do in the long-term.

Of note is the ongoing case of Amanda Knox, a University of Washington student who, while studying abroad for a semester in Luca, Italy was accused of murdering her British roommate. The rural town peopled by folk who have probably lived their entire lives in that village have little, if any, experience with foreign visitors except what is stereotypically represented. So it seems in Knox’s case being an American teenager may have prematurely cast her in the widely viewed role of “wild child.” Even I, sitting in the comfort and safety of my home in the U.S., can’t be absolutely certain if she is innocent or guilty. But while her case is on appeal and her parents wage an all-out-war, sacrificing much in time, energy and money, their daughter is serving out a 20+ year sentence.

Being a professed worrier, although I’m getting better, the rampant killings by drug cartels in Mexico City and other parts of Mexico, has me wondering about the safety of retirees who have moved south for the “good life.” In her attempts to assuage my concerns a friend, herself a regular visitor to Puerto Vallarta and whose friends’ family lives on the outskirts of the resort, assures me that Americans are safe. The resorts at which they are guests, are heavily guarded. I’ve also been told by the Mexican woman who works at the dry cleaner we frequent, that the sleepy village where she is from and where her family still resides, is untouched by the violence.

I am not as mystified about Europeans residing in countries other their own. It would be like my having moved from Hawaii to the east coast to New England to where I am now in the Pacific Northwest. The difference, of course, being that European countries are sovereignties. Furthermore the ability for Europeans to travel easily across borders, proposes a certain level of comfort. That ease and inherent comfort are not an intrinsic part of  moving from the U.S. to a country in Europe, Asia, or South America. And then there’s the language. Europeans tend to know more than their native tongue; we, on the other hand, rely heavily upon others knowing English.

It would seem that at least 2 categories of Americans make their homes abroad, those who take their identity with them insisting that their surroundings adjust; or those who are chameleons adjusting to whatever their environs require. Dear friends of ours, a gay married couple, recently bought a home in the Spanish countryside. Imagine my disbelief when my husband told me of their purchase?!?. “How could they just up and decide to move to Spain? Do they know anyone? Are they leaving for good?” But then I let the news sink in. I thought of the 2 men, their effervescent personalities, their annual social gatherings, their love of travel to places like Vietnam and the Galapagos Isles, and their talent for bringing friends together as family. Such reflection left me with no residual qualms, about these 2 fabulous men taking up residence in a foreign country. Perhaps,… I’m even a little envious of their hutzpah.

Having been raised on Maui, I often blame my islander roots as reason for not traveling farther afield with more frequency, or seriously contemplating a permanent home abroad. I use the same excuse for choosing to drive through residential neighborhoods or back roads, rather than speeding down freeways at 60 miles an hour trying to keep up with everyonelse. Call it an island mentality or fear of the unknown, I will never be Marco Polo or Magellan. Perhaps because of my dysfunctional childhood, I find that being with my husband and daughter is more important to me than traveling the globe in search of what I’m already blessed with here at home. But while my search is complete my daughter is confident she’d be fine working, and living, in Europe, if that’s where her career took her. And she goes with our blessing to live the life she envisions for herself, here or abroad. That won’t prohibit me from continuing to give advice, however, that she “drive carefully and be safe.”

is it youth that gives us wings, which when “clipped” in older age keeps some of us closer to the nest?…hugmamma.