Mindful Medicine

Being a good physician means being part scientist, part detective and always a careful observer. Case in point: Katie, a young woman with a history of underactive thyroid, consulted Cindy Geyer, M.D., with a list of troubling symptoms. Dr. Geyer, Medical Director at Canyon Ranch in Lenox, put on her Sherlock Holmes hat and went to work.

“Katie was very concerned about headaches that began occurring more frequently until they became a daily event,” Dr. Geyer said. “Along with this came increasing fatigue. She usually started the day feeling OK, but by afternoon the fatigue and headaches – which she described as moderate aching all over her head – would start. She’d take ibuprofen for pain relief.”

Katie told Dr. Geyer that her daily diet was fairly healthy, consisting of mostly vegetables, whole grains, fish and turkey; a couple cups of coffee in the morning; and on rare occasions, alcohol. She slept well and was happily married. Her thyroid levels were normal. It sounded like Katie was doing everything right, lifestyle-wise.

Searching for clues, Dr. Geyer asked Katie about her level of stress at work, her posture at her desk, possible sensitivities or allergies (people with underactive thyroid seem prone to celiac disease or gluten sensitivity). There were no obvious red flags.

After much examination, the answer became clear. Explained Dr. Geyer, “It turned out to be related not to what she was eating, but how: Katie drank her coffee in the morning, skipped breakfast and lunch, and ate her ‘healthy’ diet for dinner!” The headaches and fatigue that plagued Katie disappeared with one simple lifestyle change: eating breakfast.

Not every ache and pain can be resolved so simply, but Katie’s story serves as a good case study illustrating the value of paying close attention to your body’s subtle (and sometimes not-so-subtle) signals that something needs to change.

Messages from your GI tract
In her work with Canyon Ranch guests, Dr. Geyer frequently hears stories similar to Katie’s – and she believes that, whether addressing minor troubles or life-disrupting symptoms, the key lies in the simple act of mindfulness. That is, slowing down and listening to what your body is trying to tell you.

Your digestive tract often is the first part of your body to signal when something is out of balance. “Many people I see have symptoms of digestive distress – reflux, bloating, cramping, diarrhea or constipation,” said Dr. Geyer. The solutions can vary, depending on the individual and his or her genetic background, dietary habits, activity level, age and medical history.

Stress can have a big impact – something you know if you’ve ever experienced abdominal cramps and the urge to run to the restroom just before a giving speech or taking a test. That’s an obvious example that you’d readily recognize as connected. You may not be as astute when it comes to more low-key and long-term symptoms.

If you’re having a lot of digestive symptoms, keeping a journal can provide answers. Write down what you eat and how you feel, physically and emotionally. “Doing this will help you to recognize patterns,” Dr. Geyer said. “You may notice, for example, that your symptoms occur after eating a certain food, or eating too quickly.”

A careful recording of food intake may reveal a deficiency. One common example is magnesium. “Since magnesium is found in greens and fish, about seventy percent of Americans don’t get enough of this nutrient through their diets,” Dr. Geyer said. Magnesium is a key essential nutrient for smooth muscle and blood vessel relaxation. When you’re deficient, symptoms include headache, constipation, PMS, irritability, leg cramps, menstrual cramps, high blood pressure and heart palpitations.

Being mindful: slow down, listen
“Our bodies are pretty amazing,” Dr. Geyer said. “We can breathe, move, digest food and absorb nutrients, and generate energy, all without consciously thinking about it – until a health crisis forces us to pay attention. But there are ways we can pick up our bodies’ subtle clues that something is out of balance, and use that awareness to make proactive choices for self-care before things start to break down.”

First, she recommends: Slow down. A couple of times a day, find a quiet space and unplug. Mute the cell phone and take a few deep, cleansing breaths. “This is a good time to take a head-to-toe survey of your body – just checking in.”

Whether you’re running a household or a Fortune 500 company, it’s easy to get caught on the treadmill of life with a never-ending to-do list. There are times when you push through on too little sleep, grabbing whatever quick food is available, relegating all those little aches, pains and discomforts to the back burner. Understandable, Dr. Geyer says – but not necessarily smart.

Age: The wild card factor
Nobody likes to be viewed as a hypochondriac who panics at the slightest bodily twinge, but some aches and pains should be taken seriously, especially if you’re over 35. In a young woman, pain in the jaw is likely to be from a toothache or grinding your teeth at night – but in an older woman it could possibly signal a heart attack.

If you’re nearing 40 and struggling to follow the same basic workout regimen you began at age 20, it’s time to start listening to what your body is trying to tell you. If you’re a runner, those worsening pains in the leg just might lead to a knee replacement if you aren’t more careful. Foot pain suggests a visit to a podiatrist may be in order and, possibly, a different type of shoe or orthotics.

When something doesn’t “feel” right, check in with your health practitioner. A good physician will listen to your concerns and take them seriously. If he or she doesn’t, perhaps it’s time to look for a new physician.

“On my first clinical rotation in my residency,” Dr. Geyer recalls, “my mentor used to say, ‘Between the laboratory and the diagnosis, you have to stop at the bedside.’ He knew that the person’s story – and what one could learn from careful listening and observing – were the most important clues to figure out what’s going on.”

Your ability to listen to your body can serve as an invaluable diagnostic tool for your doctor – ultimately avoiding unnecessary tests and many hours of anxiety. Time better spent enjoying life.

At What Price Denial?

It’s a simple thing, really: Honor your body. When it sends an unmistakable message, stop pushing back. When you’re tired, rest. When you’re hungry, eat. When you feel stressed, take a bubble bath or have a massage. The price of ignoring your body: You come down with the flu, experience frequent headaches or your back goes out. Continue to deny the signals and problems are likely to ratchet up until you have no choice but to pay attention.

Hungry Games

So your weight has crept up bit by bit over the years, and now you’re desperate to shed the extra poundage. How to begin? Somewhere along the line, you stopped listening to your body signals that naturally indicate when you’re hungry and when you’re full. Learning to recognize those signals again can help you get to a healthy weight and stay there.

Real hunger is your body demanding to be fed. It’s controlled by the hypothalamus region of the brain, your blood sugar level, hormone levels and how empty your stomach and intestines are. You get the hunger message when you feel hunger pangs and your stomach growls.

Real fullness, or satiety, occurs when nerves in your stomach send a message to the brain that you’ve eaten enough and all is well. The signal is sent in response to increased blood sugar, a full stomach and altered hormone levels.

Appetite is linked with the sight, smell, or thought of food. It’s all about the brain. Appetite can create a desire for food and can override hunger and satiety, which may cause you to eat even after you feel full. Or, you can lose your appetite for food even though you are hungry, in response to stress or depression

Learning to Breathe Again

A daily meditation practice – even for a few minutes – can bring great health benefits by helping you become more attuned to your body. Many of us spend our days in such a state of mental distraction that we’ve forgotten what it’s like to just sit quietly and listen to what our bodies are trying to tell us about the state of our health.

The great thing about getting started is that you need no special equipment, clothing or shoes; no particular level of fitness is required. Find a comfortable spot where you can sit quietly and keep your back as straight as possible, shoulders relaxed and your neck long and straight.

Close your eyes and breathe. Distractions, an itchy nose or the sudden appearance of a mental shopping list will occur, and that’s normal. Don’t scold or berate yourself when it does; gently set aside the distraction and refocus on the breath. It can help to visualize stray thoughts as clouds in a sunny summer sky — you can watch them slowly float by, but don’t reach out and grab them. They are simply there for you to observe.

Try sitting quietly and focusing on the breath for five minutes each morning and evening. When you begin to feel more comfortable with the practice, you can extend the length of time and frequency to whatever feels right.