Have You Ever Hugged Your Doctor?

Hugging is a funny thing. In my experience, either you're a hugger or you're not. I'm not one. However, there are times when a hug is needed, even for an anti-hugger like me. There are times when it just feels good to have that physical connection with someone who wants to support you. The problem is, when and where is this appropriate? Hugging can be an issue between patients and doctors, because of the inequity of the relationship between the two.

The Loyola University Health System in Illinois addresses this issue in a piece called Is It Ever OK to Hug Your Doctor? because it affects both sides of the equation. A doctor may feel that a patient can use a hug just as much as a patient may wish to have one. Some people may argue with our high-tech world, a hug may be even more appropriate now, to maintain that human connection between the person who needs help and the one who is providing it. Interestingly, I have seen many nurses hug patients - I have hugged patients. Most often, they were patients who were struggling through a very tough time and they just needed that contact. Sometimes, the hug was for a relative who was absorbing some bad news or who had just lost a loved one. Other times, they were hugs of thanks as people were leaving the facility. Truth be told, I don't know if we ever discussed the appropriateness of hugging. Of course, some nurses never hugged because they just weren't comfortable with it, but even I, the non-hugger, have hugged a patient or relative in need.

The Loyola article lists ways that doctors who are unsure can make physical contact in another way, that can be just as supportive, such as touching an elbow or forearm. Other body language, such as leaning in towards the patient while talking, is also showing that the doctor is interested and making a connection. In my mind, there is nothing wrong with asking, if you're not sure. There was a doctor who had done a lot for me and really helped me heal. As we were reaching the end of our treatment, I asked for a hug. He knew I didn't usually, but when I asked for one, I got it. And it helped me a lot, I remember.

What do you think? Is hugging appropriate?

Fibromyalgia Rehab Program - It's Worth a Try

After many years of not knowing what was wrong with me, I was finally diagnosed, this time last year, with fibromyalgia. My rheumatologist asked me if I would like to participate in a fibro rehab program that has proven quite successful in helping people manage their fatigue and pain. I said, "why not?"

I did a quick search (very quick) to see what I could find about fibromyalgia rehabilitation programs. I didn't find very much. Some institutions offer group therapy, where people work on management skills. There was also a study that looked at a fitness rehab program. Those aren't for me, I thought. And I found a study that said that there weren't enough studies done to see if a multi-disciplinary program, similar to the one I am entering, does any good at all. (Multidisciplinary rehabilitation for fibromyalgia and musculoskeletal pain in working age adults)

I was warned that there was a long waiting list, about 18 months. A few weeks after my doctor sent off the request (he had filled it out on the spot during my consultation), I received a letter stating that my application was in progress and I would be hearing back sometime soon. Not long after that, I received a phone call from the coordinator and I knew that the ball was rolling. In December, I was told that I had a spot in a session that would begin at the end of February 2012.

Yesterday, a year after my diagnosis, I had the initial evaluation. I met with a physiotherapist and a kinesiologist, who had me do some simple tests. I walked up and down the corridors at my own pace for six minutes. The kinesiologist had one of those rolling measuring tools and walked beside me to see how far I could walk. Then they had me go up some stairs carrying bags to mimic groceries, go up and down a ramp, a step ladder, pick up a pen off the floor, and then walk a straight line. I could never walk a straight line. I always used to joke that if I was drunk and I was checked for impairment, I would likely be able to do it for a change.

After the evaluation, I met with the therapist who will be in charge of my case for the nine weeks. The program involves meeting with professionals to work on exercise tolerance, pain management, nutrition, stress reduction, and so on. Their goal is your goal. I have to write three goals that I would like to accomplish by the end of the program. For some people, it is to be able to go out for a bike ride, for others, to be able to do their housework or go to school and attend all the classes. My goal isn't certain yet.

The pain isn't unbearable for me. I guess I am one of the lucky ones. For me, the issue is more the fatigue. Then again, even lower level chronic pain does contribute to fatigue, so it needs to be managed too. So, now I have to think - what do I want out of this program? I will be attending two mornings a week for nine weeks. Luckily for me, the facility is only a 10-minute walk from my house, or a very quick bus ride on cold wintery blustery days.

For those who are interested in the program, I'll be updating my progress along the way.

New Year: New Resolutions? Maybe Not a Good Idea

It's the same thing every year: come the holiday season, we start hearing from gyms, exercise companies, diet gurus, and all other types of life improvement people and groups, all encouraging you to contact them so they can help you keep your New Year Resolutions. The typical ones are, of course, losing weight, getting fit, spending less money, spending more time with the people you love, and so on. But while the intention is good, is making such resolutions such a good idea? Does it work? If you're like most people - probably not.

Most our flaws, as we may see them, come from years of accumulation. That extra 30 pounds you're carrying around? That didn't just happen over a few weeks. Your smoking habit? It didn't start last month. Spending too much money? Surely that's nothing new. In other words, it took years to get where we are now, it seems almost foolhardy to think that it can take only weeks to get out of these habits.

The other drawback is that New Year's Day is an arbitrary day on the calendar. It's only one of 365 (or 366) days and it's really not that much different from any other. Except perhaps in a bad way: there is a lot of pressure on that one day. Because it is a new year, people expect others to proclaim that they will honour that new year with a new twist on life. And they'll watch you. Promise you'll lose weight? What will your friends and family say when they see you having a beer or helping yourself to a second scoop of ice cream?

All this isn't to say that we can't and shouldn't make changes. Most of us do have areas where we can improve our life. So if picking the first day of a new year isn't the right thing to do, what is?

Pick a date

First, don't be pressured because of the time of year. Allow yourself to choose when you want to make the changes in your life. Experts who help people quit smoking often say to pick a quit date - so you can do the same. Pick a date when you feel it would be good for you to start going to the gym, stop watching so much TV, start organizing your messy room, and so on. But pick a date that doesn't have any strings attached to it. Pick a day that is just an ordinary day. Write down that date, circle it on the calendar, and tell others if you think it will help. Do what you can to ensure that you will be ready when that date comes.

Make a lifestyle change - not a habit change

It's all so negative: I have to stop smoking. I have to lose weight. I have to become more organized.... Rather than focusing on what you have to do (or feel you have to do), focus on what you can do to help achieve the goals. If you want to stop smoking, changing habits that encourage cigarettes may be a big help. Do you join coworkers for a coffee and cigarette at break time? Why not go for a walk and have a cup of tea instead? Do you always have a cinnamon donut from the coffee shop on the way to work? Why not stay at home a bit longer and make your coffee, enjoying it there? Do you see the difference? You're not trying to deprive yourself - you're trying to change the circumstances so you don't engage in the behaviours you are trying to avoid.

Don't bite off more than you can chew

As mentioned already, these habits didn't just start overnight and they won't stop overnight. The best way to make stop doing something that you feel is harmful is by making lifestyle changes overall. If you want to start exercising, start out with something manageable, that you would be least likely to ditch because you can't do it. Don't pay a fortune to join a gym that you may not use. Just start walking, outside if possible. Walking outside gives you the advantage of scenery, people watching, changes in terrain, and getting some fresh air. You can choose to walk just a few blocks in the beginning, walking farther and farther as you become used to it. You can walk alone or with a partner. And it is very do-able. You can add to the walking once you are comfortable with it. Join a class maybe, go swimming, or do some other activity. Gyms are great places to work out, but before committing the money, be sure that the gym is a place you will go.

If you're trying to lose weight, don't look at *all* the weight you have to lose. It may be too overwhelming. Why not start at losing the first 10 pounds or going down a clothing size? If you give yourself smaller goals, you are much more likely to reach them.

Focus on the positive

Did you miss walking three times out of five days last week because of commitments? Don't beat yourself up. You walked twice, right? Did you walk most of the days the week before? Will you walk most of them next week? Don't focus on what you didn't do - focus on what you DID do.

It's the same thing for losing weight. Were you eating a healthy diet for the past few weeks? Did you just slip up and have a couple of glasses of wine at dinner and then a bigger piece of birthday cake than you felt you should have? Ok, you did. But what about all those other dinners where you didn't have wine and didn't eat cake? Those have to count for something, don't they? Don't focus on the "slipping," focus on the times you felt you did what you wanted to do.

Celebrate your successes

Reward yourself. The carrot is so much more appealing than the stick. If you have a goal, such as going down a clothing size, tell yourself you can buy a new pair of jeans. If your goal is to become more organized in your bedroom, promise yourself a new book or pair of earrings if you manage to keep it organized for a set amount of time. Do you want to exercise more? Treat yourself to a special coffee or lunch after you've walked a certain amount of days. Of course, things are often better if done and celebrated with someone else, so if you have support, take advantage of it and let others help you celebrate.

Forget the New Year Resolutions. Make changes in your life when you want to make them because you choose to make them.

Bone marrow transplants - would you consider being a donor?

This is a reprint of a blog post from 2008, but the topic is as timely now as it was three years ago.

Many people donate blood. Many people have signed organ donor cards. But how many people are registered to be able to donate bone marrow?

Bone marrow donation has a lot of misconceptions but if everyone who gave blood - and those who didn't - would register for bone marrow donation, the number of lives that could be saved would be astronomical.

According to the Canadian Blood Services, and keep in mind that the US is not that different, "About 1,500 Canadians have received transplants through the Canadian Blood Services Registry. However, even with millions of donors on registries worldwide, a perfect bone marrow match isn’t always available."

First, what is bone marrow and why is it so darned important?

Bone marrow is the soft tissue that is found inside our bones; it's the spongy tissue in the breast bone, ribs, hips, pelvis, skull and spine. The role of bone marrow is to make blood cells - white blood cells to fight infection, red blood cells to carry nutrients from the lungs to the body tissues, and platelets that allow the blood to clot.

People with diseases that affect the bone marrow die of infection or inability for their blood to clot. The most commonly known disease that requires bone marrow transplant is leukemia, although there are many more.



What is involved in being a donor?

Not too much initially, really. First, you need to register and your local blood collection agency needs to know what genetic make-up you have. So, that means providing a swab from inside your mouth or a vial of blood for testing.

After this has been tested, you are entered into the bone marrow data base. Now - you may never ever be called - or you might. If your marrow is found to be a match to someone in need, anywhere, you will be called and asked if you still want to donate. This is a critical moment - if you register to donate, you just may be called.

Waiting for a donor to be found is tough. A friend of mine waited for a donor. One was found and she was so cautiously optimistic. Something happened, however, and the donor backed out. My friend was devastated - as were we. Finally, a donor was found, but I can't imagine what must have been going through her mind while she waited for it to actually happen.

How is the bone marrow taken from you and given to the recipient?



Bone marrow donation is typically done as day surgery although you could be kept in the hospital for a day or two. There's no doubt that there  is some discomfort involved. You will feel soreness in the hip area for a few days after the procedure, but it isn't unbearable.

You would receive either a general anesthetic or a spinal before the procedure is done. The marrow is removed from the large bones of your pelvis using a needle. Afterwards, if you need, usually over-the-counter medications will relieve any pain. The marrow is then processed and the recipient gets it through an IV.

Are there any risks when donating?

Donating marrow is a medical procedure and no medical procedure can guarantee that there are no risks. However, that being said, considering the number of bone marrow donations done, it's been found that it is a very safe procedure. The risks do include a reaction to the anesthetic and infection where the needle was injected. Rarely, there may be some tissue damage.

So, we're back to the question: Would you consider becoming a bone marrow donor?