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Developing patience is a practice.

Waiting is a part of life and a big part of living with illness. We wait for medical appointments, test results, insurance approvals, and sometimes prescriptions. With all that waiting, either I had to develop patience or I was going to be a hot mess. Resisting reality is its own kind of hell, and I think patience feels better.

Graceful waiting is an act of courage and patience. It takes courage to live with unknowing.  Here are my tips for developing patience:

Tip #1: Don’t be a victim—be your own hero. Waiting is an active process. While waiting for better treatment, a frustrated patient once told me, “I feel like I am sitting around and doing nothing while the hepatitis C is eating away at my liver.” Don’t sit back and let this happen. Use this time to build your health.

Tip #2: Take care of your entire body. You may have a disease, but that isn’t an excuse to ignore self-care. Take care of your mind and spirit too.

Tip # 3: Get a life. It’s easy to dwell on illness, especially when we are first diagnosed. However, after awhile, thinking can become an obsession that may hurt more than help. Strike a balance between the need to pay attention to your medical problem and the need to be free from thinking about it.

Tip # 4: Imagine health. Visualization, positive self-talk, and imagination are powerful tools. We can use them to our advantage or detriment. If all we can think about is how tired and befuddled we are, it doesn’t leave room for much else.

Tip # 5: Stay connected. Surround yourself with people who are vital and wise. I found it necessary to let go of unhealthy relationships, and chose to be with people who had gumption.  Someone wrote, “Life isn’t about waiting for the storm to pass. It’s about learning to dance in the rain.” If I was going to dance in the rain, I wanted to be with other dancers.

Tip # 6: Strive for the healthiest lifestyle you can. This is courage in action. Lao Tzu said, “A man with outward courage dares to die: A man with inward courage dares to live.” Start small. I don’t smoke or use alcohol. I eat well, maintain my weight, am active, and I meditate. This took years to achieve. I gave up alcohol first, then cigarettes. Exercise came next. I am still working on meditation. It’s a process. If I tried to change all of me at once, I would have given up.

Tip # 7: Live in health, not fear. Illness is scary, and it is reasonable to freak out about it. However, fear and worry don’t help, so when you are ready, consider giving up fear. Amy Tan wrote, “If you can’t change your fate, change your attitude.” Attitude can change everything.

Tip # 8: Surround yourself with positive messages. Mary Kay Ash, founder of Mary Kay Cosmetics said, “If you think you can, you can. And if you think you can’t, you’re right.”

Tip # 9: Live in gratitude. There is a Chinese proverb that states, “We count our miseries carefully, and accept our blessings without much thought.” Are you counting your blessings or your troubles?

Tip # 10: Keep your sense of humor. The English poet, Lord Byron wrote, “Always laugh when you can. It is cheap medicine.”  In addition to scientifically proven health benefits, humor lightens even the heaviest load.

Developing patience is a practice. It takes diligent commitment, training and time. It is a declaration of intent to stay healthy no matter what. It is medicine without taking drugs. When we dare to live well, we honor ourselves and inspire others to do the same.

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What words will you leave behind?

I learned that a friend was dying. So, rather than pester people with inquiries for updates, I went to my friend’s Facebook page. Social media are often places we turn because these tools serve many purposes. In this case, I was looking for information. I read the posts. People expressed their love, concern, dismay, and support.

Then my friend died and I looked at his last post. Consistent with his nature, it poked fun at an elected official with whom he disagreed. It would be his last Facebook page, and may quite live on forever.

It made me wonder about what kind of legacy I wanted to leave. If I were to die right now, will my posts, blogs, and words reflect the thoughts I want to be in cyberspace forever? Click here for information about what happens to social media accounts after you die and how to create a digital estate plan.

What words do you want to live on forever?

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What mountains will I climb now that I am nearly 65?

The year before I turned 40, I decided to set a huge goal for myself and climb Mt. Whitney.  At roughly 14, 500 feet tall, Mt Whitney is the tallest peak in the continental U.S.. The route I chose was a 22 mile hike. I had a year to get in to shape. And I did, and it was a wonderful experience.

When I was turning 50, I was on hepatitis C treatment using peginterferon and ribavirin. My goal was to survive it without killing anyone. I made it, still with hepatitis C in my blood, but no homicide on my record.

Now I am turning 65. Hepatitis C is gone, and I’ve been thinking about goals.  Although I’ve done  a few respectable hikes and cycled a hundred kilometers a couple of times, all of that is ancient history. What is it I want to do now? More importantly, what kind of older adult do I want to be? Do I want to climb more mountains?

I want to be like Grandma Gatewood when I grow up. If you don’t know of this remarkable woman, I suggest reading, Grandma Gatewood’s Walk.  When Gatewood was 65, she told her adult children that she was going for a walk. It was 1955, before fancy recreational equipment stores existed. She headed out her door with canvas sneakers, an army blanket, and a homemade drawstring bag, and started walking the Appalachian Trail. She had no idea of what she was doing, and the walk ended fairly quickly. But she tried again, and has done the trail 3 times.

Gatewood has also walked 2,000 miles of the Oregon Trail from Independence, Missouri, to Portland, Oregon, averaging 22 miles (35 km) a day. She has traveled to every state in the continental United States. She did this all in Keds sneakers.

Then there is Olga Kotelko, a Canadian track star. Kotelko started track and field when she was 77 and kept at it well into her 90s.

Many other people are doing remarkable feats at all ages and overcoming all sorts of obstacles. What they all have in common is that they are doing something and they aren’t doing battle with an “I can’t” attitude.

And this is what I have found in myself. I don’t know yet what it is I will achieve, but I already have the main ingredient – I believe I can. I am already the person who can take on a challenge. Now the issue is tinkering with the details. Taking small steps and making slow progress is not a problem; it is a gift. And this is the gift I am giving to myself – the gift of health.

And if I tell you that I am going for a walk and you don’t hear back from me, it may be because I am on a trail.

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The universe is limitless, and so it can be with our minds.

One can’t believe impossible things,” Alice said. “I daresay you haven’t had much practice,” said the Queen. When I was your age, I always did it for half an hour a day. Why, sometimes I’ve believed as many as six impossible things before breakfast. ~ Lewis Carroll, Through the Looking Glass

I believe in the power of belief. I believe that thoughts are influential. However, sometimes my belief is rather small and limited. For instance, it is easy for me to believe that through the use of my will, I can see the bright side of a rainy day; I can focus on something good that might come out of something painful. If I am feeling ill, I can direct my thoughts on health and usually end up feeling just fine.

When I was young I focused on the negative, and the fact that now focus on the positive , speaks volumes about the power of belief.  However, I am not naive about the power of wishful thinking. I am a nurse who relies on science. I am a “show me the evidence” sort of person.

Over the years, I have found that science and belief can live compatibly, especially when it comes to health. I believe in miracles but take the necessary steps to foster them. As Louis Pasteur said, “Chance favors the prepared mind.” Belief and positive thinking are ways I prepare my mind. Rigorous study is another method I employ.

I am aging, and I could limit my dreams a bit. However, I think this is precisely the time for bigger dreams. Leonardo da Vinci believed in flight. He designed a flightless machine in the 15th century, long before airplanes and space shuttles. Why can’t I? Why can’t you?

So, if I am going to believe, then I am going to believe big. Not only do I want to dream the impossible, I am purging the word impossible from my vocabulary. This is not to say that I will treat my medical conditions with thoughts rather than medication. It merely means that when I have limitless possibilities, wisdom has more room to land, and wisdom with a broad landing space has more room to take off.  It is time to let my dreams take flight.

What do you believe about your health?

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Breathe in, breathe out. Forget this and enlightenment is unobtainable.  ~ Author unknown

Health Illness

Health and illness go in opposite directions, but the way out of illness and the way into health follow the same path.

None of us is perfect, and thank goodness we don’t have to be. All that is required of us is that we breathe in, and we breathe out—nothing more. Well, perhaps there is a wee bit more, because we need to stay healthy in order to breathe. Then of course, some of us seek joy, security, love, and other forms of fulfillment. Nevertheless, it comes back to “breathe in, breathe out.”

One of the facts of life that continues to astonish me, is that I need to practice healthy habits EVEN when I don’t feel like it. Health and illness go in opposite directions, but the way out of illness and the way in to health follow the same path. Illness and injury do not excuse me from making healthy choices. Illness and injury are the motivation for continuing to stay active, to meditate, to sleep 8 hours, to drink lots of water, to select fruits and vegetables rather than junky comfort food., and so on.

Sometimes, I lose my way. Then it is a matter of returning to the moment, just breathing in and out. It serves me well to keep life simple, particularly when trudging through pain and derailment from feeling well. There are moments when life seems impossible. It is in then, when just existing requires more than we have, the secret of life can be distilled in this single practice, “Breathe in, breathe out.” Observing the breath can lead us to the present, and that is where we see what we need to do next.

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The liver is the largest internal organ.

May is Hepatitis Awareness Month and as good as any time to have a liver talk. Many people seem barely aware of the enormous importance of the liver. This may be because the liver is a non-complaining organ.  Three quarters of the liver can be damaged and you might not notice any signs of it.  Nobel Laureate Pablo Neruda underscores this in his eloquent poem Ode to the Liver. Neruda describes the liver as “modest, together friend, profound worker” and an “invisible machine[i].

 The liver is praised in poetry, art and myth. Prometheus had his liver destroyed daily by an eagle. At night, his liver would mend, only to be pecked at again the next day. Although this exaggerates the capability of the liver, it illustrates that the Greeks recognized the awesome ability of the liver to recover.

Some ancient cultures believed that the liver was the most important organ, more so than the heart. The Greeks believed that the soul resided in the liver. It was the source of love and passion.  Journalist Mary Roach noted that if the liver maintained this prestige, we would be seeing bumper stickers declaring “I (liver symbol) New York” rather than “I ♥ New York”.

There are literary connections to the liver. In Shakespeare’s Macbeth, a coward is called lily-livered.  The liver is normally a dark reddish-brown or maroon color. A bloodless liver, white as a lily, refers to a lack of courage. Portraying the mighty liver, Neruda writes “Seafaring anger soul whose innards measure blood, you live hands on oars and eyes ahead navigating the hidden mysteries, the alchemist’s chamber of life’s microscopic, echoic, inner oceans.[ii]

In keeping with liver awareness month, here is some liver trivia. These facts may not win you a Jeopardy championship, but you may win at Hepardy.

  • The word liver traces its origins to a number of languages, Old English and German being two of them. It may mean to “fatten up.” This seems particularly apt, given the rise of fatty liver disease in the United States.
  • The liver is the largest internal organ. Roughly, the size of a football, a man’s liver typically weighs around three pounds.
  • Everything passes through your liver. This includes everything you eat, breathe, and apply to your skin.
  • The liver is made up of specialized cells called hepatocytes. Hepatic comes from the Greek word for liver, hepar. Hepatitis means inflammation of the liver. A hepatologist is a liver disease specialist.
  • The liver can re-grow damaged cells. This is known as regeneration. The liver can regenerate an entire liver from only one-fourth of a functioning liver.
  • A veritable highway system of arteries, veins and capillaries run through the liver. A quart and a half of blood flows through the liver every minute.
  • The liver produces bile, which is necessary for the digestion of fats. Bile passes through a duct system that rivals the Alaskan pipeline. Most of the bile pours into the small intestine, where it breaks down fat. Some bile is stored in the gall bladder.
  • You can live without your gall bladder. You cannot live without your liver.
  • A double-layered membrane encases the liver. This protects the liver against friction from nearby organs.
  • Liver cells do not have nerves. This means that technically a liver biopsy would not hurt if doctors could perform a liver biopsy without puncturing the skin, membrane and surrounding tissue. However, the majority of liver biopsy procedures are percutaneous, meaning a needle needs to pass through the skin and surrounding tissue in order to get to the liver. This is why a local anesthetic is used to numb the area.
  • The liver has over 500 functions. The human body relies on the liver for regulation of energy, hormonal balance and clotting.  It also filters nutrients, poisons and bacteria.
  • The immune system depends on the liver. The liver produces approximately one quart of lymph fluid daily.
  • Drugs and alcohol are metabolized by the liver.
  • The liver is an important player in the metabolism of carbohydrates, protein, and fats.

The liver is always doing something such as storing, converting, producing, maintaining, breaking down, processing, filtering, regulating, or removing something. Neruda’s ode puts it like this: “you suck and score, you distinguish and divide, you increase and lubricate, you give home to life’s enzymes and grams of experience”.

In short, the liver is more of a factory than a house for the soul. However, what a grand factory it is!  Neruda dubs it a visceral warehouse. So as you eat, drink, breathe, work, and play, remember to care for your liver. Be aware, not just in October but all year.  “Do not betray me! Work on! Do not arrest my song.[iii]

[i] Neruda, Pablo, “Oda al Higado”, translated by Morales, H. and Hochman, W.

[ii] ibid.

[iii] Neruda, Pablo, “Oda al Higado”, translated by Kalant, O.

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