Unleash Your Mindfulness on Chronic Illness

'Has there been a stressful situation in your life that you turned around by reframing your outlook?'

From NPR

When psychologist Ellen Langer asked participants at a seminar to talk about someone or something that just drove them nuts, one woman spoke about her husband always being late for breakfast — a minor, everyday annoyance that Langer suggested might be reframed: Focus on the gift of a few moments alone.
A small thing maybe, but over more than 30 years, Langer has conducted a series of ingenious experiments that show how small and seemingly simple changes in our lives can reduce stress and help us lead healthier, happier lives.
The Harvard psychologist's books include Mindfulness, The Power of Mindful Learning and Counter Clockwise: Mindful Health and the Power of Possibility. Langer talks with NPR's Neal Conan about her study of mindfulness and how easy it can be to be more mindful.

Question: Has there been a stressful situation in your life that you turned around by reframing your outlook?

 "I was a graduate student at Yale, and we were going to play poker. It was my turn to deal. And all the cards would be face down, and I dealt the card rather than to the person next to me, to the person next to that person, and they just filled in and gave the person next to me the next card. And everybody went wild.
"[They called it a] misdeal, you know, and I didn't quite understand what difference it made which card I gave the person, since we couldn't see them anyway. And that said to me that people are mindlessly following rules and seem to give up thinking.
"And so I went on then to study this concept of acting like a robot, not being there, and I must say that in almost 40 years, it's clear to me that this is pervasive, that virtually all of us, almost all the time, are not there.
"[For example,] when I was thinking about getting dressed this morning, I said: 'Let's see, what should I wear to be on your show?' And reminding people it's a radio show, so it hardly matters."
On how mindfulness can improve health
"When I started the Counter Clockwise book, I looked at chronic versus acute illness, and I couldn't find a definition for chronic. You know, did you need to have the symptoms 24/7, three hours a month? There was no definition. But it mattered enormously because when people see that they have a chronic illness, they believe that there's nothing they can do about it. And so then we set out to study this in various ways, not the least of which is once you start paying attention to when you have the symptoms and when you don't, three things happen.
"The first is you see you don't have it all the time, so it's not quite as bad as you thought. You know, people are depressed, they think they're depressed all the time. No one is anything all the time. People who are dyslexic, it turns out that most words, over 90 percent of the words, they're reading they tend to read correctly, yet they define themselves by their illness.
"So what happens is first you see you're not as bad as you thought you were. Second, by seeing that sometimes it's better, sometimes it's worse leads you to ask the question — well, why? And you may well come up with a solution. And the third, even if you don't, that whole process is mindful, and the 35-or-so years of research we've done shows that that kind of noticing new things leads to health and longevity."
On why mindfulness is easier than it sounds
"People often confuse mindfulness with thinking, and thinking has gotten a bad rap itself. Now, when you're being mindful, as I study it, you're simply noticing new things. Even when you're thinking, what is stressful is the worry that you're not going to get the answer right, not the actual playing with the material.
"Mindfulness is what you're doing when you're at leisure. If you are, oh, let's say, on a vacation, you're looking for new things. You've paid a lot of money to be in that state oftentimes. So I think that people would recognize that it's enjoyable rather than taxing. And it's even more than that. It's, I think, mostly energy begetting, not consuming

I Love My New EMR

My Staff Hates It

By Lucy Hornstein, MD  / Tech Contributor

I love my new EMR, which I’ve been using for about 18 months now. I love having all my patients’ information at my fingertips in and out of the office. I don’t miss the piles of paper charts all over the place at all! In short, there’s really nothing about it I don’t like.
My staff, on the other hand, hates it.
Now that they’re not jumping up and down all the time to go over to the shelves to pull charts a hundred times a day, they’re not getting nearly as much exercise as they used to. They just sit in their chairs all day typing and clicking, and they’re starting to get fat.
They also have to talk to patients on the phone now. They used to just tell the patient they’d have to leave a message and we’d call them back once we pulled the chart. The plumber had to call three times before they realized he just wanted to come fix the sink in Room 4. Now that they have all the patients’ records a click away, they actually have to deal with the call when it comes in, instead of passing message slips around all day long.
They’re especially annoyed at not having to pull and file paper charts all the time. Since they’re not getting all those paper cuts on their fingers any more, their nails are starting to grow, and they’re telling me they need raises to pay for their new manicures.
Not only that, but their alphabetizing skills are going to pot. One of them told me she tried to sing the alphabet song to her granddaughter last night and messed up before she got to K.
Most significantly, though, my staff points out that EMRs are bad for the economy because they contribute to unemployment. Before I implemented electronic medical records, I had two staffers. Now, because one staffer can do twice as much work in the same amount of time, I let one of them go. And the one who’s left is so lonely.
So be warned that although you’ll probably love electronic medical records as much as I do, your staff may feel very differently.
Lucy Hornstein is a family physician who blogs at Musings of a Dinosaur, and is the author of Declarations of a Dinosaur: 10 Laws I’ve Learned as a Family Doctor.

More Preventive Health for Women Begins Today

Health Reform Law Extends 8 Free Health Services to an Estimated 47 Million

By Lisa Zamosky
WebMD Health News

Aug. 1, 2012 -- Today ushers in a new provision of the health reform law that makes additional preventive health services -- from contraception to HPV testing -- available for free to an estimated 47 million women.
Women with health plans that start on or after Aug. 1, 2012, must now be allowed access to eight new preventive health services with no co-pays or deductibles. The eight new services available starting today are:

1. Well-woman visits
2. Gestational diabetes screening
3. Domestic and interpersonal violence screening and counseling
4. FDA-approved contraception, including contraceptive education and counseling
5. Breastfeeding support, supplies, and counseling
6. HPV DNA testing for women aged 30 or older
7. Counseling for sexually active women about sexually transmitted infections
8. HIV screening and counseling for sexually active women

These services build upon a roster of existing preventive care that the health reform law, officially called the Affordable Care Act (ACA), already makes available, free of cost, to people with private insurance and Medicare, including annual wellness visits, cholesterol, and other cardiovascular screenings, and cancer screenings including mammography, colonoscopy, and screening for cervical cancer.
The eight services were recommended to the Department of Health and Human Services by the independent Institute of Medicine after an extensive scientific review.

Support for the Services

The American Congress of Obstetricians and Gynecologists (ACOG) hailed the ACA's inclusion of additional women's preventive health services as an important step toward making necessary health care available to more women.
"Today, our nation affirms the importance of a woman's ability to access needed preventive care," ACOG President James T. Breeden, MD, says in a news release. "An annual well-woman visit is a fundamental part of medical care and promotes prevention practices, recognizes risk factors for disease, identifies medical problems, and establishes the often life-long patient-physician relationship. This annual visit provides an excellent opportunity for ob-gyns to counsel patients about maintaining a healthy lifestyle and minimizing health risks."
Breeden adds that contraception, which is already covered by most employer-sponsored plans, plays an important role in optimizing women's health before pregnancy and childbirth, ultimately leading to healthier pregnancies and babies.

Contraception Controversy

The law has always allowed churches and other religious organizations the choice of either buying or sponsoring group health insurance that does not pay for contraception if doing so is counter to their beliefs.
But religious-affiliated groups such as universities and hospitals were not included in this exemption.
This caused an uproar among many religious groups, most notably the Catholic church. The Obama administration says it has a compromise. The insurance companies providing health plans to employers with religious affiliations will be required to cover the cost of contraceptives, not the employer. The Obama administration extended the time until August 2013 for religious institutions to comply with the law.

Removing a Barrier to Prevention

Eliminating costs associated with women's preventive health services has been identified as an important factor in removing a major barrier to needed care.
A 2009 report by the Commonwealth Fund found that more than half of women -- up by more than 25% from 2007 -- delayed or avoided preventive care because of cost. In addition, the government cites a study that found women's use of mammograms went up by as much as 9% when costs for the screening were removed.
Although the provision takes effect today, most women won't gain access to free preventive services until the start of their plan year. For most Americans, that's likely to be in January 2013, when most health insurance policies renew.
Grandfathered health plans -- those already in place when the Affordable Care Act became law in March 2010 and that haven't made significant changes to their benefits -- are exempt from the new requirement.