I know that I have talked before about how I get my head massaged (and shrunk, but that's a different topic) every week or two on the reg, but I have yet to post any of the science behind it. My chiropractor focuses on my temporalis, masseter and suboccipitals during treatment. Speak English Tiffany! What do those sciency words mean?? Why do you give your chiropractor so much money to massage them?
Ah. Relax my friends. I don't have to explain all of this, because blogger Paul Ingraham (a self-described over-qualified massage therapist) at PainScience.com has published the most helpful article on Massage Therapy for Bruxism, Jaw Clenching and TMJ Syndrome. In this article, he describes the Trigger Points, or muscle knots, that can be self-massaged for TMJ pain relief. Am I just wasting my money? (Just kidding...I couldn't do all that Dr. Nino does for me).
Not only does he talk about where to push, but the article describes, in easy to read style, your masseter muscle anatomy, physiology, the areas that it can affect, symptoms and tips to help you relax your jaw muscles and how to care for them by lifestyle adjustments. In fact, there are so many links in there that are incredibly useful and relevant, I can't even describe them all.
Anyways, if you are still reading here, stop. Go to the article. It's long, but it's so incredibly useful and educating. And if you are reading this blog in support of me, but not because you're dealing with TMJ pain...check out the Pain Science blog. He has tips for all kinds of aches, pains and injuries. I highly recommend checking it out, even just to better understand what's going on inside all of us.
P.S. There's also an article linked in there called Pain Changes How Pain Works. It's a discussion about how pain itself results in more pain with less provocation, and he describes it as "Owner's Manual Stuff".
Monday, November 2, 2015
Tuesday, October 20, 2015
Are your limitations really limiting you?
One thing I certainly didn't expect from this injury is the limitations that have been placed on me physically. It makes me uncomfortable to say it, but I don't feel like I'm one to accept limitations without pushing them a little bit first. I wouldn't say that I'm someone who pushes through anything super human to achieve a goal, but I'm not one to say "I can't do that" without trying it first. Maybe I'll try it secretly...without announcing the results...but I'll give it a go.
This injury has been a source of almost constant discomfort. I say almost because there are good drugs and bottles of wine (not to be combined!) that can take it away but neither of these are perfect. Hangovers and side effects need to be managed! Whether it's neck, shoulder, head, jaw or tooth pain, it always seems to be something. I find that often times I'm taken aback by how unrelenting it is, and how places that I thought could never hurt, do. Like your head muscles. How many of you have asked to have your head muscles massaged? Did you even know you HAD head muscles? The ones that cover your skull and barely move? I get them massaged every other week....and it never makes the pain go away completely. (Actually, if you're reading this you probably have TMJ and totally get it. Sorry.)
Anyways, I'm not writing this to whine about my aches (ok, maybe a little bit), but to talk about accepting, and sometimes pushing, your limitations.
There are a lot of things that I want to be able to do without ending up in a pain crisis, or fully exhausted for a week, or without crying because I've over done it. Like go out for a night on the town. Or train for a competition. Or stay up past 10 pm on a weeknight. Or deal with a cold. Or go out in the cold for a day. Or make multiple plans on a weekend (with associated eating/drinking) and function like normal the following week.
You get it.
I'm whiny.
But really, all of these things end up sort of crushing me at some point. And I don't mean like "oh boy, I'm extra tired on Monday." This past weekend I went out to a late dinner Friday night, cleaned my house on Saturday, went to a friends house in the afternoon and then walked around Toronto watching my sister run a marathon on Sunday. By Monday I was exhausted, had a splitting headache and a nasty sore throat, which I really felt was set off by my lack of energy and ability to bounce back after some busy times. My jaw muscles were aching and I felt the vice-like grip around my temples that comes after a lot of talking, eating socially and maneuvering my jaw around trying to make my braces presentable after just taking a bite. Maybe it's just cold/flu season, but I'm really tired of this!
I used to just push through busy things, over-schedule myself and rebound alright....now I'm like a ticking time bomb. I have another late night, busy weekend coming up and I'm already dreading the "recovery time" from that. My sister went to work the day after the marathon, damn it!! Why can't I??
If this whole situation has taught me anything, it's got to be patience. The funny thing is, there's patience with life and then patience with yourself. Having patience with yourself (and self-care) is the hardest thing to practice. I would rather just push through my plans and obligations and deal with the tiredness later. It's just that now, it's not just being tired. It's pain, it's exhaustion, and it's the "me" that I put forth and give to my family that I have to be concerned with. Sigh.
Or here is this question to ponder....
How bad is this situation? You know when you hear about people doing incredible things, like, oh...say EVERY paralympian, EVER? Who am I to whine?
Time to feed that courage wolf...
This injury has been a source of almost constant discomfort. I say almost because there are good drugs and bottles of wine (not to be combined!) that can take it away but neither of these are perfect. Hangovers and side effects need to be managed! Whether it's neck, shoulder, head, jaw or tooth pain, it always seems to be something. I find that often times I'm taken aback by how unrelenting it is, and how places that I thought could never hurt, do. Like your head muscles. How many of you have asked to have your head muscles massaged? Did you even know you HAD head muscles? The ones that cover your skull and barely move? I get them massaged every other week....and it never makes the pain go away completely. (Actually, if you're reading this you probably have TMJ and totally get it. Sorry.)
Anyways, I'm not writing this to whine about my aches (ok, maybe a little bit), but to talk about accepting, and sometimes pushing, your limitations.
There are a lot of things that I want to be able to do without ending up in a pain crisis, or fully exhausted for a week, or without crying because I've over done it. Like go out for a night on the town. Or train for a competition. Or stay up past 10 pm on a weeknight. Or deal with a cold. Or go out in the cold for a day. Or make multiple plans on a weekend (with associated eating/drinking) and function like normal the following week.
You get it.
I'm whiny.
But really, all of these things end up sort of crushing me at some point. And I don't mean like "oh boy, I'm extra tired on Monday." This past weekend I went out to a late dinner Friday night, cleaned my house on Saturday, went to a friends house in the afternoon and then walked around Toronto watching my sister run a marathon on Sunday. By Monday I was exhausted, had a splitting headache and a nasty sore throat, which I really felt was set off by my lack of energy and ability to bounce back after some busy times. My jaw muscles were aching and I felt the vice-like grip around my temples that comes after a lot of talking, eating socially and maneuvering my jaw around trying to make my braces presentable after just taking a bite. Maybe it's just cold/flu season, but I'm really tired of this!
I used to just push through busy things, over-schedule myself and rebound alright....now I'm like a ticking time bomb. I have another late night, busy weekend coming up and I'm already dreading the "recovery time" from that. My sister went to work the day after the marathon, damn it!! Why can't I??
If this whole situation has taught me anything, it's got to be patience. The funny thing is, there's patience with life and then patience with yourself. Having patience with yourself (and self-care) is the hardest thing to practice. I would rather just push through my plans and obligations and deal with the tiredness later. It's just that now, it's not just being tired. It's pain, it's exhaustion, and it's the "me" that I put forth and give to my family that I have to be concerned with. Sigh.
Or here is this question to ponder....
How bad is this situation? You know when you hear about people doing incredible things, like, oh...say EVERY paralympian, EVER? Who am I to whine?
Time to feed that courage wolf...
Current TMJ Implant Options
The world of alloplastic implant options is small you might say. There are three options on the market for your surgeon to choose from:
1. TMJ Implants
2. TMJ Concepts
3. Biomet/Lorenz
To start, there are several criteria that are considered when designing an implant for use in the TMJ. This is done to ensure that a situation like the Vitek implant disaster does not happen again, and takes into account what was learned with that experience, as well as what can be applied from hip and knee replacement implants that have been around for decades. I found an excellent review article in the McGill Journal of Medicine that explains implant design in detail.
(Sinno H, Youssef T, Giladino M, Bobyn D. Engineering Alloplastic Temporomandibular Joint Replacements. MJM 2010 13(1): 63-72.
The following is a summary of the key factors in implant design.
1. Biocompatibility.
The implant has to affix well to the bone to which it is attached, while causing the least amount of damage to the surrounding tissues as possible.
2. Modulus, or stiffness of the material.
The more flexible the implant material, the more it can share the load with the bone it is affixed to. When bone is stressed with a load, the more bone density and strength are preserved in the long run.
3. Stiffness.
This depends on both the flexibility of the material and the shape and thickness of the implant. The thicker the implant, even if it is made of a flexible material, the stiffer it will be. This is the reason why, when you look at pictures of the implants, they show little notches in the metal parts. Putting these notches in, or making it hollow, or very porous, helps to reduce the stiffness of the implant.
4. Stress Shielding.
Similar to, and perhaps a summary of modulus and stiffness, when 2 materials have a uniform load applied to both, the stiffer material will absorb most of that load. So when an implant is attached to bone, it will absorb the loading and shield bone from the stress. As mentioned above, this will cause the bone to lose density and strength in the long term.
5. Notch Sensitivity.
This was the hardest for to me to understand, but when an implant is made with notches in it to reduce it's stiffness, or perhaps to encourage the bone to grow into the notches and rigidly fix the implant, those notches are a point of weakness. So notch sensitivity is is how sensitive the material is to fracture due to the presence of the notches.
6. Modularity.
This enables the use of different materials for different parts of the implant. Materials that are best for wear resistance can be used for bearing components. Materials that are less stiff can be used for load carrying and fixation to reduce the stress shielding and bone resorption that results.
7. Materials.
The same materials that are used in hip/knee replacements are what are used in TMJ implants. Cobalt-Chromium (Co-Cr) and titanium alloys are useful in the stems and bodies of the implants. There are also a variety of options for porous fixation surfaces. A new development is the use of highly cross-linked polyethylene, which is a very wear resistant plastic - ultra high molecular weight polyethylene (UHMWPE) that is also being used widely in hip and knee replacements.
Stainless steel is not used, because it can corrode - so it's not biocompatible for the TMJ.
A few notes on Co-Cr, titanium alloys and UHMWPE:
Co-Cr is very hard and abrasion resistant, but can cause significant stress sheilding.
Titanium alloys are more flexible than Co-Cr, but does not have good wear properties. It is also notch sensitive, so it can't be impregnated with beads or wire to promote bony ingrowth. It can, however, be roughened at the surface, or coated.
UHMWPE has had long term success in orthopaedic surgery, but is subject to wear after repeated loading.
Comparison of current implants:
The condylar portion of all implants is made with Co-Cr alloy. The Biomet/Lorenz implants have a plasma spray titanium coating on the bone-contacting surface to help bone fixation. The Co-Cr bearing has high hardness and strength.
Attached to the condyle is the ramus (below the condyle on the jaw). In TMJ Implant and Biomet, the ramus is made of Co-Cr alloy. TMJ concepts uses titanium alloy. The authors of the study thought that since the ramus is a thinner bone, using a titanium alloy would distribute the load better, and reduce stress sheilding.
The ball and socket portion of the implant is the fossa. The TMJ implants uses metal-on-metal bearings made of Co-Cr. Both TMJ Concepts and Biomet use UHMWPE.
Overall, the study suggests that Alloplastic TMJ reconstruction devices have shown a lot of predictability and reliability. Choosing Alloplastic over Autogenous reconstruction provides a few benefits, including custom made implants that allow for immediate jaw function (in most cases, no wiring shut) after surgery.
Of course, everyone in this "business" knows that these implants are not meant to last forever, and will need replacement at some point in time. The current suggestion is about 20 years of life, since they are relatively new and every year that goes by, another one lasts another year longer.
It's sure no picnic to sift through all of this information...so I hope it's somewhat helpful in learning more about TMJ implants!
1. TMJ Implants
2. TMJ Concepts
3. Biomet/Lorenz
To start, there are several criteria that are considered when designing an implant for use in the TMJ. This is done to ensure that a situation like the Vitek implant disaster does not happen again, and takes into account what was learned with that experience, as well as what can be applied from hip and knee replacement implants that have been around for decades. I found an excellent review article in the McGill Journal of Medicine that explains implant design in detail.
(Sinno H, Youssef T, Giladino M, Bobyn D. Engineering Alloplastic Temporomandibular Joint Replacements. MJM 2010 13(1): 63-72.
The following is a summary of the key factors in implant design.
1. Biocompatibility.
The implant has to affix well to the bone to which it is attached, while causing the least amount of damage to the surrounding tissues as possible.
2. Modulus, or stiffness of the material.
The more flexible the implant material, the more it can share the load with the bone it is affixed to. When bone is stressed with a load, the more bone density and strength are preserved in the long run.
3. Stiffness.
This depends on both the flexibility of the material and the shape and thickness of the implant. The thicker the implant, even if it is made of a flexible material, the stiffer it will be. This is the reason why, when you look at pictures of the implants, they show little notches in the metal parts. Putting these notches in, or making it hollow, or very porous, helps to reduce the stiffness of the implant.
4. Stress Shielding.
Similar to, and perhaps a summary of modulus and stiffness, when 2 materials have a uniform load applied to both, the stiffer material will absorb most of that load. So when an implant is attached to bone, it will absorb the loading and shield bone from the stress. As mentioned above, this will cause the bone to lose density and strength in the long term.
5. Notch Sensitivity.
This was the hardest for to me to understand, but when an implant is made with notches in it to reduce it's stiffness, or perhaps to encourage the bone to grow into the notches and rigidly fix the implant, those notches are a point of weakness. So notch sensitivity is is how sensitive the material is to fracture due to the presence of the notches.
6. Modularity.
This enables the use of different materials for different parts of the implant. Materials that are best for wear resistance can be used for bearing components. Materials that are less stiff can be used for load carrying and fixation to reduce the stress shielding and bone resorption that results.
7. Materials.
The same materials that are used in hip/knee replacements are what are used in TMJ implants. Cobalt-Chromium (Co-Cr) and titanium alloys are useful in the stems and bodies of the implants. There are also a variety of options for porous fixation surfaces. A new development is the use of highly cross-linked polyethylene, which is a very wear resistant plastic - ultra high molecular weight polyethylene (UHMWPE) that is also being used widely in hip and knee replacements.
Stainless steel is not used, because it can corrode - so it's not biocompatible for the TMJ.
A few notes on Co-Cr, titanium alloys and UHMWPE:
Co-Cr is very hard and abrasion resistant, but can cause significant stress sheilding.
Titanium alloys are more flexible than Co-Cr, but does not have good wear properties. It is also notch sensitive, so it can't be impregnated with beads or wire to promote bony ingrowth. It can, however, be roughened at the surface, or coated.
UHMWPE has had long term success in orthopaedic surgery, but is subject to wear after repeated loading.
Comparison of current implants:
The condylar portion of all implants is made with Co-Cr alloy. The Biomet/Lorenz implants have a plasma spray titanium coating on the bone-contacting surface to help bone fixation. The Co-Cr bearing has high hardness and strength.
Attached to the condyle is the ramus (below the condyle on the jaw). In TMJ Implant and Biomet, the ramus is made of Co-Cr alloy. TMJ concepts uses titanium alloy. The authors of the study thought that since the ramus is a thinner bone, using a titanium alloy would distribute the load better, and reduce stress sheilding.
The ball and socket portion of the implant is the fossa. The TMJ implants uses metal-on-metal bearings made of Co-Cr. Both TMJ Concepts and Biomet use UHMWPE.
Overall, the study suggests that Alloplastic TMJ reconstruction devices have shown a lot of predictability and reliability. Choosing Alloplastic over Autogenous reconstruction provides a few benefits, including custom made implants that allow for immediate jaw function (in most cases, no wiring shut) after surgery.
Of course, everyone in this "business" knows that these implants are not meant to last forever, and will need replacement at some point in time. The current suggestion is about 20 years of life, since they are relatively new and every year that goes by, another one lasts another year longer.
It's sure no picnic to sift through all of this information...so I hope it's somewhat helpful in learning more about TMJ implants!
Saturday, October 10, 2015
TMJ Replacement Options
I was recently asked the question: are you getting TMJ Concepts custom made implant or Biomet custom implant? Do you know by any chance what is the difference and which one may be a better one?
This is a question that I've thought a lot about myself, but just sort of trusted my surgeon to recommend what's best. And I still feel that way - whatever he is most comfortable "installing" in my face has got to give the best outcome. Some might feel differently, but allow me to explain myself. This is a very uncommon and relatively new surgery. There are fewer surgeons who actually perform the TMJ replacements, so they are on the leading edge of what is being developed and seeing the results of themselves with their patients. However, having a solid Biology background (as in, an undergrad degree), I am keenly interested in the implants that I'm getting and why.
Without disrespecting anyone who has dealt with this longer than I have, and certainly that's almost anyone who is facing this as a result of a systemic issue rather than a recent trauma (like me), I'm writing this from the perspective that your surgeon has recommended a TJR (total jaw replacement) and a certain type of implant and you're wondering why they might be recommending that type and the history behind it. In my particular case, I know that this is my only option going forward - foregoing TJR of any type is not an option. I know that there are some folks out there who believe surgery should be avoided at all costs, and certainly there are cases where this should not be jumped into. However, I've done enough research and know my own situation well enough to know that this is something that I need and there is no other option.
That being said, here are the options for complete TMJ reconstruction surgery:
Pros:
Alloplastic Replacement is the replacement of the whole joint (fossa/"socket", condyle/"ball" and ramus - what you think of as the jaw bone) with a manufactured joint. These implants can be conceptualized as the same as a hip or a knee replacement implant.
The reasons you might get an alloplastic implant are:
Some of the benefits of alloplastic joints over autogenous grafting are:
This is a question that I've thought a lot about myself, but just sort of trusted my surgeon to recommend what's best. And I still feel that way - whatever he is most comfortable "installing" in my face has got to give the best outcome. Some might feel differently, but allow me to explain myself. This is a very uncommon and relatively new surgery. There are fewer surgeons who actually perform the TMJ replacements, so they are on the leading edge of what is being developed and seeing the results of themselves with their patients. However, having a solid Biology background (as in, an undergrad degree), I am keenly interested in the implants that I'm getting and why.
Without disrespecting anyone who has dealt with this longer than I have, and certainly that's almost anyone who is facing this as a result of a systemic issue rather than a recent trauma (like me), I'm writing this from the perspective that your surgeon has recommended a TJR (total jaw replacement) and a certain type of implant and you're wondering why they might be recommending that type and the history behind it. In my particular case, I know that this is my only option going forward - foregoing TJR of any type is not an option. I know that there are some folks out there who believe surgery should be avoided at all costs, and certainly there are cases where this should not be jumped into. However, I've done enough research and know my own situation well enough to know that this is something that I need and there is no other option.
That being said, here are the options for complete TMJ reconstruction surgery:
- Autogenous Replacement (rib graft most often)
- Alloplastic Replacement (manufactured implant)
- TMJ Implant
- TMJ Concepts
- Biomet/Lorenz
Pros:
- Cost - since no manufactured parts are required, the cost is lower for this surgery. However, since there is another surgical site and associated pain, the hospital stay is longer, and the recovery may be longer. This may offset the cost savings to the patient.
- Growth potential - in children, this is the only option for reconstruction, since they will continue growing and a manufactured implant will not.
- Recovery time is long
- Only reconstructs the "ball" and not the "socket" part of the joint
- Often requires re-operation, which may ultimately include a manufactured implant
Alloplastic Replacement is the replacement of the whole joint (fossa/"socket", condyle/"ball" and ramus - what you think of as the jaw bone) with a manufactured joint. These implants can be conceptualized as the same as a hip or a knee replacement implant.
The reasons you might get an alloplastic implant are:
- Ankylosis of the TMJ with severe anatomic abnormalities
- Failure of autogenous grafts
- Failure of Proplast-Teflon or Vitek-Kent or partial joint implants
- Severe inflammatory joint disease resulting in joint mutilation and functional disability
Some of the benefits of alloplastic joints over autogenous grafting are:
- Immediate jaw function, allowing for physiotherapy to begin on Day 1 of recovery
- No need for a secondary donor site (rib sectioning, etc)
- Custom implant availability
Surgeons seem to see that immediate movement of the joints contributes to a much shorter healing time, and better outcomes. Of course, one of the deciding factors in the relative success of the surgery is dependant on how many prior surgeries a patient has had. The more surgeries, the lesser the degree of success.
I hope that this helps to understand the differences between grafting-type TMJ reconstruction and manufactured implants. In my next post, I will share what I've learned are the subtle differences between TMJ Concepts and Biomet/Lorenz manufactured implants.
Keep feeding the courage wolf!!
Monday, September 28, 2015
Surgery Upate
Someone commented (OMG I love you!) and asked if I had a date for surgery yet. Sadly, I have to say no, but I did I see my surgeon last week, which is now a 3 month standing "date". He's so reassuring, that Dr. P!
Just to refresh anyone new, if you're having your jaws replaced with TMJ concepts implants, they must take scans of your face to create the joints. If you have braces, after the scans are taken your orthodontist can't touch your mouth again...so the scans can't be done until your ortho has done their job. Then it takes 3 months to make the joints, so scheduling a date for surgery isn't as simple as picking a date.
So Dr. P was very pleasantly surprised at how my teeth are coming along. I must say, the top teeth are looking pretty darn good! The lowers are getting there....definitely in the general 'arch' position, with final touching-up needed. It felt nice to hear him say, rather surprisedly "You look good! Really good!!" This guy fucks with faces for a living. Yeah!
So throughout this whole process (and LONG before) my goal was to have another baby. Given the timeframe that was imposed on me since the accident, we accelerated our attempts (also because 3 years is a long time to try with no success) and saw a fertility clinic. We decided to say to hell with the face surgery and just go gung-ho with IVF. I was in the middle of stimulation hormone injections when I saw Dr. P, with the goal of freezing embryos until next cycle (or one after face surgery....ahh that old time-worn debate....). Then Dr. P said he thought we could be getting close to planning for surgery, and that the sooner we 'fix' my joints, the sooner I can get out of pain. He talked about chronic pain theory - whereby the longer you're in pain, your nerves can permanently change and you can end up with chronic pain even after the joints are fixed. So it's better to have surgery sooner than later. Well damn. That sure changes things.
In any case, even without all the IVF complications, I wouldn't yet have a surgery date. What Dr P. did offer me though, was to tighten up all the timelines to get the TJR surgery completed as quickly as possible - get started on planning for the scans and even a surgery date. That way, when it's over with I'd be able to implant one of those frozen littlescience experiments embryos blastocysts only about 2 months after TJR.
So there you have it... still hurry up and wait. If I don't come out of this a more patient person, then I'm just going to give up!!
Just to refresh anyone new, if you're having your jaws replaced with TMJ concepts implants, they must take scans of your face to create the joints. If you have braces, after the scans are taken your orthodontist can't touch your mouth again...so the scans can't be done until your ortho has done their job. Then it takes 3 months to make the joints, so scheduling a date for surgery isn't as simple as picking a date.
So Dr. P was very pleasantly surprised at how my teeth are coming along. I must say, the top teeth are looking pretty darn good! The lowers are getting there....definitely in the general 'arch' position, with final touching-up needed. It felt nice to hear him say, rather surprisedly "You look good! Really good!!" This guy fucks with faces for a living. Yeah!
So throughout this whole process (and LONG before) my goal was to have another baby. Given the timeframe that was imposed on me since the accident, we accelerated our attempts (also because 3 years is a long time to try with no success) and saw a fertility clinic. We decided to say to hell with the face surgery and just go gung-ho with IVF. I was in the middle of stimulation hormone injections when I saw Dr. P, with the goal of freezing embryos until next cycle (or one after face surgery....ahh that old time-worn debate....). Then Dr. P said he thought we could be getting close to planning for surgery, and that the sooner we 'fix' my joints, the sooner I can get out of pain. He talked about chronic pain theory - whereby the longer you're in pain, your nerves can permanently change and you can end up with chronic pain even after the joints are fixed. So it's better to have surgery sooner than later. Well damn. That sure changes things.
In any case, even without all the IVF complications, I wouldn't yet have a surgery date. What Dr P. did offer me though, was to tighten up all the timelines to get the TJR surgery completed as quickly as possible - get started on planning for the scans and even a surgery date. That way, when it's over with I'd be able to implant one of those frozen little
So there you have it... still hurry up and wait. If I don't come out of this a more patient person, then I'm just going to give up!!
Thursday, September 24, 2015
The Zone of Tolerance
Do you ever feel like some days the smallest things just set you off? You're short-tempered, angry, just not capable of handling your life? ("Like...I just CAN'T right now!! UGH!") Or perhaps you just feel exhausted, like you don't want to leave your bed and have no energy to even listen. You're probably outside your zone of tolerance.
Today's post is about a phenomenon that's new to me in theory and description, but I know from...well...life in general. It wasn't much of a persistent problem before my accident, but since then I've noticed big fluctuations in what I'm capable of handling at any given moment. I described this to my therapist, and she showed me the diagram and literature that explains it. It's called the Zone of Tolerance. Here's the diagram:
We all have one. The "zone"is the area within with you are operating at any given time. If your life is relatively stable (event-wise, emotionally, physically..) then your zone is probably sort of fixed in it's size. You probably can pretty reliably predict what you're capable of handling. If however, your world is shaken up by something (in my case, chronic pain and stress) your zone might shrink. Some days (high pain levels, lack of sleep, emotional turmoil) your zone is so small that the smallest things can set you off. Other days, everything is going well, you feel good - your zone is bigger and you feel like you can take on the world. These are great days!
When your zone is constantly widening and then narrowing again, it's hard to feel emotionally stable. You can get really down on yourself for even the fluctuations - let alone the reasons why it's fluctuating. So what's really important is this:
Today's post is about a phenomenon that's new to me in theory and description, but I know from...well...life in general. It wasn't much of a persistent problem before my accident, but since then I've noticed big fluctuations in what I'm capable of handling at any given moment. I described this to my therapist, and she showed me the diagram and literature that explains it. It's called the Zone of Tolerance. Here's the diagram:
We all have one. The "zone"is the area within with you are operating at any given time. If your life is relatively stable (event-wise, emotionally, physically..) then your zone is probably sort of fixed in it's size. You probably can pretty reliably predict what you're capable of handling. If however, your world is shaken up by something (in my case, chronic pain and stress) your zone might shrink. Some days (high pain levels, lack of sleep, emotional turmoil) your zone is so small that the smallest things can set you off. Other days, everything is going well, you feel good - your zone is bigger and you feel like you can take on the world. These are great days!
When your zone is constantly widening and then narrowing again, it's hard to feel emotionally stable. You can get really down on yourself for even the fluctuations - let alone the reasons why it's fluctuating. So what's really important is this:
- Recognize that you HAVE a zone! Understand that it's normal to feel super strong some days, and incapable of getting out of bed on other days.
- Scan where you are in the zone at this very moment. If you feel that you are starting to slip outside of it (however big or small it may be today), try to ground yourself. Do some deep breathing through your nose (in for a count of 4, out for a count of 4) and touch something real in your vicinity. This will take you out of your head, and back into the present.
- If you're nearing the upper limit of your zone, or are slipping out of it, do something CALMING. If you're nearing or slipping below the lower limit of your zone, do something ENERGIZING.
Tuesday, September 1, 2015
Braces Update
Last week I had another wire change on my braces. I went back through my appointment history to figure out how many different wires I've had on since I started. (For someone blogging their experience, I'm not keeping very good track of what's going on!) I figured out that I've had 8 different wires on my top teeth and 6 different ones on the bottom. The reason for the difference is that the top braces went on at the end of December 2014, while the bottom ones only went on the first week of March 2015. I can't believe I've had this many wire changes already...time sure flies!
It certainly explains why I am beginning to notice a pattern in my pain levels. The wire change happened Tuesday last week (one week ago today) and the pain has migrated from my teeth, through my facial bones, and now it is at my TMJ's. It's strange how that happens. I don't know anything scientific about why this happens, but I imagine it to be the knock-on effect of the force on my teeth when the new wire goes on, then it starts the bone-forming part of moving them a few days later, and that affects my bite, jaw position, and my TMJ's get flared up. It's so great!
Not.
Dr O moved me to a thicker rectangular-shaped wire on the top, and a thinner rectangular-shaped one on the bottom. Note: the "rectangular-shape refers to the diameter of the wire, not the overall bend to it. It's still a horse-shoe shaped wire overall. When the bottom wire went on it actually was so much force that it popped the bracket off one of my molars. Whoops. The assistant told me that she would put it on at my next visit in October. If she re-attached it now, if it stayed on it would cause me too much pain. Thanks!
As for the pain, it sucks. The TMJ pain is the worst. It's not acute when I eat, oh no...that would make me change what I eat to avoid it. Nope it happens afterwards, starting as a dull ache and then moving to a sharp pain just in front of my ears. So I still eat things like pizza crust, chips, nuts (don't judge me) and pay for it later. Clearly I'm either a slow learner or a glutton for punishment. Hopefully it will subside sooner than later.
My top front teeth hurt so badly for so long (long after the rest of my teeth have stopped aching) and since they were moved ("subluxated") during the accident, one has turned grey underneath the crown, that I get so anxious that I'm going to lose them. The anxiety hangs on for as long as the pain does. Thankfully it's gone now, but it is a lot to deal with. On a side note, I've learned so much about how chronic and acute pain affect a person's mental health. They are so related.
My teeth are moving well, the top ones look so straight that it's hard to imagine needing to move them more, but we're going for perfection here. I've decided that when I get the braces off and permanent crowns put on, I'm not going to go for the "perfectly imperfect" smile that I went for when I first had my front 6 crowns put on 5 years ago (for vanity...of course). This time, give 'em to me as white as is realistic and as straight as possible! After everything I've gone through, I want a perfect smile!
It certainly explains why I am beginning to notice a pattern in my pain levels. The wire change happened Tuesday last week (one week ago today) and the pain has migrated from my teeth, through my facial bones, and now it is at my TMJ's. It's strange how that happens. I don't know anything scientific about why this happens, but I imagine it to be the knock-on effect of the force on my teeth when the new wire goes on, then it starts the bone-forming part of moving them a few days later, and that affects my bite, jaw position, and my TMJ's get flared up. It's so great!
Not.
Dr O moved me to a thicker rectangular-shaped wire on the top, and a thinner rectangular-shaped one on the bottom. Note: the "rectangular-shape refers to the diameter of the wire, not the overall bend to it. It's still a horse-shoe shaped wire overall. When the bottom wire went on it actually was so much force that it popped the bracket off one of my molars. Whoops. The assistant told me that she would put it on at my next visit in October. If she re-attached it now, if it stayed on it would cause me too much pain. Thanks!
As for the pain, it sucks. The TMJ pain is the worst. It's not acute when I eat, oh no...that would make me change what I eat to avoid it. Nope it happens afterwards, starting as a dull ache and then moving to a sharp pain just in front of my ears. So I still eat things like pizza crust, chips, nuts (don't judge me) and pay for it later. Clearly I'm either a slow learner or a glutton for punishment. Hopefully it will subside sooner than later.
My top front teeth hurt so badly for so long (long after the rest of my teeth have stopped aching) and since they were moved ("subluxated") during the accident, one has turned grey underneath the crown, that I get so anxious that I'm going to lose them. The anxiety hangs on for as long as the pain does. Thankfully it's gone now, but it is a lot to deal with. On a side note, I've learned so much about how chronic and acute pain affect a person's mental health. They are so related.
My teeth are moving well, the top ones look so straight that it's hard to imagine needing to move them more, but we're going for perfection here. I've decided that when I get the braces off and permanent crowns put on, I'm not going to go for the "perfectly imperfect" smile that I went for when I first had my front 6 crowns put on 5 years ago (for vanity...of course). This time, give 'em to me as white as is realistic and as straight as possible! After everything I've gone through, I want a perfect smile!
Wednesday, August 26, 2015
Just when you give up...
That's when you get the motivation to keep going.
I had begun to wonder whether I should continue to write on here. I've been doing all kinds of work, processing my situation, coping, learning, and just putting one foot in front of the other, but never really knowing if I had anything more to say. You see, I feel like I may be learning so much, so quickly, that I am having trouble assimilating it.
In fact, I met with my therapist today, and my head was just swimming. It just seems like there is always something going on in my head that I'm processing, and I'm reading all these books, attending sessions, trying different therapies, that it's all up in there, but the end product isn't clear yet. What HAVE I learned? What could I share? At the end of our session today, I asked: "Is this normal? Am I being over dramatic about it all? Why do I feel so isolated?" And here's what she explained to me:
1. It's normal. (Aren't all therapists supposed to tell you that?) My situation is pretty unique, yes it's been going on for a year now (yesterday was the anniversary) and people don't understand it. But most of all - they probably don't know what the right thing to say is. And I understand that...I really do. I don't place blame on anyone for not knowing what to say. How could they? In fact, this whole situation has given me many gifts, one of which is that I now really understand how people can be walking around with some really big struggles, but functioning normally and even seeming happy.
2. I'm a processor. (Not the computer kind). Some people go through traumatic events and just keep on going, without dealing with the trauma. It seemingly is not affecting them - until it does. These people delay processing their "stuff". I don't. I want to deal with it all right away, while I am going through it, and when it's all over (for me, there will be a natural end to the big stuff, God willing), I will likely be done processing it.
Whether you are someone who processes right away or sometime later is not something you can choose or change about yourself. It's as hard-wired into you as your eye colour. I'm just dealing with this all at once. And hopefully, that's the easier way.
3. I am in the middle....the "waiting place"....the most awful place (if you've read Oh! The Places You'll Go! by Dr. Seuss, you know what I mean). It feels like not much is happening and I don't have much control of everything. I'm tired of it, and I don't really want to deal with it anymore.
I had begun to wonder whether I should continue to write on here. I've been doing all kinds of work, processing my situation, coping, learning, and just putting one foot in front of the other, but never really knowing if I had anything more to say. You see, I feel like I may be learning so much, so quickly, that I am having trouble assimilating it.
In fact, I met with my therapist today, and my head was just swimming. It just seems like there is always something going on in my head that I'm processing, and I'm reading all these books, attending sessions, trying different therapies, that it's all up in there, but the end product isn't clear yet. What HAVE I learned? What could I share? At the end of our session today, I asked: "Is this normal? Am I being over dramatic about it all? Why do I feel so isolated?" And here's what she explained to me:
1. It's normal. (Aren't all therapists supposed to tell you that?) My situation is pretty unique, yes it's been going on for a year now (yesterday was the anniversary) and people don't understand it. But most of all - they probably don't know what the right thing to say is. And I understand that...I really do. I don't place blame on anyone for not knowing what to say. How could they? In fact, this whole situation has given me many gifts, one of which is that I now really understand how people can be walking around with some really big struggles, but functioning normally and even seeming happy.
2. I'm a processor. (Not the computer kind). Some people go through traumatic events and just keep on going, without dealing with the trauma. It seemingly is not affecting them - until it does. These people delay processing their "stuff". I don't. I want to deal with it all right away, while I am going through it, and when it's all over (for me, there will be a natural end to the big stuff, God willing), I will likely be done processing it.
Whether you are someone who processes right away or sometime later is not something you can choose or change about yourself. It's as hard-wired into you as your eye colour. I'm just dealing with this all at once. And hopefully, that's the easier way.
3. I am in the middle....the "waiting place"....the most awful place (if you've read Oh! The Places You'll Go! by Dr. Seuss, you know what I mean). It feels like not much is happening and I don't have much control of everything. I'm tired of it, and I don't really want to deal with it anymore.
Thursday, July 16, 2015
Potential surgery date & other stuff
Well Hallo there friends,
It's been a while since I have posted. Sorry! Life is just so damn busy.
So what's been happening in my mouth....well, the braces are in there, doin' their thang. Teeth are moving and it's all pretty positive. I saw the orthodontist last week for a wire change, and after the power chain on the lowers my teeth were still really sore. He took it easy on me this month, putting only a slightly-higher tension wire in there and was understanding that I'm in pain. The first 2 days were still pretty awful, but I was able to eat solid-ish food, which is an improvement. He said that he's happy with the progress, the top is almost where he wants it, and the bottom is catching up nicely. Keep in mind that the lower braces didn't go on until a few months after the uppers.
The 45 tooth that was wildly twisted and tipped has really come around (I know, I could feel it!), enough so that my dentist would now be able to put a temporary crown on it and make me look more normal! Now I just have to actually schedule time to make the 2.5 hour drive to get it done.
My oral surgeon began trying to coordinate my jaw replacement surgery with my orthodontist, but is jumping the gun just a bit. It sounds like my teeth won't be done moving until around January, and I can't get the special CT scans done to fabricate the joints until then. The ortho knows that the more notice he can give of when he will be done his work, the better it is to schedule everything, so hopefully it will all go as planned and I will get a surgery date in January. I don't know how the oral surgeon's office manages that, but I suppose I'm not the first one he's done. It takes around 4 months to fabricate the joints, so I guess I'd be looking at surgery sometime in the spring. Maybe for my birthday in May? Woot.
In other, very exciting, very excellent news, the insurance company has reviewed my case and decided to extend my coverage for accident insurance from 12 months to 24 months. So if everything goes according to plan, we will be able to submit most claims for all this work before they close it forever. What a relief!!! I'd heard that it's very hard to get them to make exceptions to this policy, so they must have reviewed my case and understood that it's all very extensive and complicated. Never give up hope!!
On the mental/emotional side, I've definitely been struggling with a lot of things lately. I think that I'm still in the process of learning how best to manage my pain, and how it affects me day to day. I don't talk about the pain that I have for many reasons...mainly because it's not pleasant to talk about, and the more you talk about it, the bigger a "thing" it becomes in your life. Saying that, there are definitely times when just touching my head muscles can cause me to be nauseous, and times when the chronic tension headaches really affect my mood, patience, focus, etc. I definitely am learning that prescription medication is given to you for a reason, and that it helps when you take it as prescribed and not just when you feel like it, and it is not to be feared (especially when it's pretty innocuous, I'm not talking painkillers here).
I'm also accepting this whole situation for what it is. It seems so obvious to write it, but it's just my lot to deal with this. Everyone gets their challenges, and this is the one that was handed to me. It's not the best, but it's not the worst either. "Why me?" is such a pointless question to ask in this life...there's no answer, and there never will be.
And I keep on feeding that courage wolf!!
It's been a while since I have posted. Sorry! Life is just so damn busy.
So what's been happening in my mouth....well, the braces are in there, doin' their thang. Teeth are moving and it's all pretty positive. I saw the orthodontist last week for a wire change, and after the power chain on the lowers my teeth were still really sore. He took it easy on me this month, putting only a slightly-higher tension wire in there and was understanding that I'm in pain. The first 2 days were still pretty awful, but I was able to eat solid-ish food, which is an improvement. He said that he's happy with the progress, the top is almost where he wants it, and the bottom is catching up nicely. Keep in mind that the lower braces didn't go on until a few months after the uppers.
The 45 tooth that was wildly twisted and tipped has really come around (I know, I could feel it!), enough so that my dentist would now be able to put a temporary crown on it and make me look more normal! Now I just have to actually schedule time to make the 2.5 hour drive to get it done.
My oral surgeon began trying to coordinate my jaw replacement surgery with my orthodontist, but is jumping the gun just a bit. It sounds like my teeth won't be done moving until around January, and I can't get the special CT scans done to fabricate the joints until then. The ortho knows that the more notice he can give of when he will be done his work, the better it is to schedule everything, so hopefully it will all go as planned and I will get a surgery date in January. I don't know how the oral surgeon's office manages that, but I suppose I'm not the first one he's done. It takes around 4 months to fabricate the joints, so I guess I'd be looking at surgery sometime in the spring. Maybe for my birthday in May? Woot.
In other, very exciting, very excellent news, the insurance company has reviewed my case and decided to extend my coverage for accident insurance from 12 months to 24 months. So if everything goes according to plan, we will be able to submit most claims for all this work before they close it forever. What a relief!!! I'd heard that it's very hard to get them to make exceptions to this policy, so they must have reviewed my case and understood that it's all very extensive and complicated. Never give up hope!!
On the mental/emotional side, I've definitely been struggling with a lot of things lately. I think that I'm still in the process of learning how best to manage my pain, and how it affects me day to day. I don't talk about the pain that I have for many reasons...mainly because it's not pleasant to talk about, and the more you talk about it, the bigger a "thing" it becomes in your life. Saying that, there are definitely times when just touching my head muscles can cause me to be nauseous, and times when the chronic tension headaches really affect my mood, patience, focus, etc. I definitely am learning that prescription medication is given to you for a reason, and that it helps when you take it as prescribed and not just when you feel like it, and it is not to be feared (especially when it's pretty innocuous, I'm not talking painkillers here).
I'm also accepting this whole situation for what it is. It seems so obvious to write it, but it's just my lot to deal with this. Everyone gets their challenges, and this is the one that was handed to me. It's not the best, but it's not the worst either. "Why me?" is such a pointless question to ask in this life...there's no answer, and there never will be.
And I keep on feeding that courage wolf!!
Tuesday, June 9, 2015
Muscle pain, again!
Morning Y'all
Ok I've got to get something off my chest. WHY on earth would Kaitlyn bring Nick into the house with all those great guys? Doesn't she see that he's a total douche? Amirite???
Ok, that's over with.
I figured it was time for another update, since it's been a couple of weeks now since my wire change and the addition of thetorture device powerchain on my lower braces. It's been a rough couple of weeks to be honest. The pain from the powerchain lasted a few days, longer than I had anticipated. While I can't really bite into anything very well, there was a time when I couldn't even touch those teeth. On the other hand, the gaps are closed now. It happened so quickly, which shouldn't be surprising since it hurt so damn much!
I notice that in terms of my jaw and teeth fitting together, things are (as anticipated) getting worse. When I bite together now, the gap between my front teeth and all along the right side of my mouth is getting bigger. It also feels like my jaw is moving backward in my mouth, but that could just be mental.
I'm also noticing in pictures of myself that the asymmetry in my lower face is more pronounced, which is troubling. I know people say they don't "notice" it, but it definitely doesn't look right, and in my mind it makes me look a little.....slow, if you will. Maybe a little too "jolly", and not in the good sense of the word.
The worst part is the muscle pain. It is getting so tight and painful that I find myself short-tempered and tired lately. Last night I was trying to massage it out, and I found myself crying and saying "why did this happen to me?" to the hubs. No fun. He suggested I take a muscle relaxer before bed, and so I did. It definitely helped me to get out of the house this morning and go to work - I had thought I'd be needing to rest up today. And I might still need that day later this week, it all depends. I'm definitely still feeling it today.
I don't think that it's any secret to the people who know me that I've been trying to get pregnant before I have the big surgery. Since I'm 34 years old, and my son's turning 4 in September, I don't really have the time to wait until it's all over and done with so I'm trying to just sneak a pregnancy and childbirth into the wait time for TJR. No biggie. But that's left me wondering what I'll do if I find out that I am preggo and can't take my anti-inflamatories/muscle relaxants anymore? I don't take the latter all that often, but I need the AI's to stay out of day-to-day pain. And the MR's are huge to get me out of a pain crisis. I'm pretty terrified of the idea....not enough to give up on having a #2, but pretty scared. We'll have to up the acupuncture/massage budget significantly in that case.
Well that's it for today folks. As always, keep on feeding the courage wolf. Mine's getting more fierce everyday.
Ok I've got to get something off my chest. WHY on earth would Kaitlyn bring Nick into the house with all those great guys? Doesn't she see that he's a total douche? Amirite???
Ok, that's over with.
I figured it was time for another update, since it's been a couple of weeks now since my wire change and the addition of the
I notice that in terms of my jaw and teeth fitting together, things are (as anticipated) getting worse. When I bite together now, the gap between my front teeth and all along the right side of my mouth is getting bigger. It also feels like my jaw is moving backward in my mouth, but that could just be mental.
I'm also noticing in pictures of myself that the asymmetry in my lower face is more pronounced, which is troubling. I know people say they don't "notice" it, but it definitely doesn't look right, and in my mind it makes me look a little.....slow, if you will. Maybe a little too "jolly", and not in the good sense of the word.
The worst part is the muscle pain. It is getting so tight and painful that I find myself short-tempered and tired lately. Last night I was trying to massage it out, and I found myself crying and saying "why did this happen to me?" to the hubs. No fun. He suggested I take a muscle relaxer before bed, and so I did. It definitely helped me to get out of the house this morning and go to work - I had thought I'd be needing to rest up today. And I might still need that day later this week, it all depends. I'm definitely still feeling it today.
I don't think that it's any secret to the people who know me that I've been trying to get pregnant before I have the big surgery. Since I'm 34 years old, and my son's turning 4 in September, I don't really have the time to wait until it's all over and done with so I'm trying to just sneak a pregnancy and childbirth into the wait time for TJR. No biggie. But that's left me wondering what I'll do if I find out that I am preggo and can't take my anti-inflamatories/muscle relaxants anymore? I don't take the latter all that often, but I need the AI's to stay out of day-to-day pain. And the MR's are huge to get me out of a pain crisis. I'm pretty terrified of the idea....not enough to give up on having a #2, but pretty scared. We'll have to up the acupuncture/massage budget significantly in that case.
Well that's it for today folks. As always, keep on feeding the courage wolf. Mine's getting more fierce everyday.
Thursday, May 21, 2015
New Wires and a Powerchain
Hi Friends!
I know it's been a while since I've written. I read a lot of blogs about braces, and it always seems that people slack off posting updates when the hardware's been on for a few months, and now I know why. There's not a lot say! I have tried to share other aspects of my life here, and I plan to continue doing so. It's just that when you're doing a lot of introspective work, it's time consuming and doesn't leave a ton of writing time.
Anyways, today's post is about my wire change today. I had both top and bottom wires changed (for those not wearing the Damon braces system, this is the same as a braces "tightening") and all I can say is Fuck Fuck Fuck. Pardon my language. My mother in law and I agree that when something is really bad or frustrating, the only real way to feel better is to say a triple Fuck out loud.
The last wires were on for 6 weeks, and the bottom one partially closed the gap where my 33 was pulled from, and created a bit of a gap between another 2 bottom fronts. There's still the nasty 35 that's twisted and angled needing space to move. It has really come along, but it needs more room to straighten out, so now Dr. O put a powerchain on the bottom fronts to close the gaps and make more room for the 35. And holy triple F it hurts!!!
Part of me really wonders if I am just a really big wuss about the pain, or if it's extra bad for me because of all the trauma to my teeth. Since the absolute worst of it, what I would unequivocally call PAIN is in my front teeth, while the back are more extremely uncomfortable, I would guess that yes...braces hurt more for me than the average person. I'm going with that. It was so unbearable yesterday I considered going home from work (instead I took a painkiller and relegated myself to clearing out my inbox, no complicated tasks for me) and then had to take a muscle relaxer to sleep last night. I still don't understand why a braces adjustment causes my temporal muscle to tighten up like a vice. I'm so thankful that I have an acupuncture/massage appointment tonight.
So now it's another 6 weeks until the next wire change. This pain should subside in the coming days, and hopefully it's smooth sailing from there. In the meantime, I'm continuing to work on meditation, focused breathing and now I have a couple of mantras that I say to maintain my focus.
When I am in pain, it's "Easy Day. I breathe out pain with every breath."
When I want to calm myself and let go, I say "Life itself supports me. I trust in the universe."
So as always: Feed the courage wolf and starve the fear wolf inside you. Which wolf are you feeding?
I know it's been a while since I've written. I read a lot of blogs about braces, and it always seems that people slack off posting updates when the hardware's been on for a few months, and now I know why. There's not a lot say! I have tried to share other aspects of my life here, and I plan to continue doing so. It's just that when you're doing a lot of introspective work, it's time consuming and doesn't leave a ton of writing time.
Anyways, today's post is about my wire change today. I had both top and bottom wires changed (for those not wearing the Damon braces system, this is the same as a braces "tightening") and all I can say is Fuck Fuck Fuck. Pardon my language. My mother in law and I agree that when something is really bad or frustrating, the only real way to feel better is to say a triple Fuck out loud.
The last wires were on for 6 weeks, and the bottom one partially closed the gap where my 33 was pulled from, and created a bit of a gap between another 2 bottom fronts. There's still the nasty 35 that's twisted and angled needing space to move. It has really come along, but it needs more room to straighten out, so now Dr. O put a powerchain on the bottom fronts to close the gaps and make more room for the 35. And holy triple F it hurts!!!
Part of me really wonders if I am just a really big wuss about the pain, or if it's extra bad for me because of all the trauma to my teeth. Since the absolute worst of it, what I would unequivocally call PAIN is in my front teeth, while the back are more extremely uncomfortable, I would guess that yes...braces hurt more for me than the average person. I'm going with that. It was so unbearable yesterday I considered going home from work (instead I took a painkiller and relegated myself to clearing out my inbox, no complicated tasks for me) and then had to take a muscle relaxer to sleep last night. I still don't understand why a braces adjustment causes my temporal muscle to tighten up like a vice. I'm so thankful that I have an acupuncture/massage appointment tonight.
So now it's another 6 weeks until the next wire change. This pain should subside in the coming days, and hopefully it's smooth sailing from there. In the meantime, I'm continuing to work on meditation, focused breathing and now I have a couple of mantras that I say to maintain my focus.
When I am in pain, it's "Easy Day. I breathe out pain with every breath."
When I want to calm myself and let go, I say "Life itself supports me. I trust in the universe."
So as always: Feed the courage wolf and starve the fear wolf inside you. Which wolf are you feeding?
Thursday, April 16, 2015
Mindful Breathing
Guys, it's been 3 weeks since I've posted!! Things have gotten a little busy lately, so I haven't had the time to write, nor have I had as much time to dig deeper into what I'm learning enough to write about it. Until now.
This week I'm starting a Stress Response course, and one of the first things we are doing is mindful, focussed breathing. I've found it to be relaxing, yes, but it's also another factor of the SealFit and Unbeatable Mind programs, and so it must be pretty critical. The fact that they all practice almost the exact same breathing techniques says something about it.
So a bit about breathing.
There are a couple of mechanical aspects to breathing that need to be addressed right away. First, we should be breathing diaphragmatically. This means belly breathing, or breathing so that your belly and diaphragm are expanding. This is the type of breathing babies and children do, and it's the breathing of relaxation. When we are fully relaxed, this is the way we breathe. When we are responding to stress (good, bad, acute, chronic) we breathe shallowly and into our chests only. This doesn't allow for full lung capacity usage, and keeps us in the stress-aroused state, even after the stressor is gone. So to enable our bodies to relax, it helps to concentrate on breathing into your belly.
The second critical part is that you must breathe in through your nose. Breathing in through your nose helps to humidify the air, and most importantly, enhancing the air with secreted nitric oxide (NO). NO is a potent vasodilator, which dramatically enhances the uptake of oxygen in the lungs. This is why it's most important to breathe in through your nose, but not as critical to breathe out that way.
There's a pretty simple breathing exercise that works (with practice) to calm down your sympathetic nervous system and counteract all the panicky, fight-or-flight stress reactions in your body. It can be done almost anywhere, anytime, and nobody would know that you're doing it (even during a presentation or performance!) To start, breathe in through your nose, expanding and filling your belly with air. Then move to your upper chest and fill it. Do this slowly, for a count of 4 or more (whatever is comfortable to you) and then hold it in for that same count of time. Then, slowly exhale for the same count of time, and finally (if you can) hold your lungs empty for the same count. Do this for 3-4 minutes (or longer, if you can) and with practice, this technique will help to both keep you calm, and calm you down in times of stress.
The key to this is practice. I'm working now on implementing this technique every day so that my body becomes accustomed to the calming effect. Over time, it should take no more than a couple of breaths to start the calming effect, and will also train your body to belly breathe all the time, without having to focus on it.
A final benefit to this practice is that it increases your mental focus. First, for all the reasons you might think (more oxygen to your brain, etc), but also the focus required to practice this breathing spills over and secondarily serves to get your mind used to focusing - on anything.
I've been feeling more pain in my jaw joints and teeth recently, and I do find that this practice has helped me to manage that better.
Try this technique for a few days and see how it helps you. And remember to feed the courage wolf inside you, and starve the fear wolf.
This week I'm starting a Stress Response course, and one of the first things we are doing is mindful, focussed breathing. I've found it to be relaxing, yes, but it's also another factor of the SealFit and Unbeatable Mind programs, and so it must be pretty critical. The fact that they all practice almost the exact same breathing techniques says something about it.
So a bit about breathing.
There are a couple of mechanical aspects to breathing that need to be addressed right away. First, we should be breathing diaphragmatically. This means belly breathing, or breathing so that your belly and diaphragm are expanding. This is the type of breathing babies and children do, and it's the breathing of relaxation. When we are fully relaxed, this is the way we breathe. When we are responding to stress (good, bad, acute, chronic) we breathe shallowly and into our chests only. This doesn't allow for full lung capacity usage, and keeps us in the stress-aroused state, even after the stressor is gone. So to enable our bodies to relax, it helps to concentrate on breathing into your belly.
The second critical part is that you must breathe in through your nose. Breathing in through your nose helps to humidify the air, and most importantly, enhancing the air with secreted nitric oxide (NO). NO is a potent vasodilator, which dramatically enhances the uptake of oxygen in the lungs. This is why it's most important to breathe in through your nose, but not as critical to breathe out that way.
There's a pretty simple breathing exercise that works (with practice) to calm down your sympathetic nervous system and counteract all the panicky, fight-or-flight stress reactions in your body. It can be done almost anywhere, anytime, and nobody would know that you're doing it (even during a presentation or performance!) To start, breathe in through your nose, expanding and filling your belly with air. Then move to your upper chest and fill it. Do this slowly, for a count of 4 or more (whatever is comfortable to you) and then hold it in for that same count of time. Then, slowly exhale for the same count of time, and finally (if you can) hold your lungs empty for the same count. Do this for 3-4 minutes (or longer, if you can) and with practice, this technique will help to both keep you calm, and calm you down in times of stress.
The key to this is practice. I'm working now on implementing this technique every day so that my body becomes accustomed to the calming effect. Over time, it should take no more than a couple of breaths to start the calming effect, and will also train your body to belly breathe all the time, without having to focus on it.
A final benefit to this practice is that it increases your mental focus. First, for all the reasons you might think (more oxygen to your brain, etc), but also the focus required to practice this breathing spills over and secondarily serves to get your mind used to focusing - on anything.
I've been feeling more pain in my jaw joints and teeth recently, and I do find that this practice has helped me to manage that better.
Try this technique for a few days and see how it helps you. And remember to feed the courage wolf inside you, and starve the fear wolf.
Thursday, April 2, 2015
Mental Toughness = Emotional Resiliency
Hello Friends!
As I continue this journey I am on, I want to share some tidbits of learning with you. Today's revelation is the secrets of mental toughness and emotional resiliency.
In his book Unbeatable Mind, Mark Divine shares his top 3 secrets of mental toughness. The first is that Mental Toughness is a choice. You must first choose to control your mind, then you can turn it toward success and hone your skills. Seemingly a simple concept, it goes much deeper than that. By accepting that it is a choice, you are experiencing a paradigm shift that will change the way you view yourself, your life and the things that happen along the way. This change in mindset means that now you understand that you are not a product of what happens to you in life; you are a product of your reactions. No longer are you blown around randomly by the events in your life, seeming to be out of control of the things happening to and around you. You are choosing where to put your energy, your time and your thoughts. When you change the story you tell yourself about your life, you can change the way that stress affects you.
Second, Stress Kills Mental Toughness. This simple fact was, in a way, freeing to me. I have found that while I try to work my way through these steps on my journey to inner strength, when stress (or exhaustion) sets in, it's almost impossible to maintain the consistency of meditation, reflection and to focus on the tough things to be tackled inside. Now that I understand the effect of stress on my mind, I can stop, seek to understand what is stressing me out and why, then harness it and redirect that energy to something positive to counteract it. Giving yourself permission to feel the stress, rather than ignore it, is powerful.
The process to do this is simple, and again it involves choice. I've used this and I can tell you that it's a powerful way to control your mind and your reactions. First you must witness the stress happening and how it is affecting you in the moment. This goes as far as both your mental reactions, and your physical ones. Shortened breath, a feeling of loss of control and that panicked feeling are all very unpleasant. Allow yourself to feel them, experience the reaction. A good tool to use when trying to interdict your stress response is deep breathing. Taking just 5 deep breaths through your nose, filling your lungs and expanding your belly, then letting it all out will serve as a moment of pause while it changes your physiology. Deep breathing through your nose activates your parasympathetic nervous system, which turns off all the negative fear responses of your sympathetic nervous system. Then, interdict that experience. Choose to stop it in the moment and acknowledge that you are not going to let it continue. Then, redirect that energy to something positive.
Finally, most of what we consider Mental Toughness is actually Emotional Resilience. This means that you are able to easily and quickly bounce back from a setback. This is also a skill that can be trained, and needs to be exercised to be maintained.
The process of training emotional resiliency is much like that of reacting to stress. First, witness your negative reaction, then interdict it to stop it and observe the underlying emotion that is causing that reaction; why do I feel this way? What is making me react the way I am? Second, change your initial reaction to whatever the opposite emotion is. If it's fear, change it to courage. If it's jealousy, change it to acceptance. Then, engage this new emotion and all of the actions and feelings that go along with it and continue on with whatever you were doing.
I can tell you that I used this exact technique when I was having a negative reaction to something positive that was happening in my life. Instead of feeling joy and appreciation for what was happening, I was feeling guilt for being so fortunate. I was berating myself for making a choice that supported my own happiness and focusing on all the ways that I could have made a different choice that would have seemed less selfish. Once I recognized what I was doing, I physically took myself to a room where I could be alone and stopped myself from continuing down that rabbit hole. I looked at how I was feeling and why; then I chose to give myself permission to do this for myself. It is what I had been told several times to do. It is something that will bring me peace and joy and I deserve it. I appreciated my good fortune and felt the joy of looking forward to it. Once I had calmed my mind and stopped beating myself up, the stress went away and I was able to continue my day without those negative thoughts and self-talk in my mind.
Please try these techniques today - and remember to feed the courage wolf inside you!
As I continue this journey I am on, I want to share some tidbits of learning with you. Today's revelation is the secrets of mental toughness and emotional resiliency.
In his book Unbeatable Mind, Mark Divine shares his top 3 secrets of mental toughness. The first is that Mental Toughness is a choice. You must first choose to control your mind, then you can turn it toward success and hone your skills. Seemingly a simple concept, it goes much deeper than that. By accepting that it is a choice, you are experiencing a paradigm shift that will change the way you view yourself, your life and the things that happen along the way. This change in mindset means that now you understand that you are not a product of what happens to you in life; you are a product of your reactions. No longer are you blown around randomly by the events in your life, seeming to be out of control of the things happening to and around you. You are choosing where to put your energy, your time and your thoughts. When you change the story you tell yourself about your life, you can change the way that stress affects you.
Second, Stress Kills Mental Toughness. This simple fact was, in a way, freeing to me. I have found that while I try to work my way through these steps on my journey to inner strength, when stress (or exhaustion) sets in, it's almost impossible to maintain the consistency of meditation, reflection and to focus on the tough things to be tackled inside. Now that I understand the effect of stress on my mind, I can stop, seek to understand what is stressing me out and why, then harness it and redirect that energy to something positive to counteract it. Giving yourself permission to feel the stress, rather than ignore it, is powerful.
The process to do this is simple, and again it involves choice. I've used this and I can tell you that it's a powerful way to control your mind and your reactions. First you must witness the stress happening and how it is affecting you in the moment. This goes as far as both your mental reactions, and your physical ones. Shortened breath, a feeling of loss of control and that panicked feeling are all very unpleasant. Allow yourself to feel them, experience the reaction. A good tool to use when trying to interdict your stress response is deep breathing. Taking just 5 deep breaths through your nose, filling your lungs and expanding your belly, then letting it all out will serve as a moment of pause while it changes your physiology. Deep breathing through your nose activates your parasympathetic nervous system, which turns off all the negative fear responses of your sympathetic nervous system. Then, interdict that experience. Choose to stop it in the moment and acknowledge that you are not going to let it continue. Then, redirect that energy to something positive.
Finally, most of what we consider Mental Toughness is actually Emotional Resilience. This means that you are able to easily and quickly bounce back from a setback. This is also a skill that can be trained, and needs to be exercised to be maintained.
The process of training emotional resiliency is much like that of reacting to stress. First, witness your negative reaction, then interdict it to stop it and observe the underlying emotion that is causing that reaction; why do I feel this way? What is making me react the way I am? Second, change your initial reaction to whatever the opposite emotion is. If it's fear, change it to courage. If it's jealousy, change it to acceptance. Then, engage this new emotion and all of the actions and feelings that go along with it and continue on with whatever you were doing.
I can tell you that I used this exact technique when I was having a negative reaction to something positive that was happening in my life. Instead of feeling joy and appreciation for what was happening, I was feeling guilt for being so fortunate. I was berating myself for making a choice that supported my own happiness and focusing on all the ways that I could have made a different choice that would have seemed less selfish. Once I recognized what I was doing, I physically took myself to a room where I could be alone and stopped myself from continuing down that rabbit hole. I looked at how I was feeling and why; then I chose to give myself permission to do this for myself. It is what I had been told several times to do. It is something that will bring me peace and joy and I deserve it. I appreciated my good fortune and felt the joy of looking forward to it. Once I had calmed my mind and stopped beating myself up, the stress went away and I was able to continue my day without those negative thoughts and self-talk in my mind.
Please try these techniques today - and remember to feed the courage wolf inside you!
Friday, March 27, 2015
My 3rd Opinion
Hi Friends,
I've been trying to get up the energy to post again this week, but to be honest I didn't really have much great to say. It's been a bit of a rough week for me, and not in terms of my health or jaw situation. But I've received my final report from Best Doctors Canada, and I thought that would be a great reason to write.
To start, I'll just talk about what's been going on. I work for a large company in the Oil & Gas industry in Canada. So does my husband, although at a different location. You might be aware that oil prices have fallen sharply in the last six months, from over $100/barrel to under $45 in the first quarter of this year. As a result of the poor short to long-term outlook for oil prices (not to be confused with gas prices!) our company announced in January that they would be reducing our workforce by 1,000 people. While this number seems huge, consider that we also have a lot of contract workers in the upstream business (oil sands, in particular) and we didn't really know how many of those 1,000 would be from full time employees, and if so, who and where. Well this week we lost 4 people from our relatively small team, one of which was my work husband (..not real husband). I've been deeply affected by the unfortunate circumstances for everyone, but this loss was really personal for me, and I'm quite sad. Another person who is leaving is my boss, who is being asked to retire at the end of April. He's been the only one allowed to stay beyond the end of the day of hearing the news. Our new boss is moving here from Calgary, and I don't know anything about him except for his name. It's a sad and stressful time.
On top of that, my dog Roxy took ill last weekend and by Wednesday had to go see the vet. I had been consulting with my best friend who actually IS a vet, but she lives out of town. Upon her recommendation, I brought Roxy in. It turned out that Roxy was so ill that she needed to be hospitalized, and stayed there overnight for 2 nights on IV fluids, antibiotics and anti-nausea/diarrhea medications. Only today has she started eating again after 3 full days of not eating at all. I am to pick her up soon, and I can't wait to get her home for some love and rest.
So...it's been a stressful week, y'all.
But in GOOD news, today I received my final report from the Best Doctors Canada service. If you don't know about this service, it's a company that offers help finding doctors, getting second opinions and referring you to specialists. It's often a part of your benefits package at work, but most people don't know about it. I had seen it on my benefits before, but it wasn't until my mom told me about someone she knew who had used it that I found out what they really do.
I engaged them, and they took my history, assigned me a nurse and a case manager and went about gathering all of my physician's notes, test results, images and the like. They then had their internal physician review the information, and sought out a specialist (in my case an Oral MaxilloFacial Surgeon - OMFS) for their opinion on my treatment and diagnosis.
In my case, my information was sent to Dr. Bonnie Padwa at the Children's Hospital Boston. Essentially Dr Padwa confirmed that my condyles are indeed broken and shortened. They are not dislocated, but they are shortened which has resulted in a downwards and backwards rotation of my jaw, and an open bite. The limitation in opening of my jaw could be due to muscle spasming, and could be improved with aggressive physical therapy (PT).
Dr Padwa did agree that my condyles should have been treated with internal fixation (surgically fixing the broken condyles with pins/plates), and that it is too late for that now that so much time has passed. She thinks that I should get a new CT scan to confirm if there is ankylosis in my joints and to confirm that my mandibular fracture has healed. Ankylosis basically means joint stiffness. If there is ankylosis, she recommends the joint replacement surgery.
If there's no ankylosis, she suggests that PT could improve my mouth opening and that a less complicated LeFort 1 osteotomy surgery could be performed to move my upper jaw into alignment with my lower jaw. Um, how about no thanks??
So my feelings about this report are essentially that Dr P (my original Dr P) is correct in his diagnosis and treatment plan. Even if there is no ankylosis in my joints, I'm not really interested in surgically moving my upper teeth to a screwed up position to match the already F'd up lower jaw. (Pardon my language, I just don't see this as an actual option). I'd still end up with a messed up jaw, but I'd be able to bite. Great, but I'm not interested in creating more deformity.
To be honest, though I might sound upset in this post, I'm not. I was deeply convinced that this 2nd (or 3rd) opinion was going to confirm the TJR (total joint replacement) and I was right! (Who doesn't love saying that?!)
I've been trying to get up the energy to post again this week, but to be honest I didn't really have much great to say. It's been a bit of a rough week for me, and not in terms of my health or jaw situation. But I've received my final report from Best Doctors Canada, and I thought that would be a great reason to write.
To start, I'll just talk about what's been going on. I work for a large company in the Oil & Gas industry in Canada. So does my husband, although at a different location. You might be aware that oil prices have fallen sharply in the last six months, from over $100/barrel to under $45 in the first quarter of this year. As a result of the poor short to long-term outlook for oil prices (not to be confused with gas prices!) our company announced in January that they would be reducing our workforce by 1,000 people. While this number seems huge, consider that we also have a lot of contract workers in the upstream business (oil sands, in particular) and we didn't really know how many of those 1,000 would be from full time employees, and if so, who and where. Well this week we lost 4 people from our relatively small team, one of which was my work husband (..not real husband). I've been deeply affected by the unfortunate circumstances for everyone, but this loss was really personal for me, and I'm quite sad. Another person who is leaving is my boss, who is being asked to retire at the end of April. He's been the only one allowed to stay beyond the end of the day of hearing the news. Our new boss is moving here from Calgary, and I don't know anything about him except for his name. It's a sad and stressful time.
On top of that, my dog Roxy took ill last weekend and by Wednesday had to go see the vet. I had been consulting with my best friend who actually IS a vet, but she lives out of town. Upon her recommendation, I brought Roxy in. It turned out that Roxy was so ill that she needed to be hospitalized, and stayed there overnight for 2 nights on IV fluids, antibiotics and anti-nausea/diarrhea medications. Only today has she started eating again after 3 full days of not eating at all. I am to pick her up soon, and I can't wait to get her home for some love and rest.
So...it's been a stressful week, y'all.
But in GOOD news, today I received my final report from the Best Doctors Canada service. If you don't know about this service, it's a company that offers help finding doctors, getting second opinions and referring you to specialists. It's often a part of your benefits package at work, but most people don't know about it. I had seen it on my benefits before, but it wasn't until my mom told me about someone she knew who had used it that I found out what they really do.
I engaged them, and they took my history, assigned me a nurse and a case manager and went about gathering all of my physician's notes, test results, images and the like. They then had their internal physician review the information, and sought out a specialist (in my case an Oral MaxilloFacial Surgeon - OMFS) for their opinion on my treatment and diagnosis.
In my case, my information was sent to Dr. Bonnie Padwa at the Children's Hospital Boston. Essentially Dr Padwa confirmed that my condyles are indeed broken and shortened. They are not dislocated, but they are shortened which has resulted in a downwards and backwards rotation of my jaw, and an open bite. The limitation in opening of my jaw could be due to muscle spasming, and could be improved with aggressive physical therapy (PT).
Dr Padwa did agree that my condyles should have been treated with internal fixation (surgically fixing the broken condyles with pins/plates), and that it is too late for that now that so much time has passed. She thinks that I should get a new CT scan to confirm if there is ankylosis in my joints and to confirm that my mandibular fracture has healed. Ankylosis basically means joint stiffness. If there is ankylosis, she recommends the joint replacement surgery.
If there's no ankylosis, she suggests that PT could improve my mouth opening and that a less complicated LeFort 1 osteotomy surgery could be performed to move my upper jaw into alignment with my lower jaw. Um, how about no thanks??
So my feelings about this report are essentially that Dr P (my original Dr P) is correct in his diagnosis and treatment plan. Even if there is no ankylosis in my joints, I'm not really interested in surgically moving my upper teeth to a screwed up position to match the already F'd up lower jaw. (Pardon my language, I just don't see this as an actual option). I'd still end up with a messed up jaw, but I'd be able to bite. Great, but I'm not interested in creating more deformity.
To be honest, though I might sound upset in this post, I'm not. I was deeply convinced that this 2nd (or 3rd) opinion was going to confirm the TJR (total joint replacement) and I was right! (Who doesn't love saying that?!)
Thursday, March 19, 2015
Feeding the Courage Wolf
Native American folklore says that we all have 2 sides to us, one that is "good" and one that is "bad". These 2 sides are represented by wolves and the good is called the "Courage Wolf", while the bad is called the "Fear Wolf". This is oversimplifying things, of course, but is a metaphor that can be powerful in helping to remind us what to do in times of challenge and stress.
I've decided to take on the challenge of developing what's referred to as an "Unbeatable Mind", a concept and program developed by former Navy SEAL Mark Divine. Mark has a few programs, most notably "SEALfit", which is also a whole-person training program. Both programs are geared toward this holistic approach, it's just that SEALfit has a much stronger physical component to it than Unbeatable Mind.
And so I'm working through both at the moment, at a basic level, which means I'm reading both books and trying to implement the actions into my life. Here's what I've learned so far.
Your mind is the most powerful tool that you have. Regardless of your physical condition (they believe, as I do, that stronger is always better), you can achieve great things by harnessing the power of your mind. This isn't as simple as it seems, but for me it is boiled down to one idea: To win at anything, you must first win in your mind. Better said, "Victorious warriors win first and then go to war. Defeated warriors go to war first, then seek to win." - Sun Tzu.
The first 2 big steps in this process are to change my belief system, and begin the steps to visualize my own success in my mind. Practically speaking, this means that I wrote down the 4 guiding emotions in my life. They are as follows:
1. Fear (fearing failure)
2. Jealousy (wishing for what others have achieved)
3. Love (I believe that all things must begin with love)
4. Despair (giving up hope when things get hard).
I am proud that one of my dominant emotions is Love, however...the other 3 are directly at odds with this and so I don't believe that I'm truly acting out of love all the time.
I am working to replace these emotions with
1. Courage
2. Acceptance
3. Love
4. Hope
I reflect on these daily until they become virtues - founding principles on which my character is built. This will not happen overnight, and it will take a lot of time and effort on my part.
The visualization part is also a ways off. To start this process, first I am practicing meditation daily. Finding even 5-10 minutes of quiet at the beginning or end of my day to just clear my mind is my goal. I use the fishbowl technique, which is where you imagine your mind as a cloudy, dirty fishbowl that slowly clears to pristine waters. Anytime thoughts creep in, the fishbowl clouds again. From here, once I have a clear mind, then I can imagine my own success. For me, this is being a calm, courageous force. Someone who truly begins all things with love.
I am also beginning the physical component, which is to push myself in workouts that are quite difficult. The difference here is that although they are very physically demanding, the purpose is to both strengthen myself physically, but more importantly, to strengthen my mind. By believing that I can complete a tough physical challenge (by first visualizing myself doing, and completing, the workout) and then proving it out, I gain strength of mind. However, I also am tuning into my body much more. If I feel tired or worn out, I take a rest day. You must nurture your body with sleep and nutrition so that it can be powerful.
Will you try one of these techniques with me? Nothing ventured, nothing gained! And if you feel this is all to "new agey" or hokey, remember....these are techniques employed by Navy SEALs - the toughest of the tough.
If you have any questions, please feel free to comment. And remember to starve the Fear Wolf and feed the Courage Wolf inside of you.
I've decided to take on the challenge of developing what's referred to as an "Unbeatable Mind", a concept and program developed by former Navy SEAL Mark Divine. Mark has a few programs, most notably "SEALfit", which is also a whole-person training program. Both programs are geared toward this holistic approach, it's just that SEALfit has a much stronger physical component to it than Unbeatable Mind.
And so I'm working through both at the moment, at a basic level, which means I'm reading both books and trying to implement the actions into my life. Here's what I've learned so far.
Your mind is the most powerful tool that you have. Regardless of your physical condition (they believe, as I do, that stronger is always better), you can achieve great things by harnessing the power of your mind. This isn't as simple as it seems, but for me it is boiled down to one idea: To win at anything, you must first win in your mind. Better said, "Victorious warriors win first and then go to war. Defeated warriors go to war first, then seek to win." - Sun Tzu.
The first 2 big steps in this process are to change my belief system, and begin the steps to visualize my own success in my mind. Practically speaking, this means that I wrote down the 4 guiding emotions in my life. They are as follows:
1. Fear (fearing failure)
2. Jealousy (wishing for what others have achieved)
3. Love (I believe that all things must begin with love)
4. Despair (giving up hope when things get hard).
I am proud that one of my dominant emotions is Love, however...the other 3 are directly at odds with this and so I don't believe that I'm truly acting out of love all the time.
I am working to replace these emotions with
1. Courage
2. Acceptance
3. Love
4. Hope
I reflect on these daily until they become virtues - founding principles on which my character is built. This will not happen overnight, and it will take a lot of time and effort on my part.
The visualization part is also a ways off. To start this process, first I am practicing meditation daily. Finding even 5-10 minutes of quiet at the beginning or end of my day to just clear my mind is my goal. I use the fishbowl technique, which is where you imagine your mind as a cloudy, dirty fishbowl that slowly clears to pristine waters. Anytime thoughts creep in, the fishbowl clouds again. From here, once I have a clear mind, then I can imagine my own success. For me, this is being a calm, courageous force. Someone who truly begins all things with love.
I am also beginning the physical component, which is to push myself in workouts that are quite difficult. The difference here is that although they are very physically demanding, the purpose is to both strengthen myself physically, but more importantly, to strengthen my mind. By believing that I can complete a tough physical challenge (by first visualizing myself doing, and completing, the workout) and then proving it out, I gain strength of mind. However, I also am tuning into my body much more. If I feel tired or worn out, I take a rest day. You must nurture your body with sleep and nutrition so that it can be powerful.
Will you try one of these techniques with me? Nothing ventured, nothing gained! And if you feel this is all to "new agey" or hokey, remember....these are techniques employed by Navy SEALs - the toughest of the tough.
If you have any questions, please feel free to comment. And remember to starve the Fear Wolf and feed the Courage Wolf inside of you.
Wednesday, March 11, 2015
Gathering Strength
Recently I've been giving a great deal of thought to my psychological well-being. I think this is evidenced by my previous posts! But going further than that, I'm specifically interested in developing my mental and emotional resilience. I've always felt fairly strong in this area, or at least not weak, but since my accident my resilience has been tested, and I'm determined to emerge stronger and better after it's all said and done.
I have been broken a few times along the way, and I certainly find it easy to start to feel myself slipping toward hopelessness. My bite is getting worse with orthodontics, and I often get frustrated trying to eat, when I hear myself speak with a lisp or am asked to repeat myself and generally feeling deformed, even if it isn't super-obvious to look at me. I get tired easily, and I'm truly afraid of pushing myself physically. I've always enjoyed exercise, and challenging myself when I can. I'm not the best at much of anything (although I'm a pretty good rower), not the strongest in a fitness class, or the fastest runner. But I generally don't back down from trying. And I feel my best when challenging myself this way.
Well I'm now left feeling very deeply afraid of pushing myself, both out of fear of seriously injuring myself again, or just the current pain that might escalate as a result. I don't like this. I want to get out and go for a long run to relieve my stress. I want to go lift some weights, or do a hard class at the gym. But I'm afraid.
I know that this is temporary. My whole life won't be like this. I will have surgery, I will get the braces off, someday I will be a new normal person. This is what the doctors tell me. I will be able to do everything I used to do again, without pain. But getting to someday is hard. Yes, it helps to know that this will pass....but getting through it is another thing. The only easy day was yesterday. Today is a new day.
So I'm working on my mental toughness. Tackling some inner demons, taking control of my inner dialog. I've been doing some meditation, focussed breathing, yoga and learning about training your mind to overcome the obstacles it sets for itself. I'm feeling a shift start to happen. I need to turn these things into practice. Turn them into every day things, habits that feed my mind and soul.
What I'm hoping for through my journey and pursuit of mental resiliency, I will better prepare myself for what lies ahead, both the known and unknown challenges. I want this to be a life-long skill, to live a more mindful existence, gaining better control over my actions, reactions and working more toward my purpose than just living this life as a passenger. For too long I've been a product of what has happened to me, and not in control of where I was going. In truth, my ultimate goal is to seek out what truly makes me happy in this life, and have the courage and ability to continue to pursue it long after this whole journey is over.
In the meantime, becoming a stronger person will help me to steer myself through this whole experience. Forging mental toughness will allow me to handle the pain with control, and come out of the surgery stronger, and ready to recover fully. If you're interested in the same things, or any of this resonates with you, please comment and let me know!
I have been broken a few times along the way, and I certainly find it easy to start to feel myself slipping toward hopelessness. My bite is getting worse with orthodontics, and I often get frustrated trying to eat, when I hear myself speak with a lisp or am asked to repeat myself and generally feeling deformed, even if it isn't super-obvious to look at me. I get tired easily, and I'm truly afraid of pushing myself physically. I've always enjoyed exercise, and challenging myself when I can. I'm not the best at much of anything (although I'm a pretty good rower), not the strongest in a fitness class, or the fastest runner. But I generally don't back down from trying. And I feel my best when challenging myself this way.
Well I'm now left feeling very deeply afraid of pushing myself, both out of fear of seriously injuring myself again, or just the current pain that might escalate as a result. I don't like this. I want to get out and go for a long run to relieve my stress. I want to go lift some weights, or do a hard class at the gym. But I'm afraid.
I know that this is temporary. My whole life won't be like this. I will have surgery, I will get the braces off, someday I will be a new normal person. This is what the doctors tell me. I will be able to do everything I used to do again, without pain. But getting to someday is hard. Yes, it helps to know that this will pass....but getting through it is another thing. The only easy day was yesterday. Today is a new day.
So I'm working on my mental toughness. Tackling some inner demons, taking control of my inner dialog. I've been doing some meditation, focussed breathing, yoga and learning about training your mind to overcome the obstacles it sets for itself. I'm feeling a shift start to happen. I need to turn these things into practice. Turn them into every day things, habits that feed my mind and soul.
What I'm hoping for through my journey and pursuit of mental resiliency, I will better prepare myself for what lies ahead, both the known and unknown challenges. I want this to be a life-long skill, to live a more mindful existence, gaining better control over my actions, reactions and working more toward my purpose than just living this life as a passenger. For too long I've been a product of what has happened to me, and not in control of where I was going. In truth, my ultimate goal is to seek out what truly makes me happy in this life, and have the courage and ability to continue to pursue it long after this whole journey is over.
In the meantime, becoming a stronger person will help me to steer myself through this whole experience. Forging mental toughness will allow me to handle the pain with control, and come out of the surgery stronger, and ready to recover fully. If you're interested in the same things, or any of this resonates with you, please comment and let me know!
Monday, March 9, 2015
Coping with Facial Trauma
Living with changes to your facial appearance as a result of trauma can be incredibly difficult. In fact, studies have shown that people who acquire facial changes as a result of trauma have more difficulty coping than those with congenital disfigurement, or even that resulting from treatment of a disease, like cancers of the face or head. There have not been enough studies on the effects of these changes, and in this post I’m attempting to summarize some of the risk factors, symptoms to look for and strategies to cope.
People with oral and/or facial trauma are up to 70 % more likely report symptoms of depression, anxiety and hostility. Injuries to critical facial structures like eyes, ears and dental structures will increase these odds, and these psychological issues can impede your recovery. Being aware of the symptoms and risk factors is critically important to your health.
Key Facts:
- There is no correlation between the degree of disfigurement and type, extent or severity of psychological symptoms
- Your satisfaction with your facial appearance is a more important predictor than the objective severity of facial changes
- Women are more susceptible than men
- Depression puts you at increased risk for suicide, poor compliance with treatment and a poor rehabilitation outcome.
- Your surgeon may not recognize these symptoms - so be aware for yourself or loved ones.
- Attributing blame for your trauma to others puts you at higher risk for both anxiety and depression (vs. self-blame, or accepting of it as an accident).
Facial changes and/or disfigurement can result in depression, anxiety and even Post Traumatic Stress Disorder, or PTSD. The symptoms of PTSD are:
- Re-experiencing the trauma (via intrusive thoughts and/or distressing images and dreams);
- Avoidance of thoughts, emotions or situations related to the trauma; and
- Autonomic nervous system hyperarousal, including difficulties sleeping, having an exaggerated startle response and experiencing increased irritability and tension.
The biggest challenge is the social aspect of life after an appearance-altering trauma. The response that people have to your appearance can be painful, even if not intended to be. For many, constant worry about reactions their appearance can cause social withdrawal. Just remember that curiosity is a natural human reaction when faced with something we don't understand. Most people who may be staring at you, or even asking you inappropriate questions, are not doing so to hurt you. They are simply curious and interested. There are ways to deflect this unwanted attention. My favourite is: "You seem to find me very interesting!".
Another known effect of facial changes due to trauma is that it can ignite negative body image issues and body dysphoria in social situations that can significantly affect your life. Still others can have no body image issues despite disfigurement. It seems that predictor for this response is your self-image prior to the accident. The more value you place on your looks in general, the more likely you are to suffer from a negative body image after trauma.
Pre-Trauma Personality Traits that Affect Recovery
- Presence or absence of psychiatric illness
- Financial and social status
- Family history of psychiatric problems
- Having a family member involved in the trauma
- Family approach to the trauma and recovery
- General resilience
- Response to major life events in the past
- Survivor guilt (if relevant)
- If the trauma was the result of an accident or a workplace/industrial incident
- Presence of compensation and litigation issues
It can often be hard to know when it’s time to reach out and seek professional help. This is especially hard for loved ones, as we don’t often admit to all the symptoms we are feeling. I urge you to review the list below and be honest about how many apply to you. I bet if you have one symptom, you have at least a few more. Please reach out if even one of these symptoms applies to you.
Telltale signs that a referral to mental health professional is needed:
- Anger
- Irritability
- Poor support network present
- Crying spells
- Loss of hope for recovery
- Long in-patient stay
- Multiple surgeries
- Depressed mood
- Poor financial support
- Loss of loved ones in the same traumatic event
- Loss of job
- Flashbacks or recurring dreams
- Sleep problems
- Chronic pain
- Family or personal history of psychological illness
- Preoccupation with facial appearance after recovery
Ways to Cope
The human mind is a remarkable thing, and the beauty of it is that we are often capable of so much more than we give ourselves credit for. Remember this, and use it to your advantage when you’re feeling low. Actually...keep it in mind all the time. As Winnie the Pooh once said: “You’re braver than you believe, stronger than you seem and smarter than you think.”
There are many ways to care for yourself and improve your resiliency, and it all starts with self-care. The crux of it is to be kind to yourself.
- Set yourself up for success. This means taking care of your basic needs - get enough sleep, nourish your body with good food and make your well-being a priority. Don’t take on more than you can handle, and learn to say no.
- Be active. Don’t worry about how fit you are, or pushing yourself through a difficult workout if that’s not your thing. Go for a walk, or cycle. Just get up and move.
- Focus on developing your inner self. True beauty comes from confidence, and the best way to feel confident is to feel good about the person that you are on the inside. Take time to develop that. Things you can try are immersing yourself in a non-stressful hobby, meditation, social events.
- Talk to someone you trust.
- Try to view your situation as a positive challenge, rather than a threat.
- Remember that you are a warrior. You have been through challenges that nobody but you can understand. There is power in that. Gather strength from your successes.
Changing Faces UK is an excellent resource for all people coping with facial disfigurement for any reason. I stumbled across it in my research and found it to be very informative. They have an excellent online learning program (for free!) that teaches you how to handle social reactions to your appearance. There are 5 techniques that they teach:
- Explain in a way you’re comfortable with.
- Make a big effort to reassure people.
- Distract people away from your condition.
- Use your sense of humour.
- Be assertive.
These bullet points are not enough - I encourage you to review the course for a detailed explanation on how to employ these techniques. The course is built for teenagers, but that’s just in the way it’s presented and in fact I think that only targeting this age group is a mistake on their part. The information within is completely appropriate for all ages. It can be found here: http://learn.happyelearning.co.uk/clients/changingfaces/home.html
I hope this provides some help and support to you. Please feel free to comment, or message me personally if you need to talk to someone and don’t know who.
And take care of yourself.
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