The Tao

In my family, each person has a copy of the Tao Teh Ching. The book is sacred to me for its content, but also for how much I feel connected to my family through it. In 1999, my wise dad gave each of his three children a beautiful copy for Christmas. He inscribed it simply with "Into the next millennium." Like most of my books, it's not something I simply sit down and read; I pull it out and dip in and out at will. I always come back to it, though. Sometimes, if I want a path for my meditation, I'll slide the book off the shelf and read a favorite passage.

Tonight I'm spending some time with passage #76:

When a man is living, he is soft and supple.
When he is dead, he becomes hard and rigid.
When a plant is living, it is soft and tender.
When it is dead, it becomes withered and dry.

Hence, the hard and rigid belongs to the company of the dead:
The soft and supple belongs to the company of the living.

Therefore, a mighty army tends to fall by its own weight,
Just as dry wood is ready for the axe.

The mighty and great will be laid low;
The humble and weak will be exalted.

Sleep Hygiene

I've touched on sleep hygiene in the past, but thought I'd post the handout I got from the Penn Sleep Center. It is more detailed than things I've written about, and for anyone suffering with insomnia, I want to offer as many resources as possible. So, without further ado, the wonderful tips from the Penn Center for Sleep Disorders. My input is in italics; the rest is right from the experts.

Sleep Hygiene

A. Maintain a regular sleep/wake schedule
1. Keep the same rise time and bedtime every day. Fun? Not so much. Worth it? Absolutely. This was one of the most helpful tips for me.

B. Maintain a healthy diet
1. Include foods high in carbohydrates. I would add that they should be complex carbohydrates, like whole grains and produce. Refined carbs, like white bread and white rice, are going to convert to sugar much more quickly, which can destabilize your blood sugar and make it more difficult to sleep.
2. Foods that contain carbohydrates are: breads, pasta, rice, cereal, fruits, vegetables, & milk.
3. Going to bed hungry or eating a large meal before bedtime can worsen sleep.
4. If hungry at bedtime, eat a light snack or drink a glass of milk.

C. Avoid or minimize the use of caffeine. My friend Maggie would say this is cruel and unusual punishment, and might not even be humanly possible. It is difficult, especially if you've got a serious coffee habit. But if you have trouble sleeping, caffeine's only going to make it worse. Try to taper off, and eventually -- I promise -- you'll be sleeping better and need it less. (Don't worry, Maggie. If you sleep fine, I'm not going to suggest you give up the good stuff.)
1. It is a stimulant that interferes with sleep.
2. The effects can last as long as 8-14 hours.
3. One cup of coffee contains 100mg of caffeine and takes 3 hours to leave the body.
4. Most sodas and teas, some headache and cold medicines, and most diet pills (evil buggers!) will worsen sleep.
5. It is recommended not to drink coffee, tea or soda after Lunch. If you continue to have difficulty falling asleep, avoid drinking caffeinated beverages after Breakfast. I'll say it again -- if you're a particularly atrocious sleeper like I am, you're probably better off without any caffeine at all. I found it was the ritual I missed in the morning, almost as much as the caffeine. Now I make tea to sip while I get ready for the day. It's a different ritual, but a ritual nonetheless.

D. Avoid alcohol. I hate this one. I hate how important it is, and what a difference it makes in my life if I'm drinking or not. This might be the most frustrating for me. As with caffeine, I try to supplement the ritual. My bartenders know if I'm not sipping a Bluecoat gimlet, I'm going to be drinking club soda with lime by the gallon.
1. You may feel it helps you get to sleep, but for most people it causes awakenings as well as poor sleep later in the night. It's true. Drat.
2. Alcohol can make snoring and sleep apnea worse.

E. Smoking cigarettes will interfere with sleep. Just in case you needed another reason to quit...
1. If you currently smoke, begin to cut back on nighttime smoking.
2. Stopping smoking is a helpful step to improving your sleep. The best way to quit smoking is to be involved in a group meeting along with the patch or gum.

F. Over-the-counter sleeping medications:
1. None of the medications currently available OTC help you get into deep sleep. I took Tylenol PM almost every night for ten years. It's horrifying to think of all the REM sleep I missed. It also feels absolutely amazing to not depend on it any longer; I know longer feel anxious if I spend the night somewhere and forgot to bring Tylenol PM or Benadryl. Knowing I don't need it makes it that much easier to fall asleep.
2. These medications only help you fall asleep faster.
3. OTC sleeping pills may make your sleep worse later in the night like alcohol.

G. Maintain a regular exercise schedule. Just in case you needed another reason to start exercising...
1. Walking is an excellent form of exercise. The best time is early in the morning (7am-9am). I personally think that you walk is much more important then when you walk. If after work is more likely to become a habit for you, embrace it. Just get fresh air and some blood moving.
2. Light stretching can be done on rainy days.
3. Guard against strenuous exercise before bedtime. It is too stimulating and may prevent you from falling asleep.

Night Time Tips

A. Do not nap during the day (unless your sleep doctor has told you that you may).
1. Not napping will allow you to sleep much better at night.
2. Exercise instead of napping. This is one of those tips that makes me want to say, "You've never suffered from really serious insomnia, have you? You try exercising after getting two hours of sleep all week." That said...if you can reach down and pull this off, I bet it would help. I don't let myself nap, but I have yet to be barely able to stay awake and then decide to go running. If you can do that -- huge kudos to you.
3. Stay active during the day when you feel sleepy.

B. Eat meals at the same time each day, every day. OK, I just saw this for the first time. Haven't tried it, but I imagine it helps in getting your body on schedule. File that one away.
1. 3 to 4 small meals per day are better than 1 to 2 big meals.

C. Plan evening activities that promote relaxation.
1. Read or listen to music.
2. Avoid using watching TV in bed to fall asleep. The late night news in not very relaxing. I would take this a bit further -- avoid all screens 90 minutes before bedtime. Dim lights will help you transition more easily.
3. Meditate before bed. (That isn't on the Sleep Clinic list. I think it should be.)

D. If you tend to worry about things while lying in bed:
1. Make a list of things to deal with tomorrow. I keep paper and a pen next to bed so I can jot down things that pop into my head, rather than worry about remembering them.
2. Make a list of things to do before bedtime. Part of my night time routine includes doing a quick pick-up of my apartment. Otherwise I lie in bed thinking about the dishes in the sink. This pretty much tops the list of Things Not Worth Losing Sleep Over.

E. Keep regular bedtimes and rise times.

F. Do not spend too much time in bed "chasing sleep." In other words, if you're not sleeping, get out of bed and do something else. It may seem counterproductive, but it helps train your body that bed is for sleeping, not thinking. With time, this can prove to be one of the most useful tips.

G. Do not attempt to "make up for lost sleep" on weekends or holidays. It may not work and it means you are not up to par for the second half of the week.

H. Develop a sleep ritual: do the same things each evening before retiring for the night to give your body the cues that it is time to settle down.

I. Relax in bed.
1. Take several deep breaths (in through your nose and out through your mouth) while lying in bed and relax tense muscles, starting with your toes and working up to your head.

J. If you can't fall asleep:
1. Get up and move to another room.
2. Stay up until you are sleepy and then return to bed.
3. If you still cannot fall asleep, get up again.
4. Repeat this cycle until you fall asleep.

K. Do not use your bed as a place to read, watch television, argue, or catch up on office work. This was really tough for me to give up. My bed is by far the most comfortable place in my apartment, and sometimes all I want is to lie in bed and read the paper or dive into a book. Right now, I'm on the search for a comfy chair instead.

L. Set your alarm to get up at the same time each morning, regardless of how much sleep you got during the night, in order to maintain a consistent sleep/wake schedule. In case you weren't counting, this is the third time they've mentioned this. It's important. If you do only three things, tips J, K, and L would be my strongest recommendations.

M. Keep the bedroom dark and at a temperature that is most comfortable for you so that you are not waking up too cool or too hot.

N. Block out noises that can disturb your sleep.
1. Sponge earplugs or "white noise" made by fans, air conditions, or a white noise machine.

O. Go to bed only when you are sleepy.

P. Do not watch the alarm clock and worry about the time or lost sleep. Try to think about something that is relaxing and/or enjoyable.


There you have it. It's a lot, but try to take encouragement from that rather than feeling overwhelmed. There are so many different tools you can try. If these don't work, of if you want additional help, I would suggest a Cognitive Behavioral Therapist specializing in sleep who can walk you through specific exercises designed to tackle your biggest barriers to a good night's sleep. It's a commitment, but you can get there. Honest.

Stress and Panic Attacks

Stress and I don't get along. Some people say they thrive on stress, that it gets them motored up to push through things they wouldn't otherwise people able to do. I am not one of those people. The good thing is that I know what havoc stress wreaks on my well-being, and I work to minimize the stressors in my life. When I get stressed, my immune system starts to stutter and I get sick, my stomach gets upset, I can't sleep. Years ago I also suffered from panic attacks, which, at one point, were so bad that I considered taking time off from school.

Fortunately, I am the daughter of a very wise man. When I talked to my dad about my panic attacks, he gave me a some specific actions to take. They were just the tools I needed to get through the worst of it so I could finish up the year.

1. Eat more protein. At the time I didn't understand the importance of protein when it comes to stress and panic attacks. As I started to read up on hypoglycemia this summer, though, every source talked about how critical regular protein is to maintaining stable blood sugar. And what is one of the symptoms some hypoglycemics experience? You guessed it -- panic attacks.

2. Stop with the caffeine. I had a ten-Diet-Cokes-a-day habit. The mere thought of that horrifies me. Of course anyone who drinks that much caffeine (not to mention chemicals and aspartame) is going to feel jittery, to say the least!

3. Practice deep breathing exercises. When I first started doing breathing exercises, I only had one basic technique: Inhale through my nose to the count of five, exhale through my mouth to the count of seven. It worked, but I've since learned other techniques that work even better for me. The first is ujjayi breath, which is explained quite well here. The other might be the simplest breathing technique I know of, but it's also my favorite: focus fully on each each breath, simply observing it, but with the exhale as the "start" of the breath, and the inhale as the "end." That simple reversal in observation takes just enough focus for me to allow my mind to quiet. This is also my favorite breath for when I meditate.

This past week I have been feeling an incredibly amount of stress, and have been unable to pinpoint its root, which only frustrates me more. Doesn't much help the situation. To make matters worse, in the last three days, I've staved off four panic attacks. I'm glad I was able to prevent them, but it's been a little unsettling that they've resurfaced after so many years. So I'm going back to basics. Protein. Stay off the caffeine. Practice deep breathing. Now I have even more tools in my arsenal, though, which is encouraging. Here are the new additions:

1. In addition to deep breathing to get me through a tough moment, regular meditation to help keep me on an even keel. (If you're thinking, hey, wait, you've been doing this meditation thing for a few weeks now, and you're getting panic attacks for the first time in years. Why would I want to do that? It's because I've been slacking on the meditation. Doh.)

2. Beyond just eating more protein, work to limit my sugar intake as much as possible, thus keeping my blood sugar as stable as I can manage. (Yes, I've been slipping up and having more sugar and alcohol lately, too.)

3. Acupuncture also really helps me to feel centered and grounded. I think it's a combination of the treatment itself, and having twenty minutes to lie in quiet on the table and just decompress. After nearly having a panic attack this morning as I was getting in the shower, I booked an appointment for this afternoon as soon as I got to work.

4. Spend time outside, get some sunlight, experience some nature. I think there's a lot to be said for honoring our circadian rhythms; it makes sense that we'll feel better when we're in sync with our natural clocks.

5. Work up a sweat. Exercise gets the endorphins pumping through your system (the source of a runner's high), which brings extra feel-good chemicals to your body. Who wouldn't prefer that to feeling stressed out. It can also help you work through some pent up aggression and get out of a toxic thought loop. Find something you love -- riding your bike, doing yoga, going for a run or a swim -- and let it act as a resource rather than something on your to-do list.

6. Talk it out. If something's weighing on your mind, find people who care about you and vent a little bit. Ask if they have some insight into the situation. There's no point in going on the journey alone.

If you have other resources you call on when you're stressed out, I'd love to hear them. I'm feeling encouraged just having taken the time to think through all the resources I have at my disposal.

Pause

Over the weekend, I decided to practice something I find quite difficult. Saying no, particularly to making plans. I've been busy lately, to say the least. My beloved DD has been known to call me Type A+ Squared. I can't say I'd have much of an argument to refute that; I live by my calendar.

And sometimes it's just plum overwhelming.

Which is why I'm now trying to make the concerted effort to let my calendar be an aide, not the rule book. I have a tendency to fill up any white space in my calendar, sometimes with things I don't even want to do. Then, when something I would love to do comes along, I often have to say no because I'm either already booked or just plain old worn out.

This weekend I tried to embrace the white space. I didn't schedule a workout. I resisted the urge to offer my cousins a free night of baby-sitting (sorry La -- next time!). When my sister said she was going to be at a bar I've been dying to check out, I said no thanks. Instead I came home early on Friday, had a blissfully lazy Saturday morning -- complete with decaf soy ice coffee (I know, I know, what's the point right? I never thought I'd say it, but I'm a convert) and the New York Times -- a great afternoon complete with reading in the park and shopping with friends, and a Saturday night spent assembling my new bookshelf, organizing my books, and cleaning the apartment. It wasn't wild, it wasn't particularly social, and I didn't work on a single one of my three health things. On Sunday, I walked all over the city getting delicious, healthy food, and then met up with friends for a drink. Which turned into an outrageous and hilarious bbq until much too late on a work night. It was great.

I love knowing what to expect and what I need to do, but sometimes it feels really good to loosen the reigns a bit and just do whatever feels right in the moment.

How does a Type A+ Squared girl handle an insight like this, though? By scheduling "time off". It's a start, right?

My Three (Health) Things - Update

In an earlier post I outlined my three primary goals for improving my health. Progress has been in and fits and starts, but here's the latest.

1. Begin a meditation practice.
It's begun. But it's not quite a regular practice yet. Sometimes I miss a day (or three). That said, whenever I do practice, I'm so glad I did. I'm already experiencing lots of great benefits, but I think my favorite has been the incredible way it's sparked my memory. There have been a handful of times that I've just been jolted with a flash of memory from my early childhood. When I was shucking corn the other day, I could almost hear my grandfather talking about fresh corn in Ohio; when I was taking a walk outside, I had a snapshot memory of old family friends I haven't thought about since I was about nine. My focus at work has been (a little) better, too.

2. Resume my yoga practice.
Drat. Excuses continue. Haven't done this yet, but I have been stretching more throughout the day. Baby steps?

3. Get a better grip on my finances.
Finally starting to tackle this one. Last night I returned clothes and shoes I'd bought but never worn and decided I'd rather have the money. This morning I finally set up online banking for my big scary credit card. Most of my other bills are electronic, but I hadn't gotten to this one. I'm amazed at how relieved I feel having done this. Tonight I've scheduled down time into my calendar (no joke), and I plan to confront Quickbooks.

Am I as far along as I'd like to be? No. Am I making progress? Yes. I feel I've lapsed a little bit in the past week and a half, but I'm trying to accept that as part of the natural ebb and flow of things. What never ceases to amaze me, though, is how often I'll be doing something for my health and well-being, it'll be working, I'll feel better, and then...I stop. For example, I eat mostly raw organic food --> my energy skyrockets and my brain feels clear --> I stop eating as well --> my energy plummets and I feel foggy --> I don't have the energy to think about eating as well. It makes me frustrated at my own behavior sometimes, and I really want to understand why I do this. Is it because somewhere in the back of my mind I feel I need a break from the work of being healthy? Do I somehow think I'm "cured"? Now the trick is figuring out how to stay in the good cycles rather than slipping back out to the less healthy path. If you have some magic tricks, I'd love to hear them.

Gluten Free Goodness: Party Time

When I found out I had Celiac Disease, one of the things that bummed me out the most was feeling like I'd miss out on celebrating with friends. No birthday cake, no pumpkin pie, no wedding cake when the time was right. Sure, there are naturally gluten free (GF) options -- lots of ice creams are GF, and you could always go the healthy fruit salad route. But there's something about your best friend bringing you a carrot cupcake with cream cheese frosting for your birthday that's just tough to beat. Lucky for Celiac folk, we can still partake in these sugary little rituals. Here are my favorites.

Namaste makes amazing cake mixes (I find mine at Whole Foods). The Spice Cake is my favorite, but the others are pretty great too. I often add shredded carrots to the Spice Cake mix to make carrot cake instead.

If you're not in the mood to bake your own -- or if you want to surprise one of your Celiac friends with dessert and don't know where to start -- I highly recommend paying a visit to Mr. Ritt's. I'm fortunate to live in the same city as what could easily be the best GF bakery in the country, but those of you who live farther away don't have to miss out. The have a collection of products that ship well, and they're well worth it. My roommates in college surprised me with a cake from Mr. Ritt's for my first Celiac birthday, and it made all the difference. They also do amazing wedding cakes; the price for some is even lower than your standard gluten-full wedding cakes, and most of them taste at least as good, if not better. Just to hammer home the point: Mr. Ritt's is amazing.

Whole Foods also has a great GF bakehouse. You can find muffins and breads, but you can also find some killer chocolate chip or peanut butter cookies. I live about a five minute walk from Whole Foods, but I never buy the cookies. Why? They're so tasty, all ten or so would be gone by my front door.

Trader Joe's didn't miss out on the GF market, either. If you want a little treat, I'd highly recommend these GF Ginger Snaps. Warning: don't think for a second you'll only eat one or two.

If ginger snaps aren't your thing, you can always go for their tiramisu, found in the freezer section. I assume just about everyone like tiramisu, so it's my last suggestion for this post. Seriously. Gluten free tiramisu, and it's delicious.

If you have any other GF party favorites, post them in the comments section -- I'd love to hear about them. Enjoy!

Reactions

I'm coming up on the home stretch of the elimination diet, and have learned some pretty critical information about how my body handles different foods. The quick breakdown, without getting into the not-so-glamorous details of my various responses, is as follows:

I have shown no adverse reaction to corn (the one I was most nervous about), citrus, or any other fruits and veggies. Hurray!

I have mild reactions to aged dairy, unfermented soy, wine, and liquor. I seem to be fine if I have these items in moderation, which is good news -- I'd be pretty bummed if I could never again sit down with wine and cheese.

The bummer list is pretty short so far, thankfully. Regular dairy and I do not get along. This is one of those things I've sort of known for the past few years, but tried to ignore. After this experiment, though, I think I'll be staying away for the most part. Very small amounts seem to be ok, but anything else is not so pleasant. Good thing I really like rice and almond milks. I also can't really tolerate fermented soy (aka tofu), but I'm quite all right with that. It did add a little protein boost to my smoothie, but other than, I was never really a fan.

Then, of course, there are still the items to be tested. Soon I'll know how my body gets along with (or not) yeast, peanuts, eggs, seeds, and tree nuts. Fingers crossed.