Monday, May 1, 2017

More on Stress... and Tips for Sleep Improvement

Hello, everyone! It has been a very long time. I can write today because I am on a getaway trip to meet up with my college roommate. How refreshing to be able to hear one’s own thoughts!

Since this blog is very much a personal diary with some medical facts thrown in, today's topic is stress. A lot of this is probably common sense but I shall illustrate with a peak into my life.

So a couple of weeks ago, I had to take my medical boards which is required for certification every 7 to 10 years. It sure has been a long time since I’ve had to study for a test that counts and I’ve never had to do this while being responsible for 4 other individuals other than myself… and actually, it is even more individuals if you count my husband, extended family members, and patients that I feel responsible for every day. To say that I was stressed the week before my test is probably the understatement of the year. So aside from my increased irritability and lack of patience with everyone (I was going to write “my kids” but I think my snappy-ness applied to everyone who crossed my path)... I also developed some medical issues. Being stricken with a canker sore sandwiched between my upper gums and upper lips was uncomfortable and troublesome but getting TMJ was new and surprisingly more painful and debilitating than I ever imagined. I have new found empathy for all the patients I’ve treated in the past with this. I also realized I had taken for granted the ability to chew and even yawn. Boy, was it difficult to yawn without triggering sharp shooting pains and locking of my jaw. Thankfully, my symptoms eventually subsided when I finally gave in and took some Aleve and slowly resolved a couple of weeks after my exam.

You would be bored if I rattled off all the things that were stressing me out. However, I do think it is a good exercise to write it all down, stick it in a box, and give it all up to the Lord. My lengthy list included some unexpected added inconveniences and annoyances that I’ll save for another post.

This trip was a treat for me away from the kids and my usual routine… to catch up and spend time with my friend. It was a well needed time of rest and restoration for my body, mind, and soul. As I am finishing this blog on my flight back to real life, I can tell you that I am in a healthier frame of mind.

For a glimpse of the state of my mind before the trip… here is a snapshot of an interaction that happened on the way there.

First, I had to leave home very early at around 230am to catch my flight, so I pretty much pulled an all-nighter. Maybe I got in 2-3 hours of interrupted sleep during the first leg of my flight. When I arrived at my connecting city, I stopped at the gate counter to ask the agent how I can get to Terminal F.

“There is no terminal F” she says to me puzzled. “Where are you going?”

I show her the boarding pass I had pulled up on my phone from the e-wallet app. She looked it and wrinkled her brow. “Wait… this pass is from Philadelphia going to Bangor.” I then started to panic. Gasp. What if I booked it wrong? This is a total possible scenario given my recent track record. Another agent walks over holding a sheet of connections in his hand to try to help, “Where are you going, Miss?” he asks me. I hesitate as I rack my brains trying to answer. “Uhh… hold on… “ I frantically search my emails for the info.

“What city are you going to?” he asks again. When I still failed to answer, he responds incredulously, “Lady, you don’t even know what city you are going to?!” The original female agent I was talking to looked at me sympathetically, “Oh, the poor lady!”

Aiyayaieee!! This is exactly why I needed a getaway… my brain was overloaded and needed a reboot. But in my defense, my friend picked the location and the name of the city we were going to was unfamiliar to me so it never stuck and I didn’t want to answer “some city in Mexico”. Finally, the agent asked me for my name and proof that I am who I say I am… then pulled out a boarding pass for me from under the counter. She had that the whole time? Turns out I am to go to Terminal D. Apparently, I had pulled up an old boarding pass and it just didn’t register.

So I’ve been advocating the importance of sleep to my patients. Our human brains need sleep like computers need to be routinely shut down. If you leave your computer on too long, programs start to crash. Same with the human brain… we start to crash in all different levels. I also believe that natural sleep when your brain goes through all the four stages of sleep and REM sleep is very important and not the same as sleep induced by meds (like Ambien). These sleep aids only shut down our brain physically and give us physical rest but not the mental rest that is also needed. Sometimes sleep aids are needed to reset the sleep cycle but it is important to get back on a routine regular sleep cycle. This can be very tricky especially if it has become routine and the brain has become dependent on the sleep aid to initiate sleep. However, it is not impossible and may require persistent therapy and support from different medical professionals to work through this important issue. I’ve mentioned it before in a previous post, but here are some basic tips on how to improve sleep.

  • routine routine routine... develop a bedtime routine about 1 hour before bedtime to wind down

other important factors include:

  • induce physical relaxation
    • take a hot shower or soak in a warm bath to relax the muscles
    • give yourself a body rub with a moisturizer that has a pleasing but not super strong scent
    • can try lavendar scented candle, room spray or essential oil
  • avoid increasing stress right before bed
    • avoid the news right before bed
    • avoid hard conversations
    • write down your worries and put it in a box if need be to address in the morning
    • shut down all electronics at least 30min but the longer the better before bedtime
  • minimize sound
    • use white noise if needed
    • try ear plugs
    • go to bed and fall asleep before the person snores next to you
  • exposure to light
    • flood yourself with natural sunlight during the day
    • avoid blue light at night (computers, cell phones, ipads etc)
    • if need to use night light, use red light
  • exercise
    • don't do it too close to bedtime
    • but regular exercise during the day helps
  • watch what you eat
    • certain foods actually may help (like cherries, milk, bananas, turkey, and even not too sugary carbs)
    • avoid foods that cause heartburn (like burgers and tomato based foods or spicy foods)
    • avoid foods that are high in sugar
  • watch what you drink
    • avoid caffeine of any type past 4pm
    • avoid alcohol too close to bedtime (less than 2-3 hrs prior) as this may initiate sleep but disrupts the maintenance of sleep
    • avoid too many drinks of any type past dinner as this may cause the need to go to the bathroom during the night
    • in small quantities certain herbal teas may help
  • minimize disrutions
    • avoid sleeping with a pet
    • sleeping with small children can be disruptive

Improving sleep in adults is pretty much the same concept as improving sleep in babies. It requires some sleep training which may look different from person to person and also may take a few days to even a few weeks. Consistency is key and once disrupted, it takes some work to get it back.

Sleep is what I did get on this trip! 8am (because I had to catch a flight today) was the earliest I’ve woken up these past 3 days and I've been going to bed pretty much before 11pm every night. I plan to make more effort to keep a strict bedtime routine and follow my own advice when I get back.

Eating plenty of good food was another treat that helped me feel refreshed this weekend. Now the food was amazing!

best tuna cerviche ever

scrumptious shrimp tacos...

magnificient open fire grilled fish...

Although it is not practical to get the same kind of gourmet food when I get back, I do need to make more of an effort to eat regularly.

Exercising these past few days included walking on the beach...

trying out these bicycles...

and swimming...

And even though I may not have this kind of beautiful scenery to relax to everyday…

…I can make more effort to take a minute to breathe on a consistent basis.

So sleep, food, exercise, and relaxation… though I don't have to travel so far away to get these basics for a healthy body, soul, mind… it sure doesn’t hurt to do so every now and then. Thanks to everyone who made this trip possible!