My Favorite Colonoscopy

When I turned 50 years old, my doctor told me to get a colonoscopy.  Since I had not done a mammography in four years, I shelved the idea of the colonoscopy in my ‘to do when I get around to it one day’ list. By the time I finally did get around to that long-overdue mammography, the colonoscopy had migrated and disappeared into my ‘I forgot’ drawer.

About a year later, while reading the Wall Street Journal, a one-page ad in bright colors caught my attention The ad featured a full-page photo of Katie Couric, a well-known U.S. journalist. Katie was wearing a white long-sleeve blouse, black pants, a big smile and her arms were crossed.  The largest word on the ad was printed in white on a blue background and stated: “Really?”  My curiosity was spiked.  ‘Really, what?’ And why were her arms folded? I took a few extra seconds to scan the smaller text below. Thankfully, the ad writer had made an effort to minimize the verbiage. So I actually read the entire text. In a nutshell: colon cancer is the second leading cancer killer. And it can be prevented. I tend not to like cancers but I do like those cancers that can be prevented. So what would I need to do to prevent this second-leading cancer?

Simple.

A colonoscopy and, if present, immediate removal of any polyps.

Polyps might turn malignant and are easy to remove during a colonoscopy.  Polyps that are remove cannot turn into colon cancer.

So, why not?

I am a big advocate of preventive medicine. A sound decision today can save you much hassle in the future. Fair-skinned and green-eyed, I had always been a great candidate for skin cancer. As a child I had been sunburned to the point of crispness. Burned, I had not been able to find a painless resting position while trying to fall asleep. My male classmates always knew that a slap on the back after a weekend on the ocean would – to their delight -  elicit a loud yelp from me. So it was not surprising that twenty years later, in fact shortly before getting married (getting married can be stressful), a dermatologist diagnosed skin cancer. It’s never a good sign if the doctor calls you personally...  

We had caught it early; it was removed, and that was that.

Katie Couric’s admonishment made me dive into my bulging ‘oops, I forgot’ folder and dig out the gastroenterology referral list my doctor had once given me. Some ads do affect a reader’s behavior. I reached for the phone and called the first recommendation on the list.

“What is your insurance number?” Kim, the colonoscopy scheduler asked. “We cannot find you; you will have to call our billing department!” she informed me. Since the first available appointment was three weeks out, I suggested: “Let’s just go ahead and make that appointment.”

“Must be quite a money maker!", I thought.  Three weeks out?  Was this procedure so much fun that people were lining up out the clinic door to their turn? Was this like standing in line for your favorite ride at the amusement park?  I would quickly find out it was anything but….

“We will send you the prep instructions by mail”, Kim informed me.

A couple of weeks later, I found a thick envelope in my mailbox. Inside were five single-spaced pages full of instructions. The tone was officious and domineering. Do this, don’t do that, and if you don’t show up with a driver who will stay throughout the procedure, the colonoscopy will be cancelled. On the spot.  Too bad.

And: taking a bus or taxi home after the colonoscopy was NOT an option. (Uber, anyone?)

And this was not the only stipulation. I was advised to acquire a “protective ointment such as Preparation H, Desitin, or A & D ointment to soothe and protect the anal areas as you will start to have frequent bowel movements”.  What was I getting myself into?

The day before the procedure my diet was to consist solely of ‘foods’ that are devoid of nutrients and high in artificial flavorings, additives and colorings: ice cream, Gatorade, popsicles, Kool-Aid, jello-o, PowerAde, 7 Up or Sprite, fruit juices made of concentrates and high in added sugar, powdered lemonade and hard candy.

This did not make any sense to me. The reason I was getting a colonoscopy was to ensure that my colon was healthy. And a diet high in (organic) vegetables and fruit and low in processed, synthetic ‘foods’ is the most beneficial diet to ensuring a healthy gut. Doctor’s orders were anything but supportive of a healthy gut!

And why did I need a driver? Who decided that the only way to have this procedure was with sedation? In Europe and Asia colonoscopies are done without sedation. Without sedation I would drive myself to the clinic and drive myself away afterwards. Why sedation? A sedation-free colonoscopy was not even offered as an option.

I am not squeamish and am fine with a moderate amount of pain. When my dentist wants to change out an old filling, I ask him to do it without numbing me up. He’s been changing fillings for decades and I know he will not hurt me unnecessarily. He’s does not have a problem working without numbing me up and I do not have to deal with a paralyzed cheek for hours after the dental visit. 

I reread the colonoscopy instructions. They seemed absurd. I felt like I was being treated like a brain-dead piece of meat. How about a person-to-person conversation about the best way to prepare for a successful procedure? Here I was receiving a set of instructions in the mail without any human interaction.

I called the clinic and canceled. 

I needed to do more research. Sending me written orders by mail and expecting me to blindly following instructions was not going to work. I do not drink artificial sports drinks and, at age 50 plus, I was not going to start. It felt as if I had been asked to go to a lung screening and as part of the prep I was supposed to start smoking.

After educating myself I decided that I would only do the colonoscopy if I could find a gastroenterologist who was willing and comfortable to do one without sedation. Nor was I going to slug 64 ounces (one entire gallon!) of Gatorade before the procedure.

I checked with my husband’s GP. By coincidence he also does colonoscopies.

“I’ve done 33,000!” he boasted.

He was advanced in years.

“How depressing,” I thought.

“Would you be comfortable doing a sedation-free colonoscopy?” I asked. “Not a problem for me!” he confirmed reassuringly, “I’m on the pain-free end of the endoscope!”

I was not encouraged.

I had two distinct goals that I wanted to achieve if I was going to undergo this – to me – physically and spiritually invasive procedure:

i.               present a ‘clean’ colon.

‘Clean’ is not the right adjective. My goal was to present a colon that was not, in any way, obstructed by feces. I did not want to have to repeat the procedure because the doctor ‘could not see’, nor did I want him to miss any polyps because his visibility was not 100%. Also the threat by the insurance company that I would have to pay US$1,000.00 out of pocket if the procedure had to be repeated was highly motivating that I ‘get it right’ the first time.

ii.             I did not want to be hungry during the prep. Ever. Hunger makes me very grumpy. The goal was to provide my body the most supportive, nutritious diet possible given the circumstances (no solids the day before). I had no desire to lose weight.

So this is what I did: three days before the procedure I decided to go easy on solids and take a break from meat and diary. Since the second set of instructions concurred with the first set in forbidding any food that is red or purple, I decided that the last day I would allow myself red and purple food would be three days before the procedure.  Strawberries, blueberries went in the juicer no later than 72 hours before. I could easily survive without this fruit for a couple of days. Since beets are wonderful at staining everything red, I decided to completely avoid them.

I placed my first-class Breville juicer on the kitchen counter and headed to the grocery store to raid the produce aisles of organic vegetables and fruit. 




My shopping cart brimmed with organic spinach, broccoli, cauliflower, mixed greens, cabbage, melons, apples, grapes, blueberries, strawberries and pineapples.  Since I did not want to feel hungry but, at the same time, wanted to slowly empty the intestines, I decided on the following regiment:

Day 3 before the procedure:

Green tea and honey: no limit

Distilled water with slices of cucumber and lemon: no limit

One large pasta dish with garlic and cooked tomatoes for lunch

Freshly squeezed fruit and vegetable juices: no limit

Freshly squeezed orange, grapefruit and pomelo juice with a moderate amount of pulp

Day 2 before the procedure:

Green tea and honey: no limit

Distilled water with slices of cucumber and lemon: no limit

                 Since it was winter, I preferred warm to hot water

One large baked sweet potato with lots of butter and salt.

                                  I only managed to eat half the potato and felt full.

Probably my stomach had started to shrink by Day 2.

Freshly squeezed fruit and vegetable juices: no limit

Freshly squeezed orange, grapefruit and pomelo juice with a moderate amount of pulp: no limit

The day before the procedure:

No more solids

             By that time any solids from the previous 48 hours had most likely      been digested and excreted

Green tea and honey: no limit

Distilled water with slices of cucumber and lemon: no limit

2 tablespoons of unflavored magnesium citrate.  This is commercially sold as “Natural Calm”.

Freshly squeezed fruit and vegetable juices: no limit

I decided to forgo the freshly squeezed citrus juices as I was worried the pulp might hinder colon visibility and some of the instructions had admonished against any ‘orange-colored’ drinks

I had found one article by an MD on the Internet that suggested using magnesium citrate instead of the more invasive Miralax to cleanse the colon. When I finally managed to connect with my gastroenterologist on the phone and explained that downing 64 ounces or one gallon of Gatorade was not within my realm of doable, could I use magnesium citrate instead, he countered that he would get me a prescription for Suprep. I figured that since the doctor and I were in this together and I wanted a successful procedure, I should meet him half-way. When I informed him that I was going to follow a mainly liquid diet of freshly-squeezed fruit and vegetable juices three days before-hand he laughed and told me that it was not necessary to take ‘such drastic measures’.  ‘Drastic measures?’ I thought. Following your instructions and filling my body with artificial flavors and additives and then using a ‘bowel prep kit’ to forcefully remove any heavy meals I had eaten 24 hours before sounded more drastic than slowly easing the body into a lighter, highly nutritious and health-supporting diet.

I still wanted clarification on one important issue: I had read that sedation was not required for the removal of polyps since the large intestine was not lined with nerve cells. Just in case, I asked the doctor.  He confirmed.  No pain when removing polyps.

After talking to my gastroenterologist I decided to contact the doctor who had recommended using magnesium citrate. I found Dr. David Blyweiss’ phone number on the Internet and gave his clinic in Florida a call.  Rather than blindly follow any instructions published in an article on the Internet, I wanted to find out first-hand how much magnesium citrate he would recommend an average weight adult female take to ‘cleanse the colon’. The doctor was seeing a patient and his nurse recommended the daily recommended dose on the ‘Natural Calm’ bottle. In order to cleanse the colon this would not be enough.  Without seeing me, the good doctor was not willing to give any recommendation.

I called the customer service number for ‘Natural Calm’ to get more clarification. The friendly man on the phone advised me to check with my doctor (back to square one).  He also explained that the recommended daily dose was an average between the ideal dose for a woman and a man. Thus the dose the company was recommending was slightly higher than the ideal recommendation for a woman and slightly lower than the ideal recommendation for a man. The recommendation was based on average weight for men and women.

Finally I decided to call the lab that manufactures Suprep. I wanted to know on which weight they were basing their recommendation of drinking two 6 oz. bottles of Suprep. If they based it on the average weight of an American man, then I would drink proportionally less.

The lady on the phone was very friendly.  It took several rounds of repeated questions before she shared with me that the dosage was based on a 150 lb. man. What average American man only weighs 150 lbs.? I thought.  When you look at the recommended weight in elevators in the U.S., the assumed weight for an American man was much higher!  Whereas a dozen Thai man could easily ride an Otis elevator, in the U.S. the elevator preferred half that number in American riders.

‘Well,’ I thought, ‘if the Suprep dosage is based on 150 lb., then surely I can get away with drinking 20% less of the stuff?’  The lady from Braintree Laboratories also kindly shared with me her expert experience that in most cases one 6 oz. ‘did the job’, in other words, the patient ‘pooped clear’.

The evening before the procedure I bravely downed the diluted 6 oz. bottle and waited.  And waited.  And waited.

Since I had only eaten a plate of paste and half a sweet potato in the preceding 72 hours I had very little to give. After several hours I finally felt the urge and was dismayed that the color of the watery discharge was as dark as dark chocolate. I love chocolate and I had stopped eating any chocolate three days earlier. ‘At this rate I will never ‘poop clear’’, I thought with dismay.

With greater than usual interest I closely scrutinized the color of further discharges. I made sure to drink plenty of fluids. The dark brown seemed to most reluctantly change to a less dark brown and then an ‘average’ brown. At four thirty the next morning a call of nature woke me. Sigh, still not clear. According to the instructions no fluids were allowed four hours before the procedure. The colonoscopy was scheduled for 9 a.m.

Reluctantly, not wanting to have to repeat the procedure, I downed the second and final 6 oz. bottle. As before, I only took 80% (since I weighed 80% - give or take - of that 150 lb. fictitious man).

The next morning the discharge was clear.

In a nutshell, the gastroenterology team had not seem such a ‘clean’ colon in a long time, no polyps were discovered, the anesthesiology nurse kept himself (since he was not administering any sedation) and me distracted by telling me about his four-year stay on Oahu, the pain was very manageable – just take slow, deep breaths – and I was given a complimentary tour of my large intestines: ‘Do you want to peek into your small intestines? Now this is the opening to your appendix!  And here, that’s what the world looks like when you look through your anus from the inside out…”

I was discharged with a highly welcome: “We’ll see you in ten years!”  and sent home with a souvenir picture of the inside of my gut.

References:

How to Stop Dreading Your Colonoscopy

By David Blyweiss, M.D., Advanced Natural Medicine

November 19, 2012

Secret 50: Sleep

And so we reach the last or the 50th of Sally Beare's 50 secrets of the longest-living, healthiest people on our Earth. You may be familiar with the saying 'laughter is the best medicine'. An even stronger and more potent medicine than laughter is sleep - deep, restorative, uninterrupted sleep. My best medicine, while I was backpacking around the world in my twenties, was a medicine that cost nothing, weighed nothing, and was readily available at my fingertips whenever I needed it since it never required a doctor's visit or a prescription. It was a good night's sleep, or, depending on the affliction, several days of sleep. Certainly medication, whether Western or traditional, plays its role in facilitating the healing process, but your first line of defense is sleep. Do not underestimate the ability of your body to heal itself if you provide it with the necessary, regular down-time. Give your body the best conditions to access and activate its own seasoned arsenal of pharmacopoeial wisdom.

Not only does great sleep heal, it also slows down the aging process. Sally Beare quotes gerontology professor Edward L. Schneider from UCLA: 'To age successfully, you must get a good night's sleep'.  Deep, reinvigorating sleep allows the body to restore itself, gives the immune system and digestive system dedicated time to work and rest, and allows the mind to sort out thoughts and feelings that occurred during the waking hours. When I am faced with a major decision, or if I am unsure of my next step, I sleep on it. The next  morning I wake up with an answer to my question, a solution to my problem, or a decision that 'feels' right. Sleep is like a mini-reset between two periods of being awake. If you have enjoyed a good night's sleep, you wake with a new burst of energy (who needs coffee when you can get a good night's rest?). During sleep, your body's defensive system can get to work unobstructed and utilize antioxidants to start repairing free radical damage.

If you fall asleep easily, and are able to stay asleep until you are ready to start your next day, you are laying a strong foundation for health. What conditions are most conducive for obtaining restful, reinvigorating sleep? The ideal bedroom is dark, cool, and quiet. As much as possible you want this area of repose to be free of electronic devices. A steady flow of fresh air facilitates deep, restorative sleep. Even during a cold winter, I will keep the windows open a crack. Unfortunately modern hotel rooms are not designed for a good night's sleep. Often the windows can barely be opened - if at all - and the rooms are filled to the brim with flashing, ticking electronic gadgets such as a flat-panel TV, a dvd player, a bedside phone and a digital alarm clock. Although manufacturers will vehemently deny this and argue that nothing has been proven, do not sleep with a cell phone on the nightstand by your head and unplug any digital alarm clocks.  If you do not have the choice of leaving your cell phone in another room, then do turn it off. You will save its battery life (and perhaps protect yours). If you must own a TV, keep it in a separate room. Taking flickering images of advertisements and scenes of violence - whether real or acted - to sleep, overburdens your nervous system. You would be better off sleeping in a mosquito net outdoors.

So how much sleep does the human being need? Some research studies claim that the ideal length of sleep for adults is eight hours. But we are dynamic living things, and depending on our age, the situation of our lives, our health and ambient stress, we will need more or less sleep. When I backpacked around the world in my twenties, I discovered that if I got sick, for example, when I got a heat stroke after riding on a camel through the Thar desert for several days without taking adequate protection from the sun, or when I stupidly ate a reheated plate of spaghetti and minced meat on the coast in Peru and came down with food poisoning, my best medicine was uninterrupted sleep in a cool, dark room. I slept for days, and when I was ready to wake up, my body had been given the necessary time and space to heal. I had needed much more than eight hours of sleep. If I come down with a virulent type of flu, sleep will be my main line of defense. It may take more than 24 hours, but allowing the body the peace and quiet to deal with its stressor(s) ensures a better and faster outcome. The healthy body will know how much sleep it needs and will wake up on its own when it is ready.

The cat knows best

Going to bed at the same time each night also helps your body know when to expect its well-deserved downtime. A regular bedtime is beneficial, because the body's hormone production depends on a 24 hour cycle. An ideal job situation would allow you to wake up with the first light of day, and go to bed after the last light has receded from the horizon. Those who have irregular work hours, or have to rise in the dark, may find regulating sleep does not come as naturally. You can improve this by trying to create optimal resting conditions - darkness, quiet and lessening any distractions. The five groups of long-living people that Beare describes tend to rise with the sun and go to sleep soon after dark. Since they work outdoors, and do not live in large cities that are lit up at night, they are in tune with their natural circadian rhythms. This ensures optimal production of the anti-aging, anti-oxidant melatonin. Melatonin is produced by the body in response to darkness and enhances deep sleep, which in turn facilitates free radical repair.

Despite looks to the contrary, the sleeping state is a very active state. In most animals, including humans, sleep alternates between REM (rapid eye-movement) stages and non-REM stages. Humans need both to survive. We start the night in non-REM sleep, and over the course of the night our REM sleep increases in duration while the non-REM phases decrease in length. While our first non-REM phase may last 90 minutes, followed by 10 minutes of REM, towards early morning, we spend a longer phase in REM sleep. During REM sleep our bodies seem to be paralyzed, we dream, and our neurons  are busy making new associative connections.

While we still have much to learn about sleep, we do know which factors aggravate insomnia. Stimulants (coffee, tea), sugar, meals heavy in fat, anti-depressants and other types of medication, high levels of cortisol due to stress all adversely affect sleep. Meditation and visualization can help relax a stressed and chaotic mind. Taking the last meal of the day three hours or more before going to bed improves sleep as does exercise during the day, especially earlier in the day.  A warm glass of milk with honey (with a spoon of rum) also relaxes as does a long, hot bath. Adequate magnesium and calcium help relax the muscles. Muscle cramps and legs that switch involuntarily during sleep (restless leg syndrome) can be alleviated by increasing calcium and magnesium in the diet. Other factors that affect sleep are the type of bed you are using, the height or absence of pillows, and who else is sharing the bed with you. If you are sharing the bed with someone who will turn on the lights in the middle of the night, an eye-cover may help you stay asleep. Overall, the better and deeper you sleep, the easier it will be for your body to be ready for the next day. I conclude this blog on the last and 50th secret in Sally Beare's book with a few quotes:

A good laugh and a long sleep are the best cures in the doctor's book.  Irish Proverb

It is a common experience that a problem difficult at night is resolved in the morning after the committee of sleep has worked on it.  John Steinbeck

Sleep is the interest we have to pay on the capital which is called in at death; and the higher the rate of interest and the more regularly it is paid, the further the date of redemption is postponed.  Arthur Schopenhauer

There is no hope for a civilization which starts each day to the sound of an alarm clock. Unknown

If people were meant to pop out of bed, we'd all sleep in toasters.  Unknown

Sleep that knits up the ravelled sleave of care
The death of each day's life, sore labour's bath
Balm of hurt minds, great nature's second course,
Chief nourisher in life's feast.

Macbeth, Shakespeare

Secret 49: Avoid the SAD - the Standard American Diet

For being such an incredibly affluent country, the quality of nutrition in the U.S. is shockingly poor. Carbonated syrupy drinks (concocted according to secret recipes), sugary treats, processed, fast-food meals, junk food - you name it and it is available for purchase - is often cheaper than real food.  This is evidenced by the state of health of the average American citizen, especially the health of the next generation - the American children. According to U.S. government statistics, nearly one in three children in the United States is obese or overweight. Over the past three decades, the incidence of childhood obesity has tripled. In the U.S. in the 90ies many schools stopped offering physical education classes. Doctors are diagnosing illnesses in children that previously have only been found in the adult population: high blood pressure and type II diabetes. Over $150 billion a year is spent in the U.S. to treat obesity-related health conditions. The U.S. economy is impacted by the substandard nutrition of American employees through absenteeism and lower productivity. Even U.S. national security is affected by the nutrient-poor, high-calorie diet of its citizens! Military leaders report that one of the main disqualifiers from military service is obesity. According to a Lieutenant General Hertling at Fort Jackson, the main recruiting center for the Army in the U.S. *:

• among the roughly 130,000 applicants to the U.S. Army every year, more than 40% are obese or overweight
• more than one quarter of all 17 to 24 year olds in the U.S. are too obese to enlist
• over 60% of soldiers need significant dental work before they can be deployed. To solve this problem, the Army has had to recruit more dentists ($$$)
• in 2004 about 6% of recruits (males 4%, females 10%) were not able to pass the Army's Entry Physical Fitness Test. The test consists of one minute push-ups, one minute sit-ups, and a one mile run. By 2010, this number had exploded to a staggering 40%+ (males 47%, females 55%).** 
• due to a poor nutritional foundation, during basic training, young soldiers suffer more bone (stress fractures) and deep muscle injuries than ever before. Medical costs have increased by millions of dollars
• while the Army can whip a soldier into shape, how do you educate the soldier's family and children about the importance of physical exercise and healthy eating? If you don't, where will you find the next generation of recruits?

Who is to blame? 90% of your typical grocery store consists of synthetically produced 'food' spiked with unpronounceable artificial flavorings, colorings and preservatives. Just the cereal (aka processed grains stripped of nutrients and 're-fortified' with synthetic vitamins) aisle in supermarkets stretches from wall to wall. Strip away those cereals which contain trans fats, are unnaturally high in sugar or salt, or contain chemicals, then most of that aisle will be empty. The majority of restaurants are chains or fast-food places that serve at least partially processed foods and use the cheapest cooking oil to prepare it. And the head of the Food and Drug Administration is a former executive of Monsanto, the GMO seed company that paid $8 million to defeat the proposition on the California ballot in the recent U.S. election to start mandatory labeling of genetically modified foods. So how is this country ever going to ensure the transparency necessary for consumers to start making smart choices about food? Kudos to the Board of Health in New York for the courage and foresight to pass a ban on the use of trans fats in all restaurants in New York city by July 2008.  And luckily, in the U.S., ingredients have to be listed. Is this undesirable government intervention in a country that so prides itself on self-reliance and independence or is this necessary government regulation to improve general health and reduce public health care costs?

not SAD material
In fact, these apples had been lying on the ground in our neighborhood for weeks, ignored by humans (but enjoyed by coyotes). We gathered more than 20 lbs. or over 100 apples and made the most delicious apple juice, apple sauce and apple pie (OK, apple pie is not that healthy but I did make it from scratch)

So have a look at your diet. How closely does it mimic the Standard American diet? Is it high in processed foods, fast foods, hydrogenated fats (trans fats), salt, stress and calories? Do you drink carbonated sugary drinks? Does a large proportion of your carbohydrate intake consist of cookies, cakes, sweets and white flour? Is your diet low in fiber, low in fresh. local seasonal fruit and vegetables, and low in nutrients?  Or is your daily food intake a rich source of naturally occurring minerals and vitamins? Do you exercise daily for at least 30 minutes? SADs adherents are more likely to suffer from high blood pressure and degenerative diseases such as cancer, diabetes, and clogged arteries. If you do not provide your body with the right set of ingredients i.e. a balanced tray of nutrient-rich, fresh foods, how is your body supposed to successfully maintain and heal itself throughout your lifetime?

The good news is that any dietary pounding you may have subjected onto your body - whether by choice or because trying to locate healthy, nutritious food in this wealthiest of countries can be challenging - is reversible. Another piece of good news is that you do not suddenly have to subsist on string beans and tofu to save yourself. The body is such a strong and dynamic creation that it suffices for you to start with minuscule changes. Thousand tiny steps will eventually get you closer to that summit of peak health and performance. And you get to choose which path you would like to take. Since many paths lead up the mountain, choose the one that is most fun/scenic/pleasurable for you.  Here's a start:

• park your car a little further from your destination (you'll be less stressed about fighting for that last spot near the entrance)
• take the stairs instead of the elevator or escalator
• take a brisk 10 minute walk at lunch
• read the ingredients of the items you chose to put in your shopping basket. If you can't pronounce them, do you really want to put these in your body?
• add a salad to your meal
• replace a cookie with a piece of fruit
• buy a juicer and use it for your favorite vegetables and fruit
• take a smaller portion of that luscious chocolate cake (and eat it with more awareness so that you squeeze every last bit of pleasure out of every bite).....or take a disgustingly LARGE piece but then DO NOT TAKE SECONDS!
• try growing some vegetables. Garlic is great for beginning gardeners.
• do not combine mindless eating with staring at a screen

The options are limitless and are fueled by your creativity. Above all, be mindful of every little decision you make regarding food choices. In the long run, you and your family and future generations will benefit from each and every bite you choose to take today.

* American Grown, Crown Publishers, 2012

** Luckily modern warfare relies more on technology than actual bodies on the ground. 

Secret 48: Invite A Friend

Make new friends
But keep the old
The new are silver
The old are gold

As social beings, we derive much happiness from interacting with fellow humans who are kind to us. We exchange valuable information, give reassurance, offer a shoulder to cry on, and gather to celebrate:

A shared grief is half as painful
A shared joy twice as delicious
 -     Chinese proverb

If you are a person who places value on nutritious eating, do not neglect the additional benefit of sharing your healthy meal with good friends. When we have friends over for dinner, I always marvel at the invisible, yet incredibly soothing good vibes that linger long after our friends have left. Although not visible, the laughter and the animated conversation continue to fill our home. Even the day after, when the pots have been washed and the dishes have been put away, the positive energy generated by the gathering of friends continues to nourish and sustain me.  

Many studies confirm the importance of sharing meals as a family. 'A family that plays together, stays together.' The word 'plays' can easily be substituted by 'eats'. A family that eats together, stays together. Modern electronics can be extraordinarily divisive - mom is texting, the children are playing video games or watching a movie, and dad is checking e-mails. Turn off those electronic love-robbers, and give each other your full attention. To appreciate the work the cook has put into preparing that meal you just might want to wolf down, help out in the kitchen before (and after) the meal. The social ritual of eating is a wonderful opportunity to gather together with the common goal of replenishing everyone's physical and mental energy. 

While the first step towards healthy eating is to create occasions to eat together, the next one would be to linger. Take time to eat and enjoy the company. In work cafeterias the food is often 'inhaled' and the diners rush back to their desks. Even worse, workers eat at their desk while surfing the Internet.  Be present. Bring your awareness to the taste and texture of your food. Chew (this was addressed in blog 30: Chew). And find some company with whom to enjoy the food.

Friendship is not only invaluable around the dinner table, it is a welcome respite from daily routine and the constant challenges thrown across the paths of our lives. Make the time to meet a friend for sports - for a round of ping pong, some time on the basketball court, to catch a wave, or to go for a walk. Some of the best conversations I have had occurred spontaneously while walking. My friends and I have figured out how to better parent, put never-ending gender strife to rest, and we have even managed to solve a few world problems while walking the dog. Or meet over a cup of tea. Listen, and share. Or plan on attending a comedy show, the theater, or a movie, with one or more friends. Even if you and your friends just sit side by side in the dark, you can share the emotions that are elicited by the performance. Laughing together is sweeter than laughing alone. 

One caveat to friendship: choose your friends wisely. In a lifetime filled with obligations, duties and chores, you only have a limited amount of time. Not everyone is suitable friend material.You are too precious to waste your personal time with people who are inconsiderate, selfish, demeaning or stressful. You spend enough time at work with people that you do not chose to associate with. Even when you are careful about who you befriend, not every moment spent with a friend will be enjoyable. Sometimes friends go through hard times. During these times they will need to vent and will not be the most charming company. Likewise, there will be times when you will need your friends' support and commiseration. A friend in need is a friend indeed! But this is not a permanent situation. Friendships are reciprocal and dynamic. At times you lean on your friends, at other times, they need to be able to lean on you, yet most of the time, you can just enjoy each other's company and walk side by side and laugh and play and face life together. 

Studies have shown that people with close, supportive circles of friends enjoy better health and live longer. Friendship is a vital nutrient for your heart and soul. Vitamin 'F' may not be available in bottles, but is just as essential as vitamins found in fresh fruit and vegetables. The long-living people described in Sally Beare's book - the Symi in Greece, the Campodimele in Italy, the Okinawans in Japan, the Hunzas in Pakistan and the Bama in China - all live in supportive communities that watch out for each other and play together. In your ideal neighborhood, the doors would always be open, friends would drop by spontaneously, and help would always be at hand. A community built on the foundation of friendship strengthens and soothes. The opposite of friendship is loneliness. Which one would you like to have in excess - friends or loneliness? So get out there. Find a club or organize a group of friends who share your interests - play bridge, go skiing, biking, hiking, discuss a book or whatever this may be - and then go out and have fun together.  Your health will thank you for it.

Secret 47: Marry - or Get A Dog

Mental and emotional well-being is closely linked to physical health. "Cogito, ergo sum" Descartes wrote. "I think, therefore I am". More aptly for the human being, a social animal, would be "you acknowledge me, therefore I am."  

part of a greater whole

As creatures whose existence depends on the skills of others, we are poorly equipped to survive in isolation.  Sure, people have survived outside of human populations, but, in general, not only are we dependent on the skills of others, emotionally we fare better when we have a distinct, predefined role to play within a supportive community. Fundamentally, every human wants and needs...

• to be acknowledged: the fact that you react to me when we cross paths means that I am alive. I exist. This acknowledgment might be given via simple eye contact, a nod of the head, a hand wave, or, better yet, verbal interaction.  "Hello, how are you?" Being ignored can hurt.

• to be appreciated: even better, if you value what I do and provide me with positive feedback,  I feel even more gratified to be alive. A little appreciation goes a long way. Take a moment to look at this amusing video:                                                                            http://www.youtube.com/watch?v=Cbk980jV7Ao                                                                If I render a service to you, or give you a material gift, the simple act of saying 'thank you', not only confirms receipt, but makes me feel appreciated (and increases the chances of repetition).  

• to be needed: I want to believe that someone else is doing better because I exist. This is an incredibly powerful emotion that keeps sleep-deprived parents sane when their infants' cries wake them up for the nth time during the night.

• to be cared for: someone out there is concerned that I am well.  Studies have shown that merely living together is not as beneficial for health as living with those who sincerely care about you.

• to be loved: this is the ultimate reward of being a member of a society. A hermit may feel loved by a god-like creature, but I prefer to receive this confirmation through all five senses (rather than simply cerebrally). Being loved and being able to love makes me feel alive and makes life worthwhile.

To ensure a steady supply of the above emotions, people choose to get married. They hope that by getting married they will always be acknowledged by their partner, appreciated and needed, and, best of all, loved.  If all these criteria apply to your situation, then congratulate yourself on being in a wonderful relationship!

Sally Beare quotes several studies that confirm that people who are (happily) married live longer. According to the study by Warwick university, married people - especially men - live up to three years longer.  Note that the assumption is that you are in a healthy relationship i.e. one in which respect and the desire to meet the partner's needs happen on a reciprocal basis.  If you are married to a person who always puts their own wants and desires above yours, you would be better off without this person. Equal partners realize that they are stronger in a partnership, and will take extra care to ensure the partnership continues and thrives. They will urge their partner to seek medical advice when necessary, and will keep an eye out for the well-being of the loved one.  In 'A Cry Unheard: New Insights into the Medical Consequences of Loneliness", psychologist Dr. James J. Lynch writes that 'mortality rates in the United States for all causes of death, and not just for heart disease, are consistently higher for divorced, single, and widowed individuals of both sexes and all races". 

Over and over, when unspeakable crimes occur, in which classmates are shot or innocent movie-goers are killed, the perpetrator(s) have been severely lacking in interpersonal and social skills and been isolated long before committing their crime. For whatever reason, they have failed to connect in a healthy manner with a close community of friends. They have lost all moral perspective. Drowning in a quicksand of futility, desperate and filled with hatred, these sociopaths turn against society in the ultimate selfish act of creating bottomless grief for those who are firmly anchored in supportive, loving communities.  It is as if these misfits are screaming:"Look at me, I am not loved, I am not appreciated, nobody gives a damn about me, I am not needed. I am not acknowledged... I will MAKE you acknowledge me, whether you like it or not, by destroying what you love and what appreciates and needs YOU!"

So to keep a sense of perspective, to tend to your garden of healthy, emotional needs, marry a wonderful person, or surround yourself with dear, supportive, genki* friends.  Or, if you are in a hurry, run to the nearest shelter and adopt a homeless dog. The dog will give you unconditional love and will always greet you joyously when you come home - irrespective of your mood.  And that dog, according to the University of Warwick scientists, will triple your chances of making a friend.  And a good friend is great for health!

*genki: Okinawan expression for 'happy and healthy'