CARE FOR THE CAREGIVER
Physician. Author. Mythbuster. Dr. Nancy Snyderman takes on a few assumptions that could be keeping you from being tip top.
BY:SUSAN STRECKER RICHARD
Sometimes you just need wise words from a pro to remind you to do what's right for yourself. That's why we say "listen up" to this straight-forward advice from Nancy Snyderman, MD, Chief Medical Editor of NBC News.
Get An Annual Physical Exam
Caring Today: In your book. Medical Myths That Can Kill You, you discuss the debate of recent years that caused many of us to conclude that annual exams aren't really necessary.
Dr. Nancy Snyderman: Years back, we started promoting annual checkups for the "worried well." And when nothing was wrong with them, we extrapolated: Well, there's nothing wrong so there's really nothing to do-and checkups are a waste of money. But we forgot that when you stop checking in with [doctors], you're really stepping away from the healthcare system altogether. I think that's a mistake.
You may not need every test but, once a year, you should at least have a conversation with your healthcare provider, pee in a cup, get your blood pressure checked. Have somebody [look at you] in good times so that when things go rotten-and they always do-you have an advocate, you have somebody who already knows you.
Know Thy Doctor
CT: What should a caregiver keep in mind regarding relationships with doctors?
NS: That comes back to the fact that you have to have a relationship with someone. You have every right to say "I don't feel well. Can you check me?" And you don't have to apologize for accessing the healthcare system. I write about a woman I knew in med school who came into the emergency room, apologizing and saying that she didn't want to bother anybody. And, of course, they didn't find anything wrong. Then she dropped dead of a heart attack. Today, she probably would have apologized for dropping dead in the parking lot. That's what women do. We apologize because we think we're getting in someone's way. Enough already!
CT: And for those in our care?
NS: Most important, you need a relationship. Let's say, for instance, my parents are moving. I would start looking for doctors before there was a crisis. If you're in the heat of a crisis, it's a lousy time to go doctor shopping.
So, the things to look for: Do you have a doctor who will speak plain English to you? Do you have a doctor who is going to be nice to you-and not going to be condescending to your aging parents? A doctor who is accessible by phone or email? Is the office staff going to be there and be nice to you? What are the office hours? Who covers for that doctor if he or she is away or not on call? All those things play into the kind of relationship you're going to have. When the s... hits the fan, pardon me, it's not the time to think, "Oh my God, I wonder if I like my doctor."
This is a marriage of sorts and if you don't like the person you're with, "divorce" him or her in the good times. Don't wait for the crisis.
Listen To Your Inner Voice
CT: We may suspect something is wrong with us, but don't we often ignore the signs-even waiting until a friend tells us we look awful-before we seek help?
NS: Women are particularly intuitive, but we are rewarded in life for being intellectual. And when we think things are going wrong but we're not quite sure-well, we don't want to be a nuisance to our doctors, we don't want to bother anybody, we don't want to take anybody's time, so we talk ourselves out of having problems. And the problem is that when you turn off that intuitive self, you really open yourself up to trouble.
Now, if you're a caregiver, you may not be able to be intuitive for someone else all the time, you may sort of suspect something's wrong with them, but the reality is that the health of the person you take care of-whether it's a newborn, a toddler, an ailing husband or an older parent-is only as good as yours. It's analogous to being on an airplane and the flight attendant says, "If we lose cabin pressure, be sure to put your mask on before helping others."
Why? Because if you run out of oxygen, you can't help anybody. It's a metaphor for life. We run out of oxygen all the time, and then we have nothing else to give anyone. You really have to put yourself front and center. It's not selfish. It's self-preservation.
Believe You're Not Vulnerable To Heart Disease? Think Again!
CT: Don't too many of us presume that we're either too young to have heart disease or dismiss the possibility because it doesn't run in our family?
NS: Not only can you get heart disease, but when you're taking care of somebody, you eat the wrong foods too often, your sleep patterns are screwed up and that leads to weight gain. And the stress!
Ten to 15 years ago, I would have laughed at the idea of stress causing disease. Now we know that stress is an integral part of disease, including heart disease. So put all those things together and yes, you can get heart disease. And in fact, we know that people are getting heart disease at an earlier age than ever.
If you are a woman and your waist circumference is greater than 35 inches, you're at risk for heart attack. That's an independent risk factor now. If you're a man and your waist circumference is greater than 40 inches, that's an independent risk factor. So know those things and know that, just because you're taking care of someone else who's sick, you can get sick, too.
Heart disease is still the number one killer in this country.
Be Assertive...But Not Rude
CT: In terms of speaking with a doctor, you say be assertive, don't apologize and definitely advocate for yourself or your loved one.
NS: It's a myth that doctors don't like assertive patients. We like smart patients. We may not like patients who are rude to us, but we like people who've done their homework, ask good questions, take notes and want to know why.
Trickle-down medicine doesn't work. By that I mean that your doctor tells you what to do and you just do it-you just obey the doc. Then what happens is that patient compliance is lousy, people just don't do [what they should], but they don't tell the doctor and it just becomes a downhill spiral.
So come prepared to be a partner. But that means that you, as a patient, have to do your homework, too. Come in with a plan, with someone else to listen along the way should you need help. Come in with your questions. We spend more time preparing for the grocery store than going to the doctor.
Somehow, Some Way, Find Time For Yourself
CT: Talk about stress and other harmful issues that caregivers must face down every day.
NS: This is hard because you never feel like you can take time for yourself. But, you've got to find a way. It took my sister, who lives across the country, to remind me of this, even though I'm good about telling other people what to do.
My parents moved nearby. They're 82 and 85 and perfectly healthy! Yet they were taking up more and more of my time. I found myself getting cross. My sister said, "You've got to step back," and she was right. I just felt that if I did, I was deserting them. I felt like was I letting them down or was thinking that someday they won't be here-all those kinds of things.
But those [thoughts] are driven by guilt, not by, "What do I want to do today?" And there has to be a little bit of taking care of yourself-or you end up at 8 o'clock at night and the things you really do have to get done for work, those things that bring you value, haven't been done. There are ways to do it all. But not every day is perfect.
A Primal Scream Does Wonders
CT: What about anger?
NS: Well, I think that anger is a great motivator. You've just got to make sure it's directed at the right place. So, if you're frustrated and something's ticking you off, I think there's nothing as good as a primal scream. But your anger just can't be directed at a human being. And if it's repetitive anger, you better figure out the source and fix it. Anger's a great motivator because it tells you something's wrong. You have to cerebrally get control of your anger and ask: "Why is this? What's the issue?" And fix it.
You Can't Be All Things To All People
CT: Tell us about your own caregiving experience.
NS: I'm in the classic sandwich generation. I was a single mom of two before I got married 20 years ago to my husband and had our son. And now I have elderly parents. The hard thing is to feel like I'm giving a little bit of something to everybody.
Each day is scrunched. Every day, someone gets screwed. I just try to make sure it's not the same person day in and day out.
And I know I can't be everything to everybody. I gave a talk yesterday in New Orleans. I considered that part of my mental therapy-getting on a plane, reading a newspaper, thinking about things and spending time with myself. You have to give yourself permission to step back.
And We Asked:
How About Some Feel-Good Tricks for Caregivers?
Breathing. Breathing, breathing, breathing, breathing. When I’m tense, I’m a breath-holder. You’ve got to make sure you’re breathing. It’s as simple as that. Big breaths from your diaphragm. Make sure that you’re really breathing, and there’s a nice rhythm to them.
There are lots of different tricks to tap on any given day. Take good posture—you make yourself longer, make yourself breathe better. You have more pride. When you stand up straight, it gives a very positive feeling about who you are because you’re willing to say, “I take up space in the universe.” When you’re slumped over, you’re basically saying to people, “I don’t matter as much.”
Also, looking at something every day—whether in your house or out, there should be a visual, auditory or olfactory gift of the day, something that makes you pause for a moment and go, “Wow! That was cool.” And, quiet. It took me a long time to under-stand the difference between solitude and loneliness. When you can find the quiet in your day, that’s a captured moment.
Susan Strecker Richard is the Editor-in-Chief of Caring Today.