Health

Does your hapiness depend on your circumstances—or your attitude? I've asked myself that question so many times that I could relate when Kate, a woman in her mid-40s who was talking to me for the first time, couldn't figure out why she wasn't happy. "I've got a great guy, I've just gotten engaged, and I am still not happy," she said. "What's wrong?" I suggested that she would feel much better if she developed an attitude of gratitude, the ability to focus on what's good and right in life.

Try it yourself.
First, on a scale of one to ten, with one being blah and ten being the best you ever felt, give yourself a number. Next, write down or think about the things you're grateful for. Now rate yourself again. Did your number go up, even a little?

At every moment (and particularly during the holidays), you have a choice to look at what's right or wrong with yourself and your life. Gratitude is like a flashlight, shining on what's good. When you turn it on, you feel happier, no matter what else is going on.

I learned this most powerfully when I sat beside my father in the hospital as he lay dying. He had suffered for years with emphysema, hooked up to an oxygen tank. Now bedridden, his six-foot-two frame weighed only 130 pounds. Every breath was a struggle. I asked him whether his life was still worth living. "I like to read the comics in the newspaper," he replied. "I like to watch the ball game on TV. My life is good."

Science is now confirming the power of my father's good attitude. Studies show that being grateful increases happiness by 25 percent and boosts the amount of time people spend exercising (a terrific bonus for those of us who struggle to get to the gym). Being positive even seems to create greater equality in dividing up chores between partners.

I explained all this to Kate, who agreed to start paying attention on a daily basis to what she appreciated about her life. Sure enough, she got happier. I heard from her recently after a gap of about two years, and she was still smiling.

The great thing about the gratitude flashlight: It works no matter who you are—young or old, fat or thin, rich or poor, sick or well. All you need to do is turn it on.

6 ways to do gratitude

1. At dinnertime, take a moment to say one thing you are thankful for. Be specific.
2. Remember why you love your spouse, kids, and friends when they're annoying or frustrating you.
3. Don't compare other people's lives with yours. When you're envious, ask yourself, "How can I create more in me of what I see in them?"
4. Give thanks for your body. What can you appreciate about it right now?
5. Look for the hidden blessings in challenges. How have you grown?
6. Practice daily. Keep a gratitude journal and e-mail it to a gratitude partner, someone with whom you want to share positive thoughts.

One size fits all does not apply to painkillers. “Women are not small men when it comes to pain treatment,” says Mark Allen Young, MD.

While many basic medications, from aspirin to Ben-Gay, work equally well in both genders, there are also significant differences. In particular, recent research shows that some of the anti-inflammatory pain drugs known as NSAIDs (ibuprofen and naproxen sodium) dont always bring women the same level of relief they provide men.

And the more serious painkillers, known as opioids (codeine, morphine) often prescribed postsurgery or for short-term relief of extreme pain, cause many more side effects such as nausea, constipation, depression, and itching in women than men. Luckily, other drugs work particularly well for women.

Antidepressants
Used in lower doses than for psychological benefit, some antidepressants work on pain by “modulating the nerve feedback into the brain,” Young says. Theyre prescribed for migraine prevention, fibromyalgia, and lower back pain.

Neuropathic pain relievers
The newest weapon in the pain-killing arsenal, pain relievers such as tramadol, ease irritable bowel syndrome and menstrual pain, probably because they desensitize nerves, says Neil Kirschen, MD, president of the American Association of Orthopedic Medicine.

Trigger-point injections
Used mainly for muscular pain in conditions such as fibromyalgia, trigger-point injections ease pain with lidocaine and other desensitizing drugs. An exciting breakthrough is ultrasound-guided injections, Young says, in which imaging helps place the medication exactly where it needs to go. Another treatment option is lidocaine patches.

Spinal epidurals
Used for sciatica, herniated disks, and other back problems, steroid injections or nerve blocks “block the pain cycle,” says Joseph Shurman, MD. Theyre now used for other parts of the body, too.

The return of oxycontin
Celebrity addiction stories notwithstanding, this morphine-based painkiller is highly effective and not as addictive if used very carefully for a short period of time, on a case by case basis, Shurman says.

IstockphotoFrom Health magazine

Not every doctor is qualified to perform every procedure. Do you really want to turn your body over to someone who doesn't really know what they're doing? Here are five questions you should ask before you get a cosmetic tweak from a doctor working outside of her specialty.

How many times have you done this procedure?
Ideally, you should hear “hundreds” or “thousands,” not “dozens” or something vague like “more than I can count.” Also ask the doc how long shes been doing the procedure (less than a year means theres still a learning curve) and how many times a week she does it (too few times a week means shes less likely to have fresh product or offer you free touch-ups if you arent happy).

Do you own or rent your laser?
Renting may be a tip-off that the doctor isnt doing the procedure often enough to make owning worth it. Rented lasers arent always calibrated correctly, which could mean an increased chance of a burn. Also, not every laser is suitable for every skin type, so be wary of the physician who has only one. Ask about the number of fillers being offered, too.

What muscle causes the lid to droop?
If a doctor can tell you its the levator muscle, then he probably knows enough facial anatomy to avoid or fix this problem that can result from a poorly placed Botox injection.

How did you learn how to do this procedure?

If the answer is, “I took courses,” ask: Who taught them? How long did they last? Look for the MD who has completed multiple courses and takes continuing-ed classes in the field. If she trained with a top plastic surgeon, ask, “How did you find time for that?” She may let it slip that the training only took one afternoon.

Will you be the one doing the procedure?
It doesnt matter how many hours of training your gyno has in fillers if his assistant is the one shooting you up. If something goes wrong, you want to know that the med school grad is right there to manage the complications. Remember: Youre paying for the expertise of the best-trained person in that practice.

Augustus ButeraFrom Health magazine

A few years ago, I decided to write a novel—pretty much sheer craziness, since Id never completed anything longer than a magazine article. Yet not far into the process, a curious thing started happening. During morning runs, ideas for the book began appearing in my mind like Internet pop-ups. I quickly became Gretel in sneakers, scooping up metaphors, snippets of dialogue, and even fully hatched plot twists, which I couldnt wait to weave into my narrative the minute I returned to my computer.

Just six months later, I finished and sold my first novel, Little Pink Slips.

We all can recite the multiple benefits of exercise. It jump-starts good moods and protects us from heart disease, stroke, high blood pressure, osteoporosis, back pain, obesity, and certain kinds of diabetes. (Oh, and not to mention the uplifting effect it has on our butts.) But that its also an express lane to creativity—who knew? Whether your goal is to redecorate your living room, write a report at work, or paint a portrait, working out can deliver fresh ideas and inspiration almost by osmosis.

How come? “Physical activity gets your mind into the bodily experience, so that subconscious connections can pop up,” says Keith Sawyer, PhD, associate professor in the Department of Education of Washington University in St. Louis, whos done extensive research on creativity, and is the author of Group Genius: The Creative Power of Collaboration.

“If you take breaks—what I call ‘idle time, ideally spent in solitary activities, such as walking, running, or biking—your mind frees up to cross-fertilize so that when you return to intellectual pursuits, youre far better at connecting ideas that at first glance dont seem to be obvious or even related.”

Thats because exercise can literally change your brain to get your creative juices flowing. When you work out, your body flushes out cortisol, the hormone that helps trigger the “fight or flight” response when youre stressed, and which also shuts down brain functions for creativity and problem-solving, explains Pierce J. Howard, PhD, managing director of research and development at the Center for Applied Cognitive Studies in Charlotte, North Carolina, and author of The Owners Manual for The Brain: Everyday Applications from Mind-Brain Research.

Meanwhile, your pituitary gland releases endorphins, which can produce the feel-good “runners high.” Exercise also promotes the growth of new nerve cells and synapses through elevating levels of neurotrophins (a chemical that fosters the growth of new nerve endings) and by increasing oxygen in the blood, which helps provide mental energy.

You dont have to be superfit or coordinated to reap the benefits. In her book The Creative Habit: Learn It and Use It for Life, legendary choreographer Twyla Tharp points to the example of Beethovens creative habit: “Although he was not physically fit, Beethoven would start each day with the same ritual: a morning walk during which he would scribble into a pocket sketchbook the first rough notes of whatever musical idea inevitably entered his head. Having done that, having limbered up his mind and transported himself into his version of a trance zone during the walk, he would return to his room and get to work.”

Ready for your creative boost? You might be just one long walk away from the powerhouse idea thats going to change your life—or someone elses. Heres how to get started.

1. Pick a low-concentration exercise that allows your mind to wander, such as brisk walking, swimming laps, hiking, or running. Sports, such as golf or tennis, or team activities, like soccer or basketball require too much strategizing or in-the-moment focus.
2. Exercise for a decent duration—at least 30 minutes.
3. Unless you and a partner plan to brainstorm on a shared project, exercise alone.
4. Bring a notepad or tape recorder so you can jot down brilliant ideas.
5. Get to work right after you return, while your creative juices are flowing. The shower can wait!

IstockphotoFrom Health magazine

Here, ways women can speak out for better care and more respectful treatment—and get the help they need to reach a healthier weight:

Find a physician who isnt fatphobic.
Ask for referrals from heavier friends. Doctors who have struggled with their own weight may be more understanding.

Take a friend with you.
“A clinician is much less likely to treat someone badly when theres a witness,” says Pat Lyons, RN, co-developer of A Big Womans Passport to Best Health, a guide to overcoming barriers to health care.

Be your own advocate.
Have your doc run your numbers so you have all of your measures of health, from body mass index (BMI) to cholesterol and blood sugar. Ask for an assessment of your health based on the big picture.

Ask for tools.
Tell your doctor youre interested in sustainable health habits, like walking and eating right. Request a reasonable healthy weight and BMI range so you have goal.

Dig deeper.
If youve tried and tried and still cant lose weight, insist that your doc give you more help. For some people theres a medical reason for weight gain that goes beyond lifestyle choices, including medications or conditions that might cause weight gain. “Were trying to educate doctors so they provide obese women with more sensitive and in-depth care,” says Keith Bachman, MD, a weight-management expert with Kaiser Permanentes Care Management Institute. The goal: to help doctors see the whole patient and look for all the possible causes of weight gain.

Stick to your symptoms.
During your visit say, “Here are the symptoms Im concerned about. I know some health problems can be caused by weight, but Id like you to focus on the symptoms Im here to see you about.”

Get the doctor you deserve.
If you feel your doctor isnt giving you the kind of care you deserve, find a new one. “When I asked physicians what they would do if they perceived a negative attitude from their doctor, each one said he or she would find another doctor,” says Harvards Jerome Groopman, MD. Its your right to do the same.