Health

Inhale. Exhale. Ahhh…

"This is the first moment in weeks I've had to take a breath," my sister declared the other day, exhaling loudly. She's juggling an out-of-work husband, a job she hates, and the care of our 80-year-old mother. Her remark struck me so resoundingly, like a bell ringing to highlight something profoundly true for us all, perhaps, because a client had said something similar to me just a few hours earlier. "I just need some room to breathe," said Jackie, a mother of three with a full-time job as a school principal.

Breathing room. It's a metaphor for something we all could use more of: some space in our lives—space to catch up with ourselves, to regroup, to metabolize whatever we've been going through so we can know how we feel and what to do next.

Pausing to breathe is more than a metaphor, however. Consciously taking a few deep breaths is actually the quickest way to experience the body's relaxation response.

When you are under stress, your breath is shallow. Breathing slowly and deeply tells your body and mind that it's OK to calm down. More oxygen gets to your brain. Your heart rate slows. Your muscles relax. You come back into yourself better able to handle the problems you face. Breathing helps create the ability to face challenges with persistence, calmness, patience, and acceptance. It reminds us that we can handle the nutty things life keeps dishing out.

I had an occasion to use this technique just the other day—when my daughter and her friend spilled blue nail polish on my brand-new white tile and proceeded to "clean up" using my white bath towels. I wanted to explode. Several breaths later, though, my sense of perspective returned. Yes, the towels were a lost cause. But, thanks to a few deep breaths, I wasn't.
Next Page: The ins and outs of better breathing [ pagebreak ]The ins and outs of better breathing

Try this relaxation exercise from breathing guru Andrew Weil, MD, best-selling author and clinical professor of medicine at the University of Arizona. The payoff? "Blessed relief" from constant thinking, Weil says.

• Sit with your back straight.
• Place the tip of your tongue against the ridge just behind your front teeth.
• Exhale completely through your mouth, making a whoosh sound.
• Inhale quietly through your nose with your mouth closed to a mental count of four. Hold your breath for a count of seven.
• Exhale completely through your mouth, this time whooshing to a count of eight.
• Inhale again and repeat the exercise three times for a total of four breaths.

TIP: If you have trouble holding your breath, speed up but stick to the four-seven-eight count. Practice twice a day, but don't do more than four breaths at a time for the first month; later you can work up to eight breaths. You may feel a little light-headed, Weil says, but it will pass.

A popular pain-relief treatment that uses electricity to stimulate nerves isn't likely to benefit the millions of Americans who live with chronic low back pain and shouldn't be recommended for that purpose, new guidelines say.

Transcutaneous electric nerve stimulation, or TENS, is delivered using a small battery-operated generator connected to a set of electrodes. The generator, about the size of a BlackBerry, transmits a weak electric current through the electrodes, which are attached to the skin at the site of chronic pain or at other key points.

Despite their popularity, there is little evidence that these devices are effective for chronic low back pain, according to the guidelines from the American Academy of Neurology, which were published today in the journal Neurology.

“Physicians are advised against ordering TENS for patients with chronic low back pain since it is proven not to work," says the lead author of the guidelines, Richard Dubinsky, MD, a professor of neurology at the University of Kansas Medical Center in Kansas City, Kansas.

Dr. Dubinsky and his colleague based the guidelines on a review of past studies that compared TENS to a sham TENS procedure (a mock treatment equivalent to a placebo) for chronic low back pain, which is defined as pain lasting three months or more.

They turned up just five studies in all. Two high-quality studies found that TENS produced no benefit; the other studies had mixed results, but they were considered to be less reliable.

The relative dearth of research on TENS and chronic low back pain suggests that the new guidelines shouldn't be accepted as gospel, according to Andreas Binder, MD, and Ralf Baron, MD, neurologists at Christian-Albrecht-Universität Kiel, in Kiel, Germany, who wrote an editorial accompanying the new guidelines.

“Absence of evidence is not evidence of absence,” they wrote. Although the research on TENS may be thin, they added, "there seems to be considerable empirical evidence that, at least in some patients, TENS is useful."

Drs. Binder and Baron point out that, unlike opiates and other pain medications—which carry a risk of side effects, including abuse and addiction—TENS is a safe, fast-acting, and user-friendly treatment that has very few side effects, doesn't interact with medications, and can be stopped at any time if it isn't effective.

The treatment is also relatively affordable. TENS units can be purchased for less than $100, although some models cost several hundred dollars or more.

Next Page: TENS as a last resort [ pagebreak ]
There certainly is a market for the devices. Back pain is the second most common cause of disability in the U.S. after arthritis, according to the Centers for Disease Control and Prevention. Eight out of 10 adults will experience low back pain at some point in their lives by some estimates, although 95% of those cases will get better within three months.

Charles Cranny, the director of outpatient physical therapy at Rush University Medical Center in Chicago, says that because of the treatment's upside, TENS may still be worth recommending to patients with chronic back pain for whom other treatments have come up short.

“We use TENS as a last resort in people with chronic back pain who are not improving with other measures,” he says. “I say, lets give it a try in these patients. We have had some who swear by it and a lot who say, 'It worked for a couple of weeks, but then I returned it to the vendor.'"

Exactly how TENS works—or whether it does work—isn't known. Experts believe that the electrical current may overstimulate the nerves that sense pain, confusing the brain in the process and blocking out the real pain signals.

“TENS likely has a placebo effect, but its safety and side effect profile makes it an ideal tool in approaching chronic pain syndromes,” says Derk Krieger, MD, PhD, a neurologist at the University of Copenhagen in Denmark.

In contrast to the findings on low back pain, the new guidelines state that TENS may be useful in treating nerve pain associated with diabetes, which affects up to 70% of people with the disease.

Two studies have found that TENS has some positive effects on diabetic nerve pain, but because neither of them compared TENS to any other treatment options, it remains unclear when TENS is most appropriate to use in such cases, the guidelines say.

"No recommendations can be made about when to use TENS compared to other treatments for diabetic nerve pain,” says Dr. Dubinsky.

Cranny says that, in his experience, TENS has indeed proven effective for diabetic nerve pain. “This is a whole different type of pain than typical low back pain, and my patients with diabetic nerve pain swear by it," he says. "If they dont use TENS they will have a bad day, and if they do use it they will feel better.”

In the new guidelines, Dr. Dubinsky and his colleague call for more studies of TENS, particularly in people who have never used the devices before. Future studies should also try to determine the optimal way to administer TENS, they write.

In the meantime, says Cranny—and the new guidelines notwithstanding—patients have little reason not to try TENS.

“Try it, see if it works; if it doesnt, return it,” he says. “Its worth a shot, because there aren't too many significant side effects.”

Massage isn't just a me-time indulgence. Studies show it reduces stress, boosts immunity, and relieves pain from everyday wear and tear. And in tough times, just 30 minutes on the table (or even 10 minutes in a chair) can go a long way toward working out your kinks—as long as you make sure your needs are met. Heres how to get your moneys worth.

Find the right therapist
Just as you would with an MD, select a certified massage therapist who meets your specific needs, whether youre looking to soothe post­mara­thon aches or relieve a stiff neck. General certification in Swedish massage—long, sweeping strokes over the entire body—fits the bill when youre simply looking to relax. (Swedish is what youll get if you ask for a basic massage; Shiatsu, or acupressure, features more targeted finger pressure in specific areas.) Go here to find the most experienced certified massage therapists in your area.

Speak up!
Before the massage begins, mention any areas of your body that are feeling sensitive, tight, painful, or tender (like a knot in your neck or an achy spot in your shoulder); these should be treated with particular care, according to Leena Guptha, an osteopathic doctor, a licensed massage therapist, and past president of the American Massage Therapy Association.

Most massage isnt painful, though moderate pressure—which studies have found is necessary to provide optimal therapeutic benefits—may feel a little uncomfortable, especially if youre new to massage. Is the pressure too intense? Dont be shy. Guptha suggests saying something like, “That really hurts. Can you try something different or skip this area?” A good therapist should welcome (or even ask for) your input.

Pick your products
Its acceptable to bring your own lotion or oil, especially if you have sensitive skin, a sensitive nose, or a condition like eczema or psoriasis. Another option: Ask the therapist to show you her product stash and discuss the options (many are fragrance-free). “There are dozens available for different types of massage, and your therapist should have a variety to choose from,” Guptha says.

Reschedule if you have a cold
“Postpone your massage if you feel a cold or migraine coming on,” Guptha says. “The massage will stimulate your circulation, which could leave you feeling worse.” If youre a little stuffy or just find it difficult to breathe when lying face-down, ask to lie on your side. An experienced therapist can perform most techniques this way, or she can work on your upper back, neck, and shoulders while youre in a sitting position.

Period? No problem
Theres no medical reason to avoid a massage during your period, Guptha says. In fact, it can ease PMS symptoms like cramps and backache. But if youre worried about heavy bleeding, just wait a few days.

From Health magazine

Here is what I wish someone would have told me when I was trying to reinvent myself as an entrepreneur and life coach: Fear is not a warning sign, telling you to run in the opposite direction. Fear doesnt hold you back from hunting for a new job, starting a new business, or making some other big life change. Fear is actually a useful guide for what comes next, helping you close the gap between where you are and where you want to be. Here, four ways you can make big-change anxiety work for you.

Connect to your inner resources
Think of the qualities of heart, mind, and soul that you can use to make your dream a reality. Persistence? Networking ability? Analytic focus? When you find yourself getting scared, think about how your inner resources can help you achieve your goals. When I was 30 years old, my husband, Will, and I started a book-publishing company using our credit card to pay our first printing bill. He dragged me into it kicking and screaming, which didnt do wonders for our relationship. But we survived, thanks in part to my recognizing that Im actually really good at finding people to partner with. My first act as a publisher was to team up with an experienced marketer. Eventually, we built one of the fastest-growing publishing companies in America. If you have trouble recognizing your talents, think about the characteristics that friends, colleagues, and others appreciate about you—or ask them now.

Leverage your past
How can you use what youve already done to get you where you want to go? Focus on the step you can take thats at your fingertips, rather than the one thats a mile away. A client of mine jump-started a holistic-health business by using contacts from her previous human-resources job. When I decided to leave my job as a book editor and become a life coach, my first clients were people who wanted writing coaches. When a friend was looking to start a furniture-design business, she used what shed learned from 25 years in the corporate world to avoid basic business mistakes.

Use your six degrees of separation
No matter who you are or what you do, you have connections to people who can help launch your dream. (And, remember, they say we are all only six people away from everyone.) So start working them now. Reach out to everybody you know and ask if they can offer any contacts. Then call these people, pick their brains, and ask for help tapping connections unknown to you. You can do this online, too, with networking sites like www.linkedin.com or www.xing.com.

Look before you leap
The key is to take calculated, not crazy, risks. Ask yourself what you can do to lower the stakes—that way youll create a cushion for any possible fall. Will and I both had journalism experience and already experimented with putting out a book that had done well before estab­lishing our publishing venture. We also kept our day jobs, so we could pay off the start-up costs (little by little) even if we didnt sell anything. What homework do you need to do to minimize your risk: Get more knowledge? Learn a new skill? Whatever it is, reaching your goal depends on it.

IstockphotoI wish I were a naturally active, athletic kind of woman—then maybe it wouldnt be such a constant battle for me to stay in shape.

Im thrilled that Ive finally managed to drop 30 pounds or so, and that Im getting myself to the gym three times a week. But Im not fooled into thinking my life has totally changed: Im still addicted to my former overeating, indolent ways, and any minute now, I could fall right off the wagon. Some days, staying on that exercise bike for a full 45 minutes seems like an impossible thing to do.

If only there was some magic pill I could take to make this easier, I think to myself when Im 20 minutes or so into the pedaling.

Well, maybe there is.

A new study from the University of South Carolina crossed my desk this morning. Researchers there discovered that an antioxidant compound found in fruits and vegetables can significantly boost your endurance and aerobic fitness after just one week—making it easier for people to exercise a little longer.

The supplement is quercetin, and study author Mark Davis, PhD, a professor of exercise science at the University of South Carolinas Arnold School of Public Health says, “This is great news for those who often think theyre too tired to exercise.” People like me, he means.

Davis and his team first gave 12 student volunteers in their 20s (all fit but not considered “highly trained”) an exercise test to determine their VO2 max status, a measure of aerobic fitness. Then, half the volunteers got 500 milligrams of quercetin twice a day (mixed in Tang, to mask the supplements taste); the other half got Tang plus placebo.

After a week, the students were tested again—and those whod taken quercetin were able to exercise about 12 minutes longer than theyd been able to before they took the supplement.

I did the math and figured out that by adding 12 minutes to my exercise-biking routine three times a week for a year, I could lose an additional 4 pounds. On my 51” frame, losing even a little chunk like that could be the difference between a convex or concave (heck, Id settle for nearly flat) tummy.

What is this stuff?
Even if youre not looking for a magic bullet to make exercising easier, you might want to consider taking a daily dose of quercetin. Its an antioxidant that gobbles up the cell-damaging particles known as free radicals, it acts as antihistamine and could improve allergy symptoms, and it may protect against heart disease, according to the excellent University of Maryland Medical Centers alternative medicine database.

Im heading out to pick up a bottle now—you can find quercetin in any health-food store and many drug stores. Fingers crossed that a week from now, Im spinning for an extra 12 minutes without even noticing it!