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Charles W Smith, MD  
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Job Loss And Its Connection To Illness

Jul 26, 2009 - 0 comments
Tags:

job loss

,

illness



Two very interesting articles were published recently on the health effects of job loss and on-the-job rejection.

The first article (http://abcnews.go.com/Business/WellnessNews/story?id=7530730&page=1) looks at the health of people who have been fired. They limited their study to previously healthy adults who got sick after they lost their jobs. It didn’t seem to matter why they were let go or how quickly they found a new job. Kate Stully, an assistant professor in sociology at the State University of New York at Albany and author of “Job Loss Can Make You Sick” found that losing a job is linked to a higher risk for high blood pressure, heart disease, heart attack, diabetes or depression. I would also add an increased risk of suicide to this list.

The second article (http://www.imperialvalleynews.com/index.php?option=com_content&task=view&id=5167&Itemid=2) looks at what happens when you’ve been left out (or just think you’ve been left out) of the loop at work. Purdue University’s professor of psychological sciences, Kipling D. Williams, reported that hurt feelings for a perceived slight can affect morale, hurt job performance and productivity, and can even hurt the company financially in his article, “Avoid the Dark About Effects of Leaving Others Out of the Loop”.

The first article looks at how we define ourselves and our place in society by our jobs. The second looks at how damaging a perceived slight can be to productivity. Now these two articles on the surface seem to be talking about two different things. But if we take a closer look, aren’t both of these articles talking about the effects of rejection?

No matter how much we would like to say we don’t care what other people think, we really do care much more so than we might think. And it hurts when we feel left out or feel unwanted. According to the first article, it can even make us physically sick. It matters that we feel needed and accepted by those who play a large part in our lives. And let’s face it; we spend a lot of time with our coworkers so it would naturally follow that these people would have some influence over how we feel about ourselves.

The second article explains how just a small amount of the cold shoulder can have a significant impact on how we feel about ourselves and how we perceive others feel about us.

So how do we cope with feelings of rejection in the workplace? Most of us spend more time with coworkers than we do our families, so they often become our second family. In some cases, our work family may be the only one we’ve got. And family rejection is often the most devastating to our self-worth.

The first step in dealing with any rejection is a critical look at the rejecter as well as the rejected. Is she really rejecting me by talking with another coworker? Sure, we were a team in the meeting, but after the meeting she talked to someone else in the hall. Does this mean rejection, or does this mean she had a follow-up comment to something that person said in the meeting? Is my being fired from my job a reflection on my job performance or downsizing of the company? If it is my performance, was the job really a good fit to begin with? How could I have changed the outcome to better serve me? Could I have stepped up my performance, or changed jobs to one that I liked better? How will I deal with this in the future? Do I really want to be a part of this group in the first place? Is my desire for alliance with this group solely based on popularity? Does this group fit with my own morals and ideals? We all want to fit in, but not at the expense of losing ourselves in the process.

The second step is to realize that in order to feel rejection we must first give someone else the power to do so. Am I setting myself up for rejection? According to psychiatrist, Karen Horney, we tend to move toward, away from, or against others. Am I open and meeting others half way? Am I waiting for others to come to me or making others work harder to approach me? Or am I mistakenly pushing others away from me by rubbing them the wrong way or coming on too strong when all I really want to do is connect? Am I trying to alienate others before they get the chance to alienate or reject me?

The third step is to understand that rejection is a negative experience just like any other and that the hurt lessens when shared with others. Sometimes we can “feel” rejection when we are not being rejected at all. If I was cheated on by a loved one, or a family member raked me over the coals for showing up late for dinner, I would find a sympathetic ear to talk it out with. By discussing rejection, we find that we are not alone. We may even find that our story is not so bad when others share their horror stories of rejection. And don’t worry about fearing that we’ve blown the situation out of proportion. Maybe we have not been rejected at all. Our true friends will be the first to tell us when we are full of hot air. Our fake friends will be the last to tell us when we are wearing our underwear on our heads!

I’ll leave you with a couple of quotes on fitting in:

“I refuse to join any club that would have me as a member” Groucho Marx

“I want my individuality, so why can’t I get a tattoo? Everyone else is.” My neighbor’s teenager

The floor is now open for your comments. Please join in.

*This blog post was originally published at eDocAmerica*

Ten Tips For Overcoming your Headaches

Jun 12, 2009 - 31 comments
Tags:

chronic headaches

,

Migraines

,

Headaches

,

Migraine

,

Headache



One of our most revered faculty members, Lee Archer, MD, a neurologist, provided a copy of the handout he gives to his headache patients. With his permission, I adapted it for use with my own patients. I thought it was so good that I asked him if I could publish it on my blog so that others could benefit from his advice.

Headaches are incredibly common and usually frustrating for providers. It has become increasingly evident that chronic or frequently occurring headaches are often virtually impossible to identify as either “migraine” or “tension” headaches and often simply are called “chronic headaches”. Treatment often becomes a revolving door of trying new medications that sometimes work, but more commonly don’t. And, even worse, many headache patients gradually simply become dependent on addictive pain medications just to try to cope with their often daily discomfort.

But, there are some really basic things about dealing with chronic headaches that we should never forget to try. So, without further ado, here is his advice:

Ten Steps to Overcoming Your Headaches

There are some things that everyone can do to help their headaches. There are a number of things you can besides just take medication to help their headaches. If someone follows all of these directions, the need for prescription medication is often dramatically reduced if not eliminated.

1. First and foremost, taking pain medication everyday is definitely not a good idea. Daily pain medication tends to perpetuate headaches. This is true for over-the-counter medications like Excedrin and BC powders, as well as prescription medications like Fiorinal, Midrin, and “triptans” like Imitrex, Zomig, Relpax, Frova, etc. Exactly why this occurs is unclear, but it is a well established clinical finding. Anyone who takes pain medications more than twice a week is in danger of perpetuating their headaches. Occasional usage of pain medications several times in one week is permissible, as long as it is not a regular pattern. For instance, using pain medication several days in a row during the perimenstrual period is certainly permissible.

2. Regular exercise helps reduce headaches. Exercise stimulates the release of endorphins in the brain. These are chemicals that actually suppress pain. I encourage people to aim for at least 20 minutes of aerobic exercise (like walking or swimming) five days a week if not daily. In addition to helping reduce headaches, this also will prolong your life because of the beneficial effects on your heart.

3. Stress reduction is a definite benefit in reducing headache frequency and severity. Headaches are not caused by stress alone, but can make most headaches worse. There are no easy answers for how to reduce stress. If it is severe, we can consider referral to a therapist for help.

4. Too much or too little sleep can trigger headaches. Pay attention to this, and note whether or not you are tending to trigger headaches from sleeping too little or too much. People differ as to how much sleep is “right” for them.

5. Caffeine can precipitate headaches. I encourage patients to try stopping caffeine altogether for a few weeks, and we can decide together whether or not caffeine might be contributing. Abruptly stopping all caffeine can trigger headaches, too, so try to taper off over a week.

6. NutraSweet (aspartame) can cause headaches in some people. If you are drinking multiple servings/day of beverages containing NutraSweet you might consider trying to stop that, and see if your headaches respond.

7. There are some other foods they may trigger headaches in some people. Usually people learn this very quickly. For instance, red wine will precipitate migraines in many people, and chocolate, nuts, hot dogs and Chinese food triggers headaches in certain cases. I generally don’t advise omitting all of these foods, unless you notice a pattern where these foods are causing headaches.

8. If I give you a prophylactic medication for headaches, you should take it daily, as prescribed. If you have trouble tolerating it, please let me know and we can consider using something else. No prophylactic medication works in every patient with headaches. Generally, each of the medications works in only about 60% of people. Therefore, it is not uncommon to need to try more than one medication in any given patient. We must give any of these medications at least four to six weeks to work before giving up on them. It generally takes that long to be sure whether or not a medication is going to work.

9. Keep a calendar of your headaches. Use a standard calendar and mark the days that you have a headache, how severe it is on a scale of one to ten, what you took for it and how long it lasted. Also note anything that you think could have precipitated it. By keeping this over time we can tell if our efforts are helping.

10. Riboflavin (vitamin B2) 400mg daily helps prevent migraines in many people. It comes in 100mg size tablets, so you will need to take four of them each day. You can add it to anything else we try. You do not need a prescription for it.

Do you have chronic headaches? If so, I challenge you to apply these ten principles, then come back and provide a comment on this blog post!

Thanks and good luck!

* MedHelp note - For #9, you can track your headaches using the Migraine & Headache tracker at http://www.medhelp.org/trackers/list/89

*This blog post was originally published at eDocAmerica*