Addicted to Anti-Anxiety or “Nerve” Pills — Benzodiazepine use disorder and what to do about it

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Image by Pete Linforth from Pixabay

Many people, especially women, develop feelings of anxiety and worry. Some call it “bad nerves.” This predisposition to feeling anxious can cause problems with everyday living, coping, and sleeping. I have assessed and interviewed many older people with a range of problems with anxiety. Feeling anxious is a completely normal reaction to stress or a situation where you may feel fearful. However, being in a continuous state of feeling afraid can cause problems both mentally and physically. Some say they feel like they are “trembling inside.”

Anti-anxiety medications (also known as “nerve pills”) are used by many people. These pills come from the family of “benzodiazepines.” Some of the commonly prescribed anxiolytics in Canada or the United States include (but not limited to):

  • Clonazepam (Rivotril)
  • Alprazolam (Xanax)
  • Lorazepam (Ativan)
  • Diazepam (Valium)

A commonly prescribed non-benzodiazepine that acts like one is Zopiclone (eszopiclone in the USA). It is commonly used as a “sleeping pill.”

Generally, benzodiazepines end in “pam” or “lam.” Use of these medications can initially improve symptoms by offering a sedating effect, however, they can also be addictive. Side effects of these drugs include increasing the risk of cognitive impairment, confusion, delirium, falls, fractures, drowsiness, and motor vehical accidents. They are not recommended for use by older adults. In fact, older people are recommended to gradually reduce their dosage (a slow and steady decrease is recommended over a sudden discontinuance due to withdrawal symptoms). Always talk to a doctor about any changes to your medication. As the dose is gradually reduced and preferably stopped, it is important to identify and optimize alternatives to managing any underlying issues. These alternatives are preferably not other medicines.

Sometimes these medications are used on an “as needed” basis. For example, if you are afraid of flying, and you need to go on an airplane, you can take one of these medications (prescribed by your doctor) to use in specific situations. Or, if you have claustrophobia and you need to go for a scan such as an MRI, taking this medication may make it more bearable.

I have also seen where these medications are prescribed for help with sleep. People who have an anxiety disorder may be prescribed this classification of medications to see if it helps reduce anxiety or panic attacks. In older people, antidepressants are the preferred class of medications to help with anxiety.

Some other key tips to remember:

  • Avoid taking benzodiazepines with opioids or alcohol.
  • These medications are more often prescribed to women (Almost 1 in 5 Canadian women report to have used in the past year).
  • Almost 1 in 10 Canadians in Quebec have been reported to have an addiction to benzodiazepines.
  • If a benzodiazepine addiction is present, consider there may also be other substance use disorders or behaviours present (e.g, alcohol, opioids, marijuana, gambling).
  • If you are older, it’s best not to start taking benzodiazepines.
  • If the addiction is getting worse, an admission to a treatment facility may be necessary.

If you are finding yourself feeling “addicted” or “dependent” on these medications (or other substances or behaviours), you are “craving” these drugs, or you are needing to increase your dosage, you may want to see your doctor to discuss alternatives. Reducing the risk of harm is key.

For more details, The Canadian Coalition for Seniors Mental Health has published the Canadian Guidelines on Benzodiazepine Receptor Agonist Use Disorder Among Older Adults (2019) and is found online: https://ccsmh.ca/wp-content/uploads/2019/11/Benzodiazepine_Receptor_Agonist_Use_Disorder_ENG.pdf

Angela G. Gentile, MSW, RSW

Low-Risk Alcohol Usage Guidelines for Older Adults – Know your limits

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Photo by bruce mars on Pexels.com

Most adults enjoy drinking alcohol on occasion. Sometimes, though, this occasional drink turns into a daily habit. One drink turns into two or more. If a person is not mindful, this habit could turn into an addiction. Addiction is also known as dependency or substance use disorder.

People can become addicted to not only alcohol but drugs, including prescription drugs (such as benzodiazepines and opiates). For example, nicotine, the drug found in cigarettes, is very addictive. Addictive behaviour can also be problematic, as in gambling, sex, or online gaming.

Addiction is a complex condition, a brain disease that is manifested by compulsive substance use despite harmful consequences. People with addiction (severe substance use disorder) have an intense focus on using a certain substance(s), such as alcohol or drugs, to the point that it takes over their life. They keep using alcohol or a drug even when they know it will cause problems. Yet a number of effective treatments are available and people can recover from addiction and lead normal, productive lives. – American Psychiatric Association, retrieved 03 Dec 2019.

For a number of reasons, it is essential to keep in mind that as we age, it is recommended we reduce our consumption of alcohol. For adults aged 65 and older, it is important to be aware of the low-risk guidelines.

Canada’s Low-Risk Guidelines (DrinkSense for Seniors) which is provided by the “Canadian Centre on Substance Use and Addiction”, states that limits for adults (not older adults) who drink alcohol should be 10 drinks a week for women with no more than two per day, and 15 drinks a week for men with no more than three drinks a day on most days. There is no specific limit for older adults, but one of their “Safer Drinking Tips” includes the advice of “Always consider your age, body weight, and health problems that might suggest lower limits.”

 

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Standard Drink Portions:

      • Beer – 341 ml (12 oz.) of 5% alcohol content
      • Wine – 142 ml (5 oz.) of 12% alcohol content
      • Cider/Cooler – 341 m. (12 oz.) 5% alcohol content
      • Distilled alcohol/80 proof liquor (rye, gin, rum, vodka, etc.) – 43 ml (1.5 oz.) 40% alcohol content

 

I attended an “Aging and Addictions” course in November 2019 which was held by the Addictions Foundation of Manitoba, and they supported the drafted recommendations entitled “Prevention: Low-Risk Drinking Guidelines” for those 65 and older (noted below).

 

Low-Risk Drinking Limits (65+)

    • Women: No more than 1 standard drink per day, with no more than 5 drinks in total per week.
    • Men: No more than 1-2 standard drinks per day, with no more than 7 per week in total.
    • Non-drinking days are recommended every week.

Source: Canadian Coalition for Seniors’ Health. Canadian Guidelines for Older Adults. Prevention, Assessment, and Treatment of Alcohol Use Disorder, 2019.

 

These drafted guidelines are more in line with what I would recommend. I have seen what alcohol dependence can do to people and it is heartbreaking. And as noted in a previous post here on my website, to help preserve cognitive health, experts recommend no more than 2-4 drinks per week (see my Memory Rescue book review.)

For those who have a drinking problem, there is often stigma and shame attached. Many people can’t abstain or reduce their drinking behaviour on their own (harm reduction) and need help. If you or someone you know has a drinking problem, addiction or dependence, please contact the Addictions Helpline in your area.

> Addictions Helpline Canada 

> Addictions Helpline USA

AA 12-Step (https://www.aa.org/) or Smart Recovery (https://www.smartrecovery.org/) are peer support options to consider as well.

If you are considering getting on top of your drinking problem and need someone to talk to, please contact me and I can assist you in finding the help you need.

Angela G. Gentile, MSW, RSW

 

References:

https://www.psychiatry.org/patients-families/addiction/what-is-addiction

https://amho.ca/wp-content/uploads/Mon-300pm-IP1-3a-Older-Adults-with-Alcohol-Related-Problems-Best-Practice-Guidelines.pdf

https://www.canada.ca/en/health-canada/services/substance-use/get-help/get-help-problematic-substance-use.html

https://www.samhsa.gov/find-help/national-helpline

https://www.aa.org/

https://www.smartrecovery.org/

https://www.drinksenseab.ca/drinksense-tips/seniors/

https://ccsmh.ca/alcohol-guidelines/

“A Standard Drink” image source: https://studentaffairs.lehigh.edu/content/what-standard-drink

 

 

 

 

My Low-FODMAP Elimination Diet Experience to Treat Irritable Bowel Syndrome

 

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Pasta with garlic bread. Off-limits for people with GOS sensitivity

Normally I don’t like to share my personal stuff here on the World Wide Web, however, once in a while I come across something that I think, if I share this with the world, maybe, just maybe, it will help someone else. In this article, I want to share with you my very personal (and embarrassing) experience with irritable bowel syndrome (IBS), and a way to help diagnose and manage further episodes of diarrhea and stomach upset.

My “tummy troubles” started when I was in my early 20’s. I was in university and I remember having cramps and diarrhea that would seem to come out of nowhere. Sometimes it was worse when I felt stressed, but it usually took me by surprise. I usually had little warning and a short amount of time before I needed to relieve myself. It was embarrassing, and I remember once when I was working with Home Care, I had to use a client’s bathroom. Another time, I had to cancel a support group I was running because I was suddenly taken over by vomiting and diarrhea.

The doctor I saw at the time recommended I have a colonoscopy to determine if there was anything going on such as colitis. The results came back as “minor irritable bowel syndrome.” I am not sure how that was determined, but for me, it was more than minor. I had also been tested for celiac disease (gluten allergy), and that test came back negative.

Fast forward to 30 years later, plus a bout of chemoradiation for anal cancer, I was really desperate to figure out how to control this irritable bowel. My sphincter muscles are no longer as strong or healthy as they used to be (imagine your bum being put into a microwave oven and fried!) so my IBS symptoms are much more concerning. The control I had before is now at half the strength it used to be (I’ve never lost control, thank God!).  I asked my doctor once again for a referral to a specialist, this time to a gastroenterologist (GE).

I saw the GE in April 2019. He recommended I go on a low-FODMAP diet. He told me about a mobile app I could use on my phone. He then said he would schedule a flexible sigmoidoscopy and a biopsy for microscopic colitis. He also took a blood test to check for celiac disease.

When I went home, I looked up low FODMAP. I had heard of this before, but I was not totally sure what it was. I came across the Monash University in Australia and found out they have done a lot of work in the last 12 years on helping people manage their IBS. They had an app that cost around $10 CAD, and from the reviews I had read on it, it was something I felt I could really get some good use out of.  I purchased it and never regretted it. It is something I use regularly. I can look up things for my friends, too!

FODMAP (pronounced “fawd-map”) stands for a group of carbohydrates found in foods – Fermentable, Oligosaccharides, Disaccharides, Monosaccharides and Polyols. Many people (about 10-15%) find these types of ingredients hard to digest, therefore, causing an abdominal upset. These symptoms include abdominal pain, bloating, gas, nausea, diarrhea, constipation, and could include a combination of any or all of these. For me, it can get so severe, that I also vomit. This may be too much information for some of you, but unfortunately at times, when I am having a bad “attack,” my body expels my stomach and bowel contents at the same time. I have it “coming out of both ends.” It is very quick and short-lived. I feel better soon after these attacks. So, I get it pretty bad sometimes.

The low-FODMAP process includes eliminating all foods that have the FODMAP irritants until all symptoms noted above are gone. The foods fall into different categories: Fructose, Lactose (many people are lactose intolerant), Mannitol, Sorbitol, GOS, and Fructan. This process can take two to six weeks. For me, it only took a couple of weeks. My family was very supportive and I avoided eating out. Once symptoms are under control, then you start reintroducing each of the foods to see if it triggers a response. There are “safe serving sizes” for each food that are very helpful.

For me, it turns out I am sensitive to GOS –- Galacto-oligosaccharides. These are found in foods such as nuts, beans, legumes, wheat, and grains. I found out quickly that I can only handle 8-10 pistachios or almonds at a time and I need to wait a few hours between having these foods again, in fear of “stacking” and causing an attack.

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All those years I thought I was eating healthy (12-grain bread, almonds, cashews, pistachios, legumes, etc.) turned out to be one of the worst things I could be doing for my body. Thirty years of suffering, not understanding why I was having so much trouble. One time I remember calling a restaurant to say I was sure I had food poisoning. Looking back now, it was probably just an IBS attack.

By June of 2019 (two months later) I was feeling I had a handle on my diet. I had also seen a dietician for nutrition counselling, and I had a Nutrigenomix DNA test to help me personalize my dietary approach. I had also started intermittent fasting and tried out the ketogenic diet for a bit.

Overall, the low FODMAP diet and Monash University FODMAP Diet app changed my life, for the better. Every once in a while I have an upset, and I go to the app or I find out what the ingredients were in a meal I ate. I am still learning as I go, and unfortunately, durum wheat semolina pasta with a side order of brioche garlic bread is the equivalence of dynamite for me. Enzyme therapy is another option that I could consider to help manage my GOS sensitivity. I am looking into this.

I am hopeful that research will continue and the lives of people with IBS with improve. Although it is not a cure-all, considering doing a low-FODMAP diet to help improve and manage your “tummy troubles” is highly recommended. Working with your healthcare professionals and specialists is also important.

Angela G. Gentile, MSW, RSW

Social Worker/Author

For more info: www.AngelaGGentile.com

How to Prevent Heart Disease — The Number One Cause of Death Worldwide

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Image by Bruno Glätsch from Pixabay

Heart disease is the number one killer, worldwide. Prevention is key. Although these ten points were written for healthcare professionals,  there are a few points that we can incorporate into our own lives. In the first point, we are to be encouraged to aim for a healthy lifestyle throughout life. It’s never too early or too late to start living a heart-healthy lifestyle.

It is also important to note points four and five — the heart-healthy diet and exercise recommendations. Making healthy choices 80% of the time is what we are aiming for. Knowledge is power.

 

Top 10 Take-Home Messages for the Primary Prevention of Cardiovascular Disease

American Heart Association, 2019

1.  The most important way to prevent atherosclerotic vascular disease, heart failure, and atrial fibrillation is to promote a healthy lifestyle throughout life.

2.  A team-based care approach is an effective strategy for the prevention of cardiovascular disease. Clinicians should evaluate the social determinants of health that affect individuals to inform treatment decisions.

3.  Adults who are 40 to 75 years of age and are being evaluated for cardiovascular disease prevention should undergo 10-year atherosclerotic cardiovascular disease (ASCVD) risk estimation and have a clinician–patient risk discussion before starting on pharmacological therapy, such as antihypertensive therapy, a statin, or aspirin. In addition, assessing for other risk-enhancing factors can help guide decisions about preventive interventions in select individuals, as can coronary artery calcium scanning.

4.  All adults should consume a healthy diet that emphasizes the intake of vegetables, fruits, nuts, whole grains, lean vegetable or animal protein, and fish and minimizes the intake of trans fats, processed meats, refined carbohydrates, and sweetened beverages. For adults with overweight and obesity, counseling and caloric restriction are recommended for achieving and maintaining weight loss.

5.  Adults should engage in at least 150 minutes per week of accumulated moderate-intensity physical activity or 75 minutes per week of vigorous-intensity physical activity.

6.  For adults with type 2 diabetes mellitus, lifestyle changes, such as improving dietary habits and achieving exercise recommendations, are crucial. If medication is indicated, metformin is first-line therapy, followed by consideration of a sodium-glucose cotransporter 2 inhibitor or a glucagon-like peptide-1 receptor agonist.

7.  All adults should be assessed at every healthcare visit for tobacco use, and those who use tobacco should be assisted and strongly advised to quit.

8.  Aspirin should be used infrequently in the routine primary prevention of ASCVD because of lack of net benefit.

9.  Statin therapy is first-line treatment for primary prevention of ASCVD in patients with elevated low-density lipoprotein cholesterol levels (≥190 mg/dL), those with diabetes mellitus, who are 40 to 75 years of age, and those determined to be at sufficient ASCVD risk after a clinician–patient risk discussion.

10.  Nonpharmacological interventions are recommended for all adults with elevated blood pressure or hypertension. For those requiring pharmacological therapy, the target blood pressure should generally be <130/80 mm Hg.

Arnett et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease

https://www.ahajournals.org/doi/pdf/10.1161/CIR.0000000000000678

Age well, my friend.

Angela G. Gentile, MSW, RSW

Intermittent Fasting Information Session

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Please join me (Angela G. Gentile) at Village Chiropractic in Winnipeg (482 River Avenue) on Friday, April 26, 2019; 6:00 pm – 7:30 pm. I will be presenting an education session on “Intermittent Fasting for Health & Weight Management.” I’ve been practicing an IF lifestyle since December 26, 2018 and I haven’t looked back. I am excited to share what I have learned and I am looking forward to answering any questions you may have.

Please register soon – it’s FREE and spots are limited!

 

Angela G. Gentile, MSW, RSW

12 Tips for Making Healthy Nutrition Choices on an Intermittent Fasting Program

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Image courtesy of kerdkanno at FreeDigitalPhotos.net

Nutrition is an essential aspect of our overall health and well-being, no matter what our age. What we consume can make us gain weight, lose weight, or cause (or prevent) many health problems. I had lost 30 pounds during my cancer ordeal in 2017, and the weight started to creep back up. I realized that if I didn’t change my diet, I would probably gain the weight back and some. Scientific studies show a link between obesity and medical problems like cancer, high cholesterol, and diabetes. As I age, I want to be as healthy as I can and prevent any further medical problems – or recurrence of cancer.

After talking to my doctor about my concerns, I went to a dietician she had recommended. I told her I was following an intermittent fasting lifestyle, and the dietician was good with that as long as it’s working for me. In the hour I was with Marni, she listened to my concerns and gave me some great tips. She wants to help me make healthy choices during my “eating window.” She says my dietary habits need some “tweaking.”

Following are the words of advice that stand out for me. Keep in mind that each person’s situation will be different, and dietary recommendations given here are tailored to me, my situation and my overall goals. You may find some of these tidbits helpful, or you may want to see a dietician for your own personal advice.

#1. Consider the 80/20 Rule. For 80% of the make “healthy choices.” She said it’s okay sometimes (about 20% of the time) to eat or drink what we consider “fun foods.” We all need to satisfy our indulgences or treat ourselves once in a while. “Cheat days” are not encouraged. Instead, follow the 80/20 rule and you won’t feel guilty. FYI – 20% of equals 1½ days per week or about four meals in seven days. Read more about the 80-20 Rule.

#2. The 50/25/25 Plate. When filling up your plate, half should be vegetables, one-quarter protein, and one-quarter carbohydrates/starch. For some people, the carbohydrates can be reduced or eliminated. My doctor also told me to reduce the amount of carbs. For example, if I was having a piece of bread, cut it in half. Pasta, rice and other starches should also be consumed in smaller amounts. Here’s more info on the healthy portion plate. 

#3. Focus on Healthy Choices and Lifestyle (Not Weight Loss). Psychologists, dieticians, and obesity specialists are realising that they have to stop focusing less on weight loss as this does not help people keep weight off in the end. The focus has to be more on healthy choices and lifestyle. Also, the “set point” theory states our body is going to try and get to a certain weight, no matter what we do. If we weigh less than our set point, then our body is going to do whatever it can do to get to that weight. Case in point, on the TV sensation, “The Biggest Loser,” the contestants may have lost a lot, and I mean A LOT of weight. When some of these people were followed up six years later, they had gained most of the weight back, except for one contestant. This is a testament to the set point theory, and it is related to metabolism. All we can do is focus on healthy nutrition choices and lifestyle, and go by what our body is telling us. If it feels healthier with the choices we are making, then we can say that’s a win! The dietician told me, “Things have their way of coming together.” For example, if you are a runner, you may eat differently to fulfill your caloric needs.

#4. Know Your Why for Wanting to Lose Weight. I had to think about the reason why I wanted to lose weight. Was it because society tells me I “should” weigh less? Is it societal pressures on me as a woman? Is it because I want to “look” better? Or is it because I want to be healthier? For me, I know there are many reasons why. And what I do know for sure is that I don’t want to be overweight or obese.

#5. Keep Unhealthy Junk Food Temptations Out of the House. If you don’t have those unhealthy choices around you all the time, it’s a lot easier to avoid them. Instead of opening up the cupboard to find that unhealthy snack, you would have to drive to the store to get it. That little deterrent can help a lot. Having a supportive environment can help support healthy choice goals.

#6. Listen to Your Body – Eat When Hungry, Stop When Full. Some people don’t know what hunger feels like. If you are not hungry, don’t eat. When you do it, make sure you eat until you feel full. Eating more of the “healthy choices” will help prevent you from snacking and eating things you consider unhealthy — more quality AND quantity.

#7. Eat 1-3 Servings of Fruit a Day. Fruits are a good source of vitamins and minerals, and play a role in preventing vitamin C and A deficiencies. Read more about why fruit is so good for us. 

#8. Practice Mindful Eating. The first bite or sip of anything is the most satisfying and rewarding. We usually don’t need to eat much more than a bite or two to satisfy a craving. If what you desire is considered an unhealthy or “fun food” choice, try one or two bites, or a small amount. That’s probably all you need. We usually continue to eat something because we want that feeling to stay. But that’s usually not the case (e.g., potato chips and chocolate.)

#9. Follow the 2019 Canada Food Guide. There are lots of great tips and advice there. For example, water is recommended as the beverage of choice. Mindful eating is encouraged.

#10. Nuts and Legumes are Healthy Choices. These are considered good sources of protein and healthy fat.

#11. Dietary Fiber is Important. Beans, whole grains and brown rice are all good choices. Here’s the top 10 according to WebMD. 

#12. End Your Meal by Brushing Your Teeth. I like to end my meal with something sweet or fresh-tasting as I don’t like the food after-taste. I used to chew gum after, but in the evenings that cuts into my “fasting window” time. I was in the habit of eating chocolate or something else that was sweet (even marshmallows!). Options would be to brush my teeth, chew gum for a bit, or have a mint. A breath mint spray may also work.

The dietician was pleased that I have found something that works for me (intermittent fasting) and she is going to help me tweak it. She says regimens like WW (Weight Watchers) works for some people, and there are other programs that can help with making healthier choices. A good friend of mine has lost 20 pounds on WW! We are all different and it’s good to have choices on what works for us and complements our lifestyles. What works for one person may not work for the next.

I will consider all these tips and see what works for me. I know there are plenty more tips and you may want to add some of your own in the comments below. The dietician wants to see me again in April, and she has registered me for the Well 4 U exercise and education program. There is also a Fit 4 U program this fall that she recommends I attend.

By the way, she said I could have a little bit of dark chocolate every day! 1-2 squares daily is okay – even more if my body says I need it. But as it turns out, I gave up chocolate for Lent. No chocolate for me until Easter!

Angela G. Gentile, MSW, RSW

The ​Long Road to Recovery

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Anyone who has had or has cancer or any other chronic illness or disease knows there is a certain amount of time when they feel they are truly on the road to recovery, recovered, or have discovered their “new normal.” I am one of those people.

I was diagnosed with anal cancer in April 2017. I finished treatment in August 2017. One and a half years later, I can say I am starting to feel “recovered” for the most part – “still recovering” in other areas –– and have discovered my new normal.

My new normal includes ongoing and long-term physical rehabilitation as a result of pelvic radiation damage. I am not complaining (radiation saved my life!), I am just sharing that although some people look great after a big ordeal like cancer, there could be ongoing battles that you may know nothing about. Invisible wounds and scars are very common for people who have experienced cancer.

Recently I attended an art show, and I received a few compliments on my appearance (the picture above was taken at the end of a Hawaiian vacation last month). I know I am feeling much better physically, and my self-image is shaping up. My hair is almost all grown back and highlighted again; I am back to yoga once weekly, and I have started back on my elliptical and doing stretches and weights. I even started wearing my FitBit again. My modest goal of 6,000 steps daily is still a ways away, but at least I am working towards it.

I have also been enjoying my new “intermittent fasting” lifestyle and my relationship with food. I am feeling in control of my life and my body. It’s taken almost two years, but I finally feel like each day I feel better and better.

I am enjoying moderating and managing support groups on Facebook. The “Anal_Cancer Support” group on Facebook is doing amazingly well and has recently achieved the 10-year milestone and the 300th member. Having cancer has expanded my social network by leaps and bounds. A profound and harrowing experience can bring more people into your life – if you want it. You just have to open up and ask for it.

The “Dementia Caregiver Solutions Support Group” is also growing and the admin team recently expanded to include two new moderators who are actual caregivers. They join three professionals to moderate and keep things on track. I find comfort in knowing I have given caregivers this safe forum to share, vent, and get advice for such a difficult time in their lives.

I am also pursuing other volunteer opportunities to help me reach more people who may benefit from my experience, passion, and support. I seem to have an infinite amount of “help” to give, and I am looking for ways to do so –– in a way that will keep me balanced and not over-taxed.

I continue to write for a company called Trualta. I am enjoying my writing projects and look forward to writing for more companies and individuals as the opportunities present themselves.

I am also helping people get married, sort out their problems, write books, develop websites and more. I am starting to consider finishing up my book on aging well (this will be my fifth book!).  Where all this will take me? Who knows. The long road to recovery takes us places that we never dreamed of. I am looking forward to continuing on this journey.

Angela G. Gentile, MSW, RSW

 

My 72-Hour Fasting Experience, Part 3

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7:30 am. Half-way (36 hours) into my fast, I woke up after having a bad dream. I dreamed I was being chased by a large, vicious, hungry lion! I haven’t remembered my dreams that vividly for a long time. I was in some sort of building, a school perhaps, and I heard a loud rustling noise. My intuition told me danger was lurking. As the noise got closer, I saw the lion coming around the corner! I ran into a room and locked the door. That’s when I woke up. (Maybe it was all that thinking about hungry animals yesterday that brought it on!)

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I felt noticeably “lighter” this morning, so I stepped on the scale. I lost three pounds! Now going from 163 to 160 isn’t a lot when you look at the bigger picture, but wow, it’s interesting how lighter one can feel after not eating for 36 hours!

My energy is still good. I have a slight little nagging headache, but that will soon pass once I have my green tea and some Himalayan pink salts (I hope!). (See the screenshot above of the app I am using, it’s called LIFE.)

I will be working today so I will be kept busy.

Angela G. Gentile, MSW, RSW

 

 

Intermittent Fasting – A New Way of Eating for Health and Weight Loss

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Photo by Kaboompics .com on Pexels.com

A couple of months ago, I read an article in a newsletter written by an acquaintance about her five-day “fasting” experience. For health reasons, she drank only water for five days. I was both shocked by this news (how could any live for five days without food?!) and curious (she said she felt better and wants to try for seven days next time.) I tucked this knowledge away in my back pocket, with the intent of learning more.

Then a few weeks after that, I listened to an interview by D’vorah Lansky, bestselling author, who interviewed Gin Stephens who wrote the bestseller, “Delay, Don’t Deny.” D’vorah had adopted the “intermittent fasting” lifestyle and Gin was talking about this way of living and her book sales. This interview was so powerful, I hung on to every word Gin said about how the time-restricted feeding pattern freed her from years of dieting. She lost 80 pounds and has kept it off.

Intermittent fasting (IF) is when you choose to not eat anything for at least 12 hours and for as long as 24 hours. It can be done for religious or health reasons.

I purchased her book (ebook for Kindle) and read it in one day. I loved everything about this new way of eating (WOE) and vowed to myself that I would start on December 26, 2018. I was going to start by not eating after supper and skip breakfast, and only consume water and black tea during my 16-hour fast.

It was much easier than I thought! I felt in control. My hunger pains were short-lived and I soon realized that I was not only eating too much but TOO FREQUENTLY. We are a “well fed” society, and the more I learn about this, the more I understand why there is so much obesity and other related health problems (central abdomen obesity, high blood pressure, high bad cholesterol, low good cholesterol, and high blood sugar). Metabolic syndrome –– which includes three of the five previously-mentioned conditions –– causes an increased risk of cardiovascular disease (heart problems) and type 2 diabetes. Increasing age also causes us to have an increased risk in these areas. I realized in order to reduce my caloric intake, instead of “dieting,” I needed to give myself a “window” of time where it was okay to eat. I am learning how to delay my meals, instead of denying them.

As I write this I am on Day 12 of my new WOE. There is a lot of flexibility with intermittent fasting. For example, my usual pattern is 16 hours of fasting with an 8-hour window of feasting or eating. This is a good place for most people to start. I “close my window” at 8pm, and I don’t eat anything until noon the next day. This gives my body a good 16-hour break from eating. I can drink all the water or black tea (or coffee if I wanted) during the fast. I found I was closing my window earlier, so some of my days were 17 hours of fasting (or more).

Some people choose this 16:8, others choose 18:6 or 20:4 – or some other variation. There are also other patterns, and “extended fasting” which is what the lady did who I mentioned at the beginning of this article. (I’ve also read any fast over 72 hours is dangerous, so be mindful of that.)

For special occasions, where I know I will want to eat or drink outside of my regular window, I can switch up the fasting time. For example, I went for a 21.5-hour fast before new year’s eve so I could have champagne and snacks during the evening. This weekend, I knew I would be having two different family meals, so I did a 24-hour fast. This is also called “alternate day fasting” (ADF) which is another pattern of eating. There is also one-meal-a-day (OMAD) in which the eating window is very short, which could be anywhere between 2-4 hours. Each person finds their own “sweet spot” and you learn how to listen to your body. The Mediterranean diet is what I prefer, as it has the most research behind it for health and longevity. Oh, and my sugar addiction is being curbed as the fasts force me to abstain.

Many people find a lot of benefits associated with intermittent fasting (IF). Improved health and weight loss are the two biggest reasons why people try it. I belong to a few groups on Facebook, and the success stories and non-scale victories (NSV) are very inspiring and encouraging.

IF isn’t for everyone, however, and there isn’t a lot of research on it as it is quite new. I’ve read Gin Stephens’ books and I am also learning from Dr. Jason Fung and will be reading his books, too. Gin says IF is not for pregnant women or children. For those who have pre-existing medical conditions, they should talk to their doctor. In fact, I’ve heard of a few people now who say their doctor recommended IF for their health! It’s been known to reverse type 2 diabetes. If you are considering trying it, please speak to your doctor first.

I am enjoying this new WOE and I am already feeling less bloated and I am sleeping better. I lost 30 pounds a couple of years ago going through my cancer ordeal, and I put most of it back on. The way I lost it was not in a good way. This time I want to lose it in a way that is intentional and will benefit my well-being. I want to reap the benefits of a healthier body that is well fed –– not frequently fed. I also have my own group on Facebook for women who are 40 and better. If you’d like to join us, please drop me a line.

Age well, my friend.

Angela G. Gentile, MSW, RSW

 

Chair Exercises for Older Adults or those with Mobility Limitations

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Photo credit: jill111 – pixabay.com

I was approached by Joseph Jones at California Mobility to provide my recommendation on how to help an older adult with dementia stick to an exercise routine. My comments are in the article 21 Chair Exercises for Seniors: A Comprehensive Visual Guide.

This extensive guide on chair exercises for older adults (or anyone with mobility issues) includes easy-to-follow videos, helpful images, and lots of great tips on chair exercises. These exercises can be adapted for anyone! Please check out the article for helpful tips on keeping active, at any age.

Age well my friends!

Angela G. Gentile, MSW, RSW