Varna’s Mind

Women have hormonal cycles, smaller organs, higher body fat composition — all of which are thought to play a role in how drugs affect our bodies. We also have basic differences in gene expression, which can make differences in the way we metabolize drugs. For example, men metabolize caffeine more quickly, while women metabolize certain antibiotics and anxiety medications more quickly. In some cases, drugs work less effectively depending on sex; women are less responsive to anesthesia and ibuprofen for instance. In other cases, women are at more risk for adverse — even lethal — side effects.

These differences are particularly important for the millions of women living with chronic pain. An estimated 25 percent of Americans experience chronic pain, and a disproportionate number of them are women. A review published in the Journal of Pain in 2009 found that women faced a substantially greater risk of developing pain conditions. They are twice as likely to have multiple sclerosis, two to three times more likely to develop rheumatoid arthritis and four times more likely to have chronic fatigue syndrome than men. As a whole, autoimmune diseases, which often include debilitating pain, strike women three times more frequently than men.

While hormonal, genetic and even environmental factors might influence the manifestation and progression of autoimmune diseases, we don’t yet know the reason for this high prevalence in women.

Pain conditions are a particularly good example of the interplay between sex (our biological and chromosomal differences) and gender (the cultural roles and expectations attributed to a person). In 2011, the Institute of Medicine published a report on the public health impact of chronic pain, called “Relieving Pain in America.” It found that not only did women appear to suffer more from pain, but that women’s reports of pain were more likely to be dismissed.

This is a serious problem, because pain is subjective and self-reported, and diagnosis and treatment depend on the assumption that the person reporting symptoms is beyond doubt.

The oft-cited study “The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain” found that women were less likely to receive aggressive treatment when diagnosed, and were more likely to have their pain characterized as “emotional,” “psychogenic” and therefore “not real.”

Instead of appropriate care for physical pain, this can lead to treatment for mental health issues that might not even exist. The situation is further complicated by the fact that antidepressants are absorbed differently in women and vary in effectiveness, depending on hormonal cycles.

The routine attribution of abdominal pain from conditions like appendicitis or gastrointestinal disease to gynecological problems can also delay or complicate the diagnostic process. A 2008 study published in the journal Academic Emergency Medicine, designed to gauge gender disparities among emergency room patients complaining of abdominal pain, found that even after adjusting for race, class and triage assessment, women were still 13 to 25 percent less likely than men to receive high-strength “opioid” pain medication. Those who did get opioid pain relievers waited an average of 16 minutes longer to receive them.

Conditions like fibromyalgia or chronic fatigue syndrome, for which definitive causes have not been identified and concrete diagnostic tests are not available, illustrate the problems associated with the perceived reliability of the female patient as narrator of her pain. Women are more likely to receive diagnoses of many of these more nebulous conditions — fibromyalgia, which affects about six million patients in the United States, is nine times more likely to be diagnosed in women than in men — and this discrepancy surely contributes to the widespread skepticism that still exists over the legitimacy of these disorders.

I AM a sufferer of pain and chronic disease. Like many, I’ve had physical symptoms (in my case, respiratory problems and infections) explained away as emotional. My freshman year in college, I was in the emergency room, flanked by machines and struggling to breathe while doctors lobbed questions at me: Why wasn’t I responding to the medication the way they expected I would? Was I just too anxious? Could I not handle stress, and was that making me sick?

I was 23 before I was given a correct diagnosis of a rare genetic lung disease called primary ciliary dyskinesia. I’d been sick since birth, but long diagnostic journeys are occupational hazards of living with conditions doctors don’t often see. Still, my journey was unnecessarily protracted by my doctors’ dismissal of my symptoms as those of a neurotic young woman.

For all the medical advances of the past few decades, we still know shockingly little about pain and how to control it. Sex-based research is a crucial part of understanding not just the underlying mechanisms of pain, but the most effective ways to treat it for men and women alike. The Institute of Medicine report found gaps in research, particularly in terms of effective treatments, as well as in the oversight of pain research. The report recommended that these problems be addressed and that strategies to resolve them be implemented by 2015.

Among those improvements must be a renewed focus on discovering why women respond differently to some drugs and diseases, as well as an emphasis on training physicians to better diagnose and manage women’s pain. A report by the Campaign to End Chronic Pain in Women found that inadequate physician training in diagnosing and treating just six pain disorders that affect women either exclusively or predominantly, including fibromyalgia and chronic fatigue syndrome, added as much as $80 billion a year to America’s health care bills.

Part of the reason the diagnosis and treatment of women’s pain lag so much is simply the pace of medical research itself, which is slow to move from publication to clinical practice. Unfortunately, if anything, changes in assumptions about gender evolve even more slowly.

Laurie Edwards is the author of the forthcoming book “In the Kingdom of the Sick: A Social History of Chronic Illness in America” and a writing teacher at Northeastern University.

I don’t mean complicated, difficult, thorny or complex. I mean that these women are portrayed as volcanoes that could blow at any minute. Worse, the very abilities and skills that make them singular and interesting come coupled with some hideous psychic deficiency.

On “Nurse Jackie,” for example, the main character is an excellent R.N. in part because she’s self-medicated into a state of extreme calm. On “The Killing,” Detective Linden, the world-weary, cold-souled cop, is a tenacious investigator in part because she’s obsessive and damaged and a pretty terrible mother. And then there’s “Homeland,” on which Carrie Mathison, the nearly clairvoyant C.I.A. agent, is bipolar, unhinged and has proved, in her pursuit of an undercover terrorist, to be recklessly promiscuous.

These aren’t just complicating characteristics like, say, Don Draper’s narcissism. The suggestion in all of these shows is that a female character’s flaws are inextricably linked to her strengths. Take away this pill problem or that personality disorder, and the exceptional qualities vanish as well. And this is not always viewed as a tragedy — when Carrie undergoes electroconvulsive therapy, we breathe a sigh of relief and draw closer. Look how restful it is for her, enjoying a nice sandwich and sleeping peacefully in her childhood bed.

You’d think the outlook would be sunnier on some of the lighter TV dramas and comedies, which have also lately offered several strong and inspiring (if neurotic) female protagonists, from Annie Edison of “Community” to Leslie Knope of “Parks and Recreation.” Yet here, too, an alarming number of accomplished women are also portrayed as spending most of their waking hours swooning like lovesick tweens — whether it’s Emily on “Emily Owens, M.D.” (a knowledgeable doctor who loses focus whenever her super-dreamy crush enters the room), the title character of “Whitney” (a garrulous photographer who is nonetheless fixated on her looks and her ability to keep attractive romantic rivals away from her man), or Mindy of “The Mindy Project” (a highly paid ob-gyn who’s obsessed with being too old and not pretty enough to land a husband). Even a classical comedic heroine like Liz Lemon on “30 Rock” is frequently reduced to flailing and squirming like an overcaffeinated adolescent. The moral of many of these shows doesn’t seem so far off from that of those fatalistic female-centric magazine features that seem to run every few months; something along the lines of, “You can’t have it all, ladies, and you’ll run yourself ragged if you even try.”

We could take heart that at least women are depicted as being just as reckless and promiscuous and demanding and intense as their male counterparts, if their bad behavior weren’t so often accompanied by a horror soundtrack and dizzying camera angles that encourage us to view them as unhinged. The crazed antics of male characters like Don Draper, Walter White or Dr. Gregory House are reliably treated as bold, fearless and even ultimately heroic (a daring remark saves the big account; a lunatic gesture scares off a murderous thug; an abrasive approach miraculously yields the answer that saves a young girl’s life). Female characters rarely enjoy such romantic spin.

Their flaws are fatal, or at least obviously self-destructive, and they seem designed to invite censure. Time and again, we, the audience, are cast in the role of morally superior observers to these nut jobs. At times we might relate to a flash of anger, a fit of tears, a sudden urge to seduce a stranger in a bar, but we’re constantly being warned that these behaviors aren’t normal. They render these women out of step with the sane world.

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Our homes are an extension of who we are: what we do within the walls of our abodes shapes our mood, affects our productivity, and influences our outlook on life. Scientific studies have shown that we can have an impact on our happiness by adjusting the tiny little habits and routines that constitute our daily lives — we are, in fact, in control of our outlook on life.

It's amazing how a few tweaks to our daily habits can become a catalyst for meaningful, positive change. Here are a few simple things you can do every day to feel happier at home.

1. Make your bed. In a popular post last month, I explained the many benefits of daily bed-making. Gretchen Rubin, New York Times best-selling author of The Happiness Project, explains that this three minute task is one of the simplest habits you can adopt to positively impact your happiness.

2. Bring every room back to "ready." I learned this trick from Marilyn Paul's clever book, It's Hard to Make a Difference When You Can't Find Your Keys. It's a known fact: Clutter causes stress; order creates a haven from it. This mood-boosting routine is simple: Take about three minutes to bring each room back to "ready" before you depart it. (Unless you have a toddler, or a partner who likes to simulate earthquakes, three minutes should be sufficient.)

3. Display sentimental items around your home. One reason that experiences (and memories of those experiences) make us happier than material things is due to the entire cycle of enjoyment that experiences provide: planning the experience, looking forward to the experience, enjoying the experience, and then remembering the experience. Make your home a gallery of positive memories.

4. Start a one-line-a-day gratitude journal. Before bed, simply jot down one happy memory from that day. (If you have kids, you can ask them, "What was the best part of today?") Reflection is an important part of happiness, and pausing to reflect on a positive event from each day cultivates gratitude. (An added bonus: Later, when your memory is defunct, you will already have all of your meaningful adventures recorded!) If you have trouble getting started with journaling, consider buying a book to guide you. Simple Abundance, by Sarah Ban Breathnach, is a great one.

5. If you can't get out of it, get into it. This tip comes from The Happiness Project. I love the message: The dishes are not going to clean themselves, so you will do it, and you will like it! (Unless, of course, you can outsource this job, in which case I say: Nice work!) Otherwise, get into doing the dishes. Feel the soothing warm water on your hands. Enjoy the tickle of the tiny bubbles. Crank your favorite album at an unusually loud volume, do a couple fist-pumps while shouting "Can I get a hell yeah for the dishes? Hell! Yeah!" and pretend you love it.

6. Before you get up each morning, set an intent for the day. In The Art of Happiness, the Dali Lama says ""Every day, think as you wake up: today I am fortunate to be alive, I have a precious human life, I am not going to waste it." Wow. What a wise man. I tend to wake up with a strong visceral reaction that says, "Attention human beings: Be afraid of me before coffee. Be very afraid!" Setting a daily intent makes a huge difference. Your daily intent could be something like "be productive" or "enjoy today's delicious moments" or it could be something more specific like "say thank you to my loved ones today." But it should not be another "to do" item on your list.

7. Do small favors for your housemates, expecting nothing in return (not even a thank you!). (That's right, I said it: nothing!) Mow the lawn for your husband, but don't expect him to pat you on the back. Make the bed for your wife, but don't try to get bonus points for it. Take the trash out for your roommate, just because. The ability to cultivate strong, healthy relationships is one of the biggest contributors to health and happiness, but when you start to keep score, the benefit is lost. (No! It's YOUR turn to clean up the dog poop!) It's a well-known fact: When you do good, you feel good.

8. Call at least one friend or family member a day. You can do this while you clean, while you make the bed, or while you walk the dog. Texts and emails do not count! Make an actual phone call to a loved one, just to chat and catch up. We humans are social beings and studies show that even when we don't feel like it, even if we are naturally introverted, socializing with our loved ones makes us feel better.

9. Spend money on things that cultivate experiences at home. Save money for a new grill for parties or a new DVD for family movie night — something that will encourage you to have people over and entertain. Plan a summer barbeque, invite your closest friends, kick back and relax. (And don't forget to print out the pictures to remember the good times.)

10. Spend a few minutes each day connecting with something greater than yourself. Whatever your spiritual beliefs — or non-beliefs — may be, studies show that connecting to a high power is correlated with happiness. Just stepping back to realize that we are part of an enormous universe can put some perspective on your annoyance with the those-are-definitely-not-mine-and-they-are-abso-fricking-lutely-repulsive socks under the coffee table. Before bed, spend just a few minutes contemplating something larger than yourself. Take a walk in nature. Write in a journal. Create a sacred space in your home. (Or if spirituality is really not your thing, create a home spa: light some candles, soak in a hot bath, delve into a good book… are you feeling better yet?)

(Image: Callen & Eli's Artful Treehouse)

Looking for something to help you relax before bed that doesn't involve popping a pill? You might want to load up your iPod with a song by Manchester band, Marconi Union. Sound therapists were able to rate ten of the most relaxing songs, with Marconi Union's 8 minute trance-inducing tune, "Weightless", coming out on top thanks to its continuous rhythm of 60 BPM, an ideal tempo for synchronization with the heart and brainwaves, making it an ideal audio accompaniment for a good night's rest. Listen to it under the jump…

Lyz Cooper, founder of the British Academy of Sound Therapy notes:

"While listening, your heart rate gradually comes to match that beat. It is important that the song is eight minutes long because it takes about five minutes for this process, known as entrainment, to occur. The fall in heart rate also leads to a fall in blood pressure.

The harmonic intervals - or gaps between notes - have been chosen to create a feeling of euphoria and comfort. And there is no repeating melody, which allows your brain to completely switch off because you are no longer trying to predict what is coming next.

Instead, there are random chimes, which helps to induce a deeper sense of relaxation. The final element is the low, whooshing sounds and hums that are like buddhist chants. High tones stimulate but these low tones put you in a trance-like state."

The Top 10 Most Relaxing Tunes:
1. Marconi Union - Weightless
2. Airstream - Electra
3. DJ Shah - Mellomaniac (Chill Out Mix)
4. Enya - Watermark
5. Coldplay - Strawberry Swing
6. Barcelona - Please Don't Go
7. All Saints - Pure Shores
8. Adele - Someone Like You
9. Mozart - Canzonetta Sull'aria
10. Cafe Del Mar - We Can Fly

MORE LIFE AT HOME ON APARTMENT THERAPY:
• 10 Simple Things to Make You Happier at Home
• Your Weekly Retreat: How To Relax & Eliminate Stress at Home
• 4 Goals to Boost Happiness at Home
• Simple Ways to Relax and Enjoy Hosting

Via Shortlist.com

(Image: Shutterstock)

The picture to the right summarizes what my thoughts were one day, but of course the weight didn't just melt off after that, it took work.

What started the journey was the DECISION to make a lifestyle change which entailed a major diet change and adding exercise to my life.

I also had to STOP making excuses.

If you keep making excuses, the list below and any type of inspirational quote will never help you get to where you want to go.

The purpose of the list is to illustrate what actions I took that assisted me lose my weight. People always ask me, "how did you do it?"

So I figured I might as well document "how" I did it and I am hoping that 1 or 2 things will help someone with their weight loss journey.

These are not in any type of order. In the comments section, please go ahead and add anything that worked for you or add them on my Facebook fan page.

Now please keep in mind while reading the below that I am not a nutritionist or personal trainer. I am just a person with knowledge that was gained through experience.

1 - Prepare Breakfast at Home

What didn't work: Back in the day, I would wake up with enough time to just shower, shave and walk out the door.  I would then pick up some type of fast food breakfast "meal" on the way to work.  Typically the visit would include leaving with at least 2 sandwiches and a large soda.  With all those calories, this obviously helped me gain weight and eventually reach 355 lbs.  If it wasn't a breakfast sandwich, it was donuts.

What worked: Started preparing and eating my breakfast at home. Yes, this meant I had to get up at least 30 minutes earlier than what I was doing before I made the lifestyle changes. I stopped visiting McDonald's or Burger King or any type of doughnut shop. This stopped me from consuming up to 600-800 calories before I even started the work day and then eventually crashing later in the morning due to all the bad food I ate.

Nowadays, I eat foods that will give me energy, have complex carbs, fiber and protein and I always keep the total nutrition value in mind. Over the years I went through phases of having some of these items before I left to work: 4-5 egg whites, 2 full eggs, oatmeal, steel cut oats with berries and veggie/fruit smoothies with my Vitamix blender.

You Can Do It! What I suggest to others is that as soon as they wake up they drink 16-20 oz of room temperature water (with lemon or without) and then eat some type of breakfast at home.  Some examples are: 3-5 Egg whites, 1-2 full eggs, fruit, steel cut oats, veggies or fruit with eggs. What to avoid: sugary items or breads. These type of foods do not have a any type of nutritional benefits, will cause a energy crash and they will not help keep you full.  Fiber is key here because it will assist with having a "full" feeling. Keep your calorie count in mind. Visit MyFitnessPal if you are not sure how many calories you need to eat on a daily basis.

2 - Prepare and Bring Lunch to Work

What didn't work: In the 350+ lb days, lunch was about visiting a local fast food establishment and eating what sounded or looked good. Not too many veggies or fruits were involved in these meals.  Number of calories were never thought about and extra cheese sounded good to me. Once in a while i would bring in left overs, but I am pretty confident it was not a salad.

What worked:  I prepared my lunch at home and brought it to work in a lunch cooler. Yes, I still do this today, even if I have to carry it while taking the train and walking a mile to work. I have learned that the preparation part really does not take too long and at times it can be done the night before.  The majority of the time, my lunch meal has been the same over the last 5+ years or so. Nowadays, it typically is a salad (baby spinach, cucumbers and tomatoes) with chicken.

You Can Do It!  Find what you like to eat (that is nutritious) and bring it to work.  Do you like chicken, fish, meat?  Can you have that with some type of salad (lettuce or spinach)?  Add some fruit to it and you will have a nutritional meal and you will have a good amount of energy to finish the day.  Basically what I suggest is to make sure your meal has veggies and fruit and you decide if you want to add meat or not.

What to avoid: meals with a lot of carbohydrates, sodium or sugar. The good news is that whatever you bring to work should be better than what most restaurants have to offer.

3 - Prepare a Workout Schedule

What didn't work: Not working out. I never ran before I started on my journey, I rarely lifted weights during my younger years.  The lack of movement in my early years is the reason why I was overweight for the first 25+ years or so.

What worked: Setting a workout schedule and being flexible with it. At times throughout these years, I have worked out at a gym and then other times at home. Choose what is best for you and will help you succeed.  When I first started I determined what days worked out best for me and at what time of the day.

I stuck with this, unless my wife and I had some type of obligation. If we had an appointment then I switched around the time or day, but rarely skipped my workout. For a while I worked out after work, then I changed it up and I would wake up at 3:30am and complete my workout before my work day began.

Today, I do a mixture. Some days at 4:30am and other times at 7:30pm. My wife and son know what days I workout and what days I rest. The days I rest or workout in the morning, I read to my son at night. The nights I have to workout at night, my wife does the reading. I like to find a balance between my working out and my responsibilities as a parent. The main component of my exercise routine is running because I am a runner with many running goals. I have gone through phases where weightlifting days were just as important.  However, for me running is what helped me drop the weight quickly.

You Can Do It! Set a schedule. Determine how many days you want to commit to.  Is it only 3 because you are busy with other obligations, then do 3. It's better than none. Can you do 5?  Then pick which days it will be, communicate it to your family, then get going. Are you a morning person or night?

Pick the time and start the journey.  The time you do it vs. someone else is not important, just do what works for you.  Also, I truly believe after so many hard lessons (injuries), that your body and mind need to rest from exercise.  So when you do have a rest day, rest it. Do not force some type of activity on that day.  I also recommend you mix up your workouts.  If you are a runner, add weight workouts and bike days so your body is building and using other muscles.

4 - Prepare Some Goals

What didn't work: Not having any fitness or weight loss goals. When I didn't have any goals, I had  nothing to strive for, I lost focus and I wanted to give up some days.

What worked: Setting weight loss or fitness level goals. I knew I wanted to lose at least 100 lbs, but I also knew I needed to break that into mini-goals. So every 3 months, I set a goal of losing 25 lbs. It gave me a good benchmark and pace to meet my goal of 100 lbs in one year (ended up losing it in 11 months).  The short term goals pushed me to high levels too.  If I wanted to be negative 25 by week 12 and in week 11, I had a total of minus 23 lbs, I did what it took to lose those last two to be sure I met my objective and kept me on pace to lose the next 25.

You Can Do It! What are your goals?  Do you need to lose 50 lbs?  Do you want to do it this year?  If so, then break it over the number of months left in the year, then set mini-goals.  Have something to shoot for every 2-3 months.  If you only have one goal, it will be hard to be telling yourself you are making progress.  Meeting any type of goal, feels great which is why those mini ones are important to have. It does not have to be a weight goal either. It can losing a certain number of inches, it could be running a 5k, it could be anything you want, but make sure you have something to keep you honest with your progress.

Remember, this is a journey.  

It is okay to fail.  What matters is that you get back up. You can't lose 100 lbs in 10 days, it is just not that easy.

Let it be be hard, you will learn so much about yourself and what you are capable of.

All the knowledge you gain along the way will make you a better and stronger person.

Written on 2/25/2013 by Fred Lechuga. Fred Lechuga is author of the weight loss journey website, Fat2fitFred.  Fred lost 150+ lbs with lifestyle changes to his eating habits and adding exercise to his daily routine.  He has now kept it off for 5+ years.  The blog website includes stories about how he lost weight, kept it off and his running experiences.  It will also include stories about other people who have succeeded with make dramatic changes to their life.  He is now a marathon runner, with a PR of 4 hours, 11 minutes and a half-marathon PR of 1.50. You can find him on Twitter, Facebook and Google+.