The Hard Stats About Stress, Made Beautiful.

Stress is a killer.  We all know it, but it can be shocking to see it – really see it. That’s why I love this infogram that I stumbled across from Katie Hess, the flower guru at LOTUSWEI flower essences. Such an eye opener!  Thanks to Katie and lotuswei for permission to use. 🙂 I’m seriously considering joining the Flowerevolution movement.




Learn the stats about stress with this beautiful LotusWei-Infographic

Learn the stats about stress with this beautiful LotusWei-Infographic

We’ll talk more about alternative ways to reduce your stress level in subsequent posts, but also check here for information about Nine Practices to Create Happiness and here for information about dropping the addiction to overthinking. Now that you know the stats about stress it’s time to do something about it!



I Have MTHFR C677T Mutation – What Does That Actually Mean?

MTHFR mutations are just starting to be recognized as an issue and so more and more doctors are testing, but what happens if your doctor tells you that you’re homozygous for MTHFR C677T? They might as well be speaking Greek! So here’s the skinny on what that really means. Also here’s a post about MTHFR mutation basic in general.

MTHFR C677T Terminology Basics (or as basic as we’re going to get with genetics).

The simplest level of information here is just the plain genetics.  Here are some quick factoids to get us started:

  • MTHFR is the short name for the genes that code for the enzyme that changes folic acid to the active form that your body uses (the long name is methylfolate reductace).
  • 677 is the marker for one particular MTHFR gene.
  • The official genetics labeling of this gene is Rs1801133. Sigh.
  • You get one copy of this gene from your mother and one from your father, so there are two possible copies that can be either “normal” or “mutant”
  • If you inherited one good copy and one bad copy that’s called “heterozygous C677T”
  • If you inherited two bad copies (one from each parent) that’s called “homozygous C677T”
  • C…T stand for the bases that you actually have.  C = cytosine, T = thymine.  Bases are essentially the letters that spell out your genetic code.  There are four of them commonly (C, T, A and G).
  • When this gene is “normal” it looks like MTHFR C677C.
  • Heterozygous mutations are MTHFR C677T because there is one normal C and one abnormal T. Also occasionally written 677CT.
  • Homozygous C677T can also be written as T677T (because there are two abnormal copies with T instead of C). Occasionally you’ll also see it written 677TT




Phew! So the take-away there is MTHFR C677T means you have at least one bad copy of this gene, and if it’s called homozygous, or T677T then you have two bad copies.

How Much of a Problem Is This?

This can be a significant problem If you don’t have a good diet or you don’t take supplements. If you get lots of dark green leafy veggies, legumes and other food sources of natural folate – see this post – then you’re probably already getting good methylfolate. If your diet isn’t up to scratch, then supplementation can be useful and here’s a whole post about that.

Heterozygous MTHFR C677T have about 65% normal MTHFR activity (so 35% compromise) and homozygous MTHFR C677T (T677T) have about 30% normal activity (so 70% compromise). Normal activity refers to the way your body activates your folic acid so that it can be used, so compromise usually looks like a functional folate deficiency.

What Are The Health Risks of C677T Mutation?

According to SNPedia, which compiles research on genetics, C677T mutants have been shown in at least one research study to have an increased risk for:

  • Midline defects such as:
    • Cleft lip
    • Cleft palate
    • Neural tube defects
    • Facial asymmetries
  • Cancers including:
    • Breast
    • Lung
    • Brain
    • Stomach
    • Head and neck
    • Kidney
  • Cardiac-related issues including:
    • Thrombosis (increased tendency to clot inappropriately)
    • High homocysteine levels (a heart risk)
    • Pre-eclampsia (dangerous high blood pressure in pregnancy)
    • Vascular dementia
  • Fertility issues including:
    • Multiple pregnancy loss
    • Low sperm count
    • Birth defects such as down syndrome
  • Neurological issues including:
    • Migraines
    • Autism
    • Alzheimer’s dementia
  • Mood and psychological issues including:
    • Depression
    • Anxiety
    • Schizophrenia

You’ll notice that this is quite a list, and it can be a little daunting to think about when you’re just learning about this.

What Do You Do About This?

Compromise with the MTHFR C677T gene can have severe consequences so it’s important to work on getting good sources of natural folate, which is generally useable by mutants, or 5-MTHF (5-methyltetrahydrofolate) which is already methylated so the genetic compromise doesn’t matter.  As discussed in this article, I feel supplementation should be started slowly because for many mutants who haven’t had active forms of folate very much in their lives it feels really strange when those active forms start showing up and there is a whole lot of adjusting by your body.  This activated folate is used by your body to run enzyme pathways, to aid in some parts of normal metabolism, to help your body detoxify and even to methylate your DNA. If it isn’t there then your body does what it can, but what it can’t do starts to pile up. Any time you start supplementation then your body starts digging in that pile to clear up high priority items.  This is exactly what we want, but if you start with high doses of a supplement then it’s a little like drinking from the firehose.  Kind of out of control and not very pleasant.

A great way to start if you’re unsure, is with a folate-rich diet.  I love this image because it kind of covers what we’re looking for.  Hint – think dark greens and beans. 🙂

Is folate in foods safe in MTHFR mutants? In these foods YES - even for MTHFR C677T mutants. Thanks to exhibithealth.com for the great image.

Is folate in foods safe in MTHFR mutants? In these foods YES, even for MTHFR C677T mutants. Thanks to exhibithealth.com for the great image.

Can Mutants Become “Normal”?

If you’re a mutant (like me) then you’ll always be a mutant, but it doesn’t have to matter. Essentially as long as you’re getting enough of the active form of folate then the mutation doesn’t have to matter.  If you aren’t, then it matters a lot.

The bottom line is MTHFR C677T mutations don’t have to mean anything at all as long as you supplement and have a good diet (here’s an article about a folate-rich diet for MTHFR mutants) I always suggest taking a little more care with yourself too.  There are known health risks for things like clotting, fertility and cancers so it makes sense to take some precautions.  Eat your fiber, do your exercises, get your sleep and generally treat yourself with high regard – shouldn’t we all anyway?



Gallbladder Sludge in Pregnancy – What Now?

Go figure that pregnancy with all of it’s rapidly and vastly changing hormones is one of the most common triggers for gallbladder sludge, and it’s also one of the hardest times to do anything about it. Let’s look at why it happens and what you can do about it. If you’re unclear about what the gallbladder does, and what sludge is then read this post first.

Symptoms of Gallbladder Sludge in Pregnancy

Gallbladder can cause a wide range of issues ranging from mild to severe, but any issue is worth discussing with your doctor because untreated disease can lead to complications for the pregnancy. Symptoms include:

  • Itching – on belly, palms and soles or all over. This can happen with or without a rash. If it’s serious, go to your doctor.
  • Right sided digestive pain – at the bottom of your rib cage on the R side or radiating into the R shoulder blade, R shoulder or even L shoulder blade.
  • Gas
  • Bloating
  • Digestive discomfort
  • Diarrhea
  • Constipation

Why is Gallbladder Sludge So Common in Pregnancy?

Gallbladder sludge essentially happens when your gallbladder is overwhelmed by too much cholesterol and not enough bile.  You’ll recall that the bile acts as kind of a “soap” to emulsify fats and make them more water soluble so that they can be both excreted and absorbed in the digestive tract. Just like with dish soap, if there is too much fat or grease and not enough soap you get a sludgy goo that tends to stick to everything and generally get in the way. Hence gallbladder sludge. But why does this happen in pregnancy? Many reasons:

  • Huge hormone shifts – Rapid changes in hormone levels mean that lots of hormones (fat soluble) are being excreted by the liver, and fat soluble toxins are excreted via bile. In fact, below are pictures of a cholesterol molecule and an estrogen molecule – no doubt you’ll notice the similarities (and estrogen along with the other sex hormones is made in your body from cholesterol).

    Estrogen and testosterone (progesterone as well, but it's not pictured) are incredibly similar to cholesterol, which is why gallbladder sludge in pregnancy is such an issue.

    Estrogen and testosterone (progesterone as well, but it’s not pictured) are incredibly similar to cholesterol, which is why gallbladder sludge in pregnancy is such an issue.

  • High Water Use – Pregnancy uses a lot of water – your body is building a human and that’s no small task. It requires that you also create lots of extra blood, extra fluid to protect and support the baby and of course, all the water that goes into the baby.  Not only that but there are thousands of extra metabolic processes happening to make all of this go.  It’s just a big time for water, and so mild to moderate dehydration is incredibly common – especially in early pregnancy before mama’s intake has adjusted sufficiently to cover it all.  Dehydration is also a risk factor for gallbladder sludge just because all bodily fluids, including bile, get a little thicker and sludgier if there is less water to go around.
  • Estrogen – High estrogen is a risk factor for gallbladder sludge, or cholestasis, independent of pregnancy as well (at least it is in animal studies). In fact, the risk factors for gallstones are called the five F’s – Fair, Female, Fat Fertile and Forty. Lovely.
  • Genetics – There are some genetic conditions associated with gallbladder sludge (more specifically with Intrahepatic Cholestasis of Pregnancy, or ICP). So chances are if your mother, aunties, sisters or grandmother had troubles, you may be at greater risk.

Are There Natural Ways to Help Gallbladder Sludge in Pregnancy?

Yes and no. Pregnancy is a risky time to use any natural or medical treatment and many drugs and supplements are off limits because they may cause harm to the baby. If you’re not pregnant, then here’s a whole post about gallbladder sludge and stones. If you are, then here are the things you can do:

  • Diet – Pregnancy is a great time for a healthy diet anyway, so might as well do a healthy gallbladder-friendly diet. This means:
    • No fried foods
    • Lots of fruits
    • Limited red meat, butter, shellfish and eggs
    • LOTS of veggies – especially dark green leafy veg
    • Good lean meat, poultry and fish
    • High fiber foods – aim for 30 – 50 g per day – some examples below
      • Split peas – 16.3 g per cup cooked (split pea soup. Yummy.)
      • Lentils – 15.6 g per cup cooked
      • Black beans – 15 g per cup cooked
      • Artichokes – 10.3 g each and also gently boost liver function
      • Broccoli – 5.3 g per cup boiled
      • Raspberries – the yummiest 8 g per cup ever
      • Bran flakes – 7 g per cup
      • Avocado – 12 g each




  • Water – Bump the water WAY up. Aim for 12 eight ounce cups with 8 eight ounce cups being the absolute minimum. This will suck because pregnancy makes you pee all the time anyway and drinking this much water will have you running to the bathroom constantly. Sorry! It’s better than a gallbladder attack, believe me.
  • Lecithin – Lecithin is safe in both pregnancy and nursing because as it turns out, one of it’s major ingredients, choline, is great for baby. Typically midwives and doctors suggest 1200 mg 3-4 times per day with lots of water, but here’s more information about lecithin and it’s use in gallbladder issues. It’s also great for blocked ducts when you’re nursing and gallbladder sludge even when you’re not preggers.
  • Gentle Exercise Regularly – Exercise is good for everything in the human body, including the gallbladder. For many women this will actually eliminate mild symptoms.
  • Castor Oil – Topical (NOT INTERNAL) castor oil over the right side of your abdomen and back can help your body to deal with some of the sludge in a gentle way. Here’s a whole post on it with more detailed information. And Here’s info on a great lazy method of doing a castor oil pack. This is both anti-inflammatory and also good for the functioning of the liver and gallbladder.
  • Lukewarm Epsom Salts Baths – The magnesium in the Epsom salts will help to relax the bile duct and allow sludge to pass more easily, and the lukewarm bath can help to relieve the itching.

    Doing all of this in 9 months isn't easy! Great picture from free image.com/Jose Torres.

    Doing all of this in 9 months isn’t easy! Gallbladder is one of the places that fallout can happen. Great picture from free image.com/Jose Torres.

What About Not-Natural Ways to Relieve Gallbladder Sludge in Pregnancy?

If you’re having gallbladder attacks on top of the already uncomfortable state of being pregnant, then sometimes you want a faster option. Also severe gallbladder attacks with protracted vomiting, inflammation or infection can be a serious risk to your baby, so there’s that too.

  • Ursodiol – this prescription drug may be suggested by your doctor to help manage symptoms and increase bile flow.
  • Surgery – It is possible to have your gallbladder removed during pregnancy and sometimes it’s necessary. The second trimester is considered the safest time for both mother and baby to undergo this procedure. Depending on your doctor they  may suggest laparoscopic removal or open gallbladder surgery.

Remember pregnancy is a rough time anyway because your body is doing so much, changing so fast and generally working so hard. Be gentle with yourself, talk with your doctor, and don’t judge – sometimes you can use the natural methods for working with gallbladder sludge in pregnancy and sometimes you really do need something more intense, like surgery.



The Benefits of Being Sick – Audio!

The folks at the Diabetes Research Council were kind enough to turn a previous post, The Benefits of Being Sick, into an audio file.

That silky smooth voice isn’t mine (sadly), the post is being read by Holly Houston so please enjoy! The audio version will be in the original post as well, but I wanted to make sure that everyone sees it (or hears it, as the case may be.)

The Benefits of Being Sick, read by Holly Houston:




 

This is a good post to come back to occasionally, because it’s so easy to forget that black and white aren’t all there are.  That sometimes even “bad” things like being sick, brings you some “good” things. It’s a big deal to think about it. Thanks for listening!



Lecithin for Blocked Ducts and Gallbladder Sludge

If you’ve had gallbladder sludge, blocked ducts in your gallbladder or blocked ducts in your breast you know just how painful and horrible this can truly be. In good news there is a reasonably simple food supplement that can make a huge difference while you’re working on clearing things out, called lecithin.

What is Lecithin?

Lecithin is naturally occurring in such common foods as soy, egg and sunflower seeds. It’s a compound called a phospholipid, which is a phosphate head bound to long lipid tails. The phosphate head is water soluble, and the lipid tails are fat soluble so lecithin is a great natural emulsifier, meaning it helps to blend fat and water. Lecithin  is used as a food additive frequently for this very reason – it helps to keep fats suspended in a water solution. As a supplement it is sold in both a granule form that you can add to cereal, oatmeal, soups or just about any other food as well as a capsule.  The granules have a nice, nutty sort of flavor that adds well to things and the capsules are , well, just capsules.

Lecithin helps emulsify gallbladder sludge and open blocked ducts in the gallbladder or breast. It's commonly found in soy, sunflower and egg. Photo by John Sullivan

Lecithin helps emulsify gallbladder sludge and open blocked ducts in the gallbladder or breast. It’s commonly found in soy, sunflower and egg. Photo by John Sullivan

Why Does Lecithin Work for Blocked Ducts And Gallbladder Sludge?

Gallbladder sludge is a thick waxy build up of cholesterol and other sterol-type fats bound to bile salts.  Under normal circumstances this is a fluid mixture, but when it gets too thick it becomes waxy and semi-solid.  Blocked breast ducts are also filled with a condensed form of breast milk that is very fat-rich.  Therapeutically , we are looking for this same emulsifying action – we want to allow water to easily add into the mixture to loosen things up and get them moving. Quite literally we want to emulsify the gallbladder sludge or thickened breast milk with water so that it can pass.Lecithen, as a potent emulsifier, does a great job.

How To Take Lecithin For Gallbladder Sludge

If you’re having mild trouble with gallbladder sludge that gives you low-grade symptoms or frequent mini-attacks then 4000 – 5000 mg per day in divided doses will help to prevent further attacks and keep the sludge moving.




If you’re having a strong acute attack that isn’t serious enough for the hospital then 4000-5000 mg every 4 hours with lots of water until it resolves (not more than 24 hours without talking to your doctor or knowing for sure that it truly is gallbladder sludge and not a gallstone emergency). If the lecithin isn’t producing any changes or the symptoms get worse please do seek medical attention because if gallstones get stuck in a duct and block bile flow completely it can be a medical emergency.

How to Take Lecithin for Blocked Milk Ducts

If you’re having recurrent blocked ducts or always feel like you’re hovering on the cusp of a blocked duct then 1200 mg four times daily will help to prevent further issues.

If you’ve already got a blocked duct that you’re trying to loosen up then 4000 – 5000 mg every 4 hours with lots of water until it resolves.

How to Make The Lecithin Work it’s Best

There are a few things you can do to support the action of lecithin so that you’re getting the most benefit from it:

  1. Water – obviously we’ve got the fat, but we need the water to make the emulsifier work.  Aim for 10 8 oz glasses per day if you’re having issues with blocked ducts or gallbladder sludge. **Lecithin will not work without water**
  2. Heat – physically warming up the area can help to relax and open ducts, as well as “melt” the fatty plug. A hot compress such as a hot water bottle, infrared heating pad or wash cloth soaked in hot water over the breast area or gallbladder area (on your right side just under your rib cage straight below the nipple from the front to the back at the same area) will help to loosen things up and get them moving.
  3. Castor Oil – if you’ve read my blog before you know how much I love castor oil. *Love* castor oil. It can be rubbed on the breast tissue (be sure to wipe off completely before your baby nurses) or over the entire liver/gallbladder area to reduce inflammation and help to get things moving as well.  Even better is the combo of castor oil + heat.  Just be sure to put on an old T-shirt because the oil is heavy and will stain clothes. Here’s more information about castor oil in general and castor oil for gallbladder health.
  4. Rest – blocked ducts and gallbladder sludge are both reasonably difficult for your body.  They produce a lot of inflammation and can lead to infection and other problems if left untreated so you will need more rest, more support and generally a little more TLC while this is going on.

Other Uses for Lecithin

Lecithin, as it turns out is great for lots of things:

  • Natural source of choline
  • Improves brain heath, cognitive function and memory, possibly even ADHD
  • Reduce cholesterol and triglycerides and increases HDL (the good cholesterol)
  • Used in the formation of neurotransmitters such as acetylcholine
  • Supportive in pregnancy, as a source of choline, to help prevent neural tube defects and help healthy brain development
  • Mildly anti-inflammatory
  • Helps to gently improve anxiety
  • Helps to supplement nutritional deficiencies created by alcohol consumption.

Lecithin is a simple, safe, low-cost, beneficial supplement for blocked ducts, gallbladder sludge, and blocked bile ducts but don’t forget the water!



Is Genetic Testing Necessary if You Suspect MTHFR Mutation?

The quick answer is no. You probably don’t need genetic testing for MTHFR even if you suspect there’s a problem, but you still might want it.  If that isn’t enough information, then read on!

Why Genetic Testing for  MTHFR Might Not Be Necessary

  1. For many people with the MTHFR mutation, there is a simpler, more medically recognized, cheaper test called homocysteine.  For the majority of MTHFR folk homocysteine levels become elevated because of the lack of usable folate. This test is cheap and you won’t have any trouble talking your doctor into ordering it.  Bonus!
  2. Dr. Charis Eng, a prominent geneticist at the Cleveland Clinic makes a great argument that really, if you suspect a mutation, you can just take the methyl-folate and appropriate B vitamins and you’re done.  No harm, no foul. In short you don’t need genetic testing because you can just go ahead and take the vitamins. Good point Dr. Eng!
  3. Even with a complete genetic profile run through every methylation panel out there, finding the right dose of methylfolate for you is still a lot of educated guessing and trial and error. Testing might give you guidelines, but you really still have to start slowly and work your way up.

    Kind of awesome picture of human chromosomes. Genetic Testing for MTHFR doesn't look this cool, but still.

    Kind of awesome picture of human chromosomes. Genetic Testing for MTHFR doesn’t look this cool, but still. Image by Andreas Bolzer, Gregor Kreth, Irina Solovei, Daniela Koehler, Kaan Saracoglu, Christine Fauth, Stefan Müller, Roland Eils, Christoph Cremer, Michael R. Speicher, Thomas Cremer – Bolzer et al., (2005) Three-Dimensional Maps of All Chromosomes in Human Male Fibroblast Nuclei and Prometaphase Rosettes. PLoS Biol 3(5): e157 DOI: 10.1371/journal.pbio.0030157, Figure 7a, CC BY 2.5, https://commons.wikimedia.org/w/index.php?curid=1371900




Are There Reasons Why I Should Do Genetic Testing for MTHFR?

There are certainly some compelling reasons to get the testing done, not the least of which is your kiddos.

  1. With genetic testing, especially the complete information gathered from 23andme, you have a better idea of not only your MTHFR status but also about all of the other genes that play into the methylation and detoxification process.  It helps us understand all of the ways you might be compromised and so gives a more solid starting place. (If your doctor runs the MTHFR test then really you’ll only have info about MTHFR, not about any of the related genes).
  2.  You know right away how compromised you are (check out these handy graphics if you can’t remember) and generally the more bad copies of the genes you have the slower you want to go with supplements and detox.
  3. If you have kids or are thinking about having kids it really helps to know what their chances are of picking up bad copies of these genes from you.   If you know there might be an issue then you can start helping them find balance while they’re young (or even before they’re born).

What are the Options for Genetic Testing for MTHFR from my MD?

MDs have started ordering testing – especially if you have some strange blood coagulation issues, if you’ve had repeat miscarriages, or if you pester the hell out of them. Insurance will only cover testing if it’s “medically necessary” – and typically that is only if there are weird blood clotting issues. Just keep that in mind. There are only a few MTHFR tests that are FDA approved, and none of them are intended for people with anxiety, depression, inflammatory disorders, etc… They still work, but it can be hard to talk your doctor into ordering them. These are all spendy if insurance isn’t paying for them, so ask your doctor before you have them run.

Is there Genetic Testing for MTHFR that You Can Run Yourself?

This is by far my favorite option, simply because you get so much for so little money (relatively speaking).  It’s 23andme. They provide you with a saliva test kit that you mail in and in about a month you get a whole heap of information online including info about your ancestry, about your genetic response to certain pharmaceutical drugs, and about different health risk factors. At the time of this article it’s $199 US or $249 Canadian. Typically this is cheaper than the FDA approved testing and there’s far more information. Embedded in all of this information is your MTHFR status, although it’s hard to find unless you run your results through some kind of interpretation engine.

In terms of interpretation for MTHFR there are a couple that I like.  The one I suggest most often is called “genetic genie” and they have a methylation panel (that uses the raw data from 23andme) and a detox panel (again with the 23andme). The reports are very complete and they ask for a modest donation.  Freaking awesome.

Another good option are the reports from MTHFR support.  This report shows more gene snips than the genetic genie report, but gives less information about each one.  It also costs a little more (but still totally reasonable).  Like genetic genie, MTHFR support doesn’t actually test the genetics – you need 23andme for that – they just interpret the information.

At the end of the day you can get genetic testing for MTHFR if you choose, but you don’t really have to – you can also just go ahead and start to supplement if you suspect an issue. I’m a total geek for information, so of course I got mine done by 23andme (I’m 3% neanderthal, in case you were wondering, because obviously that is information everybody needs).  I’m glad I know, but honestly it really didn’t change too much about the way I approach my dosage of methylfolate.  It’s just better information for me (and for my kiddos).



Help! I Still Have Gallbladder Pain After Removal.

I can’t tell you how many times I’ve heard this – “I got my gallbladder removed, even though I didn’t want to, but I’m still having gallbladder pain after removal.” “They told me the surgery would fix it, but…” Yup.  Sometimes the surgery doesn’t actually make the pain disappear, so now what?  Good news, there is a lot you can do about this, but it helps to know exactly what you’re dealing with.

How Could I still Have Gallbladder Pain After Removal?

There can be many causes for this, but the simple version is that typically when the gallbladder is removed, all or part of the duct work stays behind. Therein lies the typical culprit.

All those skinny little tubes are ripe for problems that can lead to gallbladder pain after removal. GallbladderAnatomy.png by LukesAnatomy (talk); conversion to SVG by Angelito7 (talk) - GallbladderAnatomy.png, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=29818837

All those skinny little tubes are ripe for problems that can lead to gallbladder pain after removal. GallbladderAnatomy.png by LukesAnatomy (talk); conversion to SVG by Angelito7 (talk) – GallbladderAnatomy.png, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=29818837




Here are the four “S’s” of gallbladder pain after removal:

  1. Stones – Sometimes there are still gallstones, or small calcified spots left in the remaining ducts or even in the ducts from the liver that head towards the (now missing) gallbladder. These hurt just as much as the stones in the gallbladder itself.
  2. Sludge – There can be sludge still in the remaining ducts, even if the stones are gone.
  3. Steatosis – If there have been gallbladder issues for a long time sometimes the liver becomes fatty. Fatty liver, also called “hepatic steatosis” can have no symptoms, or it can feel a whole lot like gallbladder pain – especially the low-grade, chronic type that doesn’t flare up strongly but doesn’t go away either.
  4. Something else – Remember you can have fleas and ticks on the same dog.  Remember gallbladder, and your other internal organs, don’t have sensory nerves the way your fingertips do because you’re not supposed to be reaching out and touching anything with your gallbladder. This is part of why people can feel gallbladder pain so differently – for some it’s classically under the right rib cage, for some it’s between the shoulder-blades, for some it’s on the left side, for some it’s just nausea and for some it mimics a heart attack. It can happen that you have “gallbladder pain,” the doctor finds gallstones, you remove the gallbladder and there’s still something else that was actually causing the pain to begin with.

Now it feels like we’re back at square one, right? You did the surgery, but the problem is the same.  So now what?

Stopping Gallbladder Pain After Surgery

  1. Talk to Your Doctor. Step 1 really should be a follow up ultrasound to see if there are any stones remaining. This will give you a good idea of what you’re working with.
  2. Work on Gallbladder Sludge. This is the most common cause of ongoing pain and working on cleaning out your remaining sludge will help clear those ducts and also helps with a gentle liver detox. Really working on this should bring improvement within a month. If it doesn’t, or if your symptoms get worse then skip straight to step 4. There’s a whole post on supporting your gallbladder as well as one on liver health below.
  3. Give your Liver Some Love. This can be done at the same time as step 3 – each one helps the other so that you get the best results if you’re supporting your liver and clearing out sludge at the same time.
  4. Get Your Doctor on Board. You have lots of vital organs in your abdomen and we don’t really want to see any of them in trouble.  If your symptoms are not getting better, if they’re getting worse, or if your gut is telling you that there’s more going on then talk with your doctor. There can be hernias, pancreatitis, infections, tumors and other problems that your body can only tell you about in so many ways so don’t ignore symptoms just because you got your gallbladder removed.

It can be easy to get discouraged, but you’re still on the right track. The surgery sometimes isn’t an instant fix, but you’re still moving forward – just follow the steps and trust your gut. If you feel like there’s something bigger going on then talk to your doctor. Otherwise give your liver and ducts a little pampering and you’ll be good as new in no time.



Feeling Good about Feeling Good: Part 3 – Learning to Say NO Now.

Saying no is really difficult. Many of us feel guilty, get defensive, or just can’t do it, cave in and say “yes.” We then spend the entire time that we’re doing whatever it was that we didn’t want to do kicking ourselves and regretting all the things we could have been doing with that time. It’s not easy to feel good about feeling good if you’re doing something that you don’t like, didn’t want to do, or just couldn’t get out of. But still, “no” is so final, so absolute, that we shy away from it. Learning to say “no” will liberate you and free you up to say “yes” when you really want to too.

It’s far easier to create a “soft no” like “I would but we’ve got a lot on our plate right now with Billy being sick…” But there is a power and a freedom to just politely saying no without an excuse, and to meaning it.  So when someone nominates you for that committee that sounds awful, for baking cupcakes for the entire grade, for doing the backlog of bookkeeping for the church/charity/neighbor, just say “No thank you.”  And then stop talking. At least that’s the goal.

The Most Dangerous Word in the World

Psychology Today did a wonderful article about saying “no” entitled, you guessed it, The Most Dangerous Word in the World. This article explains that even seeing the word “no” causes your body to release dozens of stress hormones and neurotransmitters. This produces an altered state (really!!) that immediately influences and impairs logic, reason, communication and language processing.  In fact, the word “no” is considered to be under the blanket descriptor of “negative thinking” along with thoughts of disease, calamity, death, social problems, etc… It really is this big.  (Just as an aside, we don’t get this much of a neurological bang with “yes.” In fact the article estimates that we need to have five positive thoughts to counteract the weight of the one negative one. Sigh.)

When you look at the evidence it isn’t any wonder that it’s difficult to say “no.” We are social animals after all. We aim to please.

The Power of “NO” – an Exercise in Boundaries

A couple of years ago TIME magazine did a fantastic article on learning to say “no” without the story, the excuse, the drama (remember the drama? If not refresh your memory about your drama/story here) Letting go of the excuses, the reasons (usually a little bit untrue) why you can’t do something, is absolutely liberating. It’s also really great in terms of creating a solid boundary that then allows you the space to do the things you actually enjoy and value. This article has some great suggestions. One is practice some polite ways, without excuses, to just say no.  They suggest:

  • “I’m sorry – not today”
  • “I can’t this time”
  • “That won’t work for me but I’ll let you know if anything changes”
  • “I appreciate you thinking of me, but I can’t right now”

It’s still polite, you can smile and say it, but it’s also clearly “no.”  Is it easy? Well… no.

Learning to Say “No:” 7 Steps to Help You Get to No Now

This is a learned skill. It’s a life-enhancing, productivity-boosting, boundary-establishing wonder-tool, but it takes a lot of practice and some serious baby steps.  Here’s how to get to “no” effectively.

Learning to say no can be scary, but so very rewarding.

Learning to say no can be scary, but so very rewarding.




  1. Consider your priorities. This doesn’t happen when you’re in front of a person asking you do do/be/buy/sell/produce something that you’re not interested in. This happens now, in a quiet space, where you have time to think about what really matters to you. This might be time with your kids, it might be the concentrated productive effort you need to get a big project done, it might be your health. It could be anything, but you need to know what you really, truly value right now because every time you say “yes” and don’t want to, you’re taking away from this thing.  This is what saying “no” allows you to protect. This is what you’re building the boundaries around.  If you don’t know what matters then you’re not going to work very hard to protect it.
  2. Make the Commitment to Yourself.  You know clearly what is important to you, now it’s all on you to protect it. You have to decide that you’re willing to do some kind of scary personal growth work.
  3. Practice. Just like everything else, saying “no” takes practice and it’s probably best not to start when your overbearing boss drops another project on your overburdened plate. Or when your pastor nominates you for some great thing that you really don’t want to do. Start by saying “no” to the overly pushy sales person at the department store. Say “no” to dessert, even though the waitress was really nice. Say “no” to your best friend (who already knows you’re practicing and supports you fully). For sure say “no” to the creepy European gentleman who wants to put lotion on your hands in the mall (what is that about?!?)
  4. Prepare some scripts. So that when you panic, you have something to say. This isn’t anything complicated, it’s the short, sweet, polite “no” that we talked about above.  “I’m sorry, I can’t right now” or “Not today, but thank you” are my personal favorites.
  5. More Practice. Practice using your scripts. Make sure they roll off your tongue easily and with a smile. No excuses, no junk, just “no.” Keep practicing in low-importance situations where the stakes aren’t high either way.
  6. Be Prepared to Disappoint some Folks, and to Impress Others. There will be times when you will genuinely disappoint someone, and that is hard as a human. The reward, is that you protect the thing that matters most to you. If disappointing that other person matters more than your most valued thing, then go back and say “yes” but 99.9% of the time it won’t.  Also be prepared to receive a surprising amount of respect.  When you can say a polite, sincere “no” it’s an act of power. It’s also a sign of authority, leadership and personal strength. People notice.
  7. Find Strategies for the Boundary Pushers.  Some people will always push, always.  I have a beloved friend who is one of those people who can get me to buy something I’m lukewarm on just because she’s there and shopping with me. Or have another drink I don’t want, or get dessert when I’m already full, or whatever. It’s not because she’s mean, or has bad intentions, it’s because she’s a bucket of fun and I just enjoy her company so much I end up saying “yes” to random crap. The best strategy with her was to confess – I told her I was practicing saying “no” and that I love her dearly, but was going to be saying “no” a lot more and really wanted her support. She stepped up like a champ. Obviously that won’t work with the pushy call from the charity or the neighbor who sells real estate who really wants to list your house, but there will be different strategies for those people. Just single out the pushy people in your life and give it some thought.

Learning to say no can be daunting, but in terms of the payoff it’s the best thing you can do for yourself. It helps to build personal strength, self-respect and positive feelings in your life. Most importantly it gives you space around the things that really matter to you – whether that’s time to do the things you like, money for things that really matter to you, or any other valuable commodity that you are preserving



Feeling Good about Feeling Good: Part 2 – Ignoring Cultural Negativity

Feeling good about feeling good isn’t easy – in fact most of us feel just a little bit guilty or self-conscious when we’re really truly happy.  Our culture doesn’t look favorably on true joyfulness – maybe it’s the puritanical roots?  I talked a lot about it in the first post in this series, which focuses on the personal drama we create.  In this post let’s focus more on the drama and negativity that is culturally conditioned, because as it turns out, there’s a ton of it.

Step 2 to Feeling Good: Ignoring Cultural Negativity

The great myth of Western culture is that we are more financially blessed and privileged as a society and so it logically follows that we must also be happier than other societies, and that those two things are related. Like the happiness maybe comes from something we’ve earned, or bought or treated ourselves to. This isn’t the case. In fact, a remarkable body of research called the “World Happiness Report” found that financial factors play a small part, but social support, freedom to make life choices, generosity and the perception of corruption also have big roles to play. The World Happiness project essentially does a mountain of research to determine which countries are the happiest and how that happiness changes with large world events. The results are highly surprising. Here’s a look at the top 10 countries (U.S. came in #13 if you’re curious) and the key showing what each color represents:

Feeling good about feeling good - the top 10 happiest countries according to the World Happiness Report. (see link in text).

Feeling good about feeling good – the top 10 happiest countries according to the World Happiness Report. (see link in text).




THese are the factors that matter in happiness - financial wellbeing, social support, health (as life expectancy) generosity, honesty or corruption of the society you live in and the general angst of your country, summed up in "dystopia."

These are the factors that matter in happiness – financial wellbeing, social support, health (as life expectancy) generosity, honesty or corruption of the society you live in and the general angst of your country, summed up in “dystopia.”

All well and good, but what does this mean for our own happiness?  Here are a few key points, in the form of actions you can take to boost your happy:

  •  Stop Watching the News.  Especially North American News. Why? Because sadly journalism is a huge industry now and the thing that makes news sell is fear or moral outrage.  More people watch more news if it’s scarier, more shocking or more directly threatening to you and generally that means spinning information to have the maximum impact. News is made scarier, bigger, more fearful,  more threatening, more anger-provoking or inciting. This is not because the world is more fearful, only because news is a business and fear sells. But really, do you need more anxiety hormones coursing through your bloodstream? Really?
  • Let go of Crisis Planning. We are kind of a nation of catastrophizers – everything is going to be something awful. The media has some impact on this because if you listen to the news it sounds like there’s going to be a terrorist showing up on your street at any moment. It’s also just human nature to fear the worst and for god’s sake we have a whole industry of Worst Case Scenario Survival Guides and Zombie Apocalypse Kits. I mean really. Ironically in the World Happiness Report (I’ll call it WHR for short) countries that were impacted by some crisis actually became happier if the social structure was strong (and unhappier if it wasn’t, which leads us to our next point).
The report provided evidence of an interaction between social capital and economic or other crises, with the crisis providing a test of the quality of the underlying social fabric.
If the fabric is sufficiently strong, then the crisis may even lead to higher subjective well-being, in part by giving people a chance to work together towards good purpose, and to realize and appreciate the strength of their mutual social support; and in part because the crisis will be better handled and the underlying
social capital improved in use.
  • Help Your Neighbors.  That whole “social fabric” thing that they’re talking about it something that you and I can actually impact.  Social fabric is strong if you’re in a community that would get out there and make sure everyone has food and water if the sh*t really did hit the fan. It’s weak if you feel like everyone in your neighborhood would get their gun to safeguard their food and water from looters.  So how do we live in a society with good social fabric? Start simple by being a good neighbor and society will follow.
  • Don’t Judge. Sure sure, haters going to hate, but you don’t have to be one of them.  The WHR shows that freedom to make life choices is a really big deal for happiness and that includes the freedom legally but also socially. This means if you don’t feel like you can do what you want to do (even if it’s legal but socially unacceptable) then your happiness is impacted. Likewise if you’re adding to someone else’s feeling of not-being-able-to-do then you’re making them less happy (and yourself as well).  At the end of the day every human on this planet is doing the best they can with what they have so being a little easier on them would help all around.
  • Fix What You Can, Drop Everything Else. Someone else said this better than I will ever be able to, so whether you’re a religious person or not, I’m guessing you can grok this:

God grant me the serenity to accept the things I cannot change, courage to change the things I can, and  wisdom to know the difference.

– Reinhold Niebuhr

  • Give Away. Generosity is a simple step to happiness that you have complete and utter control over. You can choose at any moment to give something to someone, to be generous with kindness, with your smile, with laughter, with love.  And it makes YOU happy. You feel good when you help others feel good plain and simple.
  • Practice Pronoia.  I *love* the whole concept of pronoia as visioned by Rob Brezsny. Pronoia is the opposite of paranoia and involves the deep seated belief that the Universe is conspiring to shower you with blessings.  Sure, you could expect the worst, but this is far happier. It is just as likely that the Universe is sneaking up on you to make all your dreams come true as it is that it’s out to get you so might as well engage in some constructive fantasy of the former, rather than the latter (I wrote a  whole post on this too).
  • Learn Optimism. There’s a whole body of research that suggests joy is a talent that you can practice, cultivate and increase just like any other talent.  Let’s do that and start feeling good about feeling good. In fact, there’s a whole book on it.



Feeling Good About Feeling Good: Part 1 – Dropping the Drama

I’ve been seeing an alarming trend a lot in clients, friends and myself. It seems like everyone feels just a little bit guilty when they are feeling good.  Somehow as humans we are a little bit unsure that we deserve to be happy, or healthy, or whole or generally unburdened.  There’s kind of a resting level of guilt, anxiety and martyrdom that everyone acknowledges, recognizes, and accepts as their due.

It’s not quite social acceptable to actually feel good, be optimistic or have a positive world view.  Although it is socially acceptable to put on a brave face, to soldier through, and to rally under pressure. But why? And more importantly, how do we stop buying into that ridiculously destructive collective insanity? We’ll make this a series, because I’m guessing we can talk a bit about it. 🙂

Feeling good about feeling good. Un-learn your story today to get a little breathing room in the feeling good department. Lovely photo from Renesis on wikimedia commons.

Feeling good about feeling good. Un-learn your story today to get a little breathing room in the feeling good department. Lovely photo from Renesis on wikimedia commons.

Step 1 to Feeling Good: Allowing Yourself The Benefits of Drama, Without the Drama.

Here’s the thing. You love drama. You will deny this, but at a fundamental level all humans do. You LOVE drama. You crave it (I do too). Here’s why:

  • Having drama means you’re important enough to have drama – this meets our craving for status, influence, recognition.
  • It means your lire is exciting in some way (even if it’s a bad way). Internally this has a lot of value for all of us humans – we like to have interesting things to talk about. This is also about status and recognition, but also just good socializing.
  • It means you have an excuse to be “too busy” to do the things you didn’t want to do anyway or to take on the extra projects/duties/responsibilities/crap that you didn’t want to take on anyway.This allows us a graceful way to say no, because saying no is really hard.
  • Drama gets sympathy points from everyone else, and on some level we all love both sympathizing with someone else, and also getting sympathy. This is sort of what makes us human, and a community. This meets a big need for care and community from the people around us.




So – the goal here is recognizing when we really have something going on and honor that – make time and space, take what we need and be human. Also to recognize when we’re just creating drama, exaggerating a situation, or making excuses. Sometimes there really is drama and that’s life, but lots of times there really isn’t and in those moments we can just drop it.  Differentiating can be incredibly difficult, but it’s so liberating to stop making excuses, gossiping about yourself and your problems, and just be.

Recognizing when you’re Creating Drama

If you can learn to let go of the story and find what you need in another way, then things do actually get a whole lot simpler. It becomes easy to answer the question “How are you?” with a “great” rather than a dramatic story about how bad/busy/stressed/tired/overworked/crazy/etc… you are. Or to answer the “how are you” question with a “crappy” if that’s the real answer.  There doesn’t have to be a story, sometimes it’s just crappy. But all in all, letting go of your story makes it easier to just feel good. To feel good about feeling good even. Here are some ways to recognize when you’re making something more difficult than it needs to be:

What is Your Story?

Sometimes there is a story that they (or I ) tell over and over in some version that becomes sort of routine.  It’s the story you don’t have to think about, you just tell, and it usually gets an emotional reaction – sympathy, moral outrage on your behalf, something.  Often it starts with a phrase like “You wouldn’t believe…” or “Guess what’s happening now…” or “Listen to this…” and the other person responds by emoting. In many ways we are mutually entertained by this, but we also kind of get stuck in the cycle of that being the way things are because we’re getting positive reinforcement. The relevant question to ask when you notice your story, is:

Is this the way I actually want to be in the world? Or am I perpetuating a story that doesn’t need to exist?

I’ll give you the example that I am working on letting go of – this is my “story”.

You wouldn’t believe how busy I am! I’ve really bitten off more than I can chew between [insert random obligation here] and [another random obligation] I feel like I hardly have any time at all. And now my boss is asking me to [yet another obligation].

My typical story is all about being busy. SO busy. SO VERY busy. And it’s usually told as a bid for sympathy and also a bit of a brag, all rolled into one. Which is recognizably absurd – I know. Ironically it has taken me years to notice that this is my story, and as much time to sort out why.  As it turns out it’s because I perceive my value in the world to be about the things I do – the activities and the accomplishments and the ways I’m productive in the world. So by being so busy, I”m also being “so valuable” (sort of sad, right?)

The most absurd part is that while I’m telling that story I continue to perpetuate it – I take on more projects, I say yes to the next random obligation, I sleep less and try to do more.  CLEARLY this is me creating my own drama and recognizing my story can help me to stop telling it.

Letting Go Of Your Story

To start letting go of your story you have to start to recognize what you personally get out of it. This is different for every person and requires some painful soul searching. Here’s the list of things I think I get from my story:

  • Value – by telling this story some part of me feels valuable – I’m doing things.
  • Emotional connection– other people express sympathy for my workload – it’s a way to know that people care about me and to feel connected.
  • Kudos – doing it all with a smile makes me “brave” or “good” or some other undefinable something.
  • Excuses – I get to say no with good reason to the things I really don’t want to do.  I Don’t even have to say “no” I can say “I would love to, but…”

For me letting go of this story means finding other ways to get or do those things, better ways. As absurd as it sounds this is actually deeply emotional work. For most people, the story that they tell is reflective of some deeply held beliefs about the world and their place in it, and it’s usually a kind of dysfunctional way of going about it.

  1. Recognize Your Story – this has to be the first step. You can’t change it unless you see what it is.  It’s harder than it looks and the best way to figure it out is to ask your friends. Not acquaintances, but the people who have known you for years. They will know your story right away and if you give them permission, they will usually be able to tell you.  Make sure you ask when you’re in an emotional place to actually hear them and not get defensive about what they say because it can be hard to hear.
  2. Pay Attention When You’re Telling It – start to notice what you feel when you’re telling your story.  Notice how the other person reacts and how that makes you feel. Check in to see if there are benefits that you get out of this.
  3. Build Your List of Things You Get From Your Story – you have to know what you’re getting out of it to be able to change it.
  4. One At A Time Find Other Ways to Get Those Things – this is the really hard part, and it will be different for every person. I”ve used a number of tools to separate my emotional feeling that my value is in what I do (not who I am) with the logical recognition that this doesn’t make sense. This has included Byron Katie’s “The Work,” hypnotherapy, meditation and a lot of personal contemplation (not to mention years of homeopathy and the occasional counselor thrown in there). It’s also included growing enough of a spine to learn to say no (we’ll do a whole post on that).
  5. Un-Learn Your Story – practice not telling your story. Recognize the situations when you would normally launch in, and don’t.  It feels awkward to not say it, it feels like there’s a weird conversational faux-pas happening, but just don’t give in. Practice first with friends and ask them to give you gentle reminders when you’re launching into your story.  Ask them to help you notice.
  6. Be Gentle With Yourself – this is far more difficult than you think it’s going to be.  It involves looking at your own most vulnerable pieces. The parts of you that learned something in childhood that your adult brain now has to sort through.
  7. Start Feeling Good about Feeling Good – this is what it’s all about.  You’re dropping your story so that you can let go of dysfunctional ways of getting what you need. This is about learning to feel good without using drama as a crutch. It’s about learning to feel good about feeling good and not letting guilt (about being happy) get in the way of actually being happy. We humans are crazy hairless monkeys, so we might as well enjoy it and not get all neurotic.

It can be tremendously liberating to let go of your story, but it also takes time. Just be gentle with yourself and ease your way into feeling good about feeling good.