Is stress healthy ?




By: Dr. Abigail Joseph

We all have problems in life. Whoever professes to not have any is probably not human. The truth is – problems come in all sizes and forms but we control the gravity of the situation and determine whether or not they will spiral out of control. Our perception of a problem directly affects how we react, and our reaction determines how long it takes to resolve or if it will fester into something greater.

Sometimes my patients feel like I am invading their personal life when I ask questions such as “how are things at home?”, “is there a problem you want to talk about?”, “did you have an argument with someone?” or “is there a problem you feel you can’t solve?” It’s not gossip I’m interested in, but when we begin to understand that a patient is MORE than just a disease and we view them as a whole, we are able to understand that at times everyday life and situations have a direct effect on health and adds to the health problem you may be facing.

Have you ever heard or seen the Serenity Prayer? I particularly like the part that asks for understanding of the things I cannot change. Many times we get caught up in this. We dwell and frustrate ourselves with things beyond our control and end up with a chronic issue. Have you ever seen the movie “Crank?” It’s an old movie where Jason Statham was poisoned and the only way to stay alive was by keeping his adrenaline up. He did odd things like have sex in public, get in to unnecessary fights and took drugs. The movie wasn’t the best. It could probably be described as entertaining for those action movie lovers but the concept that our actions and daily activities affect our body was on point. When we focus on problems beyond our control it creates a weakened immune system without you even knowing. Well, of course your body shows it but if you aren’t looking for the signs your body gives you, you wouldn’t know the extent of which you are being affected.

When stress goes undealt with it starts to have telling signs on your body. Do you know what your telling signs are?? When I get upset I clench my jaw and my eye twitches. If I stay upset for long or something bothers me for days, I don’t sleep as well as I normally do. For some people, they experience more than one change in their body. These changes are our body’s normal response in the face of stress and threats. We have a built-in stress response to situations, where our adrenal glands found above our kidneys release a surge of hormones, including adrenaline and cortisol. We speak about the adrenaline hormone a lot, so most people are generally aware that adrenaline increases your heart rate. But it also elevates you blood pressure and for those who participate in sports, we know that it boosts energy.

Cortisol is known as the primary stress hormone. This hormone increases glucose in the blood, (for this reason you can find diabetics with elevated blood glucose despite eating properly and taking their medications – stress). But cortisol also enhances the brain’s use of glucose and increases tissue repair. When in stressful situations, we find that the release of cortisol curbs functions that are non-essential or those that could be considered detrimental in a “fight-or-flight” situation. Having cortisol in the blood changes your immune system’s response (generally for the worst) and suppresses your digestive system, reproductive system and the growth process. This stress system also affects the brain with responses to mood, motivation and fear.

I said all that to show you why it is important to understand the link between your daily life and your health problems. It is normal to go through problems. We were wired to deal with them. However, when we are exposed to a particular situation for long periods, it affects our hormonal balance and all the things I explained previously become chronic ailments. Signs that stress is taking a physical toll on your body are: uncontrolled blood glucose despite treatment, uncontrolled blood pressure despite medical compliance, anxiety, insomnia, depression, digestive problems such as gastritis, frequent headaches and difficulty concentrating. It is important that we recognize what life stressors are. It is important that we realize that we are built to undergo stress but being exposed to stressors for long periods (Chronic Stress) takes a toll on the body in a negative way.

Each person’s situation is different. Because we are unique our response to life stressors are different. Some people are naturally mellow and slow to react. Others are viewed as just carefree while still some are explosive and highly reactive. How we react to life’s stressors are directly dependent upon two main factors: genetics and life events/experiences. Our reactions are greatly influenced by whether we are able to remove ourselves from the environment and the availability of a support system. Studies show that the support system is a key aspect of learning to handle chronic stress. Chronic stress is basically a situation that lingers and most of the time they are caused by things we cannot resolve.

Having a proper support network of family and friends helps you to talk out your feelings and offer positive encouragement which may lower your cortisol levels and improve health. Support may not rid you of your troubles, but it certainly makes riding the waves of life a bit easier. Recognize your issues, eat healthy, sleep on time and nip problems in the bud. What’s the point of refusing to apologize if it takes years away from your life?? Bury that hatchet! Take time for self: read, rest, foster healthy friendships, dabble in relaxation techniques such as breathing practices or yoga and most importantly, never be afraid to seek professional help.

Pain Free – Pill Free



By: Dr. Abigail Joseph –

If we were to brainstorm what was the number one reason people visited the doctor many would say: pain, hypertension or probably diabetes, considering that the last two are diseases that are quite familiar to most households. From a medical perspective, if I were to guess without looking at research, I would say that the number one reason people seek medical consult is for pain. Why? Because I am of the opinion we always have some kind of pain. Many Belizeans will only come when they can’t bear any longer. However, for your knowledge and just as a fun fact: the reality is that when we look from a global perspective, the most common reason for medical consultation without consideration of any pandemic….the real answer on any given day would be skin disorders. From a Belizean perspective, we are just gonna stick with pain.

Pain is usually an indicator that something is wrong. Kind of like a check engine light for our bodies to let us know something is going on, or a consequence of something that we encountered a while back. Most of the time when you come in and describe a pain, specifically one that is related to muscular pain or arthritic pain – your primary physician writes you a prescription for the pain and sends you on your way. The name of the medication may vary and the price may also, especially if you keep coming back for more. It’s just the way it works. The most common drugs dispensed by our Belizean pharmacists are pain medications. As doctors, we even know you by name, for those that frequent our facilities.

During my time in the south, I would have people come into my office and ask me for their medication refill. Checking the system I would find that there were no chronic diseases attached to their name, however when I took the time out to ask what the medication was that they sought, they would tell me “TYLENOL” or “the feel good injection.” You see, before I even took over that office, doctors before me were already training the minds of people that the only solution for pain is a pill or an injection. Well, that’s what they teach you in school, don’t they?? So, that’s what I did when they came in – you have pain – touch the patient, order labs, write a prescription and send them on their way. Think about it…isn’t that what your doctor does?? The only time you see a doctor figuring out what more to do about your pain, is when you have pain and tell them you don’t take pills. Then you hear all about the “herbal remedies” and the dancing naked behind the door rituals etc. but all in all very few doctors are naturalists. We aren’t wired that way. It takes effort. We like results and we like it now!

Last week something happened to me that changed my world completely. I attended a pain management training. Of course when you hear pain management you think morphine, new and improve medications, learning new calculations etc. The instructor asked us one question – “what is fascia?” In my mind fascia is that thin white layer of tissue you cut through whenever doing surgeries. Sometimes, when patients come in with open wounds and you are stitching them back together again, it’s hard to see what muscle tissue is, and what is fascia. The best way to explain fascia to you would be to have you imagine an orange. Think about peeling the skin off – what do you see? White fibers, right? Belizeans call it roughage. When we scrape it off and tear the orange into plugs, it is still covered by a thin layer, right? And if we bite into one of the plugs and look at the piece left in our hand, it appears to be droplets with thin membrane separating each. This is the best way to explain what fascia is. The membrane or thin layer from the orange is meaningless to those who don’t take the time to look, but it plays an important role in helping the orange keep its shape. This is the same way with the body. Before last week I thought of fascia as meaningless, but as I dove into the training I began to see that fascia is more than what meets the eye.

Most of the chronic pain that we feel today – post surgeries, post-accident, many sprained ankles, back pain, shoulder pain, neck pain, headaches and some of the most disabling injuries are only fascial problems. Apart from holding the body together, fascia also conveys pain, especially when fascia is distorted, interrupted or out of place for lack of a better word. That being said, the pain medication is a band-aid solution. It dulls the pain for the period of taking the medication but comes back, giving you the impression that your pain is chronic. And indeed it may be, but only because your fascia isn’t where it belongs. The concept of FDM (Fascial Distortion Model) works. It took me three Practical clinics, a patient calling me a “witch dakta” and a woman who came in limping and then walking out through the door pain-free to make me a believer. It is a principle based on listening to the patient and observing body language. Weird, right? People refer to pain in many ways. There are those that point, others who rub the area and others that hover over the area as if to say somewhere here but I’m not sure where. Each of these physical responses expresses a different fascia distortion. When a physician recognizes this and assists the fascia in returning to its proper place using painful thumb pressure, the patient receives relief. Yes – I said my thumb. It is a hands-on technique – no needles, no pills.

So far, I am proud to say that the doctors of the San Ignacio hospital have been trained in FDM and have a “Pain Clinic” to which the Instructors from FDM donated equipment to assist in case management. My objective for the rest of this year is to show as many of my doctor friends as I can these techniques so that more Belizean doctors would sign up for the training next year. I am sure pharmacies won’t be happy if pain medications don’t sell, but at the end of the day, patients are who really matter and If we can share a technique that is cost effective, beneficial to the patient and results in that person not coming back for the same problem, Belize would be in a far better place in my books.