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On Health: A healthy start to a healthy year

By Vicki Rackner

Ken opened his lunch box.

``Not again! Not another cheese sandwich!'' How many times do I have to make it clear that I want something more than the same old cheese sandwich day after day?''

The next morning, Ken went through his morning ritual of making his lunch. He said to himself, as he did every morning, ``I really should pick up some turkey next time I'm at the store.''

Did you make health-related New Year resolutions? This story from Jamal Rahman, a Sufi minister, reminds you who will translate your intentions into action. It's you!

The evolving field of psycho-neuro-immunology, or the study of the mind-body connection, also known as ``woo-woo'' ideas, could help you keep your resolutions. This an intriguing subject of scientific inquiry that for the most part is shrouded in mystery. Just as an experiment, pretend that these ideas could be explained by science and you could harness their power to promote your health.

The `placebo effect'

When new mediations are tested, one group gets the new drug and another group gets the ``sugar pill'' or placebo. Why do this? Study after study shows that if you think you,re taking a pill, your body will respond as if it did actually get the active ingredient, even if it,s a sugar pill. Somehow the belief in the power of the medicine creates the desired outcome of lowered blood pressure or heart rate or weight loss.

The placebo effect is sometimes thought of as a nuisance factor in drug studies. What if your beliefs helped you achieved your desired goals? Have you joined a fitness club in January and told yourself in March, ``It's boring to exercise.'' This year, try ``I'm invigorated by my 20-minute walk.''

The `nocebo effect'

In November 1998, a teacher noticed a ``gasoline-like'' smell in her classroom, and soon thereafter she had a headache, nausea and dizziness. Given the concern about a toxic environmental substance, the school was evacuated and closed for five days. Almost 200 students and teachers were seen in the ER for similar symptoms. No environmental cause was identified. One explanation is that the belief that a toxic exposure occurred led to the symptoms, or the ``nocebo effect.'' This is the flip side of the placebo effect.

I reflected on this study as I was waiting with my son for his turn in the dental chair. He repeated, ``It's going to hurt; it's going to hurt.'' I suggested to him that he might be better served by saying, ``It's going to be fine; it's going to be fine.''

Has the nocebo effect undermined your efforts to keep your New Year's resolutions in the past? In February, do you tell yourself, ``This never works. I'll never be a non-smoker.'' Consider replacing that thought with, ``In the past it didn't work. I keep my promises.''

Humor

Gelotology is the study of humor and its effects on the human body. Researchers are asking the question, ``Is laughter good medicine?'' You know from your own experience that laughter breaks stress and tension. Evidence suggests that laughter may enhance the function of your immune system.

You always have the choice about whether to laugh or cry. Ann remembered that as she completed an interview for the job of her dreams. She bought a new suit that made her feel like she already had the job. It wasn't until she left the group interview that she discovered the toilet paper secured in the waist of her skirt streaming behind her like a tail.

Prayer

We are a deeply religious nations, and many of my patients used prayer as a source of strength and comfort. Can prayer promote healing? Growing evidence from well-done clinical studies suggests it can, although not enough evidence for the medical community to conclude that prayer is good for health.

What kind of evidence would you need to use prayer as part of your health regimen? Interestingly, you would consider the same factors whether you're re-considering Vioxx or Naproxen or Aryuvedic remedies, recently found to be associated with toxic levels of heavy metals. What are the desired benefits, and what are the risks?

We doctors get concerned when patients forgo conventional therapy that have proven benefit for therapies like prayer or shark cartilage that do not have proven value. What harm could prayer do?

Gratitude and giving

Some interesting, if preliminary studies suggest that the expression of gratitude and the act of giving increase brain serotonin levels, the same chemical change anti-depressant medication creates. That might support your own experience of feeling better as you reach out to the tsunami victims or express gratitude for the health and safety of those you love and the extraordinary richness of your life.

So, this year's lunches don't have to be the same old cheese sandwiches. You have the power to carry out your New Year's resolutions, whether it's achieving greater physical, financial or spiritual health. Who knows, maybe one day a greater understanding of the mind-body connection will lead to a new set of interventions your doctor can prescribe to help you get there.

Vicki Rackner, MD, president of Medical Bridges, is a board-certified surgeon, consultant, speaker and author of the Personal Health Journal and the upcoming book ``Bouncing Back.'' She can be reached at DrRackner@MedicalBridges.com or 425-451-3777

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