Mark's Musings - March 25

Below is an aggregation of the stories I posted on LinkedIn since my last edition. I curate them through the prism of an "intersection of chronic pain and appropriate treatment" and so they come attached with my opinion.

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The Unbelievable Paradox of Walking While in Pain: How “ol Doc Brophy” Changed My Beliefs About Physical Activity (301 views)

Thanks, Becky Curtis, for this reminder that "motion is lotion." Doc Brophy was an inspiration before you knew you would need it. Although walking was painful (for him and to watch), the activity helped maximize his function with an incomplete spinal cord injury. And this dialogue is the inspiration we all need ... again ...

“Why do you walk so much?” I asked, “Doesn’t it make your pain worse to do that?” 

“Are you kidding? Walking is how I manage my pain!” He replied, as if I had it all totally backwards. “Exercise helps keep my blood flowing.” He explained, “It really helps me.”

"Exercise is really for the brain, not just the body. It affects mood, vitality, alertness, and feelings of well-being." Exactly.

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Stress is Contagious: Stop 'Strezazzled' People from Encroaching on Your Brain (456 views)

"Scientists have discovered in recent years that prolonged stress results in ... reduced efficiency and streamlined communication within the brain." Short-term stress can be helpful, but having it long-term can be hurtful. Why is that important? "Researchers are looking into the idea that one person's stress can cause those same physical reactions to be transmitted to another person. In other words, you can ‘catch' stress from someone else." Does that mean to be careful who you hang out with? Maybe but not always. (1) Everybody has stress so you can't live in a bubble (2) You could possibly help someone going thru difficult times (i.e. stress). But it's important to "immunize" yourself from the stress of others (read the article to discover how). "Behavioral techniques that relax the mind and body are among the best ways to reduce stress ... Some of them: Physical activity, mindfulness meditation, deep breathing, positive social interaction, and laugh(ing)."

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The true cost of ignoring mental health in the workplace (182 views)

Good mental health should be a goal for people. It should also be a goal for employers.

• Personal - “Excessive or chronic stress is known to be associated with higher risk of developing heart disease and diabetes, because stress can affect health behaviors like smoking, physical inactivity, and overeating, which are risk factors for chronic conditions like high blood pressure and diabetes."
• Business - "In order to have a healthy workforce, employers must look at health and wellness holistically – and that includes mental health."

"The report recommends that employers take a comprehensive approach in supporting employees’ mental health across the spectrum from overall well-being to managing mental health disorders." Employees being psychologically and emotionally fit are in the best interests of everybody. Whether lessened productivity and creativity comes from absenteeism, presenteeism or poor physical health, nobody wins when whole-person health is not the goal.

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Stress Mess: 3 In 5 Millennials Say Life More Stressful Now Than Ever Before (532 views)

I initially thought this was satire, but a survey commissioned by a CBD oil company about #millennials must be irrefutable. I’m filing this under “I guess I’m too old to understand.” Is “Losing wallet/credit card” (# 1) or “Phone battery dying” (# 7) really more stressful than what happened to the passengers during and family/friends after Ethiopian Airlines flight 302? Does “life is more stressful right now than ever before” include World War I (37m people dead) or World War II (60m people dead)? What I do understand is that stress is unique to each individual in how they define “a state of mental or emotional strain or tension resulting from adverse or very demanding circumstances.” Appropriately handling stress is likewise unique. Even if I don’t fully understand it. Just to be clear, I get upset when I have to deal with "Slow WiFi" (# 6), especially since it usually occurs at the most inopportune time. But I've had health issues. I've endured the deaths of loved ones and friends. I've had $0.00 in my checking account. I've had broken relationships. I've waited for the other shoe to drop. Those are real stress. So let's keep life in context.

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Mark Debus: Empathy. Its Role in the Workers’ Compensation Claims Process (800 views)

"From the very first interaction with an injured worker, it’s important that a claim professional set the proper tone for their ongoing interaction and the process. An empathetic voice and active listening will go a long way to help the injured worker feel that the claims professional is here to help and is not simply looking to manage the claim, hold down costs, and meet compliance standards." Well said. Now everyone needs to commit to doing it, on an individual and systemic basis. Because #WordsMatter ... and so do actions & attitudes (yes, that's the title for one of my keynote presentations). The author suggests these three characteristics that Work Comp claims professionals should utilize to show empathy: Active listeners ("listen to that individual and learn from their story"), empathetic communicators ("let the individual know you hear what they are going through"), and compassionate advocates ("let the worker know you are here to help"). Thinking about it - aren't these characteristics every human being should use when interacting with another human being?

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Minnetonka’s Andy Steinfeldt, 71, Breaks World Planking Record (497 views)

I have a new hero ... Holding the abdominal plank position for 38 minutes is ridiculously good. But even more impressive is he set the record after "recently finished radiation treatment for prostate cancer." Amazing.

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Marcus Aurelius, Stoicism and Pain (1,487 views)

Did you know that Roman emperor Marcus Aurelius lived in constant pain until almost 60? Did you know that his approach, stoic philosophy, is "the inspiration for modern cognitive-behavioral therapy (CBT)"? This is a very interesting article that shows how learning to live with #ChronicPain (without pills) is not unique to 2019. Here are the primary techniques:

• Carefully distinguish what’s directly under your control from what isn’t.
• Compare the consequences of struggling versus acceptance
• Remember that it’s not events that upset us but our judgments about them
• Practice letting go of the inner struggle and actively accepting painful sensations
• Contemplate how others cope well with pain and illness and model their attitude and behavior

I especially enjoyed this example:

The Stoics compared life to a dog tied to a moving cart. If the dog tries to struggle and resist it will be pulled along roughly by the cart anyway. However, if it chooses to run behind at the same speed as the cart, things will go smoothly. If we struggle against unpleasant experiences such as pain and try to resist them or become frustrated or resentful toward them then we often just make our lives worse.

It doesn't say give up. It says find a pace that enables you to live life. In today's psychology discipline it's called Acceptance and Commitment Therapy (ACT) - "clients begin to accept their issues and hardships and commit to making necessary changes in their behavior, regardless of what is going on in their lives, and how they feel about it." It's not about giving up - it's about going on.

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Comp payers in the weeds on dosage, payments for medical pot (317 views)

Thanks to Louise Esola for including my perspective in this article. Since 2014 I’ve written (23 dedicated blogposts, 6 published articles, countless LinkedIn posts and tweets and quotes in other people's articles) and talked (114 presentations to 10,768 people in 28 states + DC) about medical #marijuana in #WorkersComp. That means I’ve seen the evolution unfold from "are you kidding" to "here's a check." From "marijuana" to more interest in CBD. Audience responses to my standard question whether #cannabis is medicine have been consistent since 2016 - overwhelming combination of Yes and Probably (always a minority of No). Payers are voluntarily reimbursing but off-the-record (I keep our conversations private). However, that reimbursement is challenging because it's reactive to the injured worker buying whatever from whomever for however much. And the only guidance on dosing/duration/frequency/formulation comes from the injured worker and their budtender (not a physician, pharmacist or other clinician). But, like it or not, that's the current reality. So, like I've been saying since 2014, it's all about risk management. Right now, the tail is wagging the dog (i.e. the payer is responding to whatever the patient has already done).

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In addition, I published one blogpost:

• "Mark's Musings - March 18" on March 18

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"It's Never the Wrong Time to do the Right Thing" - Martin Luther King, Jr.

#PreventTheMess + #CleanUpTheMess = The Answer.