Wednesday, June 29, 2011

Riding The Breath Inside My Bones

The companion piece to my last blog entry, "Secret Sculptures of Bone" was published today on the new North Atlantic Books Communities website. Please check it out by clicking here.

Saturday, June 18, 2011

Secret Sculptures Of Bone

Dear friends, family, colleagues, and blog-followers,

Hello to all my tribe members who are gathering in Indianapolis this weekend. Today's entry is dedicated to you all. I wish I could be there, but this is the next best thing. 

I have a huge collection of half-written fragments, which I have decided to share with you. Many of them are parts of other, larger pieces that are in varying states of completion. Some of them are re-written excerpts from other things I have written, or passages that didn't fit into my book.

On Tuesday, June 28th, a piece I wrote will appear on the new website from my publisher, North Atlantic Books. I will be part of the "Wellness" Community on their site. The following is the introduction to that essay, with all the content I edited out of the original to have it fit their format. I hope you enjoy them both. Here's the link to the new site from North Atlantic:

When I took the oath as a physician on graduation day from Osteopathic medical school in 1986, I promised to listen deeply, to feel the messages conveyed by my patients’ bodies, especially their bones, not knowing what that promise would eventually entail. After years of caring for people and devoting my studies and perceptual training to receiving the stories of other people’s bones, my own bones call out more loudly than anything I've ever heard...
(go to North Atlantic Books Communities on June 28th to read the rest. . .)

Here are some other things I love about bones:
Many bones include a trabecular mesh in their architecture that incorporates air spaces. Most bones are about 20% water. The air and water that are incorporated into the architecture of bones engenders them with great strength and resilience. Some bones are filled with blood-producing marrow. A bone is made of bendable, resilient collagen (which is composed from protein, vitamin C, and water) into/onto which minerals (calcium, potassium, manganese, magnesium, silica, iron, zinc, selenium, and more) have been embedded. The whole thing is surrounded by a membranous sac called the periosteum, which is chock-full of nerve endings and a hefty blood supply that continues on into and out of the bone. Sometimes the articulating ends of bones are covered with a layer of cartilage. Living bones are far from chalky or dry.

Some bones are flat, some are round, some are long, some are shaped like the crescent moon, and some are wild shapes that have no names.

Some have spiraling patterns etched on them from the way they developed and from the way things are attached to them.

The Eiffel Tower was designed based on the shape and arrangement of the stress-bearing fibers in the femur. Notice the similarity of the architecture to that of the femur.
Drawing of a femur showing stress fibers in the architecture of the bone.
Some have quite unexpected shapes, especially the bones in the cranium. Here's a picture of my second favorite bone in the body, the sphenoid bone (this is an anterior view with the ethmoid attached, for all you anatomy buffs) of the cranium, taken by my colleague Andrew Haltof, DO. This is the "secret bone behind your eyes" that Kim Rosen writes about in "The Anatomy of Wings." Kim, along with Cathie Malach put this poem to music and recorded it as a wedding present for Steve and I in 1997.

There’s a secret bone behind your eyes
carved in the shape of a butterfly
the outspread wings remember the skies
and the waves and the wind and the weather’s tides

you can only reach it from deep inside
though the wingspan might be galaxies wide
as it lifts the soul from the thickness of flesh
sweeping it out of pockets of death

some have seen it and some have not
but those with the sight
they never forgot and never returned to their childhood home,
but rode the breath inside the bone back to the sculptor’s hand. 

Have you reached deep inside and seen any of the "secret sculptures" that collectively form what you call "your body"? If you're an Osteopath or a Continuum practitioner, I know you have. How about the rest of you?

Wednesday, June 1, 2011

Do What Grandma Said Was Good For You And Earn $800

When I was in practice, I frequently heard the complaint from people that they felt fatigued. People often asked if there was some supplement they could take for what they thought was "adrenal burn out." I always replied that there is no vitamin or herb that replaces sleeping 8 hours a night, eating well, exercising, and resting - and until they do these basics of self care, that it would be an insult to their system to try to trick themselves into pushing harder. Many people were disappointed with my response, hoping that there was a magic potion (something stronger than coffee) that would allow them to override what their body was telling them they needed.

Now some researchers in the mainstream of medicine are starting to look at the effects of stress, especially poor sleep in relationship to surviving breast cancer. When I heard about this study I wanted to sign up because I hope that amassing this data will prove what I hope to be true - that all those common sense things we can do to care for ourselves will prove to be the statistically significant factor in surviving and thriving with breast cancer.

Last summer I volunteered for a study at Stanford in which they are exploring the connection between breast cancer survival and what our grandmothers told us to do: eat well, sleep 8 hours, exercise, get fresh air, rest, and relax. They are doing this by measuring all sorts of indicators in blood (cortisol, ACTH, melatonin, Interleukin-6, fasting insulin, Natural Killer cell activity, markers of inflammation, etc.), doing sleep studies (EKG, EEG, respiratory and leg movement monitors, etc.), tracking diet, and emotional stress. Then they will follow-up once a year and see if our test results predict how well we do.

I know that there are many variables that can't be measured, but why not measure the ones we can? This kind of study rarely gets done because there is no drug or product involved. If this study pans out as we hope, the result will be that more doctors will have to tell people to sleep more, eat more fruits and vegetables, meditate, rest, live a more relaxed pace, and take some time off to enjoy life more often.

They still need to have normal, healthy post-menopausal women without breast cancer or auto-immune disease, ages 45 - 75 to volunteer to be in the control group. The study is almost completed, they just need a few more subjects without breast cancer. Would you consider being a subject in this study? It's not a volunteer job; It pays $800.

The study involves an interview, which can be done over the phone, a medical and psychological screening interview, a 2 week period during which you go about your normal daily life while wearing an "Actiwatch" activity monitor that looks like a wrist watch. During that time, you fill out a questionnaire that takes less than 5 minutes per day. At the end of the 2 weeks, a sleep lab technician is sent to your home and wires you up for a home sleep study 2 nights in a row. Then you spend 28 hours in the Stanford Hospital research wing (about an hour from Santa Cruz) where you get an IV from which they draw blood samples, you give a saliva sample, you answer lots more questionnaires, and eat and drink a measured amount. The lights in the room are dim, but I was able to read and watch a movie. I loved the experience! It was a bit like a meditation retreat for me. No clock, no internet, no cell phone - just peace and quiet, for a very good cause.

Aside from the $800 they will pay you, you get some of the blood test results, and a summary of your sleep study.

If you're interested, you can contact the delightful people at Stanford directly: 

Casey Brodhead  at 650-723-2744 or email  or
Bita Nouriani at 650-723-8479 or email

Wherever You Go, However You Eat, There You Are

My friend and nutritional consultant, Mark Mead has a new website, click here to check it out.
I wrote the following story about working with him and about my relationship to my diet for the "Stories Of Healing" within the "Connections" section of his website. If you've been following my blog all along, you've read much of this story. If you haven't read my blog posts from way back in Fall of 2009, then this will be a great little summary for you. Mark works with a wide variety of people, not just people dealing with cancer. If you're looking for a fresh approach to your diet (or your life), consider doing a phone consultation with him.  

Jon Kabat-Zinn's book title reminds us, "wherever you go, there you are," and Geneen Roth writes, ". . . you can examine your life by either looking at the way you live or the way you eat. Both are paths to what is underneath and beyond the eating. . ." As you read my story, consider the way you eat to be a reflection of some attitude you have about your life, and then feel (don't think or decide) the way choices arises in you. Don't set out to change anything, just observe yourself. Let curiosity, not ideas or opinions guide you. I find this a fascinating way to discover things about my self that weren't apparent on superficial examination. The kindness and curiosity that I have for myself has allowed my diet (and my life) to profoundly shift without having to use will power or New Year's-style resolutions.

I was the last person anyone expected to get cancer when I was diagnosed with Stage IV metastatic breast cancer in October of 2009. I had a normal mammogram in July, just three months before my diagnosis, but the cancer I have is not the kind you can see on a mammogram or feel as a lump. I didn’t discover what was lurking inside of me until I developed severe pain when it spread to my bones. I am alive and thriving 2 years after my diagnosis, when 90% of women with my situation have died. The following is some of my thoughts about why I am I here to tell my story. 

After a lifetime of eating well, exercising, meditating, loving well, and having a very satisfying and successful professional life, I find myself trying to understand or at least make some meaning of this affliction. Perhaps I might have died 20 years earlier had I not been living so well prior to my diagnosis. Cancer is a sign of our times; I have learned to not take it personally. We all live in a polluted world full of toxins and carcinogens and some of us, for unknown reasons, are more vulnerable to the effects of the environment. The answer is, like so many things in life, unknown and unknowable. We have to follow our gut feelings and have trust or faith that we are doing the best that we can to care for ourselves. Gut feelings – that’s where Mark Mead enters the picture.

Working with Mark as my nutritional guide has been tremendously helpful in finding the diet and nutritional supplements that feel right and are individualized for me. But there’s much more to say about working with Mark than this simple testimonial. 

Having my initial cancer diagnosis be metastatic/Stage IV (there is no Stage V !), it was considered too late for conventional chemotherapy, surgery, or radiation to be effective. It’s not that the doctors wrote me off as a lost cause, but the mainstream medical evidence actually supports not doing these things in my type and stage of cancer. They acknowledge that “once the toothpaste is out of tube” these common treatments cause more damage than benefit. In Stage IV cancer that has only spread to bones (I have no spread to internal organs like my liver, lungs, or brain), the quality of life is better, and the body is much more prepared to deal with the cancer if the system isn’t overwhelmed by these harsh treatments. Traditional chemotherapy doesn’t target bone that well, so I chose not to do it. I am “lucky” enough to have a type of cancer that is highly sensitive to estrogen (Estrogen Receptor Positive or ER+) so the first line of treatment was to get rid of my estrogen. Bones respond very well to the presence or absence of estrogen. I chose to remove my not-yet-menopausal ovaries, and begin taking a daily pill of Arimidex, an inhibitor of the estrogen that might otherwise get produced in my fat cells and adrenal glands. Our plan was to do this simple approach and see if it would be effective before considering more extreme treatments.

Here’s the really interesting, nutritionally relevant and important part of my story:
It took about 3 weeks to decide on this approach and arrange for the surgery. During that time I began my search for other treatments and to make life style changes that felt complementary. I considered myself someone who had been eating well for decades: mostly organic, high fiber, tons of veggies, minimal sugar and processed foods, but I did eat some organic dairy, eggs, chicken, turkey, fish, with an occasional chocolate chip cookie fling. I woke up one day and felt from somewhere deep inside that I had to stop eating (mostly) all animal products. I became what I jokingly call a “coho-ovo-whey-vegan.” I eat my weekly dose of wild Pacific salmon, an occasional egg if I know it is of the highest quality, and I put whey protein in green drinks and smoothies. It was during this time I called Mark, the husband of a dear friend and fellow Continuum Movement Teacher, for some nutritional guidance. Mark didn’t need to convince me of the things that would be helpful to change in my diet, but he helped refine the details of how to do it and he guided me in the choice of supplements and vitamins to add to my regimen.

After 3 weeks of dietary changes and daily, prolonged periods of meditation, I began to see and feel a change in my bone tumors. The tumor that caused my sternum to bulge shrank by about 1/3. The pain I experienced began to decrease in intensity. During this time while I was waiting for surgery and had not yet begun the anti-estrogen treatment, I was still in the process of interviewing doctors and assembling my “team.” I told one of them about my tumor shrinkage, and she replied, “Well, that just doesn’t happen!” She refused to believe that what I was experiencing was in the realm of possibility. She was sure I was mistaken, but I wasn’t; I had it documented on CT scans where we could measure the change in size of the tumors before the “official treatment” had begun. In addition to my subjective experience, the difference could be objectively measured. I knew I couldn’t work with this doctor if she couldn’t believe in the out of the ordinary.

I have continued to consult with Mark and fine-tune my regimen of dietary changes and supplements. I love his combination of open-mindedness, curiosity, and common sense, along with a grounded respect for what can be addressed in the research literature.

I like to ponder the philosophical basis for how and why I have made changes in my life, especially in my diet and nutritional supplement program. It seems paradoxical, but I can’t wrap my head around doing anything as a way to fix or exterminate my cancer. I work with Mark to choose a program that targets my condition, and yet I don’t want to live my life as if I’m “damaged goods.” This is quite a philosophical conundrum.

Changing my diet, along with all other life style changes is a process of inquiry and exploration. Although a disease might have motivated me to change my diet, I think I benefit most when I do things in the spirit of simply caring for myself. The potential benefits of any lifestyle change get distorted when I do it in order to accomplish something specific. In my past, if I went on a diet to lose weight, I always gained it back, but now that I am eating according to what feels right for me, I’ve lost weight and kept it off as a “side effect” of just doing what’s best to care for myself. Even though some foods and dietary supplements are known to address cancer, I’m not comfortable with being confined by a fear-based treatment protocol. I eat these “anti-cancer” foods because they feel good in my body.

When I’m working with the mystery of what goes into my digestive system and what happens with it when it is absorbed and assimilated, I have to surrender to the unknown. In spite of how technologically advanced we have become, many aspects of the inner workings of the body are not fully understood. Working with the infinite number of variables in the living human body it is impossible to be entirely scientific. Mark finds a way to respect what is known scientifically and combines it with common sense and intuition in tailoring each person’s approach. 12 women with breast cancer will need 12 different diets and treatment regimens. Working with Mark has been a great way for me as a unique individual to explore what works best for me. The answer to the questions of what to eat, and what supplements to take expresses itself differently in each person.

Becoming mindful about what I eat has been an open-ended exploration that has led to nearly miraculous improvements in the quality of my life. By carefully choosing what I eat I have cultivated an attentiveness to myself that draws on the expression of the healing forces from within. Changes in diet do not rely on healing forces from outside the body. You might say that food comes from outside the body, but once I eat it, I am in relationship to how it becomes part of me. This is incredibly empowering. It’s as if any change in the progression of cancer is a “side-effect” of nourishing the internal terrain with my relationship to food.

We all need to cultivate caring for ourselves because we long to be cared for, and not because it alleviates the fear of disease, or the disease itself. If you eat a certain way because you're afraid of developing cancer or heart disease - your efforts are fear-based and they might eventually backfire. If you have a mammogram because you are afraid of breast cancer, don't think you can eliminate that possibility by checking it off your to-do list. If you do some daily practice because you are afraid of a disease and you think you are somehow cleansing yourself by doing it, it won't necessarily work. The fear is stronger and more paralyzing than the effort you make to avoid disease, especially if you are not conscious of your motivation. As long as you practice from a place of trying to change things, you might miss being informed by the necessity of how you are and what you need in the moment.

Ultimately, each of us has our own questions and answers unfold as we live our lives. Others can guide us, offer us a map, and point to a suggested path, but we are the territory. We have to choose the road and make the journey ourselves. Mark is a great guide, but he can’t make the journey for us, he can only suggest a path that has a record for helping others navigate the treacherous terrain of cancer and find their own way. This is what he does best. Mark is there to provide the container or the sacred space in which we get to live into the emerging answer.