easychairNow that you know how to be and find a hospital advocate, what about the advocate herself? How does she get her much-needed support? Being a caregiver can be a staggering job and consume your mental, physical and emotional energy. Yet there are many ways that you can be supported at this time. This not only applies to hospital advocates, but all caregivers as well.

Herbalists are caregivers, too. In fact, there are many ways to give care: emergency care as I just did with my mom in the hospital, care for someone who is dying, elder care, child care, handicap care, Alzheimer’s/dementia care, and of course everything in between.

Caregivers: Earth Element Types

There’s a distinct caregiver personality archetype. This is someone who tends to nourish, give and do for others, often regardless of whether it’s needed or wanted. In traditional Chinese medicine (TCM), this is called an Earth Element type.

We are currently in the Earth Element "time of year," the two-and-a-half month period when its energy should flourish and thrive. This means that caregivers may find themselves with an especially strong drive to give and care for others, even to the point of over-giving, or they may find that even though they want to give, it’s more difficult or tiring now than usual.

Caregivers need support and help themselves because as one reader of my recent blog said, "Disordered Shen is catching!" Being an advocate can be intense to say the least, so it’s not unusual for caregivers to become exhausted, ill, or even develop symptoms of Shen disorder – insomnia, anxiety and agitation. Caregivers are notorious for giving to everyone but themselves, and this is what leads to their illness and decline.

Regardless of whether you are a caregiver professional, caregiver archetype, in a position where you normally give care, or your care is needed now, the situation is the same: you must also care for yourself in order to stay strong so you can continue to give.

So how does the advocate or caregiver get cared for, too?

The key is – GET HELP!

If you are not taken care of, you will not be able to care for others. The same goes for the person taking care of you – if they aren’t cared for, they can’t give you the care you need. So it’s essential that the caregiver gets good rest, food, water, exercise, and help as needed. No excuses here! No buts or what ifs, and I especially mean that for those of you who give and give and give at the expense of your own needs or health.  You know who you are!

There’s no guilt that can be inferred or adopted here because if you do not take care of yourself, then you are not truly serving the one you are caring for. You are also setting up a future need of care for yourself from others – and this often appears in the form of cancer for you folks. Plus, if you don’t get help, your patient will suffer as a result and your need for care will take from them. So whether you avail yourself of help from family members, friends, neighbors, or outside help, take the self-care train and get on board!

 

About Getting Help

  • Write down your needs: Often writing down all your specific needs makes it more obvious what type of help you seek. You may actually require several different types of help such as medical, sitters, personal care, shoppers, financial planning, and so forth. List all of these along with their detailed points.
  • Make people aware: Often, people don’t know you need help but think you have it covered. If you are acting like Superman or Wonder Woman, people will think you don’t need help. That’s the fast track to a breakdown or burnout. Others may want to help, but they don’t know what to do so it’s necessary that you ask for the help you need.
  • Be specific: When you ask for help, or others offer help, provide definitive times, days and tasks. Give advance notice. If someone can sit with the person to give you a break, offer suggestions as to what they can do together.
  • Accept what is offered: Allow others to help as they can and as they offer, even if it’s just one time or a small task. Be grateful for the small things, as they do add up.
  • Share the help wealth: Don’t overburden a few people with many jobs but include many people with simple duties.
  • Don’t make demands: Make requests for what you’d ideally like to have happen and then graciously accept what does happen.
  • Be respectful: If people say no to your request, respect that. Find out what they can do and accept their limitations.
  • Get creative: If one thing doesn’t work, try another. Use your imagination. For instance, try new approaches for those who can’t read such as giving the person an iPod with recorded books. This not only provides them enjoyment, but gives you a break, too.
  • Financial Help: There are many resources available for obtaining the needed finances to care for your patient. Consider trade, Medicare, Medicaid, long-term health insurance, federal and state government agencies, volunteer programs, church groups and family members.
  • Outside help: There are many resources available where you can obtain outside help. Often the patient’s doctor sets these up, so put in your request. Consider social workers, home health care, skilled nursing, nursing homes, home health aids, personal care aids (for dressing, bathing, eating, changing beds, laundry and light chores), foster homes, boarding homes and hospice. Know that hospice is also for palliative care, not just terminal conditions, plus it offers more than home health care and covers more expenses, too. As well, be sure to check available local programs to see what they offer and how they might meet your needs.
  • Ideas for help: Keep your requests reasonable, specific and timely. Consider sharing telephone calls, staying in close touch, doing research for you, talking to the doctors or practitioners, driving, grocery shopping, picking up medications, bringing meals or other needed items, providing a listening ear, giving you breaks, walking or exercising with you, and taking on the job of finding the help you need.

Care for the Caregiver – Things You Can Do to Help Yourself

  • Eat well: Keep your diet simple. Emphasize protein, vegetables and fruits as appropriate for your body’s needs. Eat three good meals a day with perhaps one or two snacks. Keeping your blood sugar balanced increases your energy, stamina and immunity. It also helps you sleep better. When you are stressed, the body has less tolerance for internal stressors. Challenging foods such as sugar, caffeine and alcohol create internal stress and so often cause health symptoms during stressful times (including menopause) when they seemingly don’t otherwise. Foods that cause liver congestion are also less tolerated during stress. These include fried and fatty foods, alcohol, caffeine and other stimulants (maté, chocolate), cheese, nuts and nut butters, chips of all kinds, and excessive intake of turkey. 
  • Get sleep: Grab what sleep you can including naps. Post "do not disturb" signs and take them down when you may be disturbed. Sleep when the patient does. Most hospital rooms have a recliner or couch for visitors, so take advantage of it.
  • Exercise frequently: Even if you can only take 5-10 minutes off at a time, exercise as possible. Include frequent stretching and take the stairs.
  • Feed your spirit: Engage in meditation, prayer, spiritual contemplation, reading, and other activities that juice your spirit, even if just for five minutes at a time.
  • Delegate tasks: You don’t have to do it all. Truly. Determine what is key for you to do and get help with the rest.
  • Set priorities: You don’t have to do everything right now. Really. Set goals and solve problems one at a time. Pace yourself! 
  • Talk with others: Share your experiences, feelings, ideas and thoughts with others. Talk with more caregivers. Seek counseling if needed. Avoid isolation!
  • Maintain humor: Laughter and humor can lighten many a difficult situation and improve everyone’s energy.
  • Plan ahead: Bring food, water, snacks, blankets, layered clothing, music, books, drawing or writing materials, a journal, and other items to care for all your needs. Look to the next day or two and plan accordingly.
  • Take frequent breaks: It’s essential that you "get away" from the caretaking situation. If you can’t get blocks of time off, take frequent short breaks. Do what you can and be creative about it. Walk, take the stairs, go outside, call a friend, read a book – you get the idea.
  • Be informed: The more you know about the person’s condition and needs, the better prepared you will be and the less stressed as a result. Ask for help in researching proposed medications, procedures, the patient’s condition, local resources and so forth. 
  • Have back up: I know I keep harping on the get help part, but at the very least have others bring you good quality food and water, guard the door to protect everyone’s sleep, and bring requested items.
  • Emotionally release: Appropriately express and release your emotions so they don’t build up inside. Long-term suppressed emotions stagnate your energy and blood, leading to a myriad of health issues over time. Thinking about how you feel doesn’t work because it keeps you locked in mental and emotional loops that only intensify your feelings. Instead, write them down or talk with a friend or professional. 
  • Self-nurture: You know best what you need so take care of yourself. If you require specific types of food, regular exercise, or certain hours of sleep, be sure you maintain them however you can. 
  • Treat yourself: Include in your self-care plan periodic treats that nurture you. Avoid food teats as these usually make you feel worse in the long run. Instead, buy something for yourself, watch the sunrise/sunset, get take-away food, or listen to favorite music or sports.
  • Be gentle with yourself: It doesn’t help anyone to beat yourself up for forgetting or not doing something in time. Know you are under extreme stress and allow for how this affects you. Do what you reasonably can first and then seek help for the rest as you work toward the larger tasks.
  • Let go: Your normal life may well be on hold so let go of expectations, deadlines, extra duties and so on.
  • Thisis your service: Know that being a caregiver IS your service. THIS is your service, your gift and focus. Like raising a child, your patient takes precedence over everything else, except your own physical needs. Realize the gift you are giving IS your work in the worldat this moment in time. Surrender to this and know it is a gift for you as much as it is for your patient. 
  • Take herbs: Herbs are powerful. While most are gentle, they also support your body-mind complex to assist in stressful times. Herbs can increase immunity, help sleep, calm the mind and emotions, and treat issues such as anxiety, depression and disturbed Shen, all of which can easily arise during stressful caretaking situations. Herbs are also easy to find and take. Look for them in health food, herb shops or alternative markets. Even mainstream drug stores and groceries now carry common herbs. Take them as needed in the simplest forms possible – tablet, capsules or tinctures.

 

There is so much that can be said on the subject of caregiving that entire books have been written on it. One great book, although written for Alzheimer’s and dementia, is actually quite useful for any person needing long-term or end-of-life care. I highly recommend it: The 36-Hour Day by Nancy L. Mace and Peter V. Rabins, (Johns Hopkins University Press, 5th edition 2012).

maral-root-leuzia-carthamoides-capitula"Adaptogen" is a term coined by Russian professor of medicine and physiological medicine Dr. Israel I. Brekhman and colleagues to describe herbs that have the potential to increase the body’s ability to withstand stress. In this sense, stress refers primarily to physiological stress from athletic performance, work and trauma, as well emotional stress causing anxiety and insomnia. Brekhman and company were looking for herbs occurring naturally in Russia that have properties similar to well-known Chinese tonics, especially Panax ginseng. They were sponsored by the Russian government for the purpose of discovering a financially valuable indigenous plant resource.

A trio of Russian adaptogens

The first and still the most popular of the first Russian adaptogens is Eleutherococcus senticosus. Like all adaptogens, eleuthero has the ability to increase endurance and stamina. Studies have corroborated its benefit for athletes, people who work long hours, or exhibit symptoms of immune weakness.

The second Russian adaptogen is Rhodiola rosea. In addition to its endurance-enhancing properties, rhodiola has some other distinctive properties, especially on the nervous system, being beneficial for people with depression.

The third and lesser-known Russian adaptogen is Rhaponticum carthamoides, also known as maral root or leuzea. Like eleuthero and rhodiola, maral root naturally occurs in alpine and subalpine fields including the mountains of Siberia.

To call these "tonics" in the Chinese sense would have meant that these herbs would have to be classified and used in a way similar to how tonics are used in Traditional Chinese Medicine, which classifies tonics into five distinct categories based on usage: Qi, Blood, Yin, Yang and Jing. Apart from there being no long-standing record of use of these herbs in these ways, they are best categorized generally as adaptogens based on their broad actions.

Maral root

Maral root has distinguished itself among Russian military and eastern European athletes and a large number of body-building aficionados as specific along with Chinese ginseng for building muscle mass. It has a wide following that would attest to its libido-enhancing properties as well.

One of the characteristics of all three Russian adaptogens is that they strive under stressful climatic and growing conditions. According to herbalist David Winston in his book Adaptogens: Herbs for Strength, Stamina and Stress Relief (Healing Arts Press, 2007), maral root is a long-living perennial that lives anywhere from 75 to 150 years and has a long history of use in Mongolian, Siberian and possibly Chinese medicine. In Siberia, where it grows, it is used as a folk medicine "to enhance physical and sexual energy, improve mood and concentration, and help people survive the cold and challenging climate of Siberia" (Winston, 2007). It is named after the maral deer who eat its roots especially during the mating season to maintain their strength. Maral root has a wide range of adaptogenic benefits serving as a cardiac tonic, antioxidant, immune stimulant and nervine with antitumor and hepatoprotective properties.

Among its many uses include:

  • Replenishes strength and energy reserves
  • Restores sexual potency in men
  • Increases mental awareness
  • Increases lean muscle mass
  • Helps decrease fatty tissue

Adaptogens have a wider range of effect than do the traditional Chinese tonics. One would hardly consider any of the Chinese tonics as a treatment for inflammatory conditions such as fevers and sore throat. However, in Mongolian medicine, "(maral) roots are used to treat people with respiratory, liver and kidney diseases as well as fevers and severe sore throats" (Winston, 2007).

The biochemical constituents in dried Rhaponticum root are tannins, phytoecdysones, flavonoids, glycosides, lignins, alkaloids, vitamins and an organic acid which helps people to maintain mental focus and alertness, especially under stressful conditions.

Ecdysterone plays a special role in regulating protein synthesis and thus increasing muscle mass in a similar way as steroids but without their harmful effects. Ecdysterone also helps enzymes including glutamate decarboxylase and acetylcholine esterase to synthesize in the brain and in the cells to assist in the production of energy. Finally it helps to protect liver cells from oxidation and DNA and cellular membranes from hydrogen peroxide.

Scientists believe that ecdysterone mimics natural steroid hormones in the human body and will increase them if they are insufficient. These steroid hormones are comparable to Kidney Yin and are depleted when the body or mind is subject to physical or mental stress.

From the traditional Chinese medical perspective it seems that the cooling properties of Rhaponticum makes it a unique Kidney Yin and Yang tonic. In Ayurveda it could be regarded as an herb that regulates Vata, ameliorates excess Pitta and regulates Kapha.

Maral root is a rare plant in the Asteraceae family and reaches as high as 4.5 feet. Because of its slow-growing rate, its sale is far more strictly regulated than either eleuthero or rhodiola. Nevertheless, I was able to purchase seeds from Horizon Herbs. Germination was not even but thus far I have three maral plants growing in the mostly temperate, low-lying mountains of Santa Cruz, California. One source I read described maral plants thriving in Texas. The potency of these plants grown outside of their native habitat is unknown, but considering its rarity in the herb market, I think it is worth experimenting growing it locally.

I’ve never seen maral root in stores, but it is seasonally available from various Internet sources. The maral root extract I purchase and use is from this source:

http://www.amazon.com/Maral-Extract-Powdered-2-2-lbs/dp/B005DZHTEW.



REFERENCES:

Winston and Maimes, Adaptogens: Herbs for Strength, Stamina and Stress Relief. Healing Arts Press, 2007.

Leuzea-Rhaponticum carthamoides (Maral root): Introduction Questions and Application Prospects as Biologically Active Additives – Nikola Timofeev  http://leuzea.ru/leuzea_adaptogen.htm

superheroMitochondrial DNA is big on the alternative scene these days. Brain research and the role mitochondria play has given rise to many new products. Some are quite expensive and promise great brain health and to recharge the mitochondria. The question is, should we take them? Will they really help? And should we jump on this bandwagon?

I won't tell you the answer to these questions because you have to decide what's right for you, of course. However, I will say we herbalists have an advantage, particularly when we couple our knowledge with TCM. Simply put, the tiny powerhouses we call mitochondria are nothing more than Spleen Qi; we immediately know what herbs supplement Spleen Qi -- astragalus, ginseng, and reishi, for starters. Taking these herbs alone will build your mitochondria (and if you want to spark your ATP as well, then include Kidney Yang tonics).

Admittedly I wrote a blog about this three years ago, but the commercial push has grown big and vast since then so I think it bears retelling. Here it is.

A combined Western Medicine/TCM study that was done in China yielded surprising results in the connection between the Spleen in both medicines.* In the study, a tiny camera was introduced into the mucosal lining of the stomach in both normal patients and those with the TCM symptoms of deficient Spleen Qi -- poor digestion, low appetite, gas, bloating, acid regurgitation, loose stools, undigested food in the stools, malnutrition, weakness in arms and legs, fatigue, poor muscle development, edema of abdomen, hips and thighs, blood spots under the skin, easy bruising, lack of sensation of taste, prolapsed organs, frequent bleeding, abdominal distension, obsession, worry and anemia.

The results of the study showed a marked correlation between the quantity and quality of mitochondria in the normal patients versus those with deficient Spleen Qi (keep in mind here that the mitochondria are the "powerhouses" of the cells and so relate to Qi, or "energy," in the body).

In the normal patients the mitochondria were abundant in number while in those with deficient Spleen Qi, the mitochondria were not only fewer in quantity, but the ones present were damaged, swollen and/or had poor reticulation. This affected many aspects of the body, such as poor digestion, decreased hemoglobin levels and reduced muscle strength.

As an example, the deficient Spleen Qi patients in the study experienced abdominal flatulence, abnormal stools and undigested food in the stool after intake of a high protein diet. All of them had obvious quantitative and qualitative changes of their mitochondria and displayed a decreased number of the enzyme secreting cells (zymogen granules) necessary for normal digestion. A deficiency of Spleen Qi was thus found to correspond to an insufficiency of digestive enzymes and a reduction of enzyme activity, interfering with digestion of proteins.

There are many more correlations between the functions of the Spleen in TCM and that in Western Medicine, but it'll have to wait for a full article, or a book Michael and I have talked about writing for over a decade on comparing the two medicines. This blog post is meant to just give you a taste and hopefully, inspire you to explore the comparisons between the two medicines on your own.

In the meantime, there are many herbs that tonify Spleen Qi and they may well increase the number, improve the function and correct the damage and malformation of the cells' mitochondria. This is good news. Readily available and well known, they include: ginseng, dioscorea (Chinese wild yam) codonopsis, astragalus and jujube dates. Give them a try and see if they don't improve your brain function, too, since strong Spleen Qi enhances the ability to focus and memorize.

*Traditional Chinese Medicine Digest, Vol. II, 3 & 4, 1987, The People's Medical Publishing House, SHK international Services, Ltd., 22/F, 151 Gloucester Road, Hong Kong.

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