STRESS:

Stealthy foe takes many forms, extracts high price

It may be time to relax.

It’s not your usual prescription from an M.D., but Dr. Gailen Marshall thinks more patients would do well to receive that script.

He said stress burns its way from the mind through the body, surfacing as skin disorders, backaches, ground teeth, allergy-like post-nasal drip and other maladies.

“It’s estimated that 75 percent of all doctor visits in the U.S. – that’s all physician visits, not just to immunologists – are stress-related,” said Marshall, professor of medicine and director of the clinical immunology and allergy division at the University of Mississippi Medical Center.

Greater awareness of the validity of the mind-body connection – often known as integrative medicine – can drastically improve public health, he said.

A few decades ago, doctors dismissed the notion of prescribing meditation or deep-breathing exercises. But integrative medicine is gaining momentum in academic medicine, Marshall said. And it’s evidence-based.

He said the bigger picture of stress-related study is to change public policy. According to Marshall, medical insurance coverage often shorts psychiatric care disorders. The more people recognize the mind-body connection, the quicker it will get pulled back into the mainstream of clinical care. And that will help keep people healthier.

Medical Center experts weigh in on the impact stress can have on overall health.

Teeth-grinding

Feeling stressed out is bad enough, but suffering painful muscle cramps because of clenching and grinding your teeth certainly makes matters worse.

Often the pain associated with teeth-grinding is referred to as TMJ, but that’s actually the name of the joint, explained Dr. Francis Serio, professor and chairman of the Department of Periodontics and Preventive Sciences in the School of Dentistry.

TMJ stands for Temporomandibular Joint, that part of the skull where the lower jaw hinges to the cranium at either side of the face, making it possible to open and close the mouth and chew food.

“People will grind their teeth for a number of reasons, one of which is stress itself,” Serio said. “Some people notice that they’re doing it, some don’t. They might catch themselves and stop for a while. Then start up again. There is a psychological component.”

If teeth-grinding leads to TMJ disorder, the results are painful muscle knots at the temples or inside the cheeks. The pain can be treated by massaging the temples, applying moist heat or getting a prescription for muscle relaxants.

Keep in mind, a case of TMJ disorder doesn’t necessarily mean a person has too much stress. Teeth-grinding also can occur because of problems related to occlusion, or how the upper and lower teeth come together. These include “high spots” and tooth extractions, Serio said.In both cases, wearing a bite guard to bed can ease the strain on the muscles and stop the pain.

Nervous stomach

Some call it butterflies in the tummy. Others credit the condition to a “nervous stomach.” But in times of heightened anxiety, almost everyone has experienced a funny feeling in the pit of their gut. And the more intense the situation, the more the queasiness is ratcheted up.

Although the connection between stress and the stomach has long been recognized by medical professionals, it hasn’t always been completely understood, according to Dr. Roland F. Garretson, associate professor of medicine. He said 40-50 years ago, ulcer disease was thought to be more prevalent in “white-collar” high-stress jobs. Subsequently, the rate of ulcer disease in “blue collar” workers has been found to be similar.

“Stress plays a role, but it can be very difficult to quantify or to measure,” Garretson said. “’Nervous stomach’ typically refers to irritable bowel syndrome, and the best measure is that the muscle contractions of the intestines in patients with IBS is abnormal compared to thosewithout IBS.”

Garretson estimates as many as 70 percent of his GI patients have conditions that are caused or aggravated by stress.

“Modern conveniences have not increased our leisure time; rather, they have compressed time,” he said. “Avoid letting the tyranny of the urgent rob you of doing what is really important.”

The Psychology of Stress

Dr. Donald Penzien, professor of psychiatry and human behavior, said most people think of major events when they think of stress, such as loss of a loved one or a job.

Those are times when people can draw from the comfort and support of family and friends and are generally afforded accommodations by acquaintances, coworkers and employers as they strive to manage their stressors.

“But what tends to be a more common issue for people combating stress are the everyday hassles, the daily kinds of grind that chip away,” he said. “When you’re worrying about losing your job but it hasn’t happened yet. You’re worrying about being able to send your child to college.

“Those are the kinds of stressors for which there often is no quick resolution that tend to pile on and often can prove difficult to cope with.”

Stress can manifest psychologically with internal reactions, such as negative self talk, pessimism and mood swings, Penzien said.

He recommends several coping strategies, including focusing on the positive, getting appropriate sleep, healthy eating, building a support system of family and friends, taking a respite from stressful situations and taking time for leisure activities.

Joseph Verzwyvelt

Joseph Verzwyvelt is making his M2 year — often called the toughest stretch of medical school — look easy.

Not that anyone would know to meet him, but the last few years threw him a lot of adversity.

Hurricane Katrina interrupted his undergrad education at Louisiana State University when the storm flooded the Biloxi condo where his mother and brother lived. From Baton Rouge, he drove to Biloxi and found much of his hometown destroyed.

“You’re practically in a war zone,” he said. “Helicopters overhead dropping food, people fighting over ice, paranoia that somebody’s going to steal your gas. You stop and wonder, ‘Is this America?’ I didn’t sleep for three days.”

On the storm’s third anniversary, his brother, who struggled with addiction, died. That came just as Verzwyvelt faced his first round of big exams in medical school.

Since then, he’s put all that stress through the washing machine of his personal ethos: Turn around adversity, learn from it and find a way it can make you a stronger person.

Verzwyvelt volunteers, helps classmates and works out five times a week. He’s also the academic lead in his class. Volunteering, he said, always shows him how good he has it. And going into emergency medicine could give him a chance to save the life of someone like his brother.

His wife, his home, his social network and even mowing the grass all help relieve stress.

“Being married gives me a strong foundation,” he said. “You’ve got somebody there who knows you and can tell when things are getting to you. They make you more aware of what’s going on.” — JM

Barbara Sloan

Oncology nurse Barbara Sloan says she cries just about every week and asks herself why she’s doing what she’s doing. But she always has a ready answer: “because it was done for me.”

Her father died of cancer in 1988. “His nurses had a profound impact on me.” So at 35, she enrolled in nursing school so she could do for others what had been done for her.

Yes, dealing with cancer patients is difficult. Not all outcomes are bad; many more patients survive cancer than ever before. But an oncology nurse, who gets to know the patient and the family over the course of long and sometimes painful treatment, feels the pain and loss they suffer.

“Helping and supporting the families through the crisis is sometimes the most important thing we do.”

She copes with the stresses of her job with exercise (she walks three times a week) and talking to her husband.

“He’s a great listener, and is always ready to hear about my work.”  —JQ

Ivory Bogan

When things go wrong at the Medical Center, Ivory Bogan’s phone rings.

As director of physical facilities and real property management, Bogan oversees 351 employees: everybody from carpenters to electricians to boiler crews. His purview covers the Medical Center’s well system, buildings and contracts for the shuttle service and parking-lot attendants.

Plus, he’s got the ever-problematic parking issue.

But after 36 years at the Medical Center and the last three in the director’s chair, he’s got the job – and stress management – pretty well figured out.

“When stress builds up, I just manage it away. I cut the grass, work around the house and weed eat,” he said. “I’m not a TV person. I get bored and have to have something to do.”

Since his property in Terry adjoins  that of Dr. Wallace Conerly, vice chancellor emeritus for health affairs, Bogan helps out with his neighbor’s chores, too.  — JM

Cathy Taylor

Cathy Taylor’s secret to dealing with a stressful job? Getting it right.

Taylor is director of catering (actual title: catering and client services manager) for the Medical Center. What could be more stressful than getting 100 perfect plates served on time and at the right temperature? Yet Taylor says succeeding at the challenge is what makes the job rewarding – and overall less stressful.

“Catering is all about timing,” Taylor says. “You can’t be late – that’s the worst thing – but you can’t compromise quality.

“The stress for me is making sure I don’t disappoint people. I don’t want to let people down. But I do work with a great team that I can count on. I can’t personally be at every catering event on campus, but they see that it’s done properly.”

It’s a rare day that Taylor and her staff aren’t preparing food for back-to-back events, and on those atypical days, Taylor actually gets a little bored and, yes, stressed.  — JQ

Jera Anderson

After 13 years as supervisor of the Help Desk – the Medical Center’s in-house IT troubleshooting resource – Jera Anderson knows something about stress.

Within the last six months alone, Anderson and his team have been challenged by an institution-wide power failure that threatened to shut down life-sustaining hospital equipment and a dastardly computer virus that corrupted the campus network and imperiled hundreds of workstations.

Constantly staying on top of emerging information technology can take its toll. Anderson said he manages the pressure by “keeping family first.”

But to really let off steam, Anderson straps on a guitar, picks up a harmonica or settles in behind a percussion kit as front man for the Home Remedy Band.

“Playing rock and roll and taking on another persona, I can really cut loose,” said Anderson, who has performed with the band for 16 years. “I guess you might say I like to try to pretend I’m a rock star.”

Anderson said watching people being moved by music “recharges my emotional batteries. And there’s no greater stress reliever than playing the blues.”

But he credits a healthy dose of perspective for helping him weather the most challenging information-systems issues.

As members of the Patriot Guard Riders – a group of avid motorcyclists who attend the funerals of U.S. Armed Forces soldiers – Anderson and other DIS staff help provide escorts, flag lines and physical shields for grieving families against those who might protest their loved ones’ services. In the last four years, Anderson has participated in more than 50 missions, from northern Tennessee and eastern Georgia to Texas.

“When you see the grief that these fathers, mothers, husbands and wives endure with their sacrifice, the stress we encounter here is truly nothing by comparison,” Anderson said. “When you put yourself in their shoes, you recognize just how lucky we have it here at this university.”  — BC

-Jack Mazurak, Matt Westerfield, Bruce Coleman andPatrice Sawyer Guilfoyle

 

2009-04-10 00:00:00 18889