End the Negative-Thinking Game

A constant inner dialogue runs through your mind on a daily basis. Our minds don’t place any value on the content of these thoughts but does weigh them by volume. Unfortunately, research shows that humans have an inherent negativity bias that shapes perceptions about a variety of tasks and psychological situations.

This bias often creates intrusive and repetitive negative thoughts commonly referred to as Automatic Negative Thoughts (ANTs). A baseball player who repetitively tells himself that he is “no good” or “letting his team down” every time he makes a fielding error is being bitten by ANTs.

An ANT is an intrusive idea or theme that often accompanies considerable negative emotion. The aforementioned baseball player likely leaves the field feeling frustrated, tense and apprehensive after making errors simply because of the feedback loop playing in his brain. The truth is that these thoughts rarely contain any validity.

Retro Vintage Motivational Quote Poster. No Negative Thoughts Allowed. Grunge effects can be easily removed for a cleaner look. Vector illustration
Research shows that negativity can affect your health.

Health Effects

Negative thinking can affect performance as well as overall health. Considerable evidence exists that negative thinking and negative emotions contribute to increased inflammation via a release of pro-inflammatory cytokines, which can make individuals more susceptible to illness and injury and slow healing.

Automatic and repetitive negative thinking also can affect the amount and quality of sleep. Research has shown significant deficits in college students who engaged in chronic negative thinking patterns.

Common Thought Patterns

Identification of your thinking patterns and uncovering ANTs is helpful in the reduction or elimination of these cognitive habits. While somewhat similar, these thought patterns fall into certain categories:

  • Overgeneralization is a skewed thought process where one negative event is extended beyond that single event. For example, being late to work produces thoughts like, “I can’t seem to get anything together; I’ll never be successful.”
  • Filtering is a bias toward only negative feedback. “My boss thought my report was good except he said I needed to check a couple numbers. He probably thinks I’m incompetent.”
  • Emotional reasoning is mistaking feelings for facts. For example, when someone “feels fat,” they automatically assume that they are overweight.

Strategies for Tackling Negativity

Do you ever have thoughts like these? Let’s take a look at a few strategies to change your cognitive approach and your health for the better. While these thought patterns may have some commonality, solutions are not necessarily “one size fits all.”

  • Mindfulness entails having an awareness of what you are thinking and feeling and beginning to look at thoughts and situations as just that. Thinking “I am worried” or “I am embarrassed” is a first step. I work with patients to teach them to accept feelings as they are and refocus on the task at hand in that moment.
  • Decentering acknowledges that we have negative thoughts, but we also have ones that are positive and neutral. We can learn to choose which thoughts to attend to and which ones don’t matter. Put the more helpful ones front and center while decentering what doesn’t actually belong. I suggest keeping a journal and reviewing the meaning, or lack thereof, of thoughts on a certain subject.
  • Restructuring recognizes an ANT or negative idea and disputes its validity; basically finding evidence or lack thereof for this belief.

The content and quality of one’s thoughts affects your overall outlook and well-being. I challenge you to start incorporating more positivity and mindfulness into your days. It just may improve your health.

Resting Metabolic Rate: The Key to Understanding Your Metabolism

Knowing your individual resting metabolic rate (RMR) and what factors most influence your metabolism is essential in creating a smarter strategy to tackle weight loss, gain muscle, run longer or faster, taper before a race or refuel after training.

RMR represents the energy expended at rest to support basic physiological processes such as controlling body temperature, breathing, circulating blood and contracting muscles, as well as supporting brain, organ and nerve activity. RMR accounts for approximately 70% of the total energy we expend each day. Many factors influence your RMR such as age, body temperature, stress and muscle mass. Our RMR generally declines with increasing age due to a decrease in fat free mass and can increase due to stress.

The number of calories you need per day is dependent on a number of factors such as age, body weight, gender, RMR and physical activity levels. Your RMR may vary between 1200 and 2400 calories a day or more depending on your activity level. Once you know your resting metabolic rate you can determine your total daily caloric expenditure by taking into account the thermic effect of exercise (TEE) which is the amount of calories burned during exercise and the thermic effect of feeding (TEF) which is the amount of calories burned to digest food and accounts for less than 10% of your total caloric expenditure.

Learn more about the thermic effect of food and starvation mode from a previous blog, "The Meal Frequency Myth."
Learn more about the thermic effect of food and starvation mode from a previous blog, “The Meal Frequency Myth.”

Experts in Sports Performance at Houston Methodist see many people fall into the trap of eating too little when trying to lose weight which can have a negative effect on their metabolism and result in a significant slowdown of metabolism. The body thinks it is in starvation mode, making it harder to lose weight.

If you eat less than your resting metabolic rate or if you’re not eating enough calories to support your current activity level then you could be doing more harm than good to your metabolism. This is especially true for athletes. Once you find out your individual number you can determine exactly how many calories your body needs to lose, maintain or gain weight.

The opposite is also true as many people are eating way more calories than their body needs and are shocked when the results show that they need to be cutting their caloric intake in half or more. We recommend using a calorie tracker app that allows you to input your food intake and calculates your calories for the day.

RMR testing can tell you how many calories your body needs based on your goals, putting you in control of your weight rather than guessing. For accurate results, you should be fasted for at least eight hours and in a rested state at least 30 minutes prior to testing. Testing is best done first thing in the morning and involves breathing through a mask in a comfortable position for 20 minutes.

The test provides information on your metabolic rate and whether you are burning fats or carbohydrates. A nutritionist can use this information to tailor a diet plan specifically for you.

Can you ace this triple negative breast cancer quiz?

With Breast Cancer Awareness Month upon us, it’s as important as ever to ensure you have the latest breast cancer facts. Take this short quiz to boost your knowledge of triple negative breast cancer — one of the disease’s rarest and deadliest forms.

Learn more about breast cancer prevention, treatment and support → CLICK HERE.

The benefits of exercising your brain

Have you ever wondered why exercising your brain is important and how you can exercise it to keep it healthy? Research indicates that exercising the brain is like exercising the heart; when we keep blood flowing, we keep ourselves fit.

I spoke with Dr. Mario Dulay, neuropsychologist at the Houston Methodist Neurological Institute, who gave us two important factors on how to keep your brain healthy and in shape, and why doing so is good for you.

Use it or lose it

The more you test and use your brain, the better it will perform. Dulay says that any cognitive stimulation is better than none, so staying physically, mentally, and socially active allows your brain to function better than a less active person.

Brain training featured image
Mentally-stimulating activities reinforce brain cells and the connections between them, and might even create new nerve cells.

According to the Alzheimer’s Association, mentally-stimulating activities reinforce brain cells and the connections between them, and might even create new nerve cells. Such stimulating activities consist of games, educational activities and social activities.

Practice makes perfect

Cognitive compensation refers to the idea of practicing tricks to improve cognition. Examples include using mnemonics to remember people’s names, or using a calendar to improve the likelihood of not forgetting.

Dulay says people become more forgetful and lose cognitive abilities as they age. By compensating with tricks or reminders, we help maintain our independence and decrease stress.

In addition, compensatory activities may provide mental stimulation that can improve cognitive function and increase cognitive reserve, or the mind’s ability to resist damage to the brain.

Brain training is all about picking something you love so you'll do it consistently Click To Tweet

Dulay also emphasizes that it’s not just about doing anything; it’s about doing what you love and doing it often.

Here is a list of some suggested activities you can do to help exercise your brain:

  • Read
  • Volunteer or mentor
  • Learn something new; a new instrument, hobby, language, etc.
  • Explore a region or culture of the world that interests you
  • Brain teasers or word games
  • Write a blog
  • Attend a cooking class
  • Play with your grandchildren

Each of these activities can help stimulate your brain; but remember, it’s important to find something you enjoy doing and will consistently do.

How nursing allows me to give back

When I reflect on the elements which persuaded my decision to become a nurse, I cannot ignore hereditary influence. Between my maternal grandfather’s aunt serving with Florence Nightingale during the Crimean War and three of my aunts graduating as diploma nurses after WWII, I would say my genes are pretty entrenched in a passion for nursing!

My first job during college was working as a weekend secretary on an orthopedic ward at a major medical center hospital in the northeast. It was then that I grew to admire the spirit of the floor nurse who wore a starched white uniform, nurse’s cap, white stockings, white shoes and a navy blue cape clasped at the neck worn during cold, snowy weather. I was in awe of how that uniform stayed a pristine white after an eight-hour shift. I loved to sit at the bedside with some of the long-term patients to listen to their stories. I was so excited to be a small part of their team!

Although I was told, “You should have been a nurse,” many times during my life, I don’t think I seriously considered going into the nursing profession until I experienced a life-changing event that happened to me as a patient at Houston Methodist Hospital.

Florence Nightingale
Nursing has always been in Christine’s blood. Her maternal grandfather’s aunt worked with Florence Nightingale (picture here), who is considered to be the founder of modern nursing.

As an adolescent, I developed a chronic hip condition that led to significant arthritic pain and immobility. The predictable treatment was total hip replacement. I was encouraged to wait as long as possible to receive the most reliable implant that would improve my quality of life; a life without chronic arthritic pain. A nurse from our church recommended a well-known, highly respected orthopedic surgeon at Houston Methodist Hospital. At 40 years old I underwent hip replacement surgery. I remember waking up in a private room on Dunn 7, surrounded by my family; and best of all, I was free from hip pain!

My nurses exhibited a gentle and caring passion in the art of nursing. They taught me about hip precautions and infection control. I trusted them with my life and I was deeply saddened to say goodbye on the day of discharge!

This positive experience left me with a profound urge toward following the Golden Rule, that is, to “give back.” Could I be a nurse? My hip was fixed, but I was unsure I could endure the physical demands required of a nurse. My ultimate nudge was from my husband who said, “There is nothing wrong with your brain — go back to school and become a nurse.” That gentle push was what I needed to satisfy my need to give back to those who changed my life.

I have since graduated with my master’s degree and have shared my personal story with many elective joint replacement patients, some of whom are nurses and doctors here at Houston Methodist. I hope that sharing my experience has made a difference.

How my mom inspired me to become a nurse

When I was in third grade, my mom was a single parent and worked nights as a charge nurse at the local hospital. She would take her three girls to work with her because she felt it was safer than leaving us at home alone. She would make things convenient and comfortable for us in the break room. She would make sure we had enough snacks, blankets and things to keep us busy during her 11-7 shift.

Most nights I would not sleep. Being the youngest of the girls, I was pretty attached to my mom. I would get up just to follow her around and watch her take care of the patients. She was such a caring nurse and would go from patient to patient checking to see if they needed anything for pain or if they were comfortable.

I remember very vividly when a patient passed away on my mom’s shift and, being the only RN in charge, she had to prepare the body for the funeral home. I asked if I could help, she asked me if I was sure and I told her yes, I wanted to help.

As I assisted my mom, I watched how caring she was to this patient, and considering the family would be there to see him soon. She cleaned him and treated him with so much dignity and respect that even at that young age all I could think about is I how I wanted to be just like her — a caring nurse and loving mom.

Today, my mom is a retired nurse practitioner. I followed in her footsteps to become the caring nurse I am today. After 25 years, I still enjoy taking care of the patients. As a professor of nursing students, I have passion for paying it forward. All this from the inspiration came from my mom.

6 effective ways to alleviate allergies

I will never forget the day I underwent my first allergy prick test. My primary care physician recommended I see an allergy specialist after he had treated me for multiple sinus infections over the course of a year.

I scoffed and said “I don’t have allergies!” But I scheduled the appointment with the otolaryngologist nonetheless. A few weeks later, as I sat there with my arm and back on fire, nose running like a fire hose and eyes feeling like I’d been hit with pepper spray, I thought, “Hmm … maybe I do have allergies.”

What’s followed since that day is a constant battle against my many year-round allergies. Outside of medicinal remedies, there have been many tricks I’ve learned over the last few years that have helped me alleviate allergies.

1. Get informed. I have a little app on my phone that I check every day to check what allergens are in the air and what their level is. It may seem like a no brainer, but since I know ragweed is my mortal enemy, if ragweed levels are high, I know not to spend too much time outdoors. Most television weather forecasts also include allergen information.

2. Be prepared. Until I win the lottery (fingers crossed!), I’m going to have to mow my own lawn. Being allergic to grass I’ve learned that wearing a protective mask, immediately showering after I come inside and throwing the clothes I wore to mow the lawn in the washer all help keep my grass allergy in check as much as possible.

3. Be clean. In addition to taking a shower before I get to bed to get any allergens out of my hair and off my body (lest I take them to bed with me), I also make sure to wash my bedding once a week in hot water. This helps prevent allergens from building up, including dust mites, which some people are allergic to.

Washing your bedding once a week in hot water can prevent allergens from building up Click To Tweet

4. Seriously, be really clean. High Efficiency Particulate Arresting (HEPA) filters may help keep the air in your home a bit more breathable. Do your homework as you could spend a small fortune on these if you’re not careful. Make sure you change them regularly. Rugs and carpets can become cesspools for allergens. If you have a choice, go with bare floors. You may also want to make sure you dust regularly, especially in places like mini blinds and fans that seem to get dusty very quickly.

5. Drive carefully. That’s always good advice, but I mean be smart when driving. Keep your windows up and make sure your air conditioner is recirculating air and not drawing it in from outside the car. If you’re car has cabin air filter (most newer cars do), make sure you change it at least once a year or as suggested by your car’s manufacturer.

6. Talk to your doctor. If I hadn’t had a conversation about this with my primary care physician, I wouldn’t have gotten that allergy test. Now that I know what I’m up against, it’s been easier to stay healthy.

These are just a few things that others have shared with me over the years that have helped me cope with my allergies. Until NASA starts selling space suits to walk around in, I’ll keep fighting the good fight against allergens.

How Jacquline survived Chiari malformation

On May 14, 2010, Jacquline Adams, who goes by the stage name Iman Heartandsoul, abruptly woke up from her sleep and began to shake uncontrollably. She felt as if she was losing control of her body, and when she got up, she knew she wasn’t her normal self.

After numerous hospital visits, doctors couldn’t settle on a diagnosis and Jacquline started losing hope. That’s until she came across “Zipperheads,” a Facebook page about Chiari malformation, a condition in which the cerebellum, or the part of the brain at the back of the skull that controls balance, is too small or deformed, which puts pressure on the brain.

Members of the Facebook page shared similar symptoms to the ones Jacquline was experiencing, including headaches, pressure in the head, ringing in the ears, lack of sleep and depression. They advised her to see Dr. Rob G. Parrish, a neurosurgeon at Houston Methodist Hospital.

Chiari malformation MRI
This MRI image shows a Chiari malformation. Image via Wikipedia.

After reviewing a previous MRI, Dr. Parrish diagnosed Jacquline with Chiari malformation. Jacquline recalls Dr. Parrish saying he was stunned that she was still walking considering how advanced her condition was. Soon after her diagnosis, Dr. Parrish performed surgical decompression that resulted in the removal of two inches of her skull and two bones from her neck to make room for her brain. While the surgery is not a cure, in some cases it halts or stops the progression of the disease.

“I decided after my surgery that I would be a fighter, a survivor, and I was determined to bring some well-needed attention to an unknown illness,” Jacquline said. “The more attention Chiari gets, hopefully Chiarians will not have to search and suffer as long as I did just to get diagnosed and treated.”

As a singer, Jacquline knew she wanted to use her talent to financially help parents of children with Chiari. After her surgery, Jacquline recorded and released her own CD, “Determination,” where all proceeds went to helping these families in need.

She also founded a nonprofit, Iman’s Zipperhead Hearts for Chiari, and started an annual benefit concert and fundraiser, An Evening with Iman and Friends. The fundraiser was designed to raise awareness and assist Chiari patients financially, and has received a proclamation from the office of Mayor Annise Parker that declared Saturday, May 9, 2015 as “An Evening with Iman and Friends Day.”

“I have had my ups and downs, my good days, my bad days, but with the support of my husband, children, family and friends, I got better and stronger – mentally, physically, and emotionally,” Jacquline said.


Chiari malformation was earlier estimated to affect nearly 1 in every 1,000 people. With the advancement of technology, experts now believe that Chiari is more common than previously thought. To learn more about Chiari malformation, visit this resource page.

Surviving nursing school and the first years in the real world

Now you’re a Registered Nurse (RN) or working toward graduation. Plans of serious celebration have been rightfully put in order for some time. You have said goodbye to a full night’s sleep, nail polish in exchange for scrubs, learned about evidenced-based practice, good bedside manner and the diligence to work up four-to-five patients since 5 a.m.

To the rest of the world this may sound crazy. Why did you put yourself through all of that? Because you want to do the one thing that has captured your spirit and tugged on your heartstrings ever since the moment you realized you wanted to become a nurse: you want to make a difference.

Nursing school has a way of pushing a sequence of buttons. In the real world of nursing the same is true, but it’s a different set of buttons. The difference is after school you emerge stronger, refined, polished and professional. You have the thinking required to take charge, augment your responses and practice nursing in the clinical way.

Ronie Bisping quote about nursing
Keep perspective throughout your entire nursing career.

Many aspects of your career may change, but there is one thing that does not change: you and the kind of nurse you want to be. If you are in school, listen to your inner voice, do what strikes you best and get inspired. Why did you want to become a nurse? Remind yourself of that every day before beginning a shift.

Tips for new nurses

Positive communication. This is the single most important skill to master no matter. As a patient advocate and university/hospital representative, your communication skills need to be on point 100 percent of the time. People may not remember the exact verbiage that you used, but they will certainly remember how you made them feel.

Be honest about your capabilities. “RN” covers a multitude of jobs that involve patients from all different walks of life, settings and acuities. While I will always be the No. 1 cheerleader for every person climbing that nursing ladder of success, know where your limits are and know when to speak up.

Own your leadership skills. You are on the front lines of leadership and patient advocacy. The difference between someone only wanting to clock in and clock out and someone showing up to make an outstanding difference is noticed.

As a nurse, your communication skills need to be on point 100% of the time Click To Tweet

Get in there. Nursing is a lifelong journey and the destination is not graduation. Whether you are two years or 42 years into your nursing practice, the process of learning never ceases. Find what works for you, the patient and your team, and seek to understand what resources are available to you and your practice.

Organization is key. Nursing is a planning profession. Get your name on the books now. None of this is meant to panic you; only to stress the importance of organization into every element of your life.

The key to success finding out what is expected of you, knowing what tools are available, beefing up your knowledge base and organizing it in a fashion that compliments your practice and life. Watch and learn from those a few steps in front of you and do not be afraid to bring what you have to offer to the table.

Growing pains are inevitable. Bodies grow and so do minds, spirits and personal limits. If your desires are true, your intent pure and your will strong, all the things you thought you couldn’t do you, you will see in time, you have been doing all along.