chronic disease

Are You Your Illness?

One of the things I have noticed in my decades of working with chronically ill people is that they learn to identify quite closely with their illness. They have to; it’s a survival strategy. The easiest way to adapt to pain or illness is to learn its patterns -- when it strikes, when it sleeps, what will provoke it, what will mollify it.

Psychologically, living with chronic illness or pain is like living with someone who is abusive, and from whom you have no power to escape. Eventually, you come to identify with your abuser, and make their patterns your own. This disempowerment of the self, the loss of the ability to see yourself outside of your disease, makes it far easier to live with it, yet at the same time makes it more difficult to improve.

The person who identifies with their disease is perhaps the most dangerous and difficult to help manifestion of chronic illness that I have seen, and it can take many forms. I’ve had beautiful women in tears in my office over the belief that no other would accept them as a partner because of their chronic joint pain, and I frequently see posts on social media from people whose entire public presence is built around coping with their disability. Once you have identified yourself as “I have X” (X being a diagnosis, like MS, fibromyalgia, sciatica, irritable bowel disease), separating self from disease becomes a monumental task.

Part of the problem is as a result of how we look at disease in this society. We turn health issues which are basically dysfunctional processes (an overgrowth of cells, excess deposition of fatty tissue, production of inflammatory cytokines), into a static thing: “I have IBS,” we say, or “I have arthritis.”

Once you have converted something from a process into a thing, you have made it much more difficult to change. A process is the B train on the Green Line; it can go fast or slow, make stops, let riders off and on. A thing is a rock; it does not move. It can be changed by the erosion of water and ice, but it takes eons and lifetimes will end before any discernable difference is made. Processes are malleable to time and space and changes of input. On the other hand, things don’t change, without application of saw and hammer and destructive acid.

The second part of the problem becomes how we describe ourselves. Instead of a person with high inflammatory potential and impeded antioxidant processsing, we say “I have arthritis.” Rather than being a person who reacts strongly to certain foods which influence neurotransmitter production, we admit that “I have depression.”

So there we have it. We have a thing which we cannot change, which is only sufferable by controlling our behavior in the most intrusive ways possible. You might as well proclaim “I AM HEART DISEASE.” Because that, in your heart of hearts, is what you’ve been taught to believe.

This self-identity can become so strong that I have, many times, had patients abruptly abandon successful care because it was taking away a part of their selves that they had come to accept as necessary and needed. I would call them on the phone, ask them, “What is wrong?” They would reply, “It was working so well, and then I felt so bad!”

This was my failure, because I failed to prepare my patients for what they could become in the absence of disease. They could become more, not less.

Over time, I have developed a method of helping patients to realize that which they can be, without illness, without pain, and without all of the benefits they may see themselves as getting as a result of their illness.

I call it Contemplation of You As You May Be.

Step 1: Sit somewhere quiet, where you won’t be disturbed for 10 to 15 minutes. Close your eyes, and form a mental image of yourself. See yourself, as your disease affects you, in stillness and movement, in shape and color, in smell and sound. Take a minute or two, and completely build this picture of yourself in your mind. Feel and explore the effects of your disease or your pain on your body.

Step 2: Take a piece of paper, and write down all of the attributes of your illness on your body. There will be different groups of sensations: There will be the appearance -- red, pale, swollen, scaly. There will be the sensations -- burning, achy, itchy. There will be the mental -- fatigue, forgetful, hyperactive. Then there will be the emotional -- sad, mirthful, confused, scared.

There will be more than you can think of, and the first time you do this exercise, it is best not to overwhelm yourself with too many attributes. Start with the obvious ones, that’s good enough for this time.

Step 3: Having written down all of those attributes, close your eyes again, and re-imagine the mental image of yourself that you developed in step one. Then, one by one, start removing the attributes of your illness. Start with the physical ones. See yourself without the swelling, without the redness. Take your time.

Once you have a strong image of yourself in your mind without the physical attributes, begin to remove the sensations -- the pain, the burning, the ache. What do you look like without those things? How does that image of yourself feel without them? Again, take your time. This may be as far as you get the first time you do it.

But if you can go further, keep removing more and more aspects of your illness, of your pain. Take away the sadness, take away the fatigue. In your mind’s eye, what do you look like? How do you feel? How does your voice sound? What is it like to move?

Once you have removed all of the attributes of your illness, what will remain in your minds eye is you. Your without the disease. You without the pain. You without that which has forced you to be something that you are not for so long. Be prepared; your mind will keep wanting to return you to the first image. Keep yourself fixed on the self without disease.

Know that this person, this aspect of you is alive and well, and strong. Every day, do this exercise, until finding the healthy you is a trivial matter. And as that you becomes stronger and more real, the you defined by your disease becomes weaker and weaker. Eventually, you will have divorced yourself so thoroughly from the process of your illness that your therapy -- whether it is chiropractic, or acupuncture, or exercise or diet, or all of the above -- begins to take hold. You are replacing sick belief with healthy belief.

And at some point, when you look at your reflection, you’ll realize that the you in the mirror has become the you in your mind.

A Girl, A Trike and A Disease

Denise Lanier and her trikeEvery patient who walks into my exam room receives -- at no extra charge! -- a critical evaluation of their exercise regimen, or lack thereof. At this point, regular exercise has been proven so critical in the prevention and treatment of so many disorders, from depression to cancer to heart disease to the cold and flu, that in my not-very-humble opinion, any primary care doctor who does not investigate, evaluate and manipulate their patient's exercise program is committing malpractice. Yes, it's that important. It's like not taking a patient's blood pressure or pulse. A person's participation in exercise is one of the vital signs of wellness. Frequently, my job is to find exercises that will work within the boundaries set by a patient's existing disorder while at the same time optimizing it to reduce or eliminate the effects of that same disorder.

Among the chronic diseases, one of the most problematic in the exercise prescription department is Multiple Sclerosis (MS). Because of this cruel disease's frequently erratic behavior, coupled with its prediliction for shaving away a small slice of one's competence with each renewed assault, it is hard to find and develop good exercises for my patients suffering from this disease. What was possible last week becomes impossible the next. Problems in balance or sudden weakness can make many standard exercises impossible or dangerous. And the fear of such occurrences can negate even the most committed patient's determination and my craftiest motivation strategies.

Being a recidivist transportation cyclist,  an environmentalist, and a man with a grip on the purse that would make a Scotsman proud, it has rarely come as a surprise to my patients when I suggest cycling as a good all-round exercise. Bicycles are cheap, and every time you ride it to the grocery store, you save money, while at the same time becoming healthier and increasing your longevity. As the great Oregon Congressman Earl Blumenauer once said:

"Let's have a moment of silence for all those Americans who are stuck in traffic on their way to the gym to ride the stationary bicycle."

Cycling would be an excellent activity for my MS patients as well, were it not for the unpredictable and troubling manifestations that could make it downright dangerous.

Which is why I suggest a fun, albeit unusual, alternative: Trikes.

No, these aren't your average 4-year-old's Big Wheel. I'm talking about performance trikes, trikes that have been ridden to the furthest reaches of the Himalayas, in the fastest bicycle races in the world, and on the road. They are trikes that can be ridden every day, as fast or as slow as you want, without concern for the types of crashes that can befall you on a two-wheeler.

For that reason, I think trikes are an excellent source of rich cardiovascular exercise for my patients with MS. And here's how many have taken me up on my suggestion: 0. None. Nada.

Well, all of my patients with MS, and all of you reading this blog who have MS or have friends or relatives who are suffering from the effects of  MS, I want you to take note of this name: Denise Lanier. Denise is a writing professor at Broward College. Her poetry has appeared in Bloomsbury Review, Cake, Luna, Best American Poetry blog, and various anthologies. And she has MS.

In her blog, Wonky Woman on a Bent Trike, Denise writes about her two most powerful tools for fighting this disorder (in addition to her undeniable intelligence and phenomenal willpower): A mobility dog and her trike.

This weekend, after much training, Denise will be riding her trike in the New York City Marathon, as a disabled entrant in this world-famous race, and the first entrant to do it on a tricycle.

But is she doing it for herself? For an MS charity? Certainly not - that would be too self-serving for a woman as generous in spirit as her. Denise has chosen the Leary Firefighters Association as the beneficiary of the dollars she has raised. Go here to read what Denise has to say about the foundation. Then go here and donate.

But more important than any of that, read the words this woman has written, about herself, her MS, and her fight toward health. For anyone with a chronic disorder, she is an inspiration.

And I hope everyone reading this blog (all 6 of you) will join me this weekend in following her progress and cheering her on. In her most recent post, she suggests some ways to do it:

Here’re some ways for you to follow my progress in the marathon on race day, this Sunday, November 7th:

Online Athlete Tracker:  free race-day service, visit on November 7th

Text Message Athlete Alert:  sign up at to receive on-demand updates, one-time setup fee of $2.99

Tune In:  NBC4 New York offers live coverage of the entire race; after the race catch the 2-hour highlight special on NBC Sports

Marathon App:  for iPhone, iPod Touch or iPad, download it today!"

Then go out and buy a trike. And ride it.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at or by calling 860-567-5727.

How To Reduce Your Risk of Chronic Disease By 78%

Regular exercise is key to chronic disease prevention says Dr. Avery JenkinsWhat would you say if health scientists had discovered a way to reduce your risk of chronic disease by almost 80 percent? If it were a pill -- one with no side effects -- would you take it? How much would you pay for it? $50/month? $100/month?

In fact, health improvement of this magnitude was one of the goals of the billions of dollars spent on gene therapy research. Billions which were wasted, as I noted in a previous post. Even had genetic manipulation proved successful, you would still have paid through the nose to avail yourself of its solutions.

But because you are one of the five dedicated readers of this blog, I will tell you how to significantly reduce your risk of chronic disease for free.

A 2009 study involving over 23,000 Germans found that taking the following steps reduces your risk of diabetes by 93%, reduces your risk of heart attack by 81%, cuts stroke risk by 50%, and drops your chances of developing cancer by 36%.

Here's how you do it:

  • Don't smoke.
  • Keep your BMI under 30.
  • Exercise 3.5 hours every week.
  • Eat a diet rich in vegetables, fruit and grains, and low in meat.

That's it. No gene-manipulating drugs, no daily aspirin, no useless statins, no anti-osteoporosis drugs, none of the other unscientific nonsense daily fostered  on an unsuspecting public as "prevention."

Just "good, clean livin'," as my Ohio ancestors would have described it.

Now, that doesn't mean that even within those guidelines, additional nutritional or other resources might not be necessary, to combat the imbalances created by a frequently-toxic environment and food supply, or the vagaries of communicable diseases. Nor does it mean that you won't need some assistance to put your lifestyle on that healthy path. But once you are there, and the longer you are there, it will get increasingly difficult to knock your health off balance or to knock your lifestyle out of whack. But adhering to those four principles is the foundation for all of the rest.

That, of course is where my profession comes in. If you can't say yes to each of those four guidelines, I or one of my colleagues is likely to have the tools to help you get there. In fact, I can rather comfortably say that chiropractic physicians are the health care professionals best equipped for the prevention of chronic disease.

It was the great American inventor, Thomas Edison, who once said:

"The doctor of the future will give no medicine, but will interest her or his patients in the care of the human frame, in a proper diet, and in the cause and prevention of disease."

I think I know which profession represents Edison's ideal doctor. And we're here right now.