When we feel rushed for time, we often think we can’t do the things that will help us take care of ourselves. Of course time stress is one of the things that throws us off and increases our overall sensation of stress. Making it harder for us to feel well. It becomes a vicious circle. So many people I see tell me that they don’t have time to eat well or exercise regularly because they’re just too busy.

 In the world of financial advisors, you are often advised to “pay yourself first”. It means to give money to yourself before you give it to others. The standard advice is to take 10% of your income off the top in order to create a savings account. In my experience, time management works much like money management; you have to give yourself time first.

 In that light, today I’m suggesting some time management tips so that you will be able to take care of your health, which will in turn help you feel less stressed. As with money management, you need to set aside time in each day to take care of yourself. As you review your plans for any given day, or better yet, the week. Look at your schedule and find time for exercise and healthy eating. Put those times down in your calendar, in ink. Don’t let anything else interrupt that part of your schedule.

 If you have to get up a half hour earlier to do half an hour of exercise, do that and get the exercise out of the way for the day. I usually have to get up earlier to get my writing in or I won’t do it.

 Other suggestions for time management include:

Evaluate how you’re spending your time – keep a diary for three days of everything you do, including time for shower, brushing your teeth, getting ready for bed, cooking your meals, and sitting in front of the TV. At the end of those three days, see how you’re spending you time and evaluate to see if you’re getting what you want out of your days. Perhaps a half hour less TV might give you the time you need to do everything.

Keep a daily schedule – this should include your workout and eating times, and other things that have to be done

Prioritize your tasks – make sure you have time for the most important things you need to do by setting them in order of priority.

Delegate what you can – if you have things you can delegate to someone else, do that.

Take the time you need to do a good job – when you have an important job, make sure that you give it enough time to make sure you do it well.

Break large tasks into smaller chunks of time – if you have a big job, schedule it into your days in smaller amounts of time.

Take a break when you need it – if you know that you need breaks, schedule them into your day. Schedule some breaks where you step away from your tasks and take deep breaths, look outside, or even stretch so that you can continue your work in a better way.

 When you allow yourself the time to relax, your day will flow more smoothly and you will actually feel like you’re getting more done. My mom used to joke about expanding time when we were driving somewhere and we were late. She’d say “lets expand time now so that we’ll get there.” Oddly enough, it always worked; we’d end up being on time for our appointments without her having to drive faster! Of course that didn't stop her from speeding anyway.

 According to the Sacramento Bee, “The Northern Sierra Nevada, a region critical to statewide water supplies, experienced its third driest December since record keeping began in 1920.” While Californians recognize this year's dry winter season, many can’t help but to mourn the sights of the much needed recent showers.

 How many of you find the weather getting to you at this time of year? Generally I love the winter weather, but endless gray skies begin to get to my usually sunny nature.

 SAD (seasonal affective disorder) affects many people. People become more tired, cranky, moody and unhappy than usual due to the lack of sun in their lives. Symptoms of SAD include sleepiness, depression, overeating and carbohydrate cravings, lack of sociability, loss of libido, and mood changes. It is natural for most people to have some of these symptoms in winter, being that we respond to nature. The diagnosis of SAD occurs when the depression becomes so severe that a person has a hard time functioning.

 SAD is due to the lack of sunlight during the day and even though we are having an unusually sunny winter, it is also the length of daylight hours that affect our mood. Many people – 85 percent – respond to treatment of SAD using a light box. The duration of recommended usage per day varies depending on the strength of light from the box. A 10,000 lux box available for $169 only needs to be used a half-hour per day, whereas a 2,500 lux box requires four hours of exposure. It should be used daily and is usually effective within 3-4 days. You can sit in front of it and do any normal activity such as reading or writing or working at your desk.

 There are other treatments for SAD. One of the best mood elevators is doing fun things with your favorite people. In addition, exercising keeps your energy up and increases circulating endorphins that are good for the mood. In terms of nutrition, a low carbohydrate diet helps the blood sugar remain steady, preventing ups and downs.

 People who get severely depressed sometimes need antidepressants to get them through the season. If that is the case, it is best to begin medications in the autumn before symptoms get really bad. Drugs like Prozac, Wellbutrin, and Effexor tend to help people be more alert and active.

 If you are against using these kinds of medications there are many herbs and supplements that can help support the mood. If you have a doctor who understands how to use herbs, you can get a supplement that is personalized to your particular symptoms. 5 HTP, SAM-e, St John’s Wort, Shizandra and B-vitamins are among just a few. An Ayurvedic herb called “holy basil” is remarkably effective at calming the adrenal glands and anxiety without a drug effect.

 Winter is a wonderful time to focus on your inner self and do things that you wouldn’t do at other times of the year. Invest in your happiness and take time to do things that you love this season. Or, if you feel so inclined, just hibernate!

 When I was a young physician and began making money for the first time in my life, someone came up to me and said that it was time for me to have a “financial plan”. Ooooh! I had no idea at the time what that meant. Of course, that same person quickly began to educate me, being a financial planner.

 As most of you know, a financial plan is a system of making sure that your money is working for you so you can begin to make more than you need for immediate survival. Within that framework of taking care of your finances, you are often encouraged to invest in large insurance policies that will cover you “just in case”.  Often the “just in case” is a bad thing that happens to your health. But no one ever talks to you about having a plan for your health.

 Why not have a plan for your health? Doesn’t it make sense to figure out what your health needs might be and to take care of them so that you don’t need to worry about illness? Most people think that their health insurance is their health plan, but it isn’t really. Health insurance covers you when you are sick with something and allows for you to have tests that will be paid by insurance, only if you have evidence that you need those tests.

Our insurance culture is designed around waiting for us to get a serious illness. It doesn’t cover planning for us to remain healthy so that we can do what we want for as long as we like.

 I propose that everyone should have a Health Plan, which involves an understanding of what health means to you, and a plan for sustaining your health. It should be reviewed annually, and acted upon with the intention of being able to enjoy your favorite activities and have fun as much as possible.

 A good health plan should involve a review of your lifestyle, including how you eat, sleep, work, exercise, attitudes, and whether you are enjoying your life, a physical exam, and a discussion of your desires for your health. Together you and your practitioner should then create a plan for how you will achieve your desires for health in the coming year.

I love this time of year for so many reasons. The music, the parties, dressing up, sharing meals with friends, and focusing on sharing time with my closest friends. It wasn’t always one of my favorite holidays. I would be anxiously figuring out what gifts to get for everyone on my list, trying to create an impressive meal for whoever was coming over, and during my years as an Emergency Doctor, often I’d be working in the ER seeing drunk, unhappy people.

I could always count on someone in my family having a fight or getting upset about something. Rarely did I experience a Christmas where things were peaceful without drama and people got and gave gifts that they loved.

Somehow I decided that Christmas gifts should mean something special at a young age. It shouldn’t just be about buying expensive gifts for people that you didn’t care about. Every year, I spent a lot of energy thinking about what gifts I would give to my friends and family, in order to make sure they were happy. My way of doing that was to make something. One year I made quilts, another I knit sweaters. Every year, I had some hobby that I inflicted on my friends and family, thinking because I’d made it myself, it should be special. I remember the year that I made my mom a big orange red and yellow quilt for her bed. The look on her face told me that she didn’t love it, but she was pretending to. She had bought me a brown leather purse that I just hated, and pretended that I loved. The whole event had an emptiness that was painful to experience.

20 years ago, I decided that I didn’t want to have unhappy stressful Christmas times any more. I wanted to enjoy myself as much as possible and bring joy to those around me. I set about trying to figure out how to do that. I called my friends and family and asked them if it would be all right with them if I didn’t do presents this year. They all agreed it would be fine. That was the first year I felt somewhat relaxed during the holidays. I had no expectations, no worries about whether someone would like their gifts or not and I didn’t have to worry about acting like I enjoyed whatever things someone else gave me.

Since then, as the holidays approach, I’ve had a conversation with whoever was going to be participating about how we want to spend our time this year. Do we want to do gifts, where do we want to go, who do we want to be with. We never do gifts, which removes a lot of stress from the occasion. For years, we did a holiday party at my office every December, starting the season out in the mood. I hadn’t done that for a few years and decided to start doing them again this year. It really put me in the mood for the holidays. 

I want to invite you to have a different holiday season this year. Even if you decide you want to do gifts and big feasts, think about changing the focus of the holiday to make it more about the love and friendship in your life. Find special ways to enjoy the people you love. Sit down with everyone who will be involved in the holidays and have a discussion. How do you all want to spend the days? Do you want to share the same meal you usually do? Whose house will it be at? If there’s a lot of travel involved, do you want to save the travel for another time of year, when its easier? Ask each other how you can create the most love, fun, joy, and pleasure during this special time of year.

We often take our daily stress out on the people who are closest to us for any number of reasons. We might be angry about something else. Old childhood patterns play a role in making us see our partners according to a bygone experience rather than how they really are.

Perhaps we think that dumping on our loved ones is natural or okay to do because that’s what we learned as children. We create more problems when we do. He may not act on it right away but eventually the man I saw in the store will release his anger. Abuse increases stress in the home. Suppressing our feelings brings health problems later. This man might later have heart disease and never know that it had to do with his suppressed anger.

Ideally our home should be a haven from the rest of the world. Whatever stress is going on in our lives, coming home should feel good, and the loved ones we live with should feel like they are supporting us.

 How can you create a haven for yourself? Recognize that whatever your life is like, you made the choice to be there. Find a way to forgive your past. Drop the need to be right. I was eavesdropping in the gym one day when a woman was griping about her husband. She was determined to continue battling with him until he got that she was right. Being right was more important than whatever love she had for him. Rather than getting caught up with being right when you have a conflict, determine that you want to find a solution to the problem together. If you set your mind to finding loving solutions, your behaviors and responses will automatically change.

When you’re having a stressful time in your life, try to see your mate as your ally instead of as the enemy. Try your best not to take it out on him/her even if the stress looks like its related to something he’s doing.  You can become closer because of your willingness not to blame each other if you can wait it out. Your outside stresses can become easier to bear if you remember the love you have. It helps to remember that your mate or children are usually not the cause of your stress. Use them to help you feel better rather than worse. Work at creating friendship in your home.

There are many ways to begin creating your haven. Some friends of mine keep a little box in a central part of their house for love notes. When things are going well, they write nice notes to each other and put them in the box. During hard times they take the notes out and read them to each other.

Try to find something to laugh about together every day-or at least once a week. One man I know takes songs and changes the words to make a silly expression of how he feels about things. He sings them to his wife and makes her laugh. Make a date night at least once a month, preferably more often, try to do something that shows your partner you love and appreciate her.

No matter what is going wrong, there’s always something to be grateful for. We are often told that successful people know how to be grateful. Try practicing gratitude every day even if all you can think of is to be happy that you don’t live in Afghanistan.

As the holidays approach this year, think of something fun and loving to do that’s completely different than the usual annual ritual you have. Not that you have to change your ritual, just add something new, fun, and personal into the mix.

      Even though California is sneaky about its seasons, your system knows they are coming and going. In Chinese medicine, each organ system is ruled by a season: fall rules the lungs, winter the kidneys, spring the liver, and while the heart is influenced by early summer, late summer takes on the spleen and stomach. Each season brings a particular health risk to the organ that it governs.

            With no other organ is this as clear as with the lungs. In fall, kids come together in a crowded classroom, bringing all the viruses they’ve collected over the summer to pass freely among their classmates. The flu season is arriving earlier this year. You can prevent a lot of that right now with your annual fall tune-up.

            If you read this column regularly, you know I’m not a fan of flu shots. Basic good health and preventive measures will protect you against many more illnesses than a single flu shot.  Take your usual preventive vitamins and supplements with extra vitamin C and omega fatty acids such as fish oil to keep you healthy.

            Use specific herbs to help balance the lungs. Astragalus strengthens the lungs and the immune system, and can be used safely for a long time. Even children can use it safely. Start now for early prevention and immune building. Host Defense made by New Chapter is a formula made of sixteen different medicinal mushrooms. You can take it all winter long without harm to your body. I recommend it to people who tend to get sick often in the winter.

            At the first sign of a winter flu or cold, begin to take some herbs. Wellness formula has many herbs you can use to get rid of a cold at the beginning. Several Chinese herbal formulas available over the counter can also help. Yin Qiao is good for flu symptoms. Gan Mao Ling is good for colds with scratchy throat and runny nose. All of these products should be taken several times a day beginning as soon as you feel symptoms. They don’t work if you just take one.

            Hydrogen peroxide is one of my favorite home remedies. I recommend that you make a gargle of hydrogen peroxide diluted either with water or a little mouth wash. Use it as soon as you feel a scratchy throat starting. Gargle with the solution as far back in your throat as you can get it. Hold it there for a minute if you can. Do that up to three times in an hour. You can interrupt the life cycle of the virus or bacteria if you catch it early enough.

             Last but not least, try to keep your stress levels down this season. If you remember to take it easy sometimes, especially when things feel their craziest, you won’t even need to take herbs to keep you from getting sick.

She was saying "I can't do it all." "I'm not strong."  "I am overwhelmed." "I am sooooo sick!" As I was listening to her, I realized that I hear things like that every day. 

My first language was German and I studied Spanish in college. In those languages, when you feel, a certain way, you say " I feel overwhelmed" or "I feel weak"  In our English language, how we feel is basically a statement of our beingness, meaning that our feelings define us in some way. In European languages, our feelings a just feelings, they are not who we are. 

I began to wonder if Tina began to talk about her feelings as feelings rather than as a definition of herself, would it help her feel better? I was thinking about how I've felt angry in the past and said "I'm so mad!!" or "I'm so Angry!!!" Would it help if I said "I feel so angry!! right now!!"  

I'd love your thoughts and feedback, if any of you have experienced this or thought about, send me a comment.

The movie Contagion which is currently out in the theaters is ideally suited to make us all aware of one of our biggest fears. Infection used to be the scourge of our populations killing people without apparent regard for any social class. Our immune systems are one of our biggest vulnerabilities as humans. Should an infection choose take up residence in our bodies, we seem helpless against it. The best protection is prevention, taking good care of our bodies all year long and paying attention to them helps our immune systems be strong. 

 I continue to be against the flu shot.  It doesn’t make the body stronger or healthier and it may contribute to more illness later. Our bodies are always at war. Getting ready for the next attacker, our immune system is constantly scavenging to find things that don’t belong in our blood stream. In this high stress day and age, we have plenty of things to fight. If you keep adding to the pile, its like sending in more troops from the enemy, they have a better chance of breaking down the walls.

Chinese medicine says that cold weather, wind, and rain enter the body via points on the neck just below the ear. Grandmother was right - you can prevent illness by staying warm and covering your neck. Its not quite as simple as that but being aware of the environment you are in is the basic premise of maintaining your health in any season.

 The flu shot is made each year based on a prediction of which virus will come across the ocean from Asia to our continent – its kind of like a beauty contest, only the top three get chosen. There are thousands of viral strains with new ones mutating every day. Last year they guessed wrong and the shot didn’t protect against the virus that arrived. In a person with weak immunity the shot can stress the system more, possibly leading to worse illness. If you have allergies, your immune system is already hyperactive, adding one more stimulant, could make your allergies worse.

 When you think about your immune system, think of it as your army, ready to fight against whatever comes in that doesn’t belong. Sound familiar? Rather than beating it down, help it out with as much support as you can give it.

 Each season represents a different organ system and there are unique challenges to taking optimal care of that organ. Fall is the time of the lungs. They are responsible for the entire immune system and the respiratory system. A good prevention plan in fall includes taking immune building herbs and doing lung-strengthening treatments. Winter is the time of the kidneys – the source of vitality and energy. Preventing illness now includes getting plenty of rest, keeping your body warm, and avoiding stress.

 Paying attention to your body and using the environment as a guide at all times of year is a basic tenet in Chinese medicine. You can keep your natural state of balance by using common sense. Listen to your body and watch what is going on in your life.

 This winter you can stay healthy by taking medicinal mushrooms, such as Host Defense by MyCommunity. Your local health food store has many other mushroom formulas to choose from. Make sure you are taking plenty of Vitamin D, vitamin C, a good multi-vitamin, and essential fatty acids such as fish or flax oil. Next fall; begin a flu prevention program early by boosting your vitamin intake and using lung-building herbs including astragalus. Acupuncture can help your body have smooth seasonal transitions.

 If you start to feel ill, take action immediately. Double the amount of vitamin C you take and start taking an herbal anti-flu formula that has Echinacea, goldenseal or Isatis in it. Some available products are: Wellness formula, Yin Qiao – a Chinese herbal formula, or Sinus and Respiratory by New Chapter. Take the herbs every two hours. Gargle with hydrogen peroxide. Wash your hands frequently. Take time off and get a little extra rest. Don’t say to yourself….”I have to much to do, I’m going to keep on doing.” More detail is available on my web site at www.hthmc.com.

 For those of us who are anti-war activists, the war starts inside our bodies. Become an anti-war activist at home first. Help your body be at peace.

 There are disadvantages of restaurant food that you have to contend with right away. They usually cook with a lot of fat, put sugar in their food, and don’t always use organic ingredients, especially for meat products. I have a few hints to help you deal with these disadvantages.

 First off, you should find the best quality restaurants you can find. There are certain foods you should never eat if they’re not organic, try to stick to that. A website called the environmental work group has lists of pesticides in foods; cosmetics and skin care products, and mercury content of fish. Check them out before you eat out or shop – http://www.ewg.org. For example the list currently has apples, celery, and strawberries as the top three worst foods to eat if they’re not organic. Spinach is number five on their list of the top 12 worst foods. Many people order spinach at restaurants because they think it’s healthier.

 When you go to a restaurant, you should order whatever meal has the most vegetables, or just order a side of steamed vegetables. Some of the least expensive restaurants are the most flexible about this; you can almost always get a plate of steamed vegetables.  Some people tease me because I visit a local bar to eat, but I order organic chicken and brussels sprouts for dinner. Or I have a hamburger patty with avocado and a side of broccolini instead of French fries. Restaurants that have a lot of vegetables on their menu include Chinese, Thai and Indian, and many “California” places. If you are out for breakfast – try to go to places that serve organic eggs, or omelettes that have vegetables. Basically, you should become a “vegetable seeking missile” in order to optimize your health when you out.

 I went on a trip with some friends recently, both of them are from the Midwest and love their comfort foods. I found myself in places without vegetables the first day and a half. By the second day, I declared a state of emergency for myself. I begged them to help me find some vegetables. Finally we went to a little grocery store and found a premade platter of carrots/broccoli/peas that I could eat. It was amazing how much better I felt.

 This brings us to fast/easy foods to buy in grocery stores. Even Safeway has organic foods now, which at least will be free of toxic pesticides. You can buy various vegetables already prepared so that you don’t have to. One simple thing is those bags of prewashed precut organic carrots, which you can eat with some hummus dip it makes an excellent lunch. Dehydrated soups – such as curried lentils, or black bean soup are a quick meal which you just have to add water to. Add easy to prepare vegetables either fresh or frozen  to your hot water. I carry a bag of organic roasted nuts with me for snacks. When I’m hungry in the middle of a work day, I either have nuts or organic almond or peanut butter on hand, I just take a little spoonful to sustain me until lunch.

 I recommend that you take vitamins, omega fatty acids, and antioxidants regularly. You can mitigate the poorer quality of foods that you eat by supporting your system with nutrients in other ways. Even Whole Foods organic produce doesn’t have the vitamins it once had, it sits on the shelf for days before we eat it. Alpha Lipoic Acid supports the liver in its detoxification pathways. Everyone who drinks a lot of alcohol or eats out a lot should have it on their list of supplements.

From the perspective of energy medicine, menopause is a time when the energy focus of the body shifts from the second chakra to the fourth chakra. The second chakra is focused on survival. Nothing is more basic to the survival of a species than reproduction. The fourth chakra is the heart chakra. It relates to finding what is true for you. How do you create what you want in your life?

Menopause is often a time of high stress. Children are grown and leaving home. Divorce or re-evaluation of relationships often occurs. Some women are re-evaluating their careers at this time. These kinds of stresses are all related to an evaluation of your life and to finding what is really right for you. Emotional stresses combine with hormonal shifts to create the perfect storm. Baby Boomers have been leaders in the area of self-discovery. Many of us spent years searching for the key to our happiness. Naturally, menopause would be a time of continued searching.

For many women, hot flashes signify the physical aspect of the energy shift. Hot flashes are jokingly called, “power surges” which isn’t so far from the truth. When you have more energy in your heart, you become more powerful.

Part of your approach to menopause should include lifestyle changes with your diet, exercise, and nutritional supplements. You could make some basic nutritional changes. As hormone production declines, our tolerance for carbohydrates declines and contributes to the weight gain many women experience at menopause. A diet higher in protein is more balancing. I don’t recommend a diet as extreme as the Atkins’ diet because it is filled with poor quality protein, such as bacon and sausage.

Helpful supplements include such things as B complex, omega fatty acids, and a good multivitamin. If you have tried vitamins and fatty acids for a month and still have symptoms you can begin to work with herbs. The most common herbs in a typical menopause formula include black cohosh, damiana, dong quai, and vitex-chaste tree berry, as well as soy based supplements. Each of them is effective for some people. You can experiment to see which one will help you.

If you don’t experience relief with these, I encourage you to seek the help of either a professional herbalist or Chinese medicine specialist or a doctor who does integrative medicine. The possibilities of treatment are endless and should be personalized to your set of symptoms.

With all the controversy surrounding hormone replacement therapy (HRT) it is still a viable option for many women. When your symptoms don’t respond to supplements or herbs a low dose of a bio-identical hormone combination can make all the difference. What do I mean by bio-identical?

Bio-identical or “natural” hormones are chemically identical to the hormones your body would naturally produce. Theoretically, they are safer to use because they are not interfering with our bodies natural processes, just supplementing them. They are made in a lab, not taken from the ground. No amount of soy beans or wild yams will give you enough hormones to survive menopause, they are just the base from which bio-identical hormones are made.

Premarin, is a natural estrogen for horses, it is made from pregnant mare’s urine, but isn’t natural to humans. When the studies implicating HRT as bad were done in 2002, the researchers used Premarin and Provera. Provera is a synthetic progesterone, that is not bio-identical.

While there isn’t much conclusive research saying that bio-identical hormones are safer, the philosophy of using bio-identical hormones is more from a place of making sure you sustain balance in your body. We give doses that will support your well being, for long enough to get through the bothersome symptoms of menopause, and using delivery methods that won’t challenge your liver-such as creams or topical applications. The whole approach is different from what used to be done with giving everyone the same medication at the same doses regardless of side effects.