Provision #544: A Holiday Gift

by Bob Tschannen-Moran

LifeTrek Laser Provision

Last week I wrote about a health scare I had a few weeks ago, even though I was a bit reticent to make myself that vulnerable. After all, when someone like me, a professional coach, reveals that he had what turned out to be a panic attack, it's easy to conclude that the man must not be walking the talk. Setting that risk aside, I decided to err on the side of honesty -- a key factor in Optimal Wellness. I'm sure glad I did because the outpouring of benevolence was not only much appreciated, it was transformational. You won't believe what happened.

LifeTrek Provision

My clinical and research experiences show that almost all patients who are having panic attacks bad enough that they require medical treatment (with benzodiazepines or BDZs) also have reflux. Reflux should be treated at the same time as the treatment for panic attacks.

Reflux is often confused with anxiety. Patients seem to get used to the constant discomfort and experience it as a sense of worry. Nervous stomach is felt as a mental sensation of anxiety over time. I have seen patients who initially did not feel that they were having any stomach or esophageal discomfort. It was only after treatment that these people realized how much of what they thought was anxiety was really reflux related symptoms.

Reflux in panic disorder is often a result of bile flowing backwards from the small intestine into the stomach. Bile dissolves the mucous barrier that lines the stomach, making it sensitive to the effects of the hydrochloric acid that is produced by the stomach. Also bile itself is a powerful irritant to the stomach, causing further release of acid and more irritation. Because bile is alkaline, the stomach produces even more acid to neutralize the alkalinity. So bile both irritates the stomach and stimulates acid release. When the stomach fills with acid then the acid, and sometimes both acid and bile, may go up the esophagus causing a variety of problems.

The primary neurotransmitter/hormone responsible for the release of bile is cholecystokinin (CCK). The BDZs act to chemically oppose the action of cholecystokinin. So BDZs themselves may reduce release of bile and help relieve bile-related gastritis and reflux....

In some patients who don’t want to take any sort of mind-altering medication I have treated the reflux alone and found that the patient may experience significant improvement in their anxiety. I consider treatment of gastritis and esophagitis to be an essential part of the treatment of panic disorder. In treating reflux, I have had quite a few patients who no longer had problems with other manifestations of reflux such as sinusitis or chronic cough.

If a patient has panic disorder of sufficient intensity to warrant treatment with a BDZ, then I usually consider a trial of treatment for reflux to be worthwhile. Even if it doesn’t help it is safe and unlikely to cause harm. On the other hand, many patients will have become accustomed to living with their reflux-based heartburn, sinusitis or cough and attribute the discomfort to their mental anxiety. For these patients treatment of reflux is an important part of treating panic disorder.

Dr. Shipko then goes on to describe the medication sucralfate as his medication of choice for the treatment of such reflux. It is a relatively inert compound that does little more than coat the stomach and GI tract, giving it time to heal (in a matter of weeks or months) from whatever damage it may have suffered.

That description of cause and effect, as well as that prescription for treatment, hit me right between the eyes. As someone who had not suffered from anxiety or panic in the first 50 years of life, it has seemed odd to think of those things as now becoming part of my mental landscape in the second 50 years. It makes a lot more sense to think that I might have a physical problem, like reflux, which is manifesting itself in psychological and emotional ways.

So I faxed that chapter to my doctor with the following cover page note: "Read two pages and call me in the morning." He did just that, explaining, with some excitement, that the chapter made a lot of sense, that it could explain numerous cases over the past 10 years in which patients had failed to respond to conventional treatment, that he had already passed it along to another doctor in his office for use with a particular patient, and that he wanted to follow Dr. Shipko's treatment protocol with me, given my other test results, effective immediately.

Talk about an abrupt change of face! In three days time, I went from being on anti-anxiety and acid-reflux medication to being on nothing but sucralfate. Gone were the nouveau benzodiazepines and Proton Pump Inhibitors (PPIs) in favor of an old standby (sucralfate was approved by the FDA in 1981) that does little more than allow the body to heal itself -- as it's designed to do, if we just manage to get out of its way.

How did I manage to get in the way? Well, it may have all started about two years ago when I happened to catch Dr. Andrew Weil on television. He mentioned that he took two baby aspirins a day, as a heart-protective measure. I had been taking one baby aspirin, per my cardiologist's recommendation, with no apparent gastrointestinal (GI) problems. Following Dr. Weil, however, I doubled the dose and I also started to make my own pill, by cutting a standard aspirin in half.

In and of itself, that might not have caused a GI problem. But I was taking that aspirin at night, right before I went to sleep, on an empty stomach, because one study had indicated that this might also help to lower blood pressure. Unfortunately, taking that much aspirin every night on an empty stomach, just as I was lying down, may have eventually contributed to reflux and gastritis. And the rest of my symptoms followed.

I am only beginning to follow Dr. Shipko's treatment protocol for reflux-based anxiety and panic, but the early results are encouraging and I, for one, am glad to be done with both BDZs and PPIs.

Sucralfate works by going to the root of the problem. By serving as little more than a bandage over the irritated lining of the GI tract, it allows the body to heal and regain its balance, in natural ways. That's one of the beautiful things about Optimal Wellness: the body wants to cooperate. With the right support, the right diet, exercise, stress management, and -- when necessary -- recuperative care, the body will work its magic and do what it can to thrive.

That's my hope, anyway, when it comes to the path I am now following. It's really the best holiday gift I could have received. And to think, it all came from being honest with you, the readers of LifeTrek Provisions.

People are like that, though, when it comes to the factors that make for Optimal Wellness. Empathy, reciprocity, and honesty all work together for good, in perfect harmony, when it comes to making life more wonderful. At our core, people are more inclined to help than to hurt. Contrary to how it may seem at times, we do not enjoy making life more miserable or difficult for ourselves or anyone else. We just have to learn how to stop fueling the fires of inflammation in order for the wounds to heal and the beauty to be restored.

Do you see the connection between Optimal Wellness on a physical level and Optimal Wellness on all the other levels (psychological, emotional, relational, social, and spiritual)? Benevolence is not an afterthought when it comes to the Optimal Wellness Prototype, it is integral to the model and absolutely essential to human well being. Apart from benevolent intentions and actions, no well-being is possible. With benevolent intentions and actions, beautiful things happen.

So make that your holiday gift as well in this holiday season. Forget the gadgets that will soon be gone; focus on the goodness that makes life worth living. With that as your focus, so it will be.

Coaching Inquiries: What is your focus at this time of year? What are your intentions for the coming year? How could your actions make life more wonderful both for yourself and others? With whom could you risk being more vulnerable and honest? When might you be willing to take the plunge?

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LifeTrek Readers' Forum (selected feedback from the past week)

Editor's Note: The LifeTrek Readers' Forum contains selections from the comments and materials sent in each week by the readers of LifeTrek Provisions. They do not necessarily reflect the perspective of LifeTrek Coaching International. To submit your comment, Email Bob.