Grief eventually touches everyone’s life. Maybe you have suffered a recent loss that is immensely fresh and painful. Perhaps you are not currently in the midst of waves of panic stricken grief, but someone you know is. Or maybe you have past losses that have been pushed aside, swept under the rug so to speak. Well, this article and the resources listed below are for you. 

No Apologies Necessary
Grief and the emotions associated with it do not warrant an apology. So, stop apologizing. Grief has no expiration date and is individual for everyone. No two people will experience grief in the same way, so stop comparing. When people ask what they can do for you, give them a job. Often those on the outside of your grief will want to do something to help, let them. Food is the most common way others want to help, and it definitely serves a purpose. Other helpful suggestions might be mowing the lawn/snow removal, supplying pet food/supplies, housekeeping, laundry, or help finishing a large project that is now postponed due to the death. Disposing of wilting flower arrangements left over from funeral services is another painful task that can be delegated out.  Sometimes just coffee and talk time is what your lonely heart needs most. Remember, you’re a changed person now, you’ll grieve the loss of your loved one as well as the person you used to be. Grief is exhausting, you don’t need to apologize for being tired.

Remembering Your Loved One
Carrying on the legacy of the person you love can be exhausting too, but establishing meaningful traditions can promote positive coping and aid in healing. Consider lighting a candle at holidays to honor the deceased. Having a memorial table at a wedding or graduation to pay homage. Saying the deceased’s name and not making it “off limits” in your home, and with family and friends. Decorate graves as the season changes. Do acts of kindness to celebrate your loved ones birthday and honor their death anniversary, this puts purpose and action to your emotions. Share memories frequently, such as when eating a favorite meal, visiting a favorite spot, or enjoying a favorite activity of the deceased. It can be healthy to imagine your departed loved one being proud when a milestone is accomplished, or joking about a funny scenario. 

Explaining Death To Children
Often we want to shield children from the pain of death and loss. Don’t. Usually a child’s first experience with death is with a pet or elderly relative. When children grow up knowing grief is part of life, they may display a heightened level of compassion and increased comfort with emotions. It’s important to only give kids the information they are asking for, don’t try and push feelings or sadness on them. Phrases that directly explain what has happened, like “their body stopped working” seem to be most effective. Be truthful and to the point. Avoid associating death with sleep, that is what nightmares are made of. Literally. Sometimes kids display magical thinking, where they blame themselves for the death. For example: “Grandma died because I wasn’t a good boy.” Kids may ask about when they will die or when other people in their life may die. This presents an opportunity to discuss common causes of death: illness, injury, and age. Discuss how every living thing has a lifetime and that the child is not responsible for the death. Coloring pictures, talking, making cards, and planting flowers can be good coping mechanisms for children to use. If they tend to be avoidant or frequently distracted, that is completely normal, just give them space to process the loss. 

Moving Forward? Or Just Marching In Place?
It might feel like the calendar is moving on without you as you're figuring out your “new normal.” Or, you might be watching a friend or family member struggling with grief to the point of anxiety, depression, and social phobias. I’m here to tell you that there is beauty amidst the pain and that there are resources available. While no one can grieve for you, a support group can provide community, mental health services can help with resulting depression, and therapy can help with reestablishing coping mechanisms and processing trauma. Other healthcare providers can assist you on your journey too by ensuring your lab work, hormones, and gut health are in balance.

Here at Integrative Family Medicine, we have two mental health providers on staff: Dr Danielle Fitch (West Des Moines and Ankeny offices) and Dr Justin Janss (Sacred Health office). New patient appointments with them may be booked from our website. Unsure which provider might be the best fit for your situation? Email us: [email protected]

Local Community Resources

The Compassionate Friends, a support group for individuals who have experienced the death of a child, at any age, from any cause. Typically provides support to Parents, Grandparents, Adult Siblings (children welcome at special events), Aunts and Uncles. https://www.compassionatefriends.org/chapter/central-iowa-chapter/

Amanda The Panda, offers support groups and camps for adults and children. Some of the sessions are topical. Childcare is available upon request. Fill out an interest form so staff can assist you in finding services to best meet your needs. https://www.everystep.org/services/grief-loss/registration

Hamilton’s Academy of Grief and Loss, Hamilton’s Funeral Home offers many services to children and adults. Children’s classes are available for children age 3 ½ thru 6th grade. Older children can attend adult sessions. Resources for pet death are also available. https://www.hamiltonsfuneralhome.com/academy/index.aspx?t=support

Grief Share, weekly support group meetings on a 13 week rotation of topics. The meetings consist of seminar, group discussion, and personal study. Offered at multiple locations (usually churches and virtual) and many different days of the week. Visit their website to find a meeting near you.  https://www.griefshare.org/findagroup

Are there additional resources you’ve found helpful? Please share them in the comments section.

Sara Lynn, RN BSN

“If you don’t invest in your health, no one else will.” 

The average child will eat about 3 cups of sugar on Halloween, which results in almost 16 times the recommended amount of sugar they should consume (according to 2013 data collected by Coupon Follow). With this increased consumption comes an acutely weakened immune system and potential behavioral outbursts. These effects can last days to weeks. Long term problems with increased intake of sweets and highly processed carbohydrates are neurodegeneration, memory decline, parkinson’s, mood disorders, hormone disorders, along with a multitude of other health concerns.
 
If Halloween is truly a “treat” night in your house, the likelihood of this indulgent evening affecting the systems mentioned above for an extended period of time is minimal.  Now, if there is a year round treat bowl sitting out that regularly needs refilled, it may be a good time to take note of how that candy and processed sugar are impacting your health. 

Here are a few easy tips for lessening these sugar demons as we head into what is hands down the most indulgent time of the year: 

1. Try out the “Switch Witch” on Halloween. This sweet little witch flies into your house on Halloween night and replaces the bags and bowls of candy with an equally sweet small gift. 
2. Allow your child (and yourself) a limit on the amount of candy that will be kept in a “safe place” + out of site and to be enjoyed only on special occasions
3. Fill up prior to beggar’s night on a protein and veggie rich meal, incorporating a few of your child’s favorites. A family favorite in our house is “Mac n’ Cheese and Trees” (aka broccoli) served along with tree stumps (aka chicken sausages cut up). Encourage hydration also during times of indulging in sweets. 

Most importantly, enjoy beggars night and this beautiful season we are in. Encourage the focus in the coming months to be on memories and togetherness instead of material things and favorite dishes.  Allowing treats, by simply keeping them as treats will make every holiday that much sweeter. 

As Fall winds down, do you find yourself clinging to the last bits of nice weather? Why not round out these beautiful evenings with the tackle-box instead of the X-Box. Unplug and reconnect. Grab some good company, bait, rod & reel, and hit the local fishing hole.

Fishing helps children refine motor skills with casting, reeling, and baiting a hook. Fishing is also a highly sensory experience; from slimy fish, to tension on the line, to a submerged bobber, and listening to bullfrogs and waterfowl. Tangles in fishing line are opportunities to problem solve, practice patience, and learn when to ask for help. Conversations naturally flourish in this type of environment, even with the quietest of children. From the first bite, they’ll be hooked.

Not sure how to get started? I recommend starting at a bait shop. They’re the local experts. You’ll get set up with a pole, tackle, bait, and advice. 

Fishing is affordable fun. Children 15 and younger fish free in Iowa, residents 16 and older can purchase a yearly license for $22 at over 700 retailers. The Jester Park Nature Center is also a great resource for central Iowans, they loan out poles for a refundable deposit and the center is within walking distance of a pond loaded with hungry panfish. Bait is usually under $5 and simple lures are only a few bucks for a multi-pack. This Summer we’ve been experimenting with catching fish with hotdogs. For $2 we’ve gotten enough “hotdog bait” for 3 fishing outings. Simply cut them up ahead of time into small coins or half coins, microwave for a minute or two to toughen them up, and you’re ready to go.

Remember to take pictures of the lunkers you reel in. Even if you don’t catch any fish, enjoy the opportunity to soak in nature, unplug from technology with your loved ones, enjoy a delicious picnic, and make up a few fish tales about the one that got away. 

For more information on borrowing poles from Jester Park Nature Center, visit their website.
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https://www.polkcountyiowa.gov/conservation/education/free-resources/

Sara Lynn, RN, BSN

“If you don’t invest in your health, no one else will.”

Attachment to certain foods can be very difficult to overcome. A lot of people have fallen into bad habits with food where they don’t even think about what they are eating because it has become so routine that it is no longer at the forefront of their minds. This is how we operate with a lot of things (like driving a car, playing an instrument, etc) – we don’t have to think about how to do something or what we are doing because it has become such a common thing for us to do that our brain doesn’t need to think about it anymore. It just does it almost automatically. This is called the cognitive or association power of the material side of our intellects. 

These are the types of habits that we must change. Bad habit is called vice whereas good habit is called virtue. We are weak as human beings because of our passions (or emotions) getting the best of us. Emotion is a very good thing and is a part of us. But it must be relegated to its proper purpose. We have to let our reasonable side be the part of us that makes decisions. We must avoid making decisions because of how we might feel at a particular moment. Feelings can change on a dime. But if one thinks out a particular problem and thinks about a good solution, that solution often does not need correction. This is because of your mind’s capability to reason out what is true.

For instance, if I leave my computer behind at home and thus cannot perform some of my job duties, and I live 30 minutes away, I need to think of a careful solution to the problem. I grow irritated and frustrated with myself with a moment such as this and my first instinct is to race back home and grab the computer, cursing at myself the whole way home. However I hit the pause button on that option because it actually doesn’t make sense given the circumstances (I need to see my patient in 5 minutes when his or her appointment starts). My patient is waiting for me so I have a duty to stay and make the situation work. Instead, I will need to either find another solution or find a time to go back home when time allows. Because of taking an extra five minutes out of my day to plan around this problem, I was able to find an alternative more reasonable solution than trying to race back home (and risk causing a wreck and missing at least one patient appointment) - all to get that computer that I really didn’t NEED at that time. I instead chose to suffer the loss of my computer for the day and use an alternative one (that has not been tailored to my work flow) as that allowed me to see my first patient without delay or rescheduling. Ultimately, I knew that by not getting my computer, I would be suffering the inefficiency of a slower work flow and thereby staying later at work and missing out on family time. But it was my mistake, and so it was reasonable of me to fight that emotional instinct that I wanted to follow initially. 

The same thinking process can be applied to bad habits of choosing unhealthy food. In this instance, one must choose to accept that one is going to suffer the lack of the pleasure one gets from eating very tasty but unhealthy food. The human brain sees that as an evil (because of attachment to the pleasing effect it gives us) and we naturally try to avoid evils. But the mind knows that this is really not an evil and is actually good so it overrides the emotional side of us and wills what is truly good. One will then suffer the emotional consequences meaning one must suffer the effects of not feeling those pleasing effects for a short time (the brain doesn’t secrete as much dopamine). However after one eats a healthy meal, he will then realize that this was actually good for him even from an emotional side because he actually feels better too after finishing it (no bloating, fatigue, feeling gross, etc). By choosing the right path, one has accepted suffering and pain into his life and thereby strengthens his will and tempers his emotional attachment. With continued practice, the emotions/passions become detached from those bad foods. The pace of this differs amongst people depending on where they are at mentally/psychologically. 
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This is ultimately the step one must make when trying to lose weight and maintain a healthy balanced body. One must accept pain and suffering in one’s life. Suffering will find you either way as if you do eat unhealthy or do not exercise enough, then you will likely suffer the consequences in the long run with associated diseases and disabilities. Suffer the lack of pleasure now for the good of your body later. It doesn’t mean you can never have snacks and such – it just means it needs to be tightly regulated for your health. I always encourage my patients to continue to think two steps ahead. Where are you going to be at in five years with this weight gain you have had over the last year? Something has to change, and the time for that change is now. By accepting that pain and suffering is just a part of this life, and choosing to bear it well, you will go far with getting your passions/emotions under control and thereby making it much easier to lead a healthy lifestyle. 
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Remember too that this process is not simple. One may accept the idea that he will undergo a lot of suffering to overcome his attachments to certain foods. But this does not mean that he will be perfect in his quest. In fact, there is a very high chance that he will “fail” quite often. This is OK. You should never fret over such things because, as human beings, we are weak. It is ok to accept that. It doesn’t mean that you shouldn’t or can’t try to grow stronger though. But by accepting that you are a work in progress, you can accept minor failures in the process and move on to grow from them. I also encourage everyone to have someone there for them to help them with this process whether it be a family member, friend, provider, health coach, etc. The journey is easier when you have a helping hand. We will continue to delve more into the specifics of dieting and how one can hold one’s self accountable moving forward in the next blog.