Ray D’Alonzo, Ph.D., is Manager of Doctoral Recruiting & University Relations and a former Associate Director of Research and Development at Procter & Gamble Pharmaceuticals where he has worked for 30 years.  He has led research programs in bone metabolism, infectious disease, respiratory disease, arthritis, and nutrition and has published scientific papers on a wide variety of topics from the chemical composition of fats and oils to the pharmacoeconomics of osteoporosis. Dr. D’Alonzo is the recipient of the Chancellor’s Medal from the University of Massachusetts, Amherst, in part, for his contributions to the development of new pharmaceutical agents. As both a patient and scientist, he has made a personal effort to increase the awareness of Chiari in the health care sector and to assist others afflicted with the syndrome.  He has published the story of his personal struggle with Chiari in a book, Contents Under Pressure, with 100% of royalties going towards Chiari education, awareness, and research programs.

November 30, 2008 --     

The effects of stress on health and well-being are difficult to measure or determine. Stress is often unjustly blamed for disease particularly when doctors cannot objectively diagnose the cause of illness. For decades, physicians firmly believed that stress caused stomach ulcers when in fact ulcers are now known to be caused by the bacterium, Helicobacter pylori. Nevertheless, if stress is not directly involved in disease causation, I think it is safe to say that it can make illness worse and is something we should try to avoid or at least keep to a minimum.

Documentation now exists that the incidence of anxiety in Chiari patients may be as high as 30%[1]. It is usually described by patients as severe and unrelenting. I know firsthand what anxiety associated with Chiari feels like. It’s agonizing. It makes functioning during the day nearly impossible at times. It keeps you up all night and drains the affected individual of every ounce of energy. When stress is added, the level of anxiety can go through the roof.

Unfortunately, many Chiari patients continue to experience some level of anxiety well after decompression even when there is improvement with many other symptoms. Many Chiari patients talk about their sensitivity to stress. I can personally testify to this. While I experienced a remarkable recovery, I still have some minor but lingering symptoms nine years after surgery. I have mild ringing in both ears, moderate sleep dysfunction and difficulty swallowing certain foods at times particularly hamburger and bread. I also would describe myself as stress sensitive. For me, stress doesn’t necessarily bring on anxiety but it certainly exacerbates my insomnia. For others, it may not only aggravate anxiety but other symptoms as well including abdominal pain, frequent urination, generalized pain, and headache.

Stress can be associated by both good and bad events. It can be stressful to lose a loved one but it can also be stressful to win the lottery. Certain environments can be stressful such as noisy children, smoky rooms or hot and stuffy class rooms. Anticipating important events can be stressful like a relative’s visit or a final exam. As many of you know, anticipating decompression surgery can be extremely stressful. Every decompressed Chiari patient I have met has told me that they were not able to sleep the night before surgery.

I have recently encountered several good and bad stressful events. A good form of stress I encountered was retiring from industry this last August after 31 years of service but it involved a lot of paper work and big financial decisions to be made. It was also stressful to leave my daily routine and begin a totally new daily life style. In September, I began my post retirement career as a university professor which required moving to another state, leaving our children and grandchildren behind and planning about 40 lectures for the fall semester. It may sound somewhat strange but I also got stressed out the week before I ran the Hartford marathon in October. I worry prior to running a marathon due to the uncertainty of being able to finish. Even the best runners experience this as anything can happen during a 26.2 mile run. On top of these events, my mother-in-law passed away and my 90 year old father went into the hospital with heart failure in mid November. Such events for a Chiarian who is stress sensitive can be challenging to say the least.

I do not believe that my stressful events are any more different, unusual or severe than anyone else’s. We all have our problems. We also have certain stressful events in common. Given the time of year, anticipating holidays and the holidays themselves can be challenging for all stress sensitive Chiari patients. Stress with holidays can be associated with financial problems, particularly this year, and relationship problems.

So the big question is what can we do to minimize stress and help ourselves to more effectively cope with the upcoming holidays? Is there something special stress sensitive Chiarians can do? I could suggest that you indulge in relaxing activities like listening to music, taking hot bathes or lighting scented candles but you can find that advice in any number of popular magazines and journals. I’d like to suggest something different.

My suggestion in a sense is to fight fire with fire. Rather than chilling out or relaxing, I suggest you take action but not any kind of action. The idea is to take action that produces happiness and then use happiness to fight or neutralize stress and anxiety. The best way I know of producing happiness, true happiness, is to engage in something that gives you purpose. I’ve written about this before in terms of managing depression but I have also found it effective for fighting stress. When you are emotionally fit you can withstand other emotional attacks and stresses. Trying to simply relax or chill out only provides a temporary escape and it’s not usually effective in the long-term. Strengthening your emotional state by generating happiness through finding purpose is a more permanent and long lasting cure.

Finding ones purpose is not straightforward for most people. It certainly wasn’t for me. It first requires a thorough examination of conscience asking yourself what you really believe you are here on earth for. This examination may take days or even weeks. It may take talking to others. But I would suggest that for many of us, the answer lies right before our eyes. It’s usually just shrouded by some artificial want or desire or some degree of personal laziness or false impression that something is too difficult. But with a little persistence and self honesty, you can figure out what your purpose might be.

We are each here for different purposes. Whatever that purpose is, it is not trivial even if it seems less complicated or sophisticated than something grand you may have been pursuing. For some people, it may be the opposite. Their purpose may be something much more demanding than what they are currently doing. The important thing to understand is that when you realize what your purpose is and you pursue it, you will become both happy and emotionally strong. It may be something that you have thought about your entire life but never explored. If that is the case, don’t be afraid. For those of you who are very ill and not yet decompressed, you may have to delay these actions. Your purpose for now should be to focus on getting well and getting the treatment you need. In this regard, put yourself first as you can’t put the interests of others first, even your own children, unless you are well.

After identifying your purpose, you must then pursue it. This may take some minor or major life adjustments. You can think about a trial period if you are unsure and design something that doesn’t require a permanent change. The world is full of people who have made changes late in life to pursue their true purpose. Some have become artists, missionaries, educators, and even politicians. They’ve done so with passion, energy and joy. It may take a bit of bravery to take the first step. While writing this I cannot help but think of the new Batman movie, The Dark Knight. There is a scene where Two Face says, “Introduce a little chaos into your life” or something to that effect. Taking that first step can be a little chaotic but it may well be worth it.

Over the upcoming holidays take a little time out to think about your purpose and perhaps formulate some tentative plans that you can discuss with someone you are close to. Place yourself on the road to finding self purpose. The pursuit of purpose not pleasure brings happiness and happiness will prevail over stress and anxiety. I guarantee it.

-- Ray D'Alonzo

1 Mueller and Oro, J. Am. Acad. Nurs. Prac., Vol. 16, Issue 3, pp. 134-8, March 2004

 ** If you would like to share your comments, thoughts, or ideas with Ray,  please send them to dalonzo.rp@gmail.com.  Due to the volume and nature of email received, individual responses are not possible. **

[Ed. Note:  The opinions expressed above are solely those of the author.  They do not represent the opinions of the editor, publisher, or this publication.  Mr. D'Alonzo is not a medical doctor and does not give medical advice.  Anyone with a medical problem is strongly encouraged to seek professional medical care.]    
 

Return To Table Of Contents