I drank enough alcohol in my first 38 years to last several lifetimes. As much as I wanted to be like normal people who can control and enjoy their drinking, my Irish genetics predisposed me to excess.

Cissy the Teatotaler - Moroccan Mint Tea in a Fancy Glass

They say an Irishman is never drunk as long as he can hold on to one blade of grass and not fall off the face of the earth! In fact, that very saying hung on the wall in my childhood home – complete with an illustration of a happy-go-lucky leprechaun holding a mug of ale!

Becoming a committed teetotaler twelve years ago is one of the best decisions I’ve made. And, while “teatotaler” (implying that the person prefers to drink tea instead of alcohol) is considered a misspelling, it describes me to a “T”!

While moderate alcohol consumption (one drink daily for women and two drinks daily for men) has been associated with some health benefits, excessive drinking contributes to numerous health risks — including cancers of the mouth, esophagus, liver, colon, rectum and breast, cardiovascular disease, and gastrointestinal problems.

Moreover, apart from abuse or dependence and health risks, alcohol is a source of empty calories that contributes to excess energy storage in the fat cells of the body. Those hungry little guys are just doing their job when they hold on to the unused calories we consume. Historically, they were essential for survival. Our ancestor’s bodies were finely trained to store energy for the lean months when food was scarce.

The two other primary considerations for weight loss are related to fat metabolism and protein synthesis. Alcohol puts the brakes on fat burning and muscle building from the minute you ingest it until it is completely out of your system. Even if you’re drinking “moderately” you may be impeding your ability to burn fat and build lean muscle tissue. One night of excessive drinking or a daily habit of moderate drinking may be significantly hampering all your other efforts to deplete your excess energy stores and increase your muscle mass.

A coaching client whose steady weight loss cycle had plateaued gave up her almost daily cocktail or beer with dinner and saw immediate shift back into burning stored energy. While she was somewhat surprised, she also said it lined up with her inner wisdom that even moderate daily drinking wasn’t supporting her optimal health and well being.

Tea anyone??

“Health is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.” (World Health Organization)

What is complete physical, mental and social well-being worth to you?

Since my breast cancer diagnosis and treatment in 1992 I’ve invested a significant amount of time, money and energy to be physically, mentally and spiritual healthy.

I started buying organic back when organic was hard to find.

I’ve paid out-of-pocket for healthcare services I consider essential even though my insurance company did not.

I paid out-of-pocket for my personal psychotherapy over the years because I didn’t want my mental health (or lack thereof) to be anyone’s business but my own.

I’ve given up work (and the money I could have made taking on those extra clients or jobs) in order to have time to exercise regularly.

But most of all, I’ve invested countless hours learning to listen to my body and to make choices about eating, drinking, moving, sleeping, relaxing, working, playing, engaging, serving  based on the wisdom that comes from paying attention to my own experience.

Taking time to listen to your life–body, mind, spirit–is the most important investment you can make in your health.

Health coaching, therapy and spiritual direction are different modalities that help you do that.

Coaching focuses on behavioral change. Coaches listen, ask questions and help you to discover your inner wisdom about where you want to be, what you want to do and develop strategies to get you there.

Psychotherapy focuses on mental, emotional and relational health. Therapists listen with you and help you listen to yourself to increase self-understanding, better regulate your mental and emotional energies and improve your relationships.

Spiritual direction focuses on your relationship with your soul, God and things of the spirit. Spiritual directors listen with you to hear what your soul is saying, what God or the spirit might be saying and help you deepen your capacity to live from these depths.

I’ve invested a ton of time, money and energy in all three modalities–both as a recipient and as a student/practitioner. Of all the investments I’ve made for my health, these have provided the greatest return-on-investment.

What about you?

Learning to listen to yourself and become your own expert on good health will make the money, time or energy spent on nutrition, exercise and other pursuits much more effective and sustainable.

If you’re interested in finding out more, check out my services page or contact me for details. I or my colleague Lisa would love to explore with you how learning to listen to yourself can support your complete physical, mental, spiritual and social well-being.

Two articles from the NY Times, “No Quick or Easy Choices on Breast Reconstruction” and “The Outrageous Cost of a Gene Test” ,” expand on the themes I raised in my last blog.

As one of the plastic surgeons quoted in the first article states, reconstruction is major surgery with all the inherent risks and takes most people up to a year to fully recover.  Jolie’s seeming “easy and quick” three month recovery may leave people underestimating the risks and potential complications of mastectomy and reconstruction.

In addition to the loss of sensation and sexual arousal (even in many skin and nipple conserving mastectomies) many women have other complications including: infections and bleeding, anesthesia complications, scarring, discomfort, pain that never goes away, implants that rupture or need to be replaced…just to name a few.

When I made my choice I figured that implants were like tires–they’d need to be replaced at some point with another surgery. That didn’t sound like a very healthful option!

In fact, the American Cancer Society says that as many as half of all implants (saline and silicone) need to be replaced in 10 years. Going with that statistic, I’d potentially already have had two more surgeries if I’d chosen reconstruction. Definitely not the way I want to spend my free time!

The fabulous research assistant who sent me these links (and also happens to be my husband) said this article made him happy I’d not chosen reconstruction. Me too.

My point about the audacious ethics of Myriad Genetics (the company that currently owns the patten on the BRCA tests) is fleshed out in “The Outrageous Cost of a Gene Test.” The author, a medical oncologist who consults in the area of genetics, points out that Myriad is estimating  a profit margin of 87% on a 25-gene cancer risk evaluation that will phase out the BRCA tests in 2015.

87% profit? At whose expense? Yours and mine.

When did it become acceptable for a company to patten and profit off of genes that they had nothing to do with creating?

I am glad that Angelina stepped up and brought the conversation about breast health to our attention. She made a courageous decision in line with her own values as I did mine.

My hope is that all of us will be informed consumers of services and not blindsided by media hoopla about quick and easy answers to life and death issues.

Angelina Jolie’s disclosure of her choice to remove both breasts spurred me to share my story about deciding not to test for the BRCA gene mutation that prompted Jolie’s decision.

I was thirty years old when diagnosed with early stage breast cancer. In 1992 the options for treating my ductal carcinoma in-situ were either a lumpectomy with radiation or a mastectomy with the option for reconstruction.

I had no interest in radiation and amidst grieving the loss of my mom (who’d recently died) and my breast, I didn’t have energy to deal with the added physical and emotional stress of adding something new to my body. I choose a mastectomy without reconstruction. At the time I thought perhaps after I had kids I’d have both breasts done to match!

I never had kids, but never felt the need for reconstruction either. My left breast keeps me and my husband happy and my prosthesis works just fine for providing a matched set when needed.

At my semi-annual breast check a few years ago an associate of my dear doctor Armando Guiliano (whom I love and highly recommend to anyone seeking a great breast surgeon) suggested I consider genetic testing. She briefly explained what it involved and why it was recommended.  I asked what treatment would entail if I tested positive for the mutation. She very matter-of-factually stated “Prophylactic removal of both ovaries and the remaining breast.”

Shocked! I asked if there weren’t any less extreme options?

She said that the breast could continue to be monitored as we’d been doing but no comparable methods for the ovaries existed. She handed me some literature, said if I had any questions to let her know and left the room saying “I’ll be back in a few minutes with Dr. G.”

When they returned I greeted Dr. G. with a big hug and chatted a bit as he perform my exam. After a few minutes I mentioned the genetic testing recommendation. “Yes” he said, “we weren’t doing that when you were first diagnosed but it would be a good thing to consider now.”

“That’s all well and good,” I replied, “but if I test positive the treatment options aren’t very appealing. How would you like it if someone recommended prophylactic removal of your testicles?”

We all got a good laugh out of that, but it presses a point. As Dr. Susan Love points out  “We really don’t have good prevention for breast cancer. When you have to cut off normal body parts to prevent a disease, that’s really pretty barbaric when you think about it.”

You can be sure that if the likelihood and rate of survival of testicular cancer in men (1 in 250 men will be diagnosed with an 80-100% rate of survival depending on stage) were comparable to that of breast cancer for women (1 in 8 women will be diagnosed with a 15-93% rate of survival depending on stage) someone would have developed far better measures for monitoring and treating it than they’ve done for female cancers.

Barbaric!

I decided that even if I did test positive for the mutation, I wouldn’t remove my ovaries or my remaining breast. Since I don’t have children, like Jolie who lost her own mother to breast cancer at age 56 and said she did it so her children wouldn’t have to lose their mom they way she did, I don’t have that weighing on me. If I did, perhaps I might have made a different choice.

Beyond that, I don’t want to live in fear of death. As Joel Shuman and Brian Volck point out in Reclaiming the Body: Christians and the Faithful Use of Modern Medicine, when it comes to extreme measures of avoiding illness and prolonging life “few people seem interested in asking whether or to what extent such an aim is appropriate for creatures of a providential God.”

The additional issues of cost ($3000 which might be paid for in my case, but not necessarily) and the audacious ethics of  the only company who currently offers the testing (their patent on the BRCA genes is currently under consideration with the Supreme court) also factored into my decision.

The bottom-line question was: What difference will knowing make? Testing negative for the mutation wouldn’t make any difference to how I live each day. Testing positive might increase my vigilance about self-care and monitoring, but I already do everything I’m “suppose to” in terms of prevention.

I’ve always said that I reserve the right to change my mind about reconstruction. And I feel the same about testing for BRCA.

But for today, I am alive and well, being of service to many, and full of gratitude for the goodness of life that has come to me. If one day I decide two breasts are better than one or knowing my genetic status would give me a better life, I’ll go for it.

But until then, I’ll remain a one-breasted woman committed to living in the love of a providential God that has no room for fear of death, disease, aging, accidents, and whatever else might stand in the way of fully loving and enjoying my life, just as I am.

Join me on Saturday, May 18th at The Dynamic Advantage in Eagle Rock, California for a free workshop.  I’ll provide a short presentation on the Duke Integrative Medicine personalized health planning model, then give you the opportunity to experience it for yourself.

Duke Integrative Medicine is on the cutting edge of transforming healthcare in America. I use their Wheel of Health as the framework for helping you identify how making changes in multiple dimensions of your life can support your overall health.

Bring your own health goal, concern or challenge and see how individual health coaching might be a good fit for your current needs.

That’s the question that comes to mind as I ponder the current debate on making the “Plan B” morning-after contraceptive available to girls of any age. As Sandy Banks points out in her opinion piece, the “women” in question are 12, 13 and 14 years old. And even younger in some cases!

The key issue at stake in the discussion appears to be the hard won right of women to choose what to do with our reproductive capacities. But does the biological capacity to bear a child make a girl psychologically capable of making “woman” decisions without adult support? I think not.

I went through precocious puberty. I began menstruating  in fourth grade at ten years old–long before other girls even began to think about such matters.  While my body was ready to bear children and make adult decisions, “I” certainly was not!

I understand the potential complications in family where girls so young are having intercourse and in need of a some kind of  “Plan B.”  A girl who doesn’t feel safe asking her parents for support in such matters needs help with far more than her contraceptive options. But this is not the “Plan B” that will provide the real help she needs.

As Sandy, the single mother of two now adult women, points out so clearly: “If parents took more responsibility and paid more attention to their kids, perhaps the debate about the contraceptive Plan B would become unnecessary.”

Amen Sandy.

I’m all for women’s reproductive rights, but girls aren’t women, even if their bodies say otherwise.

A former participant in my coaching and mentoring programs told me today that learning to listen to her body–to sense her body, to be aware of bodily reactions to emotions and thoughts–was one of the most valuable lessons of her time with me. “I’d never realized how disembodied I was.”

We live in a culture of disembodied ways of being. We pop painkillers to soothe tension headaches rather than alter our too busy lifestyles. We take vitamins instead of  preparing and eating real foods.  And we slather our bodies and faces with products containing known carcinogens because that is what we’ve been taught to do. It’s normal, so no one questions it.

Dove’s “Real Beauty Sketches” documents a social experiment showing the distorted images many people have of their physical attractiveness. Dove has capitalized on their “real beauty” message–using it to sell many carcinogenic containing products under the auspices of promoting better self-esteem.

On the surface, the message Dove sends is: “You are more beautiful than you think.” But underlying it is the same old disembodied, objectified view of beauty that keeps women obsessing about appearances rather than claiming our unique beauty and getting on with being the dynamic forces for good that we were created to be. Dove presents beauty as an external reality, disconnected from the “real woman” beneath the surface who has an interior experience and her own beautiful story that is about far more than the size of her nose or her wrinkles.

LA Times writer Meghan Daum nails this in her editorial “Real beauty, really Dove?” She points out that all the women in the project conform to cultural stereotypes of attractiveness. As she puts it, “None of the video participants was forced to thumb through the thesaurus looking for a nice way of saying ‘has three heads’.” What if one of the sketch models did have a large nose or a double chin? Would the participant describing her to the artist have said so? Probably not.

As my shero India Aria says “I am not my hair. I am not my skin. I am the soul that lives within.”

Hair comes and goes. Skin changes with the seasons. I’ve heard it said that our noses and ears continue to grow throughout our lives. If my bulbous nosed Irish relatives are any indicator of what I have to look forward to, I’ll be sporting a significantly larger schnoz in my eighties!

So, with all due respect to their intention to support “real beauty”, Dove is still missing the essential piece: soul work. Beauty is an inside job.

The story of beauty that begins in our souls guides us to deeply inhabit our bodies and love our flesh, to value each hair on our head whatever the color, and celebrate each wrinkle as documentation of another year of life. When beauty is an expression of the soul that lives within, the externals fall into proper perspective.