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HEALTH NATURAL-BEAUTY STRETCHING

Seeing a surgeon?

A doctor and patient seated on opposite sides of a desk, leaning in toward each other as they talk; the doctor is pointing to a tablet between them

A visit with a surgeon can be overwhelming. You may feel anxious about your planned surgery. Many questions could be swirling in your head during a rushed visit. While surgeons have a reputation as technical specialists, bedside manner may be lacking at times.

It sounds simple, but setting the right expectations — on both sides — can ease your anxiety and help you feel more comfortable during a visit with your surgeon. So what exactly does this mean? And how can you accomplish it?

Tell your story

Tell your story to help set clear goals. Beyond simply stating what hurts or what is not working, be sure to include details such as

  • how your current condition limits what you enjoy doing
  • your daily activities
  • how your condition affects your relationship with your social circle and family
  • upcoming plans or goals such as travel, or life events like vacations or weddings.

Sharing details like these helps you collaborate to define a successful outcome for surgery.

Listen with your goals in mind

When explaining surgical options, surgeons are obligated to discuss key information, including risks, potential complications, and likely outcomes. Encourage your surgeon to put these facts into context based on what is important to you.

  • Ask questions about how surgery will affect things you enjoy doing, such as playing pickleball, taking walks, cooking, reading, or listening to music.
  • Ask what you should realistically expect during recovery and once you have recovered. For example, if you have a vacation or travel planned, be sure to discuss how surgery will affect your plans.

Define success before your surgery

Once you are confident that you have told your story and feel like you and your surgeon have set appropriate expectations, take the next step. Ask whether this discussion affects your surgeon’s approach to surgery, and explore how you each define surgical success.

Often, both surgeon and patient agree on a definition of success: for example, remove the entire tumor. But this simple definition may leave room for misalignment. Let’s say a surgeon is able to entirely remove a thyroid tumor, but now the patient speaks in a hoarse voice. While technically successful, this surgery may feel like a failure unless the person understood and accepted the risk that it could affect how they speak.

This highlights the importance of setting expectations. In this example, clear speech after surgery might be your expectation as a patient. Your surgeon must balance explaining how surgical risks might affect that expectation with the reality of treating the condition. Surgery is more likely to feel successful if both sides discuss and align their expectations.

Give yourself time when possible

Processing information about surgery can take time. A surgeon may have to provide realistic expectations that do not align with your initial expectations and hopes.

Some surgeries are urgent, others are not. If you do not need to make an immediate decision, be open with your surgeon. Let them know that you need time to consider the surgeon’s definition of success and your own. Reflecting on the discussion can reduce the stress and anxiety you’re likely to feel during an initial visit.

The bottom line: Making the most of your appointment

Communication goes two ways during a good pre-surgery visit. Do your best to tell your story and emphasize details of your life that are important. When listening, ensure that your surgeon acknowledges these details and describes how surgery may affect your life, as opposed to simply stating technical facts about the surgery. Setting expectations together will help you achieve a common goal and establish a strong surgeon-patient relationship that is essential for a positive surgical outcome.

About the Author

photo of James Naples, MD

James Naples, MD,

Contributor; Editorial Advisory Board Member, Harvard Health Publishing

Dr. James Naples is a physician at Beth Israel Deaconess Medical Center, and a clinical instructor at Harvard Medical School in Boston, MA. He earned his medical degree from the University of Connecticut School of Medicine, … See Full Bio View all posts by James Naples, MD

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HEALTH NATURAL-BEAUTY STRETCHING

A mindful way to help manage type 2 diabetes?

A group of people doing a standing pose in a yoga class; a woman wearing a pink top and dark purple leggings in the foreground along with a blurred paire of hands

Lifestyle changes like regular exercise, a healthy diet, and sufficient sleep are cornerstones of self-care for people with type 2 diabetes.

But what about mind-body practices? Can they also help people manage or even treat type 2 diabetes? An analysis of multiple studies, published in the Journal of Integrative and Complementary Medicine, suggests they might.

Which mindfulness practices did the study look at?

Researchers analyzed 28 studies that explored the effect of mind-body practices on people with type 2 diabetes. Those participating in the studies did not need insulin to control their diabetes, or have certain health conditions such as heart or kidney disease. The mind-body activities used in the research were:

  • yoga
  • qigong, a slow-moving martial art similar to tai chi
  • mindfulness-based stress reduction, a training program designed to help people manage stress and anxiety
  • meditation
  • guided imagery, visualizing positive images to relax the mind.

How often and over what time period people engaged in the activities varied, ranging from daily to several times a week, and from four weeks to six months.

What did the study find about people with diabetes who practiced mindfulness?

Those who participated in any of the mind-body activities for any length of time lowered their levels of hemoglobin A1C, a key marker for diabetes. On average, A1C levels dropped by 0.84%. This is similar to the effect of taking metformin (Glucophage), a first-line medication for treating type 2 diabetes, according to the researchers.

A1C levels are determined by a blood test that shows a person’s average blood sugar levels over the past two to three months. Levels below 5.7% are deemed normal, levels from 5.7% to less than 6.5% are considered prediabetes, and levels 6.5% and higher are in the diabetes range.

How can mind-body practices help control blood sugar?

Their ability to reduce stress may play a big part. “Yoga and other mindfulness practices elicit a relaxation response — the opposite of the stress response,” says Dr. Shalu Ramchandani, a health coach and internist at the Harvard-affiliated Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital. “A relaxation response can lower levels of the stress hormone cortisol. This improves insulin resistance and keeps blood sugar levels in check, thus lowering A1C levels.”

A relaxation response can help people with diabetes in other ways, such as by improving blood flow and lowering blood pressure, which protects against heart attacks and strokes.

What else should you know about this study?

The results of studies like this suggest a link between various mind-body practices and lower A1C levels, but do not offer firm proof of it. Levels of participation varied widely. But because all mindfulness practices studied had a modest positive effect, the researchers suggested that these types of activities could become part of diabetes therapy along with standard lifestyle treatments.

Could mind-body practices protect people against developing type 2 diabetes, especially for those at high risk? While this study wasn’t designed to look at this, Dr. Ramchandani again points to the long-range benefits of the relaxation response.

“Reducing and managing stress leads to improved moods, and greater self-awareness and self-regulation,” she says. “This can lead to more mindful eating, such as fighting cravings for unhealthy foods, adhering to a good diet, and committing to regular exercise, all of which can help reduce one’s risk for type 2 diabetes.”

Trying mind-body practices

There are many ways to adopt mind-body practices that can create relaxation responses. Here are some suggestions from Dr. Ramchandani:

  • Do a daily 10-minute or longer meditation using an app like Insight Timer, Calm, or Headspace.
  • Attend a gentle yoga, qigong, or tai chi class at a local yoga studio or community center.
  • Try videos and exercises to help reduce stress and initiate relaxation responses.
  • Practice slow controlled breathing. Lie on your back with one or both of your hands on your abdomen. Inhale slowly and deeply, drawing air into the lowest part of your lungs so your hand rises. Your belly should expand and rise as you inhale, then contract and lower as you exhale. Repeat for several minutes.

About the Author

photo of Matthew Solan

Matthew Solan, Executive Editor, Harvard Men's Health Watch

Matthew Solan is the executive editor of Harvard Men’s Health Watch. He previously served as executive editor for UCLA Health’s Healthy Years and as a contributor to Duke Medicine’s Health News and Weill Cornell Medical College’s … See Full Bio View all posts by Matthew Solan

About the Reviewer

photo of Howard E. LeWine, MD

Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing

Howard LeWine, M.D., is a practicing internist at Brigham and Women’s Hospital in Boston, Chief Medical Editor at Harvard Health Publishing, and editor in chief of Harvard Men’s Health Watch. See Full Bio View all posts by Howard E. LeWine, MD