This is Scott Selinger and welcome toanother scintillating episode (webisode? pod? I’m not totally sure what to callthese serial casts) any way, it’s another ABC’s for ECP’s, the podcast onbehalf of the Northern California’s chapter of the American College ofPhysicians Council of Early Career Physicians. 

As I’ve got a wedding to head to inbeautiful scenic St. Louis this weekend flanked by a trip to the national ACPmeeting in Orlando next week, I’ll make this a brief one.  We’ve all heard aboutmindfulness and mindful meditation, and it sounds great in theory, but how dowe bring it into our daily practice?  Isthere actually a way in our hectic shift schedules to find time for a calmingexperience?  I think so, and I’ve beenstarting to do it.

Deep breathing exercises are a greatrelaxation technique.  The NIH’s NationalCenter for Complementary and Alternative Medicine has noted research supportingthe power of relaxation techniques on improving control of numerous medical andpsychiatric conditions, or to put it a way we more commonly hear it, “Sideeffects of relaxation techniques may include improved control of anxiety,depression, asthma, fibromyalgia, headaches, chronic pain, angina,hypertension, insomnia, IBS, nausea, TMJ syndrome, tinnitus, and overactivebladder.”  Sounds pretty good right?  If only we had a time when we couldincorporate it into our daily practice …

But fear not!  There is a way!  The next time you’re getting ready to performan auscultation as part of your respiratory exam, give this a try: put yourhand on your patient’s shoulder, your stethoscope on their chest, ask them totake some deep slow breaths through their mouths, and then breathe along withthem.  This can help you out in a fewways:

1)  Firstly, if you’re breathingalong with them, you’ll be able to make sure they aren’t hyperventilating tothe point they might pass out by the end of the exam (as I’ve seen a fewovereager patients do)

2)  Second, as mentionedabove, for the patient with any of the conditions mentioned above, the act ofdeep breathing may help put them more at ease in their interaction withyou.  They may feel less anxious, theirpain may be a little diminished, their blood pressure may go down a little bitand if they do get any of these benefits, you will have just illustrated asafe, effective, free, non-pharmacologic treatment that they can take home withthem

3) Finally, looking at your own wellness and all the stress andexternal stimuli we’re bombarded with in our daily practice, it can help giveYOU a moment of calmness and clarity, probably making you spend a few extraseconds on auscultation, and let you both come out on the other side of theexam feeling a little more at ease and connected as you get ready to discussthe assessment and plan.

Personally I can say that I’ve been trying this for the lastfew months and in the midst of seeing 11 or 12 patients every 4 hours, it hasbeen a little oasis of respite so I definitely encourage you to give it a shotwith your next patient.

Additionally,I want to give another little plug for mini meditation sessions to make yourday easier.  Search for “how to meditatein a minute” and you’ll find a nice, short, animated cartoon that will talkabout the benefits of meditation and show you how quickly you can see them ifyou can find just a minute in your busy day. It’s a cartoon and it’s about 5 minutes long and I think it’s somethingthat can be beneficial for us and our patients in a ton of different situations.

As always, we’dlove to hear your feedback on this, so if you have any burning questions orcomments, you can post them on our facebook page or email them tocanocecp@gmail.com.  And if you havetime, be sure to head on over to our facebook page for the Northern CaliforniaChapter of the ACP Council of Early Career Physicians so you can find out moreabout the events going on in the chapter.