Adrian Blotner, MD  
Patient Education
Seminar Series


Area Physician, Dr Adrian Blotner, To Host Seminar Series,
?Achieving Healthy Balance: Caring for Yourself & Those You Love?

The monthly seminars will begin on September 11, 2009 and will wrap up on August 13, 2010. The cost for each hour long seminar is $30.00; they will start promptly at 7:30am.
At 6401 Poplar Ave # 316, Memphis, TN 38119 The following is a current schedule of the series recently released:


Home, School, Work: Achieving Healthy balance 09/11/2009

Managing Holiday Finances 10/09/2009

Managing Holiday Stress 11/06/2009

Enjoy YOUR Holidays 12/11/2009

Healthy Beginnings for the New Year 01/15/2010

Enhance Your Romance: Valentine?s Day & more 02/06/2010

Reducing Stress at Tax Time 03/12/2010

Spring Break-Give ME a Break! 04/09/2010

School?s Out: Oh, No-Now What 05/14/2010

Beating the Heat: Enjoying YOUR Summer 06/11/2010

How to NOT need a Vacation after Your Vacation 07/16/2010

Family & Friends: Achieving Healthy Balance 08/13/2010

For more information, contact:

J Blotner Advertising (media)
Jonathan Blotner (901) 568-4800, email:

Seminar reservations and information:
Joanna 901-761-3255 ext 302, email:

self-Renewal & Changing Habits

7 Questions for Highly Effective Self-Renewal

What healthy physical activities can I do?

How can I improve my nutritional health?

How can I improve my medical health?

How can I improve my mental & emotional health?

How can I improve important relationships in my life?

What can I accomplish that is important to me?

What can I do today that will lead to a better tomorrow?

Changing Habits

We often have habits we think of as bad and that we want to change, but we often find it very difficult. It is uncomfortable to let go of habits we think of as unhealthy, because we derive some immediate pleasure and/or relief of emotional or physical discomfort.

Take the example of those with problems with cigarette smoking, overeating, alcohol, or drugs. The disadvantages of these habits are usually obvious to the person with the unhealthy habit(s) and their loved ones. So, why are these habits so difficult to change?

To start with, there are positive aspects to these habits in the first place. Cigarettes provide short term satisfaction, unhealthy foods taste good, alcohol provides relief from psychic pain, drugs offer a chemical high or low that may be, to the individual, preferable to ordinary daily suffering. In the short run, the body and mind may see them as good.

Then there is the issue of physiologic withdrawal?the body has to go through a biochemical adjustment to not having the substance around. (I believe this even applies to attempts to significantly reduce fat and/or carbohydrates in the diet).

Perhaps more importantly, social groups and social rituals are intimately associated with the use of these substances. People smoke cigarettes, drink alcohol, take drugs, or eat unhealthy foods. They have shaped their daily lives to include spending time with people who share their habits.

Often, the most difficult part of giving up unhealthy habits is dealing with the social changes: giving up this pleasurable time with friends, being the only one in a group of friends who does not smoke, or drink, or do drugs, or eat dessert. The power of these social rituals is considerable. Anyone who has tried to make this type of change can attest to the physiological, emotional, and social discomfort that occurs during the initial stages of healthy change. No wonder it is so difficult to make successful and long-lasting changes.

You need a lot of motivation. You have to replace all these underlying aspects of the unhealthy habit with some sort of healthy alternative or "plan."

These can include efforts to increase healthy foods in the diet, properly selected nutritional supplements, gradual increases in physical activity, and spending more time with healthy people, doing healthy activities, in healthy places & situations. Non-habit-forming medications, certain natural herbs, and tonics may be helpful and even necessary but these must be carefully selected. In the case of cigarette smoking, which is a true addiction (nicotine is a highly addictive drug), special medical help to reduce withdrawal symptoms may be necessary to accomplish change. As with all healthy change, remember: the first rule is "do no harm."

There?s a funny thing about changing habits: sometimes a terrible experience will provide the needed motivation for a healthy change. I have heard a surprising number of patients say, "I feel funny saying this, but having a heart attack was the best thing that ever happened to me." Of course, they are not glad that some of their heart muscle has been permanently damaged. But they are surprised at the increased amount of pleasure they experience with time as they consistently maintain healthy change. They express regret that it took such a terrible event as a heart attack to give them the motivation and permission to make this healthy change and wish they had made it years ago, without needing something as terrible as a heart attack to facilitate the change.

Healthy changes can be facilitated by any other life-threatening illness such as cancer or trauma. Witnessing these illnesses happen to people we know and love can sometimes be enough to motivate change. People commonly say that it results in their reassessing their priorities--how they spend their time and energy. Some things that used to seem important (like material things) become less important, while others (like relationships and peace of mind) are moved up on the priority list and no longer taken for granted.

One important variable here is often the reaction of family and friends, who support, facilitate, and even demand healthy changes out of their love for the survivor of the heart attack or other trauma. But can people change habits as strong as these without the incentive of such terrible events happening in their lives? Can you?

Well, I?ve got good news and bad news for you. The good news is that you have the power to make your life better, by your own definition of what that would be.

The first important question is: What do you really want? Is it worth taking action to get what you really want? To look better, feel better, have more fun, get more pleasure out of your important relationships? Do you want to be less sensitive to stress? Do you want to be an active participant in helping your body and mind to be in better health, in helping your body and mind to heal themselves?

Now for the bad news. Only you can be the one to do this. No one else can do this for you, though others can do this with you and support your efforts. In order to get what you want, you must be willing to try an experiment: take a small, healthy step in one of your habits and hold the line for a few days. Make it "bite-sized," "small change." And keep your focus just on today and tomorrow. When you focus on making a "bite-sized" positive step today, you can go to bed tonight feeling good about what you?ve accomplished.

I easier said than done. And give yourself a break: no one bats 1,000. (The best hitters in baseball rarely bat over .350). Also, remember to notice and enjoy even small benefits of your change. What do you have to lose? You can always return to your old habits.

Connections in the Brain Between Pain & Depression

Scientists Find Connections in the Brain Between Physical and Emotional Pain
By Brian Vastag (JAMA. 2003;290:2389-2390)

Poets muse about the agony of a broken heart. Losing a friend hurts, and rejection can feel like a kick in the gut.

It turns out that these expressions are more than metaphorical. When Wake Forest University psychologist Mark Leary, PhD, investigated the linguistics of pain, he discovered that the overlap is not a coincidence of English. Each of the 15 languages he analyzed likened emotional pain to physical harm.

Scientists are beginning to understand why. It turns out that the brain processes both experiences in much the same way. While a large part of how the brain responds to physical pain remains mysterious, a series of recent discoveries has unveiled an evolutionary efficiency: the brain circuits and structures that respond to a twisted ankle also recognize a stinging rebuke.

For decades, physicians have known that physical pain and depression are intertwined. Chronic pain can cause depression, while depression can heighten pain. In fact, up to 80% of patients with depression present with mainly physical symptoms (Am J Psychiatry. 1993;150:734-741).

Thirty years ago, the first evidence of a chemical overlap between pain and depression appeared when physicians discovered that small doses of tricyclic antidepressants can ease chronic pain. The phenomenon is so well-known that tricyclics are considered a first-line therapy for fibromyalgia and other poorly understood pain syndromes (Curr Opin Investig Drugs. 2002;3:454-458). The latest research continues to bear out the benefit of these older antidepressants. One recent study found that in patients with chronic tension headaches, tricyclic antidepressants work better than relaxation strategies; combined, the two approaches proved synergistic (JAMA. 2001;285:2208-2215).

Newer antidepressants show promise, too. A few clinical studies have found that drugs that work on serotonin and norepinephrine?two hormones in the brain that help regulate mood?can relieve some chronic pain, including migraine headaches. One review found that venlafaxine (Effexor), the best studied of the newer antidepressants, is just as efficacious against neuropathic pain as the tricyclic antidepressants, with fewer adverse effects (Minerva Anestesiol. 2002;68:105-114).

One connection between mood and chronic pain, then, lies with these two brain hormones called serotonin and norepinephrine. Brain cells that produce these hormones connect to mood-regulating areas of the brain. But these cells also connect to the spinal cord, where they help regulate external and internal sensation, according to research from Stephan Stahl, MD, PhD, a psychopharmacologist at the University of California, San Diego.

When the body is functioning normally, serotonin and norepinephrine circuits suppress routine body sensations, like that from the stomach during digestion, and other sensations from the body, like those from muscles and joints. This prevents the brain from wasting energy on irrelevant details. But in people who have clinical depression, these routinely ignored sensations may reach the brain.

"It's entirely possible that a malfunctioning of these serotonin and norepinephrine pathways allows routine sensory input to be felt as uncomfortable or even painful," said Stahl. "When those who suffer from clinical depression complain of headache, stomach pain, or pain in the lower back, joints, and neck . . . these sensations are [made worse by increased sensitivity to pain due to malfunctioning of these serotonin and norepinephrine pathways in] the spinal cord and into the brain." Stahl recommends antidepressants with serotonin and norepinephrine action for those who suffer from clinical depression and pain.
Arthritis Diet

A diet lower in fat, 20 grams of fat a day, reduced headache frequency by 71 percent and intensity by 66 percent in a study done at the University of California at Irvine.

Hydration: 8 to 10 cups of water/day

Vitamin, Mineral, & Nutritional Supplementation

Vitamins B-2 (riboflavin), B-3 (niacinamide), B5 (pantothenic acid), & B-6;
Vitamins C, D, E, & beta-carotene;
Calcium, Magnesium(common deficiency in younger & pre-menopausal women), Copper, Molybdenum, Zinc, Boron,
Glucosamine & chondroitin, Quercetin;

Carbs: High complex carbohydrate-60% of total calories
High-carbohydrate bedtime snack

Proteins: Restrict to 10-15% total calories & more plant protein, less animal protein (as possible)
Eat products made from wheat and soy.

Fats: Moderate fat-25% of total calories (minimize polyunsaturated oils, trans-fatty acids)
Use extra-virgin olive oil as your main fat.
Increase intake of omega-3 fatty acids (i.e., salmon, mackerel, herring, sardines, tuna).

Fiber: Emphasis on fiber-rich fruits, vegetables, whole-grain breads and cereals

Nutrients that reduce inflammation (may be taken as supplements): ginger and turmeric.

Reduce potential sources of food allergies:
Eat organically grown fruits and vegetables as much as possible to avoid toxins
Eliminate milk and milk products, substituting other sources or protein and calcium.
Eliminate polyunsaturated vegetable oils, margarine, vegetable shortening, all partially hydrogenated oils, and all foods (i.e., deep-fried foods) that contain ?trans? fatty acids.
Limit caffeine