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Stress The Unseen Killer
by: Dr. John Rumberger
Introducing Stress Management
There are very many proven skills that we can use to manage stress. These help us to remain calm and effective in high pressure situations, and help us avoid the problems of long term stress.

These skills fall into three main groups:
Action-oriented skills: In which we seek to confront the problem causing the stress, often changing the environment or the situation;
Emotional-oriented skills: In which we do not have the power to change the situation, but we can manage stress by changing our interpretation of the situation and the way we feel about it;
Acceptance-oriented skills: Where something has happened over which we have no power and no emotional control, and where our focus must be on surviving the stress.
In the rest of this section, we look at some important techniques in each of these three groups.

Become aware of your stressors and your emotional and physical reactions.
Notice your distress. Do not ignore it. Do not gloss over your problems.
Determine what events distress you.
What are you telling yourself about meaning of these events?
Determine how your body responds to the stress.
Do you become nervous or physically upset? If so, in what specific ways?

Recognize what you can change.
Can you change your stressors by avoiding or eliminating them completely?
Can you reduce their intensity (manage them over a period of time instead of on a daily or weekly basis)?
Can you shorten your exposure to stress (take a break, leave the physical premises)?
Can you devote the time and energy necessary to making a change (goal setting, time management techniques, and delayed gratification strategies may be helpful here)?

Reduce the intensity of your emotional reactions to stress. The stress reaction is triggered by your perception of danger...physical danger and/or emotional danger.
Are you viewing your stressors in exaggerated terms and/or taking a difficult situation and making it a disaster?
Are you expecting to please everyone?
Are you overreacting and viewing things as absolutely critical and urgent?
Do you feel you must always prevail in every situation?
Work at adopting more moderate views; try to see the stress as something you can cope with rather than something that overpowers you. Try to temper your excess emotions. Put the situation in perspective. Do not labor on the negative aspects and the "what if's."

Learn to moderate your physical reactions to stress.
Slow, deep breathing will bring your heart rate and respiration back to normal.
Relaxation techniques can reduce muscle tension.
Electronic biofeedback – my favorite is listening to music – the genre depends on my mood and can range from classical to “oldies” to classic rock and roll. This can help you gain voluntary control over such things as muscle tension, heart rate, and blood pressure.
Medications, when prescribed by a physician, can help in the short term and, if serious, in the long term in moderating your physical reactions. Medications alone of course are not the full answer; but please don’t forget that your doctor is there to help you.
Learning to moderate these reactions on your own is one of the most viable long-term solutions.

Build your physical reserves.
Exercise or some physical activity that you enjoy gets your mind focused, even for short periods, in another direction.
Eat well-balanced, nutritious meals.
Avoid nicotine, excessive caffeine, and other stimulants.
Mix leisure with work. Take breaks and get away when you can. A 5 minute break from the grind and concentration can often allow you to focus. When I was in college and had to spend hours and hours studying, I found that a regiment of working with a clear goal to when I was going to take a break, was very productive. I would make “deals” with myself in terms of doing activities that I did not particularly like by telling myself I could then be allowed to work on something I enjoyed at the end of the drudgery.
Get enough sleep. Be as consistent with your sleep schedule as possible. Try to maximize your sleep: wake ratios.

About the author:
I have dedicated my life to studying the heart and the blood that pumps throughout the human body. I have spent much of the last thirty years doing research and spending valuable time with patients, trying to better understand the heart.

My experience in the field is extensive, and includes achieving my doctorate in 1976 (Bio-Engineering/ Fluid Dynamics/ Applied Mathematics) from The Ohio State University Columbus, Ohio, with a dissertation on, A Non-Linear Model of Coronary Artery Blood Flow.

I then continued my education into my true love, medicine, when in 1978 I became a M.D. graduating from the School of Medicine at the University of Miami, Florida.

I became an Internist and then a Cardiologist. Since then, I have pioneered how the medical field views the process of blood flow through the heart. From my appointment as professor at the Mayo Clinic in Minnesota, to Medical Director at the HealthWISE Wellness Diagnostic Center in Ohio I have treated patients with heart problems. Though each patient is unique, the heart in each of us works the same way.

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