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HANFORD DOWNWINDERS WERE KEPT IN THE DARK!

Coping with Uncertainty and Illness - Concerns of Hanford Downwinders

Over the last three years, the Hanford Health Information Network's health educators have spoken with thousands of people. Some call the Network because they want more information about Hanford's past radioactive releases. Others want to know about the possible health risks. Still others call to talk about their personal experiences - worry, unexplained illnesses, chronic health problems or losses.

These experiences point to another impact of Hanford's releases in addition to possible health risks. Many Hanford downwinders express concern and worry about the connection between exposure and health problems. Many also fear for the future health of loved ones. In previous publications, the Network has referred to this uncertainty and worry as the "human toll" of Hanford's radioactive releases.

Other Network publications focus on Hanford's releases of radioactive materials and on current scientific research about the potential health effects of exposure to these releases. Topics include the basics of radiation health effects, cancer health risks, genetic effects and birth defects, radiation and the immune system, and potential health problems from radionuclides released to the air and to the Columbia River. But current science leaves many questions unanswered. The results of individual studies sometimes conflict. While science is still searching for answers, how are people to cope with their concerns and their health problems?

This publication focuses on coping with the physical and emotional concerns expressed by Hanford downwinders (those who lived in the areas "downwind" or "downriver" from the Hanford site). The people who have expressed concerns are not only those who have illnesses, such as thyroid diseases, cancer or autoimmune disorders, but also people who are well and are concerned that they or their families might become ill.

Downwinders are of varying ages and perspectives. Because of this range of differences, no single suggestion for coping will be right for everyone. The ideas in this publication are intended to help you develop your own approach to coping for yourself and your family.

"THE DARK CLOUD OF EMOTIONS"

"I'm pretty healthy, but in the 1980s when I found out about the releases I may have been exposed to, I began to worry about what kinds of health effects are caused by radiation - and what might develop for me and my family down the road. My father died of liver cancer and my sister has breast cancer. I'd like to know if there's a connection between those conditions and the exposures. I'd also like to know that's happening to others and what my family and our health care provider should be aware of. "

A man born in 1941 in Wapato, Wash., who has lived there all his life. He and his family spent time fishing and recreating in the Columbia River when he was a child. Name withheld by request.

Exposure to radiation may lead to a range of feelings and emotions. Concerns about exposure may be likened to a large, dark cloud that hangs above your head. This cloud contains the many emotions that you, as a downwinder, might experience: fear, anger, frustration, anxiety, distrust, uncertainty and grief. All together, these feelings may seem overwhelming and unmanageable. However, as you gain more knowledge and start taking action to address even one of these emotions, this overwhelming "dark cloud" may break apart into several smaller clouds, making it easier to acknowledge and address all of these different feelings.

Here are some of the feelings expressed by people who have called the Network and which you also may experience:

* Anger - You may be angry at the government for exposing you and your family to a potentially harmful substance. People were involuntarily exposed to radioactive substances as a result of routine, intentional and accidental releases.

* Resentment - You may be resentful that the releases were kept secret for so many years. Some people spent years trying to obtain classified documents so that Hanford's secrets could finally be revealed. Some documents still remain classified.

* Fear and anxiety - You may be fearful or anxious that you or your children may get sick in the future.

* Feeling overwhelmed - You may have a diagnosed disease and are overwhelmed by the prospect of living with it. Or, you may be ill, but health care providers haven't diagnosed the problem.

* Grief - You may have experienced grief and a long-term sense of loss over the illness or deaths of your loved ones. These, as well as other emotions, are real. They are echoed in thousands of conversations with downwinders who have called the Network. The fact of Hanford's past releases can't be changed. These feelings often come up as people ask about the releases or talk about their illnesses and concerns about their health.

Asking Why an Illness Develops

Science can't always tell us conclusively why a disease develops. But there is a human need to determine why we are sick. Trying to determine the cause of an illness is one of the steps we take towards healing. Often we say, "I must have caught this cold from my co-worker" or "I'm sure that I got food poisoning from that restaurant."

But for some health problems, identifying a single cause may be elusive or impossible. Was a cancer, for example, caused because there was a history of cancer in the family or because of exposure to radiation? Was a heart attack caused by poor diet and stress or by genetic makeup? In these and other instances, current science cannot always provide clear answers about the cause of a specific illness.

Often people find that putting questions to rest about the cause of an illness is an important step in the healing process. For example, a woman from Oregon just learned that she was a "downwinder." After considering information about Hanford's releases in light of her own experiences, she now believes that the thyroid disease which she has lived with since she was 10 years old resulted from her exposure. Until she read about the releases, she had no explanation for her disease.

Now, as she focuses on coping with the problems associated with her disease, she has called various support organizations for information. She believes the more knowledge she has, the more capable she'll be in managing her illness and explaining her concerns to her health care provider. This, she says, has given her the feeling that she is more in control of her life.

Improving Your Sense of Well-Being

Some things are beyond our power to change. If you have multiple sclerosis, for example, you will live with the disease throughout your life. Genetics and environmental factors, such as exposure to toxic substances, also play a role in determining health. It can be helpful to remember that even healthy people have lives that are demanding and sometimes seem overwhelming. Those who have a chronic or life-threatening illness have all the demands of ordinary life, plus the extra burden of trying to cope with an illness.

But, as one counselor who works with the chronically ill said, "We can't discount the relationship between the mind and the body. I have yet to see a patient whose mind and body come in separate packages." Both what we do and what we think can affect our health and sense of well-being. For example, instead of worrying about your illness, you can concentrate on developing or maintaining as healthy a lifestyle as possible and on preventing illness, or preventing an illness from worsening. Instead of focusing on what you're unable to do, concentrate on what you're capable of doing.

RESOURCES - Relaxation

The Relaxation Response, by Herbert Benson, M.D. (Avon Books, 1976) is a classic on relaxation techniques.

The Relaxation and Stress Reduction Workbook, by Martha Davis, Ph.D., et al. (New Harbinger Publications, 4th edition, 1982) is an especially easy-to-use publication.

Seven Things You Can Do in Your Daily Life

Whether you seek to maintain your health or to make the most of life despite your illness, there are a number of things you can do that don't have to be financially costly. Here are seven steps toward coping that are recommended by many sources:

1. Communicate - People who adapt best to life are engaged with others. You can cultivate relationships and share your feelings and concerns with family, friends or colleagues. It may be helpful to seek outside help from time to time from someone who can listen, share your concerns and/or offer help. Consider counseling if you feel depressed or anxious or need to speak with someone who is not directly involved in your life. If you have a specific concern, joining a support group can be a way to express yourself. You might want to start your own group for people who have similar concerns about specific diseases or about Hanford. Or, join a community action or citizen awareness group whose mission is important to you. Some downwinders have found it helpful to communicate their concerns to someone who is in a position to effect change.

There are also other ways to express yourself. Artistic expression may be a helpful avenue. Some people find a sense of well-being through spirituality, prayer or meditation.

2. Exercise - Long periods of inactivity can lead to weakness, stiffness, fatigue, poor appetite, high blood pressure, obesity, increased sensitivity to pain, anxiety and depression. Exercise reconditions the body, helping to improve function previously lost because of disuse or illness. Just 20 minutes a day could make a big difference in your life. Stretching or walking can be extremely beneficial. More strenuous activities, such as swimming, jogging or biking, may suit you. Check first with your health care provider before starting an exercise program. The key to a successful program is choosing an activity you like and sticking to it. If you suffer from chronic pain, make sure the program you choose does not worsen your condition. Exercise does not have to be painful to be beneficial.
RESOURCES - Exercise

Your local area parks and recreation department, YMCA, or YWCA, American Heart Association or American Lung Association can suggest ways to make exercise a regular and enjoyable part of your life. Check with your health care provider before you begin an exercise program.

3. Relax - Most people do not take time to relax. The goal of relaxation is to turn off the outside world so that both your mind and your body are at rest. Relaxation does not mean watching television or sleeping. Relaxation can be achieved through breathing exercises, walking, time alone, massage, hot baths, visualization techniques or meditation.

4. Eat well - Good nutrition is important. Food is fuel. People need fuel for healing. There is a relationship between the words "nurture" and "nutrition." Normally, a person should eat several times a day to re-fuel the body with healthy food, not empty calories. In addition:

* Eat a variety of foods: include grains, vegetables, fruits, dairy products and protein (legumes, fish, meats).

* Choose a diet low in fat.

* Eat plenty of vegetables, fruits and grains.

* Limit your use of sugars, salt and alcohol.

* Strive for a peaceful, relaxing setting at meals; in many ways the setting may be as important to health as what we eat. * Maintain a healthy weight.

The right foods may also help you stay healthy. According to the Harvard Health Letter, at least 200 epidemiological studies from around the world have found a link between a plant-rich diet (fruits, vegetables and grains) and a lower risk of many types of tumors.

5. Restructure your daily schedule and goals - Many downwinders report experiencing fatigue, often in conjunction with other health problems. This may limit the number of "productive" hours in the person's day. To cope with this limitation, determine if it's possible to work out of your home and/or organize your responsibilities so that they can be done during your most "productive" hours of the day. Keep your goals reasonable; don't try to do more than your health and energy allow.

6. Re-design your life - Look at your daily routine to identify behaviors that are not as healthy as they could be. Is your diet high in fat and/or low in nutrition? Do you smoke, use alcohol or drugs? Do you get too little sleep or have irregular sleeping habits? Is there a lot of stress in your life? Keeping a diary of your diet, stressful events and feelings may help you to understand your behaviors better. Then, you can take steps to modify or eliminate unhealthy ones.

7. Be pro-active about your health - For people who show no symptoms but are concerned about the potential health effects from Hanford's releases of radioactive materials, Network health educators suggest being pro-active about your health. For example, inform your health care provider of your concerns. Ask to have your thyroid checked if you are experiencing any symptoms or are concerned. You might take the Network's Health Bulletin to your provider. It briefly explains the potential health effects of Hanford's releases of iodine-131, which concentrates in the thyroid and may affect the parathyroid glands, as well.*

BUILDING A GOOD RELATIONSHIP WITH YOUR HEALTH CARE PROVIDER

 
"How do you tell a team of physicians about Hanford? I've tried. they smile and nod their heads. It feels like no one is listening, like I don't have a voice. When they don't respond to my questions, it eats away at my confidence in my doctors. It makes me very frustrated."

A woman born in 1943 who lived in Richland, Wash., from 1947 through the mid-1950s. Both her parents worked at Hanford. She has been diagnosed with thyroid disease and cancer. Name withheld by request.

People want to have a good relationship with their health care providers. An American Hospital Association study revealed that the most common complaint of patients is that their doctors lacked compassion and failed to listen. If you believe that your health care provider is not taking your problems seriously or if you have concerns about the quality of care you are receiving, you can learn to be a more assertive medical consumer, or change to another health care provider. The Network's publication, Working with Health Care Providers, may be helpful. You, ultimately, must be your own advocate for your health care. You may want to ask your health care provider if he or she is familiar with the Hanford situation and how past exposures could affect your health.

Different health care providers have different perspectives on the prevention and treatment of illness. For some people, traditional Western medicine may be the right choice, while others may choose "alternative" medicine. Naturopaths, acupuncturists and chiropractors, for example, may provide relief for some symptoms. Nutritionists and herbalists may provide diet support. A combination of traditional and alternative health care may be useful to some people. The choice is up to you.

Be sure to see the health care provider of your choice at the first sign of symptoms. Regular check-ups and medical examinations may detect problems before they threaten your health and your financial well-being. Be very clear and specific about your symptoms. If your health care provider doesn't know the whole story, it will be harder to make an accurate diagnosis.

SEEKING A DIAGNOSIS

 
I" have been diagnosed with RSD, reflex symptomatic dystrophy, which doesn't account for all the tumors I keep getting. Every time I turn around, I get them. I am going in next week to get another one removed. By the time they will know anything about this [health effects from Hanford], we'll all be dead - that's just how I feel. "

A woman in her early 40s who grew up in Spokane, Wash. She lived there from 1951 to 1964 and also spent a great deal of time in Pasco at an aunt's house. She ate peaches off her aunt's trees, drank locally produced milk and ate local vegetables. Name withheld by request.

Many downwinders report experiencing a variety of ailments but are not diagnosed with a particular disease. They know something is wrong with their bodies but are unable to find out what it is or what to do about it.

A diagnosis may be difficult to attain. Health care providers may not always have all of the information needed to make a diagnosis. In some cases, even state-of-the-art methods for detecting disease may not be successful. Or, it is possible that a health care provider may not be familiar with a "new" disease. It is also possible that the symptoms are not part of a disease process. Some symptoms, such as fatigue or headaches, can have many causes, including disease or the stress of daily life.

There are a number of illnesses now in the news that, until recently, were familiar only to specialists in the medical community. Chronic fatigue syndrome is one example. A periodical about this illness, the CFIDS Chronicle, notes: "Unfortunately, many physicians are not very familiar with chronic fatigue immune deficiency syndrome (CFIDS) and have difficulty diagnosing it. Others still do not even know that the illness exists or have only recently learned of it. As a result, people with CFIDS have often been misdiagnosed in the past."

Lack of diagnosis is a problem that has been documented in several populations exposed to contaminants - atomic veterans, Love Canal residents, owners of livestock exposed to polybrominated biphenyls (PBB), and industrial workers exposed to toxic chemicals. As one writer on chronic illness puts it, "Is it any wonder that the life of the undiagnosed is filled with anguish? Without an objective explanation of [his or] her ailments, the suffering person is terribly vulnerable to the notion that [he or] she is suffering from psychosomatic illness or that [he or] she is depressed, neurotic or hysterical."

Why is a diagnosis helpful? Because when you are diagnosed, you have a name for your illness. You can then shift your energy from seeking a diagnosis to learning how to cope with your illness. You can learn about the illness and the symptoms, treatments and prognosis. You can find out whether lifestyle changes will help relieve the symptoms. You can contact associations that provide information on the specific disease you have. You can join support groups and discuss your concerns with people who can empathize and help you to feel less alone. Additionally, receiving a diagnosis for certain disabling diseases may entitle you to receive assistance from government programs (such as the Social Security Administration) if you are too sick to work.

Having a diagnosis - a clear understanding of what you are facing - can help you to overcome the feeling of powerlessness and enable you to take charge of the situation. But receiving a diagnosis doesn't necessarily mean there is a known cure.

LIVING WITH CHRONIC ILLNESSES

 
"Many of us who were exposed to Hanford's radiation are suffering from multiple health problems which can cause limited energy and decreased ability to pull in a steady income. It helps to try to figure out which part of the day one feels best, and to try to do as many of the work and/or family activities one can during these hours. It also is helpful to contact groups which have advice, support, or information on the health problems or diseases a person has."

A woman who was born in the early 1950s in the Tri-Cities in southeastern Washington and who lived there until age 10. She ate locally grown food and often swam in the Columbia River. Name withheld by request.

Some illnesses are chronic. This means that they do not follow the typical progression of illness: onset, period of illness, recuperation and recovery. Instead, chronic illnesses continue, sometimes indefinitely. The symptoms may vary, but the ways in which chronic illnesses take a physical and emotional toll on people are similar.

There are many kinds of chronic illness. Heart disease, arthritis, stroke, diabetes, asthma, bronchitis and emphysema, for example, are chronic diseases that usually are easily diagnosed by a health care provider. However, there are other chronic illnesses that may be hard to diagnose. These have been called "hidden disabilities" or "invisible chronic illnesses." These illnesses have several things in common:

* They are difficult to diagnose in their early stages and milder forms.

* There are generally no cures (at this time).

* The symptoms can come and go.

* They can have a significant, debilitating impact.

* They are usually not fatal. People who have these illnesses share common ground:

* Many encounter skepticism about whether they are really sick and may experience self-doubt.

* They fear that the symptoms will worsen.

* They face uncertainty concerning the effectiveness of treatments.

Many downwinders who have called the Network report suffering from both chronic illness and some invisible chronic illnesses, such as chronic fatigue syndrome, multiple sclerosis, thyroid disease and fibromyalgia.

Steps You Can Take To Cope with Chronic Illness

Following are suggestions for dealing with the human aspects of living with a chronic illness. Some of the suggestions in "Seven Things You Can Do in Your Daily Life" above may be helpful, too.

1. Learn to manage your treatment program. You are the one who has to live with your chronic condition. You need to make your health care provider aware of what you need and want. A woman who wrote about her methods of coping with chronic fatigue syndrome noted: "After a year of reading case studies of people with chronic and incurable conditions, I saw a pattern emerging. Those who are most successful in coping take charge of their treatment and develop a strong belief in their own ability to control the course of their lives."

2. Work to maintain and improve your relationship with your health care provider(s). Review the suggestions above in "Building a Good Relationship with Your Health Care Provider."

3. Educate yourself. If your illness has been diagnosed, read and learn as much as you can about it. Attend support groups or join associations that distribute information on your illness. If the volume of reading is too large, ask a friend or family member to read to you or highlight useful sections. Even if your illness has not been diagnosed, you can read about your symptoms and get a better understanding of what is happening in your body.

There may also be support groups or other referral resources for people who face this same health problem.

4. Stay in contact with family and friends. It may be natural to limit social activities because you don't feel well or because you believe that people don't understand the limitations of your illness. Develop or renew support systems with people who can be not only empathetic, but helpful as well. Surround yourself with friends who lift your spirits and make you laugh. Get involved with your community by volunteering.

5. Talk about your illness. Keeping your fear, anger or frustration pent-up inside can lead to stress. Talking about your feelings can help to avoid stress-related problems. Also, be straightforward with others about what you can and cannot do. Share your thoughts. You may want to talk with family or friends or be part of a support group. In addition to working with your health care provider and talking with family and friends, some people have found counseling services helpful. Social workers, psychologists, psychiatrists, and members of the clergy are among the professionals who may offer counseling services.
RESOURCES

The Complete Directory for People with Chronic Illness, (Grey House, 1994) contains information on 82 chronic diseases including a list of national and/or state organizations, support groups, libraries, reference books, magazines, pamphlets, videos and children's books.

Living a Healthy Life with Chronic conditions: Self-Management of heart Disease, Arthritis, Stroke, Diabetes, Asthma, Bronchitis and Emphysema, by Kate Lorig, et al. (Bull Publishing Company, 1994) is a workbook that offers more than 200 practical suggestions for coping and making life more manageable.

Call the Americans with Disabilities Act Hotline at 1-800-949-4232 (voice ) or 1-800-669-3302 (TDD) and request booklets BK-17 and BK-18 for information on your rights under this Act.

6. Develop your own strategies for coping. Learn to recognize your symptoms. Alter your lifestyle if you believe it is making your condition worse.

7. Use your mind to help manage some of your physical symptoms. Keeping a journal or tape recording of your thoughts or using biofeedback, yoga, guided imagery or breathing exercises may be helpful. Cognitive therapy and behavioral medicine specialists are available to help, as well.

8. Manage your medicines. Generally, medicines for a chronic illness do not cure the disease; they can only help to relieve some symptoms or keep your situation from worsening. Speak with your health care provider if you have questions. Read about your medications. For example, The American Medical Association Guide to Prescription and Over-the-Counter Drugs may be helpful. If you are going to more than one health care provider, make sure each provider knows all the medications you are taking and the current dose. Mixing medications can sometimes cause adverse reactions.

9. Consider making changes in your work life. If you suffer from fatigue, for example, you might modify or cut back on your work schedule. For long-term chronic illnesses, you may want to investigate vocational rehabilitation programs. Also, you may want to investigate what rights you have under the Americans with Disabilities Act.

Your outlook is key to being able to enjoy life in the face of chronic illness. As one author points out, "If you see your illness as pure tragedy, you'll gain nothing from it but depression. If, however, you see it as an important challenge that demands a creative response, you can act accordingly."

In Conclusion

Hanford downwinders have spoken with the Network's health educators about a wide variety of health concerns. The difficulties of living with an illness - or with fears and uncertainties about the possibility of illness - are often combined with a range of feelings and emotions about Hanford's radioactive releases. Those who face these worries have all the demands of ordinary life, plus the burden of coping with the uncertainty of exposure to radiation.

Whether you are well or have a chronic illness, there may be steps you can take to improve the quality of your life. Attitudes and personal goals can be redesigned, relationships with loved ones can be strengthened, and your support system can be developed and used often to help you cope.

Above all, as one counselor says, "You have your own coping style. One style is not better than another. Do whatever works!"

NOTES

*The Hanford Environmental Dose Reconstruction (HEDR) Project was established to estimate what radiation dose people living near Hanford some time between 1944 and 1992 might have received from releases of radioactive materials. The Technical Steering Panel, which directed the study, completed its role in 1995. The federal Centers for Disease Control and Prevention (CDC) is now working with the HEDR Task Completion Working Group to continue public participation and to assure completion of the remaining HEDR activities. When using information from the Dose Reconstruction Project and other studies, readers should keep in mind that research results depend on a number of factors, such as the information available, and the methods and type of analysis used. RELATED READING AVAILABLE FROM HHIN

HHIN offers publications on Hanford's releases of radioactive materials and on scientific research on the potential health effects from exposure to these releases. These include:

Epidemiology: Understanding Health Studies

Health Bulletin

Health Risk Viewpoints: Radiation and Cancer

The Immune System and Radiation

Radiation Health Effects: An Overview

Working with Health Care Providers SELECTED READING

Check your local library for the following books and newsletters. Your librarian can help you find other related titles. HHIN does not advocate particular treatments or diets but offers information to help you make your own decisions.

Health and Wellness

The American Holistic Health Association Complete Guide to Alternative Medicine by William Collinge, M.P.H., Ph.D. (Warner Books, 1996. 321 pp.) A comprehensive look at the practices of Chinese medicine, ayurveda, naturopathic medicine, homeopathy, mind/body medicine, osteopathic medicine, chiropractic, massage therapy and body work.

Anatomy of an Illness by Norman Cousins (W.W. Norton & Co., 1979. 160 pp.) Cousins proposes that recovery from illness depends on the patient's ability to mobilize his or her own mechanisms of resistance to disease. He demonstrates through his own healing story that the mental attitudes of patients have a great deal to do with the course of their disease. The author emphasizes that finding the healer within, having a highly developed purpose in life and the will to live are among the prime raw materials of human existence. A healing partnership between physician and patient is also extremely important. He tells patients to educate themselves and be proactive about their treatment.

Be Sick Well: A Healthy Approach to Chronic Illness by Jeff Kane, M.D. (New Harbinger Publications, Inc., 1991. 164 pp.) This paperback is written by an M.D. for patients and health care providers. It is a how-to guide for healthy approaches to living with an illness. Dr. Kane includes guidelines for choosing a doctor and useful exercises on learning to relax, reducing pain by visualization, setting goals to create a more supportive lifestyle, being assertive about your health care, maximizing your serenity, learning from your illness, and dealing with such emotions as guilt, blame and loss. The book is easy to read and includes examples, stories and tips for achieving a healthy lifestyle as a chronically ill person.

Chronic Fatigue Syndrome: How you can benefit from diet, vitamins, minerals, herbs, exercise and other natural methods by Michael T. Murray, N.D. (Prima Publishing, 1994. 175 pp.) The co-author of the Encyclopedia of Natural Medicine clearly explains specific measures that can be taken to improve stamina, mental energy and physical abilities. He discusses the causes of chronic fatigue syndrome, ways to enhance your immune system, adrenal balance and stress management techniques.

Creating Health by Deepak Chopra, M.D. (Houghton Mifflin Co., 1987. 205 pp.) This book addresses how to be healthy from spiritual, emotional, mental and physical perspectives. Dr. Chopra assesses lifestyle patterns and presents research to back up his suggestions for change. He writes of the power of our negative thoughts and feelings to kill us. Dr. Chopra also discusses how to change your idea of what is normal and healthy. The last two sections of the book give examples and techniques on how to achieve this change, which he defines as "having control over the psychophysiological connection and mastery over what the mind thinks."

Eat Right for (4) Your Health by Dr. Peter J. DíAdamo with Catherine Whitney (G.P. Putnamís Son, 1996. 351 pp.) This book focuses on blood type as reflecting a personís internal chemistry. The author connects blood type with susceptibility to illness, the foods a person should eat and ways to avoid the most troubling health problems. The book specifies what foods, spices, teas and condiments help someone of each blood type maintain optimal health and ideal weight, along with recommended exercises. Includes dietary outlines and recipes.

Five Steps to Selecting the Best Alternative Medicine. A Guide to Complementary and Integrative Health Care by Mary and Michael Morton (New World Library, 1996. 275 pp.) An easy-to-understand guide and introduction to the five licensed systems of alternative medicine: traditional Chinese medicine, naturopathic medicine, chiropractic, osteopathy and the M.D. as an alternative practitioner. Offers steps on how to make the best use of alternative medicine.

Food and Healing by Annemarie Colbin (Ballantine Books, 1986. 311 pp.) The author highlights current research on foodís effects in reducing risks of developing disease and the use of food as medicine. She clearly explains how what one eats can determine health, well-being and quality of life. This book also addressees many issues about food, such as cravings and binges, the "fat-free" illusion of healthy eating, and food allergies.

Full Catastrophe Living: Using the wisdom of your body and mind to face stress, pain and illness by Jon Kabat-Zinn, Ph.D. (Delta Books, 1990. 443 pp.) This book on how to reduce stress is based on the eight-week program of the Stress Reduction Clinic at the University of Massachusetts Medical Center (featured in the Bill Moyers television special "Healing and the Mind"). The book focuses on mindfulness and meditation and includes exercises on dealing with stress, pain and issues associated with illness. Case histories show positive effects of these techniques. Also included is advice on how to cultivate a "treatment partnership" with your health care provider(s).

Healing with Whole Foods: Oriental Traditions and Modern Nutrition by Paul Pitchford (North Atlantic Books, 1993. 595 pp.) This book covers good nutrition and diet as well as some dietary and herbal suggestions for the treatment of disease. Discussion includes issues of water consumption, supplements (how and when to use them), micro-algae, antioxidants and food combining. Pitchford suggests foods and herbs that have proven beneficial to people suffering from disease. Based on a Chinese medicine philosophy, the book explains some of the basics in understanding Chinese diagnosis and why certain herbs, foods and recipes are indicated as remedies.

Invisible Trauma: The Psychosocial Effects of Invisible Environmental Contaminants by Henry M. Vyner, M.D. (Lexington Books, 1988. 195 pp.) This book specifically addresses the experience of radiation exposure victims and draws on case examples of atomic veterans and Three Mile Island downwinders. Dr. Vyner examines the psychological effects on downwinders of continually being told by institutions that they have not been exposed. He suggests that the lack of information on radiation health effects leads to dysfunctional relationships between doctors and environmentally exposed patients. Dr. Vyner also makes several public policy recommendations to reduce the psychological effects on exposed citizens. (Written for a college-level audience, this book is more difficult reading than other books in this book list.)

Jane Brodyís Nutrition Book: A Lifetime Guide to Good Eating for Better Health and Weight Control by Jane Brody (Bantam Books, 1987. 530 pp.) This reference book answers many questions related to food, nutrition and diet. It offers information on fats, cholesterol, sugar, salt, vitamins, minerals, vegetarianism, water sources, weight control, addictions, nutrition during pregnancy, nutrition for babies and children, and food additives and labeling.

Living a Healthy Life with Chronic Conditions by Kate Lorig, et al. (Bull Publishing, 1994. 286 pp.) This workbook-style resource book is easy to read and includes many exercises for coping with chronic illness. One chapter includes more than 200 practical suggestions from people who have "been there." The book addresses some specific illnesses and provides techniques for relaxation, visualization and self-talk. Four chapters on exercise cover flexibility, strengthening, endurance and specific tips for certain conditions. Another chapter discusses attitude, motivational assistance and scheduling tips.

Living with Chronic Illness by Cheri Register (The Free Press, 1987. 306 pp.) Register, who herself has a rare congenital disease, uses her own experience and the experiences of people from across the country to discuss how chronic illness impacts self-image, feelings, relationships, work, aspirations and overall views on life and death. This book would be useful for family members of chronically ill patients and health care providers, as well as for individuals with an illness.

Love, Medicine & Miracles by Bernie S. Siegel, M.D. (Harper & Ross, 1986. 236 pp.) This book teaches how to become an exceptional patient or a survivor of life-threatening and/or chronic illnesses. The pages are filled with examples of patients who have beaten the odds. Dr. Siegel discusses the importance of attitude and the powerful role the mind plays in any illness. One chapter focuses on how to develop a healing partnership with your health care provider, which Dr. Siegel says is critical to a patient's overall health and well-being. Techniques for focusing the mind and using visualization are also described. This book would be useful for both patients and health care providers.

Sick and Tired of Feeling Sick and Tired: Living with Invisible Chronic Illness by Paul J. Donoghue, Ph.D., and Mary E. Siegel, Ph.D. (W.W. Norton & Co., 1992. 240 pp.) This easy-to-read book addresses the frustration that often arises with chronic diseases that are hard to diagnose and treat. The authors cite case histories and name the feelings common to this population - self-doubt, self-loathing, uncertainty, fears, losses, guilt - and the roller-coaster style in which these feelings appear. The book is geared toward people who have invisible chronic illnesses (such as chronic fatigue syndrome or fibromyalgia) and is written by someone who is living with one - multiple sclerosis. The book includes a list of disease-specific organizations across the United States and Canada.

Spontaneous Healing: How to discover and enhance your body's natural ability to maintain and heal itself by Andrew Weil, M.D. (Alfred A. Knopf, 1995. 281 pp.). Dr. Weil addresses an array of treatment approaches to illness. He addresses, through case examples, individual health problems that have been turned around by acupuncture, Ayurvedic medicine, traditional Chinese medicine, relaxation exercises and other strategies or techniques. This book focuses on how the body heals itself and how to assist in that healing process or to enhance good health. Dr. Weil gives advice on managing illness and explains strengths and weaknesses of conventional and alternative/complementary treatment approaches.

Total Wellness by John Pizzorno, N.D. (Prima Publishing, 1996. 347 pp.) Dr. Pizzorno, co-author of the Encyclopedia of Natural Medicine, explains how seven core systems maintain the bodyís strength and vitality and how all illnesses can be traced to weaknesses in one or more of these systems. He discusses herbs, supplements, dietary modifications and other natural treatments for hundreds of common conditions.

Other books about health and wellness:

Directory of Self-help and Mutual Aid Groups (Self-Help Center, 7th edition, 1992). Lists self-help groups all over the country.

Feeling Good Handbook by D. Burns, M.D. (New American Library/Dutton, 1990)

Fighting Radiation and Chemical Pollutants with Foods, Herbs, and Vitamins by Steven R. Schechter, N.D. (Vitality Inc., P.O. Box 294, Encinitas, CA 92024, 1992)

Healing and the Mind by Bill Moyers (Doubleday, 1993)

Mind as Healer, Mind as Slayer: A holistic approach to preventing stress disorders by Kenneth R. Pelletier (Dell, 1977)

Participating in Your Medical Care

The American Medical Association Guide to Prescriptions and Over-the-Counter Drugs (Random House, 1988)

The Savvy Patient: How To Be an Active Participant in Your Medical Care by D.R. Stutz, M.D., B. Feder and editors of Consumer Reports Books (Consumers Union, 1990)

Smart Patient, Good Medicine: Working with Your Doctor To Get the Best Medical Care by Richard & Wayne Sribnick, M.D. (Walker and Company, 1994)

Newsletters

Harvard Health Letter, P.O. Box 420235, Palm Coast, FL 32142-0235

The Menninger Letter for Mental Health, P.O. Box 829, Topeka, Kansas 66601-0829

Personal Best, 420 5th Avenue South, Suite D, Edmonds, WA 98020-3584

University of California at Berkeley Wellness Letter, Health Letter Associates, P.O. Box 420148, Palm Coast, FL 32142 Click Here to Search This Site

LINKS

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Hanford History and Information about Releases of Radioactive Materials into the Environment: 1944-1972
Overview of Radiation and Known and Potential Health Effects
Health Care: Finding a Provider and Getting Health-Related Records
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Glossary
Monograph for Health Care Providers
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