Attitude in Recovery

 

Contents

·        Helping Patients Adjust

·        Ten Ostomate Commandments

·        Emotions and Ostomy Surgery

·        A Positive Image of Ostomates

·        Attitude in Recovery

·        Quality of Life

·        You’re Not Alone

·        It’s a Matter of Sharing

·        Ostomy Surgery and Depression

·        The Dumbest Things Ever Said

·        Think Positive ... Lengthen Life

 

Helping Patients Adjust

--Ostomy Highlife

 

     The patient with an ostomy is apt to foresee a life of ostracism.  Even though he/she may have been ill and limited in activity for a long period, it will be difficult for him/her to acknowledge the inability to voluntarily control his/her bowel or urine function.

     As his/her family doctor, you may be able to handle the patient's questions and emotional difficulties better than the consultant, a stranger to the patient.  But, the best medicine is a visit by a healthy, happy, fellow ostomate.  It is also important that the patient is associated with an enterostomal therapist.

     If the patient is a woman, the sight of an ostomate in a slim sheath without a telltale bulge can provide assurance.  And, the visitor will answer the type of questions the patient might be reluctant to ask others.  The following are typical questions new ostomates ask, and the answers a fellow ostomate can provide.

     Can I have Intercourse?  When the patient asks about the potential for sexual intercourse, it's a harbinger of a successful adjustment.  A man will be concerned about his ability to perform; a woman about her ability to attract and satisfy.  All too often, the subject is skirted or, even worse, is handled negatively with, "What difference does it make at your age?" or "This operation is going to save your life—isn't that enough?"

     According to the United Ostomy Association, it is estimated that approximately 10-20 per cent of male ileostomates suffer impairment of sexual function and potency.  But fortunately, this is only temporary in most cases.

     Males who have had urinary ostomies early in childhood can usually perform sexually, but they may be sterile.  More than half of the males who have urinary surgery as adults for bladder malignancy are impotent.  The average age for this surgery is 74.  

     Male colostomates vary in their degree of potency from full potency to complete impotency.  In many instances, potency is retained, but in these cases the patient is sometimes sterile.  In some patients, potency is lost due to the extent of the surgery.  In a few cases, regardless of the type ostomy, it may take as long as two years to regain potency.

     Is marriage possible for me?  Many ostomates have married.  An ostomy is not a barrier to getting married.  The first ET nurse, Norma Gill, was married after her ostomy surgery. 

     And usually, no marriage breaks up solely on the basis of the ostomy, although it may put added pressure on an already weak relationship as will any serious illness or emotional event.  In fact, a remarkable 82% of ostomates are still married to the same spouse a year after surgery.  This compares to 76% of the normal population.

     Can I have a child?  A patient contemplating pregnancy should consult her physician for evaluation of her individual situation, but an ostomy in a woman does not preclude a successful pregnancy.  In addition, an ostomy is not an indication for a caesarean section.  Many ostomy woman have normal vaginal births.

     There is a need, however, for close medical care during pregnancy.  The ostomy may tend to enlarge or protrude.  This may require a temporary change in her ostomy management system to permit the modifications to the size and location of the stoma.  An ostomy woman may also require more careful monitoring of her diet and fluid needs.  But, on the other side, ostomy women never worry about constipation or hemorrhoids like their continent friends.

     Can I travel?  The patient can go anywhere in any type of vehicle.  An ostomy alone does not stop someone from climbing mountains; riding horseback; flying in airplanes; driving in autos; riding bicycles; taking cruises; etc. 

    All ostomy patients should buy a copy of the book, Yes We Can! by Barbara Kupfer.  It is currently the best resource on traveling, and offers all types of valuable advise on traveling with an ostomy and tips for everyday living.

     Will I be able to sleep at night?  Any comfortable position may be assumed with a correctly applied ostomy appliance.  Having an ostomy will probably improve the sleep of a patient who had previously been sick. 

     Can I participate in sports?  Ostomates report enjoying many types of sports—water skiing, body surfing, skin diving, tennis, golf, baseball, football, hockey, weight lifting, running, bicycling, hiking…you name it. 

     Rough contact sports require special protection for the stoma.  But, there are professional athletes in all types of sports with stomas.  An ostomy alone is not a reason not to participate in sports.  You can assure your patient that he/she will be back on the golf course, hitting them as good as always.  The ostomates desire is to return to his/her normal way of life, and there is every reason he/she will do just that.

 

     Ten Ostomate Commandments

By Ron Bartlett, Halton-Peel, ON Newsletter

 

1.      Thou shalt not take out thy feelings of anger and frustration on thy spouse, friends or family.

2.      Thou shalt not demand special consideration.  Thy ostomy doth not make thee an invalid or render thee disabled.

3.      Thou shalt remember to leave the bathroom clean and fresh after ostomy care.

4.      Remember that thy family needs thy love and affection just as thee needs theirs.

5.      Honor they ET nurse.  He/she is your friend in need.

6.      Thou shalt not be ashamed of thy ostomy, it has saved thy life.

7.      Thou shalt be ready at all times to support others who had or will have ostomy surgery.

8.      Thou shalt not feel sorry for thyself.  Instead, thou shalt give thanks for a new lease on life.

9.      Thou shalt remember at all times that thy partner in life suffers with thee and thou shalt not add to his/her suffering.

10.  Above all, thou shalt give thanks to God for a new life and freedom from pain.

 

Emotions and Ostomy Surgery

By Julie Maloy, RN/CETN

 

     Ostomy surgery causes a threat to one’s self esteem and causes a readjustment of one’s body image.  Self esteem is based on how each person accepts and values himself or herself.  Fears have a negative effect on self esteem.  Some of the common fears that one who has had an ostomy may experience first after surgery are fear of rejection, leakage, odor embarrassment and a decrease in feelings of personal attractiveness.

     Not only can these fears lower one’s self esteem, but also, they can create a barrier in an intimate relationship. Successfully fitting, changing and caring for an appliance independently, along with honest, open communication, are the steps necessary for restoring one’s self esteem and returning to the previously held roles in a relationship. There are several phases in rehabilitation from ostomy surgery.  The meaning the diagnosis has to each person can cause an emotional impact, as well as the adapting and adjusting to an ostomy.  

     In the first few weeks after surgery, energy is exerted toward recovery and toward the task of mastering ostomy care. Independence, when possible, has a positive effect on self esteem.  The need to wear a pouch may cause anxiety. To minimize appliance anxiety, a pouch that is unobtrusive, odor proof and secure, is essential. Develop a routine of changing the appliance before a leak occurs. Check the appliance regularly for signs of wearing or undermining, such as staining under the tape or discoloration from the stoma to the edge of the pouch.  Keep the tail of the pouch clean.  Individual moist towelettes carried in a pocket or purse are handy to clean the pouch tail after emptying.

     As one masters the task of stoma care, it is not unusual to discover that there is a hypersensitivity to the reaction of others.  Any behavior or reactions that are interpreted as negative can have an effect on interpersonal relationships, self esteem, self confidence and the physical competence of the person.  The person with an ostomy who can be independent yet allows the spouse to stay in a caregiver role is fostering an invalid image and not promoting the return of the previous sexual relationship.

     Good personal hygiene will help decrease anxiety and promote confidence, particularly during intimate times.  Pouch covers that are plain, lace or in pastels or prints are available for those who would like to cover the appliance. Taping the body of the appliance in place will help prevent pouch movement during sexual activity.  A common fear of the spouse is one of hurting the partner or the stoma.  Reassurance will dispel fears.  Experiment with positions that will not rub or irritate the stoma.

     During recovery from ostomy surgery, holding, touching, caressing and kissing are all important methods of expressing affection that should not be forgotten. The readjustment period continues for several months after surgery as each person reestablishes a suitable lifestyle.  The supportive network of friends, family and health care team is important; however, the overall adjustment is ultimately the responsibility of each person.  Patience is necessary with oneself as the process unfolds; however, if a particular hurdle seems very large, seek help to put things in the proper perspective.

 

A Positive Image of Ostomates

 By Pat Murphy, RN, CETN


     Each of us can make life better—for ourselves and for those we meet who might someday have to face ostomy surgery for their own good.  I’d like to suggest two ways to do this:

     First, support the United Ostomy Association—not only financially but also giving volunteer help in your local chapter. Your involvement keeps the chapter strong and makes it interesting and fun.

     Second, become aware of the image of an ostomate that you project to others.  Be sure it’s a positive one!  Whether an ostomate or not, everyone at some point in life chooses between life and death. You can tell which one people have chosen by observing their attitudes and lifestyles. We are advised to choose life.  And that involves projecting a positive image to others.

     President Bush’s brother, Marvin, said in an article that his ostomy surgery had given him a “second chance” to live.  What a marvelous thing to be able to have—a second chance!  To be able to live, enjoy family, friends and work or play, is the greatest joy.  Marvin Bush wrote how grateful he was to have a second chance to live.  

     We should all feel this way, because we have chosen life. Sometimes, though, we can get on a negative track and focus on our problems instead of being grateful. Look at yourself today. Have you been focusing on your complaints and problems? What kind of image do you project to others?

     Here’s a simple plan to help us all become more positive and project a better image:  Watch yourself for a few days; see if negative thoughts and feelings keep repeating. Replace negative thoughts with thankful thoughts. You can’t just remove negative thoughts; that leaves an empty spot, and they’ll just come back.

     You must put positive thoughts in their place. Express your thankfulness to those around you.  Be optimistic in what you say, instead of saying, “I’m so busy, I don’t know what to do,” for example, you could say, “I have so many interesting challenges I don’t know which one to take on first.” Make thankfulness a habit.  If you do, you will project a wonderful, powerful, positive, attractive image to all you meet.  This will help others to choose life—or an ostomy, if need be—in their future.

 

Attitude in Recovery

--Ostomy Digest, Omaha, NB, edited by The New Outlook

 

Do you feel as if the bottom has dropped out of your world?  Has your doctor just shown you your ostomy for the time?   Are you surprised that your stoma is so red?  You cannot visualize how life is going to be from now on.  You wonder if you will ever become accustomed to this strange thing.  Be assured that you will … in time.  An ostomy is the result of a life saving surgery.  You can make it whatever you desire.  You can hibernate becoming a recluse and withdrawing into your own small world.  Or, you can take it in stride learning the proper care of your ostomy and then forgetting about yourself enjoying the extra time God has allotted to you.

 

You will find, as time goes on, the bewilderment will disappear, and the problems you encounter as a new ostomate will be solved.  You will minimize the issues you originally thought overwhelming.  You will be delighted to find you can still lead a perfectly normal life.  You can participate in activities of normal living just as you did before surgery.  You may like swimming, dancing, reading, running, working, playing, golfing, boxing, sky diving, bungee jumping, praying, visiting friends… whatever. 

 

If ulcerative colitis was the reason for your surgery, then you will be able to do more than you did before surgery.  Your life will be better.  You will virtually never have to run to the toilet again.  The new ostomate has a tendency to become overly sensitive about little things like if the prosthetic shows, if you smell, if your stoma is making noises, or if you'll have an accident.  There are many techniques experienced ostomates use to address these issues.  You'll find clothes look the same on you as they did before; that nobody can really see your appliance; commercial odor controls are available from all ostomy suppliers, if you even need them; noises are generally louder to you than anyone else and most people have noises of their own anyway; you'll have more accidents driving a car then you will once your experienced with your ostomy equipment.

 

Yes, at first you will be all thumbs trying to tackle the art of ostomy management, whether it is because of challenges applying your system or learning irrigation techniques according to whichever ostomy you have.  As you become familiar with your appliance, your care time will be a fraction of what it is originally.  With the new appliances and supplies available, your management will eventually become easier and almost automatic.  Don't become discouraged.  Summon up your patience and courage to see you through this phase of your rehabilitation. 

 

Remember, all of us ostomy graduates went through this same thing after surgery.  We come to our local UOA chapter meetings to take comfort in the fact that we are not alone; to bolster up our morale; to be educated in options regarding ostomy management and equipment; to receive practical hints on skin and health care; to help ourselves by serving others … etc.  Always check with your health care professional regarding anything new you learn.  We at UOA do not practice medicine.  But, this being said, most doctors do recognize that many experienced ostomates at UOA are near expert in the care and management of stomas. 

 

Fight that depression.  It is your enemy.  Things are going to get much better than they are right after surgery.  And, be happy.  You have been given a new life. 

 

QUALITY OF LIFE
Excerpted from article by Kevin McHugh, MD, Hamilton, ON

 
    
I have postulated for some time that both medical professionals and to some extent people involved with ostomy associations have some wrongly-skewed impressions about living with an ostomy. I have heard a young gastroenterologist say, “Ostomies are fine, as long as you never want to go to the beach.”  And, a member of the executives of IOA said to me: “I don’t believe a person with an ostomy can ever feel truly normal.”

     These are only two examples of a prejudice that I believe is pervasive.  My contention is this: Medical professionals and people involved in ostomy groups interact far more with people who have difficulty adapting to life with an ostomy than with those who adapt well.  I would go so far as to opine that the majority of people who have the surgery adapt well, have few problems, and do not interact with either the medical or ostomy communities, thus leading to the false perception that there are many more problems associated with the procedure than found in reality.

     The term “quality of life” is used in medical research to define a person’s ability to participate in and enjoy their chosen activities of daily life. A quick search of Medicine (a catalogue of all medical publications), reveals over twice as many articles in the last ten years on “mastectomy” and “quality of life” than “ileostomy” and “quality of life.”  Moreover, the articles on ileostomy often compare the surgery only to people who have alternative procedures; i.e., pelvic pouch, and not to the general populace. 

     This discrepancy is also found with regards to publications on colostomies and mastectomy, which is remarkable in that both are generally performed in the same age group and for cancer, albeit in a different anatomical location. Further investigations will reveal if this reflects a higher incidence and prevalence of breast cancer over colon cancer or if there is another explanation. A recent publication in the Journal of The Royal College of Surgeons of England, by Brennan and Steele, of Dundee, Scotland, entitled: Objective Assessment of Quality of Life Following Pan-proctocolectomy and Ileostomy for Ulcerative Colitis, is some of the first research comparing the “quality of life” of people who have undergone ostomy surgery to that of the general public. 

     While the fact that this study only examined people undergoing ileostomy for ulcerative colitis, limits its applicability to other ostomy surgeries, some extrapolation is possible.  The study compared forty-nine patients who had a permanent ileostomy for ulcerative colitis with population norms of similar age and gender in the UK. The study found that not only is “quality of life” good after surgery, but it is similar and in some ways better than that of the general population.  Patients with an ileostomy reported less body pain, more energy and vitality, and higher social functioning. This research finding stands in stark contrast to the attitudes I described having encountered in the medical and ostomy worlds.

     I hope that this research spurs more and larger studies of this kind.  Moreover, I would urge all people with ostomies to discuss with their surgeons and ETs if they are actively involved in ostomy research. The United Ostomy Association of Canada could be a significant resource for this research and would benefit from having better knowledge of the number and status of people with ostomies in the country.  Some Canadian surgical centers are already leaders in this area and others should be prompted to follow their example.

     While some may wish to view their ostomy with the attitude, “It is better than death”, this report clearly demonstrates that a significant cohort of people undergoing ileostomy surgery have little or no negative impact due to their stomas. I think the research underscores the importance of the ostomy association fulfilling its mandate of assisting people in adjusting to their ostomy. With this demonstration of the successful adaptation of a group with ileostomies, the importance of addressing the needs of those who are having difficulty in adapting is reinforced.  Clearly, research of the nature described here is critical to improving the lives of all people with ostomies.

 

You're Not Alone

--Milwaukee Chapter of UOA

 

     New ostomates, do you feel as if the bottom has dropped out of your world?  Your doctor has just shown you your ostomy for the first time.  You cannot visualize how it is going to be from now on.  You wonder if you will ever become accustomed to this strange thing.  Be assured that you will…in time.

     An ostomy is a lifesaving device, you can make of it what you desire.  You can hibernate, become a recluse and withdraw into your own small world, or you can take it in stride; lean the proper care of your ostomy; then forget about yourself and enjoy the extra time God has allotted to you.

     You will find that as time goes on, the bewilderment will disappear, and the problems you encountered with the first association of your ostomy will become minimized.  You will be delighted to find that you can still lead a perfectly normal life: swim, dance, work and participate in things just the same as before surgery.  If ulcerative colitis was the reason for your surgery, then you will be able to do more things than you did before surgery.

     The new ostomate has a tendency to become overly sensitive…particularly to odor.  There are many ways of eliminating all odor should this be a future problem.  Most modern appliances are odor proof.  That means that if they are just used as directed, there will be no odor.  In addition, there are over the counter internal deodorants as well as many tablets, liquids and powders to be used in the pouch itself.

     Yes, at first you will be all thumbs tackling an appliance or irrigating according to whichever ostomy you have.  As you become familiar with your apparatus, care-time will be cut to a fraction of what you use as a new-bee.  With the new appliances and supplies available, your job will eventually become easier and automatic.  Don't become discouraged.  Summon up all your patience and courage to see you through this phase of your rehabilitation.

     Remember, all of us ostomy graduates went through this period of adjustment, and we are available for help whenever needed: if only to bolster your morale; to assist in choosing an appliance or irrigating equipment; practical hints on skin care, etc.  But be sure to check with your doctor or ET nurse first.  We don't practice medicine.  But, most doctors recognize the fact that ostomates soon become near expert in care and management of stomas.

     Fight that depression, it's your enemy.  Things are going to get a hundred per-cent better than they are now.  Thank God that you're alive, and take comfort in the fact that "You're Not Alone."

 

It’s a Matter of Sharing 

-- Ostomy News Review, Green Bay, WI


     I know a man, a colostomate, when asked why he didn’t join the ostomy chapter said, “I’ve adjusted just fine.  I don’t need the group.”  His complacency set me back a bit.  I thought it over.

     So, maybe he doesn’t need the chapter—whatever that means.  But the group needs him and others like him—well adjusted ostomates who walk around flat-tummied and non-odorous. Of course, I’m  not talking about after-shave or perfume.

     An ostomy chapter is not a “half-way house” sort of thing.  We don’t get together to feel sorry for ourselves, to talk exclusively about the “fun and games” of our various operations.  We get together because we want to help each other or maybe to get some help with some little problem that’s been bugging us.  Something our doctors can’t answer but another ostomate may.  We want to prove to all those non-believers—oops, guess I’d better call them skeptics—and non-ostomates who may think an ostomy is the end of the world—well, it’s not.  In most cases, it’s the beginning.  We are alive because we are ostomates.

 

Ostomy Surgery and Depression
--Rosette Gazette, Owensboro, KY Ostomy Chapter

 

     Sleepiness, loss of appetite, feelings of guilt or worthlessness, irritability, and a desire to be alone, as well as a loss of sexual desire, are some of the symptoms of depression.  It can be triggered by the inability to participate in normal daily pleasurable activities, or by a sense of helplessness and lack of control over your body.

     Depression also can be caused by medications, stress, malnutrition, anesthesia, or metabolic imbalance.  Some patients conceal their ostomy from their spouse, families, or lovers because they fear rejections, or feel embarrassment.  This also can result in feelings of isolation, depression and chronic anxiety.

     Patients who base their self-esteem on their physical appearance, their independence, their “always in control, take charge” character, or their Good Samaritan—always the helper or solver—behavior have a harder time dealing with cancer, their ostomy, their lack of control over their bodies, and their need to depend on others for help, even if only temporarily.  Constantly tired from efforts to cope with daily household or work routines, as well as a learning to adapt to the physical requirements of this unpredictable, new addition to your body, leaves little energy for enjoyment of leisure activities or romantic involvement.

     It takes time to return to our normal lifestyle, so relax.  Do what you are capable of doing at this time, and don’t try to rush things.  You’ve had enough pain and misery and deserve the time.  You don’t want to return to the hospital if you can help it, do you?  Give yourself a year for a good recovery and if it should happen to take a lot less time, consider yourself a very lucky person. 

     In the meantime, do what you have to do in whatever way you are capable of doing it but don’t give more than a passing thought to the things you can’t do right now.  You might have to take some short cuts, do some fancy improvising, or indulge in some healthy neglect.  Don’t be bashful about asking for and accepting help.  You’d do the same for them if they needed help, wouldn’t you?  You are not alone—we all go through this.

 

The Dumbest Things Ever Said

--Pouchclip

 

I'm sure these stories will bring to mind some funny things that happened to you that weren't so funny at the time:

 

·             After my ostomy surgery, a well-meaning aunt told me not to worry.  She said I was still a beautiful girl—it's not like I wore the bag on my face.

 

·             Back when I had my ileostomy for about three years, I had to have some surgery to clear a lingering Crohn's related infection.  While I was recuperating from this surgery, my new-age nurse tried to convince me of the rejuvenating powers of enemas.  The pitch was "Rejuvenation Through Elimination."  This with "Ileostomate" stamped on my medical records.

 

·             Last year, I went for a prostate cancer check-up.  The doctor showed up with a student doctor, looked at my chart and then proceeded to tell me to drop my trousers while putting on a pair of rubber gloves. Then, he asked me to turn around and bend over.  I stood there in total bewilderment and asked, "what exactly are you going to do doc?"  After telling me about the usual probing method involved, I smilingly informed him that he would have no results with this exam.  Miffed he asked "why not?"  I kindly told   him, "Re-look at my chart."  One advantage of my ostomy is that I'm sewn up tighter than a drum back there…no one is ever going to cause me discomfort in my butt again, thank you.  He slumped in a chair.  Now he had the bewildered look.  Needless to say, I pulled up my pants and hastily left his office.  Makes you wonder doesn't it?

 

·             Right after I returned to work from my ileostomy surgery, I was in the lunch room eating my lunch.  A co-worker who had seen me there several days in a row, looked at my lunch and said, "I want to give you some advice.  If you don't eat more roughage, you'll end up getting colon cancer."  I looked up at her and said, "Not likely."

 

·        I was in a grocery store at the check-out stand.  I had a little gas and my pouch was sort of puffed out but hidden under my shirt.  The cashier challenged my as to what was under my shirt—assuming I may have stolen something.  I tried to explain but her facial expression dictated I show-off.  So, I opened my pants reveling a full-pouch.  The girl turned purple with embarrassment.  But the little boy of the lady in line behind me responded, "Oh, neat, I want one mommy!"

 

·        I was in class one day when as I like to call it, my carry-on-bag sort of busted—it was falling off.  I went up to the teacher—the name has been changed to protect the ignorant—Ms. Smell, and asked her if I could go to the bathroom.  She replied, "Can't you just hold it."  I said pathetically, "I am."  Needless to say she didn't get the joke.

 

·        Shortly after I had my surgery, I had an ultrasound performed.  I asked the nurse if she could see on the screen if the doctors had done a good job…without saying I had my colon removed.  She looked for my colon for an hour; then, she was shocked when she couldn't find it.  She keep right on looking for it.  Makes you wonder how she graduated nursing school.

 

·        You'll love this…You know the crinkling plastic bag sound that can be so audible in a quiet public restroom?  Well, as I was discarding contents at a night club, the guy next to me must have thought I was opening a bag of cocaine or something.  With a real life voice of a surfer-dude cartoon character he whispered, "Hey man, don't sniff it all yourself.  How about giving me a little hit?'  Trying terribly hard to contain my laughter after I figured out what he meant, I said, "Yeah man, this is some really good s---."

 

·        "No.  We can't go to that shopping center, Karen doesn't know where all the bathrooms are."

 

·        A questionably well-educated woman told me that after I had surgery to remove my large intestine, my stomach should look flatter…Duh?

 

·        After removal of my colon, on my ET's first visit, she told me the things I could and could not do.  "Don't have stoma intercourse for at least six months." And, "Cut the end of the pouch so it is shorter, and use a rubber band over the clip."  The former will produce a quick trip to the surgeon, only a moron would even attempt this.  The latter produced a stupendous mess right in the hospital.  This occurred 12 years ago in Germany at a military hospital.  I have to say, since her, I have only had very helpful and technically competent ET's.

 

·        A co-worker of my husband said, "How much do you think a colon weights?  I bet seven pounds or so.  What an easy way that would be to lose a few pounds."

 

·        There is a major amusement park in the UK called Alton Towers.  One of my brothers was planning to go there and invited me.  But, he wanted to know, would my "thingy" stop me from going on the rides?  My response, "Of course not.  I'll be the only one who isn't in danger of needing a change of underwear after The Corkscrew."

 

·        All my life I've been overweight.  By the time I was diagnosed with Crohn's Disease, I'd been sick for five months and lost over 30 pounds.  More than one person said to me, "Gosh, I wish I could lose that much weight.  You look really good."

                                                                                                                                                            Think Positive…Lengthen Life

Contributed by Jane Michnik

            

     Want to live longer? Then think positive, researchers advise.  A study of 660 volunteers ages 50 and older shows negative stereotypes about aging may have an adverse effect on longevity.  Even if you are not aware of them, subtle associations of the elderly with illness or frailty may be shortening your life by affecting your will to live, the study suggests. 

     In fact, the scientists assert, positive self-perceptions of aging may influence lifespan more than not smoking or exercising, said lead researcher Becca Levy of Yale University's Department of Epidemiology and Public Health. The study found that older people with more positive self-perceptions of aging, measured up to 23 years earlier, lived 7.5 years longer than those with less positive ones.

     "The effect of more positive self-perceptions of aging on survival is greater than the physiological measures of low systolic blood pressure and cholesterol, each of which is associated with a longer lifespan of four years or less," The authors wrote in the Journal of Personality and Social Psychology. "It is also greater than the independent contributions of lower body mass index, no history of smoking and a tendency to exercise; each of these factors has been found to contribute between one and three years of added life."

 

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