Health sense: What to do about head injuries

Head injuries are one of the most common reasons people consult a doctor. The degree of head injuries can range from mild, only resulting in minor bruises or wounds, to severe or life-threatening. Moreover, the injury process can be primary or secondary. Primary injuries result from the damage done by the actual impact.

On the other hand, secondary injuries are subsequent changes that occur as a result of the initial insult. Thus secondary head injuries add further damage.

Unfortunately, there is very little that anybody can do about serious brain injury. For example, a person who sustains massive brain injury from a steamroller will need a miracle to live a productive life after the incident. Fortunately, minor to moderate primary head injuries and secondary brain injuries can be satisfactorily treated.

Secondary injuries, as mentioned, are the secondary events that occur after the primary injury. They can cause or contribute to further brain damage. Most commonly, these include bleeding, swelling of the brain (cerebral edema), and death of brain tissue (cerebral infarction) from lack of blood flow and oxygen to the brain. A speedy and appropriate management can make a great difference in determining the outcome or prognosis.

Let’s take a look at minor head injuries. A concussion occurs when there is an accelerative force to the brain greater than 200 milliseconds. Concussions can cause loss of consciousness, memory loss or amnesia, confusion with subsequent headaches, nausea, grogginess, irritability and vomiting.

The degree of concussion varies but there should be no significant long-term after-effects or sequelae if: 1) the period of loss of consciousness is less than 10 minutes and 2) the patient is well orientated with no neurological deficit when seen at the Accident and Emergency Department of the hospital.

What about major head injuries? Management must start at the site of trauma. After a neurological examination, prompt resuscitation to provide for an adequate blood pressure and oxygenation has been shown to significantly improve the prognosis.

Medical management is focused on preventing cerebral edema and high blood pressure. Since 60 percent of head injuries involve neck injuries, oxygen may be administered through a tube until serious neck injuries have been excluded. Medicines to prevent seizures are given to prevent further damage and loss of oxygen. Dilantin, the drug of choice for seizures, can be tapered off after a week unless delayed seizures occur. Hyperventilation or the rapid artificial oxygenation of the patient should not be done. This is because blood flow to the brain has been shown to be low during the first 24 hours and hyperventilation will just worsen the case. Antibiotic therapy is a good idea especially when there are multiple injuries or open wounds.

Ideally, the patient is brought to a tertiary-level hospital with well-developed head injury services and resident neurosurgeons.

An unconscious patient should immediately undergo a CT scan of the brain as well as x-ray imaging of the spinal column and chest. Should there be difficulty in maintaining blood pressure, the medical team will look for other sources of bleeding because there cannot be that much bleeding in the brain to cause a blood pressure drop.

If internal bleeding is present, it may accumulate inside space surrounding the lungs. This is called pleural effusion. Draining the accumulated fluid treats pleural effusion. Also, by providing low-flow oxygenation, the patient’s blood pressure should remain stable.

If a large clot in the brain is detected on CT scan, surgery is needed. Damaged brain tissue is removed to minimize the likelihood of swelling. Fractures are commonly present and will be treated accordingly.
Sometimes, the fractures can cause the fluid in the spine to leak out into the cavities of the nose and ears. Initially, the head will be elevated to prevent this. Antibiotics may be prescribed and the doctor may order lumbar cerebrospinal fluid drainage.

If these conservative measures fail, surgical repair will have to be done to prevent meningitis, the inflammation of the membrane that covers the brain and spinal cord.

A significant brain swelling is treated by surgically removing a large bone flap from the skull. This will afford space for the brain to expand. Another surgery is needed to correct the deformity left by the initial procedure.

In the Intensive Care Unit, vital signs are carefully monitored to ensure the brain is receiving enough oxygen. The head of the bed is elevated to at least 30 degrees to promote good circulation.

Medicines like Mannitol can be given to reduce the pressure within the skull. A comatose patient should have full coma nursing care with regular turning, chest and limb physiotherapy. An artificial airway may be done surgically (tracheotomy) if the patient is expected to be on assisted respiration. Uncontrolled intracranial pressure rise causes a poor prognosis. Medically inducing a coma can be done to correct this. However, results have been relatively disappointing, especially in children.

In summary, quick and efficient response to head injuries promote a better outcome for the patient.

Minor to moderate head injuries are easily treated in the AED. On the other hand, severe head injuries need referral to appropriately equipped hospitals.

The goal in treating severe head injuries is to prevent further damage to the brain. This is done by adequate oxygenation, relieving the pressure inside the skull, stopping the swelling of the brain (cerebral edema) and treating other injuries like fractures. Close contact nursing care is needed throughout the recovery phase of the patient.

Yogic breathing for high altitude

A couple of months ago, I was visiting a mountainous area about 4,200 meters above sea level, when yoga came my rescue. We had flown on a chopper for much of the way up there, hardly giving us any time to acclimatize, and as I sat in the car going up the mountain, I began to feel a mild sensation of discomfort.

I found it hard to breathe, and felt slightly light-headed. A person traveling in our group felt worse, she could barely stand up, felt nauseous and was eventually given oxygen.

Then I remembered the yogic breathing, I began to deepen my inhale and prolong my exhale, focusing on my breath until the discomfort disappeared as fast as it had appeared.

The few times I forgot to maintain the deep diaphragmatic breathing, I felt the discomfort creeping in again.

I was experiencing a mild case of altitude sickness, which occurs when the body runs out of oxygen in high altitude. Symptoms vary from nausea, exhaustion and hyperventilation, to cerebral edema, the accumulation of excessive fluid in the substance of the brain.

Interestingly, shortly after, I was asked to teach yoga to a group of mountaineers on an expedition to climb the world’s seven highest summits. Having climbed two of the mountains, they were intent on complementing their training with yoga to help them overcome more dangerous challenges awaiting them.

Mountaineering requires a high level of fitness and strong mental preparedness, and yoga practice is increasingly known to help climbers cope with the challenges of adapting to high altitude.

Research published in the European Journal of Applied Physiology in 2007 compares the physiological responses to high altitude hypoxic conditions in four groups of human subjects: a group of Caucasian subjects, Caucasian yoga practitioners, Nepalese native Sherpas with an active lifestyle, and Nepalese Buddhist monks who are yoga practitioners.

The results showed that at a high altitude, the Caucasian yoga trainees maintained satisfactory oxygen transport, with a minimal increase in ventilation and with reduced hematological changes. This kind of efficiency is comparable to that of the native Sherpas and the Buddhist monks.

The study concludes that respiratory adaptations induced by the practice of yoga may represent an efficient strategy to cope with altitude-induced hypoxia.

The Indian army has known this all along. In the past few years, it has incorporated yoga practice into the daily training routine of its soldiers posted in the conflict area of Kashmir.

At 11,000 to 21,000 feet above sea level and with often minus 60 degree Celsius weather, the Siachen Glacier is the world’s highest battlefield, making the soldiers vulnerable to high altitude sickness, hypoxia (deficiency of oxygen reaching the tissues) and the psychological stresses of isolation, monotony and separation from their family.

According to the High Altitude Medical Research Centre (HAMRC), the highest multi-specialty hospital in the world focusing on high-altitude medicine, yoga reduces wear and tear of the heart and produces mental tranquility, greater alertness, flexibility and enhanced tolerance of the cold.

By practicing a few minutes of pranayama (breathing technique), gentle asanas (postures) and meditation, many of the soldiers have testified to the physical and mental benefits.

But even if you’re just a casual hiker or someone who, like me, happened to be on a brief visit to a high-altitude area, you could benefit from the deep breathing technique used in yoga practice to avert hypoxia.

Here’s a pranayama practice that might come in handy when preparing yourself for the challenge of high-altitude breathing, as well as to help you cope with it when you’re there

Complete breathing
This is a simple deep breathing exercise that uses all respiratory muscles to their fullest. To do this, you can lie down on your mat or bed in a comfortable savasana position but without a pillow, or sit on a chair, or cross-legged on a cushion.

If you’re sitting, find a comfortable position to sit upright without being rigid, allow your shoulders to drop and your hands to rest anywhere comfortable, then close your eyes gently.

First empty your lungs by extending your exhale. Now slowly breathe in allowing the belly to relax and enlarge, the diaphragm to lower, allowing the air to enter the lungs.

Continue breathing the second stage of your inhale by expanding the ribcage without straining.

The third stage of your inhale must allow the lungs to fill completely by raising the collar bone.

When the lungs are completely full, breathe out in the same sequence as when inhaling.

At the beginning, inhale and exhale for the same amount of counts, for example, if you breathe in five counts, breathe out also in five counts.

Later, as you gain more strength and your lungs increase in capacity, try to exhale twice as long as you inhale. So if you inhale for five counts, exhale for 10 counts.

Make sure you breathe easily without straining, and your body continues to be relaxed. Ideally, keep your respiration deep, slow, silent and easy.

You can practice this breathing technique every day as part of your daily training before you practice yoga asana or other physical exercises, or as a standalone practice in the morning or evening.

This is not meditation, but after a while, you can let go of the controlled part of your breathing and just watch yourself breathe naturally for a few minutes or more. Then you will enter a more meditative practice.

I did not include an asana practice here, but basically all yoga poses are beneficial as integrated training for climbing, trekking or mountaineering.

You can begin your practice with a few rounds of sun salutations, then proceed to do some standing poses, followed by some backbends, some core strengthening, and then wind down with some twists, forward bends, deeper hip openers, inversion and then savasana.

Being in nature induces a meditative state of mind. And what better way to cultivate this state of mind then by connecting to your breath? Namaste.

Frequently-asked questions about Yoga

One of my regular students came up to me the other day after a class, and asked: “Is yoga stretching?”

There are many ways to answer this question. What it showed me, however, was that yoga remains a mystery to many, even to regular practitioners.

So in this issue, I’ll address some basic frequently asked questions about yoga and hope this will help clear some misperceptions.

1. Is yoga a religion? No, yoga is not a religion. Although yoga came out of ancient India, it is not a form of Hinduism.

For over a century it has been practiced by Christians, Buddhists, Jews, Muslims, atheist and agnostics a like (some of my students and fellow yoga teachers are devout Muslims, some are women who wear Islamic headscarves).

There is a certainly a spiritual side to yoga, but you don’t have to subscribe to any particular beliefs to benefit from it.

Yoga allows you to have a “take what you can use and ignore the rest” approach.

Meditation, which is an integral part of yoga (and often thought of as a Buddhist practice) is beneficial but you don’t have to do it either if you don’t feel a connection to it, at least in the beginning.

The same goes with chanting. So, if your yoga teacher chants “Om” at the end of the class because it is part of her discipline’s tradition, it doesn’t mean you’re worshipping someone else’s God.

And you don’t have to sing if you don’t feel like it. I usually tell my students to just enjoy the vibration.

2. I’m not flexible, can I do yoga?

Of course! Some people avoid yoga because they think they will never be able to touch their toes or do those backbends and roll up into a shoulder stand.

How silly! In fact, if you feel you can’t possibly do yoga, then more likely yoga will be helpful to you. Yoga is a process and a journey. The key is consistent practice.

3. I am not young/ I have chronic medical conditions (asthma, high blood pressure, etc). Can I do yoga?

Yes, yoga isn’t only for those healthy people you see at the gyms or studios. For many years yoga has been used to treat people with various medical conditions. People with all kinds of physical, mental and emotional problems, elderly people, people with years of chronic disease, people in pain, people who are depressed, all have come to yoga to seek help.

Yoga has been used successfully on schizophrenics and on children with Down syndrome, cerebral palsy, and autism. Wheelchair or bed-bound people can practice a modified type of yoga for their needs and abilities.

There are people in their 80s and 90s who are still doing yoga, and, chances are, if you keep your yoga practice consistent you might reach that age and still be doing yoga.

People with special conditions need to seek a special yoga therapist, however, so it is not recommended that they attend a general yoga class. So, talk to a dedicated yoga studio at your place to see whether they have a teacher who is qualified to teach yoga therapies to address your problems, because not all teachers are.

4. Can you lose weight with yoga?

Well, this is a question that often puts me in a dilemma. I don’t want people to start doing yoga with unrealistic expectations they will lose weight after a couple of weeks.

Having said that, of course, yoga has been known to help people lose weight, especially some more dynamic types of yoga such as asthanga or power yoga or bikram yoga.

Practicing any type of yoga will build strength, but some types may not raise your heart rate enough to make them the only form of exercise you need to include in your weight-loss regime. It depends on the type of yoga you select and how frequently you practice it.

In order to lose weight you must eat healthily and burn calories by doing exercise that raises your heart rate on a regular basis. If yoga is your primary form of exercise, take a dynamic 90-minute class at least three times a week.

In addition, the longer you practice, the more you cultivate a mindful way of living. This means you’ll start looking at how you treat your body, what you put into it as this affects your practice too.

Then you become drawn to more healthy and nutritious food without any elements of self-denial. Believe me, it’s much better than dieting.

5. Is yoga just about stretching?

Yoga does involve stretching your muscles, but it is different than just the warm-up and cool-down stretches you do at the gym. Yoga places importance on alignment. This means how you touch your toes is more important than whether you can actually touch them or not.

Most yoga poses are not stretching an isolated area but rather involving the whole body in both stretching and strengthening. Some yoga styles use the technique of vinyasa or flow where there is movement from pose to pose with an awareness of the breath.

And last, but not least, here’s one of my favorite questions:

6. How come I always seem to fart in yoga class?

Passing gas while practicing yoga is actually very common. You’re moving your body in ways that will stir up your belly, which is good for you.

Farting is perfectly natural, (I’ve had students do it in my class, and I’ve done it also as a student and — ahem — while teaching).

If you happen to do it, just pay attention whether it has caused an effect in the class. Acknowledge it casually or light heartedly — or even apologize — if it seems to bother or disrupt the flow of the class.

But chances are nobody will notice, or if they do they will choose to ignore it, as I’m sure that has happened to them too.

If you have any questions, however embarrassing, just write to me, I’ll be happy to address them. Namaste.

Keeping the heart soft with loving kindness

The one thing I’m most grateful for with my yoga practice is that it helps me navigate life’s fluctuating dynamics – its ups and downs – by softening my heart.

Yes, all those bending, twisting, balancing, lifting and inverting maneuvers do something to your muscles, joints, bones and organs, but it is the contemplative aspect of yoga that touches the deeper inner muscles of a person — those of tolerance, courage, love and compassion. I’m talking about meditation.

One of my meditation teachers called this spiritual journey a “revolution”, a journey toward our inner self, the part that is unchanged. It is not always easy, in fact it can be pretty arduous, painful and confusing at times. But in the end, any form of contemplative spiritual practice will awaken the gentle part of you that celebrates happiness in others, making equanimity a more accessible state of mind.

When you have equanimity, even the most powerful anger does not seem to linger long. The Buddhists call this compassionate quality loving kindness.

This came to my attention as I watched and observed sad news of natural disasters that have been rocking the country over the past week.

As a journalist, I had been witness in the past to a host of both manmade and natural disasters, from the string of bombing attacks, the 2004 tsunami to air crashes.

Back then I kept myself detached, as I had to move around to do my job with relative ease.

But since leaving full-time journalism, it has become harder to sit through the news on disasters without being overwhelmed with sadness and the yearning to do something to help the victims.

Of course nothing is wrong with this. After all, our capacity to feel compassion for other beings may be the most redeeming quality about us, the one thing that may help the earth’s survival, just as its opposite has sped up the planet’s decline.

And so we do what we can to help ease the sufferings of others, by donating money, organizing aid, becoming a volunteer or drawing attention to the tragedies.

Being kind goes deeper than meets the eyes, however. It starts from within by regularly kindling the flame of loving kindness or metta in Pali and maitri in Sanskrit. Loving kindness is the quality of goodwill, sympathy and kindness to others. It is love without clinging.

The cultivation of loving kindness (metta bhavana) is a popular form of meditation in Buddhism. But it has been practiced by many non-Buddhists and followers of other beliefs for ages, and its benefits
have been studied in the new field of study on contemplative practices.

A Standford University study suggests that a short 7-minute practice of loving-kindness meditation can increase social connectedness.

Clinical scientists from Duke University also found that loving-kindness meditation has been shown to reduce pain and anger in people with chronic lower back pain.

A researcher at the University of North Carolina at Chapel Hill found that loving-kindness meditation could help boost positive emotions and well-being in life.

An EEG study also from Stanford University focused on people who do metta meditation with a minimum of 10,000 hours of practice, and showed that compassion meditation could lower the participants reaction to inflammation and distress, both of which are associated with “major depression, heart disease and diabetes”, in response to stressors.

So here I share a simple guide on loving-kindness meditation. It can be practiced before or toward the end of other meditation practice such as vipassana or mindful meditation, or as a standalone practice in itself.

In the beginning, keep it simple and consistent so it becomes easy and not too much effort, but try to keep it sincere and avoid it becoming artificial and mechanical.

Loving-kindness meditation

Start by finding a comfortable place to sit upright, either cross legged on a cushion or on a chair, and allow your body to hang loosely on your spine.

Close your eyes gently and allow your body and breath to soften. Then bring your attention to the area of the heart, see if you can feel your heart and breath together, as if you could breathe into and out of your heart. Feel your breath as if it comes in and out right there at your heart center.

Start by directing loving-kindness toward yourself, because it is hard to fully love others when there are things that you hate or cannot accept in yourself.

Begin to feel compassion for your struggles and sorrows. Try to embrace the sorrow with an open heart and with compassion and loving kindness.

You can start by saying: “May I be happy and may I be filled with loving kindness”.

Next, think of someone you love, someone for whom you naturally feel compassion, your spouse or partner, your kids or your parents. Try to feel their suffering and struggle and wish also for their happiness.

“May [this person] be happy, and may [they] be filled with loving kindness.”

Then open your heart a little wider to include other loved ones and wish for them the same way. Then open your heart even further to let in all of your friends and the people you love.

“May they all be happy and may they all be filled with loving kindness.

Then try to make your heart even larger, to include everyone you know, whether or not you have special relations with them; then to include someone you are not too crazy about, your enemy.

Gradually make your heart even larger, large enough to fill the entire house, the entire housing complex, the entire city, the entire country, even the entire planet. Take the whole earth in your heart, and wish all beings happiness and loving kindness.

“May all beings be happy and may they all be filled with loving-kindness.”

This practice is beautiful because it takes us beyond ourselves and it allows us to extend loving kindness to every sentient being.

Kindness starts from within. Now go out there and manifest this in your everyday actions. Namaste.

Quotations about Happiness

“Remember that happiness is a way of travel, not a destination.”

Roy Goodman

“Our happiness is greatest when we contribute most to the happiness of others.”

Harriet Shepard

“Don't cry when the sun is gone, because the tears won't let you see the stars”

Violeta Parra

“To be able to find joy in another's joy, that is the secret of happiness.”

George Bernanos

“Most of the shadows of this life are caused by standing in one's own sunshine.”

Ralph Waldo Emerson

“Before you talk about what you want - Really appreciate what you have before it's gone.”

Ethan Daniel

“Dont cry because its over, smile because it happened.”

Unknown

Quotations about Happiness

“Anyone who says sunshine brings happiness has never danced in the rain.”

Unknown

“Happiness is a function of accepting what is.”

Werner Erhard

“Success is not the key to happiness. Happiness is the key to success. If you love what you are doing, you will be successful.”

Herman Cain

“It is not how much we have, but how much we enjoy, that makes happiness.”

Charles Haddon Spurgeon

“The best way to cheer yourself up is to try to cheer somebody else up.”

Mark Twain

“There are hundreds of languages in the world, but a smile speaks them all.”

Unknown

“A happy person is not a person in a certain set of circumstances, but rather a person with a certain set of attitudes.”

Hugh Downs

“People are just about as happy as they make up their minds to be.”

Abraham Lincoln

“The happiest of people don't necessarily have the best of everything; they just make the most of everything that comes along their way.”

Unknown

“If you're going to be able to look back on something and laugh about it, you might as well laugh about it now.”

Marie Osmond

Quotations about Happiness

“Don't frown. You never know who is falling in love with your smile.”

Unknown

“Believe in yourself! Have faith in your abilities! Without a humble but reasonable confidence in your own powers you cannot be successful or happy.”

Norman Vincent Peale

“Those who bring sunshine into the lives of others cannot keep it from themselves.”

James Matthew Barrie

“No one needs a smile as much as a person who fails to give one.”

Unknown

“People take different roads seeking fulfillment and happiness. Just because they are not on your road does not mean they have gotten lost.”

Jackson Browne

“Action may not always bring happiness, but there is no happiness without action.”

Benjamin Disraeli

“Happiness is a choice that requires effort at times.”

Unknown

“Time you enjoy wasting, was not wasted.”

John Lennon

“The foolish person seeks happiness in the distance; the wise person grows it under his feet.”

James Oppenheim

“For every minute you are angry you lose sixty seconds of happiness.”

Ralph Waldo Emerson

Quotations about Friendship

“A friend may well be reckoned the masterpiece of nature.”

Ralph Waldo Emerson

“A friend may well be reckoned the masterpiece of nature.”

Unkown

“Friends are those rare people who ask how we are and then wait to hear the answer.”

Ed Cunningham

“Stay is a charming word in a friend's vocabulary.”

Louisa May Alcott

“Sometimes our light goes out but is blown into flame by another human being. Each of us owes deepest thanks to those who have rekindled this light.”

Albert Schweitzer

“When a friend is in trouble, don't annoy him by asking if there is anything you can do. Think up something appropriate and do it.”

E. W. Howe

“I value the friend who for me finds time on his calendar, but I cherish the friend who for me does not consult his calendar.”

Robert Brault

“Carve your name on hearts and not marble.”

Charles Haddon Spurgeon

Quotations about Friendship

“A true friend is someone who is there for you when he'd rather be anywhere else.”

Len Wein

“Let us be grateful to people who make us happy; they are the charming gardeners who make our souls blossom.”

Marcel Proust

“There is nothing better than the encouragement of a good friend.”

Katherine Hathaway

“Friendship consists in forgetting what one gives, and remembering what one receives.”

Dumas The Younger

“A friend is one who knows us, but loves us anyway.”

Fr. Jerome Cummings

“It's the friends you can call up at 4:00 a.m. that really matter.”

Marlene Dietrich

“Some people come into our lives and quickly go. Some stay for awhile and leave footprints on our hearts, and we are never, ever the same.”

Unknown

“The best way to destroy an enemy is to make him a friend.”

Abraham Lincoln

“The only way to have friends is to be one.”

Ralph Waldo Emerson

“Do not save your loving speeches for your friends till they are dead; Do not write them on their tombstones, speak them rather now instead.”

Anna Cummins

Quotations about Friendship

“You cannot be friends upon any other terms than upon the terms of equality.”

Woodrow Wilson

“True friendship comes when silence between two people is comfortable.”

David Tyson Gentry

“One who looks for a friend without faults will have none.”

Unknown

“If we would build on a sure foundation in friendship, we must love friends for their sake rather than for our own.”

Charlotte Bronte

“Go often to the house of thy friend, for weeds choke the unused path.”

Ralph Waldo Emerson

“Don't wait for people to be friendly, show them how.”

Unknown

“I no doubt deserved my enemies, but I do not believe I deserved my friends.”

Walt Whitman

“A friend is one who believes in you when you have ceased to believe in yourself.”

Unknown

“True friends are two people who are comfortable sharing silence together.”

Ralph Waldo Emerson

“You can make more friends in two months by becoming interested in other people than you can in two years by trying to get other people interested in you.”

Dale Carnegie

Quotations about Enthusiasm

“The world belongs to the enthusiast who keeps cool”

William McFee

“No person who is enthusiastic about his work has anything to fear from life.”

Samuel Goldwyn

“There is real magic in enthusiasm. It spells the difference between mediocrity and accomplishment.”

Unknown

“Enthusiasm is the greatest asset in the world. It beats money, power and influence”

Henry Chester

“The worst bankruptcy in the world is the person who has lost his enthusiasm.”

H. W. Arnold

Quotations about Enthusiasm

“Never apologize for showing feeling. When you do so, you apologize for the truth.”

Benjamin Disraeli

“Nothing great was ever achieved without enthusiasm.”

Ralph Waldo Emerson

“Success is going from failure to failure without a loss of enthusiasm.”

Sir Winston Churchill

“What lies behind us and what lies before us are tiny matters compared to what lies within us.”

Ralph Waldo Emerson

“Enthusiasm is that secret and harmonious spirit which hovers over the production of genius.”

Isaac Disraeli

“A man can succeed at almost anything for which he has unlimited enthusiasm.”

Charles Schwab

“A mediocre idea that generates enthusiasm will go farther than a great idea that inspires no one.”

Mary Kay Ash

“Most great men and women are not perfectly rounded in their personalities, but are instead people whose one driving enthusiasm is so great it makes their faults seem insignificant.”

Charles A. Cerami

“Flaming enthusiasm backed by horse sense and persistence, is the quality that most frequently makes for success.”

Dale Carnegie

“In the end, the size of a person's accomplishment can best be measured by the size of their heart.”

Unknown

Quotations about Character

“Be more concerned with your character than your reputation, because your character is what you really are, while your reputation is merely what others think you are.”

John Wooden

“Ability may get you to the top, but it takes character to keep you there.”

John Wooden

“People seem not to see that their opinion of the world is a confession of character.”

Ralph Waldo Emerson

“Talent is commonly developed at the expense of character.”

Ralph Waldo Emerson

“There is no need to boast of your accomplishments and what you can do. A great man is known. He needs no introduction.”

Unknown

“The weak can never forgive. Forgiveness is the attribute of the strong.”

Mahatma Gandhi

“How a man plays a game shows something of his character, how he loses shows all of it.”

Unknown

“Sports do not build character. They reveal it.”

John Wooden

“What lies behind us and what lies before us are tiny matters compared to what lies within us.”

Ralph Waldo Emerson

“Most great men and women are not perfectly rounded in their personalities, but are instead people whose one driving enthusiasm is so great it makes their faults seem insignificant.”

Charles A. Cerami

Quotations about Character

“Character may be manifested in the great moments, but it is made in the small ones.”

Phillips Brooks

“When a man is wrong and won't admit it, he always gets angry.”

Thomas Chandler Haliburton

“We should be too big to take offense and too noble to give it.”

Abraham Lincoln

“If the whole world followed you, would you be pleased with where you took it?”

Neale Donald Walsch

“I look to a day when people will not be judged by the color of their skin, but by the content of their character.”

Martin Luther King, Jr.

“No change of circumstances can repair a defect of character.”

Ralph Waldo Emerson

“No one who deserves confidence ever solicits it.”

John Lennon

“The best indices to a person's character are how he treats people who can't do him any good, and how he treats people who can't fight back.”

Abigail Van Buren

“Outside show is a poor substitute for inner worth.”

Aesop

“Character consists of what you do on the third and fourth tries.”

James A. Michener

Quotations about business

“Just because something is easy to measure doesn't mean it's important.”

Seth Godin

“Selling to people who actually want to hear from you is more effective than interrupting strangers who don't.”

Seth Godin

“Take away my people, but leave my factories, and soon grass will grow on the factory floors. Take away my factories, but leave my people, and soon we will have a new and better factory.”

Andrew Carnegie

Quotations about Attitude & Outlook

“No pessimist ever discovered the secret of the stars, or sailed to an uncharted land, or opened a new doorway for the human spirit.”

Helen Keller

“To different minds, the same world is a hell, and a heaven.”

Ralph Waldo Emerson

“The rainbows of life follow the storms.”

Unknown

“What we see depends mainly on what we look for.”

John Lubbock

“If you don't like something change it. If you can't change it, change your attitude. Don't complain.”

Maya Angelou

“When one door closes another door opens; but we so often look so long and so regretfully upon the closed door, that we do not see the ones which open for us.”

Helen Keller

“Do not spoil what you have by desiring what you have not; but remember that what you now have was once among the things only hoped for.”

Epicurus

“Clear your mind of can't.”

Samuel Johnson

“He who has so little knowledge of human nature as to seek happiness by changing anything but his own disposition will waste his life away in fruitless efforts.”

Samuel Johnson

“Dont cry because its over, smile because it happened.”

Unknown

Quotations about Attitude & Outlook

“If you want to test your memory, try to recall what you were worrying about one year ago today.”

E. Joseph Cossman

“It's not who you are that holds you back, it's who you think you're not.”

Unknown

“Whether you think you can or think you can't, you are right.”

Henry Ford

“There is nothing either good or bad, but thinking makes it so.”

William Shakespeare

“Too many people miss the silver lining because they're expecting gold.”

Maurice Seitter

“If you don't think every day is a good day, just try missing one.”

Cavett Robert

“Things turn out best for people who make the best of the way things turn out.”

John Wooden

“In the long run the pessimist may be proved right, but the optimist has a better time on the trip.”

Daniel L. Reardon

“One of the secrets of life is to make stepping stones out of stumbling blocks.”

Jack Penn

“Worrying is like a rocking chair, it gives you something to do, but it doesn't get you anywhere”

Unknown

Quotations about Attitude & Outlook

“Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, It is the only thing that ever has.”

Margaret Mead

“The greatest obstacle to discovery is not ignorance - it is the illusion of knowledge.”

Daniel J. Boorstin

“Many of life's failures are men who did not realize how close they were to success when they gave up.”

Thomas Edison

“The best thing about the future is that it only comes one day at a time.”

Abraham Lincoln

“There is no failure. Only feedback.”

Unknown

“The crisis of yesterday is the joke of tomorrow.”

H. G. Wells

“A happy person is not a person in a certain set of circumstances, but rather a person with a certain set of attitudes.”

Hugh Downs

“The happiest of people don't necessarily have the best of everything; they just make the most of everything that comes along their way.”

Unknown

“If you're going to be able to look back on something and laugh about it, you might as well laugh about it now.”

Marie Osmond

“Remember that happiness is a way of travel, not a destination.”

Roy Goodman

Life Inspiration: 12 Tips for Successful Living

1. Constant affirmation without accountability is a sure-fire way to cripple a child. In other words, belief in yourself without responsibility leads to a sense of entitlement.

2. Raise your hand if you've ever been rejected for anything, anytime, anywhere. We all have. How would you like to have a nice little four-letter word for the next time you're rejected? It's: NEXT. Next sale, next job, next date, next whatever.

3. Beware of people who use their own emotional pain as a tool to manipulate others instead of as a motivation to change themselves.

4. Parents of teens need to watch out for NMK Syndrome: Not My Kid, as in "my kid couldn't have done ___" (fill in the blank). Well, yes, they could have. Even if you have faithfully raised them not to do certain things, kids still have the power of choice, which means they can make bad choices.

NMK Syndrome can blind you to something that needs immediate attention. Trust in your kids and in your parenting, and always check out what you hear.

5. When you receive a notice in your credit card statement that says, "Congratulations, because of your excellent payment history, there is no minimum fee due this month," it's not a time for celebration. You're still being charged interest. These people are not your friends.

6. It's a humbling and sobering experience to have a child who wants to be like you.

7. I've noticed more and more people doing what I call "caboose living."

Picture a three-car train. The engine in front we'll call facts/reality; the car in the middle is our thoughts, beliefs, decisions, choices and behaviors based on the facts; the caboose is our feelings. The facts/reality come first, then thoughts and behaviors followed by feelings.

Many folks try to run their life train with the caboose (feelings) in the lead. Feelings are interesting and important, but they cannot drive the train. Pay attention to your feelings, but let the facts/reality drive the train.

8. A successful marriage requires selective and strategic ignoring. The right things to ignore are little habits and irritating peculiarities that we all have. The problem comes when you select the wrong things to ignore.

9. I wonder if it's a bad thing to believe that football on TV is one of the first signs of fall approaching.

10. Most folks live with the illusion that worrying about something can actually make a difference. The only possible way that worrying can make a difference is if the worrying motivates you to take action to do something about the subject of your worry.

11.People often say, "Well, I'm just going with the flow." The problem with going with the flow is that many times the flow is lost and does not know where it is going.

12. Best quote I've seen since last time, by Miami Herald columnist Leonard Pitts: "At some point, though, a problem ought to be defined less by our ability to explain why it happens than by our willingness to demand that it happen no more."

The Secret to Positive Thinking

Positive thinking is something that eludes many because they simply don’t understand or believe that positive thinking can help them in any way. There really is no single big secret to positive thinking. The miracle of positive thinking truly lies within yourself. In this article, I’m going to give you the keys to positive thinking and show you why they work.

SECRET #1: NOBODY’S PERFECT
When you can latch onto this simple little secret, you will be amazed at the change you’ll notice within yourself. You’ll no longer feel so angry all the time. You will start to give people the benefit of the doubt. Best of all, you will learn to forgive and not hold grudges.

SECRET #2: EVERYONE MAKES MISTAKES
What’s the first thing that happens when you see someone make a mistake? Are you immediately judgmental? Do you think to yourself that they had it coming to them? Negative thoughts like these are detrimental, not only to the other person, but more so to you. Allow for mistakes, and refer back to Secret #1.

SECRET #3 BAD THINGS HAPPEN TO GOOD PEOPLE
Just because you consider yourself to be a good person, that doesn’t exclude you from having anything bad happen to you. All too often, a negative and pessimistic attitude is brought on because of seemingly one bad thing happening after another. Life is filled with bad things and disappointments. It is up to you to choose how to react to them, though.

SECRET #4: YOUR MIND DETERMINES YOUR LIFE
You really can determine how your life will turn out, based on your way of thinking. If you constantly look for bad things to happen, guess what? Bad things will most likely happen to you. But if you turn your thoughts to a more positive nature, and find the good in everything, you’ll soon become a happier person and live a much happier life.

How to Motivate Yourself

Do you make big plans for your life, only to end up disgusted and frustrated because you can never seem to follow through with them? Motivation plays a huge factor in how we live our lives. Lack of motivation leads to stagnation, which in turn creates an unproductive and unfulfilling life.

MAKE A PLAN

The groundwork for motivation is a plan. Without a solid plan of action, you’ll stay stuck doing the same things again and again, even though you get nowhere. Make a list of your goals for 1, 5, and 10 years. Envision where you want to be, what you want to accomplish.

GIVE YOURSELF INCENTIVES

Sometimes it’s necessary to trick your brain by giving yourself incentives. Set benchmarks for your life plan, along with special incentives for reaching each one. When you can see measurable accomplishments, reward yourself with an incentive.

GET EXCITED

If you can’t get excited about your goals, you’ll never become motivated enough to do something about it. Setting goals that are boring and dull will only lead to you quitting early on. When you can truly get excited about what you are doing with your life, you will find this gives you an extra boost of motivation.

BE HAPPY

Depression and lack of self-esteem and confidence plays a huge role in loss of motivation. When you feel like nothing you do is good enough, and you are miserable and unhappy, you are much less likely to become proactive towards reaching your goals. Find your happy place and your motivation level will rise.

Positive self esteem

Positive self esteem means that you have healthy self esteem that is filled with positive feelings that allow you to feel vibrant and happy. Your mind is made up of trillions of positive ideas about yourself that you may have not yet unleashed into your life up until now.

Sometimes negative feelings, thoughts or behaviors can weigh our self esteem down. But If you can learn from your mistakes and make learning fun, you’ll not only increase your self esteem by conquering your negative habits, but you’ll also begin to appreciate yourself for the positive life-style your about to create. Learning from mistakes and turning doubts, insecurities and emotional problems into personal power is the first key to manifesting positive self esteem.

The second key is to recognize and appreciate yourself for every positive thought, idea or feeling you have about yourself and use these great ideas to justify your positive future success. When you do this you begin to heal the negative past issues that effected your self esteem and be in this present moment with a fountain of wealth and positive resources that contribute to your future happiness.

To become an authentic person with positive self esteem you must heal your negative past!

Positive self esteem is a must have when you want to become effective at socializing, relationships, finances and so much more… Because a positive foundation of success starts from inside of you, then expands into every area of your life.

When you build a positive foundation inside of yourself first, nothing can stop you because nothing will ever stop you from improving the quality of your life based on the positive foundation you are living with.

Nothing Is Impossible

Everyone, at some point of his or her life, has dreamed of being somebody special, somebody big. Who hasn’t fantasized about being the one who hits the game-winning homer? Who hasn’t dreamed of being the homecoming queen? And how many times have we dreamed of being rich, or successful, or happy with our relationships?

Often, we dream big dreams and have great aspirations. Unfortunately, our dreams remain just that – dreams. And our aspirations easily collect dust in our attic. This is a sad turn of events in our life. Instead of experiencing exciting adventures in self actualization, we get caught up in the humdrum of living from day-to-day just barely existing.

But you know what? Life could be so much better, if only we learned to aim higher. The most common problem to setting goals is the word impossible. Most people get hung up thinking I can’t do this. It’s too hard. It’s too impossible. No one can do this.

However, if everyone thought that, there would be no inventions, no innovations, and no breakthroughs in human accomplishment. Remember that scientists were baffled when they took a look at the humble bumblebee. Theoretically, they said, it was impossible for the bumblebee to fly. Unfortunately for the bumblebee no one has told it so. So fly it does.

On the other hand, some people suffer from dreaming totally outrageous dreams and not acting on them. The result? Broken dreams, and tattered aspirations.

If you limit yourself with self-doubt, and self-limiting assumptions, you will never be able to break past what you deem impossible. If you reach too far out into the sky without working towards your goal, you will find yourself clinging on to the impossible dream.

Try this exercise. Take a piece of paper and write down some goals in your life. Under one header, list down things ‘you know you can do’. Under another header, write the things ‘you might be able to do.’ And under one more, list the things that that are ‘impossible for you to do.’

Now look at all the headers strive every day to accomplish the goals that are under things ‘you know you can do’. Check them when you are able to accomplish them. As you slowly are able to check all of your goals under that heading, try accomplishing the goals under the other header-the one that reads ‘you might be able to do.’

As of the items you wrote under things I could do are accomplished, you can move the goals that are under things that are ‘impossible for you to do’ to the list of things ‘you might be able to do.’

As you iterate through this process, you will find out that the goals you thought were impossible become easier to accomplish. And the impossible begin to seem possible after all.

You see, the technique here is not to limit your imagination. It is to aim high, and start working towards that goal little by little. However, it also is unwise to set a goal that is truly unrealistic.

Those who just dream towards a goal without working hard end up disappointed and disillusioned. On the other hand, if you told someone a hundred years ago that it was possible for man to be on the moon, they would laugh at you. If you had told them that you could send mail from here to the other side of the world in a few seconds, they would say you were out of your mind. But, through sheer desire and perseverance, these impossible dreams are now realities.

Thomas Edison once said that genius is 1% inspiration and 99% perspiration. Nothing could be truer. For one to accomplish his or her dreams, there has to be had work and discipline. But take note that that 1% has to be a think-big dream, and not some easily accomplished one.

Don’t get caught up with your perceived limitations. Think big and work hard to attain those dreams. As you step up the ladder of progress, you will just about find out that the impossible has just become a little bit more possible.

inspirational

hat chance gathers she easily scatters. A great person attracts great people and knows how to hold them together. Johann Wolfgang Von Goethe

A general is just as good or just as bad as the troops under his command make him.General Douglas MacArthur

The real leader has no need to lead-- he is content to point the way.Henry Miller

Go to the people. Learn from them. Live with them. Start with what they know. Build with what they have. The best of leaders when the job is done, when the task is accomplished, the people will say we have done it ourselves.Lao Tzu

Rely on your own strength of body and soul. Take for your star self-reliance, faith, honesty and industry. Don't take too much advice — keep at the helm and steer your own ship, and remember that the great art of commanding is to take a fair share of the work. Fire above the mark you intend to hit. Energy, invincible determination with the right motive, are the levers that move the world.Noah Porter

If your actions inspire others to dream more,
learn more, do more and become more,
you are a leader. John Quincy Adams

A Friend...

(A)ccepts you as you are
(B)elieves in "you"
(C)alls you just to say "HI"
(D)oesn't give up on you
(E)nvisions the whole of you (even the unfinished parts)
(F)orgives your mistakes
(G)ives unconditionally
(H)elps you
(I)nvites you over
(J)ust "be" with you
(K)eeps you close at heart
(L)oves you for who you are
(M)akes a difference in your life
(N)ever Judges
(O)ffer support
(P)icks you up
(Q)uiets your fears
(R)aises your spirits
(S)ays nice things about you
(T)ells you the truth when you need to hear it
(U)nderstands you
(V)alues you
(W)alks beside you
(X)-plains thing you don't understand
(Y)ells when you won't listen and
(Z)aps you back to reality