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Medical Edge Newspaper Column from Mayo Clinic

HOW CAN I MAKE MOM STOP PUTTING ME DOWN?

DEAR MAYO CLINIC: How can I approach my mother to let her know that I’m sick of the way she puts me down and points out my flaws? She constantly says horrible things to me that I feel are detrimental to my mental health. I just want to have a good relationship with her. What should I do, and how should I approach her?

ANSWER: If your mother is open to working on the relationship, consider seeing a counselor together to help improve your communication. If she’s not interested, you could see a counselor to help you find a degree of acceptance. The relationship isn’t ideal, and that’s the reality you’re facing.

I suggest you bring up the issues that are bothering you in a constructive way. Try something like this: “Mom, it helps me when you tell me something positive about my job or family. Right now, I’m OK making my own decisions. When I need help, I’ll come and ask.”

You’re telling your mother you value her as a resource, but not as a critic. Granted, this is gentle approach. But a more direct demand for her to stop probably won’t be a good conversation starter. Your mom might not understand your concerns. Her comments might be a misguided way of showing that she cares about you. Even if she does understand, she might not change.

Assuming you still want to see your mom, focus on what you can do to make the relationship more positive. Ideas might include:

— Shorten your visits or conversations. Use the time to talk about positive topics, or let her know what you’ve been doing.

— Find activities you can do together. If you’re seeing a movie or doing a project, the focus is on something besides your relationship.

— Include others in your activities. If family or friends are included, your mother may be less likely to criticize you.

— Use humor. It can defuse tense situations.

Sheila Jowsey M.D., Psychiatry and Psychology, Mayo Clinic, Rochester, Minn.

Additional Resources:
Psychiatry and Psychology
Appointment Information
More Information on Mental Health

DEAR MAYO CLINIC: I have severe coronary artery disease. Treatments have included nine bypasses, with eight stents and seven balloons. I continue to have problems and have been told there is no more room to do anything. Is laser revascularization an option? — Fargo, N.D.

ANSWER: You do have options. First, continue to focus on the cornerstones of heart disease therapy:

— Management of cholesterol, blood pressure, and if you have diabetes, blood sugar. Talk with your doctors to make sure your medications are working effectively.

— Exercise and, if you’re overweight, lose weight. If exercise is difficult due to severe symptoms, consider a supervised cardiac rehabilitation program.

These procedures may be options:

— Transmyocardial laser revascularization: This open-heart procedure involves “drilling” laser channels into the heart to create new pathways for blood to nourish the heart. Studies have shown that the procedure improves angina (chest pain) symptoms, but it may not reduce death rates from vascular disease.

— Enhanced external counterpulsation: Inflatable pressure cuffs are placed on the calves, thighs and buttocks and then inflated and deflated in sync with your heartbeat. EECP is believed to create new pathways around blocked arteries in the heart, providing benefit in much the same way as exercise.

— Spinal cord stimulation: An implanted pacemaker-sized generator provides low-level electrical stimulation that can reduce pain. The therapy has been tested in small clinical trials, and research is ongoing.

— Gene therapy: Researchers are studying ways to use genes to improve the body’s natural ability to grow new blood vessels around blockages. In small studies, patients have reduced pain and improved ability to exercise. This therapy is experimental.

— Heart transplant: It’s an option when other treatments don’t control persistent angina.

Advanced heart centers will offer many of these treatment options. External counterpulsation is often a first choice as a safe, effective strategy for patients in circumstances like yours. Treatment usually includes 35 one-hour sessions over seven weeks. The therapy has been shown to provide long-term relief of symptoms in patients who have heart disease.

Spinal cord stimulation and gene therapy are available to patients who are interested and who qualify for research protocols. Laser therapy is less frequently used as it involves open-heart surgery and entails greater risks.

Gregory Barsness, M.D., Cardiovascular Disease, Mayo Clinic, Rochester, Minn.

Additional Resources:
Treatment of Coronary Artery Disease
Appointment Information
More Information on Coronary Artery Disease
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Medical Edge from Mayo Clinic is an educational resource and doesn’t replace regular medical care. To e-mail a question, go to www.mayoclinic.org, or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.