This is not medical advice.  Continuing to read this blog assumes that you have read this website's disclaimer.

In a world filled with information, how do you filter out what is right for you and your health? Clinicians are called to rely on evidence to make our clinical decisions and recommendations.  Evidence comes in a variety of forms - folklore, anecdotal, qualitative research, and quantitative research.  The gold standard being randomized controlled trials. The more evidence that suggests a particular modality has the ability to promote our health or wellbeing, the more likely it will be accepted into mainstream healthcare.

The 8th Annual Blue Mind Summit was filled with these various forms of evidence linking health and well-being to water. Perhaps the most impressive research presented was on waters ability to reduce anxiety. 
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Let's take a look at some of this evidence.
 
ANECDOTAL EVIDENCE:
 
Anecdotal basically means a personal account, or story of an experience.  The reliability of a story is often based on how trustworthy the storyteller is.  However, when large numbers of people, from various walks of life, start to report the same experience, it builds credibility.  Nature, including water, falls into this realm easily because how it interacts with us is so abstruse.

Pain Relief
One of my favorite personal accounts on how water heals comes from a couple that call themselves the Sand Mates.  Diane and Mike Lough work together to build exquisite sandcastles.  Diane experiences chronic pain in her shoulder after she was electrocuted in an elevator.  When she builds sandcastles by the sea, however, the pain miraculously disappears for a few days. 

​Drug Addiction
Rebecca Illing describes her experience with addiction as, "repeating things that are detrimental to my health." She didn't know how to find inner peace.  Water was the anecdote. Here is her story: Video

PTSD
If water can help relieve the symptoms of post-traumatic stress disorder (PTSD) incurred by our soldiers, imagine what it can do for the rest of us?  Force Blue Team, a group of special ops diver veterans, are just one of many veteran groups using water as part of their healing tools.  As they report, water allows them to connect with something greater, experiencing a state of awe.  
Many who have been exposed to trauma are reporting that engaging with water has literally been life saving from the anxiety, stress and depression that can occur with PTSD.  Of note, a Psychiatrist who works with Veterans has said that therapeutic recreation in nature is just part of the treatment plan for PTSD.  Mental healthcare, such as psychotherapy, medications and/or other treatments are often required as well.  Veterans experiencing feelings of suicide or PTSD should alert their healthcare providers immediately, go to an Emergency room or consult with Headstrong.org.   

QUALITATIVE RESARCH:
 
Qualitative research is an exploratory process seeking to understand the why and how of a social phenomena.  This type of inquiry might best be used to gather the themes and experiences of all the anecdotal evidence being expressed about waters healing power.
 
An example using this type of research is a study done that examined pregnant women’s' views on using water exercise as a pain reduction tool.  Lower back pain is common amongst pregnant women.
 
The study found that the pregnant women studied do desire to exercise. The women reported water exercise was an acceptable way to do that.  Water exercise did indeed have physical and mental well-being benefits. The greatest barrier to using this modality was found to be crowded pools.

QUANTITATIVE RESEARCH:
 
Quantitative research is a structured way of gathering and analyzing data from various sources.  
 
In 2017, a group of researchers reviewed the studies that were currently available that investigated the potential benefits of outdoor bluespaces (lakes, rivers, sea, etc) and human health.  A study of this sort, where multiple studies are reviewed and analyzed, is called a meta-analysis. This meta-analysis found that the strongest evidence linking bluespaces and health existed in the arena of mental health and well-being.  The relationship of outdoor blue activity and general health, its impact on obesity and cardiovascular health, however, was less consistent.

Dr. Justin Feinstein, a Clinical Neuropsychologist and Director of the LIBR Float Clinical and Research Center, presented his research on floatation therapy at the Blue Mind Summit. It was by far the most impressive evidence of the summit.  Fifty anxious and depressed participants, with various degrees of anxiety and stress-related disorders, participated in a study examining the effect of a single one-hour floating session with reduced environmental stimulation.  Participants were asked to float supine in a pool of water saturated with Epsom salt for one hour. 

​The results are impressive.  Every study participant had a reduction in anxiety.

Dr. Feinstein has been awarded a grant by the National Center for Complementary and Integrative Health to study this further. Imagine the implications float therapy centers might have on healthcare professionals experiencing burnout, college students studying for final exams and others who may not have a full-blown anxiety disorder.
 
Many of us already know, by our own experience, that water makes us feel better in some way, whether it be in our mind, body or spirit.  As long as we can safely engage in it, and the water itself is healthy, there is no need to wait for a study or a prescription.  We can choose to add this into our health and wellness toolbox. Float spas are popping up in many areas.  A warm bath with Epsom salts may be just what we need to help sleep or ease the stress of a hard day.  Sometimes just soaking our feet in warm water can soothe our soul.
 
Does this information intrigue, and perhaps inspire you, to engage in water in a more intentional way? 
 
Do you have stories of your own that you would like to share on how water has healed you? Please share in the comments below. We welcome your thoughts. 

I will be reviewing some of the information presented within these themes and adding further data and information.  Surprisingly, the conference attracted people from all walks of life and a multitude of professions.  I was the only nurse there and there were a few doctors.  It was refreshing to be surrounded by like-minded people who are interested in, or already using water, in various ways to help their fellow human beings: surfers, inventors, educators, marine biologists, journalists, aquarium personnel, spa owners, and health coaches just to name a few.
 
The key takeaway from the conference: Water has the power to make us not only heal and improve our lives, it can also transform us at times.  How exactly that happens, we do not know exactly, but we are starting to get some information.  
 
In order for humans to have the best opportunity to indulge in what water has to offer, learning how to swim at the earliest age that is appropriate is beneficial. This diminishes the possibility of being fearful in, on, near or under water. 
 
As of this publish date, the American Academy of Pediatrics recommends that depending on the child, and the surrounding conditions such as the amount of water nearby, some children may be ready to learn to swim as early as one years old.  This does not, however, relinquish a parent or caregiver’s responsibility for ensuring that child’s safety around water with supervision and structural barriers to the water. A variety of factors go into the decision when it is appropriate to teach a child to swim.  To learn more, visit the American Academy of Pediatrics informational page on the subject here. 
 
Let's begin exploring in more detail exactly what water might actually do for us by looking first at the topic of pools and swimming.
 
In Tel Aviv, Israel, hydrotherapy is a well-accepted, and widely implemented means of providing therapy for individuals with a variety of medical situations including chronic pain, traumatic brain injuries, autism, and orthopedic rehabilitation.  I can speak to the benefit of this personally.
 
A few years ago I dislocated and broke my ankle in three places.  When the cast, and later the boot, were removed, my ankle was as stiff as a brick.  It was painful and frightening to bear weight on it or try to rotate it.  After the initial few weeks of physical therapy in their office, I instinctively turned to water to help me progress. 
 
As Caroline Barmatz, Director of Hydrotherapy at Sheba Medical Center, Tel Aviv, Israel, stated at the BlueMind Summit, "I see abilities in water that are disabilities on land."  
 
That indeed was what I found.  The weight that water helped me bear gave me confidence to stretch my ankle a little more. When I saw it was possible to move it that much in the water, I felt more confident to allow my ankle to stretch that far on land.
 
Barmatz's hydrotherapy program provides over 27,000 treatments a year in Israel.  There are several hydrotherapy pools around the city and medical professionals of all levels are educated about, and invited to experience, the therapeutic effect of water in order to assist with or advocate for it.
 
Looking at how other cultures are using water as therapy allows us to discover best practices and inspires us to think differently.  Bob Hubbard, co-founder of the Hubbard Family Swim School in Phoenix, Arizona, was another speaker at the BlueMind Summit.  Hubbard referenced a study done by Griffith University in Australia in which researchers surveyed parents of 7000 children aged five years old and under from Australia, New Zealand and the US over a four-year time period.  It found that children under the age of four who swam at least once a week, were anywhere from six to 15 months ahead of the average population when it came to cognitive skills, problem solving in mathematics, counting, language and following instructions.

Hubbard states there are other great benefits to getting kids and those with special needs into the pool. Touch is one of them. Parents hold normally squirmy toddlers skin to skin for long periods of time and autistic kids allow others to touch them, which might not ordinarily happen.  He says that often the greatest barrier to getting kids into the water is the parents.  
 
"Studies show that 50-60% of adults are uncomfortable with water over their head," Hubbard shared. "Other countries such as Japan, Australia, and Norway require that by the third grade a child can pass a 400 meter swim test. We often spend more time educating the parents than the kids."
 
Learning how to swim is not only important to prevent fatal drowning, which is the second-leading cause of unintentional injury-related death for children ages 1-14, it is essential to open the door to the therapeutic and mind-body enhancing benefits that water engagement offers.  Like many other socio-economic situations, knowing how to swim is not equal across different cultures and ethnicities. 64 percent of African-American and 45 percent of Hispanic children cannot swim, compared to just 40 percent of Caucasian children.

We discussed a variety of potential ways this disparity might be tackled at the BlueMind Summit including: Expanding education of the benefits of swimming and water engagement via healthcare providers such as by Lamaze Class Instructors, Pediatric Providers, and School Nurses. Perhaps once made more aware, health insurance companies will cover swim lessons and build more pools in public areas including low-income areas.  Imagine the preventive health benefits.
 
Do you swim or engage in water yourself?  How has it affected your health and well-being? Please feel free to add your experiences in the comments below. We will continue to discuss other ways water heals us in upcoming blogs so be sure to subscribe if you are interested.  I hope you will find it the information as intriguing as I have!

​[1] B.M. Dossey, Holistic Nursing: A Handbook for Practice, 5th Ed., ed. B. M. Dossey and L. Keegan (Sudbury, MA: Jones and Barlett, 2009, 721.

If you would like to watch the BlueMind Summit: Water Is Medicine, Pools Session, in its entirety please click here.  The audio from Tel Aviv is difficult to hear, unfortunately.
 
https://www.facebook.com/bluemindworks/videos/975527835973710/
 
 

If you are looking for good news, hope and ways that you and your family, organization and/or community can enhance your health and wellness, you will want to watch for upcoming newletters, blogs and videos provided by The Nature Nurse™.  So sign up/subscribe now to be the first to learn about the positive power water offers us.  

In a world filled with things tugging for our attention, it takes a conscious effort to practice mindfulness.  The practice of slowing down, being present, and simply allowing thoughts and feelings wander into our heads, then letting them go may not be easy at first.  The beach with its soothing, rhythmic lullaby of the waves can be a perfect place to try this self-care tool.

For those of us with busy minds, searching for treasures on the beach can be an entryway into a deeper meditative state.  By focusing on what lies amongst the minute pieces of sand, we can begin blocking out many of life's distractions.
 
A couple of guidelines to consider before taking anything from the beach or sea include:
 
1.  Check with local beach authorities if there are any rules or restrictions about removing things from the beach.  Believe it or not, a tourist was recently issued a hefty fine for taking sand during his trip to Sardinia. (3) 

​2.  Never take anything that is alive.
 
For example: Sand dollars. 
Sand dollars are actually flat, burrowing sea urchins. When they die, their exoskeleton is white with a five point star-like design in the center.  

The brownish, green one on the left below is alive.  A pure white one is dead.

So, what can you search for? Let's take a look at 3 things.  
 
1.  Seaglass:  Glass objects that make their way into the ocean break and are tumbled in rocks and sand to create smooth edged pieces of glass. They can come in a large assortment of colors with varying shades.  Green, white and brown are often the most common as they come from beer or soda bottles. These jewels from the sea can be used to make a variety of crafts or just sprinkle them around your home as decor. Orange is the most rare color to find.

2. Shark Teeth: The jaws of shark house three rows of teeth that shed like a conveyer belt.  Having lived for millions of years, their ancestors teeth have fossilized and may be found dotting the shores of places like the southeast coast of the United States.  

Finding a Megalodon tooth is akin to winning the lottery!  It does occasionally happen. If you missed our recent interview with Megalodon shark tooth expert, Elliot Weston, check it out when you have time.  

​Most teeth, however, are from one of the many other species of sharks. You'll have to look very closely to find one.  Their black, shiny coating is often mistaken for shells that have similar coloring. If you're lucky to find one, wrap it in wire to create a necklace and good conversation piece.

3. Trash: Sadly no matter where you are in the world, you will likely find litter during your search.  Plastic, cigarette butts, balloons, kids toys, plastic bags and bottles are just a few items you may find.  This trash sculpture made from beach litter demonstrates how diverse the garbage invading our beaches has become.  Consider bringing a trash bag along to pick up the trash you find and say thank you to the joy the beach brings. 

But, what about shells and stones?
 
The guiding principle of engaging in nature is to leave it as you found it.  While taking a token or your favorite shell might not have a devastating effect on the environment, billions of people taking shells will. Our current global population is at 7.6 billion and counting. Imagine if everyone decided to take home shells from the beach?  Beachcombers removing shells may impact the marine ecosystem (4). 

If we must take a shell home, perhaps we can pick our favorite find of the day, rather than taking a bucketful home. Finding your own memento rather than purchasing a shell from a tourist shop is probably a better option. It just may help the environment. The souvenir industry is devastating ocean animal populations worldwide for their shells. Harvesting live marine life for the souvenir industry is devastating ocean animal populations worldwide. (5)  

As you find yourself sinking into a deeper relaxed state, you may find that you notice things hiding in the sand that you never noticed before.  Sand crabs peeking out of holes, the remains of a sandcastle built earlier but slowly being deconstructed by the waves, or maybe even footprints left by a baby sea turtle who has just hatched and ran for the water.
 
Watch as Jackie Levin, board certified Advanced Holistic Nurse, who specializes in teaching mindfulness to nurses explains how we can engage in mindfulness in a deeper way along the beach:

​How deep do you think you can practice mindfulness at the beach?  Could simply enjoying observing the magnificence of nature's treasures lying amongst the sand, while the warm sun releases the tension in your muscles and the gentle wind whispers in your ear be enough of a treasure to take home?
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Can't get to the beach right now? Enjoy these short scenes from the sea and please comment below on how they make you feel.