Surgery Update 2

Things are going great! Here is a picture of my foot when they took off the cast.

Here it is now...

So things are doing well. I'm really grateful. :)

Salem and His Wonky Eye

Today was a little bit of a different day. Lately I spend most of my days resting to make sure that my foot and ankle are healing well from the surgery. I have an appointment to get my cast off in 2 weeks and I'm hopeful it will be healed up enough that I can do that and won't need to get another cast put on. So I spend my days resting and doing miscellaneous things that I can do while sitting with my foot up.

Today I realized fairly quickly that one of my cats was having a problem with his eye. Salem has chronic respiratory disease and so it is very easy for him to catch different infections due to it. I was able to make an emergency appointment with one of my local vets and get him in and he currently has drops to help his eyes feel better. If his eye doesn't feel better by Thursday, then I will have to take him back in.

The major problem today was getting him into the vet. I'm not allowed to put any weight on my foot and so finding a way to get to the shed to get the cat crate, then getting it back to the house and getting the cat into it, and then getting the box with Salem in it to the car was going to be a nearly impossible task. I did manage to get the case out of the shed and into the house while using my crutches. However, getting Salem into the box and to the car required full weight on my foot. The wonderful staff at the veterinary clinic took care of carrying him from the car and throughout the clinic as needed and then got him back to the car. Then I had to put the weight on my foot to get him back into the house.

I'm pretty sure I did not re-injure it and it doesn't feel nearly as bad as I thought it would. So yay for that! Salem looks like he's doing a little better and I'm glad I took him because he clearly needed it. However I thought it prudent to spend the rest of the day on my back with my foot up and I have done that. I'll make sure I baby the ankle more tomorrow to make sure that I take good care of it. I'm glad that it was healed up enough that I didn't hurt myself doing what needed to be done today. I'm hopeful that this will not have to happen again. I was able to make arrangements with a friend to help me on Thursday if he has to go back in to get a different antibiotic. Otherwise both of us are resting this evening and looking forward to tomorrow.

Remus

I can't believe it's been a year-and-a-half since I picked up Remus from the vet's office. The cat now known as Remus was a stray that had been hit by a car in Surry and brought to the local vet. He was in really big trouble and is lucky to be alive. Most cats who are hit by a car do not live to tell the tale. He is especially lucky that somebody noticed and stopped as the car that hit him did not. It was the car behind the car who hit him who stopped to help him. Instead of letting him go to the shelter to attempt to recover and be adopted he came to my house.

He has grown and healed over the last year or so. He is relatively healthy and happy now and gets along with all the other cats in the household. He likes to rest and play with a cat laser and loves catnip as well. He has problems with weight now as his metabolism isn't great from the accident. But he loves to snuggle and he stays very close to me when he can. I am also thankful for the few people who donated money to help with his vet bills when he was originally in need. Between a Good Samaritan fund and those donations from a Go Fund Me post I paid very little of his vet bills during this time. Those costs included his neuter and vaccinations and a tail amputation.

I am a lucky woman to have him in my life and I am grateful that I took the opportunity to say yes and bring him home.

Things to Smile About

I'm trying to recover from a gluten exposure this week. I hate the way that my body feels as it tries to heal up because everything feels fragile and weak or doesn't work well. I lose most of my desire for food and have no desire to do anything but remain stationary. For the most part, the option of doing nothing really isn't a viable choice so I try to accomplish the minimum needed so that I am able to give my body the rest it needs to heal up. So today I did some needful errands and chores as well as paperwork and have tried to intersperse restful behavior throughout. Settling down to rest sometimes allows me to really look at some of my 'favorite' things and enjoy them for what they are... instead of just a quick glance as I head off or out to do something. Here are a few of them.

I got this really cool dragon from a Value Village in Seattle. I had been shopping with Shaneen and Katey and I can't remember who suggested that 'who doesn't need a cool dragon in the house'... but I decided I did. Bug loves it and considers it his and as it gets moved and carried around enough it is starting to break around the wings and ears. But I can't help but smile every time I look at it. Its a pretty cool piece of work and I wonder who made it and how they managed to let it go.

I love this vase. I'm not sure why specifically, but I love the way it looks and I always smile when I look at it. Daisies are my favorite flowers and they look great in it and each emphasizes the beauty of the other. I have no idea who made this vase, but it's pretty awesome.

I love houseplants. I got this one when someone left it in the free room at the transfer station and I happily scooped it up and brought it home. I got it last fall and it had a pink flower or two but almost no leaves. I tried to water it and coax it into growth and got absolutely nothing... just a few leaves that limped along on the stems throughout the winter. This summer I made sure the plant spent a lot of time outside and it developed lots of leaves and several flowers, but as fall came it still didn't have the 'hearty' look I had hoped for. So I have fussed and worried about it concerned that it might struggle to survive this winter as well. However, while the flowers are gone, all of the remaining leaves have stayed on. not only that, but soft slim tendrils are stretching up my wall to wrap around the curtain rod. Just seeing that brings a large smile to my face.It is still a bit 'awkward' in how is it growing and in appearance, but I see that as a metaphor for life and enjoy it anyway.

When Remus had his tail removed, the stump looked naked, tight, and weird. It looked a bit indecent and watching him 'wag' it was hilarious and appalling all at once. I remember telling Katey that I hoped he managed to get some of the hair to grow back onto it so that it was 'less' difficult to look at. Today, Remus sat by me hoping for as much attention as he could get and I got a really good close look at his stump... and it is beautiful. The hair has grown over it and the stitches are starting to fall out as everything heals. (Purple stitches on dark black skin looked a bit odd as well.) I am so glad that his tail matches the rest of him now and when he wags it the tail looks like a part of him instead of something stuck on with glue.

I found myself thinking of the film 'Picnic' today. I love the story and the images so I pulled it out today to watch. Its only about five minutes long and it is for children, but I love it and find it restful and fun to watch all the same. I just want to hug the little mouse when he finds and hugs his doll. It's a sweet peaceful film to enjoy.






These are the main things that brought some joy into my life today. I intend to spend what little of the day is left with a book by one of my favorite authors.(She must be a favorite- I've named a few cats after characters from her novels. Cyril is the most recent animal to share the name of the cat who annoys Racer in the police station although my Cyril is much more calm and docile than his namesake in the novels :) What did you enjoy today?

Little Things

Isn't is interesting that it is the little things in life that really make this journey worthwhile? Each of us has different ideas of what a 'little thing' is in our lives, but each of us can find something we are grateful for. I found myself dwelling on the idea of little things today and how wonderful they make life... and also confound it. How many times have we found our focus moved to a little thing- a small fluid leak from our cars, a short temporary illness, a small want that isn't fulfilled- in such a way that we are unable to fully and clearly focus on the really big things in our life. Sometimes a little thing is vastly important or becomes so... and sometimes we find that it was truly something that we could have ignored and wasted too much of our limited time on. It really is the little things that can bind and bring us joy.

There is so much ugly in the world and my country right now with so much violence and anger... so much I can do so little about. So today my focus is rest, healing, my son and service.... with a small focus on petting cats... boy I love that!

What are some of the little things that you are focused on right now?

What in a Team Name? A Lot!

It is almost impossible to not know about the controversies over sports team names that are named after slurs or white shorthand for Native Americans as they are pretty consistently in the news. I haven’t owned a television for over ten years, but the controversies about these names is also in the newspapers, radio, etc… I have felt for many years that these names are wrong and offensive for several reasons. Those reasons can be slightly different depending on the particular ‘name’. Here are some of the names and my thoughts on them.

Redskins - This is a word that was used to describe the skin color of Native Americans and is widely considered to be a racial slur and studies show that to most likely be correct. Why it’s a slur – whether the word means the color of skin, a bloody scalp, or a description of the corpse with the scalp removed – seems clear. In 2014, Amanda Blackhorse, a Navajo activist stated: "The name itself actually dates back [to] the time when the Native American population was being exterminated, and bounty hunters were hired to kill Native American people... So, in order to show that they made their kill, they had to bring back a scalp or their skin." According to the Los Angeles Herald, different parts of the colonial government would pay up to 50 pounds for the scalps of Indian males over the age of twelve, 25 pounds for Indian women over the age of twelve, and twenty pounds for the scalps of children of either gender. The owners of the team named the “Washington Redskins” state that the team name is respectful and has been from its inception, however, it appears that is not necessarily true and is more of a myth that is clung to in the hopes that they will not feel forced to change the team name. In the end, many people see the word 'redskins' to be as rude and bigoted as the word 'nigger'... if we are unable to accept the use of that word because of its connotations, why would we be okay with this one?

Braves- One the face of it, this word seems respectful. It brings to mind an Indian warrior – a tall male, proud, and strong, etc... However, when I really thing about this I realize that I am seeing an image in my head that is part myth, part caricature. I am not seeing what that word really shows because I do not know the culture well enough to understand the full nuances of what the word really symbolizes. So what this term really suggests is what white people think of Indian culture which shows how not only how limited our understanding of their culture is, but how little we actually respect it as well. A whole intricate culture is not made to be simplified into a few actions of a mascot or boiled down to a single stereotype or image. So, in the end, this word really isn't nice or respectful either as many Native Americans have tried to express to us through speech and writings. Currently, the US has a major league baseball team named the Atlanta Braves and a few minor league affiliates with the same name.

There are other team names that are named after specific tribes (such as the Chicago Blackhawks and the Florida State Seminoles), stereotypes (Elora Mohawks) or simply as Indians (such as the Cleveland Indians) and they tend to be seen by native tribes as offensive, racist and derogatory. When I look at the issue in that light, I can't have any opinion but that the names need to be changed. First of all, while it might cost the teams money to change things, it would be a very great gesture which I believe would go a long way into helping to promote healing in the Native American community. I also think that would potentially bring in more revenue as another group of people who currently feel angry and alienated (and maybe even mocked) would potentially become customers when it feels more respectful and fun for them. Sports teams have been complaining over the last several years that they need to attract more customers- this seems like a good potential way to do it. It also seems like changing a name is really a small thing to do to help build bridges and create opportunities for community gathering and understanding. Just my thoughts....


pictures from:
http://www.redskins.com/, http://en.wikipedia.org/wiki/Atlanta_Braves,

Reconciliation after Genocide

I believe that the model of reconciliation that was used in the aftermath of the Rwandan genocide could be used in the aftermath for all genocides. Depending of the circumstances within each individual genocide, I think could be easily used with some potential changes if needed. There are a few reasons that come to mind that I would like to share. I think this may be a stream of consciousness post so I apologize in advance.

My first thought is that the idea... the process of reconciliation... is necessary to heal people and communities- period. The idea of 'to reconcile' is not necessarily simply defined. The simple side of the coin is that reconciliation 'restores friendly relations between' or 'cause to coexist in harmony', but we must also acknowledge the other side of the spectrum; 'to cause (a person) to accept or be resigned to something not desired.’ For any process of reconciliation to be successful, both sides of the situation have to be addressed and when we then look at that full spectrum, it becomes clear not only how important it is to accomplish reconciliation, but how difficult it actually will be in practice. One thing that happens with all genocides is that people leave. Victims flee and usually resettle themselves in an area they consider safe whether it's a few towns away or even continents. Physical distance can bring safety and even rebirth... but it also hinders this important process. An important part of reconciliation is communication and being able to try and open things up and create vulnerability for both the victims and perpetrators. The separation of both groups feels to me like a cauterization of a blood vessel; both sides are seared closed and apart which stops bleeding and open difficulty, but leaves the situation on unstable ground... Some may heal, some may become infected and permanently damaged, some will die, but all will have scarring from it. That scaring, permanent damage, or death can affect the families of the individuals as well as their communities in both small and large ways. I feel like many people cannot actually move forward without the communication and natural expression. Reconciliation helps both the survivors and perpetrators to deal with their fear, their mutual guilt (even if the guilt is different), as well as the anger and other emotions that has been closed inside their minds and body systems. From everything I have watched, read, and from the work that I have begun on my project, it seems like this is a crucial step for healing that many people are unable to get or participate in. If that could change for future genocide participants as well as those who are living today, I think that would be a really good step forward for not only those individuals, their families and their communities, but for all of us as a whole. This is not always possible. In the first world, people move more easily to other areas and perpetrators can more easily hide, especially if they have monetary resources. People who have fled tend to put down roots in new areas and do not tend to move back to their original places, especially when their property has been taken. However, I think that open communication with mediation and with the community remaining pretty intact is the best way to facilitate healing between all parties.

I also think that forgiveness is an important aspect of reconciliation that is not often addressed or is misunderstood. Some people believe that if you forgive your perpetrator, you have given them a 'free pass' or that their inappropriate actions no longer matter… i.e., justice is no longer important. Other individuals believe that if they forgive the person that they no longer remember or acknowledge the hurts and so they are stymied. Others are simply too angry and too hurt to be able to see what blessings they still have left; all they can see is their losses and what others (especially the perpetrators) still have. My understanding of forgiveness doesn't relieve the perpetrator or their guilt or crimes nor does it suggest that you totally forget the wrongs done to you. It doesn't require you to put yourself into unsafe situations with a perpetrator nor to focus on the loss and impermanence of the people and positions that we lose. I believe when we work on the process of forgiving, we do not do anything for anyone except for ourselves. We give ourselves permission to let go of the pain, to remember and recognize the past but not let it rule our current life and feelings. In essence, we release ourselves from the burden of the pain, anger, etc... and allows us to be able to feel the positive emotions of love and joy again in our life. Please understand, I recognize that forgiveness is really hard and the longer you wait and the more you feel you need to hold onto the 'bag' of experience, the harder it will be (if not impossible.) The model of reconciliation includes forgiveness in it and I think that is a very important but overlooked aspect that is important for people to be able to be able to really live and not just 'survive'. One last thought on this idea is that many of us find it challenging to forgive ourselves for our mistakes – far more difficult than we find it to forgive others. I think that a perpetrator needs to learn and work to forgive themselves. Denial, repression, shame, anger at oneself or even people who are too narcissistic rarely helps you or anyone around you and I feel like the perpetrator themselves is 'broken' until they are able to complete that process for themselves.

My last thought is that part of reconciliation in my mind is restitution. As many people mentioned in the documentary “As We Forgive” and in so many other resources and testimonies (and from my own personal experiences), service / restitution towards those we have harmed can help with healing and kind feelings for both the survivors and perpetrators. Survivors get a service that is needed and helps them to feel valued and important to the community they live in. Perpetrators get to serve someone they have harmed. Nothing they can do can replace or 'fix' what they have done, but the act of serving someone you have harmed changes the relationship between the two individuals. Over time as service is performed, a more positive relationship and feelings between the individuals are created and are able to grow. It helps people and communities to become more accepting of each other and their history and differences. Restitution brings us to the other side of the spectrum; the idea that something must be accepted that is not desired. For many people, seeing people, being around individuals who have harmed us is difficult. Why do people move away to other areas when they hurt someone? I suspect that it allows them to 'redefine' themselves and to 'start over'. Why do victims move away from the area of abuse or genocide? Some of the same ideas apply. However, I really feel that the model that Rwanda has given us is so valuable because it encompasses all three vital ideas of communication, restitution, and forgiveness that enables both individuals and groups to work together to recover and rebuild themselves, their families and their communities.

What do you think? Do you have a personal experience that you are willing to share?

pictures from: http://en.wikipedia.org/wiki/As_We_Forgive, http://www.catholicnewsagency.com/blog/radical-mercy-in-the-heart-of-rwanda/

The Experiences of Kevin Michaud working for the ICRC

This was one of the most interesting and painful lectures I have ever listened to. I decided to write about the conversation with Kevin Michaud and some of the things he said… because my mind has continued to dwell on it over the weekend no matter how much I try and focus on other thoughts. I will sit down to do or read something and I will find that my mind will be dragged back to the lecture or the responses to questions that Mr. Michaud made. I have found myself bouncing back and forth in my thoughts between phrases I hear echoing from his talk and then an image I get from different readings. I think the fact that my brain does that is a testimony to how some of the experiences in genocide are so universal and so similar and how our perceptions of them in our learnings are also colored by what we see, expect and filter through our own thoughts, biases and experiences. So for those of you who didn’t make it to the seminar, here are a few excepts from it and my thoughts on them….


"Bill Clinton told his staff to not use the word genocide because if they did he would be required to act."

I read something about this in some of the links for the Rwandan genocide as well as the textbook reading. I’m not even sure what to say about this. It feels a little bit like a boy in a sandbox with all the toys and the adults are his and he sees a child sitting by the side of the sandbox… and he tells everyone to ignore that child so he doesn’t have to share his toys, blessings, benefits, etc… Was President Clinton too busy having sex with his interns to pay attention to the fact that people were dying and suffering in large numbers? (That was a low blow, sorry) Clearly not as he realized it and actively worked on making sure he didn’t have to do anything. I don’t understand how someone can become so focused on getting the job of the US presidency and then want to hold onto it so much that many of the reasons that they wanted that position are no longer valid…. and they no longer do what they say they wanted to do. I can recognize that as an outsider who has never had the job that I do not understand the nuances and stressors that the job actually entails. However, as a human being I am still accountable for my decisions by others and if I have picked values and things that I believe are important… I should stick with them. It’s a tiring phrase, but “What is right is not always popular and what is popular is not always right” is really true. Maybe he wouldn’t have been elected again, but he would have done the right thing and isn’t that what we are all supposed to do. I am once again disappointed in my country and the men and the few women who run it. I am constantly told that I am so blessed to be an American… it appears that I am because I can have a few freedoms women in other countries do not and can over consume and be a little safer. I’m not sure that is a blessing if I look at the fact that I live and consume and pay for leaders who let others die for their own comfort and mine… The sad thing is that President Clinton deeply regrets his decision to not act in this case and around the same time, the American public was angry at him for responding in Somalia (which is the main reason he chose to not send the military into Rwanda. I guess it’s easy for me to suggest the right choices now. It’s just so sad though...


"Investigating mass graves – more than twenty years on I still smell them"

What a painful statement… that he ended up making a few times over the discussions on the different situations and genocides he responded to. One thing that I thought was interesting about this statement was I thought I knew the reasons for examining mass graves- body count discover missing individuals, possible autopsy for causes of death, etc… When Kevin mentioned that he did that with the Red Cross it made me wonder what the full motivations and reasons for doing that really are and if the fact that he can still ‘smell’ it is really worthwhile. I found that the task of figuring out all the reasons was really challenging from an internet perspective and only found variations on the same ideas I had: ‘ finding out what happened’, ‘discover the missing or ‘lost’, quelling speculation and questions as well as to restore the dignity of the victims themselves. One site was specific that opening up and examining mass graves ‘provides vital evidence for war crime prosecutions’ while other sites had the same sentiment that examining these places of death helps bring the perpetrators to justice. My question on that is why is a ‘neutral’ group doing any of that process- I can’t imagine that looks neutral and I wondered if at least that particular trauma could be spared from people in these groups like the Red Cross….? So that is an idea that I need more information on and I am sorry that he had to deal with those images and smells along with the other things he did.


"I saw it… I still live it…. I’m broken"

This really hurt to hear and he repeated parts of it over and over again. It made me wonder if things might have been different for him if he had more breaks and more support between assignments and if they changed the assignments so that certain aspects of the job were held by different individuals allowing a little more sheltering of the one person on top. In some cases, I would see that as a bad thing, but in cases like this, I wonder if it would help protect the resiliency of the volunteers and those who give so much to it. Dealing with hatred and the consequences of it over and over and feeling beaten by it constantly is a process that cannot help by cause people to feel broken, to feel like the pain and trouble is so big that it overflows them and they can no longer be a whole person. Maybe that is one reason that I believe in reconciliation so much… I want people to be able to be whole. And maybe I feel so strongly because I want that for myself. I could never do his work… I wish that I could. A part of me has always wanted to help people, but when I try I feel like I not only haven’t made a difference, I have only hurt myself. When he was talking, I thought of a practice of repairing broken objects by the Japanese called Kintsukuroi. I don’t know much about it, but I have a picture of a vase on my wall that was repaired by it. The vase has several breaks in it- some that are from the top to the bottom- and it has been repaired by using precious metals like gold. It is no longer valuable only as a vase and something to look at but as something that retains both of its original attributes but now has value as something that has survived something bad and is more valuable and beautiful for it. I wonder how Kevin and those around him can help him heal and see the parts of him that haven’t healed in a twisted, ugly scar… but are healing into parts that are beautiful and more valuable than the original. Something that caused pain (and may still) but can also be cherished as a new part of the person. Maybe that is easy for me to say because I haven’t had his experiences and I probably will not, but that was what was in my mind as he spoke and I wished I had even a small way to help him fill the cracks with gold and things that make him feel more cherished and valued for his experiences and less ‘broken’.


"Some people are alive today because of what we did… the difference in the lives of a few people."


I am still torn from my research about whether Aid agencies are really helpful in the long term scheme of things. However, what I am sure of is that human beings have caused war as long as they have existed and some suggest even before we were ‘fully’ Homo sapiens. So even if the criticisms of NGO’s keeping wars going on longer is true, I’m not sure that we can give them full blame for the beginning of conflicts. And I do imagine that in the thick of it, he did help people survive who would have had no chance. Thinking about the man, walking down the beach and throwing starfish back into the seas… ‘What I do matters to this one.’ And that is good and right. In his place, I hope I would do the same thing.

I am so grateful for the experience to listen to him and to hear about his experiences. I hope he continues to find fulfilling things in his life and can feel less 'broken' over time. A good man.


pictures from: http://voiceseducation.org/content/rwanda-poetry-genocide, http://nehandaradio.com/2011/04/06/mass-grave-bodies-must-be-exhumed-by-forensic-experts/, https://www.pinterest.com/valerieglerum/11-scars-cuts-and-bruises/,

Journey Forth #5 : Causes of Poorly Responsive Celiac Disease

For the majority of individuals with celiac disease on a strict gluten free diet, their intestines will, over time, heal and they will not feel pain or have to deal with many of the challenges that can be caused by the disorder. However, there is a small percentage of individuals with the disorder in whom the body and its ability to heal is either blunted or unable to function. This is sometimes known as poorly responsive celiac disease. There are a few situations that can continue to either cause the damage, keep the body from healing in a timely or appropriate matter, or even continuing some of the symptoms due to other physical malfunctions. The known reasons for these continued difficulties are:

1. Continuing gluten ingestion – In case many people haven't noticed, gluten seems to be in everything! So it can be very challenging to make sure that everything consumed is gluten free. To make that more challenging, affected individuals must be introspective and know themselves and their habits well. So, for those who wear lip gloss, lipstick, etc...that must also be gluten free. If you tend to suck on the ends of your hair... it might be a good idea to now what is in your shampoo. Eye drops and other medications can have systemic interactions and therefore can cause damage... even if it was just one drop into an eye. Hands contaminated with gluten and then used to chew nails, etc... can also cause a small exposure. And as mentioned in an earlier post, any exposure no matter how small is dangerous and can cause damage.

2. Refractory celiac disease (refractory sprue) – Approximately 5% of patients can end up with this diagnosis and it reflects the body's inability to heal from the damage caused by the past gluten ingestion. Any future exposure will continue to cause damage while past damage remains... leaving the individuals digestive system crippled and unable to perform its necessary duties with any efficiency at all. More energy is used to digest and important nutrients are less able to be digested even with the expense of the added energy. These individuals tend to struggle for the rest of their lives trying to improve their digestion and health and may take supplements and medicine to try and help the body not only digest but continue to function in a positive way by providing missing needed nutrients.

3. Pancreatic insufficiency - For some patients, their ability to appropriately digest food can be hampered due to the lack of needed enzymes.

4. Small intestinal bacterial overgrowth - This is actually a fairly common problem that can happen alongside the damage in the intestines, but doesn't necessarily repair itself when the intestinal walls themselves are starting to recover. In this instance, the bacterial balance in the small intestine changes in two ways -first, the bacteria in the small intestine changes form and becomes more like the bacteria in the colon (which is pretty different.) Secondly, this abnormal bacteria tends to grow faster in the small intestine so that there is simply too much of it around.

5. Undiagnosed sister disease – some patients do not get better very quickly for the simple reason that celiac disease wasn't the whole answer. So many patients as they begin the gluten free diet and continue to have symptomology and difficulty after several months discover that they also have a concurring digestive disorder. The most common of these are microscopic colitis, Crohn's disease and ulcerative colitis.

6. Casein ingestion – Some people find that their symptoms do not clear up until they stop consuming Casein as well. Casein is the protein found in almost all dairy products such as milk, yogurt, cheese, ice cream, etc... even breast milk. This reaction is not well studied or proven and is listed here because it is being studied and discussed among researchers, doctors, and patients. I have found for myself that, because the gluten protein is similarly built to the casein protein, I do have more problems for the first few months after a gluten exposure if I continue to eat dairy in large quantities... Bug has found the same thing. That is just my experience however. I'll discuss the theory more in another post. :)

In my case, I have been told that I do probably have refractory sprue. I have not been healing well and even a small exposure can really mess me up for months. Even without exposures, my digestion is not improving a lot. I can have what appears to be random pain that comes and goes and is fairly consistent over months. I have discolored patches of skin causes by the digestion issues in a few areas. As soon as I have insurance, my physician is planning on another upper endoscopy with biopsies to check on the healing process.... or lack there of. I won't deny I am not looking forward to it.

What are your thoughts? Experiences... please share. :)

Journey Forth #1 : What is Celiac Disease and its Common Symptoms

So, what is celiac disease... also known as celiac sprue, non-tropical sprue and gluten sensitive enteropathy? The easiest definition is that it is an genetic autoimmune disorder which is caused by the body's hyper response to gluten in its system. When gluten is ingested and the patient is exposed, the proteins cause the immune system to produce antibodies (transglutaminase or tTG) that cause damage to the intestinal system- mostly to the small intestinal villi. At a minimum, the small intestines are damaged and they can no longer fully aid in digestion and nutrient absorption. So no matter how much the individual eats, they will be unable to get the nutrients needed from their food... or even supplements, causing many of the symptoms that characterize the disorder. And in severe cases, the intestines develop small holes which can cause leakage into the other areas of the body. It affects on average 1 in 100 people around the world and it is estimated that in America alone, over two million people are currently undiagnosed leaving themselves open to serious long term health consequences. Some doctors suggest that celiac disease is primarily a nearological disease and that the intestinal damage itself is a symptom... and not just a 'cause'.

The list of common symptoms is actually quite long... this post would probably be a page longer if I described all the symptoms that have been attributed to celiac sprue. No patient will have all of these symptoms (at least I hope not!) and many will only have a few of them. However, no matter how you look at it, these symptoms cover more than just the digestive system which explains why this disorder affects the individual in almost all aspects of their life.

Abdominal pain and cramps
ADHD - like behavior
Anxiety, depression and 'foggy mind'
Bloating and gas
Bone and joint pain
Canker sores
Chronic fatigue, sometimes 'knock out' sleep
Constipation or diarrhea
Emotional challenges including anger and irritability
Headaches and migraines
Missed menstrual periods, infertility and miscarriages
Nausea / vomiting
Restless leg syndrome
Rheumatoid arthritis
Tingling in the extremities

In some ways, I am very typical. I have struggled with canker sores since my childhood and have thrown up at least once a day since the age of sixteen until a few months after diagnosis and the subsequent dietary changes. One thing about the vomiting is that the abdominal pain would lessen or disappear after throwing up... a blessing in the yuck. :) I can sometimes struggle with depression, but most of the time my major emotional changes focus around anxiety and irritability. I have been told several times I am infertile (Bug is the best miracle I have ever received!) and I have never had a regular cycle until about a year after dietary changes. I have struggled with headaches, random abdominal pain and sometimes I wake up because my legs are shifting and 'twitching' while I'm resting. I also tend to feel tired all the time and sleep is something that I am not very successful with as often as I would like.

There is only one treatment for celiac disorder that is effective and allows the individual to lead a relatively healthy, normal life. The patient must adhere to a strict diet that is free from gluten and its proteins. Even the smallest amount of gluten, such as crumbs from wheat toast or a smidgeon of regular soy sauce can cause the unwanted immune response. Also, those individuals who are most sensitive can get an exposure not just from eating gluten, but from breathing it in or getting gluten into sores and other openings in the skin. And while it takes only a short amount of time for the damage to start, it takes weeks and even months for the healing to be effective enough for digestion to get back to a decent absorption rate. And for some, they may never recover fully due to the extensive damage done to the intestinal walls and villi. Depending on how long it took the patient to be diagnosed and to change their diet and lifestyle, there could be only small amounts of damage... or years worth of serious impairment and harm. In my case, when I was diagnosed with the disorder with the usual endoscopy and the unusual over forty biopsies, I was over thirty years old and the damage was pretty bad. My physician said that my stomach and the first several feet of small intestine looked like shattered and splintered glass. The pictures I've seen are quite horrifying and when I look at them and try to imagine what I see 'inside' me it's challenging. It's not difficult to understand why I tend to feel so much pain though. :)

There is a big difference between celiac disease and gluten sensitivity although it is not as easily seen. The big difference is that people with gluten sensitivity have the majority of the symptoms, but they do not have the intestinal damage as part of the package- the autoimmune part isn't their burden. Don't get me wrong- their bodies sensitivity to gluten is still uncomfortable and probably many other descriptive words. But the immune system doesn’t try to tear apart the body and that my friends, it a wonderful thing! How a person is diagnosed is quite simple. If you have the problems with gluten, but have no antibodies in your blood and a clean endoscopy.... then you are simply gluten sensitive. (Living it isn’t quite that simple, but I digress.)

So here is the first part of the journey! Next up I'll write about the a few of the less common problems – such as skin trouble as well as appropriate food and items to avoid. Thoughts...?

Ethical Concerns for Providers when Dealing with Refugee Populations

There is no doubt that mental health professionals and other service providers can help alleviate the effects of trauma, torture and other crimes that are perpetrated against people and communities due to circumstances, religion, war, etc... Throughout this class, I have learned quite a bit about the consequences to both individuals and groups based on trauma/ torture and have even broadened my views of how those terms should be defined. Between therapies that are individualized or set up for groups (such as a family, community or people with the same traumas and problems in common) and interactions that attempt to alleviate suffering through the use of medical training, pharmaceuticals, neurobiological or cognitive therapies, etc... Many groups and professional have been focused on – and continue to try- to help victims and the society as a whole heal, develop techniques for survival and daily care, as well as trying to improve the quality of health and life of those affected. However, there can be challenges as well as ethical problems that the mental health / medical provider can face in these situations.

One challenge can come in the form of using pharmaceuticals to help the patient deal with some of the symptoms that cause difficulty in their lives. While studies do suggest that medication makes a bigger impact on an individual's symptoms, the issue is not that black and white. How the patient and/or their family feels about medical care in general (or mental health medication specifically) has an effect on how the medication is used and therefore, how successful it can be. An individual's culture may also weigh into the decision to use medical treatments/ medicine of any kind. And how the services are provided might also affect the utilization of those services. Language, economics, and other barriers can cause misunderstandings and challenges as well. A perfect example of this problem can be found in the book, “The Spirit Catches You and You Fall Down” written by Anne Fadiman. An amazing and very sad biography.

Another thing that is very important for the provider to acknowledge and understand is that the trauma itself may be what the provider wishes to treat and focus on... but the provider is still treating a person. An individual with different perceptions, biases, experiences and other ways of seeing and moving through the world. And so while trying to treat the troublesome symptoms of the past trauma, it is imperative that the person being treated isn't seen in the narrow sense as a label or a diagnosis. The patient needs to be viewed and looked at in the 'prism' of their views and life... so recommendations and therapies need to be available to the patient in a way that fits their current set of circumstance and needs. I thought of an experience in my life when I had a few sick animals who lived with me and my family in a one room yurt. The vet said that one cat needed to be fed a special food, another cat needed a different special food and the other cats couldn't eat either food. When I mentioned that I lived in one room, I was told to deal with it. I did figure out a solution that worked, but it took a while and I didn't use the resources that had been offered nor have I been back to that clinic. I probably would have felt differently and used the resources offered if the provider had made them seem possible. Just a thought on that topic.... So making sure that the resources used are more helpful than stressful and really address the 'whole person' are needed. That takes more time and energy as well as an understanding of an an attempt to put your own biases, etc... aside. That is a bit difficult to do for most of us. :) Also making sure that the resources are available to use in a way that works for the client makes them more likely to be utilized and more likely to help the patient with lasting change in their lives... which is the goal!

Another important element – which I touched on in the last paragraph is to make sure that a thorough understand of the person and their culture are attained. By understanding what is important to the individual and what they use to not only make decisions but base most of what is important in their life on.... the suggestions and recommendations that are given by the mental health providers are more likely to not only be followed but misunderstandings are more likely to be caught quickly and early in the process. That helps develop the trust relationship between the provider and the patient as well as help the patient to work harder to help themselves because not only does it matter to them as individuals, the provider has shown that it matter to them too. (Aren't we all more likely to accomplish our goals when we have a friendly goal 'buddy'?) So by having decent understanding of the background and viewpoint of the patient, the service providers can make fewer but more meaningful referrals and help keep the patient on task. An example is not suggesting a patient with PTSD have an occasional drink to relax but maybe a cookie or a walk with a friend instead. If the culture sees nightmares and terrors as a curse from God that must be overcome.... then they are much less likely to take the Ambien to sleep nor will their family encourage them to do so. Telling an individual to eat pork or stop smoking for their health when smoking is part of their religious practices or the eating of pork is against their beliefs will either cause total noncompliance or partial uncompliance as the patient will only do it when they feel pressed to do so or have another compelling reason to do so. It is important that the clinician recognizes what his values are and recognize when he is potentially pushing values and cultural norms on the patient and not actual treatment. I know those examples are not mental health related, but I thought they did help me make the point I was attempting to make. :)

Another thing that it is imperative that mental health providers think about when dealing with challenged and refugee populations is to follow the information and tools that have work in the past as evidenced by studies and their own observations and life experience, but to also recognize that the current work that is being done can give good insights into potential therapies simply because if it appears to be currently working, with so few good studies out there.... if every is in agreement to try something new... that has the potential to help victims now as well as future populations. This kind of flexibility to look outside the box but also to be cautious and thoughtful about trying therapies that haven't had a lot of use and study is a challenging but needed trait in these providers. It is also this flexibility that allows the clinician to look at the individual in a well rounded way, and not just the way that they have been taught to see certain symptoms or mental distress.

Lastly, it is important that the clinician recognize and maintain clear boundaries between themselves and their patients so that both parties can work together for improvement and satisfaction. When the boundaries are loosened, both parties may find it very challenging to continue to work together and to work towards progress in the manner that was possible when the division between the two was clearly laid out. Providing services that also allow the individual to have privacy not only from strangers who do not have a legitimate need to know their information, but also family can also help the patient by making things clearer and less likely to be misunderstood through another person's biases and thoughts mixing into the mix. An example could be when the parties involved have a language barrier – a translator from outside the patients inner circle may make a different translation that a family member or a friend who may interpret what the patient is saying or needs based on what they think the patient needs... not quite the same thing. This kind of translation can also compromise a patient's need and right for confidentiality making services more challenging for them to get and undermining the trust needed between the patient and the provider. The provider must also to make sure to care for and recognize problems that may crop up with themselves from working with this population and take care to not allow themselves to become burned out or harmed in the process of helping others... which can cause them to be unable to continue to help or even to cause more trauma to the patient.

To be a provider to such a challenged population comes with both risks and rewards for the clinician and the patients. Understanding the important ethical concerns that should be addressed can help everyone involved do a better job, be safer, and to help people gain more resiliency and a better quality of life through the therapies. What more can we ask for? :)

The New Friend

It has been approximately two months since I gained a new housemate...namely a new cat! How she joined my quirky entourage is a funny and frankly lucky story, but it feels sufficient for me to say that I came home from church on a blissful and restful Sabbath afternoon and in less than an hour, my day had changed. An impulsive move and a lot of luck... brought a filthy, scrawny ball of energy that was soon hiding under my bed. And like my other three 'strays', she would hiss lightly when I lifted up the end of the futon. It was a funny image to see four cats in a line- three hissing and then Morianna sitting quietly and realizing that at least in this instance, the same mutual concerns of fear and and the unknown were able to allow a new, unknown cat to merge into my small herd with no fuss or territorial squabbling. In fact, you would think they had never known a time without each other. It was pretty amazing to witness and so I could begin to focus on the immediate needs- a bath was really essential as well as potential worming and flea removal and all that sort of thing.

So the next day, I began. After a trip to the pet store after my shift I began the semi arduous and struggling task of corralling the new member and bathing her. I named her Bellatrix – she reminded me of a character in the Harry Potter series, Bellatrix Lestrange, due to the amount of dirt, frizzy hair and the snarl marring her otherwise beautiful face. With a good friend, I managed to clean her without drowning us both and without a large loss of blood on my end. The amount of hair that came tumbling and shedding off into the tub was an amount significantly large enough that when pressed together, it resembled a small guinea pig. However, within a few days, Ms. Bella was eating, purring and quickly became an irreplaceable part of my household. Taking her cue from Morianna, I would find her waiting near the door when I arrived home or running cheerfully towards it to greet me. Treats given from my hand soon encouraged some good closeness and as her weight became more acceptable her fur began to shine and she began to use her new found energy more productively. (She is still too skinny, but she feels more 'solid' now; when I first picked her up she felt like skin wrapped around bird bones... totally light and easily breakable.) A trip to my favorite vet with shots and wormer and she is as good as 'new'... and she has been rechristened Bella as she no longer reminds me of that dark character in the least. Her clear relief at easy food and safety has really come out as she follows me everywhere and guides even my two most stubborn strays to do the same. Her physical beauty and her deep inner joy began to trickle out and now flood into the home environment and I feel her contentment when I come home. It's just a great experience everyday. Today she is at the veterinarian getting spayed and ready to hopefully have a good long life with me. I will truly miss her tonight.

So, I think its official. I am now a 'crazy old cat lady'. The fact that I also own a hamster only puts an even more interesting spin on the funny stereotype, doesn't it? But I feel content and happy. I love coming home to be greeted by two, maybe three friends and I find a little exasperation, but mostly joy in getting covered in cat hair with beautiful, purring sweeties rubbing on my legs and sitting on my lap and bed when I settle. Reading the scriptures next to a purring cat is wonderful for a few reasons. The soft comforting sound helps clear my mind for reading and real study. While doing this I have found that I focus longer as I am pulled in and I find that I don't want to end the moment. That time of peace and comfort has been getting longer as it has become not just something I have been told to do, but something I look forward to throughout my day. When I get home, I see an exciting and happy time about to open... and not the dark lonely nights that I used to feel. (I won't pretend that those nights are all gone, but they feel fewer and far between.) What a beautiful and wonderful gift! I am very grateful. :)

Alone No More....

I had an interesting, painful experience at church last Sunday. It has taken me a few days to really process it and to understand this profound experience and how to complete my grief process to a peaceful acceptance. I once shared a really painful and challenging post on a different blog site about some of my previous experiences at church. And at that time, for the first time in a long time, I felt some support and a feeling of relief. I had so much emotion and pain bundled into my body and my heart and sharing some of the grief and challenges felt so releasing. I thought that in that experience I might have removed some of the pain- to puncture the bubble of figurative pus and then clean and bandage the wound so healing would occur. I now realize that was only a start, and not actually an experience that brought me near the end of my journey.

I have been enjoying Sacrament meeting so much lately. After years of being unable to really hear it, I take great comfort in being able to sit with paper and pen and just listen. I try and take notes on the things that strike me in the talks and later I usually head back to the apartment and reread and ponder the things that I have learned after a visit from Bug . I have also had the wonderful opportunity to help new friends with their children and so I can sit and rock with a beautiful spirit snuggled into my lap while we color or draw and sit and work on reverence. It is something that I enjoy so much and I look forward to every week. Sometimes, I will be surrounded by so many beautiful children that I can't take any notes, but I feel the spirit and I do feel spiritually fed. I so look forward to those meetings and the peace that I feel.

Yesterday was fast Sunday. I came to church a bit disheveled and very tired so I sorta knew that being or feeling spiritual would be harder for me. Within a few minutes of sitting down as we were singing the opening hymn I saw Ian out of the corner of my eye. When I looked over at him, he waved and slowly came over to sit with me. And so I spent Sacrament meeting with Ian sitting next to me watching him draw and quietly encouraging him to listen. It was a relatively normal Sabbath meeting for me... until the last testimony.

At that time, Ian had climbed right up onto my lap and was quietly sucking on his thumb while I slowly rocked him back and forth. Sister Erickson started talking about our ward family and how much it means to her. And as I listened, I slowly came to the realization that I feel a part of this family. For the very first time in my life, I truly feel like I have a real, supportive church family... a group that loves me and I belong to. And, as I rocked back and forth, I saw the past image of me standing in the back of the room. Standing all alone with my son in my arms or one my shoulders. Just alone. Feeling blocked off and alone and not able to fit in. Wishing for help, wanting help, begging and needed a friend and having no one. Just standing and wishing that I too could sit with everyone. And now I have it, but I don't have my son. I can't sit with him or hold him and that opportunity I lost forever. And without meaning to, I found myself rocking Ian and quietly sobbing like my heart was broken. I felt so alone and sad and just unable to stop rocking and crying. I just pulled Ian closer who seemed to enjoy it and he continued to smile and look at me as I sobbed. The testimony ended and the group started sing the hymn “Because I Have Been Given Much” and as I listened to the words I felt this pulling of gratitude for what I do have, but at that moment I felt so hurt and alone. I missed my son, my life, my loved ones, my siblings who are so far away and I didn't feel like I could move for the pain of it all. A moment later, I felt a person sit next to me and put their arm around me. For a brief moment, it felt like the Savior holding me and I heard the voice of Spencer W. Kimball saying “God does watch over us and does notice us, but it is usually through someone else that he meets our needs.” As people continued to sing, I sat and felt so loved and not alone at all. Even though I was in the back of the chapel and this brother had been sitting in the front, he felt prompted to notice and come help me... to hold me.... to remind me of Heavenly Father's pure love for me and soon I was able to sing the words as well.... “I shall give love to those in need; I'll show that love by word and deed: Thus shall my thanks be thanks indeed....”

I know it to be true from the very bottom of my heart. I am not alone any more.