Snow Day

It's been a nice quiet day watching the snow and sleet come down. It's still beautiful outside... although I suspect I feel that way because I haven't been out in any of it. I've just watched from my windows. I've got to enjoy some sewing, some self care and lots of cat fun. Listening to purring cats makes the day wonderful. Lots to feel grateful for today. I hope all of my friends are warm and snug and cared for. Love to all.

Forced Rest

I'm a bit tired and wrung out today... a bone deep exhaustion that I am struggling to deal with. I need to rest this weekend so that I have the strength to work all next week and even the thought of moving my body right now seems so painful that I have been sitting and reading or watching films for the majority of the afternoon... except when I have napped. I worry that I am letting my friends and my co-workers down with my inability to continue to push myself in ways that I could in the past, but am unable to do now for long periods of time. I feel like I'm letting myself down too. This problem is something that I think I am going to learn to accept

it and stop being so hard on myself for it. I am trying to look at the positive side of the health problem; I have been able to take the time to read and watch some movies which I rarely have taken time to do in years. Some of the films that I have watched recently I have held onto for years to watch when I had the time. I am slowly winnowing through those piles of films including the massive collection that my Uncle Rick gave me years ago in a large stack. Because of that gift, I am enjoying films that I would never have gone out of my way to see if he hadn't given them to me. (Don't get me wrong- there are some serious duds in the collection, but I have found a few gems. And this package used to be full to the top... it was an amazing gift.)

So today and tomorrow I will rest and see what energy I can pull up out of the recesses of my muscles for the week and what will be will be. I am grateful for the day of rest that I have and a day to spend with family.

Self Care.... Filled with Hormones

I have been struggling this semester. I think there are a few reasons including feeling a lot less motivation with the loss of my grandpa, work health problems... the usual suspects. I tried to work on some homework but I seem to be unable to concentrate on either history nor interdisciplinary studies so I found myself roaming my shelves for something to read. I have agreed to try and take some time for self care- I'm quite terrible at it and I am working to do a little better- and I have decided that some of my self care should include stretching and fun reading. My eyes slid down the rows of books and then stopped on my nutrition textbook. I have never been willing to get rid of it because I sometimes find myself using it as a resource for trying to understand comments from my doctor better or even as a resource for a history paper. So, amusingly enough I hauled it to the couch (We can't say I picked it up because it's huge) for a bit of 'light, restful reading. I found myself quite frustrated by the reading so please take that in mind when I discuss my thoughts below... I guess it wasn't very restful reading.

I entered this chapter with little knowledge about hormones and how they affect the average person’s body, and by extension, my own. I have listened to doctors chatting about my hormones to my parents from about the age of 14 onward. In almost every doctor’s appointment that I attend as well as incidental evidence in my own life, my hormones are in control of me… and not me of them. I see menstruation and the whole process of hormones in a very negative light. As early as 18 years old I wanted to get a hysterectomy to try and end at least part of the process. The only thing that has stopped me from a hysterectomy is money... and if I was offered the opportunity to have it done tomorrow and have it paid for...I would not hesitate at all. As mentioned in the text, some of the societal and cultural ideas around menstruation are definitely alive in my mind for I too believe that I am filthier and more disgusting during the time of my menstruation and I want to avoid people and try to do anything I can to hide it. I don't talk about it much and I used to go to great lengths to hide any evidence including sanitary supplies from any one in my home- I even used to hide it from my husband when I was married... which was challenging and sure looks foolish from where I stand now. The way I think sure has changed... as evidenced that I am try to talk about it here. I found myself a bit bemused to read the words on the pages in front of me such as “One Indian phrase for menstruation is the flower growing in the house of the god of love” and “when researchers looked for positive changes in the premenstrual phase, they can find those as well." I haven't found those yet I guess.

The chapter listed a lot of research on women's health as well as hormones and sexuality. I suspect that the reason there appears to be so much research focused towards these topics is that hormonal changes are seen as an overall negative in quality of life for the majority of women. As Americans live in a fairly patriarchal society and women are not seen or treated in many cases as equal to men, focusing on the differences- and perceived negative differences- makes perfect sense. In general, if we look for the bad over the good that is what we will find. As a history buff, the discussion of women, women’s health, and sexuality have been seen in a negative light throughout many cultures and ages in time. The text also mentions that religion can also play a role in how hormonal changes, menstruation and reproductive activities are viewed and treated. It seems clear to me that many cultures and religions view the unique actions of women's bodies as problematic and use social pressure to control these actions, using members of both genders to create and reinforce this pressure. Another thing that most people who practice medicine have noticed that wasn’t mentioned in the text is that there is gender bias when it comes to many serious problems such as pain, heart attack, etc. How a person is treated when experiencing these disorders can vary widely based on the gender of the person experiencing them and that bias tends to create more negative outcomes for women than for men. What these facts and ideas say about our culture are not great. If the perspectives and biases in our culture and society tend to be more negative towards women, their health and potential in our society, it shouldn’t come as a shock that more studies are focused on the negative aspects of women and their health when research is being discussed, funded, and developed. If society sees men unconsciously as physically better and less hormonal as the male gender has no outward appearance of hormonal changes as stated in the text, then it also makes sense that research is much less likely to turn its focus toward men. Research in general tends to start with the spark of an idea on how something works, an idea of how to change something, or even how to fix a problem or perceived difficulty. If a culture in general is unable to recognize that men’s hormonal cycles exist or that they are important, no funding or time is going to be focused on that as it will be seen as waste of time and resources. I think that creates difficulty for both genders as men’s health and experience is ignored or undervalued so that problems are not recognized and potentially helped and women find that that their health and the study of their health is focused more on the negative aspects of it – or perceived negative aspects- and less on the positive traits and aspects of the health differences.

If more research was focused towards men and their health as well as hormonal cycles, I believe that we could gain knowledge that could be quite beneficial for men and the health problems that occur for them. However, it must be acknowledged that the majority of all medical research is focused on men- just not hormonal research- and it is vital to start including women in these processes. Excuses for leaving women out of health studies include the perceived 'variability' of their hormone cycle and the 'uniqueness' of the female body's functions... which feels a bit like a cope out. After all, the majority of all of our bodies- male and female- work and respond the same in similar circumstances.

I am not sure that reading this was really good self care or if I found myself distracted and worked up about something that really isn't super relevant to my life right now. But I found a few things that I was interested in researching at some point. I wonder how much of my health problems is based on some of the external influences the text mentioned. Do I feel more pain because of hormonal changes or because I feel like I ‘should’? Do I feel dirty and awful because of my sensory disorders which cause challenges with the physical sensations… or do I feel that way because I have been taught/ influenced to feel that way? Are the mental symptoms of confusion and personality ‘changes’ really a part of the hormonal changes, part of what I expect to happen, or pieces of both intertwined in the perspective and package of me? Certainly interesting questions to ponder this evening. Although the ponder must end soon as the guys are headed over. :D

What are your thoughts?

One Week In....

Well, I have been without an official job for about a week and I am so glad to say that many aspects of my health are starting to improve, but also a little annoyed that I haven't accomplished more in the time that I have had. Granted, I have accomplished alot including some cover letters, an unpaid internship for class, house cleaning, CBT's for re-certifications, a math exam, etc... it just doesn't feel like enough actually. So I think I need to accept that as long as I am trying I am really doing OK. Maybe, all of us need to recognize that we are doing the best we can and cut ourselves some slack... and just pet some kitties. Food for thought. :)

The Balance Gap

There is no way to really put this except for just being blunt. I have managed to over the last few weeks to lose the balance that I had managed to attain in my life and schedule. (I guess that’s not too bad for a New Year’s resolution is it… ;) So I found myself last night so exhausted and looking over my rapidly growing list of ‘need to do’ as well as adding work and CPR classes around my full time job … well, even that sentence seems to point out the lack of unplanned time. No wonder I am falling behind on so many things! I was reminded that I had lost my balance a few weeks ago, but I have found it challenging to try and change the pattern quickly. Trying to work on rebuilding my nest egg as well as continuing to pay down bills and of course pay the daily expenses has been a bit draining. I am also getting ready to buy a plane ticket to Utah to see my grandfather and they do not tend to be cheap either- although seeing Grandpa Carlile is priceless and well worth the money! So I have managed to lose my balance again as I have let everything creep up on me.

The good thing is that I am starting to actually recognize the problem and so my body is less likely to break down and collapse for long periods of time. As I have come to start and recognize the symptoms and how my body tends to react I have found myself developing coping mechanism and I have managed over the last few years to be willing to give myself permission to just rest… no matter how big the list is of things that need to be completed. I feel a little lazy when I do it, but I have found that I am able to use the rest of the time more productively and I appear to be able to feel healthier for longer periods of time. As finding an even path in my life is challenging and has always been so, the fact that I have clearly worked hard enough to make some serious inroads into my impulsiveness and ‘overdoing’ is wonderful. I’m clearly not perfect, but…… I’m still trying!

What are some of the things that you do to keep your life on a fairly predictable even keel? To help keep your focus and needs in the forefront of your actions? Did they come naturally to you or are they skills you have developed over your lifetime?

2014 Poetry Corner # 2 - "Meditation" (a haiku)

slow, breathe in, focus
on you, your needs, your feelings
understand yourself

2013 Poetry Corner #9 - "Night Swimming"

A click and the darkness flows
quickly to fill all space
cool sheets press against my cheek
arms flayed, spread out
feet dangling in the air

a slight breeze moves the air
leaving ripples of breath and hair
floating, gliding, sinking in the deep
and even though my physical sense hasn't moved
hasn't budged, hasn't twitched

I sense the waves of exhaustion flow in
the riptide of need to rest, to forget, to lessen
A whirlpool of darkness, soft voices and purring
And you sink down, down into the abyss
the light patterns on your lids begin to fade
from white to green and blue
and suddenly you're gone and only spiritual remains

The tide flows by and pulls you in.....
… the hamster on the wheel
… the fears of your heart
… the images of film explored
… the joy of memories relived
… the revelation of things to come
together they flow, merge and tug your mind

As they merge, your breathing slows
yet your mind is full of visions
sometimes you backstroke and float unaided
and sometimes your fears win

Suddenly, the blue turns light
the darkness quickly fading
the movies gone, the images dissolve
only the emotions remain, dripping off
My eyes crash open, appendages start to twitch
consciousness and self break free

A stretch, a yawn... and the images are gone
A day of possibilities beyond
and yet I smile and think of evening
for the joys of night swimming

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? :)

Aaack! Aaack!

In the past, I have found myself really busy and struggling to juggle all the 'needs' and how to meet and accomplish all of them. Juggling Bug and appointments and the household and the spouse was barely doable – no surprise that my health became really poor as taking care of myself wasn't in my list of priorities. With the other family changes in my life, I have been able to make caring for myself a great priority and my health has improved a lot. Gluten is still a huge issue for me – sometimes I feel like the world is made of wheat and so I can't touch anything or go anywhere.

I'm back in a little bit of a crunch time again. After I was laid off in August, I have continued to look for work and I am still enrolled and completing three college classes. In September, I accepted a 'temporary / part time' job which was supposed to last three weeks and I would either have full time or nothing. I have been working almost forty hours a week at around minimum wage since that time. The company that I am working for is now suggesting that they may keep everyone at relatively low hours, wages, and 'temporary' positioning through December. So I'm hanging in there in the hopes of full time because I have the potential to make a lot more. But I would be lying if I didn't say that I feel the weight of the work that I am trying to accomplish. Working full time, doing school work full time, continuing to look for work and trying to fulfill my church, family and personal responsibilities... well, I feel really pushed and rushed around. (I'm also in the middle of moving as well.) I haven't been taking care of myself as well as I could and my sleep has been problematic again. It's like my brain can't shut off and is constantly continuing to try and rearrange and figure out how I am going to get it all done. So I will wake up after a few hours and my brain is already 'running' as I wake up. And it has to run for a bit before I can sleep again. So part of my brain will continue the list, rearrange it, or add more to it... while another part of my head is quietly swearing and imaging sleep. So I'm making lists, thinking 'Ack', and trying to image my mind into dreams. I will admit it's not working well. ; )

So over the last few weeks I have been trying something new... and its working! A few weeks ago, many of you know that I adopted two almost grown kittens who needed a home quickly... or they wouldn't have been around for one! So even though I didn't need any more cats... didn't want any more cats... I have two more cats! And they are such a blessing. We have a race to the door when I come home and a race to bed when I am getting ready to head there. I have purring and snuggling during scripture study and I am sleeping so much better. It's funny because I am still behind on so much but I don't feel nearly as stressed about it now. It's just a wonderful thing. Sleep, I took you for granted when I was younger.... I don't anymore. So I am grateful for my new pals and the other blessings in my life. They mean a lot to me!

What new blessings do you have in your life? :)

The Basic 'Daily Recommended Intake' Stats :)

So, as part of my new health and 'rebuild' me regime set up by my doctor a few weeks ago, I have been doing some more research on a few things. Instead of just focusing on the boring (and semi selfish) idea of how much my intake is... then subtract the percentage that was most likely not digested spending on what kind of food it was in... then determining how much more to eat, etc... I have also been trying to sort of learn in my head what foods do have what in them and then multiplying numbers of how many to eat and how to mix them up so I can actually eat a little less. Part of that is to keep the vomiting down and another is to make his whole exercise more of an idea and not so much of what it felt like which was a horrible chore (and one that in some moments, just didn't really feel worthwhile completing) So I have been completing silly games and for your enjoyment... or perhaps your boredom... here are some of the very basic numbers for everyone in their daily recommended intake.

Daily Recommended Intake

Fat 65 grams
Sat Fat 20 grams
Cholesterol 300 mg
Sodium 2400 mg
Potassium 3500 mg
Carbohydrates 300mg
Fiber 25 grams
Protein 50 grams
Vt A 900 ug
Vit B-6 2 mg
Vit B-12 6 ug
Vit C 90 mg
Vitamin D 400 iu
Vit E 30 ug
Vitamin K 80 ug
Biotin 300 ug
Chloride 3400 mg
Calcium 1300 mg
Chromium 120 ug
Copper 2 mg
Folate 400 ug
Iodine 150 mg
Iron 18 mg
Magnesium 400 mg
Manganese 400 mg
Molybdenum 75 ug
Niacin 20 mg
Panthothenic Acid 10 mg
Phosphorus 1000 mg
Riboflavin 1.7 mg
Selenium 70 ug
Thiamin 1.5 mg
Zinc 15 mg

Please feel free to suggest changes or additions to this list if you have information that I do not have and any ideas on if this is helpful to you. It seemed like a nice idea this evening. :)