A journal of healing

Archive for the ‘healing’ Category


dog1  It has been almost two months that I have been going through a “thing.” I am on the other side of it now and thought I would share. To help illustrate my thoughts, this young golden was photographed up at the docks in the TI Park, 1000 Islands. It is one of my favorite places.

Just before vacation, I took my shot for my Psoriatic Arthritis. I have been on Simponi for about eight months with some relief, but not great. This time, I had a reaction at the injection site which is something I have never experienced before.

At work, I was having issues with one of my employees who is enthusiastic, but a royal pain in the butt. She was working on a project and had managed to take a small pilot and manifest it into a major fiasco that was causing issues everywhere. She also was racking up hours that I did not have budgeted as she is per diem. I decided to have a meeting with her and my boss to get some clarity on her role. She went absolutely bat shit in the meeting and accused me of all sorts of mismanagement. She was almost screaming and my boss said nothing. And her main point was that I did not understand because “I am not a clinician”.  Anyone who knows me knows this is a hot button for me. I sat in the meeting listening to her accused me of cancelling meetings with her and not responding to emails and more lies. I felt my chest tighten and thought, “holy shit, I am having a heart attack.” The pain was sharp and frightening. I disengaged from the meeting and let her rant. I figured my boss would see through her lines of bull. But I was extremely upset.

The next day, and the last day before my vacation, I went to see my boss and expected she would say that this girl was nuts. Instead, she lambasted me with “I need to communicate with her and manage her better.” I was stunned.

By then, I was feeling really crappy. I was going to my favorite place in the world and I was anxious and upset. My gut was killing me. I never truly let go of the meeting and situation at work and at night, I was having heart flutters and anxiety attacks. During the day, I felt bloated. I knew my blood pressure was up. My stomach and gut was flaring with pain.


When I came back, I emailed the employee and asked that she validate everything she accused me of. She said in the meeting she had emails of me cancelling her and using a “tone” with her. I went through my stuff and found nothing; I have been keeping every email she ever wrote. I spoke with my boss who apologized when she came back from her wedding and vacation because she realized she had inadvertently validated this person. With both knew that was disastrous.


Three weeks from taking the shot, my blood pressure was still extremely high for me and I was dizzy and felt out of it. I was still having some flutters and tightness, so I called the doctor. He ran blood tests on everything and many of my levels were extremely high, including my sugar. (HA1C) By the time I saw him, it was a month from the shot. He decided to put me on a beta blocker to help lower my still high blood pressure. It was a tiny dose of metoprolol.

But OMG, did I have a reaction from it. First I had insomnia, then that went away. Then I was nauseous every morning and the short 20 minute ride to work was a nightmare as there are no bathrooms. I had several close calls. Then the diarrhea was all the time. I was gaining weight every morning which was counter intuitive to the output I was having. I felt like…pardon the pun, shit. I was going to see the doctor again soon. I had all the tests redone and then decided enough was enough and weaned myself off the drug. The results from the lab indicated everything was fine. After going off this drug that was supposed to help my cardiac issues, they all stopped. MY BP at the doc’s visit was 124/80. MY HA1C was back below my prior visits and so were most of my levels. Problems solved.

And this issue with the employee? She went off on a tangent and was spreading lies about me to people. She never validated any of her claims and when I met with her and again called her on it, she said, “oh, let’s not open that all up again.” She was racking up staggering hours and when I called her on them, she would push back with more bullshit. The results of her craziness combined with putting her nose in places it did not belong ended up with another meeting with three directors and myself and my boss, the VP of HR.


Finally, after almost two years of her torment, she will be put on a plan of improvement that will be so restrictive that she will probably quit. She will be mandated to remain solely in the position she was hired for, which is an instructor and abandon all other pursuits. But if she does not and continues with us, she will surely cross the line in a very short time and then we will severe her from the agency. She will have to eat crow big time because she is facing insubordinate charges but will remain under my supervision. Finally, someone heard me. One of the directors she went to with her garbage suggested she be mandated to go to EAP, for psych support. This employee has burned all her bridges.

And me? I am feeling like my old self for the first time in a long time. Was it just the shot? I do not think so, although a big contributor. I think it was a lot about not being heard and validated. It brought back many feelings from my childhood where I was invisible but took a lot of punishment for the sins of my siblings. I hate when people dismiss me, or say I am over reacting. I hate when I see people getting away with things because they lie or are weasels. I am a good manager and a fair one.  I have never had such a renegade employee in all my thirty plus years of managing people where I had so little control. The stress truly was affecting me. PTSD, the gift that keeps on giving.


“Relaxing don’t come easy……..”

cu charlene We are currently at the River. My house and furbabies are safely being watched by a loving friend. There is should be nothing for me to worry about. But even here, the most beautiful place in the world, I did not find the calm I so needed. But I did get some fabulous photos which I will share in time.

If you know me, my favorite bird is the Blue Heron. Every year since I can remember, there has been a heron who comes at night across the little lagoon from our room. She comes and fishes and stays for a while. I have gotten close shots of her only a few times. This year, she spent a couple of nights on our side of the cove, and I went out to photograph her. ( I could not type shoot her.) This year, it was like she posed for me.  At one point, she actually walked towards me. I was delighted.

Why can I not relax? Although I have been going to bed exhausted, the sun and water really takes it out of you, I have had nothing but troubling dreams. Dreams of my past marriage and the pain inflicted by my ex’s cheating. Why does this haunt me only in my dreams? It has been 13 years since I spoke to him, and have no desire to contact him at all. One night I woke up to chest pain and flutters. It was a very weird sensation and not pleasant at all. So then I perseverated on the possibility of a heart attack and sleep again alluded me. One night, I was being chased by something and I have no recollection of what other than I woke up with a startle. Maybe it is because it is not my own bed.

Before we left, my father-in-law was in the hospital and near death. My Mother-in-law fell and broke her pelvis. My FIL is now in rehab, having survived a miracle. He is however, very depressed. My MIL is in a nasty nursing facility. 62 years of marriage and this is how they will end up. I too would be depressed. I am not sure that living so long that you end up just hanging on day by day is the way I want to end up. What is life if there is no quality to it? I dread the idea of just sucking up the maintenance care of being in a nursing home, knowing there is no way out. As I sat out at night, pondering the meaning of life, my last thoughts of the day are to make the next one count.

One thing I know for sure; people who are affected with PTSD never really get over it. I continue with my research and reading on the topic. Although there are many methods of down playing the hypersensitivity, it NEVER really goes away. For me, new places with strangers puts me on high alert. Even though I know the Islands so very well, when it is crowded up here, it stresses me. We went out on a packed boat tour that lasted three hours. The idiot next to me had to have his wife sit with him and so three of us were crushed in a seat for two. I could not move, and I do not like strangers touching me. It was also 90 degrees. Usually the water turns me to mush, but not that trip. I was so sore when we got back from being all tightly wrapped and on hyper alert, I actually had a muscle spasm in my back.

rock charlene  There was also a situation at work that happened just before I left. It really had me tweaked as it had to do with one of my employees lying. I hate lying in any form. But this was about me. I could not let it go. I perseverated on it for  days when something came to light that sort of put me at ease. I spent every morning connecting with work because there was so much going on when I left. I will be coming back to a very large project which includes the whole agency, all divisions and departments. I am co-project manager. It will entail the loss of jobs and that is very hard to know about. It will be a complete restructure. But before I left, I was promoted to Director and given a new division. I had a new employee start the week before we left and that needed me to  keep in contact with her as well. She will be great and I am excited about the future for this program. We also lost our Corporate Compliance Director on Friday and she left me completely in the lurch for some training she was supposed to write months ago, and did not. So that has me pretty well tweaked as well.

take off charlene I do know that this year was hard for us with all the things going on back home. My husband’s daughter moved back and is living on her own for the first time. She is extremely needy and it has put a strain on us, well me actually. I resent her in truth, even though I know I should not. But she is manipulative and very, very immature. She has never worked in her life, not even babysitting because she hates children, and does not drive. But it has brought my husband great joy to have her back and I think he loves her neediness. But for  me, it is one more thing to have to deal with. The issue is if she has stayed with us, instead of living with her mother who let her do NOTHING, she would have completed college and been driving and having a life. BTW, she turns 26 in September. We are dealing with a 16 year old instead. An example of what we are dealing with is what happened this morning. Because she was the sole heir to the money her mother had, it has created an issue with her uncle, who is a moron. He expected her to give him a huge some of money to save his over mortgaged house. She did not give it to him, which was the right thing to do. As far as we know, there was no agreement that she would from her mother, which is what he is charging her with. His family took her in after her mother passed away and helped her to move up here. She did pay rent and paid him to move her. He is furious and is now spreading crap about her on Facebook. She called this morning all in tears. Honestly, Facebook? We are talking a 50 year old and a 25 year old.

This time of year for me is the end of my year and October is my New Year. There are so many changes happening this next year. My husband turns 65. I turn 62 and will collect my teacher pension. It is not great, but it is something else. We are talking about retirement and what will that look like. Spending 8 days together doing not much showed me I am not ready to retire for awhile. While he is content with playing golf, which he is doing right now, or sitting on the computer playing a game, I am not able to just relax. Even forced relaxation does not happen for me.



I think the hardest thing a human has to face is not diving into the drama of emotional turmoil. I believe that we are set on this earth to learn to overcome this. That enlightenment is learning to not cave or participate in the negativity that we are all born with and are force fed through our lives. The challenge is to believe in the higher force that is there to pull us out of the mire, however you achieve this relationship. We are given the tools, but like the treasure this knowledge is, we have to search for it.

Along the way in the journey of life, there are obstacles of huge and small proportions. How we deal with them is called Grace. The Higher-self is the Captain of the ship we call life and we are the sailor. The trouble is that we cannot always hear this voice, or we think the voice comes from without, and not within. It has to be a unique set of directions for each human is unique in design and creation. The internal navigation equipment in time can get obliterated with the noise and clutter we subject our over-stimulated lives with. The chatter in our heads is like the static of a radio fueled with the nonsense of television and other media. Ever notice how TV has transformed from simple comedies and joyful family life to intense drama and the emotional targeting of watching others suffer? People watch this stuff because it fuels the ego’s need for superiority. “I would never do that”, said in arrogance. “Look at that poor fat slob trying to lose weight,” uttered while shoveling potato chips in their mouth in the safety of their overstuff chair.

Many spend years trying to find their way using other people’s road maps, only to find the wrong destination for them. It is also easier to have someone else guide us; to have someone else create a chart for us. There are thousands of books out there to read on the “way to enlightenment”. There are multiple people willing to take your money to feed your junkie need to be told how to find peace in your life. We all want it, whether we admit it or not. We think we want to be safe, and that is part of it. The more difficult part is trust. I am not just talking about trusting others, because that’s a disastrous route. We need to trust in ourselves that whatever happens, it will be ok. And that is the tricky part.

In my situation and many others like me, grow up to learn that people cannot be trusted. What does that really mean? Trust in what; that they will do something for you? Protect you? Keep you safe? Somehow I must have been able to keep safe enough to survive and that is all that matters. The bottom line is trusting in others has to have some limitations. Drama occurs when you put your self-worth in someone else. Inevitably, they will disappoint you. The degree of infliction will vary, but your reaction to it is what will harm you for the rest of your life. Children expect and deserve protection and love. But I truly doubt that anyone gets through life unscathed in parental disillusionment. Friends disappoint and so do spouses and your own children. The only solution to this is the act of forgiveness and the realization that the infliction is harmless if you believe in yourself and are able to move beyond it.

We are programmed for daily doses of emotional targeting. Being human means being emotional. Media feeds into this by playing on your emotions in order to sell you things. Pay attention to the input that makes you feel emotional and decide whether that emotion is something you really want in your life. I truly feel that the news and other forms of media are helping to bring this world to its knees. We are bombarded with how imperfect we are, how horrible people treat each other and how we are poisoning the world. It is very difficult to more past this constant feed of negativity. Hence we become helpless, angry and emotionally crippled.

Do I have the answer? Yes and no. I have the where-for-all to find it for myself. And what I discover is meant only for me. How I achieve that is also my solitary path. I have been given the tools of discovery but I need to sift through the garbage floating in my head. I must be mindful that the destination is obscure and will never ultimately be reached. Life is discovery and that is the miracle. How we treat people along the way is our legacy. We all have the same opportunities yet each accomplishment of life is as individual as the person participating. For me, overcoming my own negativity, accepted people for who and what they are and learning to be non-judgmental are my biggest hurdles.

I originally wrote roadblock, but that implies the inability to get over something. A hurdle is something to get over. What are some of your hurdles?


Mid-summer thoughts

sunshine streamers

It is hard to believe that summer is half over. It has been a wet one and cool. The last moments of my day is usually spent in the garden in my chair. It has been so cool, that I can still wrap myself up in blankets. This also helps to keep the profuse mosquitos off of me.  I spend this time thinking about things that have happened in the day and then meditation…..which often ends up with me waking up to my glasses being fogged up as I have dropped my head into the blanket when I fall asleep.

I am currently devouring anything written by Stuart Wilde. I really like his teachings and the way he deals with the study of metaphysics. He is not preachy nor punitive. But his concepts really resonate with me. One theory he speaks about is that we all choose our path, starting with our family. He states that before we hit the earthly plan, we know exactly what we are getting ourselves into. There is a reason for it, a lesson to learn, growth to obtain with the results making us better for the next time around. The issue is, once we hit the earthly plane in birth, the concepts go deep inside.

fluffy 1 It is our path to discover and figure out. There may be moments of realization when something strikes a chord inside. There are many people who would argue and say why would I ever choose to place myself in the circumstances of my family? It was horrific and I have spent the rest of my life suffering from their influence be it violence or sexual abuse.

to the water

Well my thinking is, and very much based on his teachings, is that there is something to learn from your history? You just have to choose how you’re going to handle it. Are you supposed to become an advocate for others to help them grow and understand? Is there purpose to strife? I think so.

to the water2

I think we are all supposed to gravitate to our higher self. I think as we develop we are supposed to become strong and steady. And once we achieve enough balance, then we can stand as role models and guides. There is such a fine line not to cross in helping others. You always have to ask are you helping someone or are you stroking your own ego? Sometimes doing nothing is the best answer. Sometimes, teaching is the answer. But surviving and being the best you can be in spite of the circumstances is achieving the highest goal.

 mom g

The Clearing of the Fog

fog and heron

There have been times in my life where there have been heavy difficulties. I have always managed to overcome them but going through the situation, the end seems unattainable. I believe we receive the support and information we need if we open ourselves to all possibilities.

My morning started with my eyes flying open after a terrible dream. It had to do with my job and the lack of safety again in my world.

We just had consultants come in and do a complete evaluation of our agency, new and old, and went thoroughly through the organization. The result was a 175 page report which dictates a complete restructure including the closing of some operations and layoffs. That is all our inept leadership is leaking and it is causing a lot of worry and morale is the worse it has ever been. On top of all this, and because of the foretold future, two vice presidents are leaving; one director who headed up the innovative services (very telling) and they were much revered in their positions. These three people have over 75 years of experience with this agency and are running from the building.

The litany of errors of what is happening is too long to put into words. I am not sure what will happen in the long run. For myself, I do not seem to be in actual harm’s way. Instead, I am being assigned new personnel and growing my responsibilities in oversight of more operations. But the paranoia permeates the building. Those who should be leaving are clinging to a branch hanging over a cliff and are very difficult to work with because of their fear. Those that are leaving are checked out and the support of the daily operations is suffering. It is impacting our clinical human resources at a time when the Medical Center is putting heavier demands on them. I fear we will lose more great people.

Enter in the philosophy of Stuart Wilde. I am reading his books like crazy. Again, ask and the teacher will be delivered. He talks about many theories but I am embracing his concept of “see it, be it and it will be.” Many others have talked about this but his simplistic process seems to resonate with me. He says, plant the thought of what you want. Begin to believe you have what it is you want. Live within the concept like it has already manifested but within your current means. And then forget about it. Do not perseverate. Let it happen.

I am using this in many areas of my life. But for work I believe that things will be fine in the long run. Truthfully, if works goes down the tubes, I will be fine. That is one good thing about being old enough to retire. But I am not ready. I want to see this through. I held a staff meeting on Friday and let my folks vent. I heard them and did not dismiss their worries as that is out of my realm. Instead I offered up that this turmoil was the beginning of a metamorphosis that was inevitable. The agency had been operating in the same way since the 80’s and needed a major shakeup. We get to rebuild the organization and be part of the new agency. I really believe this and I know there are others who also embrace this. It just is going to be a rough patch as things get sorted out.

The place I am struggling is all due to my ego. I see the silliness and ineptitude and I am rendered helpless in making any changes. I have to let that go as it is clearly not my role. My huge ego is pushing me and the conflict is making me physically  worn out. I struggle not to fix things that I know I could. Again, this is the lesson; to let go.

I chose this particular picture today because it is how I feel. It is also my new favorite picture. I took this at the River at 6 am the day we were leaving. I watched as the fog rolled in and bathed everything in its mist. At times it got so thick, you could not see in front of you. And then it just lifted, gone without issue. What was left was pristine and clear.


Birthday wishes for me


On turning 61

I am not sure how and when, but tomorrow I turn 61. My last birthday at 60 was terrible. I am more used to the number but still overwhelmed with the swift passing of time. As the years accumulate, the time seems to expedite like traveling down a slope, picking up speed as I tumble and slide. There are no brakes.  I can see how the feeling of hopelessness can accompany someone as they age but that is not how I am feeling. Ok, well not all the time.

My dearest friend and I spent Friday night sitting in the garden and talking about our lives. We asked each other what we would do if we could do anything in our golden years of retirement. Her dream is to get into an RV and drive the country taken pictures and blogging about them. What a wonderful idea. My brain immediately went to all the reasons why I would not be able to do that. Fear is the biggest road block to happiness.

I have no clue what I would do. I could only see myself as I am now, working where I am and in my current home. That is not the real desire, but I could not put myself to the future and relinquish the controlled life I have now.  It spoke volumes about the level of stress I am in right now.

I am a believer of the power of vision. We all have the ability to close our eyes and “see” things, but you have to be ready and you have to really concentrate. The concept of the third eye and dream visions and so forth are real and has been around forever. I am not gifted like some with the power of vision, but I have an amazing empathic sense of the current situation. This is not to say I haven’t ever had visions or knowledge of something without tangible proof.

I find the lack of a plan for the future unsettling. I like to have a direction or path with a destination of some sort even if it is only a stopping point to the next place. Some say it is the journey not the destination that counts. Not having a plan is making me feel a bit lost and hitting this marker of my birthday had caused this concern to resurface.

I know every day is a blessing for me at this point. I watched my parents and many friends and family depart this plane of existence too early. I have always said I want to leave this world a better place because of my influence. I thought it would be through my own children, and that was not to be. I thought teaching was my contribution, but my level of influence in that area is negligible.

There is something  deep within me that says there is something I am supposed to do that will make a bigger difference in the world. I really only became aware of this in the past few years. It is like a simmering pot that has been turned up. We all have a calling, but many people do not hear it. For me, it burns within and shouts in my head. But it is unclear as to what it is supposed to be. It is very frustrating and being so adds to the noise and muddles the resolution. Meanwhile, time keeps ticking away.

I spent a lot of time studying many spiritual things. I read about neuroscience and the workings of the brain. I have done energy work and spent a small fortune on taking classes in Healing Touch and Reiki and Mindfulness. I have read volumes from the nonsense of Doreen Virtue, the science of many doctors like Peter Levin, and Robert Scaer to the prophecies of Eckhart Tolle, Brene Brown, Eric Pepin and Don Ruiz. I have over sixty or so spiritual books in my Kindle alone. My newest author is Stuart Wilde and I am devouring his books like candy.  I have studied Christian, Buddhist, Zen and Pagan methodologies and teachings. I lean more to a Pantheist viewpoint with rituals and the Craft.   I have taken classes in trauma treatment and may work on another certification in the fall.  It all is leading somewhere.

On this eve of this birthday, I am sending birthday wishes for a few things. I need a guide. I have known this for a while and have been asking every night for a guide. I had a dream about a friend of mine at work who is the Spiritual Chaplin for hospice. The next day, he stopped by at my desk. Was that the opportunity and I blew it? We talked about Weight Watchers as he was part of the group who was taking it at work. Not all is lost, but I am not sure about his connection. But that’s the point.

Am I supposed to take this next certification? It will cost me but the result will be a certification as a Trauma Specialist. I can work as a consultant for providers and schools. Do I  make this investment of time and money at this point? Not sure… So I wish for clarity of my path.

And my other wish is the health and strength to be physically able to do whatever is next. Some say if it is to be, I will be strong enough. I was lucky that there were other drugs to take when the Enbrel stopped working. The Simponi I am on is finally working. My 25 year old step daughter cannot keep up with me when we go shopping or work around the house. Granted, she is in terrible shape for a 25 year old. But I seem to have regrouped some of my energy and strength. I am so much better than I was a year ago at this time. Although I have stopped being extreme on my diet, I am still holding off the weight I lost. This month is not one for diets. We start celebrating the first week of June, and it goes right on until Father’s day when we celebrate that. You can never have enough birthday cake. We also are heading for The River for a while and I am going to enjoy myself. (I have a whole post brewing about being on a diet and how people can be so invasive of your life.)

I am hoping my time at The River will help me focus and find my footing again.  I am off to sit in my garden, give thanks for all I have received in my life, and acknowledge my gratitude to the Goddess for all she has given me and the world.  I am so blessed in so many ways. And I will again ask for guidance and direction.

So mote it be.



Changes and growth

Azalea 2

Ten years ago, mu husband’s only daughter decided living with us was too much. We did not have a penny to spare, we expected her to do chores, and sitting in her room sulking was only on a limited basis, permissible because she was 15 and it is just part of that age. She decided to move out and permanently live with her mother in California. It was the best thing possible on so many layers. We were finishing our Master’s and working multiple jobs. We did not have the time and patience for her shenanigans. And her mother kept trying to interject and it all added to the mess.

azalea and bug  After she moved across the country, we were all on friendly terms and E seemed happy. Less than two years later, her step-father, who was the nicest guy in the world, passed away from a brain tumor. It was the first in a series of things that confirmed that although we may not know it, there is a reason for everything. E’s move was necessary so she could be there to help her mother. The two of them spent the next years traveling and really bonding for the first time in their relationship. Her mother would not have ever won the Mother of the Year award, and when E’s parents divorced, her dad had sole custody. Her visits with her mom were short stints from the age of 7.

rhoda 1 2015 We knew that her mother did not take the best care of herself and there were repeated emergency phone calls when her mother was in the hospital. As time passed, E and her dad grew apart. My husband was angry about the whole thing, but would not inquire as to why she did not call or even acknowledge him. We believe that there were some “tales” told to E about her father as a retribution for the past.

Last fall, we got a weepy phone call out of the blue from her that her mother again was in the hospital. She did not come forth with the details until a few more phone calls. Her mother was dying and on a ventilator. She passed on when E ordered the vent turned off. As the next weeks of turmoil ensued, her mother’s family stepped in and all was decided that E would move back to this state but live with them. There was no consultation with her dad, even though we told her she could come back here to our house. I spent a lot of time helping her get organized for her move over the phone and email. Still, there was no desire on her part to come back home, here.

Without going into detail, the journey gets muddy as there was a lot of money involved. She moved back but pays whopping amount of  rent to live in a hovel of a house where she has one room. She helps supplement the family’s bills and I think there was hope she would continue indefinitely. At Easter, her dad drove down to get her and had her come up for the weekend. It was dicey at first but then the anger melted. We all enjoyed her time with us. She returned again for another visit and she sat and cried at our kitchen table, letting all the pain and anger at her mother out. She apologized to her dad and we just let the bad stuff all go.

rhoda 3

She asked if we could help her move back here and find a place of her own. She could well afford to and we of course thought it would be best at her age to have her own place too. She returned for another weekend two weeks ago and we found a cute little condo and she bought it. As we celebrated her growth, she opened up and told us a lot of what had transpired and how messed up things were from her mother’s situation. The trust left to her was tied up in legalities and her mother had not paid a bill in two years. E thought this was  a recent thing, but actually was the way her mother had always been. We took her to our lawyer and now she has a team of people supporting her. We are very proud of her.

The best thing is we are a family again. The anger and pain in my husband seems to have left and he is thrilled to have his “baby” close again. She and I have re-established our “maternal” friendship like nothing happened. We had gotten very close when she lived here before and that was part of the issue with her mother interjecting herself. She was jealous.

It is not all going to be peaches and cream. She has a lot of issues to fix. She has not worked and will need a job. She has the potential to have a healthy income from the trust, but it will be tied up for a while longer. Her mother was afraid to drive and never did and passed that on to E. She will need to learn to drive. She will need to finish her college pursuits, but there are a lot of opportunities locally for what she thinks she wants to do.

The best part is watching her blossom and grow. I am looking forward to seeing her fulfill her destiny. I love it when the three of us are doing things, whether it is all of making dinner or just sitting in the garden chatting. There is a sentiment that says helping others helps yourself, and I truly feel like that is true. Times have been tough in my life with work and I have been doubting I am making any impact in this world. Helping this young lady has been very beneficial for me.

rainbow 5-2015 View from my garden chair just this week.



Getting juiced


Over fifteen years ago, getting juiced meant sitting and drinking all night long. It was my method of numbing. I would consume a ton of crushed ice and then my chosen poison which was usually wine. I was committing slow suicide and I knew it. Now, getting juiced means a completely different thing to me.

The idea of getting juiced was brought to me by a very talented young woman who I am developing at work as a Mindfulness Instructor. She is amazing and her demeanor is one of such utter calm. I feel like a whirling dervish around her in contrast. She and I are working on our next series of instruction for clinicians on self-care. She just came back from a workshop and in conjunction with the work I am doing on Trauma Informed Care, we are putting a class together to teach compassionate care for caregivers (clinicians).

We talked about other programs I have in my head for the near future including alternative therapies in homecare. I have been promoting them since I started and was poo pooed. Last week, one of the PT managers said they are reconsidering a program I participated in as being offered for pain management. Inside my head I was doing all kinds of happy dances. One goal I have always had is to get our programs out of 1980 medicine. Maybe now with some of the old school leadership leaving and with the foreseen housecleaning coming, we can progress.

As we are talking, my young instructor was getting more excited with all the possibilities. She said to me, “this is what juices me.” I laughed as I often think buzz words, especially in the Woo Woo world, are so funny. She went on to explain that she wants to keep working with hospice patients but the idea of bringing classes in on Mindfulness Based Stress Reduction and now her work in self-care “juices her to the max.” We already include MBSR in orientation and I guess at the workshop she went to that was quite impressive.

Later at night as I sat in my garden chair, I pondered what juices me? I have been in such a negative place lately that I thought not much. But what juices me was actually demonstrated right in the conversation the young lady and I were having. It was apparent later with the PT manager.

What juices me is getting the best out of people. I love development. I can see potential in people that others may not see. I love innovation. I love creative thinking. I realized that I struggle so much where I work because they are so stuck with doing things the way they always have. It has now come to haunt them and it will be their demise. I get juiced talking about new ways of doing things. I get juiced working with creative people who have so much to offer but need the push or a hand up. I understand now that this is a threat to the survival of the people who have put up roadblocks or who are actually miserable to me. I think they are frightened. They should be. I do not feel bad for them because there are more than enough educational roadways to get up to snuff. But in their arrogance, they did nothing to stay current and now the Mothership is sailing without them.

I also realized that I get juiced up working in my garden. Later I will post pictures. Planting flowers and vegetables really brings me great pleasure. I love the various lights and statues I have collected over the years. I get juiced when I get to take pictures of the flowers, birds and animals that come to visit. For me, creating a sanctuary, even though a lot of people will never see it, juices me.

Getting juiced is great for the soul. Some people call it putting oil into your lamp. But it is the sustenance of life. What juices you?

I can’t get no satisfaction


My thoughts today are a reflection in respond to a friend’s blog who is going to be about the overkill of patient satisfaction and the impact on the cost of medical practice. I was going to use the link to an article that she used to explain where this discussion is coming from. However, the article is not substantiated and does not use cited resources or even verified statistics. It is claptrap.

Patient satisfaction in health care has become the elephant in the room. The problem is now the government has stepped in and will (and in some cases is) attaching a numerical reimbursement rate based on a scoring. The scores are based on patient’s answers from a survey. Statically, it is proven, more people will respond to a survey if they have an emotion attachment to the outcome. In other words, if you’re pissed, you are more like to answer the survey. To that, the opposite is should be true and it is to some extent. I get the survey results and tabulate them for our agency. I would say that most patients are satisfied with our services. But in order for the survey to be counted towards reaching the mark, the patient has to give a 9 or 10. I personally very rarely give a 10 for anything. But if the patient is pissed, we have to do cartwheels to resolve the issue. And that negative score is going to cost us revenue someday in a climate where the government is already trying to take back as much money as they can for reimbursement.

It does not matter to the government that the patient had dementia or was giving a diagnosis which has caused them to be pissed at the world. Some surveys come in with all the answers with terrible negative responses until the last two where they answer we are the best and would recommend us. Clearly, they do not understand the survey. Also, we teach that a score of ten on a pain scale if horrible, the worse pain ever. BUT the government in its stupidity makes a ten the best answer on the survey. No problem there. We are not allowed to teach using the survey to the patient so we have used a discharge checklist with similar language to remind them of what happened with our service. The survey can come at any time, but often after the patient is discharged and has forgotten how bad they were when we started working with them. The whole process is stacked against the agency, hospital or provider.

The survey does not measure things like the environment of care, the caliber of the care…or in other words was the patient a complex visit which is much more involved, or even the overall health of the patient to begin with. It does not measure the attitude of the patient in general. If the patient is not one who is taking care of themselves to begin with, medical care is just another intrusion.

Having said all that, patient satisfaction is critical to the wellness or the ability of the patient to get well. Health Care is reforming and the responsibility of care will be more on the patient. If the patient views health care systems and all the clinicians as something to fear, or they come away from a service angry or upset, be it a hospital stay or a visit to a practitioner, it impacts their wellness. It keeps people away from the care they need. Bottom line, most people will not subject themselves to something not pleasant until it is a desperate situation. And then the cost for the care is more expensive. They are not going to keep appointments, which costs the practice lost revenue. They are not going to listen to what the prescribed recovery entails and they will be non-adherent. And often that ends up in a hospital readmission which then costs the hospital more as they get dinged for those by the government. And that all drives up medical costs more so then having some person in-charge of patient satisfaction.

Locally, our Patient and Family Centered Care practices came about when the Chief Medical Officer of the largest hospital in the area had a bad fall from his bicycle. He ended up losing all senses from his neck down. He said the one thing that made his initial situation tolerable was when a nurse offered to wash his hair for him when he was in ICU. He said because it was the only place he had feelings, so her touch was critical to his healing. The power of simply touch and caring had such an impact on him that once better (he recovered much of his abilities) he made it a major initiative for the whole URMC system. The fervor died down over the years, but there still is a PFCC unit and all employees of URMC and the affiliates still train on the principals and work hard at giving the best service possible to our patients.

My point is that until you experience a personal situation of being the patient, it is very difficult to understand how necessary it is to continue to have patient satisfaction an important part of health care. I feel there are way too many caustic and omnipotent clinicians out there that do more harm than good with their arrogance and judgments. The cold impersonal care of clinicians with too much on their caseloads drives up the cost of health care. Unfortunately, it is hard to statistically prove that because they produce high volume revenue. It’s hard to find the losses if their numbers look great.

And that is the problem with health care in general. It is all numbers. It is the flaw with patient satisfaction scores. “I did not like my doctor telling me something I do not want to face so I am going to give him/her a lousy score.” This in no way measures the clinician’s ability to do good work. And yes, there is a cost for providing good customer satisfaction as the article explains, but there can be overkill on anything. I do not think that it is the general case and that we actually have a long way to go to improve the patient experience.

This is the link to the good doctor’s blog. https://doctorly.wordpress.com/2015/04/25/closed-door/



Trauma Informed Organziations

crystal light

I am currently working on a certification from the University of Buffalo on Trauma Informed Organizations.  I have been studying trauma related materials for a while. It has been fascinating and helpful  healing for me.

What is a Trauma Informed organization? It is an organization that has taught trauma informed care from the person who answers the phone to the CEO. It is the basis for policy and procedures. Trauma informed agencies and organizations are totally aware that every contact with a patient makes a difference in their reaction to the care being offered and also in their ability to get well.

For example, a person with mild PTSD is coming to see a doctor for stomach upset. The admission person snarls at them because they are lacking some information on their admission form. She tosses the clip board at the patient and says snottily, “you need to fill out all of the information!” She is line with several people behind her. (Having people behind you is a big trigger for trauma patients.) The client/patient did not fill out all the information on purpose because she is not ready to share her details yet. She will once she sees the clinician but not with everyone else. It is her right. Her stomach issues are actually a response to the stress from domestic violence, but she is not going to share that easily. A trauma informed organization treats everyone like they have a trauma. The clinician who she eventually works with should request a trauma screen once the patient is comfortable with the plan of care. By doing a root cause analysis, then, and only then, will the real healing begin.

Trust is huge along with safety for someone who is traumatized. Just walking into a new environment is bad enough, let alone in a waiting room with strangers, standing in line  and having to answering questions to someone who does not give a rats-ass about why your there.

Another perfect example of a non-informed practice is the process of getting vitals. This is me: I am sitting way too long in the waiting room. Other patients are called before me. I start to worry why I am not getting called back. Did they forget me? (Blood pressure begins to rise) Finally someone swings the door open, and even though I have been coming to this practice for years, and they all know me, they bark my name from across the room. I get my stuff and in a cadence for jogging, we go back to where all the rooms are. They stop and bark “get on the scale.” I am immediately humiliated. Blood pressure is really rising. Then we trundle off to the little room where she asks questions about meds. She pulls a cuff from the drawer and puts it on over my sweater. The pressure is high.  She sharply asks me why I am there. Of course by this point I am upset.

This is how I dealt with this. I sit near the door so they do not have to yell across the room. I refuse the scale….which used to be a fight. But it is your right and the trauma issues getting weighed causes me…well, they know now not to ask. I tell the doctor because I weigh myself every day. In winter, the clothes you have on can add many pounds.  I make them use the right sized cuff and on my skin. It bothers me that they don’t wipe it down afterwards. Surprisingly since I started doing this my blood pressure readings have been wonderful. When they ask why I am there to see the doctor, I simply and nicely say, “I will tell the doctor” or I say “follow-up.” They have no reason to know. If I need a shot, the doctor has to order it and he will tell them.

Being a trauma informed organization can only improve healthcare across the board. Non-adherence and non-compliance are huge issues. Patients need to want to take their medicine and follow their plan of care to improve their health. Our medical system in the USA is totally reactive. We spend millions on after-the-crisis care. Being trauma informed and using methods such as trauma screenings and motivational interviewing can only improve patient care.

Being trauma informed is for all health organizations. The scenario I described about myself is my GP at a family practice. Even though I work in homecare, being trauma informed can be practiced there as well. It can be used in every environment where there is a community. When we see people who seem out of it, or stand-offish or short tempered, it would be mindful to remember: You do not know the whole story.