A journal of healing

Archive for the ‘Safety’ Category

4th of July Liberties

 

I was born in America. I have never experienced anything but the freedoms we have here in this country. I do not know any better and so I take it for granted. I am disgusted by piss-poor politicians and can be vocal about my feelings. I am entitled. I take for granted the rights and liberties we have. But I am proud to be an American.

However, I hate the way we celebrate this holiday with fireworks. I personally love the display and the colors. But I hate the noise. It upsets my little Cookie.

Last night we were all sitting in the garden as is our ritual before bed. The dogs take a walk around the yard. We call it the perimeter check. And then we sit for a bit and meditate. There were a few little pops in the distance and Cookie was a bit nervous but still quiet. Then a neighbor set off a huge firework which exploded right over the garden. She panicked.

We ran inside and she took off for the bedroom. I had prepared for this and had the air conditioner and fans going. We crawled into bed and she crawled on top of me and shook. I finally calmed her down and she fell asleep next to me but in my arms. I thought we were ok when another one went off. She again crawled on top of my chest and buried her face in my arms. Finally they stopped and she fell asleep attached to me on my side.

I know everyone has the right to celebrate. I wish they would go back to making fireworks illegal in NY. There are enough displays that are set off by the municipalities to enjoy. I am sure tonight and the next night will be even worse for my little dogs. Browny does not seem to get upset by the noise. But he does get upset when Cookie is upset.

I wish I could teach them something I just learned. I am taking a class to become a Certified Trauma Professional. This class has taught me so much about PTSD and trauma. It is taught by Dr. Eric Gentry, who is an internationally recognized leader in the field of disaster and clinical traumatology.

He teaches that people cannot feel the effects of stress or trauma in a relaxed body. Seems so simple. But he explains in length how the human body is always reacting to triggers of some kind. People who have had extended periods of some form of trauma are in a hypervigilant mode all the time. There are chemical reactions in the brain and the parasympathetic and sympathetic systems go into over drive.  In short, our body is in control.

He explains that we need to be aware that this is always on in one degree or another. And we react by constricting our muscles all day. An example is when at the end of the day, you neck and shoulders are way up and hurt and you have no idea why. It is the constriction of the muscles that you held in a clench all day. We clench our muscles everywhere. It is one cause of leg cramps and back pain.

It is common now for people to understand the concept of just take a breath. Dr. Gentry talks about the power of just taking a breath. He talked about other methods for getting control. But the method I think is amazing and it works is called the pelvic floor relaxation. First you have to become aware of the muscles in you hip area. Do a few kegal exercises by squeezing the muscles that can stop you when you pee. Now just completely relax that area completely. Do that several times a day. Concentrate on those muscles being relaxed when something stressful is happening and you will find you won’t be as stressed.

The issue is that the effect only lasts for a very short time. This is something you have to do all the time. It only takes a second and no one knows you are doing it. Another method to use  is called the wet noodle. This is where you go absolutely limp in a chair for ten seconds. It is like a mini vacation. The effect of being in a relaxed body is how people are learning to deal with PTSD and every day stress.

I wish I could teach my little pup this. But for her, the only comfort is a dark quiet room and being held by her Mommer.

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How does that look?

This week and a half has been crazy. A week ago Wednesday we had a windstorm of epic proportions. Then this past week, on Tuesday and Wednesday, we received almost three feet of snow with more winds. They did not call it a blizzard, but it sure looked like one.

I do not like to drive in snow, especially blowing snow. I knew the storm was coming. We all did. I prepared. I moved all the classes, prepared my instructors and staff and told them to be safe and stay at home. I and my salaried staff all have access to the work systems from our home computers. I planned on working at home. I am actually very productive at home.

Wednesday morning, I get an email from my boss that if I am staying at home I must take PTO and so must my staff. Her main concern: How did it look?  Four people on the HR team came in, including her, but no one in Education did. How did that look? She said since I was a director, I should have come in because it looks better.

I replied, as a director, I executed an emergency plan that kept people safe. I had spent Monday rescheduling all the Tuesday and Wednesday classes, in case. I told my staff to bring work home in case. They would have been productive at home, as I trust them. I said I am not crossed trained to do anything else at the office. I am not on the Emergency Planning Committee, I cannot triage, and I am not in any manner essential to operations. I cannot even answer the switch board. I asked her, what would you have had me do if I did get in? Her reply only was to say it did not look good.

This is just one more stone in the bucket that makes me want to stop working. Those who came in are twenty and thirty years younger than me, including her. The three HR staff members do not have much in their PTO banks and did not want to waste it and one lives right around the corner from the office. This Momma don’t drive in blizzards anymore. Not for anyone. How would it look if I was somewhere in a ditch? I can’t walk for very long on flat dry land. Where am I going in a blizzard? I told her that from now on, I will take PTO when the weather is bad, so plan on it. I have enough PTO in my banks this year that I may lose it if I do not use it. That is what being faithful and not taking excessive time off does for you.

Maybe this is just her, but I have worked for other people where appearances are tantamount. It does not matter how good you are in your job, but how you make them look. This is not the first time with this boss that she was more worried about how she looked than being judicial. Our CEO is also very preoccupied with appearances. She enacted a dress code right out of the 70’s for in house staff.

I understand that health care providers need to be available and that part of the job is to be there in emergencies. But it was so bad that the visiting clinicians were told by the VP of Clinical to only make essential visits and to remain home….and work on audits. How does that work? The folks who could and should have reported were allowed to stay home and work. Supposedly he made the call before he checked with the CEO and VP of HR who should have made the call.

   Dad digging a poop spot

The medical center we are connected with sent an email saying essential staff only. That means staff who work in support areas such as HR and Ed were not to report. Our CEO over ruled that and said she was not calling an Essential Only Staff emergency. She was concerned more about the almighty dollar. She was also very upset because none of the switchboard operators came in. How did that look? One of the HR staff who used to answer the phones was in so she was sent down there. This is the gist of why everyone was so pissy.

We have triage nurses who are set up to answer incoming calls by switching over the system to their home phones. HELLO??? Why did they not do that? We do it every day from 5pm to 7 am. Pay them the frigging overtime.

My loyalty for this agency is dwindling rapidly. My desire to participate in crazy behavior in pursuit of the almighty dollar is gone. It is just not that important to me. I did the right thing and my team all agreed. They too were ordered to take PTO. I had gotten up at 5:30 on Wednesday and called my paraprofessional educator as we still had not formally cancelled a Health Aide training class. But we were prepared. We had warned them we may and would text them if we cancelled.  We texted everyone by 6:30 and they were grateful. They are not even employees and I offered a better situation for them. How does that look?

Just for an understanding of how bad it was out there, our governor called a State of Emergency for the whole state on Monday in preparation. By Tuesday, the county was under a travel ban and no unessential travel. All the malls, schools, and town and county offices were closed. The plows could not keep up. This picture below is my husband’s car. I could not have gotten out of the garage let alone the drive way. Our plow guy did not even come until almost 2PM.

But I shut off my computer. I did laundry and I actually sorted out my sock drawer. How does it look? It looks amazing.

Trauma informed

little girl

I have spent a great deal in the past months seeing a variety of doctors for various reasons. At every visit, every time, the patient care-tech brings me back to the visiting room to wait for the doctor. It is their responsibility to weigh, check blood pressure and ask a few questions. One of those questions is the medical community’s answer to being trauma informed. It misses by a huge mark.

Being trauma informed simply means being sensitive to a patient’s history or the possibility of the patient being in a dangerous living situation. We are talking domestic violence, and all forms of abuse: mental, physical and sexual at any age. Being a trauma informed  means everyone on your team from the receptionist to the doctor is sensitive to how they treat a patient. Some may say this is over the top but the concept is very important to the true wellness of all patients.

For example, the patient who keeps coming back with bruises or injuries from falls. Very suspicious if the patient is only forty. Maybe not so for someone who is eighty. But in the case of the eighty year old, she or he may have a care giver who has been frustrated in having to provide care and pushes them to make them move faster, or hits them when they spill things. And the patient is not going to do anything about it because the next step is being forced into a nursing home. They are living in an abusive home and are trapped. They certainly are not going to be forth coming about it.

Patients who have experienced domestic violence of any form will react differently to the way someone approaches their safety bubble. What I mean by this is that everyone has a comfort zone for how close people can get and how comfortable they are being touched. Some people are huggers and touchers and love to get close to anyone, including a stranger. People who have been abused have much larger safety zones and very often do not want to be touched. This not wanting to be touched can range from the patient being able to tolerate it by disassociation or the patient who has a panic attack at the mere thought of having to be touched, which often leads them to not go to the doctor when they really need to.

It an attempt to becoming trauma informed, our local medical center has all providers asking about the safety of their patients? It is a useless attempt to meet a standard. First of all, it is not the doctor who asks this question. It is the care-tech, the gum chewing little twenty-something who is trying to beat a record of some kind by seeing how fast she can get patients in the rooms ready for the doctor. They change regularly and even so, I doubt highly any patient who is in a domestic violence situation is going to open up to that individual as if they are going to be able to do anything. AND… it is none of their business. The lack of sensitivity to the situation of an actual abuse situation is very typical. Unless there has been some form of specific training done with people who are asking that question, simply asking the question almost makes it worse. What are they going to do if a patient says, “no I am not safe. My husband routinely comes home drunk and beats the shit out of me and then rapes me.” The response to that can make or break the patient. The care-tech’s only course of action would be to type ABUSED into the chart. That works!

I would love to know how asking this question, “do you feel safe in your living environment” is the proper opening for a patient to disclose something so humiliating and degrading as being abused. And how many providers are even trained to handle the situation past the physical? Do they know who in the community is providing help for domestic violence? But the bottom line, most patients will not jeopardize themselves by spilling the beans about their crappy home life in a brief visit to a doctor, especially if there is not a relationship built over time with that doctor.

But being trauma informed goes beyond asking that inane question. It is things like how the patient is treated by everyone; from the rushed handling of the care-tech to the actual doctor. Patients who are victims of abuse will react from the way they are placed in a room and then left abruptly to wait for an extended period for the doctor. Letting the patients know if the doctor is running late, or checking in on the patient to see if they are ok would go much further to calm a nervous person. Having the doctor explain what and why they are going to do something BEFORE doing it will help also. Even the simple act of having them listen to the heart can be traumatic. Some doctors will do it over clothes, some doctors reach right in without warning for skin contact. Sometimes there may be a need to hold the patients head while examining their throat for example. This simple act can terrify someone who has had their head restrained in an abusive act such as forced oral sex. Lying down on an examining table makes anyone vulnerable, but for an abused patient, it is excruciating.

For some patients, the act of disrobing will send them back to a place of past abuse. These patients need a sense of safety which throwing them into a sterile, brightly lit room and demanding they disrobe behind a flimsy curtain does not provide. Then they have to sit in anticipation of being probed on a ridiculous scary examining table sitting in the middle of the room as if they were a piece of meat shivering in a paper gown. Would it be so absolutely terrible to provide a soft blanket to comfort and to also help with limiting the exposure while being examined? Something that simple is being trauma informed.

The patient is brought back to the exam room and sat down after being weighed. For some, being weighed is very traumatic. I know that doctors need the vitals but unless you are suspicious of your patients and do not trust them, can you not simply ask them what they weigh? Or make it part of the exam in private and not in a hallway where everyone is walking by. The scale calculates and the care-tech yells out the reading like everyone needs to know….and you still have your boots on. I skip it and refuse. Unless I am there for weight related issues, I know what I weigh and I will tell the doctor if they ask.

Health care workers are highly trained. But in the area of trauma informed, there is much to learn. This study goes hand in hand with a comprehension of the ACE study, which identified the link of abuse to chronic illnesses. I have asked all the doctors who I see if they are aware of the ACE study, and none of them are. I am going to leave a couple of articles for them to read. (see below) We need to work on this information being disseminated and so if you found this helpful, read and print these out and give them to your doctors.

Ace study: http://www.ajpmonline.org/article/S0749-3797%2898%2900017-8/fulltext

PDF of journal article: http://www.ajpmonline.org/article/S0749-3797(98)00017-8/pdf

https://acestoohigh.com/2017/01/05/dear-doctor-a-letter-from-a-survivor-of-sexual-trauma-to-all-medical-professionals/

https://acestoohigh.com/2016/08/10/childhood-trauma-leads-to-lifelong-chronic-illness-so-why-isnt-the-medical-community-helping-patients/

 

 

 

Thanksgiving

writing spot 2014

It is Thanksgiving week. Many people travel at this time back to their family homes to gather to give thanks. I am sitting at my spot at the kitchen table thinking how wonderful and blessed I am and grateful. Many times I will sit here or in my chair and look around my home and think how lucky I am and how much I love this place. I did from the moment I moved in.

I saw the house in a whirlwind of viewings of places when I needed to move and get out of the house I was in. I was in the process of a crappy divorce and did not want to remain in that house. I had sold it and already successfully secure a mortgage loan. I actually do not remember much of the visit other than I liked it, it was in the village  where I wanted to live and it had a garden and a pool.

Heron Hill 2012  house after renovations and painting

The interior was very dark. They had covered all the windows with heavy drapes. It was early spring and the garden had not quite come to life but I saw potential. I bought it, had it inspected and moved in. Little did I know that the  inspection was a fraud and I discovered many things that needed to be redone, including a very leaky roof.

At that time, my one basset had seizures every so often. She would circle and her face wound cave and her tongue would hand out. She would be like that for hours and sometimes, she would whimper or cry. They were awful. I had her tested and they feel that she had been so abused that there was traumatic brain injury. My friend took her and Bishop for the day. They came over with them after the move was done. She walked into the house like she owned it. She pranced around the back yard. At night, she walked down to our bedroom, pulled the blanket on her bed over her as she always did and slept. She did not have another seizure until four years later, which was actually a stroke and she lost her life to it.

side after

There is an old style enclosed back porch with large screened windows that was my spot in the summer. I would sit out there for hours. In the winter, the downstairs room became the TV room and I filled it with overstuffed comfortable furniture. That was the only new thing I bought for years as I have too much furniture and need to get rid of some. There are many hand-me-downs and antiques and furniture I got in my first marriage. There is one room I call the museum which has a lot of crystal and fine things that were given to me by relatives. I wish I had a relative to pass it on, but sadly, there is no one who wants or even gets what they mean.

I have made improvement through the years. The interior has been redone with bright paint and papers. I had the bathroom and kitchen refurbished and the lower level area redone to include a man cave for my husband.  The exterior was painted the colors of the blue heron. We call the house now Heron Hill as there are over a dozen heron garden features all over. I had the old pool removed and the garden completely re-landscaped. I had the driveway widened and redone along with some new retaining walls.

The house was built in the same year I was born. We have aged and have creaks and groans but are still functioning. People comment on how comfortable the house is and often say it has a warm special feel to it. No one will ever say it is glamourous or worry about spilling something. It is a place to relax and recoup. I have one person who stays here to watch the dogs while we are away who absolutely loves the place and calls it her vacation spot.

Waiting for Santa Paws

I am sitting here this morning gazing at the snow falling. The house has an abundance of windows including a bank of almost  floor to ceiling ones in the front. They are old and drafty and I will soon cover them to keep the warmth in. But that’s ok because I have many plants inside and they have white lights in them to keep a festive feel even after I take down the Christmas stuff sometime in MARCH!!!! ( wish I was kidding)

Christmas 2014 1

On Thursday, my husband and his daughter will sit down to a meal which we all helped to prepare. I insist we say at least one thing we are grateful for. I practice every night thinking of things I am grateful for before I sleep. Even when the pain of my Psoriatic arthritis is pulsing through me, I find peace and solitude in my humble abode.

 

 

Transitions

sept-doves-2016

I have been writing about the Doves who have lived with us all summer. They left their spot up on the porch for a long time in August and we figured they were done having babies. We were wrong. A new pair had another set of babies this September. That made three sets of twins and one single baby dove that came into the world in my garden.

We lost one young bird from the first pair that was attacked earlier in the summer.  I found her on the walkway and she died in my hands. She is buried in the garden.

dove-love

This newest pair grew quite large. Yesterday, the nest was empty. But I found one of them on the deck. We knew that one was not doing great from birth. We could see that she breathed a lot faster than the other one. I think she cannot fly because I was able to walk up to her pretty close and all she did was walk away. Throughout the day, I would see her in another spot, often with her nest mate. The bigger one can fly away. I put out seed and I hoped she would be ok.

How frightening it must have been for her to find herself on the deck after being in her nest for so long. Now she is in this huge space and alone, unless her brother/sister comes back. Last seen she had meandered closer to the bird seed I put out, but in the safety of a bush. I worried all night and I am waiting for day break to go out see if she is ok or gone. I pray she flew away, if that is possible.

spet-doves1

There may be a day when we will vaporize and be transported to our next location by breaking apart and reassembling somewhere else. I doubt I will see that in my time. For now, I have to physically move myself and enter into a new arena from the comfort of where I was. For some people like me, it is hard and disruptive. But I have been practicing doing a Soft Landing, one of the new Mindful Self-Compassion skills from the class I am taking.

I am very sensitive to my environment. So much so that I am not even completely aware of all the signals coming into my brain, but I do react. I am still hyper-vigilant, but not as bad as I was years ago. I do not like loud sounds or bright lights. And I can detect emotional distributions or as they say, bad vibes, very easily and it puts me on alert.

The concept of a soft landing is to take a moment every time you go from one spot to the next in your day. When you enter somewhere and find you seat, take a moment to breath. Close your eyes if you can and listen for whatever sounds are in the room. Go inward to your body and scan for discomfort. Much like you would massage a muscle, send soothing energy to the discomfort or simply become aware of it. I find the act of just being aware of pain seems to lessen its grip. I do this now all the time including when I get into my car and drive anywhere. It only takes a moment.

garden-sept-center

My favorite grounding is when I come home from work. I change out of my work clothes into something soft and comforting. I like to sit in the garden and just be there for a moment. Then and only then, my husband and I will share our days. He knows he is not supposed to hit me with drama when I come through the door. It was a hard habit for him to break.

However, now he forgets sometimes to tell me I had a phone call. This was the case last week. By the time he remembered, it was too late to call them back. Unfortunately, this was a call that was crucial that I returned. Seems my mammogram is “inconclusive” and I had to reschedule for another series of images and then a consult.

After talking with a few girlfriends, I learned that this was not an uncommon occurrence when you have a mammogram done. But when it happens to you, it is very troubling. I have been having them done since I was 21. My Aunt had breast cancer was diagnosed at a very early age and ended up with a double mastectomy. My mother died of cancer at 56, although her original diagnosis was lung cancer. Every therapy I have taken for my Psoriatic Arthritis has a warning that it can “encourage” lymphoma.

From all the classes I have taken and including this one, the principal of living in the present moment is a basic core truth. I worry way too much about way too much which causes undo stress and physical pain. I have to learn to stay in the present moment. The MSC class is helping me recall many of the strategies that I let go of. Being in the present moment while in this situation is critical for my wellbeing while I wait to hear what is going on. But it is hard to not worry.

So like the little dove, I am in a transition that I am not really happy about. But then that is life. If we do not move forward and face our issues head on, we become stuck. The image that pops into my mind is one from childhood. It is a dinosaur stuck in a tar pit. The outcome is never good.

The Gift of Listening

blue-ball     There are a few things that humans can give and they mean so much and cost so little. One is a smile. Another is to just listen to someone. The act of being quiet and still being present to hear someone’s story is a compassionate gift. This Friday, under a fool moon, my friend and I sat out in the garden and spent the evening just talking. I so desperately needed to just vent all the frustrations that have been building in my heart

I do not share much at work with anyone. I have learned the hard way that what may be said in personal conversation can come back to bite you. However, many people come to me to talk about their issues. I have been told it is because they trust me to keep what is said confidential. But I think it is because I listen with a compassionate ear and fully pay attention to them when they are speaking. I listen. One young girl will sit at my desk and blurt out things and then will pick up her phone and text when she is done speaking.  She just wants to dump and run. I find her rude and self-centered, but I still listen to her.  I absolutely hate people who look at their phone or text when you are talking together.

Most nights, I come home and go out to the garden to ground and relax. I will often recount the day to my husband and try to explain the nuances of issues that have popped up. I know he is not listening. He often is looking everywhere else. He does not comment at all while I am speaking. He is too busy thinking about something else, which he will say once I pause. I can be going on about something as serious as fraud that had been discovered at work and he will reply with “The Yankees won today.” As much as I should not waste my voice, I do need to vent and if nothing else, it gets it out of me and I can relax. Sometimes, however, I just get more frustrated.

Talking with my girlfriend was also difficult. She likes to fix. And as much as I appreciate her thoughts and ideas, I am not asking her to fix my life. I just want someone to listen. I heard her sometimes cruel yet honest replies and felt wounded at times. I listened to her discourse of issues in her life and tied to validate her feelings. We sat out there until the moon was high in the sky and the next day had come.

I was sad because I realized through the conversation that my friendship had been strained and I had not realized how she had felt about me in certain areas. I have known her for over thirty years. But I also had a sense of relief within myself. Like a rock that was in the pit of my gut had left. I realized though venting, I had released much of the angst that has been building in me. I was not looking for a solution; I just needed to be heard.

But I also realized I had listened to myself and had a chance to “soak in” what I had said. I used to journal and I used to blog much more and I realized that was where I went to be heard. I need to go back to writing more. Putting words down on paper is a great method of release. It is why there are so many blogs out there. We love to see those “like” icons piling up because it shows we have been heard.

I feel like I am being taken on a different path in my journey. It is quite bumpy right now and steep and there are lots of rocks to navigate. I also sense a change happening in my life. I do not like change…. I am struggling against it. Part of it is knowing that I am in the sunset of my career and the other part is I have to accept the lower level of energy and pain I am constantly in. It’s not the fear of getting older that is worrying me, either. I am looking forward to not HAVING to work and to live my life on my own schedule when I retire. For right now though, I need to change how I live my life through this transition and be ok with it. I need to let go and just see what happens.

 

Midsummer Dreams

Nightview 2015

The light has shifted ever so slightly in the garden at night. I have been doing an epic battle to keep everything hydrated. But even so, things are crisp or wilted. My glorious ferns are gone and the grass is brown and crunchy. The trees in their deprived state are dropping leaves early. I fear for how brown our fall will be this year.

I am not good with the heat. The other night, the little air conditioner in our bedroom could not overcome the heat and it was still 80 in the room. I find myself longing for a storm or two. I realize I could never live somewhere that was sunny perpetually.

I spend my last hours of the day in the garden readying from my Kindle. It’s so dry that the bugs and mosquitos are less and so the light does not attract them. I finished a non-fiction book intended to reflect on what it is like to live with PTSD. It was a story of woman who was raped by her boyfriend over a period of times when she was 16. She lived with his threats and never told anyone. The book revolves around her growing up and dealing with the ramifications. She is splinter from her family, her own choice, and ends up as a disenfranchised woman living in a hovel.

Although the book explained about triggers it was not a good representation of what it is like to live PTSD. The woman in the story goes to a psychiatrist and is “healed” by simple breathing methods and other mindful exercises. She meets a man and life goes on off into the sunset. Although the authors attempt to help bring awareness, I think she misrepresents the truth.

People do not ever heal from PTDS. They learn to cope. And while some are better than others, it still can rear its ugly head at any moment. Triggers come from everywhere. I was reading where a female soldier (nurse) who had PTSD after being in Nam was fine for years. Then she moved to a new area to work at a hospital. She started having horrible flashbacks and attacks. She could not figure it out when on a very still night she heard the sound of a chopper flying to the landing pad at the hospital. It was not the first flight since she moved there. Normally it was noisy with other ambient sounds and this was so subtle she never paid attention. But her ears did. They heard and she would start to have panic attacks.

The shift in light for me is a trigger. I am so sensitive to it that I am aware before it really gets to the point where it bothers me. Something about the afternoon light before sunset in the fall and winter makes my chest tighten and other sensations. It has to do with sunset around 5 pm. This was the cocktail hour when my parents would barricade themselves away from us and start drinking. Yes, this still affects me forty years later. I am aware of it and can normally deal with it. But I still get a stomach ache and my mood shifts.

This morning, as many Sunday mornings, I sleep an hour or two longer than normal. It is very common for me to have nasty dreams but there is a prevalence of one reoccurring situation and it often plays out in these stolen moments of extra sleep. I have no idea why and I cannot control my dreams. Even after being divorced for over 13 years, I still have horrible dreams about the way I was treated. I am not going to dwell by explaining this as I need to let the dream I had this morning go. But my point is PTSD does not just end.

I know what I have to do and will tend to it. The summer ending is always hard for me. We are off to the River for our long extended stay in a couple of weeks. That will help me to focus and ground. There needs to be more awareness of PTSD, and not just for Vets. It affects many people in many ways.