A journal of healing

Posts tagged ‘abuse’

Fat Hatred

This weekend celebrated the second Women’s March in Seneca Falls. There were over 10,000 people there to voice their concerns. Voicing concerns is everyone’s right in the USA. I support that right as a woman and as a blogger. I am not able to accept and even understand what gives people the right to go on to someone’s blog and write an evil and threatening message. It happens all the time and to totally innocuous blogs.

Blogging is the opportunity for the blogger-author to express their thoughts. It is therapeutic at times and it can be a gift of education or just simply an outlet for the blogger to write about their experiences. It is a wonderful outlet.

I follow several blogs. There is one I find at times quite humorous called Dancing with Fat by Ragen Chastain. She is a large size lady who writes, is a triathlete, and a dancer. She also is a motivational speaker who encourages people of all size to be the best that they are no matter what their size. She is a true hero for the thousands of people who let their size inhibit their lives.

There are many other activists who are trying to simply educate people about size discrimination. It is totally acceptable in our country if not encouraged to harass and bully people of size. I do not get it and never have. But I was astounded by the hatred these activists have had hurled at them on their websites and even face to face.

In Regen’s blog she talks about trolls. She actually created a website and posted some of the comments and her very funny and witty replies. The comments are graphic and threatening and just frightening. She has never hurt anyone or tried to change anyone. She is only offering a glimpse into her life with joy and support for others. Pardon the language of this, but this is an example: “cant we just kill the fat people and make cat food out of them? 99% of obese people are just stupid lazy ugly pieces of lard,fuck em”  Can you imagine how this makes me feel as a large person to be judge that I should be KILLED and made into cat food simply because I take a larger dress size? Of course the sentiment loses value in the quality of the rant… and we move on. But how horrible is it that this person is out there expressing that much hatred and violence to an innocent group of fat people. Really? There are a lot more worthy groups to hate if you got to hate.

I am so naïve even at this ripe old age. I never knew there was so much hatred against fat people. This hatred is a learned behavior because it is not embraced by everyone in the world. What difference is to anyone if a person is large or small as long as they are not hurting anyone? This issue is becoming more prevalent now because people are standing up and saying “STOP IT!” Count me in!

We would never tolerate this type of harassment and hatred towards people of color. But I lived with that hatred growing up and I still hear it whispered behind closed doors. The fact is now it is unacceptable to slur and insult people simply because they have different skin color. It was an arduous fight. I am not saying the fight is over either. But when I was a young child it was a segregated world and it was nationally acceptable. But no more. It gives me hope.

I am not going to go on a political rant here. It would be too easy. Change has to happen. We need to be aware of this hatred in order for it to change. People don’t like to get involved in controversy and we have become a nation of complacency, which is why we are where we are with the leaders we have.

My goal is to just point out something that many people might not even be aware of. Next time you sit next to a fat person, understand that they know when they are being ostracized. They can see the looks and feel the shame you want them to feel for just existing. In many cases, their size is their protection from the harm and hurt their life has been. Try to understand and not judge.

Living the Ace Study

This past week was terrible. I did not get through it unscathed. I am wounded and in a bad way. Let me explain something about triggers and how simple things can dig so deep that it can immobilize someone. I again point to the ACE Study http://www.acestudy.org/index.html  about Childhood Trauma and the lasting effects of living in and witnessing trauma.

The effects of trauma are pervasive and unique. What triggers me may not trigger you. And how I react and for how long will also be different. The first thing that I learned when I became a Certified Trauma Professional is to allow the feelings. Never tell anyone what they feel is wrong, or over-reactive. What a person feels is their right. Trying to modify behavior by saying they are wrong to feel that way or try to change them can make things a whole lot worse. It is the same principal as working with grief. Time and reaction is unique.

Reaction to trauma is also a chemical and physically wired behavior. Neuropathways are developed as trauma is experienced or witnessed. When triggered, the body reacts out of protection secreting chemicals to produce energy for flight or arousal. Long time exposure will create a programed system reaction which often includes the shutdown of the body, anger and explosive behavior, and often a desire to stop participating in life. These are the three basic reactions of trauma: fight flight or freeze. A triggered person will resort to one or all of those reactions without a sense of doing it.

This prolonged constant flooding of chemicals like cortisol and other potent hormones designed for safety will affect the body and cause illness. It is proven. See Ace Study. And this reaction does not fade, but for many, it exponentially gets worse. And so in time, less creates more of reaction. For some it becomes over whelming and they cannot function. There is no actual cure for PTSD. The only hope is to learn to live with it and tame the Tiger so to speak. By exposure to more positive situations and learning to self-sooth and calm, many people learn to cope.

I learned that revisiting the trauma is not a good thing. The old method of recreating events and mollifying them does not work and is not healthy. You actually recreate a new trauma by doing that. I found that out too late for me as I spent a lot of time recreating my events in an attempt to grow past them. It did not work. It is enough to say that I spent over forty-five years in an abusive state caused by my alcoholic parents and an abusive husband. Forty-five years is a long time to be treated like shit; emotionally, physically and sexually mistreated. One does not get over that.

So back to this week: things at work are to the point that I am reacting by shutting down. It has progressively getting harder for me to be there. On Monday,  I was “in trouble” because I was being negative in a meeting. Supposedly I was grimacing and my body language was offensive. I swear this is what was reported. In the past I was written up for rolling my eyes. My boss is a terrible boss and the person who reported this is her mini-me. I understand the dynamics and I could spend a whole other post on how horrible it is at work. But let it suffice that my boss’s words to me were cruel and hurtful. She told me no one wants to work with me. In a previous accusation of misdoing, she told me no one likes me. She then said stop reacting like you’re the victim. If she only knew.

My Clinical Educator resigned after 27 years there.. I threw a reception for Margaret on Tuesday right on site. We had a fabulous relationship. She had my back, and I had hers. I would never have survived without her when I first started. Her leaving trigger all sorts of abandonment issues for me. She saw the mistreatment and the poor leadership. She left because she had enough.

One of Margaret’s favorite things is cake…. Well actually frosting. I had a special cake created for her. It was beautiful and fresh. I was sitting enjoying a small piece, minding my own business. The VP of Clinical was standing in front of me eating a large piece of cake as well. Then, totally unsolicited, he turns and says over his shoulder just as I was putting a piece of cake in my mouth, “should YOU be having that?” I was flabbergasted.

What happens to me when something triggers me is I shut down. I go into this place of protection. Unfortunately, I am unable to speak. I remained in the room until the end of the reception. I never touched the piece of cake again. When I left the building, I burst into tears and cried all the way home. (I actually cried again when I wrote this) I had my fill of painful criticism and hurtful remarks. This is continuing to affect me as I have not been able to sleep through the night. I wake up and perseverate on all the nasty comments.  This is physically causing some nasty flares and a lot of pain.

I am hyper aroused and anything sets me off like a loud noise or small issues. On Wednesday, Joe’s car had a huge malfunction with alarms and flashing lights going off when we were going somewhere and I completely flipped out. I was so upset I was hyperventilating and curled up. We got the car home as we were not too far way but I cannot explain how terrifying it was for those four minutes. I was so bad; I took the next day off. I had to lie because they would never have understood.

I know what I have to do and I am working on getting out. But it is not so easy. I am lucky there will be escape. But how many other people are out there who deal with this daily? No one knows the effect rude and nasty comments can make. We all agree a positive remark can make someone’s day. Why is so hard to see what a offensive, uncalled-for comment can do?  We need to learn to be more sensitive to people. Kids are killing themselves or becoming addicted to escape the effects of bullying which is extremely traumatic. Bullying continues in adulthood and some people are true experts at being bullies. I have met many. How many people suffer in silence only to get sicker and sicker because the effect of childhood experiences haunt them as adults?

 

Don’t take this personally

“You’re too sensitive.” “I meant this is a good way.” And my favorite: Don’t take this personally.” Everyone time someone says those things; I know it is going to be a dagger in my soul. I am too sensitive. I will take it badly. And I most definitely will take it personally. Because that is the honest intent. Prefacing statements with “honestly” or to “tell the truth” does not excuse the fact that you are about to be mean. “It’s for your own good” never really is. It’s about you feeling superior to me.

Being an empath is not a pleasure. I see right through most people’s crap in a heartbeat. It does not mean that I can shield myself from the hurt. I never learned that part of survival. Because of that, I am very vulnerable to insults, even if they are shrouded in good intentions. They never really are good intentions.

When you are a large woman, you are a walking target for these kinds of insults. People feel so justified to say, “You would be so pretty if…..” “or you have a beautiful face….” People tell you how much better your life would be if only you could be more like them with statements like: “you should run with me some morning.” Oh Honey, if you really knew me, you would know I can hardly walk some mornings due to psoriatic arthritis. But you don’t really see me, so thanks but no thanks.

These comments do more than just hurt me. They trigger me. My family never lacked in cruel comments. It was a sport to see how clever someone could insult another. I was an enigma in the sense I was the only woman in my family who was large. I mean I am the tallest by 5 to 7 inches, I wore a much larger size (my Mom was a zero to 3) and I had boobs. I spent my childhood listening to “how much better I would be if I only…” This is emotional abuse by the way. I was deprived of treats, often subjected to ridiculous diets like green beans and Jello and constantly harangued about my shape.

[And this is how just writing about my childhood trigger me to justify it. I realized this when I went back to reread what I wrote:] My mom was in charge of the food in the house and meals were excessively high in carbs and fat. There was always soda and cookies available because the other siblings could gorge on them. They were thin. I was an extremely active child and teen often spending the day swimming or riding a bike for miles. I was not allowed to sit around and watch TV or even read. As a younger woman, I was very active. I only slowed down because of the PsA and if I did not have it, I would still be playing tennis and other activities as much as I could.

My family’s constant barrage of self-improvement comments were actually telling me how I failed. There was little said to counter the demeaning of the words. It successfully made me feel like a failure and that was the intent. I know this now, but it scarred me. So now when people make their veiled comments, I hear the disappointment in my mother and father and it brings me back to that time. When you have PTSD, it does not take much to trigger you.

When you grow up with a sense of failure, you have two choices: over achieve or lie down and whither. I overachieved. My success had not dampened the hurt I feel when someone is critical. I am so sensitive, that a look can set me off. I feel people’s disdain of me even if they think they are hiding it. I read people very clearly. It does not matter who or what the relationship. It does not matter if I love or hate the person. Their intent comes beaming through.

Next time you go to make a comment, try to remember that a large person already knows they are large. Chances are they have spent a lifetime trying to meet other’s expectations and have failed. They may not be strong, and your words will haunt them for days. You have no right to demean someone ever. If you think you are helping them, you are not. Get off your white horse and stop being so pompous. Learn that “right reflexing” (the attempt to take charge of someone else’s change process) does not motivate anyone to change. Understand your motive before you speak. Send love, not hurt.

 

Drug Testing

Potty

Just this month, our agency was surveyed by the Department of Health. It is done minimally every three years and it is something that evokes fear and great trepidation within. We did really well, but came up with one deficiency, which truly is unfair. They said that this regulation has been required since 2005. But, we never have been dinged before for it.  The State feels that enforcing this will help with the opioid addiction condition we face in the country.  It requires everyone who sees patients to attest to a MD or NP that they are not addicted to drugs or alcohol and then sign a statement. It is the stupidest regulation amongst many. Our agency now has to have over 500 staff, from RN to HHA sit before one of our NPs and sign off. It is costing us plenty in time and effort.

We drug screen everyone when they are hired. We mandate everyone to go to Occupational Health and piss in a cup. When in doubt, we can order a supervised piss, which means they are watched when then pee. Even staff who will never leave the office or touch a patient have to do a drug screen to be hired. We can also mandate any one at any time to go. It costs the company every cup full.

Every year, we have to sign off a health assessment where we HAVE to disclose any and all our medical conditions and medicines we are on. If you lie and get caught, you are terminated. It then goes to the Senior HR Manager, RN who reviews them and then they are filed. I personally find these invasive. I think for someone like me who is on a very expensive drug that this is pointing a target at me. In another report from the insurance company, it indicates the cost the company insurance has to cover, and hence the agency is aware of my burden on their insurance carrier. If they have to downsize….who would you let go?

We also have to annually get tested for tuberculosis with a PPD. It is a simple procedure but someone has to administer a shot under the skin and then someone two days later has to read it. There are hoops to go through if you come up positive.

So when I hear people bitching about the invasion of privacy and stepping on people’s rights when the conversation turns to mandated drug testing for people who receive government subsidy, I go crazy. Why not? This money comes out of my pocket to pay for them to have support and help. Without going into a moral rant, you should not get ANYTHING if you are on drugs. Ok, maybe a drug recovery program. Clean up and then we will talk. I mean everything from pot to booze. If you need money to feed your kids stop drinking and smoking. Even cigarettes are $10.00 a pack… STOP. Or go get a job and pay for your addiction on your own. That goes for gambling as well. I think that there should be a check on people who go to the casino and piss their welfare checks away while their kids are home eating paint.

I am all for helping people when they need it. I am not blind however and have worked in environments where people on welfare brag about how they are getting away with what it basically stealing.

I am coming up on retirement in a few years. I worked hard for the last 47 years. Every week I had money taken from me and put into a system that supposedly is going to pay for my retirement. It won’t. I will still have to pay for insurance and other health costs. There is no free ride for us seniors.

Do I seem harsh? Tough. We penalize healthcare workers and others all the time with drug testing. If you want money for food, free housing and other benefits….it’s simple. Submit to a drug screen and if you are clean, then ok. I also think there should be other strict limits but that’s another blog.

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/

 

 

 

I am a sinner!!!

pink clouds 8-15

“I am a sinner. I have done something so egregious in my life that I deserve completely the issue at hand.”

This is how someone who has PTSD brought on by childhood trauma thinks. This is how a woman copes with the reality of living within an abusive relationship of a spouse or family member. This is what the perpetrator tells them and when it is someone you are supposed to trust, you take it as gospel.

The lesson is learned early when in innocence, the child or woman stands up to the inflictions and is beaten worse or punished even more cruelly. There is guilt placed on them that they are so flawed that their judgement is totally wrong. When you add isolation, which often happens, the person is so humiliated because they are led to believe they have caused their own situation and it is their entire fault. So they submit which is why so many people end up either dead or remain in the relationship.

Children often have no escape. They hear nothing but ridicule and criticism. They are abused mentally, physically and sexually by members of their closet trust unit, their family. This circle of constant wearing down of any self-worth is worn like a cloak and the energy given off to others in the world is a reflection of this lack of confidence. People treat people as the person treats themselves. And this only perpetuates their loss of confidence. When all hopes of a bright future are dashed at the malicious behavior of others, the person mentally gives up.

What happens in the body is another story. The body is designed to protect us. I have written a lot about the reaction of trauma and there is a ton of information on the physical deterioration of the human life form from trauma whether it is a one-time happening or many. There is evidence based research on the impact of trauma and the propensity of chronic illness later on in life. Please read the Ace Study information here: http://www.acestudy.org/

Now repeat this treatment for fifty years and then ask, who could possibly have a different outcome of low esteem and self-deprivation? How could the body after all those years of cortisol floods and other hormones and muscles in a permanent clinch all the time not affect the health of someone? This is my story. It is not about sympathy and it is very difficult, more difficult to talk and write about than anything I have ever done because you see….I am a sinner. I still in my subconscious think I deserved everything that ever happened to me. And so the manifestation of chronic illnesses is only another reinforcer.

The reason I am writing about this stems from another blog of the dear Dr. Victo Doloro: https://doctorly.wordpress.com/2015/08/27/eroding/ . It is about how obese patients are treated by the medical community. I wrote a long reply to that but it made me come to grips with something currently in my own life.

A week or so ago, I started to feel like absolute crap. We were headed out for vacation; I was able to quell the uneasiness of my ickiness with the anxiety of the trip. I always am anxious to some extreme, but going away is very difficult. I lose what little safety I think I have. Once away, I still was anxious and I thought it was about work. It is what I do. I find a reason for something so I can deal with the guilt of not being perfect. Although we had a splendid time, I knew something was wrong Big Time. We got back and the symptoms did not get better. If anything, I felt worse. I had my nurse educator take my blood pressure and sure enough it was up there, more so than it has been for a long while. I decided to look at my glucose, and yup, it was up. I took readings for four days and it was constantly up there.

I did a very difficult thing. I called my doctor and made an appointment and I asked him to order all sorts of blood work. On Friday, the lab tests came back and there was nothing significant in the findings. I was within a range I had been in before. This summer had been a whirlwind of barbeques and going out every weekend and enjoying ice cream cones while sitting by the canal. And I just came back from vacation where we treated ourselves to what-ever we wanted including shell fish. I had brought all my numbers down when I was on Weight Watchers and because of the change in eating habits, I actually as mindful on the trip and not a crazy fool. I only gained four pounds back from which meant I was still 20 pounds lighter than where I was less than a year ago. Just knowing that made me feel better.

This morning, the last test came back (urine) and it was off the chart. From what I can tell, my kidney crashed again. I had taken a shot (Simponi for my Psoriatic Arthritis) the Wednesday before we left. I had a reaction at the injection site I have never had before (I have had seven shots of this product) I noticed the next day that I felt like my blood pressure was up and I was very stressed. As I said, the anxiety of the trip and so forth. On the trip, I was not drinking water as much as I normally do because of how much I have to pee every five minutes and you can’t do that when you are traveling. I also consumed restaurant food which has a ton more salt than I use. But according to what I have read, I should have edema, and I don’t. There is also the possibility that the test was contaminated and the outrageous reading is inaccurate.

But here is the point of this long epistle. It took me four days to call the doctor. Why? Because in my mind I am totally blaming myself for whatever is happening. I am in a state of being triggered from guilt and the fear of oncoming punishment. For me, having to go to the hospital for more tests makes everything in my body tighten to the point of almost being crippled. I am sure it is adding to the heighten BP. Worse is the treatment I know I will receive. My GP is not like that. But this will surely mean a trip to a nephrologist and/or endocrinologist. My last experience was beyond awful and I wrote about it in Victo’ s post and I have written before about it. Even the nephrologist I saw never talked to me about kidney disease, but only about he bet me I would be so much healthier if I lost 25 pounds. HELLO??? I did and this happened anyways.

I feel in the depth of my soul like I have been captured like a caged animal and I am trapped. Now I will be paraded like a circus animal where people can poke fun and ridicule me. They will tell me that this is all my fault because I am fat and from the front desk to the person who will have to weight me, they will treat me terrible. It is an awful feeling. But I know I have to do something. My fear at one point was so strong that I almost said “screw it. I have to die of something.” Then my new found bravery came into play and I am facing this head on. First asshole who says something that this is my fault because I am fat is going to get an earful from me. I wish I could come up with a card to hand out starting with, “ you are an uniformed asshole! IF you only knew…..” The other thing that this and the conversations on Victo’s blog did was reinforced my desire to continue to work in trauma informed studies. I completed a certification last year in working with organizations to be more trauma informed. There is another longer certification in becoming a trauma informed specialist and I am going to go for that this year.

I know that the fear of seeking medical help is extremely common. The level of anxiety brought on from illness for people with PTSD from any form of trauma is unmeasurable. It is a major cause of suicide. It is only in recent years that PTSD is acceptable for people in the military. It was not uncommon and is still prevalent for soldiers returning to suffer major uncorrectable illnesses because of PTSD. They try to treat the illness and not the whole situation. There is still a stigma of being a weakling. People with childhood trauma and domestic violence victims are very much not understood or even accepted. Countless doctors do not do a trauma screen to see the route of diseases started back when they were physically abused when they were five. And until we stop  degrading and humiliating the victims, they are not going to speak up.

I am going to add to this, although I know this is going to be another post at another time. There is a lot of work out there dealing with people with PTSD and downregulating the body reaction to it. There is ton of stuff on mindfulness and meditation and sensory and energy work and other therapies. I have spent a ton of money and years on trying to find a solution. Although it has helped, some more than others, I am convinced that this is not the cure. I believe there is some so deeply engrained in the body that no one has actually discovered and is able to truly turn off. They can dim it, but not eradicate it. And, like anything, it is hard to say that this too is a failure. But this is all for another time.

 

 

 

 

 

 

 

 

 

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.

 

 

 

Family that sticks…..

little girl

You can pick your nose. You can pick your seat. But you can’t pick your family. Some people hold that you pick your family prior to coming to earth

When I met my husband his daughter was 12 and going through all the drama and crap that comes with that age. My husband had sole custody of her. Her mother was alive but lived on the other side of the continent. By the time I was on the scene her mother had married a wonderful gentleman. Stepdaughter (SD) went to see them at least twice a year, paid for by them. The whole relationship between all of us was actually quite pleasant and friendly. I actually worked for her mother for a while when I was back in college full time.

After living together, SD and I started to bond. The phone calls to her mother were filled with things we were doing and she often would say things that I had said. This made Mom pretty upset and she started to insert herself in our situation. I would say, “SD, please do this chore” and she would come back with the “You’re not my Mother” crap. She started to lie. She skipped classes. She spent a lot of time in her room. Some of this was just being 15. The rest of it was her mother.

After living with us for almost two years, she decided she wanted to stay with her mother. We were more than fine with it.

It turned out to be exactly what was supposed to happen. Her mother’s husband ended up having a brain tumor and dying. He did everything for those two. And he had money. It was a mess when he died and no one was there to take care of them.

Fast forward to fall last year and ten years after SD had left… We get a call from SD saying her mother was in the hospital and it was not good. She passed away this December. She left SD in a difficult situation. The ties of SD and her father and I were pretty strained. So SD moved back and is living with her mother’s relatives downstate.

This weekend she came here to stay for the weekend only. She is a mess. Her weight, which is a family issue, is very bad. She is in need of serious dental work. She has not seen a doctor in years. She has no direction and an inflated sense of what she is capable of.

Fortunately, she is also independently wealthy….she thinks. This is where it gets messy and it makes me angry.

SD is a 25 year old who has no idea of how to take care of herself. She has never worked a day in her life. Not even babysitting.

She has no idea of her trust fund and how to protect it. A friend of her mother is the executor. Yikes!

SD does not drive.

And she does not take care of herself. She has no health insurance. She could not even keep up with me when we went shopping for a bit yesterday. I am 60 and have PsA.

But as we chatted last night, SD opened up a bit. I had asked her why had her mother died so suddenly and we were not aware of her being so sick. It was not sudden. Her mother, a long time diabetic (II) never took her insulin or even read her BG. It was like this when she was married to my husband over 20 years ago. This transferred to kidney issues and then serious heart problems. Her mother smoked and her idea of walking was to come down three steps from the office in the house (she worked remotely) to the recliner where they ate and watched TV.

As SD sat at our table, she started to cry. She is angry. Her mother expected her to take care of her and yet, never provided her with the knowledge of how. Her mother was told many years ago that she was on a path of an early death. She needed to lose weight and exercise. SD used to fight with her to take better care of herself. Her mother needed to take her meds and she needed to monitor her BG. She did none of it. The progression of deterioration went to her liver. At that point they said she was not a candidate for a liver transplant because she was so non-adherent. There was no DNR, no advanced directive and we had to tell SD how to become the health proxy so she could do what needed to be done. Her liver failed and SD had to make the decision to have the medical apparatus that was keeping her alive removed. I also cannot fathom how that must have made SD feel.

She spoke about how her mother was so impaired that she could not get her out of her chair at night. You could hear the anger in SD’s voice as she spoke of how her mother made no effort to help herself.

And so, of course, SD has no clue at 25 of how to take care of herself. I chastise myself a bit that we let her go out there. Her life would have been very different. But even deeper inside of me is my own anger at her mother. SD has her faults as we all do. She is also a product of her childhood and the lack of parenting. But she was a child. I did have my own children and it is my greatest regret. It was not my choice either. I am angry that her mother did not cherish her life enough to honor this wonderful youngster and allowed this all to happen.

This is a very smart young woman who is a disaster and who is afraid.  SD has an amazing sense of humor and for all that she has been through, she is pretty resilient. I am hoping in time we can get her up and going in a healthy and better way. I think that this might be also incentive for my husband to be a better role model, too. I can only hope.
 

 

 

 

 

 

 

Creating New neuropathways

bush

I cracked my eyes open a bit, struggling in the weird morning light. I looked at the clock and thought, geeze, it should be brighter. The cat had been pulling on my covers and the dogs stirred. It was time to get up. I pulled back the curtain to reveal the street lights still on and a blinding snow storm raging outside. The snow is coming down so hard that it is hard to see across the street. This was not at all expected and certainly not welcome. The only good thing about it is that it is Sunday and I do not have to drive to work in it. But my enthusiasm for being positive was gone and it was going to be a struggle not to feel trapped in the house and worried about the weight of the snow on some of the budding trees. March is a mean month around here.

I want to share something I using. I have been practicing meditation for some time. Some days I can get quiet and really go deep. Most days it is very difficult to quiet my mind and retain that quiet for any length of time. I have learned that even a few moments are good. I find some days that trying to focus on nothing produces a worse effect of perseveration. When I find myself digging in on something that is bothering me, trying to get quiet is like trying to hold on to water with a sieve. It won’t work.

But I do have something that does work. It takes time to develop especially if you have PTSD. Being hypervigilant makes it very near impossible to quiet the mind. I have to be in a place that I feel very secure. This spot where I write is one. But I am often interrupted by an animal that thinks because I am quiet I need to pet them. My favorite place, and the place I am the happiest, is outside in my garden. I realized yesterday as I was sitting in the sun, that this was the tonic that I needed. Being inside for over five months has depleted me.

I am working on something else to help calm me and make me feel less like I am going to explode. I have been trying to do this for a couple of years. It has taken me all this time to make this successful. Serendipitously, someone sent me an email talking about the very thing I was doing.

When you are hypervigilant or suffering from some form of PTSD, your mind has been trained to go to a place of fear. That happens in milliseconds. Something triggers you, and there you are. When you are not aware or do not have the ability to feel and see when it happens, it is extremely hard to not go there. And what happens is you build your fear base exponentially. One little trigger sets off a chain reaction and down you go. For me, it gets compounded with a physical reaction producing pain and immobility.

When I am in the throes of a panic attack, trying to calm myself is not happening. Matter of fact it exacerbates it. It’s like not trying to look at an accident when you drive by. Instead you’re drawn to it.

My new practice, which is really helping, is to do “spot ahh” moments. It has taken sometime to feel what that is. When we are children, we do this naturally. It is when someone does something or we see something that is miraculous. We sometimes hold our breath as if to breathe would disrupt the moment.  It is finding the joy and wonder in small, inconsequential things. They are everywhere. But if you are spending your life in fear, the darkness shields your eyes and plugs your ears.

Why is this good medicine? Our brains are constantly learning and developing new neuropathways. We get wired every time we do something and we print this as a memory. For children and adults who are subject to constant horrors and trauma, the brain prints neuropathways that will enable them to be safe. One must remember that trauma is based on the perception of the victim. We learn early on basic dos and don’ts in order to survive. Things like not trusting people, being quick on your feet, being defensive, never having your back to someone are methods used to survive. This type of protection has to be hardwired and impulsive. That is what makes it so hard to change. On top of that, our brain builds negative reactions faster and holds on to them harder than positive ones. It goes beyond just thinking. It is a chemical reaction occurring spontaneously to a trigger whether real or perceived.

Trying to “talk someone” down is near impossible. Imagine how difficult it is for the individual to try to “talk them self down”.  It does not work. Things like affirmations and listening to just words is not enough. Trying to meditate to calm is like swimming in a pool with a shark. You know it is there and you are trying to enjoy the water, but something is lurking and threatening you. You cannot think safe. It needs an all-encompassing mind-printing, neuropathway-generating situation. Mediation is an excellent tool to calm down a bit. The breathing and relaxing is a great way to calm physically. But you need both the brain and body to connect.

I am trying this method. When I start to feel something nice… that soft glowy feeling of “ahh”, I stop and totally focus on it. I print it. I feel what my body feels which is usually deep and soft breathing, my skin almost tingles, and for a brief moment, I have no pain. I pay attention to the perception of no fear. Time stops for a moment and I am lost in a sea of pleasure. Sometimes I say in my head “print this”. Pay attention. The sensation goes very deep. I can feel it coming on and I have to stop and focus.

An example of this is what I experienced yesterday. I had several “moments of ahh”. One was outside. The birds were singing, the wind was gently ringing my wind chimes, the sun was on my face and warm and it was blissful. Later, I was sitting in my recliner reading a good book. I stopped and paid attention to how I felt. I was bundled in a comforter which made me feel like I was floating in a cloud. The light was streaming in the uncurtained windows and through my plants creating a lovely array of shapes and colors and I had a dog curled up with me.  I was totally safe. I deeply felt it. I can actually draw it back up as a memory now. I am building an arsenal of those moments.

This is what will make the difference. I will create a system over time of these memories. And because they are new and very strong, they are slowly replacing the fear based ones. Someone once asked me why I struggle so much. I said because I did not know what safe was. The memories were obliterated with years of fear which grew stronger with each infliction. I am sure there were happy times in my past, but I honestly struggle to be able to pull them out. So I have to create new ones. I have to teach my brain to be able to go to a happy place…..seriously.

Paying attention to the world around you is not new. It is called Mindfulness. There is tons of work being done in this field. I have taken classes and read tons on it. I have actually brought into my workplace and have a class in my orientation program. There is no real skill other than a decision to work at it. And it takes work. In our hurry-up, instant gratification world, it takes dedication to this practice.  I am not talking about running around in a Zen like trance. No one can teach this to someone. It has to be embraced by the individual. Just take a moment to stop and pay attention to the environment and your place in it. An added bonus to this practice is that it makes me aware of how lucky I am, how wonderful things can be in my world and I am grateful. Feeling gratitude is also very beneficial to your well-being.

 

 

 

 

 

My mother and Weight Watchers

stone goddesses

I began Weight Watchers in January, 2015. I am strongly letting everyone know that it has nothing to do with being accepted or trying to meet anyone else’s expectations. It is about me getting my Psoriatic Arthritis under control, which it is not. I found out that inflammation changes the hormones and body chemistry making it very difficult to lose weight. In fact, most people gain. And I am like most.

In the last two years, I sat back and watched my weight steadily increase, some of it since last May when I had a horrible incident with a kidney stone that was 6mm big. It threw my chemistry completely off and within a month I had put on 8 pounds. I thought it was fluid, but it kept climbing higher, even after I passed the stone.

I did a lot of research, as I often do when I come up against something. I thought about bariatric surgery and discovered it should be called barbaric surgery. I asked around a lot and found from the mouths of people who had the surgery that it worked at first, but then MANY gained back some, if not all. And then on top of that heartbreak, they all had some form of  new issue such as diarrhea, hair loss, pain, mal-nutrition, anemia and the list went on. This to me was not an option for me because of the other complications with my blood clotting. I scratched it right off the list.

Then I looked into serious weight loss plans. Again, major rebound issues coupled with health problems. One program was good for small weight loss like 20 or so pounds, but very impossible for long term. The diet was 500 calories with multiple supplements. Really? How does that change a life for better?

So I turned back to old Faithful Weight Watchers (WW). This was my third go at it. First time I lost about 30 pounds but rebounded. Last time I gained right off the bat. This time…. well…. First my story. This is triggered by a friend’s blog I read tonight.

My weight issues began when I was very, very young. I do not remember ever not having a weight problem. I was pudgy as baby. I had severe food allergies and then that seem to not be a problem. There is one picture of me around three and I am not fat but I am not thin. I was tall though. A picture of me at five is that of a beach ball. It remains that way the rest of my life. But in truth, there is a picture I found of me standing up and I was around 13 or 14. I was fully developed, taller than any woman in my family and thick. Not fat, not thin. Shapely. I think at that time I was a size 14-16. The same size clothes now would be a 10-12. I had fabulous legs because I rode a bike everywhere and for miles. I walked, skated, swam all the time and danced. I had a bit of a gut compare to others, but I also had a shapely figure. But by then, I learned to hide, so to see a full shot of me was startling. I also realized I was not the beast my family had portrayed.

My mother, sister, aunt and both grandmothers were petite women. No one was over 5’1 and no one was over 120 pounds. In 6th grade, I was 5’5” and 117 pounds and in a DD bra. I was considered an aberration and chastised soundly by everyone. I can remember my aunt telling me to wear a girdle when I was 13.

My mother decided right about then she was going to “fix” me. She put me on this diet of green beans and Jello. I like both, but it was all I was allowed. I bought lunch at school and that was when you did not have choices, just one hot lunch for 25 cents. Our house was filled with candy and cookies. My father made his own root beer. We had store-bought bakery goodies and donuts every Sunday. Dinner was a roast or casserole with white bread, whole milk, fresh butter, and some dessert.  Crème sauces were big and on everything like fish, potatoes, veggies and meat. Veggies were lima beans, corn, peas and potatoes. I did not have a tossed salad until I was 16. Fruit was rare and often a “salad” was a canned pear on a leaf of lettuce with a glob of mayo and a maraschino cherry. Very chic! Very 50’s.

So her solution to my EATING problem was making me eat beans and Jello for a while. Now mind you, when I was younger, if you did not eat your dinner, you were severely punished. As children, we did not eat with the adults until we were older. On holidays we were allowed at the dinner table, but no talking and no messing around. Just eat and shut up.  I learned very early to eat everything. I was the kind of child who hated being scolded in any manner. Still don’t like it.

My mother could out eat us all. Her metabolism was not given to me. My siblings could eat and remained thin until much later in life. Not me. I ate what was on my plate. Rewards were foods like a special Dunkin donut covered in frosting. Birthday meals were fried chicken or lasagna. Candy lurked everywhere, dishes and bowls of the stuff. Fortunately for me, I am not a big fan of most hard candy, but in a pinch. My mother and father had buckets of Fanny Farmers’ assorted chocolates. There was always a full cookie jar on the counter in the kitchen.  Cheap soda was in the refrigerator and the famous root beer was shared on special occasions. Even alcohol was allowed early in life and on special occasions. I learned to love Cherry brandy by the time I was eight

The part as an adult that I have had to work on so very hard is to get my mother’s critical voice and disapproving looks out of my head. She would skew her face up and would look at me with such distain sometimes that it would hurt me to the core. Food was the enemy she deemed and would go on rampages to humiliate me or shame me into “doing something about my weight.”

Dinner often turned into a battlefield, especially if they had been drinking, which….. they did every night. Some nights, it was a race to be done eating to get away before something happened. Common tortures were a heavy knife handle to the elbow for having it on the table. We had these ball shaped salt shakers which my father would swipe up and pelt at you for some perceived misdoing. As time went on, and my siblings left to go to college or their own lives, I was the featured target. My father would take his dinner plate and fling it at the back of your head like a Frisbee. If he was really out of it, he would fling whatever he could reach.

But I always ate my dinner with my head down and quiet until I was around 15. Then I began to cook for myself and eat privately when I could. My parents often never got to dinner or it would be ten o’clock or so. They were so smashed it didn’t matter. My father munched on cheese and crackers and Mom smoked. But by this point in my life, my food issues were tightly engrained and my body was never going to be petite. NEVER. I ended up at 5’ 6’ inches with size 8 feet. (Mom’s were a size 5) My hip bones (pelvic area) were a good five inches wider than hers, and at her  4’9 inches, I towered over her.

But her voice never left me. is I will always see her dark hair framing her disapproving looks.

Fast forward to now, the present moment… well we will back up first. When I started working at my job there was this woman who I saw for the first time from the back and my heart skipped a beat. I swore it was my Mom.  Something about the way she held herself.  This woman and I do not get along. She is critical of everything and everyone. She has a frown on her face most of the time. She especially does not like me. I am in the position she held for ten years as head of Education. She is a nurse, I am not. This is my failing and she and a few others let me know at every opportunity they do not approve of me. It was very hard for me to get passed her and ignore her and her cryptic comments and her LOOK.

Now, present moment. What does any of this have to do with Weight Watchers? I was doing WW on line since January. But they offered a deal at work and were going to have meetings there. So I signed up and arrived early to the first meeting last week.  Who do you think walks in to join? Mind you, if she has ten pounds to lose, it is a lot. So there I am and all the old guilt, resentment, and uglies surfaced. I could barely speak in the meeting. We had to share why we were there and I wanted to stand up and scream because my mother was a mean bitch and so are you….(looking at this woman). But in a shaky voice I mumbled about being a big beautiful woman and that I was here to get healthier. I went home so upset I thought I should quit.

But I did not. Instead, I challenged her. She has four other participants and we have our own team from HR/ED. We will win. This week our team all had significant weight loss. I am doing really well, after a couple of stalls. This will happen and then I lose a few more. Right now I have lost 5% of my total body weight from where I started. It’s all numbers. I am still big. I am also still in pain. But I have not had a shot in two months. It will be interesting to see what happens once I get a shot and calm the inflammation. Right now I can barely walk so I am not exercising. But that will become necessary soon.

The team that loses the most total poundage gets a lunch provided by the other team. I will enjoy watching her serve me……hahahah. I keep holding on to that.