A journal of healing

Posts tagged ‘self-compasssion’

A Pissy Situation part six: Selective survival

“There is only one possibility for survival for you and that will be dialysis.”  When I heard that from the nephrologist, I could not believe my ears. Matter of fact, I sort of denied it for a while. Now it has been brewing in my head for many weeks. The whole visit was so overwhelming that I thought at first I misunderstood her, but I did not. But my advice is to take someone along with you when you go to the doctor. Someone you trust and who will remember what was said.

But I did hear her correctly because my next thing to do was take a class on kidney care and dialysis. Unfortunately, the nurse who taught it was terrible and self-centered. But she too said the same thing. And she also stated that there would be only one type of dialysis for me to choose.

And this sentence, this proclamation of my mortality is based solely on my size. No one looked at any medical chart. No one did an evaluation or in-depth study of my health history. One look at my physical shape and the decision was made.

I get this all the time with medical people. I was going to use medical professionals but there is nothing professional about the instant judgement based on the bias and discrimination inflicted on people of size.

Most of my adult life, before I became sick from a hereditary malady with my blood, I was healthy as an ox. I had normal blood pressure, normal everything including not being diabetic. I was very physical and active. I was just fat. I have been so my whole entire life from birth. I was a pudgy baby. Then it was cute. Doctors used to get so frustrated with the fact my glucose was below normal and it was like they were trying to make me diabetic. I did become diabetic but that was  because of the reaction to medication for the psoriatic arthritis. Matter of fact, ever thing cascaded downward after I had to go on very strong medications. I often wonder what would be if I never needed to take those drugs. How different my life would be?

But this is the cards I was dealt, so I have to deal with it. But I do not have to accept being told that I do not have options because I am fat. No one should. If they had said I could only have this one type of dialysis because of my blood condition, I would understand it. But to tell me that a transplant is out of the question without delving into a complete work up is wrong. To tell me that there is only one kind of dialysis that I will be able to use without knowing my history and for that fact, not being a doctor, was unethical of that nurse.

You cannot imagine how this feels. I know so many large people who face this every day. The declared sentences, the judgments, the uniformed decisions based on prejudice and bias are rampant. Our health care system is not accepting and it is not just for people of size. It is for anyone who does not fit the mold of the desired patient. I won’t even go into poverty and how the poor get treated. That is not this fight.

People think that people of size choose to be fat. The word FAT has such a horrible connotation to it, unlike any other word to describe a human. We don’t cringe when say someone is tall or short. We have learned not to designate a person by their skin in a derogatory manner anymore. (Well some still do) We are offended if someone calls someone by their disability. Why is it an insult to call someone fat? Because our country has been fed bullshit by the medical world and by the media that being fat is the worst thing in the world to be. It is preached by certain religions that gluttony is a sin. Someone who is large is not automatically a “glutton”. Even small children know fat is a “bad” thing.

This is not just about whether or not I can have a transplant. It is about treating people equally. This is just my personal example of a death sentence handed unjustified and without full discovery. It a court of law, it would be thrown out. This is just one small example of how discrimination kills. This is a form of annihilation. “We let the fat people die and they will go away.” Fat people live in a ghetto of isolation all over this country.

As I approach the celebration of another birthday this Friday, I cannot sit back and let this continue. I am becoming a warrior. I am powering up with education. I am gathering information and arming myself with facts. And I will fight this fight as much as I can. I know there are many of us now who will not sit back and let this discrimination continue.

 

 

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A Pissy Situation part one

I have been putting this post off long enough. I wanted to tell a few people to their faces but that does not seem to be happening. I feel like I am about to burst and I need the release my blogging gives me. I have been writing about my life now for over six years and now it is time for me to write about my death. Yes, that is correct. I am coming into a phase that everyone eventually arrives at. It is all a matter of time. Mine has just been defined a little more accurately. This may seem dramatic, and it is. But I am not going to soften this because it will make it easier for others. Nope! This is about me, totally me and what I am feeling.

In 2006 I was diagnose with Psoriatic Arthritis (PsA) and Psoriasis (P). It took over two years for the diagnosis because I am fat. I went from someone who played tournament level tennis three times a week to someone whose hands were claws and could not walk. Everyone blamed the fat for the joint pain. Finally, when my hands curled up, I was sent for tests and to a rheumatologist. Oh boy, did I have inflammation. I did not develop the psoriasis like anyone else and so they misdiagnosed that as well. They said it was a form of hives and it was everywhere. Now, they know what my type of psoriasis I have.

Why did this happen? I truly believe the trauma of going through a life altering situation triggered it. I was going through a divorce after 27 years of a miserable marriage. I had to sell my house as part of the divorce and get my own place, which I did. But then I lost my job the day after I signed the mortgage. It was so terrifying for me. I only had the support of one or two good friends to get me through it. My social life had been based on my husband’s circle.

It was like a cascade of failing health thereafter. About a year after I moved in to my home, I had an episode where I might have had a mini stroke. I went to the hospital and they discovered five blood clots, including one very near my heart. I have written about this before so I won’t at this time. The diagnosis and the whole event probably saved me from the grave fifteen years ago. I have an inherited blood condition called Factor V Leiden. My blood clots too much. My father had it, his mother, and my brother has it. I was fine and have been on a blood thinner ever since. But this led to a gynecological issue which required more medical attention. But for over a year, I would bleed out during my monthly. I almost had to have a transfusion. All of this was over the course of two years.

Meanwhile, my body was revolting with inflammation. There is a strong correlation to stress and inflammation. During these years I met my now husband who moved in with his 13 year old daughter. We both went back to college and we were working a multitude of little jobs to get by. His daughter was not happy and we had to contend with her mother who would not stop interfering. We eventually shipped her off to her mother in California which was the right thing to do.

So back now to 2006: Once I was officially diagnosed with PsA and P, I was put on huge doses of methotrexate, prednisone, and Advil. About a year in, I started to have cranberry colored urine. The doctors said it was from the blood thinner. They did nothing and I stayed on the drugs. Meanwhile, I was putting on weight like crazy. Finally, a blood test revealed that my A1C was 13 and the other labs were indicating some kidney issues. They actually told me to diet. Really? I went from to low blood glucose with an A1C of 5-6 for most of the time since they tested me to 13 and its diet? I finally got to the rheumatologist who said looking at my labs, “did anyone tell you your kidneys crashed?”  They did not.

For the following years I was on just Enbrel for the PsA. They did nothing else. My glucose went back down although not where it was. Everything seemed to be ok. My physical ability was never the same however. Then I started passing kidney stones. I am talking rocks. I passed one so big it made my doctor cringe. I passed over 100 stones. I never went into the hospital. I just suffered on my own. They found five rather large ones in my right kidney and said there was nothing they could do. They were so large, they would never pass. They put me on Allopurinol finally only four years ago to help with the formation and it did help. But the damage was done.

It seems that these kidney issues are not uncommon with someone with PsA. The disease changes your blood chemistry to be more acidic, and uric acid is formed in great quantities. The stones I passed were all uric acid based. Think battery acid for piss. All of this can damage the kidney if left unchecked. I was unchecked for too long.

On top of that issue, about four years ago the Enbrel stopped working. I had to go on something new. I went through eight different highly potent biologicals in an attempt to improve my condition. They all had horrible side effects. The worse was chronic diarrhea. I had it so bad on one drug I could not drive to work without an issue. Work was only 20 minutes away. One morning I had to pull into a park and shit against a building. There was a Sherriff on the other side and if he had gotten out and walked around I would have been arrested. I exploded three times at work, once covering the bathroom that the CEO used. It was intolerable. They all made me sick and they did not help the PsA or P. I was getting covered with splotches and my hair was falling out. I lost  a lot of my mobility and started to need a cane.

In 2016, I was put on Humira. It did nothing for me and I had to use Advil to be able to walk. I was not taking big doses of Advil, but I should have been told to take none. The doctor knew I was taking it. The Humira gave me such issues that I had to see a cardiologist. They found nothing wrong and I finally demanded I stop the Humira. In 2017, I was put on an outrageously expensive shot called Stelara. My world changed immediately. The psoriasis was gone. The PsA was less and I felt like a human being again.

My labs were indicating things were not as rosy as I felt. First my A1C started to climb again. My blood pressure was getting very high. I put on weight, as I did with all the drugs. But the kidney function was declining. In September of 2017 my GFR (which is the measure of output the kidneys are functioning at) was down to 23. I had been there once before when I was passing a huge kidney stone and I got it back up to about 40. The GFR is saying that my kidneys were functioning at about 23%. Not good.

I decided I needed to change my life. I needed to destress. My job had become horrible and intolerable. I did not need it. We had been planning on my retiring anyways in another two years. I took the leap.

The next lab which was a month after I retired my GFR went up two points. I had made the right decision. But I felt like crap. I had little energy. I was short of breath on exertion, which was something I never had before. I was sleeping terribly and constantly tired. My PCP wanted me to see the nephrologist to see what she had to say. It took three months, but I finally got an appointment.

In the beginning of April my labs were God awful. I have enough medical background to know I was in deep doo doo. I had my first meltdown of what will be a series I am sure. My A1C had gone up a lot, and other readings indicated something was going on. Since I was put on the Stelara, my triglycerides were climbing and they were now three times what they were a year ago and at a dangerous level. But the worse part was my kidney GFR went back down 2 points.

I took my husband to the nephrologist appointment because I knew it was not going to be good. It was not good. I really like this doctor and had seen her way back in 2009 when I had my first issue. She told it like it is and what I am going to have to face. It was shocking to tell the truth and to face mortality is the worse feeling in the world.

This is the bottom line: I am facing dialysis. It may be in a year or less, or it may be two years. But it is going to have to happen as I will die otherwise. Once I am on dialysis, the prognosis is five to ten years. That is for someone who is healthy otherwise with no comorbidities. And yes I know, some people live for years and years on dialysis but guess what others don’t. One thing I am not tolerating is Pollyanna like remarks. I will go into more of all this in another post. Bottom line, my life has changed drastically and I have been told what my future holds.

Am I sad? Yes. Am I frightened? I am terrified. But I am going to fight like I have my whole life. Right now the goal is to preserve what kidney function I have. I am drinking sodium citrate twice a day to turn down the acid in my blood. I am taking more insulin. Because my kidneys aren’t functioning well, I am extremely anemic (which is why I am so friggin tired). I am on high doses of iron and vitamin D. I am trying as best as I can to be more physical. And I have had to change my diet drastically. I am going to see a renal dietician next week.

This is the most ironic part of all this: all these years I have been dieting on whole grains and tons of chicken and vegetables, I have been hurting my kidneys. I have to right now avoid potassium at all costs. Who knew my stables of broccoli, Brussel sprouts, darks greens and chicken were the worse things I could be consuming. In the effort to meet everyone else’s standard of looking appropriate, I was poisoning myself.  I will be going into this more as I learn about it. But am I angry about this…well yes I am.

In truth, I am very angry about the whole thing. I went to a renal class already as the nephrologist suggested it would be good for me to know what I am facing. She knows I already have done a lot of research on things but she wants me to get the truth, not the Internet truth. I am actually looking forward to seeing the dietician because for once, it won’t be about being fat. This is one thing I am going to write about because the discrimination of people of size is outrageous in the kidney world.

My life is altered completely. I am not taking crap from anyone. I am going to do what I want without guilt. I don’t think my husband fully understands, but we have talked about it and he is compassionate. That’s all I want right now as I lick my wounds and get my fierce up. I am glad I am retired as I can do as I can when I want. My future will be tethered to a machine, but for now, I am not. And I am going to treasure this time.

 

 

 

 

Change is needed

            My Doves

I lived with “gun fanatics” all my life. I found in my father’s archives a Lifetime member certificate for him. The date was my birth day. I started shooting when I was eight. I was good. I married someone who was fanatical about guns.  He wasn’t when I first met him. My father turned him on to guns. Then he started hanging out with other gun fanatics. He became a cop. His career was being the head of the firearms training academy.

Everything we did was centered on guns. Our friends all shot. Some were police, others were sportsmen, and one owned a gun shop.  Every weekend was about shooting. Even some of the women shot. I did not.

They ate, drank and talked incessantly about guns, gun control and how unfair it would be if they had stricter gun control. As time went on, the group became more militant and also more narrow minded, putting it too nicely. They hated everyone who was not white, Christian and straight. Somehow, I ended up in a nightmare. But this is not about that, it is about the mindset.

Yes, they had assault weapons. Why? I could never see the beauty in them like I good well-designed wooden rifle. My father had two collectable rifles which he used for competitive shooting of clay pigeons. He belonged to a gun club where he socialized. The group my husband hung with went to ranges or private locations which had set up assault fields. They were tactical ranges where you had to shoot around things. In all the times I went along, I never saw anyone use a military rifle to practice in competition. It was always hand guns. Why did they have the military guns? Because….. just because.

I am long out of that group and divorced. But I saw what happened and witnessed the hatred and bigotry first hand. I actually was on the receiving end of it often. Sometimes it was like living with a powder keg. The fuse was there. Fortunately, there were few kids. Most of the couples did not have children, including us. But if there had been, I could easily see how their minds would have been melted by the warped narrow thinking that permeated this clan. And they would have access to an arsenal.

I have always said and will say this until I die….there is no reason for guns in civilian hands, especially military grade artillery. (See how well I fit in before?) You want to shoot something, get a paintball gun. I also am not into hunting and see no need for that for most people. If you feed your family off of hunting, then I understand. But the group I was in all had enough money and there were plenty of stores around. Yes I understand the skeet and being a marksman and all. But then we used to throw people to the lions for entertainment. Isn’t there something less harmful you can do? There is no other activity on earth that makes sport of killing. It strips the humanity out of the significance of life.

This blog says it better than I can. https://agingmillennialengineer.wordpress.com/2018/02/15/fuck-you-i-like-guns-2/  This is a man who is an Army Vet. He says it all about why do we have assault weapons for civilian use.

We need to do something about better gun control. There is absolutely no reason for military weapons to be available to anyone other than the military. We need to have stricter control and better training for people who have guns in their homes. I agree with the concept of licensing and recertifying to be able to have guns, whether they are long guns or not.

The government can regulate anything it wants to the ridiculousness in the name of protecting the people. For example, my washing machine was redesigned to protect people from hurting themselves by reaching in the tub when it is running. Really? If you put your hand in a spinning machine, you get what you get. But they will allow a child to buy a gun. Anyone else see the problem with this?

Hatred: a Learned Behavior

Currently I am reading “Shrill”, a book by Lindy West. It is not for the easily offended reader. She is a comedian and is very funny. But she is also FAT. Lindy is a true Fat activist and writes for about the struggles she has. She deals with hate every day. But she wants to change the world and I think she has many valid points. She says, “Being fat is like walking around with a sandwich board that says, “HERE’S WHERE TO HURT ME!” That’s why reclaiming fatness— living visibly, declaring, “I’m fat and I am not ashamed”— is a social tool so revolutionary, so liberating, it saves lives.”

When I was growing up, bullying existed but it was not exonerated. Bullies were known. They were outcasts and shunned, unless you were one. As a child, you learned to fight back or suffer. Parents did not fight your fight for you. You could rat out a bully if you dared and they would be “in trouble,” which meant something in those days.

Today’s culture is very different. I blame the media who created movies like “Mean Girls.” Then we have TV shows like the “Biggest Loser” where they abused Fat people for entertainment. There was nothing real or entertaining about that show. There is one out there now called “My 600 Pound Life” about very large people who are suffering and struggling to just survive. There is nothing entertaining about witnessing suffering. But it creates absolution for the hatred of people of size and fosters bigotry.

Lindy talks about flying and the stigma attached to Fat people when they board an airplane. I have sat in seats that do not fit me. It is humiliating at best as well as painful. And my butt is not as big as a Kardashian. I love Lindy’s retort: “We don’t insist on a solution because it’s still culturally acceptable to be cruel to fat people. When even pointing out the problem— saying, “my body does not fit in these seats that I pay for”— returns nothing but abuse and scorn, how can we ever expect that problem to be addressed? The real issue here isn’t money, it’s bigotry. We don’t care about fat people because it is okay not to care about them, and we don’t take care of them because we think they don’t deserve care…..We don’t insist on a solution because it’s still culturally acceptable to be cruel to fat people.

We are not born hating people different from us. Babies do not see Fat people as a threat. They learn that from their parents. My parents hated Fat people and had no issues making hurtful comments my whole life. Their mothers hated Fat people too and passed that down. They had no reason to hate fat people. They also hated people of different religions and especially hated people of color. They had no tolerance for anyone different from them, actually. They were upper class snobs full of themselves. My siblings to some degree reflect the same thinking. I never did learn the behavior and was an outcast in my own family sphere. But I held true to my principals.

We live in a country where hatred, bigotry, misogynic behaviors are being tolerated and actually glorified by some. But we are starting to have people who are standing up and saying no more. We have to do this. The energy of hatred is toxic. We have to change what we teach our children. I am aghast at the comments I hear from young people that are vile and filled with prejudice of things and people they have no direct experience with. How is that possible? Because hatred is a learned behavior and we have to stop teaching and accepting it.

West, Lindy. Shrill: Notes from a Loud Woman (p. 148). Hachette Books. Kindle Edition.

 

 

 

 

 

 

 

 

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.

Hyperarousal and Hyperviligance

I have lived with insomnia for many years. I remember as a young teen sitting in my parent’s living room watching the slow dying glow of a log burning in the fire place. It was the middle of the night. I was told as a very young child that I used to sleep walk and I actually fell down the stairs. I can remember when I was 30 the sleep walking started up again and I also had other sleep issues. The biggest issue I have now is related to PTSD. This is when you wake up in the middle of the night and cannot go back to sleep for hours. But there is more to this than a bit of anxiety. It is hyperarousal.

Hyperarousal can be defined as the state of being aroused, on guard, being overly alert and perceptive. The person who is suffering from hyperarousal is actually in the middle of the ‘fight-or-flight’ reflex that occurs when the brain sends out signals of impending danger or feels threatened. It puts the body on guard – ready to run away or stand and fight. Either way the heart beats faster, the eyes dilate, breathing is shallower and you become very alert. https://www.sixstepstosleep.com/hyperarousal-insomnia-sleep-anxiety/

I suffer from hyperarousal during the day as well. But in the middle of the night, this beast rears its ugly head and I am struggling for hours. If I do fall back asleep, I usually end up with a nightmare of some sort. All this is chemically regulated in the body. I do not know what exactly the trigger is all the time for me, but it happens when I am in a state of stress. I can perseverate on the smallest detail and by the end of an episode; I will have worried myself into a real frenzy.

Two weeks ago I actually got up and took my blood pressure and the reading was extremely high. But it was high all week from the stress of leaving my job. The physical condition I was in from the pressure of work and the all BS going on played havoc with me. But even with being away from the situation, I am able to find other things to fret about.

Hyperarousal also causes me to erupt. I can over react to the smallest things such as simply dropping something. I get frustrated very easily and have an over the top reaction. For me, it is compounded with the high level of pain I am in from my psoriatic arthritis. Unfortunately, it is a nasty loop. I get mad from being in pain and limited in my mobility and then I get a flare from being upset. They feed each other and around I go.

Compounding the situation is the sister reaction to hyperarousal which is hypervigilance. That is when you are always on alert. This is when you constantly are scanning for threats. When I was first diagnosed with PTSD, the therapist said I was like a trapped animal. I never turned my back to him. I constantly watched every move he made, especially with his hands. I think I am better but when I get threatened or perceive I am being threatened, I go back to being hypervigilant. I realize now that the past couple of years being in the toxic work environment I was in really set me back. A result of being hypervigilant is being exhausted. So I fall asleep very quickly but wake up in the middle of the night. On average, I sleep in two to three hour blocks. A good night is when I can sleep with a four hour block.

I write this not as a venue to complain but to share for someone who is going through similar things. There is comfort in knowing that you are not alone. I am planning on talking with my doctor about this if my sleep does not get any better. They recommended last year I seek retirement. It has been a long haul getting away from work and the nasty people I worked with. I have had some things going on in my home which has been concerning so I have not been able to totally calm down. But I am physically more active at home and that helps. I also need to get back to a strong practice of meditation again. That really helps. I already feel better and I know I am healing. But it is a slow path.

https://www.medicalnewstoday.com/articles/319289.php?sr

 

I did it!

I did it. I left my job. I “retired.” It has been a tumultuous month getting prepared for the last day. It came and went with a whimper. My body reacted far more than my mind. In my head, I kept feeling like I was going on vacation. Not even on the last day when I packed the light that has been on my desk for 6.5 years  did I feel like it was a permanent situation. Handing in my badge was emotional however. That has been my identity for so long. “Employee” “Director.” Now what am I?

I am relieved. It is hard to explain how much physically different my body feels. I have been living in terror for so long and the last month was even more so, if that is possible. When you have PTSD, your body takes over and reacts without your thoughts. I was a knot of tension which got worse until the last day. My stomach ached, my blood pressure was way up and my chest was tight all the time. My normal aches and pains were heightened. I did not sleep. I was a mess.

But my Spirit guides showed me that the path to leave was the right choice by showing me a glimpse of the future. I left turmoil and a toxic environment that was only going to get worse.

One by one, my employees came to me to tell me their plans for the future. One has a sick mother and will probably be taking FLMA and the new extended paid FLMA is the spring. She already asked for two weeks in February to make plans. Another one wants to go back to her family in Africa where she has a sick sister. She too is planning on using FLMA to scope things out in the early summer and then leave later this year.

They never hired the new clinical education manager. Now, they are so desperate, they may promote the girl I hired to be the Educator. I hope they do that as at least she has an idea of what is going on. When I resigned, the VP redid her job, and took away most of the responsibilities that made the job challenging and interesting. If they keep her at the position, she will walk. She wants to grow in her career, not go backwards. The Lead Preceptor is still on limited restrictions and only working five hours a day when she can. She detests the VP and will go back to field if he messes with her.

But the final conflict was with the part time paraprofessional trainer I hired last year. She was a pain in the ass from day one. She wanted more hours. She did as she wanted. She did not follow regulations when it came to training. It was a tough job to fill and so many times I looked the other way on certain things. But I knew she was a liar because she got caught in lies so many times. What made her lies so hard to comprehend was that her other job is a Pastor of a Church, unless that is a lie too. The last straw was her timesheet the week after Christmas. She marked herself in an hour and half sooner than when I know she was there. I had four people looking for her on this day who all said she showed up at 1:30. She marked she was in at noon. I went back and pulled her timesheets for six months and matched them up to her badge swipes and there were huge discrepancies. We have to swipe to get into the buildings. I never trusted her time, but I did not think she was padding her timesheet as much as she was. And it is hard to prove because I was not in the same building as she was so I never knew for sure when she came in. But this was fraud and I had witnesses. I had to fire her.  The stress of this was terrible. But somehow she got wind of it or knew her performance was terrible and resigned on this past Wednesday. I was so relieved because she is very unstable and firing her might have been very dramatic and possibly violent.

There was so much else going on during all this. I left a mess that was only going to get worse in time. The new regulations coming out governing the way home care agencies do business are ridiculous. The amount of documentation that the clinicians are going to have to do is extraordinary. It will be too much for some and they will go back to the hospitals, where there is much less documentation. The insurance companies are building in requirements that are so restrictive in order to deny payments when they are not met. Much of the work that was done in the last two year at the agency has come unraveled. The big Lean projects designed to correct money issues are collapsing due to lack of oversight. Since June, the agency has lost even more money that they did the previous two years and will be at an all-time new low as far as meeting the budget. They will lose over 5 million this year. It will mean even more layoffs with a support staff that is extremely limited. They already canned one Administrator. The “Mothership” will be replacing higher positions with their personnel and absorbing more of the support roles. That has already started. They will never shut them down, but they will run the agency.

But through all this, I came to realize that I was not cut out for the tension and back stabbing anymore. I also do not like the “new” workforce. I had to train this young chicky who is the golden child of the VP I worked for. She is the typical young spoiled child in her late twenties. One day when I was training her on a training system we use, she was slumped across my desk with her head in her hand yawing in my face. This lack of respect display was only heightened by her continually picking up her phone to check something and text. How much do you think I really showed her? Good luck! On the last day, she was panicking because the VP asked her to pull a report and she had no clue as what to do. The three of us had to meet and I did explain it again to her in front of the VP.  I will not miss that crap at all.

I will not miss the hurry up and do something only to have it not used or forgotten. I think of all the stupid busy work that I was requested to do by the rotten VP only to have him move on to something else. I think of all the finger pointing and the excuses and blame. I will not miss that. Did I just get old and was this crap always there?

The firing of the part time instructor caused a huge issue. She was also the train the trainer, and instructor for the agency’s CPR program. By regulation, we have to have some of our staff CPR trained. The same chicky who was so bored during her training with me was to be trained as a new instructor and to take over the oversight of the program when I left. She missed her training (three times) and so was not certified. I was leaving them without an instructor in CPR. This caused me great worry. She could give a crap.

I finally figured it out. Her generation was raised, and especially her because she was an only child of elderly parents, that she never had to resolve anything in her life. Someone else always has fixed it or she just didn’t care. I have seen this behavior in so many 20 and 30 year olds. I was raised to take responsibility seriously. I took it to an extreme where it was physically harming me.

This lack of concern is apparent in the quality of documentation performed by the clinicians. I see it in young managers who cannot deal with conflict and go running immediately to their superior. I see the degradation of leadership where the “what-ever” attitude is beginning to permeate. This is not an arena I am comfortable in. I want to work with people who give a shit and take it to heart when they are in charge. I cannot abide the cocksure attitude of children who think they know everything until they are put to the test and then point fingers at others in their failure. I see it our training rooms where people are looking at cell phones instead of absorbing the lessons that will make them successful. What is even scarier is the increase in errors in medical practice. Very scary. My favorite horror story is where some packed a sacral wound only to discover it was the person’s anus they packed.

I know too much. I know what has been buried. I sat too long on boards that over saw the discrepancies and issues that were harming patients as well as the agency. I am no longer able to tolerate the lack of concern and I know I was not the only one. I was the last of the senior staff that was with me from the day I got hired.  We called ourselves the Brain Trust and we were powerful and passionate about our jobs.  They all have left or retired.

Smugly, it pleases me that it will take two new directors and two new managers to do my “job”.

The only thing I am in charge of now is me.  I think I am in a good place finally.