Christina's Considerations

Celebrating 420 with CBD

Last year, I celebrated my first 420 with a gift guide.  Since then, I've continued to learn and test CBD for a variety of symptoms.  I've also received great feedback from others who have tried the products.  This year I share a new list of recommendations focusing in on the needs of those asking, "What CBD product is best?" or "Where do I start?".

I first want to note that the products listed here come from HempMeds and I've selected them because I trust the quality and safety of their growing, testing and production processes.  My trust was recently reinforced with they announcement that they have the first CBD product to be listed in the medical mainstream resource Prescribers Digital Reference (formerly known as Physicians Desk Reference.  Now, on to the list!

Tinctures and oils seem to be an easy way for people to get started with CBD.  The price-points and less stressful and oils are easy to take.  My recommendation is to look for full spectrum oils and the amount of CBD in the bottle and each recommended dose.  A simple hemp oil is much different and may not provide the effect one is seeking.  

A 1 oz bottle of RSHO Blue Label Tincture is an ideal starter supplement for anyone wanting to give CBD a try.  It is full spectrum decarboxylated hemp oil containing  100 mg of CBD.

 

RSHO Hemp Oil Gold  This 4 oz bottle of  easy to use liquid oil is full spectrum and contains 1000mg of CBD.  It has a clean light coconut oil flavor with only a hint of earthy hemp.  It is an ideal choice for those using CBD during the day and, possibly, using larger doses.

 

 

 

Another easy-to-use CBD product was featured in my list last year, but it now comes in a new flavor - Sour Apple.  The Dixie Botanicals Kicks contain 5 mg of CBD, B vitamins and slow-release 100 mg caffeine for a low calorie energy chew.  It is ideal for getting through an afternoon or anytime you need a little extra boost without the calories of energy drinks.  Chocolate and Mango Citrus are also available.

 

Last year my list included a salve that has further proved its value - especially for swollen and irritated injection/IV sites.  But, some might prefer the efficiency of a roll-on, especially if it is needed for the back or other large areas of the body.  The Active Relief Roll-On contains 10 mg of fast acting CBD that combats stiffness from everyday activities.

 

 

Lastly, to celebrate, I'll be adding "beauty" products to the shop for those with functional limitations.  Why?  Because, those challenged by chronic illness, pain and the limitations it brings can feel and look a bit run down at times.  Seeing ourselves look  better and less aged, might also help us feel better.  That positive feeling and outlook could actually impact our overall health and wellness.  

The first item added is  Defined Anti-Aging Cleanser contains CBD-rich hemp oil, dragon's blood and astragalus to nourish and deeply cleanse the skin.  It removes and hydrates the skin; leaving a noticable difference.  If you don't believe me, ask my husband or 80-something year old sister-in-law.  

 

 

Medications and Dry Weather

My mom first learned I had drier skin than most during one of my newborn visits.  Dry skin and use of lotions and moisturizers has been a part of everyday life for me.   Growing up in the humid south was a bit easier than it is now that I'm in Southern California.  Dry weather (winter or summer), dehydration and a new medication all add to dry, cracking and painful lips. 

Our lips don't have oil glands, so applying balms and ointments directly to the lips can help.  But, sometimes this isn't enough and we also need to make sure we are drinking plenty of fluids. Last summer, while on a road trip to Nevada and the desert, I had severely chapped lips after starting a new medication.  I used ointments, kept a bottle or glass of water with me constantly and patted water on my face.  It was painful and a bit labor intensive.  After returning home, I pulled out the humidifier I used for my children when they were sick and plugged it in on dry days.

At some point I started thinking about a portable humidifier.  As luck would have it, I was sent a sample of MistPro3 from MistyMate.  The funny thing is that it was pitched to me as a personal mist-cooling device for the music festival season.  While this might be an excellent use, I immediately thought of a portable and personal humidifier to provide relief when dry weather or environments (airplane, home, office, car, etc) leads to severely chapped lips!   

This week has been particularly dry and windy here in Southern California and it was my first opportunity to really test the MistPro3.  What I like best is that it uses manual pumping to pressurize  and propel an ultra-fine mist.  I fill it with water, take it ANYWHERE and gently pump to pressurize the device.  I can spray it right on my face/lips and because it uses microparticles that flash evaporate, I'm not a dripping mess.  In addition, the water lasts much longer that anyone would expect by looking at the small canister capacity.

The MistyMate is truly a portable personal humidifier and anyone with chronically dry skin and lips will appreciate this little device.  The langanippe is the cooling effect it will also have on those especially hot days. I don't think I'll be leaving home without it! 

Eat Pray Love: The Spoonie Senior Version

A few years ago I listened to the audio book Eat Pray Love. It is the story of a woman who re-examines herself after a life change and goes in search of her new self.  My hero, of course, plans ahead for her journey to foreign lands.

My life change has been a chronic illness and aging; also just a few years away from being an empty nester.  I've found myself re-examining myself in the context of my functional limitations, treatment schedule and young adult children who increasingly are pulling away.  I've also started looking toward my husband's retirement and went home to help care for my mom for a month and a half.  She and I cleaned and cleared her bathroom and bedroom of clutter and things no longer relevant, so she could focus on what she needed and was important.

After returning to my home early this year and catching up on my life, I found myself starting to clear and clean my own clutter and things that are no longer relevant, so I can focus on what I need and is important.  I also find myself wanting to prepare for a smaller household and move, so that I can expand my own inner search by journeying to not so foreign lands.  This has made me remember Elizabeth Gilbert's book ... and the need to use or rid myself of things so I can travel lightly - in body and soul!

What follows are things others like me can do to begin to shed some of the weight that burdens us.  The weights sometimes add work and time to what should be a simple routine, or divert resources away from what is more important.

1.  My first stop was in the bathroom and my makeup drawer.  Years of being a working woman meant looking the part.  No longer do I want to need to wear makeup every day.  And, there were things in that drawer that I will never wear again because it is out of style or as in the case of mascara, I can't due to tremors.  What is left are the few things that I do want and need, a clean drawer and a little bowl of all the extra suit and dress buttons I always saved in case a mend was needed.  For now, these buttons are a small reminder of what was my past.

2. In the kitchen, I'm currently going through drawers and cabinets and riding myself of things no longer or never needed and wanted.  These are things like a set of frames that got lost so long ago and serving dishes that haven't served and probably never will.  It also includes baking and cooking items bought over a generation, so that my three children could join me in the kitchen to learn to measure, cook, clean and appreciate accomplishments.  These special items are offered to the kids and they are choosing what to keep and what to donate to others.  All the empty sprinkles bottles and broken popsicle molds are going in recycling.

3. In my office... oh my office.  The paper is being recycled slowly, but surely.  I'm reliving the newspaper clippings, shredding old consulting files and recycling all the old business cards and back up materials to move me closer to a fully digital world.  The extra space is being used for new interests and hobbies; including my Etsy shop that is great hand therapy and my store for people with functional limitations.  There is also room for me to move gloves and hand tools closer to the garden.

4. Speaking of the garden.  I can't do the big push gardening, as I did in the past.  So I moved it outside my office where I can see it every day and enjoy short tinkering around the plants.  In addition, walk up gardening is much more enjoyable and forces you to prioritize the amount of planting.

5.  The collection of things in the garage was my most recent project. Skateboards, helmets, surf wear, balls and more went first to the local sports shop that buys used equipment.  The rest was donated.  Move boxes left by my young adults were consolidated and returned. Trash, empty boxes were pulled out and the rest was organized.  The art desk - not touched in many moons - is partially done.  The dried up finger paint and dough are in the trash.  The beads have been donated in bits and spurts.  I'll hold on to a few things that may come in handy for my new life or if I just need a little more time to give it up.

What's next?  Our yard is a mini Lotusland and our collection of exotic plants.  My husband and I can no longer manage the amount of care needed and in some cases need to thin what we have so other plants have more room.  We will sell what we can, so others can enjoy our labors over several years.  We will also prune and trim fruit trees down significantly to make them more manageable; and probably improve the quality of fruit at the expense of quantity, which isn't really needed.  After that, the attic!

I have five years to prepare.  Five years to continually lighten my load and free me from stuff and responsibilities no longer desired.  Five years to reflect and prepare for a new journey.  I'm off to a good start.  Are you?

An End to Upside Down Thinking

Early in my career I focused my mental energy on my goals, and opportunities seemed to appear when needed the most.  I'm an optimist and also believe I must address challenges in order to control my destiny.  The mind has always fascinated - why do people do what they do? And, how do they do it?

Mark Gober's recent book, An End to Upside Down Thinking considers the role of the brain in creating consciousness and explores scientific data in a variety of  fields; including quantum physics, psychic phenomena and near death experiences.  He guides the reader in critically thinking about the role of the brain (physical matter) on reality and consciousness.  It is a fascinating read that has implications for medicine and wellbeing.

Below are key considerations we should all ponder.

1. Proven and accepted science sometimes defies common sense.
2. Quantum physics, the idea that "the universe doesn't always work in a way that aligns with our everyday experience".  It can explain invisible connections or "weird phenomena"; such as, telepathy, psychic abilities, and extrasensory perception.
3. Evidence presented suggests the need to re-think the materialist claim that the brain produces consciousnesses.  This has significant implications for neuroscience.
4. Science and mainstream thought have been wrong in the past. "The world is flat!"  The idea that the brain doesn't produce consciousness would require a paradigm shift in thinking; and some scientists to admit they were wrong.
5. Nikola Tesla once said, "the day science begins to study non-physical phenomena, it will make more progress in one decade than in all the previous centuries of its existence."
6. The statistical evidence for telepathy (mind to mind communications) is overwhelming.
7. Precognition - studies show parts of the body (skin, eyes, brain, heart) respond before participants know what is coming.
8. Energy healing experiments suggest mental interventions can protect cells from radiation and kill cancer cells.
9. Our broader reality of conscious can be drowned out by the noise of our everyday, localized life - delaying attainment of self actualization.
10. Communications with the dead (mediums), deathbed visions and terminal lucidity (unexplained mental clarity before death) challenge our definitions of life and death.
11. All humans have the potential for psychic abilities.  Yoga, meditation, sensory deprivation, etc. can help sharpen ones skills.
12. "The abilities, limitations, and threats of artificial intelligence may ultimately depend on our understanding of where consciousness originates."
13. Psychedelics (psilocybin) has reduced anxiety and depression about the prospect of dying in terminally ill cancer patients.  There are also potential therapeutic benefits in other areas of mental health; including PTSD and addiction.
14. Our minds  and intentions can impact our healing and be enhanced by patient engagement and activation activities.
15. Doctors should not limit their focus to physical causes and treatments of illness.  They should also incorporate non-physical and mental aspects for a broader approach to patient-centered care.

What do you think?  Is it possible to open up our consciousness so that we can find the paths we should travel?

Ghosting: Tips for when your doctor disappears

I recently learned about "ghosting patients" - a term used when patients find their physician (or other provider) has left a practice/clinic/medical group/hospital/etc and they don't know how to find them.  This often happens due to some sort of separation like leaving to start one's own practice/group, moving to a new practice/group or being fired -- with or without cause.  Ghosting usually arises due to contract clauses and the medical group or practice to lose that physician's patients.  But to patients, it feels like their physician has disappeared into a puff of smoke. 

It got me thinking and I wrote an article on it for healthcare leaders to understand the impact on patients.  I also considered reaching out to patients and their family caregivers  who might be perplexed and not understand what options are available.  It all comes from my personal belief that no one should tell me who I can, or can't, see as my physician.  Well, other than insurance companies who tell us who is in network and who isn't.  Even in these cases, we can see who we want, but they might not pay for the fees.

So, what can/should you do if you call and find your physician is no longer practicing at that number, or you show up for an appointment and there is a new physician in his or her place?  My answer is to advocate for yourself.  If it doesn't bother you to see the new physician, and you actually want to try someone new, then see one recommended or suggested by the office.

If you want to continue seeing the same physician for continuity and the trusting relationship you have built, then inquire about where you doctor has gone.  Perhaps they have moved out of state, changed their practice or retired and you don't have much choice to see them again.  The office staff should be able to tell you something, even if it is a generic "he/she has moved to another practice."

My tips for what to do next are listed below.  It may take some extra effort, but it may be worth it to you.  The text in red are keywords to use that will get the attention of most administrators.  Not everything will apply in all situations, so use what makes most sense to you.

1. Ask around or Google the name of the physician you want to continue seeing.  Is their new office within your travel circle?
2. Once you find the new office, call to schedule an appointment.  If you are told the physician can no longer see you, ask why.  Ask if it is due to a clause in his/her contract at their prior location.
3. If it is a contractual clause, call both locations - the previous office and the new one - and focus on quality and safety reasons for you to continue care with your existing physician.  Be prepared to explain why you feel you need to continue with that physician. Reasons can include:
   1. you have a complex set of health conditions or a carefully constructed treatment plan.
   2. the physician is uniquely qualified and competent to treat your specific disease or set of conditions.
   3. you and the physician have built up mutual trust and a routine that has kept you safe, on track for recovery or avoided a deterioration of your health.
   4. you believe there hasn't been an adequate hand-off process.
4. Ask the existing practice to share with you the information that demonstrates any of their other physicians are qualified and competent in treating your condition(s).
5. By this point, you will hopefully have an appointment with the physician of your choice.  If there are still objections related to the contract and non-compete clauses, then
   1. ask to speak to the person is is responsible for ethics in the practice 
   2. ask for the process for filing a grievance
   3. Ask how the prior practice/group plans to force you to continue treatment in the practice
   4. ask how they plan to enforce non-compete clause of the contract; and mention a recent Kaiser Health News article; noting that courts are hesitant to uphold and enforce some non-compete clauses because they don't like denying patients their choice. (A precident!)
   5. let the practice that employed the physician know you look forward to completing your next patient satisfaction survey.  Increasingly, insurance reimbursement (especially Medicare) is tied in part to patient satisfaction.
6.  Hospitals, clinics and medical groups that are licensed or accredited are required to hang these documents where they can be easily seen by the public. Look for these documents and call and file complaints. State licensing agencies, the Joint Commission, Accreditation Association for Ambulatory Health Care and other certifying organizations regularly assess the quality and safety of care provided.  Complaints and patient satisfaction are included in their decisions.
7. If you are a Medicaid or Medicare patient you can also file a complaint or grievance.
8. Go online and make some noise.  Clinics, medical groups and even small physician practices are increasinging concerned about their Yelp reviews. The two most popular physician rating sites are Healthgrades and Vitals

Most importantly, use your own words to convey why it is important for you to continue seeing your current doctor.  Insert any of the keywords that are relevant to your situation.  If you find that any of these or other techniques work, please share them below.

At some point in the process of following your physician, you may also need to request a copy of your medical record from the previous practice or medical group.  Talk to your physician to see how much he/she needs or wants.

Most importantly, advocate for yourself!

 

Safety In Healthcare: Considerations for Consumers, Patients & Family Caregivers

Safety in healthcare has been around for a really long time.  Florence Nightingale is sometimes referred to as "the mother of patient safety"  because of her attention to healthcare design.  In the 1800's, she advocated for improved ventilation and sanitary conditions.  She also addressed overcrowding and nutrition, check patients at night and believed in education and spreading knowledge to improve care.  Her new way of thinking about patient safety and advances over time have lead to safer healthcare environments.  But, safety in healthcare continues to evolve from being something professionals do for patients to now including the need for patients to fulfilling their responsibilities for better care.

Existing safety thinking in healthcare is to eliminate all accidents, failures and injuries.  It involves identifying what went wrong and implementing fixes to make sure it doesn't happen again.  This includes imagining the ideal for how doctors, nurses and other staff provide care to each and every patient.  But, there is some though that it might be time to step back and reflect ... and consider that patients are all different and how they experience disease, injury, illness also differs.  

The new way of thinking, Safety II,  is that there will be times where flexibility and adjustments will be needed to ensure that every patient is safe.  The conditions of work  and people change.  How care is delivered to one patient with diabetes, may not be the care needed by another patient who also has a heart condition and can't read.  Or consider a young woman who is pregnant for the first time and also battling a mental health condition and obesity; compared to a relatively healthy young mother pregnant with another child.

What this means for consumers of healthcare, patients and family caregivers is that we too must realize that adjustments to the care process  must sometimes be made to accommodate the variation that comes from our differences.  The patient or family caregiver role is also to speak up and communicate how we are different and how the care may need to be adjusted to match our circumstances.  The video below provides some ideas for identifying when flexibility and adjustments may need to be made with your care... or even your own activities so that recovery isn't jeopardized.

 

The next time you visit your doctor or receive other healthcare services, consider how you and your needs might be different and talk to the staff about adjustments and flexibility that might be needed.

Disaster Supply Kit: A Visual Checklist

Being prepared for a disaster is the responsible thing to do both personally and professionally.  Disasters create business and personal risks... especially for those with special needs and/or functional limitations.

Over the years of promoting preparedness and urging communities and individuals to collect supplies in advance of an event, I've come across several checklists to provide guidance with the process.  But at a recent senior fair, I found a visual checklist and thought this would be important for some individuals - beyond those who are unable to read.

Whether you follow a written or visual checklist, collect and prepare supplies you will need if something happens and you will need to be on your own for a while.  This means:

• no grocery
• no pharmacy
• no hospital/doctors
• no or limited utilities
• no gasoline/transportation

What is most important to you?  What do you need if you are at home... or on the road?

For more, see Ready.gov!

 

 

Does ALL CAPS still indicate screaming online?

In the early days of the Internet, typing in all caps was deemed to be rude and screaming during online conversations with others.  However, is this really always or still the case?  This question occurred to me after reading an exchange in an online support group and it may be time for a re-visit.

When I want to emphasise something, I often use an exclamation point,  italics, bold or colored text.  I really can't remember a time when I used ALL CAPS - until now.  Other options are also available, such as using heavier fonts.

What I read in the online support group, after an accusation of screaming, is that this person uses all caps in her typing routinely - because it is easier for her to see and make out letters.  She has a visual impairment!  I guess she could increase the font, but that requires some extra clicking for each textbox.  But, we are all different and capital letters may just be the easiest for her to read.

Research findings from 2007 do indicate "upper-case is more legible than the other case styles, especially for visually-impaired readers, because smaller letter sizes can be used than with the other case styles, with no diminution of legibility."  They found that upper-case text is more legible in terms of reading speed, for readers with reduced acuity due to visual impairment, and in normally-sighted readers when text is visually small. The bottom line is upper-case text is simply more legible, albeit less aesthetically appealing, than lower-case.

But, do a Google search and you will find not everyone agrees, including the American Foundation for the Blind. So, this brings us back to the individual person and their specific vision impairment or sight weakness.  Older adults are online in much greater numbers today; and we know vision impairment is common in older adults.  So, what do you think?  Is ALL CAPS easier for  you to read?

Aging Pets and CBD

Aging often brings chronic illness and pain into our lives.  However, we aren't the only ones in the family who can suffer from this.  Our pets - dogs, cats, horses, etc - can also experience arthritis and other conditions.  And, even our younger pets, especially those who were rescued, may also experience anxiety.

Fortunately, cannabinoids (CBD) can also help our four-legged family members.  The CBD I've seen tested is HempBone Bacon Apple Donuts with 4 mg of CBD in each chew.  Just as for their human friends, finding the right dose and quality products is important is important for pets, too.  

Each bag includes 40 to 50 donut chews and recommended dosing depends upon the size of the animal.  

• 1-2 Chews per day for Small Pets (20 lbs and smaller)
• 2-3 Chews per day for Medium Pets (20 lbs – 30 lbs)
• 3-4 Chews per day for Large Pets (30+ lbs)

Feel free to share your experience with CBD and pet(s) in a comment to add to the conversation.

Comfort in A Healthcare Facility

Since my post on Comfort in the Hospital, I've collected some new ideas and want to share them along with some new insight as a caregiver, as well as, a patient and former hospital administrator.  With Easter and Mothers/Fathers Day celebrations coming, a little something can go a long way to making an assisted living, skilled nursing, rehabilitation or hospital stay a bit more comfortable.

My list comes from samples I've received and tested over the last few months.  Each makes one feel more comfortable in their own unique way.  Links to where you can learn more and find these items are included as hyperlinks.

Arm Warmers - I get colder now and do layer, but sometimes just need periodic warmth on my arms.  In addition, I find that arm warmers provide a bit of compression to help my arms feel a little less fatigued as the day goes on.  I've tested a couple, but the ones I like best are  from Derivative; mostly because the don't slip.  They are a soft cotton blend; and as a more conservative dresser, I like the solid colors.  I can put them on in the morning and easily slip them off as the day warms up.  Or, keep them on if I need my arms need some extra support throughout the day.  Besides, their models make me feel like I'm one of the cool people!

Compression Socks - Like the arm warmers, compression socks are a must have for those with circulation issues.  They are excellent for long trips, but also for those who may be sitting and not moving around for long periods of time in a facility or at home. The compression socks from Comrad have a comfortably tight feel, without being too challenging to pull on or off - especially for those who already struggle with hand strength and coordination.

Airborne Particle Blocker - Healthcare facilities can have questionable air.  NasalGuard provides an invisible barrier against contaminated air, virus-size particles, pollen, dust mites, smoke and more.  Those with significant allergies or suffering with air pollution will really appreciate the electrostatic technology that reduces the inhalation of airborne particles.  All it takes is a drop rubbed under your nose every 4 to 6 hours.

Denture & Partial Spray - The EverSmile FreshDent is a portable cleaner and that kills bacteria for denture and partial wearers - even while they are in the mouth.  As a long time retainer wearer, this is certainly a welcomed product for those on the move, as well.

New & Improved Toothbrush -  Dr Plotka's toothbrush has antimicrobial bristles infused with silver to naturally eliminate 99.9% of bacteria that grows in between uses.  This is great for the average person. But, for those with fatigue, arm/hand weakness and/or coordination challenges, it also means more effective brushing - and who doesn't love a new toothbrush!

Blue Light Blocking Eyewear - Patients and residents of healthcare facilities don't have control over all lighting.  And, sleep is really important and valued.  SafetyBlue offers two styles of glasses for wearing before bed to signal your body to produce melatonin naturally.  Some will need to work up to wearing them for longer periods, since it is an odd feeling at first.  But, after a few nights you will be wearing them for a couple of hours  before bed and sleeping better.  On style even allows you to wear them over your regular glasses.

If you have tried any other products and want to share what you have found, leave a comment for all to benefit.

Firearm Safety and a Dementia Diagnosis

The US Census Bureau estimates that  older people will outnumber children for the first time in US history by 2035.  So, it makes sense that we will see a corresponding increase in the more common “older people” conditions over the next several years.  This includes Alzheimer’s and other dementias that impact cognitive functioning – including the reality they may no longer recognize close family and friends.

In prior blog posts I’ve addressed gun violence restraining orders, as well as, personal safety planning and want to bring these two together today.  Why?  Because I’ve been reading in social support groups about the struggles caregivers are facing as they remove guns, or attempt to remove them, from the homes of parents, grandparents, spouses, and others with dementia.  It occurred to me that we are more focused on the safety of older loved who are still driving.  But, what about those who own guns?  Just as someone may no longer be considered a responsible/safe driver, they might also no longer be considered a responsible/safe gun owner.

The Alzheimer’s Association has produced a fact sheet that provides some tips to help caregivers with the conversation and process, but it isn’t always going to be easy.  Family caregivers also need help from physicians and other professional caregivers; who should at least ask about the presence of guns in the home during the assessment process.

Friends and family members, as well as, healthcare providers need to assess risks and focus conversations on safety during care planning activities.   For example, the Veterans Health Administrations recommends that clinicians and care teams ask about firearms during safety screenings of those with a suspected or definitive diagnosis of dementia.

The American College of Physicians has also established policy positions based on a public health approach to support caregivers.  They recommend medical professionals speak out on prevention of firearm-related injuries and deaths, just as physicians have spoken out on other public health issues.  They encourage physicians to counsel patients on the risk of having firearms in the home, especially when “children, adolescents, people with dementia, people with mental illnesses, people with substance use disorders or others who are at increased risk of harming themselves or others are present.” 

In an NPR article, one psychologist who promotes the idea of talking to patients about the presence and location of guns, also addressed ways to guide the conversation to make it more acceptable.  Dr. Joleen Susman suggests a more successful approach -- talking about “retiring” from driving and using firearms  – instead of taking these privileges away.

Dr. Emmy Betz, an emergency room physician, also recommends having these conversations early in the disease and involving loved ones in the planning and decision process.  She encourages use of  written firearms agreements, such as the sample below.

Beyond being non-judgmental and simply asking patients if there are firearms in the home, UC Davis has created guidance for healthcare professionals who need and want to have a focused interventions with at risk patients.  Resources available also include patient handouts.

In some cases, those with cognitive dysfunction can become angry, aggressive and refuse to voluntarily have guns removed from their possession and/or the home.  In these cases, family member must keep safety – to self and others – at the forefront of conversations and reach out to local law enforcement for assistance.

Thirteen states have established “red flag” laws that allow law enforcement, and sometimes family members, to petition a judge for temporary seizure of firearms from those who exhibit dangerous behavior. Both the  NRA Institute for Legislative Action or the Giffords Law Center to Prevent Gun Violence are resources for the status in each state.

We do all have the right to keep and bear arms.  But, we also have a responsibility to recognize when it is time to relinquish that privilege for the safety of others and ourselves.

A Call to Healthcare Professionals: Contrary to what you’ve been taught, use social media

Way back in 2005, I began blogging.  After a couple of years, I got tired of explaining to my hospital administration and physician  friends "what's a blog?" and "why would I want to Twitter?"  Since all of the young people knew these answers, and the correct terminology, I thought I should write a book so that my peers could have more intelligent conversations with young innovative staff and recognize the value of emerging social technologies.  Now, whenever anyone wants to know "what's a tweet?" or "but, what about the risks/HIPAA/etc?", I just direct them to my  first book - published by Health Administration Press.  When they want to go deeper and she case studies of how other healthcare organizations are leveraging social tools I point to my book published by HIMSS.  In both cases, I attempted to educate, overcome fears and and build confidence in healthcare leaders who needed, and wanted, to move beyond "how we have always done it in healthcare."

So, when Dr. Mansour seemed to have a similiar observation on lingering concern among the medical community, I had to share his post.  He believes physicians especially are still timid and many have been consistently taught otherwise in school.  He is correct to share his vantage point as physician to help other physicians reflect upon and address their own concerns.     

Guest Post:  By Joshua Mansour, M.D. is a board-certified hematologist and oncologist in Stanford, California doing work in the field of  Hematopoietic Stem Cell Transplantation and Cellular Immunotherapy. Follow him on Instagram @DoctorJosh_MD

From the beginning of medical school, one of the first things “instructional videos” that we had to watch during orientation was about “social media” and what “not to do”.  There began this stigma and it was frowned upon to use social media if you were a healthcare provider. 

There are the obvious things that physicians should not do, such as post private information about patients, show a patient’s face without their permission, or exploit medically sensitive information.  But no one tells you what you can do and possibly what you actually should do. 

There is a new wave that has now taken over that we as a healthcare community and a community as a whole should support, especially if it is meant to help others. Most recently I have approached social media in a different way and gone out to explore what is available as a tool to help others.  What I’m finding has been mind-blowing and I am very excited to see where it continues to progress in the future. 

People are sharing their journeys, inspiring others, raising awareness.  There is a whole community of individuals working as a team to help others.  It is incredibly inspiring.  Before recently I had thought of social media as being full of people only posting pictures of fun trips or nights out, throwing out their opinions out into the open for people to see.  We now have social impact movements, live videos with question and answers for students, people showing their tough times and how they are overcoming them.  People are reaching out to others for encouragement, collaborations, and progress. Using it to spread the message.  With the busy days of many healthcare professionals, it is difficult for them to find the time to engage with social media and with others.  There are many healthcare providers that are making an impact and finding the time to do it.  

What we need to start teaching in medical school and in other schools in not only what not to do on social media, but how to use social media in a positive light.  This is something that is happening and only continuing to grow.  It is time to get on board but shine the light in a positive manner.  Teach students from early what to do instead of only what not to do.  You never know they may be able to influence people in a way like never before. 

Recently I have recently been able to connect with others across the world and learn new things about medicine and how it is practiced in those locations.  This will help me evolve as a physician as well and has helped my patients. 

 

Tips for Getting Through a Difficult Time

It isn't uncommon for people to make supportive and encouraging comments to me after hearing bits of my GBS story.  I suppose it is partly because I am an optimist, but I explain that I truly am fortunate.  I didn't become completely paralyzed - in a hospital ICU, on a ventilator, for several months, then in rehab and stuck in a wheelchair.  Instead, I truly appreciate what I have because I also wasn't young - just embarking on my college education, new career or have a new family.  I wasn't one of the new moms that didn't get to hold their newborn baby for months, or the young child who didn't understand what happened that they needed to re-learn how to walk.  Instead, I had already finished college, started a family and launched little adults from the nest and had progressed up my career ladder.  I'm on the sunset side of my life and have the time, security and mental strength to fight my disease and re-build my functioning.

The tips below are from one of the young people... those with what I believe are the greater challenges. Go little turtles!

Guest Post:  Blogger Holly Frances of Holly After GBS

One of the most common questions I get asked, is HOW did you get through what you did? And its a tough question to answer. Spending nearly 3 months in ICU, getting off a ventilator and learning to walk again - all with a newborn baby - is something I never thought I would be able to get through. But I did. I persevered and am stronger than ever. 

And that wasn't the only hardship in my life. I've gone through a LOT of awful things. From broken hearts, to financial trouble, to divorce. Plus all the in between; the day-to-day stresses we experience from being an adult, a parent, a human being.  And when we experience these challenging times, its often difficult to believe we are going to get through them. But you will! 

Here are some tips I use when I'm going through a difficult time:

1. 1. Write down the biggest thing that you are struggling with right now. Then brainstorm a list of ANY TINY possible things you could do that might improve the situation. They may not solve your problem but even small improvements can help. Without brainstorming, you may not even realize the options you have.
   2. Make a list of long term goals  you think would improve your life. What do you want to achieve this year? What would you like to be doing? What gives you purpose? What things can you do every day to get you closer to those goals? Taking steps towards these goals will give you a sense of accomplishment.
   3. Every day, write down something you are grateful for. It can be as simple as having a house to live in, or finding a dollar on the ground the day before. On hard days you may have to dig deep, but it’s a good reminder that there is always something to be grateful for. 
   4. Make a list of the things that you love doing (that you are able to do) that set your soul on fire. They can be things that are done daily, like cooking or drawing, or things that can be done periodically; like going to see a play. Just make sure you are doing the hobbies that you love to do! On the flip side, is there anything you are able to remove/change from your life?  Stop doing things you hate to do! 
   5. Make a list of some of the hardest times in your life. Remind yourself that you made it through those times. You are so much stronger than you think you are. And you can get through this too. Say that to yourself as many times a day that you have to. 
   6. At the end of your day, write down three things that you accomplished. On particularly bad days, small things like doing your hair counts, even having a shower or getting out of bed!  Writing accomplishments down, no matter how small they are, reminds you that you are moving forward!  Keep going! 
   7. Make sure you surround yourself with friends and family that you love. Alone time is often needed, but isolating yourself can make you feel worse. Spend time with your favorite people and ASK for support! 
   8. Get your body moving! Exercise is the most underused medication in the world!.You have the ability to increase your dopamine levels (the feel-good chemicals inside us that make us happy) at any point in the day! If you struggle with finding the motivation or the time to get to the gym, then start small! Its amazing how you can feel after just ten minutes of say yoga or a brisk walk a few days a week.   
   9. Pick a charity to get involved with or donate money to. Research shows that donating either your time or money to charity makes you feel GOOD! And it’s good for society too ;)
   10. Watch online videos of inspiring people overcoming devastating tragedies. Not to see that there are others who have it worse than you (because what you are going through is hard too; don’t diminish that) but to remind yourself that there are so many people that have overcome the impossible — and you can too. 
   11. As often as you can, try to change  your view. Positivity goes a long way. Just once, trust that everything is happening for a reason. Trust that everything is going to work out the way you want it to. Rembever, no one expects you to be cheery all the time, but just try to ditch the negative self-talk as much as you can. And no matter how bad of a day you have, no matter how negative you feel when you go to bed each night - start fresh with a positive attitude every day. If it doesn’t go to plan, it’s OK to try again tomorrow.  It doesn't matter how many times you have to start over. You just keep trying. 

Virtual reality: From the OR to the patient bedside

I haven't written much these last few months, because my typing accuracy and speed have not been the best.  But, I'm still trying and just had a new article published after several months. 

Some of you may remember the old Atari game, Pong.  It was the first virtual reality game I ever experienced.  Virtual reality has evolved and is much more sophisticated in 2019.  And, it isn't just fun and games anymore.

My article reviews the latest in the world of virtual reality and its use in surgery and medical training.  It describes how neurosurgeons can "practice" a procedure they are about to actually perform on a person's brain using three dimensional virtual reality.  But, perhaps, more importantly, I point out the value of these tools to patient education and their understanding for better decision making.   The informed consent process is very important and most patients probably don't truly understand the significance.  This becomes a much more important issue as risks increase; as does the possibility of poor outcomes - serious injury or death.

My important message for consumers, family caregivers and patients themselves is to ask questions, research and appreciate the application of technology to improve understanding and the ability to act and make better decisions.  Technology, if well planned, designed and implemented, can improve the quality and safety of the care we all receive. Be open to trying something new, such as, virtual reality!

Read the article and let me know what you think by leaving a comment.

Patient Caregivers: The Importance of Self-Care

I just returned from a long trip to help my dad care for my mom.  I was able to get my own scheduled treatments shifted over to providers in that state and community.  

Upon arriving at my parents' home; I assessed a serious state and quickly got to work taking steps, as any nurse would, to improve my mom's condition.  My efforts were a ultimately a success and I felt comfortable returning to my own home and family; after having been there through Thanksgiving, Christmas and New Years day.

At first, I was happy to cook, clean, organize, shop, as well as, facilitate and provide care for my mom.  It was my turn and chance to give back.  But, then I started feeling the fatigue coming earlier each day.  I prompted family to help, but old habits were hard to break.  I finally got to the point of having to announce I wasn't cooking or cleaning after meals.  People showed up on New Years day (while I was packing my car to leave the next day) expecting the traditional feast and I brought out leftovers; which weren't so well received.

My family are all aware of my GBS/CIDP and functional limitations, but they were spoiled by mom.  As her health improved, I had her helping to empty the dishwasher and fold laundry to exercise her body and mind.  However, she could not do what she use to do. And, we couldn't sustain doing the work alone.  My children and husband arrived and helped us, but even then it would have been nice to see the whole family involved.

Then, I return home and read an article about George Price, a completely altruistic evolutionary biologist and scientist ... who ultimately died as a result of his selflessness.  The author of the article draws a couple of lessons from the story of such an intelligent man; especially on the importance of self care.

"But the second, broader lesson is that self-care is important. Price’s altruism was all-consuming, to a point of self-destruction and collapse. That wasn’t good for him, obviously. But it wasn’t good for the homeless community he joined and tried to help either. That isn’t a statement on Price’s character, which I do not feel in any real position to judge. But it’s a statement about the value of all-consuming altruism as an ethos."

I have always believed a hospital has to function in a way that allows it to sustain its operations; in order for it to be able to continue serving its community.  Working with so many professional caregivers, I also saw the importance of self-care  for preventing burnout and maintaining staff health.  Now, as a patient what I know was put to the test as I had my own experience with needing to put myself first, so I could continue to focus on my priority (caring for myself and mom) instead of lesser demands (feeding my unhelpful family members).

If you find yourself caring for others, put yourself first so you have the strength and endurance needed to complete important tasks.  Why, because if your health deteriorates to the point that you can no longer care for others, who will take your place... and care for you?  A burnt out caregiver becomes the patient themselves - adding to to the workload.

It is ok to ask for help (family/friends or home care and respite services), prioritize and set boundaries or simply say no when you are being asked or expected to take on too much.  Being strong ultimately benefits all involved.