3/17/10

Let go or be dragged

I have a friend who builds piers. He defends dry land against the force of oceans, tides, and rising waters. You might think he's a burly dude, into all his heavy equipment and massive impact. But not so much. He's about the smart trade-off; minimizing damage done. 

When my friend recently shared the expression, "Let go or be dragged," I knew it was a keeper. I've never heard of a better way to describe the pain caused by a failure to let go. How about you? Can you find an incidence of being "dragged" in your own life? Would letting go help?

"Let go or be dragged" ... It's quite a handy little phrase.

***

3/8/10

Choosing growth

Michele Woodward is a personal coach who really knows her stuff. Yesterday she posted, "Finally Un-stuck" and I think it is so important that I just have to excerpt it here:
... 
Stuck is a nerve-wracking place.  And takes a ton of energy.  So much energy, in fact, that it’s hard to find the oomph to do anything other than be stuck.

People who are stuck often face some kind of big decision or life change.  And they torment themselves with, “Is this the right choice? What if I make a mistake?”

That is the stuck place.  Can’t move forward for fear of doing something wrong, and can’t go back due to the space-time continuum, so… stay stuck.

There’s only one way to break through the muck and get un-stuck. And that is to reframe the question from, “Is this the right choice?” to “Am I choosing growth?”
...
What great advice. Having a flexible framework that serves as a decision aid is a super idea and one worth sharing. I'm definitely choosing growth!

Read the whole post here.

2/11/10

Fall seven times, stand up eight: A review of Therese Borchard's "Beyond Blue"

Therese Borchard defies the simple summary...

Maybe it is her beauty that keeps one unsuspecting of her storm within. Or maybe it's her uncommon gift of elevating the practical and accessible buried within the shrouded and hard-to-talk about. Whatever the reasons, Therese is a gifted writer giving voice to themes of darkness, despair, and empowerment in a style reserved for only the most articulate, curious and self-actualized women writers of our time. 

Today, thousands already read her thoughts about life with depression and bipolar on The Huffington Post, on Beyond Blue, and on many other mental health portals. Now she's written a generous book, Beyond Blue: Surviving Depression & Anxiety and Making the Most of Bad Genes that offers her readers 17 broad chapters of authetic and transparent insight into her personal experience of life with depression and bipolar. A few witty chapter heads read: 
  • Booze: The Quiet Car in My Very Loud Brain (Chapter 3)
  • No Really, I'm Not Making It Up: Depression Is a Brain Disease (Chapter 10)
  • Sorry, Wrong Number: Codependency and Boundaries (Chapter 15)
As I read the book, I noticed that Therese's spirit is an honest guide, at once accepting of where she's at and then very demanding of herself to get better and keep at it.  She is all about walking the road beyond "Your Momma's Mental Illness" and giving a view into a wide open frontier rich with Christian tradition, Buddhist teaching, physical endurance training, nutrition guidance, mind-altering pharma, and old-fashioned "muddling on through," American common sense. A "post modern mental health guide" is the phrase that comes to mind.

I highly recommend the book for "advanced" readers; those people ready to explore a modern and more explicitly personal approach to coping with serious mental illness. This is not "chicken soup for the soul", although those ideas are held within. No, it's more of a unique look at how a woman -- even in her lowest moments of despair -- remains engaged and fierce as she attempts to solve the most stubborn of her problems; her mind.

No doubt Therese's tenacity and drive to excel in life fuels much of her self-discovery while breaking the barriers down for others to follow. In Chapter 11, Work it, Girlfriend! My personal 12-Step Program, Therese describes in witty detail how she weaves spirituality, pharma, lifestyle, relationships, and psychology into a set of simple steps. This is not to say that by working these steps one will forever be free of relapse. Quite the contrary. These steps are a component of her healthy living regimen, not its totality, so take them with a grain of salt. (And if you still aren't convinced, see  Chapter 6...) 

Since most of us could benefit from working these steps, I'll summarize them here:
Step 1: Find the right doctor - It was doctor number 7, from Johns Hopkins that was her winner.
Step 2: Find the right cocktail - It took her 23 different tries before she found relief in pharmaceuticals.
Step 3: Exercise - Cardio, cardio, cardio.
Step 4: Eat well - "Because some of us really are what we eat," she notices her mood drop after a day or two of toxic eating. 
Step 5: Sleep! "... It's about putting your head on the same pillow, on the same bed, at the same time every night, and sleeping for the same amount of time."
Step 6: Light Up - Use light to supplement what's naturally available to you. This helps optimize your circadian rhythms.
Step 7: Reach Out! - Connect with a community of folks like yourself. She quotes Martin Buber, "When two people relate to each other authentically and humanly, God is the electricity that surges between them."
Step 8: Get Involved - "... Love must drive every sentence and blog post that I write, every decision and behavior throughout my day."
Step 9: Keep a Mood/Sleep/Gratitude Journal - Discover your own personal patterns. Get insight.
Step 10: Therapy and Lots of It - This mini-chapter alone serves as an incredible cheat sheet for finding the right therapeutic fit. There is no "one size fits all solution" to mental health, especially if you have a chronic disease such as bipolar.
Step 11: Pray and Meditate - Therese writes, "I yell at God a lot, too, and I consider my loud rants prayer because getting mad and communicating my frustration means that I'm in a real, organic relationship with my Higher Power."
Step 12: Fake It 'Til You Make It - "For at least 18 months, forty-five of my fifty minute therapy sessions went to acting lessons; how to feign a stable and functional person until I became one."  
Therese spares little detail telling her story and some may identify strongly with the depression, anxiety, and addiction issues she writes out.  Me, what I found most interesting is Therese's pattern of productive "wrestling" with her own truth. It's hard work! But it is an approach that is becoming more relevant as the complexity and pace of the world (and its changes) accelerate.

The compulsion to understand one's internal workings is not universal but can often pay big dividends of service to the world. While many, many people need to read Beyond Blue because they or people they love suffer from serious mental illness, even more people should read this book to listen into what Therese is calling us to do: Explore, safely, the realm of personal experience in whatever ails you.

This ability to reach within personal chaos and create a cosmos for others is a rare gift. It's like a special evolutionary skill set, one just as rare as these butterflies are rare. 

And come to think of it, isn't life about metamorphosis? It's an especially relevant theme for women who regenerate and respond to so many forces. I am all for brave teachers like Therese to lead us in their areas of expertise.
_________

Related:


***

2/2/10

10 mistakes every patient makes: Trisha Torrey's new book

Most patients don't understand that their own healthcare is not a right, it's a responsibility.  --Trisha Torrey

Trisha Torrey, Every Patient's Advocate for About.com, frequent Health 2.0 contributor, and active Twitter colleague has just written and released You Bet Your Life: The 10 Mistakes Every Patient Makes.
 
Part consumer guide, part recipe book, part "doctor-patient dating" guide, this book is practical, forward, and detailed in its recommendations to patients like us. The most remarkable aspect of the book is that it takes dozens of complex situations such as patient privacy, patient safety, provider apologies, confirming a diagnosis, to name a few, and breaks them down into usable bites of kitchen table wisdom that can be ported, shared and easily applied. In fact, since reading the book, I have cited dozens of passages in response to questions from friends and family. 

While clever and witty and humorous at times, this is probably not a book that you would hand to a person in crisis who may already be feeling overwhelmed by a complicated situation. No. It is not a book of comfort, per se. But it is an essential book that trains us to make better choices, so it would make an excellent addition to most home libraries. If you have a friend in crisis, why not buy the book for yourself and help your friend navigate the situation with Trisha's insight? There will be plenty to share and your friend may be sparked by some of the advice. 

To showcase just a bit of Trisha's style and convince you to check out the book, below is a paraphrasing of information included in Chapter 6, "An EmPatient's Strategy for Choosing Dr. Right."

Q - How should I establish a doctor's credentials?
Start by looking the doctor up on the state licensing boards. Take a look at the credentials, and make sure that the license is up to date. (One "dirty little secret" of state licensing information is that some states require the practitioner to keep their license up to date themselves, p.70)

If you have a complicated care issue, then check for problems, errors or malpractice by Googling "Dr. Firstname Lastname" plus the word "error" or "complaint" or "malpractice." See what you find.

Also make sure that the doctor is licensed and practicing in the same realm. (She once saw a doctor practicing as a psychiatrist who was not licensed in Psychiatry, but in Internal Medicine!)
 
Once you have found a provider relationship you like, she offers a few things you might want to do to keep it positive:
  • Say thank you. If you feel well-served then go on and say thank you.
  • Refer your friends to the doctor. 
  • Send a "report card" via http://diagKNOWsis.org/reportcard to highlight the positive or where there is room for improvement.
This review would be remiss without emphasizing that creating health and focusing on prevention of illness is the great-empowered patient stance. Trisha's book does cover this idea at the back of the book, in Chapter 24, "Avoiding the Whole Ugly Healthcare Mess: Prevention." She makes a few quiet points about prevention that deserve amplification:
  • Prevention is about taking responsibility for your own health, no matter how good or bad it is, and taking the steps you can take in spite of health challenges; 
  • Prevention is about following doctors orders once the two of you have determined a course of action;
  • Prevention is about stepping out of a comfort zone, or "happy" zone
  • Prevention is about education. Keep on learning and you'll avoid engaging with less effective treatments.

1/20/10

The soul of the child

Sometimes I feel like all I do is think, wonder, dream, write, and work to change the health care system at the level of the individual. But, in reality, that's just my hobby.  My real job is Mom and home is where I do all of my primary research on healthy living for individuals. Call me a "techno-domestic sensualist." Which is why, for this post, I'd like to celebrate the soul of the child. 

I look at the soul of my child as an aspect of my own soul, and use this framework for keeping in touch with my child's inner life without being overbearing. 

I recently experienced being interconnected with my son when he had a tough year in school (last year). It wasn't tough in a traditional way; there were no bad grades, no attention issues, bullying or behavior problems dogging him. His grades were excellent, his teachers liked him, and his behavior was just fine. The trouble was, his heart and soul weren't present.  He wasn't engaged in what he was doing in the least. He was drifting. He was sad. He didn't want to go to school.

This is the kind of disconnect that makes a mother crazy. I mean, when your kid needs help, I for one prefer to have a clear failure to point to, not a murky, uneasy, sinking feeling that something unnamed is amiss when we go to the school admin and ask for help. And yet, the soul of my child (which is how I framed the problem we had) was whispering in a quiet voice and moving to its own rhythm.  You can imagine the challenge I had bringing this to the table in a traditional school environment. 

I spent roughly 4 months advocating for our son at our neighborhood public school. The work included: initiating mediation with our Principal, lots of bedtime conversations, staying in constant contact with the school and asking for specific changes to his school day. It took dozens and dozens of hours from work, and was truly uncomfortable to become such a squeaky wheel. But what was the other choice? If not a parent, then who will advocate for the soul of the child?

As I stepped through this process, I was mindful of just how fortunate we are to know how to work the channels. There are millions of mothers and fathers who don't know how, or are too strapped for time, vision, confidence, or money to take even the first steps outbound to the school on behalf of their child.  

I am going to skip some detail about how things resolved. Suffice it to say that he recovered by the end of the year, but that we have also moved him to an independent school where he is thriving.  

Here's the point: Pay attention to the soul of your child. Trust your instincts. When you feel burnt out and as if you just cannot do another thing about the situation, take a rest and count it as a blessing that you possess the tools to be a powerful advocate. Your child's soul is watching, and learning how to do the same for itself someday.

Related
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1/18/10

"Doing" health

My comment, "No one knows how to “do” health" on last night's #hcsm radio session brought some puzzled tweets my way.  Let me expand:

Health is learned
On the most fundamental level, a health encounter in our system is a learned transaction. It is a learned experience. No adult or child knows how to “survive” cancer, or “beat” diabetes, or be a parent for that matter when he or she starts on day 1. Quite the contrary.

Health is developmental
Health is a developmental process, a series of baby steps deeply and inextricably linked to cultural norms and expectations. Since so many of those norms are being challenged right now, it is a great time to think about how we learn to navigate the health system and what opportunities exist today to make improvements.

Oversimplifying this I realize, but if you were taught not to ask questions of your doctor, then you'll probably need more encouragement to start asking questions and participate more. If you were taught (from experience or environment) that medicine is a crap shoot, then you may be more comfortable advocating for yourself or another in a health care setting. You might feel righteous ... as many do. Or, you may simply give up from the stress of it all and become uncompliant.

We learn by participating
My point is that we learn to "do" health. We learn by participating. By showing up and "muddling on through" in many cases. We learn by accepting uncomfortable treatments, procedures and interventions; by asking questions and wrestling with the answers we get until we are able to take a step forward. The maddening paradox is that healing often brings discomfort, at least initially.

And more discomfort is hard to tolerate when you're in a healing crisis.

"Just right" health care
A patient learning how to participate in her own care can look a lot like Goldilocks from the children's classic. An empowered, participatory patient won't stop looking and learning until she finds what feels "just right" right to her. While the social web can help a patient climb a steep learning curve, so may pharma, tech, friendship, prayer, play, and (____you name it here___). These are all powerful cultural modalities in the healing repertoire.

So, while we don't start out knowing how to "do" a health crisis, the silver lining is that wherever you begin your challenge along the continuum of health, you will have an opportunity to learn and develop. That's right; we are all beginners. Even doctors and nurses are beginners when it comes to their own health crises. And while anything can happen, there is no guarantee that it will.

Get better at health by practicing it
Whether it is learning to eat better and exercise; stay calm and organize a response to a terrifying diagnosis; work like hell to seek alternative treatments; or advocate to “free the damn data,” as ePatient Dave says - adults learn how to “do” health by participating in it.

The good news is…we get much better at "doing" health with practice. Start when you are healthy.

------

Related posts:
Communicating with doctors: Practice when you're healthy
Are we betting on the "me" in medicine?

1/12/10

Why tech firms target moms

Most of us have recently seen headlines such as this one: This is not your father's gadget: Tech firms target moms.  This constant Recession/Reform era re-positioning of Mom as "The CEO of This and That Domestic Role" has got me thinking about an insidious pattern of patronizing women...

Take this quote from the article above:
When families with children set out to buy a new laptop computer, for example, it is Mom, not Dad, who is more likely to initiate the discussion, the study revealed. And Mom is more likely to make the final decisions on what features to look for and how much to pay for it.
Most striking is that Mom is much more likely to use the new laptop than Dad. The survey found that 96 percent of mothers said they would make “regular use” of the device, compared to only 80 percent of fathers.
Moms use laptops? Astounding. Groundbreaking. How could we have missed such big news?

If you detect a bit of sarcasm in my tone, you got it. I have a different take on the trends. Moms buy technology because they Have to Get Stuff Done or their kids won't make it. Further:
  • Moms buy computers, gaming systems, gadgets, etc., in part, to keep control over the extent to which others in the house get to use technology. They set the tone. (It may look like offense, but it is actually defense.)
  • Moms buy cameras that help them get stuff done so that after work and cleaning and putting the kids to bed they get a professional result when they spend 100s of hours doing image editing and uploading shots as CEO of the "Family Memory."
  • Moms conduct lots and lots of online health research because -- either separated from or disappointed by their extended families -- there is literally nowhere else to turn for quick health advice that wouldn't involve 1 hour waits, high co-pays, and time off from work. (The Library used to be handy, but they've had to trim back on evening hours due to resource constraints.)
  • Moms buy and adopt technology to serve others and to feel successful about serving others. Mothering, in spite of all the media noise surrounding it, is still one tough and invisible job.
I'll leave you with this: If you are in the business of developing products for women -- or are in the business of marketing a tech product or concept to women -- spend some time going a bit deeper before you claim to have broken new ground. Ask yourself, "How does my product serve women?" Upon a closer look, you'll see that emancipating them from serving others is probably not something your tool offers, so don't package it that way. Your tool helps a woman get stuff done for the family.

1/8/10

Unleash the hot talent: A letter from a patient

An appeal for Participatory Medicine, inspired by Diva e-Patient friends and colleagues:
***
January 2010 

Dear Wonderful Doctor and Care Team,

I am writing to suggest that you cast me in the most important performance of my life: My Health Care Crisis.

I realize you hardly know me and that you can't really stop to get to know me at this point because there is a long line of folks just like me waiting for your services... But since we're suddenly on a kind of "Fast Track" to get to know my body (given last week's diagnosis), I was hoping that you'd at least consider giving me a supporting role in my upcoming treatment. 

I'll play it straight; no Femme Fatal, Gypsy Rose Lee, or Little Lost Soul. Nope, I'll go for a completely modern (dare I say, "sexy") evolving archetype, The Empowered Patient.

I am sure you have questions. And yes, I am a rookie. I cannot predict with the exactness of a doctor like you the outcome of my involvement in my care. But acknowledging that I have a role would be a powerful component in the show. And this is a kind of show, Doctor, isn't it? 

What do you say? Can you accept a wee bit of showmanship from the patient side while you miraculously cut that large tumor out of my endometrial liner and administer powerful technology reserved for only the most specially trained among us? This *is* high drama but I promise I won't be too saccharine or too melancholy. I'll take the pain meds as directed and open up to the fear as best as I can.

Doctor, if I haven't made it precisely, exactly, clear to you yet, I think we make a great team. You've gotta let me show you what I've got.

Sincerely,
Your Patient

***

Related:

The mother of all health reform
Who's on the other end of a search query?
Are we betting on the "me" in medicine?
14 takeaways from Gel Health 2009
A limitation of Health 2.0
Shopping for health insurance
If e-health was simple...


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1/6/10

Predicting the future

Yesterday, my 3rd grader came home with an assignment asking him to write up his predictions for the future. It read: "What are some of the changes you imagine will take place in the next 100 years?"

We got to talking.  My son offered a few inventive ideas inspired by experiences with technology: the Wii, TV, the remote, iPhone, instruments, the computer, cool cars, etc. I made a single prediction. I predicted that in the year 2110 we'd have 30% more land being used for active farming in America.

His eyes glazed over at my suggestion and even I had to chuckle at how outlandish the idea seemed. But who knows, maybe it isn't that outlandish after all. Consider it. Given the speed with which people are becoming conscious of the food-farm-health connection, maybe reclaiming a percentage of the land and the productivity we've lost is possible.

Stranger things have happened in America over a span of 100 years...