Monday, August 29, 2005

Pray for the People of New Orleans

Ms. Julien speaks from personal experience, reminding us to hold the people of New Orleans in our thoughts, prayers, and wishes for their safety and the safety of their city. She says,

I went through hurricane Andrew and lost everything I owned. I just recently went through Katrina (which was only a category I, but a very mean one at that). I am very, very scared about the situation in New Orleans area. There is not enough room for all the people who need shelter, and the safety of those crowding in the Super Dome is nebulous at best, as the stadium sits right near the river.

Monday, August 22, 2005

Nursing School

Nursing school officially started today.

I already took two one-week classes this month, and had a full day of orientation last week, but today was the official start date.

I've Joined the TulsaTrade Yahoo Newsgroup

I just signed up to be a member of a Tulsa, Oklahoma online Yahoo group where members post items for sale. I'm hoping this Tulsa Trade Yahoo Board will provide a way to connect with people who are looking for someone who sells Country Bunny Bath and Body products.

Here's my first post to the TulsaTrade Yahoo Newsgroup:

Date: Mon Aug 22, 2005 6:28 pm
Subject: Country Bunny Bath and Body -

Hello Bath and Body fans,

I have Country Bunny Bath and Body products available to sell.

I've purchased Lotion Bars and Satin Shea Body Butter in these fragrances -

Pearberry, Sugar Sweet Pea, Grapefruit and Lime, Oatmeal Milk and Honey, Peach Mango, Lavender and Eucalyptus, Coastal Blue, and Mountain Fresh. I also have these items available in the Naturally Unscented variety.

If you like the fresh, clean scent of C-Spa, I'm offering $5 off your purchase price when you buy one each of C-Spa Lotion Bar, C-Spa Satin Shea Body Butter, C-Spa 9 ounce Shower Gel, and C-Spa 9 ounce Spritzer.

I also have Salt Scrub, Spa Polish, Bath Paints (for kids), Glycerine Soaps (in pearberry, mountain fresh, and lavender and eucalyptus scents), and gift sets (Oatmeal Milk and Honey gift crates and Kids Premier Product Set).

If you purchase $100 in products directly from me, you can pay me $90 at the time of the transaction as my personal "$10 Thank You" for your $100 purchase.

Please contact me about having a spa party or a 'book party', too, if you'd like to receive free and discounted products.

I'd love to show you the products. If you'd rather shop online, or if you are not close to Tulsa, Oklahoma, please visit my online store at .

All inquiries are welcomed.


Thursday, August 18, 2005

What Are We Going To Do With Dad?

What Are We Going To Do With Dad?
No Pat Answers For the 'Old Old'

By Jerald WinakurSunday, August 7, 2005

My father is 86 years old. He was never a big man, except perhaps to me when I was his little boy. At most he was 5 feet 2 inches tall and weighed 160 pounds.

Today he weighs barely 120. Maybe he is 5 foot 2. He teeters on spindly legs, a parched blade of grass in the wind, refusing the walker his doctor recommends or the arm extended by those of us who love him.

He doesn't know what day it is. Shaving exhausts him. His clothes hang like a scarecrow's. He is nearly deaf but won't wear his hearing aids or loses them as often as a kid might misplace his marbles. He drives my mother -- five years younger -- crazy to tears.

My only sibling, an architect, asks me every time we are together (which is often because we all live in San Antonio) and every time we speak on the phone (which is almost every day because we are a close family now in crisis): "What are we going to do with Dad?" As if there must be a definitive answer, some fix -- say, putting a grab bar in the bathroom or increasing the width of the doorways.

He asks me this question not just out of fear and frustration, but because he figures that his older brother, the physician, should know the answer. I do not know the answer. I do not have a pat solution for my father or yours -- neither as a son, a man past middle age with grown children of his own, nor as a specialist in geriatrics who is also a credentialed long-term care medical director.

In the United States today there are 35 million geriatric patients -- defined as over the age of 65. Of these, 4.5 million are older than 85, now characterized as the "old old." Yet the American Medical Directors
Association, which credentials physicians in long-term care, has certified only 1,900 such doctors in the entire country; only 2 percent of physicians in training say they want to go into geriatric care.

As we baby boomers go about our lives, frozen into our routines of work and family responsibilities, a vast inland sea of elders is building. By 2020 there will be an estimated 53 million Americans older than 65, 6.5 million of whom will be "old old." Many of you will be among them. America will be inundated with old folks, each with a unique set of circumstances, medical and financial.

Compounding all of this is the sad and frustrating fact that our government appears to have no policy vision for long-term elder care. It's as if our leaders wish -- perhaps reflecting our collective yearnings as a vain, youth-worshiping society -- that when the time comes, the elderly will take their shuffling tired selves, their drooling and incontinence, their demented ravings, their drain on family and national resources, and sprawl out on an ice floe to be carried off to a white, comforting place, never to be heard from again.

For the past nine years I have been the medical director of my hospital's skilled nursing unit, or SNU. This unit receives patients from other parts of the hospital who no longer need acute care services yet are unable to return home. Sometimes it is obvious what we have to do: finish out a course of intravenous antibiotics or provide a few more days of rehab to a competent elder who has just undergone a hip replacement. But more and more, as our patients grow older and more frail, it becomes clear that the attending physicians have referred their patients to the SNU because they don't know what else to do with them.

Each week I attend the SNU team care conference. Every staff professional who has a role in patient care attends. The nurses provide up-to-the-minute reports on each patient's medical progress; the therapists discuss whether the patient is meeting goals set the previous week; we hear about the situation at home, what help we can expect from family or other caretakers, and what the patient's insurance may or may not provide. Our main goal is to answer one question: What are we going to do with this patient? Where can we safely send him -- given his medical, social and financial circumstances -- and expect him to maintain his highest level of functioning, his remaining dignity? Very often, we don't know.

Families are encouraged to join us after our review. Most do not -- often, I think, because they are afraid we will tell them there is nothing more we can do. They are already despondent, overwhelmed by Dad's (or Mom's) decline and the acute event that led to hospitalization (the pneumonia, the fall, the stroke); bewildered by his mental decline (the confusion, the weakness); frustrated in dealing with the hospital staff (the inattentive aides, the callous nurses, the harried attending physicians who often drift in and out like white-coated apparitions).

So now your dad's physician -- maybe the one person you trusted to solve all of this (although less and less so in these days of managed care, because it is hard to trust someone you might have just met or whose name was picked at random from a list of names) -- comes into his room and says, "I don't think there is much more we can do for him here."

Your mind reels. Nothing more to do? In America? Home of the most advanced health care in the world? You think about all the glowing seniors -- continent, smiling, sexually active -- in those drug ads on TV or the aging but robust movie stars on the cover of the AARP magazine. Nothing to do?! You gotta be kidding, doc! And anyway, he was just fine until he came to the hospital!

The doctor sighs. She has been through this many times and still doesn't quite know how to handle it. Even though the ravages of aging are not her fault, she feels the stern gaze of Hippocrates on her back and wants to do more. She might remind you -- tactfully -- that this patient, your father, lying with sallow distorted face, partial paralysis, a Foley catheter draining his urine into a bag clipped to the bedrail, was not fine when he came to the hospital. He was not shanghaied from home while smoking his pipe and reading the Wall Street Journal. Rather, he arrived in the ER at 4 a.m., hypertensive and gurgling, brought in by ambulance after he passed out and hit his head on the toilet.

"I think perhaps we can transfer your father to our skilled nursing unit for some rehabilitation," the doctor says. I say it all the time. Family members are uncertain what this means but temporarily grateful: The doctor has postponed answering the "What are we going to do with Dad?" question for a while longer.

Every Medicare patient has coverage for 100 lifetime SNU days if the criteria outlined in thousands of pages of regulations are met. Past the first few weeks or so, these criteria usually can no longer be satisfied -- not because the patient recovers; very few get well in the SNU -- but because the patient is "no longer making progress." No documented progress, no Medicare reimbursement.

Much of the time, there is no "progress" except toward the grave. And the next way station is chronic custodial nursing home care. Family members will soon discover, if they haven't already, this essential fact: There is no Medicare coverage for long-term custodial nursing home care. Unless, of course, an elderly loved one is destitute, in which case he might qualify for some state-sponsored Medicaid assistance.

And typical of our government, even as many medical practitioners are using SNUs more and more in answer to the "What are we going to do next?" question, Medicare has cut the reimbursements to these units drastically (but not decreasing the benefit to the patient, of course, which might anger the consuming public). As a result, many hospitals are closing them. My own unit shrank to half its size before being shut down by its sponsoring hospital last year, even as I was working on this article.

Although the CEO told me that this was done because my hospital needed more "acute care beds" -- certainly true -- closing the SNU coincided with the change in Medicare reimbursements that made it financially advantageous for acute care hospitals to jettison SNUs in favor of more acute care beds.

Three years ago my father, a longtime heart patient, was admitted into the hospital with congestive heart failure. This is the hospital in which I have made rounds almost every day since the mid-1970s. The CEO is my friend and patient. My father's physician is one of my young associates, well trained and eager. I was confident that my father would receive the best medical care available in America today. Yet I would not leave him alone in his hospital room. If my brother or mother or I could not be there, I had a hired sitter by his bed.

It's rarely talked about, but hospitalizations are the most dangerous times for the elderly. Even if they have never manifested any signs of disorientation, it is in the hospital -- in a strange and threatening environment, under the influence of anesthetics, pain pills, anti-emetics and soporifics -- that many elderly will meet their match. Add to this the treatment mishaps (caused by the "normally expected" side effects and complications of standard medical procedures) and the human errors (mistakes in drug dosing, the right medication given to the wrong patient), now multiplying in our modern hospitals like germs in a Petri dish, and it is almost a miracle that any elderly patient gets out relatively unscathed.
Every night, I slept in the reclining chair by my father's bed. I got up when he did; ran interference with bedrails, side tables and IV poles; guarded his every move to the bathroom; looked at every medication and every fluid-filled bag plugged into his arm. Yet each day, my father descended deeper into paranoid confusion. He was restless, and intermittently unsure of who I was.

At first I could calm him with my voice, talking about the old days, reminding him of our fishing trips on the Chesapeake Bay when I was young. Then he needed the physical reassurance of my hand on his arm or shoulder at all times. Finally, so that he could get some rest, I got in the bed and held him, comforting him as he once -- in a long-ago life -- did me.
After four days and nights his doctor told me that his heart failure was better and that his dementia evaluation did not show a treatable or reversible cause. But he didn't like the way my father looked -- agitated, sleep-deprived and deconditioned, a perfect candidate for time in the SNU. And, after all, here I was, his senior associate, the SNU medical director. Surely, my dad would get good care there.

Instead, I took my father home. I knew that if I didn't get him out of the hospital at that moment, he would never come home again. The SNU would have been a way station to a custodial nursing home. I arranged for a home health agency to provide my father with physical therapy and to assist him with his bathing, dressing and grooming -- something Medicare covers, but for only a limited period.

I went to the pharmacy and filled the eight prescriptions he was given as he left the hospital. Then, when I realized that my mother was having trouble reading the labels and following the instructions, I went back again to buy a plastic container divided into daily dosing compartments. How long, I wondered, had this been going on?

When I visit my father these days, if he is not asleep, I sit down beside him and talk at high volume into his hearing aid, if he has remembered it. Our conversations go something like this:

"How are you feeling today, Dad?"
"Not so good. You ought to come around more often."
"Dad, I was just here yesterday."
"Why are you calling me that? You're not my son."
"Of course I'm your son. That's your wife, my mother, sitting over there."
(My mother, shouting at my father: "What are you saying! Of course he's your son!")
"I like you and all, but you're not my son."
"Well, I love you anyway."
"You're older than I am. How could you be my son?"
"I love you, Dad."
"You ought to come around more."

Once in a while, though, he will surprise me: "Remember those big rockfish we used to catch off Thomas Point Light?" he might say. And then nothing.Between my brother and me, one of us is there almost every day. We have been fortunate to find two dedicated women to help my mother in attending to my father's daily needs.

My brother and I help with the cost -- $1,500 a month, but still only one-third of the expense of custodial nursing home care. I often wonder: Why isn't this kind of care covered by Medicare or Medicaid? After all, when my parents use up their meager savings (which they will, just like most families with a demented elder), they will become eligible for Medicaid, and the state of Texas will then pay the entire cost of custodial nursing home care. But the longer we can keep my father at home attended by aides, the cheaper his long-term care cost will be to society as a whole.
Drinking the nutritional supplements my brother brings to the house by the case (another non-covered cost of several hundred dollars a month), my father has actually put on a few pounds. But every week he gets worse, harder to deal with, more bizarre. Recently, he has begun to holler at my mother every time she tries to help him change his clothes, which is often because he wets himself. "You're my sister! You're not supposed to see me naked!" he screams at her.

At first, my mother didn't believe that my father was demented. Most of us do not recognize the reduction in the mental capacities of our spouses or parents unless something unexpected happens. My mother continued to see his stubbornness and withdrawal as purposeful acts of belligerence against her -- until the day she realized he could no longer figure out how to unlock the front door by himself.

From my years as a geriatrician and now as the son of an "old old" man, I recognize that there is one inescapable truth: Our parents will become our children if they live long enough. Perhaps if we looked on our elderly in this way, we would be kinder to them.

I don't know what else to do for Dad at this moment, but I can imagine what is likely to happen to him if he does not die in his sleep (a heaven-sent coup de grace that I know, from long experience, is unlikely to occur). One day I will get a frantic call from my mother that my father is on the floor and crying out in terrible pain. I will race over there. I will find that one of his legs is shortened and externally rotated. His hip is broken.

I will call my brother and tell him all the reasons why we should not send him to the hospital: He might not recover from the surgery -- indeed, he might die on the table, given his bad heart. If he does survive, he will spend days in the ICU, probably on a respirator. At best he will end up in a nursing home, bedridden, at the mercy of overworked, underpaid aides. He will descend deeper into disorientation, require medications to keep him from harming himself, and die anyway in a few months -- or perhaps a year or two if he is unfortunate and the care is better than average.

My brother will hear my mother crying and my father hollering. He will feel guilty that he is not there with me. He will remember the time Dad took us on a vacation to Whiteface Mountain in the Adirondacks, and we all huddled on the swinging bridge in the mist, as the Ausable River roared through High Falls Gorge. Then he will say, "Maybe it won't be as bad as you think. Maybe we can set up a hospital bed in his room, and it won't take much to alter the shower to accommodate a wheelchair." There will be a moment of silence. He'll say: "I don't know. You're the doctor. What do you think we should do?"

I do not tell him that often, in fitful sleep, I dream that when the time comes, I go to my father's bed, quietly fill a syringe with morphine and stroke his arm as I tie the tourniquet. I tell him I love him and what a good father he has been to me as I slip the needle into his antecubital vein. Then I say how much I will miss him and goodbye, Dad, goodbye, as I push the contents into his bloodstream. In this dream I tell my mother and my brother that he has gone peacefully in his sleep.

Yet I have not until now given voice to this dream because I know, in the end, I could never do this. Not to my demented, suffering father. Not to anyone. I know there are some who disagree with me, and perhaps this is one way our society will ultimately deal with its flood of elders in this age of limits. I will by then, I hope, be old and no longer on the front lines.

When my time comes -- before it comes -- I will choose for myself. But for now, as long as I have the will and the strength to practice, I am a physician firmly rooted in the art and tradition of healing, of comforting.So instead, I will tell my brother that I will handle it and hang up the phone. Then I'll pick it up again and dial 911.

Author's e-mail:

Jerald Winakur, a Maryland native, has practiced internal medicine and geriatrics in San Antonio for almost 30 years. He is an associate faculty member at the Center for Medical Humanities and Ethics at the University of Texas Health Science Center. This essay is adapted from a longer version in the July-August issue of Health Affairs, available online at

© 2005 The Washington Post Company

Biking Toward Nowhere - New York Times

Biking Toward Nowhere - New York Times

August 17, 2005
Biking Toward Nowhere

How could President Bush be cavorting around on a long vacation with American troops struggling with a spiraling crisis in Iraq?Wasn't he worried that his vacation activities might send a frivolous signal at a time when he had put so many young Americans in harm's way?

"I'm determined that life goes on," Mr. Bush said stubbornly.

That wasn't the son, believe it or not. It was the father - 15 years ago. I was in Kennebunkport then to cover the first President Bush's frenetic attempts to relax while reporters were pressing him about how he could be taking a month to play around when he had started sending American troops to the Persian Gulf only three days before.

On Saturday, the current President Bush was pressed about how he could be taking five weeks to ride bikes and nap and fish and clear brush even though his occupation of Iraq had become a fiasco.

"I think it's also important for me to go on with my life," W. said, "to keep a balanced life."

Pressed about how he could ride his bike while refusing to see a grieving mom of a dead soldier who's camped outside his ranch, he added: "So I'm mindful of what goes on around me. On the other hand, I'm also mindful that I've got a life to live and will do so."

Ah, the insensitivity of reporters who ask the President Bushes how they can expect to deal with Middle East fighting while they're off fishing.The first President Bush told us that he kept a telephone in his golf cart and his cigarette boat so he could easily stay on top of Saddam's invasion of Kuwait. But at least he seemed worried that he was sending the wrong signal, as his boating and golfing was juxtaposed on the news with footage of the frightened families of troops leaving for the Middle East.

"I just don't like taking questions on serious matters on my vacation," the usually good-natured Bush senior barked at reporters on the golf course. "So I hope you'll understand if I, when I'm recreating, will recreate." His hot-tempered oldest son, who was golfing with his father that day, was even more irritated. "Hey! Hey!" W. snapped at reporters asking questions on the first tee. "Can't you wait until we finish hitting, at least?"Junior always had his priorities straight.

As W.'s neighbors get in scraps with the antiwar forces coalescing around the ranch; as the Pentagon tries to rustle up updated armor for our soldiers, who are still sitting ducks in the third year of the war; as the Iraqi police we train keep getting blown up by terrorists, who come right back every time U.S. troops beat them up; as Shiites working on the Iraqi constitution conspire with Iran about turning Iraq into an Islamic state that represses women; and as Iraq hurtles toward a possible civil war, W. seems far more oblivious than his father was with his Persian Gulf crisis.

This president is in a truly scary place in Iraq. Americans can't get out, or they risk turning the country into a terrorist haven that will make the old Afghanistan look like Cipriani's. Yet his war, which has not accomplished any of its purposes, swallows ever more American lives and inflames ever more Muslim hearts as W. reads a book about the history of salt and looks forward to his biking date with Lance Armstrong on Saturday.

The son wanted to go into Iraq to best his daddy in the history books, by finishing what Bush senior started. He swept aside the warnings of Brent Scowcroft and Colin Powell and didn't bother to ask his father's advice. Now he is caught in the very trap his father said he feared: that America would get bogged down as "an occupying power in a bitterly hostile land," facing a possibly "barren" outcome.

It turns out that the people of Iraq have ethnic and religious identities, not a national identity. Shiites and Kurds want to suppress the Sunnis who once repressed them and break off into their own states, smashing the Bush model kitchen of democracy.

At long last, a senior Bush official admits that administration officials can no longer cling to their own version of reality. "We are in a process of absorbing the factors of the situation we're in and shedding the unreality that dominated at the beginning," the official told The Washington Post.

They had better start absorbing and shedding a lot faster, before many more American kids die to create a pawn of Iran. And they had better tell the Boy in the Bubble, who continues to dwell in delusion, hailing the fights and delays on the Iraqi constitution as "a tribute to democracy."

The president's pedaling as fast as he can, but he's going nowhere.

Thomas L. Friedman is on vacation.

Friday, August 05, 2005

Adam Tendler's Free Piano Concert Tour

I heard an interview on the local NPR station about 8pm last night. The guy sounded really enthusiastic. He was talking about traveling across the USA.

At the end of the interview, they said, “He will be performing tonight at the German-American Society” at 7pm. It was almost 8pm, but I was near there, so I stopped by. I arrived at the end of the intermission.

He’s a pianist and he performs classical and contemporary music. (Contemporary meaning Aaron Copeland, not commercial radio music.) He’s calling his tour 88 x 50 (I think! the program is in the car).

I talked with him afterwards. He’s performed in about 15 states so far. He’s still looking for a piano and a group to perform for in GA. (We did not discuss which other states he needs.) He did say he is willing to perform more than one concert, or in more than one city, in a given state if his schedule allows.

He seems like a cool guy. His name is Adam Tendler. You can get in touch with him by writing if you'd like to talk with him about performing.

He's living a dream he's had for years. I only heard part of his story in the radio interview and part of the story at the end of the intermission, but it sounds like he's doing a neat thing. He sells CDs at his free performances to help cover the travel costs. (He's driving through the USA.)

He might make a good subject for a local news story or a magazine article, too. He’s energetic and idealistic and has a lot to say about what he’s learning about people and places around the country.

Tuesday, August 02, 2005

Welcome Herland Sisters


Welcome Herland Sisters!

Thanks for visiting my web log.

If you were at the picnic in June and heard the Country Bunny song, you heard me. I wrote the song. I was hoping it would be fun and memorable enough to spark your interest.

Thank you for visiting my 'blog'. I've been calling it "my bunny blog." Please feel free to look around and read as much as you'd like.

If you've not heard the term 'blog', it's a combination of the words "web" and "log". It's kind of an online journal.

I started this blog as a way to find new customers for my Country Bunny Bath and Body business. CBBB is a company based in Missouri. It was started by a woman who mixed up soaps and lotions in her kitchen using ingredients she was willing to allow her family to use. (For that reason, she calls her products 'family friendly'.)

Her most popular creation, the lotion bar, was such a sensation people started asking how they could get in on the business. Her husband quit his job to work with her, and now the two of them run Country Bunny Bath and Body. One of their friends took over the manufacturing of the products and does that in a separate company.

I signed up as a CBBB Independent Representative on April 15, 2005. It made sense to me. I love the products. They smell good and they feel good. They pretty much sell themselves when people have the opportunity to try them. (In the five years since they officially formed the company, they've sold over half a million lotion bars.)

This is how it happened for me. I smelled the products, then tried the products, then bought the products. That happened in a matter of minutes. In less than ten minutes later, I was asking how I could sign up to sell the products.

The start up package for someone interested in selling Country Bunny Bath and Body products costs $89. You get a CBBB 'briefcase', products worth as much as the cost of the start up, sales tools and training tools, and a personal 'online store' provided by the CBBB company for one year.

You can sign up as a CBBB Independent Rep by clicking on the link to my online store and then clicking the link to sign up to sell CBBB. If you do that, you'll be signing up to work with me. That means I'm supposed to answer your questions and encourage you in your business.

What I'm looking for is people who have not heard of CBBB who would like to try the products. I would also love to sell to those who have already used CBBB products and are ready to reorder. Also, if you think you might be interested in selling CBBB, or if you know someone who might be interested in having her own CBBB business, I'd love to discuss that with you, too.

You can purchase CBBB products directly from me if you'd like. Or, if you'd prefer, you can order CBBB products online through my online store (by clicking the links on the side column to get to my online store home page and then scrolling down to the 'continue shopping' link).

If you like to shop by phone, you can call the CBBB customer service line and order directly from them. If you do that, be sure to give them my Independent Representative number (7733). That way, you'll be ordering from me. To do that, call 1-877-66BUNNY.

If you want free products, you can have a spa party, or you can do a 'book party' (taking orders and collecting money). You'll be able to get 10% credit towards your purchases for every $100 sold by you or at your party. If sales exceed $200, you can also purchase one half-price item ($25 or less) for every $100 in sales from $200 on.

I started this blog as a way to market the Country Bunny Bath and Body products I sell. But, I've also written about my EMT-Paramedic (school) clinicals on the ambulance. I've written about attitudes and feelings and about the loss of one of my dearly loved pets. And, I've written about immunizations and injuries and safety and health.

I'm interested in people being healthy and safe as much as I am interested in people pampering themselves and feeling good and smelling good.

Thank you again for visiting my blog.

Oh, a p.s., I went to Bunnyvention two weekends ago. I did not know what to expect from an event called 'Bunnyvention'. As it turned out, I had a marvelous time. It was held in Kansas City at the Hyatt Regency.

The next Bunnyvention will be held in Branson, MO in March 2006. If you are signed up as a CBBB Independent Rep, it's a great way to get a lot of good ideas about how to introduce the products to others.

I almost cancelled my trip to Bunnyvention. I was not sure I'd enjoy being there. But, I had a great time.

Bunnyvention was certainly affordable. The major part of the cost was for the hotel and transportation. The event itself only cost $125 for three days. That included vouchers for two $10 meals and one sit down dinner.

At Bunnyvention, they had a motivational speaker, a question and answer session with Nancy and Ron (the owners of the company), a new product introduction session (a new line of face care products are being introduced at the end of this month), a demonstration of a fun spa party, and a number of national representatives spoke and shared some of their experiences and insights. It was fun.

If you have any idea that you'd enjoy something like this, please think about attending Bunnyvention 2006 in Branson, MO in March 2006. We can talk about it between now and then.

Monday, August 01, 2005

A 3-D-Living-Breathing Picture Is Worth 1,000 Words

The human body is amazing. The human mind is amazing. The human ability to cope in the face of incredible odds is amazing.

That said, even if I were to stop school right now and never work in the medical field, I've seen enough for it to be a reminder for the rest of my life that all those things 'they' say about eating a proper diet, exercising, and avoiding tobacco, alcohol, and other drugs are worth listening to.

And, that's just from a medical standpoint. Wearing seatbelts, driving while NOT impaired, defensive driving, driving at a safe speed, gun safety, child safety, fire safety, home safety, personal safety (avoiding angry and abusive people, choosing not to ride with people who are 'driving while impaired', being aware of your surroundings and alert to potential dangers)... are all in the "how to prevent trauma" category.

When I took my EMT-Basic class 3 semesters ago (starting January 2004), my instructor told us that she'd be out and about (in a store, for example) and see people and think about what disease process was going on. I think she may have said something like "a heart attack waiting to happen." I have that experience now.

It's really scary (from a 'being concerned about people' point of view) to look at people and realize that it's only a matter of time until something really bad happens to them. I realize that many diseases are more likely to occur if the genetic history says a person is predisposed to get that disease. But, there are so many problems we (USA - residents and citizens) are having more and more of, because of excessive use of food, alcohol, tobacco and other substances, and because of inactivity of the physical body. And, there are so many things we could avoid by making good choices each day.

A goal in EMS is to take care of any life threats and get the patient to the hospital where he or she can receive further care (ex - surgery, advanced medical care). A sad thing about EMS, and much advanced medical care, is that so many problems could have been avoided.

Don't get me wrong, I don't do all the right things either. But, I believe in them. I eat too much chocolate and sugar, and I do too little aerobic and weight-bearing exercise. I need to have a more balanced diet and make more daily choices to do healthy things for myself, too. But, being on the ambulance is a daily reminder of what can happen if I do not make healthy choices.

We picked up a patient the other day who was not dying, but my thought was that he's on the way out. He has so much wrong with his body at this point. My thought was that he won't be long for this world. Or, if he lives, he will be very sick until he dies. My feeling was echoed by another EMT who said later, "he's a train wreck," and another who made a motion like an airplane spiraling down and said, "he's just waiting for the other engine to go out."

Those words were spoken privately to each other. I think they were an expression of concern and sadness for this man and his family for the dire medical situation he is in. The really sad part is that this man is much too young to be so damaged. But, his body has been damaged by years of doing the wrong things. Too many calories? Too little physical exertion? Years of tobacco use? Alcohol? Maybe he drew the short straw in the genetics pool, but maybe not. Maybe he could have had another 20 or 30 years of healthy life if different choices had been made for the preceding 20 or 30 years.

It's always easier to look back and see what might have been. What will it take to look forward and see what can be, in a good way, if good choices are made each day? 12-step groups focus on One Day At A Time. They encourage members to even focus on one minute or one hour at a time if that's what it takes. And, each person has a sponsor, another person who is struggling with the same issues.

What about these things? -

What if each of us living in the USA, the land of ease of access and ease of excess, had a life-sponsor and acted as a life-sponsor for someone else?

What if each of us helped each other to make good choices?

What if we ate "all you need" instead of "all you can eat"?

What if we excercised to relieve stress instead of using chemicals or television?

What if we drank water, ate fresh fruits and vegetables, and walked a few miles a day?

What if we chose to give others the benefit of the doubt rather than holding grudges and carrying anger?

What if we opened our eyes to what is beautiful in the world and breathed it in?

What if we opened our hearts to others and let our relationships be guided by gentleness and compassion?


Yes, I wander off topic now and then! ;) I started out talking mostly of physical health and what it takes to keep it. Hmmmm. Maybe all of those things are not off topic. Maybe it's all part of the same picture.

I do think we all have a lot more power than we realize. We each have the power to make hundreds (if not more) choices every day. We each have the power to choose to love ourselves through our choices. If we make good physical choices, we are also showing love to our loved ones when the sadness of illness and loss through disease and death are postponed for many years.

I'm probably going to turn into some soapbox speaker for healthy choices and healthy lifestyles! lol. Oops! I'm already up on that soapbox! ;)

I don't get to say these things to people in my personal life, because we all already know all these things, right? We all know what the results are of years of excesses in food and tobacco and other chemicals, and we know the results of lack of physical activity. And, we've all heard about how stress can trigger disease or make it worse.

Don't we? Maybe not. Maybe that's why I'm writing this. I'm seeing the results of poor choices every day. But, I can only change myself and make my own choices. I can't do anything about anyone else's choices in life.

Ten Good Things to Choose:

1) Healthy Diet (balanced nutrition plus lots of water, fresh fruits and vegetables)

2) Physical Activity (yard work, walking, working out, individual and team sports)

3) Yearly Medical Checkups (bloodwork, blood pressure and pulse check, disease screening, yearly recommended tests)

4) Relaxation (meditation, being in a beautiful natural place, yoga, breathing, pets, spirituality, lying in the hammock, pampering the body)

5) Choices (realizing that I have control over so many choices in my life every day, realizing that I make those choices for myself)

6) Changes (realizing that I CAN make changes, and realizing that I am the only person I can change).

7) Relationships (focusing on positive, healthy, loving and supportive relationships, and making every effort to leave the drama and trauma in my work life)




I'm still working on those last three. I think I need to go lie in the hammock and think about it! ;)

(ps - I've spent 24 hours doing EMS clinicals in the past two days and will do another 12 hours overnight tonight. I'm not totally in relaxation mode. I'm just pretending to be for a few hours.)