Many Diagnoses Come With Uncertainty

Just like this pandemic year, many diagnoses come with uncertainty. Truthfully, they all do. Getting comfortable with not knowing can help lead to the healthiest path for dealing with the coming months or a disconcerting diagnosis.

The contrasts of this year seem especially sharp as Christmas 2020 approaches. The middle road we often cruise has given way to distinct divisions between comfort and danger. And it feels disconcerting because many of the holiday traditions in which we usually find comfort are not currently safe. The pandemic has brought uncertainty we cannot avoid. Too much has changed too fast.

Under normal conditions, many of us shove uncertainty aside. We believe we know what each day will hold. We focus on that and tune out things we don’t expect or don’t want to deal with. We know that there will be minor mishaps – spills that stain a favorite blouse, flat tires, computer malfunctions, etc. We limit our expectations to those and move forward. That works great until an unavoidable life-altering event presents itself.

Big events often mean big decisions. It’s so much easier to make a decision if the outcome is immediate and known. But that’s not really how it works in most life-altering situations. Every choice is a gamble.

So how can we stay grounded and trust ourselves to make good enough choices?

It’s important to note that good enough choices aren’t always perfect choices. We can move toward health by making informed, if imperfect, choices. When we feel confident in our choices, we lessen the fear and anxiety created by uncertainty.

Fear triggers the urge to fight, flee, freeze, or fawn or hey, if things are really bad, all four! Just recognizing this can lessen the impact of the feelings when they arise. And there are ways to help calm your lower brain so that you can move in and out of fear deliberately and effectively.

Here are a few techniques to try:

Grounding – plant your feet firmly on the floor and press as if you’re getting ready for the starting gun of a race. If you still need to calm down, look around the room (leave your feet planted) and count all of the red you see, then green, then black, etc. You can continue by looking for shapes.

Tapping – Memorize a simple sequence of tapping. When you feel distress coming on, tap the sequence until you feel better.

Feeling your body – gently squeeze your arms noting how the skin feels and how the muscles feel beneath your arms. Continue with your legs or feet. Sometimes resting one hand on your chest just below your throat can feel calming. Feeling your body will help bring you into the present moment instead of getting lost in a panic of “what if”.

Breathing – stand in mountain pose and breathe. What I love about this pose is that you can do it anywhere without inviting the stares that downward dog would bring. If you’re at home, try alternate nostril breathing.

Once you develop successful methods to calm yourself, you will be ready to explore leaning into the feeling of fear. What works best for me is to allow myself to feel scared and to stay in that feeling as long as I can stand it. Having done this many times, I know that there will be a point at which things will shift and I will no longer feel afraid. If I can’t stick with it that long, I let it go for the moment knowing I can move in and out of fear as needed.

I don’t try to figure anything out or make any decisions when I’m leaning into fear. I just feel it and observe how my body responds. I trust that things will seem more clear once I’ve worked through some of the fear. When dealt with directly and immediately (or deliberately over a relatively short period of time), fear doesn’t have a chance to turn into long-term anxiety. It simply dissipates and goes away.

You can’t expect yourself to work through the fear brought by a diagnosis while you’re in the doctor’s office. At that moment, or any time you need to make immediate decisions under duress, I compartmentalize. I understand that many mental health professionals may not support that idea, but it works for me. The key is to create time and space soon after to feel my way through what has happened.

In other words, I compartmentalize temporarily. That gives me the clarity to proceed to another step of feeling confident in my decisions: gathering information. I set my feelings aside to ask the doctor as many questions as I can think of. I also ask the process for submitting questions that may come up once I’ve processed a bit longer.

Once I leave the doctor’s office, I research my options until I reach the point that I feel comfortable working with my doctor to devise a care plan. This sometimes includes getting a second opinion. Having the knowledge of more than one expert makes me feel more confident moving forward. While there is no way to know for sure whether we’ll achieve the outcome I desire, making informed plans builds my confidence and comfort level make uncertainty feel more tolerable.

Uncertainty can still weigh heavy. That’s when I like to get outside. Or on days like today, a trip outdoors offers an opportunity to bank good feelings to pull from when I need them. It’s such a gorgeous day! The work view I’ve chosen is from the porch overlooking my back yard.

Multiple birds chirp as they shuffle in and out of the wisteria on the arbor. Crows caw in the distance. Sugar snap peas extend their small white blossoms above the fence into a net trellis. The sun is full on my face and I’m comfortable in a light sweater. At sunset, we’ll be able to see Jupiter and Saturn align into a bright Christmas star. How could anything be bad?

Of course I’m aware of the perils of delivering gifts to my friends. Any other year, we’d be sharing food, wine, and laughter along with our gift bags. This year, we’re navigating quarantine just to get them to each other’s porches.

But while I sit under a brilliant blue sky, I don’t have to think about that. I can simply soak in the sun, the sounds, and the smell of BBQ when the breeze shifts just so. The smell of smoke from that nearby BBQ pit is a peril in itself. Live here long, and you’ll crave barbecue for breakfast.

As we move through stunted holiday celebrations into more months of pandemic uncertainty, some of us will receive unwanted diagnoses with the potential to increase anxiety. Having tools to reduce discomfort can mean better decision making and more peace of mind.

That’s my wish for all of us through the holidays…peace of mind and spirit!

What’s in it For Me?

Go ahead and ask, “What’s in it for me?” You may cringe when you read that. I know a lot of people feel like they’re currently surrounded by selfishness. But I really want to explore the opposite: What’s in it for me when I give my time to help someone else?

My timing may seem off to you. Most of us are struggling just to get through the craziness of 2020. But sometimes the best way to get past a struggle is to help someone else. I’m not suggesting that you leave your home or take more risks of exposure to COVID-19. There are many ways to contribute from where you sit.

When you feel bored, anxious, or worried, changing focus can work wonders. But it can be hard to think of a constructive way to use your time when you’re stuck at home with nothing on the agenda. So, let’s go back to the question at hand, “What’s in it for me?”

I’ve fallen into some really great opportunities to volunteer by attending a training, workshop, or lecture. I go for the intellectual stimulation, but I stay because I find a place I feel I can make a difference. This year, I’ve discovered I can actually attend more events because there’s no travel involved and fees have been lowered.

You don’t have to be passionate about any particular cause to make a difference. Perhaps your talent is making connections. You may be able to help a friend or associate find a new job by putting them into contact with people you know. You may be the perfect person to solicit committee members, put together a task force, or provide resources for a newcomer. You could end up introducing someone to a new partner. The right introduction can change a life.

If you’re a good communicator, you may want to write letters to teens residing in behavioral health hospitals. With COVID limiting visitors, children can use extra comforting words. Our nursing home residents and prisoners can also use extra comfort this year. Words are powerful. They can provide distraction and inspiration.

And let’s not forget healthcare workers. I have a handful of doctors I email or text on a regular basis to let them know I appreciate them. In spite of their added burdens, they often respond with encouraging messages for me. These are incredible people! And although it is not my intent for them to feel obligated to respond, there’s a lot of gratitude and reassurance available for me to absorb.

If you’re crafty, you can knit caps for newborns, sew masks for hospital visitors, or create Christmas stockings for teachers and fill them with supplies. This Christmas, I’m planning to fill stockings with holiday treats for my neighbors and leave them on their porches. I did this for Easter and the 4th of July. It’s a tiny thing to do, but brightening their day brightens mine.

And that’s the point. If you feel there’s something missing from your life, try giving that something to someone else. I’m not saying to do this in place of self-care, but as a form of self-care. We often think of giving as a tiring obligation, until we try it. Once you start using your time to create joy or comfort for someone else, you’ll be amazed how it will fill your heart and bring you joy as well.

There you have it. That’s what’s in it for me.

Volunteer Opportunities

Increase Your Chances of a Good Recovery

Increase your chances of a good recovery. Hospital discharge is a vulnerable time for a patient and one that’s rife with miscommunication. How can you increase your chances of a good recovery?

Different frames of reference coupled with broad, ambiguous recommendations mean that health messages are often misunderstood or interpreted in ways that surprise those making the recommendation. Last month, I weighed in on a discussion regarding hospital discharge instructions. Communicating discharge instructions effectively can have a significant impact on a patient’s recovery.

Discharge is known to be a vulnerable point in making a successful transition to a different location and level of care. With limited visitors currently allowed in hospitals due to Covid-19, patients are often alone when receiving oral discharge instructions. The absence of another set of ears leaves patients even more vulnerable to one of the unplanned re-hospitalizations that cost Medicare over $17 billion annually. While cost to the system is a factor, as patients we just want the best chance to recover as quickly and fully as possible.

The goals of patients, physicians, and hospitals often align at the time of discharge and yet according to one study, those goals are not met almost 20% of the time. There are many factors we as patients cannot control, but that does not mean we are helpless.

Here are 10 things you can do to increase your chances of a good recovery:

1)Have an advocate present when receiving discharge instructions. If visitation rules don’t allow you to bring someone with you in person, a video phone call can be a good option.  A voice call will also work and is best done in real time while the instructions are being delivered to the patient.

If you do not have family or a close friend available, request a patient advocate. Your hospital will most likely have at least one on staff.

2)Ask questions. Do not worry about wasting someone’s time or sounding silly and do not assume your question is stupid. We all sometimes misspeak or mishear things. And, many smart, competent, well-intentioned professionals are not skilled communicators. Clarification is good. Repetition may be necessary. Knowing the why may make the what easier to follow.

3)Request resources. If you need help navigating financial options and insurance coverage, ask that resources to assist with those be included in written doctor’s orders.

4)Get wellness support. A change in health conditions may mean a need for additional time for physical activity, mindfulness activities, support groups, or counseling. Other support services like housecleaning, babysitting, school pick-ups, or food preparation may be needed to free up time for wellness support.

5)Get another opinion. If you want to get another opinion about long-term or follow-up treatment, make a temporary plan with your doctor that will be reflected in any written discharge orders.

6)Request time to research. If there is no emergency and you are not sure which treatment option to pursue, ask for a temporary plan then schedule a time for a follow-up visit. Allow yourself time to read about up on all of the options available.

Make sure to use reputable sources like the National Institutes of Health, The Center for Disease Control and Prevention, The New England Journal of Medicine, The Lancet, and The Journal of the American Medical Association (JAMA) for your research. Social media sites are not reliable sources of information.

7)Ask for a referral. If your research leads you to a physician/facility that specializes in treatment of your diagnosis that is not offered by your current doctor or hospital, request a referral to a new doctor and/or facility and sign a form allowing the release of your records to the new facility.

8)Make sure treatment plans match your values and goals. If you and your doctor are not on the same page regarding desired outcome and the best way to achieve it, you will not be successful. Insist that you play a part in developing a plan.

9)Follow the plan. Once you and your doctor agree on a treatment plan, follow it. Period. No plan will be successful if you don’t follow it. (If you develop reservations about the plan, continue treatment until your follow-up visit or call your doctor and work out a revised plan.)

10)Give feedback. When you receive a survey about your experience, provide specific answers. This may not speed your current recovery, but it will help you and other patients in the long run. Your experience is valuable.

Sometimes getting sick is unavoidable, but a few simple steps is all it takes to increase your chances of a good recovery.  

Stomach Hurt? Hit Your Finger With a Hammer

Five Ground Rules for Using Distractions Effectively

Stomach hurt? Hit your finger with a hammer. Your stomach may still hurt, but you won’t notice it anymore! (You know I’m right if you’ve ever stubbed your little toe on the couch!) Should you discover afterward the cure is worse than the disease, well, you learned something.

I’ve seen this pain management technique used in movies, but I don’t know anyone brave enough to purposely hit their hand hard with a hammer. On the other hand, I know plenty of people who use other forms of distraction that are dangerous: drinking & driving, drinking & shooting, having unprotected sex with strangers, driving aggressively, and gambling.

While the risk is always there, only occasionally does such distraction lead to tragedy. That means such behavior goes mostly unchecked until someone gets a DUI or ends up in bankruptcy and people begin to take notice.

Right now, with the pandemic, unjust law enforcement, and economic hardship, there’s plenty of pain and loss to go around. Everyone is trying to figure out ways to cope. This makes me wonder…

Is it always bad to use distraction to relieve physical or psychic pain?

Obviously, nothing is all good or all bad per se and there’s not an absolute answer to this question. For example, drinking, gambling, and drug use bring significantly more risk for those struggling with addiction than for those who are not. Drinking and driving on the other hand is a risky combination for everyone. Drinking and shooting are never the best mix, but one beer and a round of sporting clays won’t raise any special alarms for me. And there are distractions like enjoyable work and creative hobbies that don’t pose danger.

While I’m musing about this, I’d say my ultimate intention is to heal physical and/or psychic pain as fully as possible and thereby eliminate the need for pain-relieving distractions. With that said, I realize healing is a process that is sometimes lengthy. Distractions may be a useful technique for functioning in the interim.

Here are five ground rules for using distractions effectively:

Acknowledge the source of underlying pain. If you do not start here, distractions will hinder healing.

Make a deliberate choice to include distraction as a way to manage underlying pain.

Choose distractions that add meaning and value to your life or the lives of others. Volunteer work, political activism, gardening, flower arranging, performing music, reading, writing, painting, sculpting, building, and cooking are all examples of valuable distractions.

Choose distractions that require you to be your best self. Putting your best qualities on display and receiving positive feedback will feed your spirit.

Seek balance. There are times that it is more important to focus on a problem than to be distracted from it. Finding a balance between focus and distraction will put you in the best position to pivot when needed.

Some pain is unavoidable. It will come in waves from nature, from others, and from ourselves. Without balance, pain can become all-consuming.

Carefully chosen distractions are helpful for mitigating pain and shifting focus. I use them on a regular basis. I do so judiciously, recognizing that distractions can become all-consuming as well.

That doesn’t mean I only choose highbrow distractions. Sometimes I binge watch. Sometimes I read the TMZ website. I check @ass_Deans tweets. I build something with the grandkid’s blocks. I take off my shoes and focus on how my feet feel walking through the grass.

Using distractions well means I can shift easily. Being able to shift gives me freedom to make choices rather than be stuck and frozen. Playful distractions are my favorite, but mostly I try to stay away from extremes like hitting my finger with a hammer to make my stomach stop hurting.