Balancing Giving and Receiving This Holiday Season

We’ve all been raised with the idea it is better to give then to receive and where this is most exemplified is during the Holidays. “What do you mean you aren’t going to go to your parents (who live 300 miles away) for Christmas? How can you be so selfish?” “It’s the perfect present for Jack (substitute any name). You can always put it on plastic.”

I’ve done a variety of posts on this topic. However, at this time of year, we all need the reminder to try and achieve some sort of balance in this season of excess.

The fact is, when you are dealing with a chronic disease, you don’t always have the energy to travel or party or have the money to pay for expensive presents. At the same time, you may have to heavily depend on others to help you with the basics of daily living, such as getting to doctor’s appointments, grocery shopping, child care etc. If you are a caregiver, you may be so depleted from giving that the idea of “holiday giving” is more than you can stand

We need to keep a balance of giving and receiving. It can’t go all one way. We only need to look outside our window to get the picture. At this time of year, when we have just celebrated the bounty of harvest, the ground now lays quiet. Living in snow country, it is if the land is tucked in for a long much needed sleep. It is it’s time for the earth to recharge so that in the spring it can once again bloom and provide.

Consider the following:

• Watch for warning signs that you are out of balance. These can include: feelings of being very anxious and tense (clenched jaws); a flare in symptoms; complaining; feeling listless and not wanting to do anything.

• Identify yourself: Are you a constant giver? (No rationalizations about why you give too much). If so, be willing to receive. Are you a constant taker? If so, start giving of yourself. For tips on balancing giving and receiving, read January’s post on this topic.

• Read previous holiday posts:
Holiday Songs Can be good Reminders for People With Chronic Conditions

Holidays: Over Do the Laughter and Under Do the Stress

• Do what you can realistically do. The idea of sacrificing yourself for others is not a good idea.

• Use this time to let people know how special they are to you with meaningful gifts that do not deplete your income. Check out the following posts for ideas and suggestions:

Balancing Giving and Receiving: Includes ideas on giving when you are relying on others for help and assistance

Holiday Gifts for People with chronic disease

Unique Gifts for Hospital Patients

The Best and Worst Holiday Gifts for People with Cancer

• Keep the joy alive by reminding yourself daily of what you have to be grateful for and brings you joy. They can be as simple as watching snowfall, the smell of baking cookies or a fresh cut pine tree or the smile of appreciation from someone you helped.

• Take a Break. Every Wednesday is “take a break day.” If you don’t care for this particular weeks “break,” try the archive section, which includes hundreds of ideas.

Take A Break: Make Count Downs to Christmas

I grew up with the tradition of an Advent wreath. The Sunday before Advent began, my mother would manufacture a wreath using four candleholders with greens wrapped around them. Three of the candles were purple and one was rose colored. Each candle represented one of the four weeks before Christmas, with the rose candle being lit the third Sunday of Advent or Gaudete Sunday. Purple, being the color of royalty, represents Christ as the “Prince of Peace,” while the rose for Gaudete (rejoice) Sunday combines the mixture of the Advent purple and the Christmas White.

Each evening after dinner, my brother, sister and I would fight for the chance to light the candle(s) of the Advent wreath. Once that was decided, we’d light the candle(s) and sing “O Come O Come Emanuel.” With each passing Sunday a new candle would be lit so that by the last Sunday before Christmas, all four candles were ablaze. On Christmas Eve, the candles were lit for the last time and allowed to burn down.

My children enjoyed Advent Calendars, most of which came from Germany. If they were the kind that didn’t have chocolate behind each day, we’d close all the doors and store them flat so they could be reopened the next year.

After we were grown, my mother still had an Advent wreath, but surrounded it with the various Advent calendars we would send her. She loved her ritual of marking the days until Christmas

So if you want to mark the days until Christmas, using a calendar or a wreath, below are a variety of ways you can do that.

• Use a small Christmas tree, or several branches stuck in a vase and add an ornament for each day. You make small snowflakes and add per day.

• Printable Advent Calendar Definitely for the crafty folks.

• Christmas Treasury Advent Calendar. You download the front and back, tape together and have a calendar that’s just as pretty as anything you would purchase.

• Online Fun Advent Calendar: Each day contains a different stencil that you can print Use the free stencils for decorating windows, cakes, friezes in schools and play schools or just for fun at home on a rainy day. Size them all to small squares and make your own advent calendar in felt by adding one item every day.

• Opt for a digital Calendar. Below are links to various ones.
- Busted Halo: This calendar brings its sense of surprise by showing you the whole calendar, but not letting you open each day and find out what’s behind the picture until that day comes along. This year’s calendar has weekly themes — hope, love, joy, and peace — that will help you connect to the significance of the season of Advent. Each day, that day’s link in the Advent calendar will start working, leading to a special Advent-themed Daily Jolt, with an opportunity for reflection, a microChallenge and a chance to enter our contest. Some of the reflections come from unlikely sources, and the challenges help you to take an action, usually a small one, based on the reflection.

- Advent Calendar 2011-Countdown to Christmas

- Christmas Advent Calendar

- Other Christian Advent Calendars

- A German Advent Calendar with Daily Christmas Facts (in both English and German) h

- Calendar video (a different video each day)

• Bookmark Count Down to Christmas, and you can see exactly how many days, hours, minutes and seconds before Christmas arrives. This site also offers a variety of activities, such as reading Santa’s blog.

• Advent wreaths can be done without spending any money-you don’t have to have purple and rose colored candles. Some new ways to consider:
- Use four votive candles, in holders, placed in a bowl filled with cranberries.

- Take a wire clothes hanger and stretch into a circle. Undo the wire by the hook end and string Christmas Tree balls to create a stunning wreath. Place four votives in the center. Cut off the hook, or place a large bow over it. Of course, if you’d prefer, you could skip the candles and have a nice wreath for the door.

- Using a bread loaf pan, place four tapered candles in holders and fill with greens, cranberries, nuts, rocks or something that appeals to you.

Relaying information: Be mindful of the how and when

Recently, we had a situation in my community where an 18 year old was killed in a car accident. The fast means of today’s communication-cell phone, text, e-mail and twitter-presented new challenges in distributing factual information in a timely manner.

We wanted to tell our son, since this was his friend, versus getting a text message or seeing it on Facebook. Since the accident took place during school hours, we did have the option of having him taken from class. Ultimately, we sent him a text (since he can’t use his cell phone at school) and told him to call home.

Since we were able to talk to him, we made sure he wasn’t driving before we relayed the information and provided him with facts, versus rumors that were swirling around. Ideally, we would have preferred to tell him face to face, but given the circumstances, particularly the rapid way information is now spread in this digital age, particularly among teens, this was the best we could do.

Several years ago, a friend called to learn about test results while driving. The information was not good. Fortunately, the person was not alone in the car, and the passenger had the presence of mine to tell them to pull over.

In the past week, we learned that a friend is very ill. Again, the e-mails, texts etc. are flying. Factual information is needed and a tweet isn’t necessarily the best way to distribute it.

Below are some ways to consider relaying information in our digital age.

• When relaying difficult information, try to do it in person if possible. If you have to call, start by asking where and what the person is doing. If they are driving, ask them to pull over or call when they have reached their destination. Be mindful that newer cars are equipped with speakerphones. The information you may be relaying may be broadcast to everyone in the car. Check to see who is with them.

• If the person is not available when you call, leave a message asking them to call you as soon as possible. When they do call, ask them where they are.

• When making calls about a family or friend’s situation, or your test results, do not do it when you are driving, operating equipment or doing something, which if distracted, could cause problems.

• Take advantage of the various free websites like Cares Pages, CaringBridge and my favorite Lotsa Helping Hands as a way to keep family and close friends aware of the situation. It’s easier to set up a Cares Page or CaringBridge initially. The down side is that once a person has the password to the site, they can forward that to anyone they choose. Lotsa Helping Hands is a bit more involved, since it requires a site manager to approve those who wish to be members.

• Check out the previous post on Communications

Take a Break: Learn Wampanoag

Many of us were taught that the first Thanksgiving occurred in 1621, when the Wampanoag (wahm-pah-no-ahg) "eastern people" or "people of the dawn" and white settlers-think Mayflower 1620- celebrated a three day harvest festival together. This was not a “Thanksgiving, “ as Pilgrims viewed such celebrations as days of worship, in which they prayed to God in thanks for a specific event. A good harvest, victory in battle during the Revolutionary war, and sufficient rain were all viewed as reasons for a Thanksgiving.

The Wampanoag had lived in southeastern New England for over 12,000 years. Within 50 years of the 1621 harvest feast, the Indians were driven from their land and many died from disease brought by the Europeans. Today, there are less than 5,000 of their descendants.

Along with the destruction of their culture, the Wampanoag were banned from speaking their language. However, thanks to Jessie “little doe” Baird, the Wopanaak language is once being spoken.

The Wôpanâak Language Reclamation Project began in 1993 under the direction of Jessie 'little doe' Baird who earned a Masters Degree in Algonquian Linguistics from MIT in 2000. Through the joint collaborative efforts of members of The Assonet Band of Wampanoag, The Mashpee Wampanoag Tribe, the Wampanoag Tribe of Aquinnah and the Herring Pond Barnd of Wampanoag, the project aims to return fluency to the Wampanoag Nation as a principal means of expression.

Today’s “take a break” is to learn some simple words in Wopanaak. Check out the following links:

Wôpanâak Language Reclamation Project

We Still Live Here Details Effort to Restore Wampanoag Language (PBS Documentary) Excerpt

Happy Thanksgiving!

Setting Your Own course When Living with a Chronic Condition

Recently, I watched a video Video of Elizabeth Gilbert, author of “Eat, Pray, Love” speaking at the tenth anniversary celebration of “O” magazine. She talked about how women are in a unique position as they have few role models, as the choices and opportunities that we have today were never available to our female ancestors. As she noted, her dust bowl era grandmother didn’t wake in the middle of the night obsessing about whether she should learn to speak French.

People with chronic conditions are in a very similar situation. Diseases, such as cancer and AIDS, which even just a few years ago were terminal diagnosis, are now conditions people can live with for many years. Fact is, people are outliving their diagnosis and dying from something totally different.

The “baby boomer” generation has now entered the “golden years,” as they turn 65 this year. They too are facing unique challenges and are lacking for role models since many did not have parents that lived to see retirement. Still others are sandwiched between very elderly parents, children of various ages and even grandchildren they are raising. To top it off, many of the boomer generation are already living with one or more chronic conditions.

The big question is how do we live? Who is doing it right? If I try x, y or z, because that’s what Fred is doing and he’s having great results, and it doesn’t work, does it mean I’m a failure? Am I failure because I have this diagnosis? Do I feel worthless because I’m 70?

While we can look at our career paths, or lack there of, and think about the choices we made, it’s seems a bit different when it comes to health care. Why? Because medicine is suppose to be a science. “This medication works for 90% of the people.” “By the end of five years, only 5% of those with that diagnosis are alive.” And so it goes. The fact is, medicine is far from an exact science. Statistics they give today, have no relevance when a new study comes out a week from now. Or does it?

The bottom line, is that as much as we’d like to think that scientific method is the end all and be all when it comes to health care, living with a chronic conditions, and aging, are just as much a journey as figuring out what you want to be when you grow up. (As if I’ve succeeded in that department.)

As Gilbert noted in her talk, women are pioneers in continuing on. This is very true for those learning to live with chronic conditions. A hundred years ago, 80% or more of the population died from an acute illness and a small minority lived for many years with the condition that would result in their death. Today these numbers are reversed-most of us will live for many years with one or more chronic conditions.

Consequently, the medical community, which is based on an acute care model, is still trying to figure out how to handle this very different situation. Those with chronic conditions can’t afford to wait while it’s being figured out. We need to be in charge of our health care.

For each of us, the journey will be uniquely ours. We will make mistakes. We will take risks and succeed and other times we will fall flat on our face. However, we need to continue on, charting our own course, sharing what we know, and supporting one another in the process.

If you haven’t checked out Healing Whole on Facebook, you’ll find regular postings on a variety of topics, including the latest research. You don’t have to join Facebook to read the posts.

Take a Break: Thanksgiving Center Piece/Seven Wonders of the World

With Thanksgiving just a little over a week away, give yourself a few days to collect leaves and other out door items to create a unique Thanksgiving centerpiece. So here a few ideas to get you started.

• Leave bouquets: I tried this a few days ago and was amazed how beautiful they turn out. It was a lot easier than I thought it would be.

• Cornucopia (Horn of Plenty): While you can find inexpensive wicker cornucopia baskets, you can also make simple ones.
Bread dough

How to Make a cornucopia (video)

Mini Cornucopia: Instructions on making cornucopia using a Styrofoam cone shape and covering with jute of felt.

Once you have your cornucopia, be it purchased or made, fill with gourds, apples, pears, leaves, colored corn, and of course some wonderful wrapped chocolates.

• Cranberries: There are lots of ways to use cranberries. Pour a bunch in a large clear vase and then fill with flowers or pillar candle. Use a trifle bowl and layer cranberries with other fruits, such as apples, oranges, limes and add some flowers or greens coming out of the top.

• Lentils, split peas: Layer in a clear glass container, dried split peas, lentils, small red beans etc., and stick in a burnt orange pillar candle.

• Easy and Elegant Thanksgiving Centerpieces from Good Housekeeping

So if making a Thanksgiving centerpiece isn’t your idea of a break, check out The Seven Wonders of the Ancient World at the Museum of Unnatural Mystery.

Polypharmacy: Are you taking too many drugs? What can you do?

Recently I was an advocate for a patient that when asked about medications, named the one prescribed by his doctor, but didn’t mention the variety of vitamins and supplements that are part of his daily regiment. Since they were experiencing some serious side effects from their prescribed meds, I couldn’t help but wonder if some of the supplements, at least one of which I had never even heard of, could be interacting with medications.

People with chronic conditions are often prescribed a number of medications, plus many add vitamins, supplements and over the counter (OTC) drugs. It is not uncommon for people to be taking drugs to counter side effects from another medication. Further, some people want to take all their meds, including vitamins, at the same time. The fact is all this “mixing” can lead to nasty effects (tiredness, confusion, falls, dizziness etc.) and/or needed medications not working.

Food can also interact with medications, both prescribed and OTC. They can combine to make the drug more effective, keep nutrients from being absorbed, or render the medication useless. When you eat and take your medications can also make a difference. Alcohol and meds should never be mixed and drinking something hot should be avoided as it may destroy effectiveness.

You are at risk for polympharmacy if you:
• Take five or more prescribed drugs.
• Take supplements, OTCs, vitamins etc.
• Use more than one pharmacy
• Take meds more than once a day.
• Have a hard time remembering to take medications

To avoid the complications caused by Polypharmacy, consider the following:
• Make sure all your health providers (primary care, specialists etc.) knows all medications you are taking, how you take them and when. This includes prescriptions, vitamins, supplements and OTCs. Write down the name of the medication, supplement, OTC. For each one, write how much you take, when you take it (e.g. with breakfast), and how you take it (with a glass of water). Up date it regularly and provide a copy to all your medical providers. Be sure to include it in your personal health notebook and carry it with you.

• If you are being given a new prescription, ask about possible interactions with your current regiment. Both medical provider and pharmacist can check a drug interaction database. You can also check Drug Digest http://www.drugdigest.org, which provides information on possible interactions for all medications including vitamins and herbs.

• Use only one pharmacy to fill prescriptions.

• Learn your medications by name and what they are for

• Read the directions and labels on all medications (including OTCs) to avoid interactions. Don’t hesitate to ask the pharmacist or your health care provider if you have questions.

• Avoid combination products such as cold formulas. Ask the pharmacist and/or medical provider for other options.

• Take medications as prescribed.

• Consider alternative solutions that do not involve medications. For example, exercise, mindfulness based stress reduction (MBSR) and/or therapy can be effective for treatment of depression and anxiety. The Center for Mindfulness at the University of Massachusetts Medical School has been conducting research for years on MBSR and finds that it can positively and often profoundly affect participants’ ability to reduce medical symptoms and psychological distress. The Stress Reduction Program has benefited people reporting a variety of conditions and concerns including chronic illness or pain, high blood pressure, fibromyalgia, heart disease, asthma, GI distress, skin disorder and many other conditions.

• For more information: University of Chicago Polypharmacy and the Elderly