Take a break: Celebrate the Triple Crown/Animation Video

Growing up in Baltimore, Md, May was all about the Preakness and Triple Crown hopefuls. The Preakness is the second of the three race series for three-year old thoroughbred horses. The other two are the Kentucky Derby (Churchill Downs in Kentucky), held two weeks before Preakness and the Belmont Stakes (Belmont Park in Elmont, New York), which takes places five weeks after the Derby.

Even though I now live in a part of the country where there isn’t a week dedicated to a horse race, many people still have Derby or Preakness parties. In keeping with this idea, below are ways to celebrate the various legs of the Triple Crown.

Kentucky Derby: I’ll Have Another won on Saturday but I’m still including some traditions that will be fun to try out, if not this year, maybe next. Of course if he wins in Baltimore, you might want to add a few items for the Belmont Stakes, since there hasn’t been a Triple Crown winner since Affirmed in 1978.

Ladies in big hats sipping mint juleps seems to sum up the first leg of the Triple Crown. However, there are other lovely traditions, such as derby pie, which is really pecan pie.

• Roses are the traditional flower, so make some out of duct tape, if they aren’t in season (or affordable) where you live.

• . Follow along with the singing of “My Old Kentucky Home.” Notice how dressed many people are.

• Ride the Kentucky Derby Winner (virtually)

• Make Your Own Derby Hat

• Check out some of this year’s Derby Hats

Preakness: Having spent more than one Preakness performing in the infield of Pimlico Race Track, the single biggest thing I saw was the consumption of Black-Eyed-Susans. While some folks in the grandstands may have worn hats, I was a lot more familiar with the baseball caps and “beach attire” of the infield. With BBQ’s going and people playing volleyball and tossing the Frisbee, it felt like a day at the beach more then a day at the races. That said, here are some “traditions” to try out:

• Sing along with Maryland My Maryland. If you think it sounds like “Oh Christmas Tree, Oh Christmas Tree,” you are correct. In 1861, James Ryder Randall, a native of Maryland, was teaching in a Creole school in Louisiana during the early days of the Civil War. On April 19, 1861, Union troops marching through Baltimore to the President Street station were attacked by a crowd of men hurling bricks. The troops opened fire, killing several in the crowd. Outraged by the news that his friend, Francis Xavier Ward, was among the casualties, Randall articulated his Confederate sympathies as a nine-stanza poem entitled "Maryland, My Maryland." The poem was immediately popular throughout the south and was set to the traditional tune "Lauriger Horatius" ("O, Tannenbaum"). Teaching American History in Maryland

• Black Eyed Susan is both the official flower of Preakness, as well as the state’s flower. However, it doesn’t bloom until mid to late summer. In Vermont, it’s basically considered a weed. They are a hearty perennial and grow in many different climates. Purchase some seeds, plant and enjoy for many years to come.

• Crab in any form is the choice for many during Preakness week. There is nothing like a good crab cake. I’ve done some searching on-line and found a recipe close to the one I grew up with. When I can afford to make crab cakes, there are some givens that are required-saltine crackers (not a lot though), Old Bay Seasoning, egg, light on the mayo, Worcestershire, salt, pepper and dried mustard. Use whatever type of crabmeat you can afford. I’ll often get special as I like a stronger crab flavor. While many pan or deep fry, I put the crab cakes in the oven along with the Old Bay seasoned potato wedges that I’m roasting. Served along with Cole slaw, sliced tomatoes and some tartar sauce, the crab cakes are a perfect anecdote when I’m homesick

• Watch Secretariat: This movie is about the triple crown winner in 1973 and includes footage from his Preakness Race.

Belmont Stakes: With each leg of the Triple Crown, the mood becomes more relaxed and easy going. Well that’s true unless you have a horse that’s won the first two legs and is now a Triple Crown contender. Here the “blanket” for the winning horse is made of white carnations.

• Make tissue paper carnations. Use pinking shears to get the jagged edge so familiar to the carnation.

• Sing along with Frank Sinatra the official theme song for the Stakes New York, New York.

• While the official drink is Belmont Breeze, it doesn’t have the following of the Mint Julep or Black-Eyed-Susan. Instead the crowd tends to drink beer.

• Make some cupcakes that are frosted with green or white icing. Decorate with the official logo of 2012.

If you aren’t a Triple Crown fan, watch the most amazing medical animation video.

Confidentiality, HIPAA and Getting What You Need

This past week I watching a very sad story unfold. Just before heading into emergency surgery, a patient called a close friend, and asked them to come to the hospital. Being a good friend, Sal (not the real name) headed to the hospital, where they were informed by the staff that they weren’t allowed to see the patient, or obtain any information. It seems that the patient’s spouse, who wasn’t present and wouldn’t be for several days, had left strict orders that there were to be no visitors.

For the patient, things were going from bad to worse. In fact, the only information the friend could get to repeated requests to the medical staff of “but what can I do,” was “pray.” Calls to the spouse by several friends of the patient were met with the same response, “no visitors.”

While I explained to the friend the rules of HIPAA (Health Insurance Portability and Accountability Act) and confidentiality, it didn’t help with Sal’s very realistic fears that their friend was going to die alone. I did suggest that if the patient should have any wakeful periods, “Ask the staff to let the patient know you are there and whether they would like to see them.” If the patient’s response is “yes,” the staff could allow the visit. Since the patient was able to speak for them self, the spouse’s permission was not needed.

The take home point of this story is that hospitals and medical providers operate under a set of guidelines regarding patient information confidentiality that have been set forth under HIPAA. However, each provider and organization will implement policies and procedures that they believe best meet their needs. For example HIPAA does not require that you give your health care provider written permission to discuss your health information with family, friends or others involved in your care. Yet, many providers and hospitals will require it.

To avoid the situation described above, as well as ensure that your wishes are honored and your confidentiality kept, please consider the following:

• Be very careful who you select to make decisions for you in the event you are unable to do so. Called power of health attorney, health proxy, or medical power of attorney, this individual can make health decisions for you if you are unable to do so. States vary about the type of forms required, which can be obtained on-line.

If you are checking into the hospital, the person doing the intake will ask who can speak for you and will make a note in your chart accordingly. It can be confusing, since this question is often asked by saying, “in the event of an emergency whom should we contact?” Some hospitals will ask if you have a medical power of attorney. This person may not be your spouse or partner, so be as clear as you can about who should be contacted. They will want a phone number if they don’t have one on record. I have been in situations where the admissions department would not use the most appropriate person simply because the patient didn’t have a phone number with them.

While it would seem logical that your spouse or partner should speak for you in the event that you can’t, there are many people who recognize that differing viewpoints as well as emotional strain may make it best if someone else serves this function.

• In general, providers can not discuss your condition with family or friends unless you have given them permission. However, in certain cases, such as an emergency, they will. In the situation described above, the spouse had spoken for the patient to the medical staff and so “no visitors” had to be observed by the hospital.

• Download and Read “A Patient’s Guide to the HIPAA Privacy Rule: When Health Care Providers May Communicate About You with Your Family, Friends, or Others Involved in Your Care.” Consider taking this document with you to your next medical appointment and discuss it with your provider.

• Complete Advance Directives (Living Will). This is a legal document, which varies by state that outlines your decision about what kind of end-of-life care you are willing to have or not have. This includes things like dialysis, breathing machines, tube feeding etc. You can also specify if you want to be an organ or tissue donor.

Download your states form. While some states have on-line Living Will Registries, others do not and in some cases, the state has discontinued them. There is a private company that offers an on-line Living Will Registry. In the event you do not use an on-line registry, make sure you form is completed, signed and dated, with copies being given to medical provider(s), family members, hospital where you receive care and attorney.

• If a family member, neighbor or friend accompanies you to the hospital for an emergency, if you don’t want them privy to conversations between you and the medical staff, ask them to wait outside. Otherwise, the provider can assume that since they are present with you, it’s okay to discuss your medical situation in front of them.

• Use an advocate. Learn more about being an advocate.

Take a Break: Make a Bookmark

Truth be told, I’ve had some nice bookmarks over the years, but I’m forever loosing them. More often than not, I use a scrap piece of paper (such as the shopping list I forgot to take to the store). Every now and then someone gives me one that I keep for a while. If they are really nice, they don’t end up in the trash, and eventually I’ll find them again and use them until they once again mysteriously disappear.

With Mother’s Day just around the corner, a book with a customized bookmark might make a very nice present.

Below are some fun bookmarks to try:

• Take a photograph of someone. Glue to a piece of cardstock and then cut out the person, as close as possible. Cover and back with clear contact paper. If you like, punch a hole to attach a tassels. My husband made a birth announcement for our youngest, just before Christmas, using the same technique. Instead of a bookmark, his idea was an ornament. It’s really fun to see his baby face on our friends’ Christmas trees, particularly now that he’s 18. Check out bookmarks with tassels, for a good tutorial on making tassels, as well as a variation on the photograph bookmark.

• Have some odds and ends of jewelry? Repurpose it into a book mark. Using a 16 inch piece of ribbon, sew or glue, a “jump ring” to each end, to which you can add a few odds and ends of jewelry, charms or whatever else sticks your fancy. Also check out the tutorial, Charming Bookmarks.

• For someone that’s always painting, be it their house or an artist, use a paint chip card. You can punch a hole at the top and string some rattan or a tassel at the top. Write or draw something clever on it.

• For the person that needs “readers,” the bookmark/glasses holder will solve that problem. Use an inexpensive glasses case (Dollar Store), or make one. Sew or glue a ribbon to the top edge and make it sufficiently long enough loop around most books. For an all in one project, try Eyeglass Bookmark Tutorial.

• I know that my cookbooks are filled with scraps of paper to mark favorite recipes. A set of cookbook markers would be very helpful. You can make your own by putting different cooking related items on each bookmark, make your own template or download a set for free.

• It’s really frustrating to be using a new recipe, only to have the cookbook page refusing to stay put. Solve that problem by making a magnetic bookmark. Take a 9 inch strip of cardstock (width depends on what you want to put on the bookmark), and fold in half. On the inside of the bookmark, attach a magnetic strip about a half an inch from the bottom, to each side. Make sure they line up correctly. You can pick up magnetic stripping at any craft store as well as hard ware stores. Since I love making things out of duct tape, think I’ll try this with some of the new designer duct tape. http://duckbrand.com

• Check out 16 Creative and Cool Bookmarks

Ways to Fulfill the Obligation of the Cured/Healed

In October 1996 Lance Armstrong was diagnosed with end stage testicular cancer, which had spread to his brain, lungs and abdomen. In 1997, he established the Lance Armstrong Foundation and the yellow bracelet and the marketing concept “Live Strong” were born. Oh and he also went on to win seven Tour de Frances, the famous long distant bicycle race.

In his various presentations, Armstrong explains that when he left the hospital after several months of inpatient treatment, his oncologist Dr. Craig Nichols, "asked me if I wanted to hear about the 'obligation of the cured. I answered yes, since I liked the word cured, but he told me it wasn't about being cured, since he couldn't promise me that. It was about how much you want to share your story."

Armstrong often quotes one of my heroes, whose books and life help to shape what I’ve done with my own career. Albert Schweitzer, the famous Alsace-Lorraine doctor, theologian, missionary and organist who spent a life time working in Africa, wrote the following about why doctors must go to the colonies as a humane duty mandated by the conscience of society. Maybe this quote summarizes best what is meant by the “obligation of the cured.” Whoever among us has learned through personal experience what pain and anxiety really are must help to ensure that those out there who are in physical need obtain the same help that once came to him. He no longer belongs to himself alone; he has become the brother of all who suffer. Out of My Life and Thought: An Autobiography by Albert Schweitzer

As I have written before, I tend to use the term heal instead of cure, since ultimately we all die of something. Semantics aside, what is that we can do to help others who are dealing with similar issues to our own? While few of us are in the position of a Lance Armstrong, there is a great deal we can do under the idea of “obligation of the cured.” Some of the best examples I’ve seen where the men and women, living with HIV/AIDS, particularly in the early years of the AIDS epidemic. They formed organizations, fought the FDA, City Hall, and governmental agencies, started “buddy programs” and told their story in public. This was no small task, as there was considerable prejudice against those with this virus.

While this post was prompted by watching Armstrong’s 2011TEDMed presentation, it is inspired by the HIV+ men and women who stood up for themselves and their peers to create a better world for many. One of the important things I learned from them, which is now being supported by research, is that when you give to others, you actually improve your own sense of well-being.

Below are ways to fulfill the “obligation of the cured.”
• Be an E-patient and share your data
• Participate in fundraising activities
• Organize a fundraiser. This can be as simple as donating all the money from a yard sale to a condition specific organization or to someone who needs help.
• Work in disease prevention, e.g. help build out door space for people to recreate; take a healthy meal to a neighbor
• Be an advocate for others, help them navigate the system
• Share your story
• Listen to others’ stories
• Support healthcare legislation by calling, e-mailing your state and national representatives.
• Testify about what it’s like to live with your condition.
• Accept speaking engagements so that you can tell your story in a variety of places
• Tell someone you are there for them and mean it
• Do small things, like send encouraging e-mails or notes, to those who may be in treatment and/or are in the middle of a “flair.”
• Live your life
• Wear a ribbon, pin or another item, which lets people know you support others in the healing process
• Identify yourself as a thriver not a victim
• Help to educate others
• Start a support group-in person or on-line
• Participate in a support group
• Offer your skills. Volunteer. Don’t know where help is needed? Try VolunteerMatch
• Donate clothing, cars or other items that can be repurposed and profits given to the non profit of your choice
• Donate/recycle durable medical goods and/or unused medications when possible
• If you own a business, offer things like copying and staff resources to help local organizations.
• Grow a row-donate vegetables from your garden to local groups and people that would benefit.

4th National Prescription Take Back Day

The federal Drug Enforcement Agency's fourth National Prescription Drug Take-Back Day is Saturday, April 28, 2012, 10:00 a.m. - 2:00 p.m. Check for locations nearest to you. Check out what to do with unused medical supplies

Take a Break: Repurpose Something

n keeping with this past weekend’s celebration of Earth Day, this week’s take a break is all about repurposing. What do you have lying around your house that you don’t want, need, like, or use that could be reconfigured to be something you might have a use for and/or enjoy? Need some ideas?

• Have earrings, bracelets or other pieces of jewelry you don’t wear, particularly the earring that’s lost its mate? Take them apart and create something new.

• If you have little slivers of soap, put them in a microwavable dish, zap until melted and form into a new bar of soap. A mug that’s chipped or no longer has a handle can make a great mold. You can also do the same thing with odds and ends of candles. However, better to use a double boiler (a tin can with the wax in it, sits in a bath of water) for candles.

• Have leftover stale bread? Make croutons.

• A 60 minute cassette has approximately 285 feet of tape. Because it’s strong and flexible, it can be used like string (bundle up old newspapers). You can also make a Cassette Tape Table Lamp (or you can just say it 10 times really fast).

• Take an old door, repaint and turn into a table. Saw horses can be used for legs. For doors with panels, you can create miniature Zen gardens, by placing sand in them and creating interesting displays, covering it with a glass top to keep it in place. On the subject of Zen gardens, make one from an old bowl or other object you aren’t using.

• Have a stack of birthday, holiday or other occasion cards that you don’t know what to do with? Try some of these ideas:
- If you are a scrap booker, cut out shapes, or use punches and make items that will be useful for future scrapbook projects.
- Cut up to create “to/from” gift tags.
- Glue cut out shapes on to card stock and make new cards

• Lots of paper, magazines? Try Iris Folding.

• Haven’t had a chance to recycle soda cans? Turn them into art instead.

• Check out Websites/Blogs on repurposing
49 Creative Reuse Ideas
50 Repurposed Project Ideas
Blue Velvet Chair
My Repurposed Life

While not repurposing, but inspiring, check out WikiPaintings. The project aims to create high-quality, most complete and well-structured online repository of fine art. We hope to make classical art a little more accessible and comprehensible, and also want to provide a new form of interaction between contemporary artists and their audience. In the future we plan to cover the entire history of art — from cave artworks to the new talents of today.

Rational Healthcare

In reading an interview of Dr. Otis Brawley’s new book, How We Do Harm: A Doctor Breaks Ranks About Being Sick in America,” I came across the following sentences by Brawley that mirrored by own thoughts after more than 30 years working in health care. A lot of people didn’t seem to realize that in a lot of the discussion, we’re talking about human beings who are suffering because of lack of health care, and sometimes we’re suffering because of overuse of health. People are so focused on fears about rationing of health care. The talk should not be about rationing health care but about rational health care. So much of what we do in health care is irrational. http://well.blogs.nytimes.com/2012/04/20/how-doctors-and-patients-do-harm/

This morning I posed the following question to myself, what three things could be changed that would create a more rational healthcare system? While I do understand that putting these three words together is a bit of an oxymoron, below is my “first pass” thinking. What would yours be?

• Those who use healthcare and those who provide it accept that death is part of life. Often, more money is spent at the end of a person’s life then at any other time. As much of a concern as the fiscal piece is, the person and those that love them, can loose quality (and even quantity) of life as well as reduce, or even eliminate, the ability to bring closure.

• We accept the responsible for the choices we make and their outcomes. One of the best examples of this came from a nurse working in hepatitis C (HCV). She was beside herself about a patient, whom they had successfully treated for the virus, who then continued to engage in behaviors so he became re infected. While he wanted treatment, he also wasn’t planning on stopping the behaviors that caused him to be infected. She voiced her concern at a meeting where a number of those in attendance were HCV infected. A number of them, as well as some of the providers, were clear that this individual should not be treated until they were ready to commit to their own well being. Interestingly, some believed that it was the responsibility of the provider to heal the patient regardless of the choices the person made. While this is HCV, which comes with a dark cloud over it because the primary reason for infection is IV drug use, is this really all that different from the diabetic that refuses to give up sweets, alcohol and a sedentary life style?

• Understanding that more testing and treatment don’t necessarily translate to better outcomes. Providers order more tests and treatments then are necessary for a host of reasons, with two of the leading ones being fear of being sued and “the patient wanted something done.”