Take a Break: Replace the Christmas Tree/Percussion

I come from a tradition where the Christmas tree goes up on Christmas eve, and stays until January 6. After 12 days, when the tree comes down, it leaves a big hole. I miss the tiny lights more than anything.

Living in Vermont, people do all sorts of creative things with birch and other tree limbs, branches and saplings. Several people I know have taken large pots, put branches in them and strung them with lights. They are a wonderful part of their décor and cost little to create.

You may not want a floor to ceiling length tree limb in your home, but a vase with twigs and small branches, sprinkled with tiny lights can give you the same effect. You can even decorate it with small hearts for Valentine’s Day, shamrocks for St. Patrick’s and so forth.

So take a break today by going outside and finding twigs (or a limb) and create a new décor piece to brighten the New Year.

I was totally inspired this week by the Siberian Percussionists playing ice sheets on Lake Baikal. particularly when compared to their “land” video. 

Creating positive health outcomes for patients: Five Things Family/Friends can do

This past week, I dealt with a number of people who are coping with a wide array of chronic and acute health care issues. Unfortunately, I witnessed a variety of ways patient care was compromised -understaffing; vital information not entered into a chart; a patient falling because the alarm buzzer hadn’t been set on their bed and so forth. When I discussed this with my sister, who has been a nurse for well over 35 years, she said, “It’s always been like this. ” Other people I talked to agreed with her and made comments along the same line, often shrugging their shoulders, telling their own horror stories, and saying, “So what’s new?" What can you do?” 

At this juncture, complacency isn’t an option, particularly with the aging population and the arrival of Obama care. It’s time we each do what we can do to make this better. Making a change in one area can create a whole new way of thinking and doing.

On New Year’s Day, I sent an e-mail to colleagues and friends detailing some of what I had witnessed and posing a challenge-to implement a demonstration project that would improve care that can be replicated for nominal costs.  This has created some very interesting dialogue and good suggestions. As a result, this is Part I of a four part series where I will be posting five suggestions each, for family/friends, patients, communities and hospitals, which they can do to improve health outcomes for patients.

My goal is to identify straight forward approaches that have minimal or no costs associated with them, are effective based on research and/or from those with extensive experience working in the field, and can be easily implemented in a variety of settings.

Please post your comments, suggestions and relevant resources below, or e-mail them to me at margoc@tds.net At the completion of the series, the posts, along with additional comments and suggestions, will be formatted into a simple PDF handout, which will be available by e-mailing margoc@tds.net

Five Things Family/Friends Can do to Create Positive Health Outcomes for Patients

Your relationship with the patient, how close you live to them, as well as the nature of their condition, will determine the full measure of what you can realistically do. However, whether you are a caregiver, or a distant neighbor,  everyone can do something, even if it’s just sending e-mails or notes of support.

1. Respond. How to Respond When You Learn that Someone is Ill or Injured is one of the most frequently downloaded items on this blog. It’s clear that many want to help but don’t know how. Read this post to learn simple ways you can provide support regardless of where you live or who the patient might be.

2. Learn to be an effective advocate. When a person is compromised by age, a variety of chronic conditions, critically ill,  and/or has been newly diagnosed with a very serious condition, they need help. Even on a good day, people only retain a portion of what transpires in a medical office visit, so if you’re very sick or compromised in some way, you may have no clue what the provider is telling you. Research shows that taking a advocate to appointments results in better visits and ultimately better patient care. 

Become a “Friend with a Pen.” Go to medical appointments, as well as visits with case managers, social service agencies and other places where they receive either medical care or social services support. Take notes, speaking up when the patient is unable to do so and with their approval when possible. 

Stay with them in the hospital, helping them obtain the care they have specified and need.

Further reading on this topic:

• Health Advocate-Who, What, When and Where 

• Hospitalized: A Three part series to help patients get better care when hospitalized

- What Family and Friends Can Do 

- Your patient is one of many to the staff 

- Consumer Reports Recommendations 

3. Help them navigate the health and social service systems. Using the “Getting What You Need: Checklist" understand what the person might need and know what is available locally. This handout includes information on the following:

-       Resource numbers/websites-Among the resources are connecting with the local chapters of condition specific organizations, such as the American Cancer Society. These groups will often have advocates and case managers that can make this process a lot easier. They can also provide easy to understand information about the condition, treatment plans etc.

-       Building and organizing support networks-Don’t go it alone.

-       Legal issues

-       Health Insurance and paying for health care/medications/non medical needs

-       Benefits-disability, supplemental, worker’s compensation

-       Life settlements, viaticals, reverse mortgages

-       End of life care

-       Work-disability, vocational rehabilitation

-       Maintaining a personal health notebook

-       Case management

-       Decision making

4. Encourage them to be an effective/empowered patient: While there are times that family/friends need to take the lead, in general patients are their own best advocate. Since 99% of chronic care takes place outside of a medical facility, it is important that the patient recognize that they are in charge of their own care. Besides, research shows that more involved patients do better. You can help them in taking responsibility for their care by:

-       Role modeling advocacy skills

-       Letting them take the lead and only stepping in when they need help or are unable to speak for themselves.

-       Helping them set goals about what they want for themselves as far as healthy outcomes, treatments etc. This can be done in a number of ways- having them outline areas of concern prior to medical appointments; framing questions and concerns in ways that are more likely to get a response; identifying underlying and root issues to problems; completing legal documents, such as advanced directives; keeping a personal health notebook

-       Accepting what they tell you

-       Encouraging them to learn more about their condition, joining a support group etc.

Keep in mind that regardless of how helpful you want to be, it’s their life. You may not agree with what they are choosing to do, but it’s ultimately their choice to do what they believe is right for them.

Note that if the patient is capable of doing things on their own, and you do it instead, regardless of reason (they take to long; they may not do it right) you under mind their ability to do things on their own. 

5. Be a Healthy Caregiver: If you are in the role of primary care giver, it’s important that you take care of yourself. Use the Caregiver Resources page to learn about self-care as well as the various challenges of care giving and ways to deal with them. Note that there is also a Youth Caregiver page. 

Take a Break: Make a Joy Jar/Secret Behind Mind Reading

As a follow up to this past Saturday’s post Joy: Embrace it for Healing, I thought making a joy jar would be a great way to reinforce the idea of paying attention to the positive events in one’s life. It’s also a nice way to start off the New Year.

The idea is simple, decorate a jar, vase, box or whatever strikes your fancy. Each day, take a slip of paper and write at least one positive thing you’ve experienced, are grateful for, and/or made you have a moment of joy. These are often simple things like seeing a cardinal at your bird feeder, a crisp snowy morning with the sun shinning, the smell of coffee that your spouse made so you could sleep a little later, a phone call from a good friend, good test results from your last medical appointment and so forth.

Slip the paper into your jar and at the end of a week, month, or year; take the time to read them.

Ideas for decorating:

• Decorating Jars Five Ways 

• Easy and beautiful enamel-painted vases 

You can also post your gratitude on-line  and be part of an international experience of sharing gratitude.

For something completely different, watch a 2 minute video to see what’s behind the amazing mind reader. 

Joy: Embrace It for Healing

The second word of the holiday season I’ve been thinking about is “joy.” [Last week’s post was Believe-It Effects How we Feel]How often do we let ourselves totally enjoy it?

Four years ago on New Year’s Eve, I took a neighbor and friend to their monthly medical appointment, where they were continuing to be monitored for a return of lung cancer. It was a very good visit, and as we were leaving the hospital, I said, “we have much to celebrate tonight.” While she had been happy to report “everything is fine,” she became a bit sad and said, “It’s fine now, but the cancer will return.”

Last week I came across a quote from Brene Brown, which would have been a good response to this comment.  “Don’t squander joy. We can’t prepare for tragedy and loss. When we turn every opportunity to feel joy into a test drive for despair, we actually diminish our resilience. Yes, softening into joy is uncomfortable. Yes, it’s scary. Yes, it’s vulnerable. But every time we allow ourselves to lean into joy and give in to those moments, we build resilience and we cultivate hope. The joy becomes part of who we are, and when bad things happen—and they do happen—we are stronger.”

Our brains are wired to make us fearful, as for centuries, being on guard kept us from being eaten by the tiger. “Yes, the hunt was successful, but it could attract animals that could steal the food and/or kill us.” In short, we have been “programmed” and have a lot of practice at tamping down our joy.

Since emotions and experiences leave lasting impressions on the brain, which influences how we feel, it’s important to understand that one negative experience can wreck many positive ones. Have you been at a party, on vacation or had a visit with a friend, where 99% of it was fun and very enjoyable, yet one negative thing happened and that becomes the lasting memory? Now if you’ve talked about this with friends, some will say, “just let it go and concentrate on the good stuff.” Good advice, but one we have little practice doing.

 “Imprinting” our brain with positive thoughts and joy, as Brown noted, has some very important benefits including:

-       They lower the stress response in the body.

-       Increase resilience and can counter act the effects of trauma

-       Help to protect against depression

-       Increase well being

In order to emphasize the positive through conscious attention, Rick Hanson’s, author of Buddha’s Brain: The Practical Neuroscience of Happiness, Love, and Wisdom, outlines Three Simple Steps as part of Seven Facts about the Brain That Incline the Mind to Joy 

1. Help positive events become positive experiences. You can do this by:

• Paying attention to the good things in your world, and inside yourself. So often, good events roll by our eyes without us noticing them. You could set a goal each day to actively look for beauty in your world, or signs of caring for you by others, or good qualities within yourself, etc.

• Deciding to let yourself feel pleasure and be happy, rather than feel ascetic or guilty about enjoying life. In particular, release any resistance for feeling good about yourself. You've earned the good times: the meal is set before you, it's already paid for, and you might as well dig in! You are just being fair, seeing the truth of things. You are not being vain or arrogant - which distort the truth of things.

• Opening up to the emotional and sensate aspects of your responses to positive events, since that is the pathway to experiencing things.

• Sometimes doing things deliberately to create positive experiences for yourself. For example, you could take on a challenge, or do something nice for others, or bring to mind feelings of compassion and caring, or call up the sense or memory of feeling contented, peaceful, and happy.

2. Extend the experience in time and space:

• Keep your attention on it so it lingers; don't just jump onto something else. Notice any discomfort with staying with feeling good.

• Let it fill your body with positive sensations and emotions. (That’s the space part.)

In sum, savor, relish the positive experience. It's delicious!

3. Sense that the positive experience is soaking into your brain and body - registering deeply in emotional memory.

Perhaps imagine that it's sinking into your chest and back and brainstem. Maybe imagine a treasure chest in your heart.

Take the time to do this: 5 or 10 or 20 seconds. Keep relaxing your body and absorbing the positive experience.

As Hanson notes, The innate neurological circuitry of your mind poses a very real challenge: positive stimuli tend to roll through it while negative stimuli get flagged and captured and deferred to. But you can consciously override those tendencies in simple and effective ways each day, by focusing on positive experiences, valuing them, and helping them sink in.

That’s a deeply wise and wonderful undertaking: happiness is skillful means. And happily for happiness, this is aligned with your deepest nature: awake, interested, benign, at peace, and quietly inclined to joy.

In keeping with this post, the last one for 2012, I send you best wishes for a joyous New Year.

Take a Break: Celebrate St. Stephen’s Day/Napping

The day after Christmas is the perfect time for a nap. One where you curl up with a good book, soothing music, comfy sofa, or reading chair and a warm “blankie.” Read a few pages and doze. Enjoy.

St. Stephen’s Day is the opposite of napping. Celebrated on Dec. 26, this is a holiday in Ireland that has little to do with the saint, who was the first martyr stoned to death shortly after the crucifixion.  Also called “Hunting the Wren” or “Going on the Wren,” originally, groups of small boys would hunt for a wren, and then chase the bird until they either caught it or it died from exhaustion. The dead bird was tied to the top of a pole or holly bush, which was decorated with ribbons or colored paper.

Early in the morning of St. Stephen’s Day, the wren was carried from house to house by the boys, who wore straw masks or blackened their faces with burnt cork, and dressed in old clothes (often women’s dresses.) At each house, the boys sing the Wren Boys’ song. There are many versions and variations of this song, including the following:

The wren, the wren, the king of all birds,

On St. Stephen’s Day was caught in the furze,

Although he is little, his family is great,

I pray you, good landlady, give us a treat.

My box would speak, if it had but a tongue,

And two or three shillings, would do it not wrong,

Sing holly, sing ivy–sing ivy, sing holly,

A drop just to drink, it would drown melancholy.

And if you draw it of the best,

I hope in heaven your soul will rest;

But if you draw it of the small,

It won’t agree with these wren boys at all.

Sometimes those who gave money were given a feather from the wren for good luck. The money collected by the Wren Boys was used to hold a dance for the whole village. http://www.noblenet.org/year/ststephen/

Today wrens are no longer killed and girls as well as boys go on the wren. Traditional dancing and music are part of the celebration, along with prizes for best costume and Irish food. The money collected is often used for community projects.

 Ways to celebrate:

• Make a St. Stephen’s Pie 

• Watch a Wren boy perform with a broom 

• Watch Saint Stephens day, Carrigaline, Strawboys and Wrenboys 

• Listen to The Chieftains - "St. Stephen's Day Murders" featuring Elvis Costello. Note this is a tongue in check tribute to the murders people would like to commit on St. Stephen’s Day 

Believe-It effects how we feel

Given that a popular expression on holiday cards is “Believe,” it made me start thinking about how our beliefs impact healing. Then I came across an entry on Ellen Langer’s blog:

 A friend’s brother, a physician, told him that if he ever became sick, “Don’t bleed.” What he meant was that illness is a time to “keep a stiff upper lip” or “whistle a happy tune,” choose your favorite metaphor.

I recently told a friend with cancer that, even if he has to walk at a snail’s pace to “Stand tall.” He has and as a result he doesn’t seem to be suffering as much. I have another suffering friend who I told early on that she can play it for sympathy or be heroic. Sympathy, however, wears thin very soon.

There’s ample research showing that friends and loved ones take the cues for how they treat sick friends and family from their own attitude to the diagnosis. The problem is that the patient then takes cues from them to assess the seriousness of her condition, oblivious to how she influenced the view. Often what then happens becomes a self-fulfilling prophecy. She sees herself as sick, behaves accordingly, and as a result, may worsen her condition.

I believe that for as long as we can, we want to live each moment fully. When we do that, we actually may influence the disease process. Regardless, though, we influence those around us who influence us, which results in more life to our years

If you are not familiar with Dr. Langer, she is a Harvard Professor of Psychology who has authored eleven books and over 200 research articles on the illusion of control, perceived control, successful aging, decision-making, to name a few of the topics. Each of these is examined through the lens of her theory of mindfulness. Her research has demonstrated that by actively noticing new things—the essence of mindfulness—health, well being, and competence follow. http://www.ellenlanger.com/about/

Years ago, a very inspired woman with HIV/AIDS made the comment about some of the people she came across with her diagnosis, “It’s simple, if you whine, you die.” While I’m not sure how “simple” that may be,  I do know that people who constantly complain about their condition are not among the healthiest people I know

Given the parameters that we’re all mortal, we can make each day, regardless of what we’re facing, much better and help ourselves heal,  by having some positive beliefs about ourselves. Believe in your health, and your ability to heal (that’s not the same as cure) regardless of your diagnosis. Outward expressions of positive health, will help others mirror that back to you.

Some things to consider:

• Looking good can make you feel better. Learn more at Looking Good: Improve How You Feel 

• Find contentment in what you are doing.

• Surround yourself with people that are positive and support healing in you. 

• Fake it ‘till you make it. Your body language shapes who you are, Basically, if you assume positions and behaviors that change how encounters go, do it long enough and you ultimately will change your brain and outlook. Check out Power Posing: Could it Help You Heal. 

• Healing the Whole Person: Check out ways to increase Well-Being 

For previous posts on living with a chronic condition during the holidays, check out

• Balancing Giving and Receiving This Holiday Season 

• Holiday songs can be good reminders for people with chronic disease 

• Holidays: Over Do the Laughter and Under Do the Stress 

Take a Break: Make something with sugar other than cookies/Snow Globe

With less than a week away from Christmas, if you have lots of sugar in the house,  need some quick presents, and definitely don’t feel like baking (who needs the extra calories) consider some of the following:

Sugar Scrubs: These are so easy-mix oil (almond, olive, coconut, safflower) with sugar and put into a jar. Add essence and a colorant if you choose. The question is proportion of oil to sugar. I’ve seen some recipes of 1 1/2 cups of sugar to 1/4 to 1/3 a cup of oil. Others call for 2 cups of sugar to one part oil. Check out some of these sites for more ideas for recipes as well as jars:

• Peppermint Candy Cane Sugar Scrub  She uses Starbucks Frappucino Drink bottles for the jar.

• Simple Sugar Scrub Recipe 

• Ginger and Coconut Oil Sugar Body Scrub 

Vanilla Sugar: To two cups of sugar, slice a vanilla bean open and scrap out the seeds into an airtight container with the sugar. Bury bean in sugar and seal. Let sit for 1-2 weeks. Since the Mason jelly jars hold about 3/4 cup of sugar, you can make several presents with one vanilla bean.

Quick Fix Jar: Put sugar in an interesting jar/container along with the following note. Sugar can be used in a number of ways. Use the enclosed to:

•  Heal a number of ills, such as easing the sting when you’ve burned your tongue on hot pizza, coffee. Suck on a sprinkle of sugar and the pain will ease. A dash of sugar can lessen the pain of too much spiciness in the mouth. 

• Feed your flowers-Add 3 t of sugar and 2T of white vinegar per quart of warm water for fresh cut flowers.

• Clean coffee bean and spice grinders by pouring 1/4 cup of sugar into the grinder and run it for 2-3 minutes. Dump out and wipe well.

• Get rid of roaches by combing equal parts sugar and baking powder and sprinkle where the roaches appear. The sugar will attract them and the baking powder will kill them.

•  Clean your hands, particularly if they are coated with oil or grease.

• Remove grass stains: A paste of sugar and water, rubbed gently into a grass stain, and left to sit for an hour or so, should produce clean clothes after washing as normal.

• Wasp Trap: Boil 2 oz of sugar and a little water to make a sticky liquid. Pour into empty jars or a dish and leave in the open. Wasps will be attracted by the sweetness but can’t get out because of the “sugar quicksand.”

• Start a Fire: If you can’t get a fire started, toss a handful of sugar on it. The sugar will ignite and help get the fire going.

 Natural Fly Strip: While this isn’t a present you can wrap and leave under the Christmas tree, if you live someplace were flies are a pain, even in the winter, make up some strips and hang with festive ribbons. Combine equal parts sugar, honey and water in a saucepan. Boil the mixture, stirring occasionally, until thickened. Let cool. Cut pieces of brown packing tape, punch a hole on the end and make a loop with string through the hole. Dip the strips in the mix; hang to let excess drips drop (don’t forget the paper or pan to catch the drips) until sticky, and then hang where the flies are most active.

If you’ve finished your shopping and are tired of watching Holiday specials, see your house in a snow globe.