Vicarious Vlogging: DoNut Stop...

Last Friday was my friend Connie's 60th birthday. We had a special donut run planned for her, all caught on video. Watch a bunch of runners try to figure out how to light a candle on top of a donut.

Between becoming a card-carrying member of the frequent donut club and celebrating the long-awaited M Day, it's been a busy couple of weeks and we're getting ready to go on vacation soon. We'll be going through Las Vegas on our way to LA. As long as Pokémon Go players don't destroy it by then. As long as Sushi Koma is safe, I don't care.

Some crazy F#$@! was playing this stupid new obsession in the empty Mormon church parking lot last week and nearly ran me over. I was walking on the sidewalk, crossing the exit drive from the parking lot , and this dumbshit in a Subaru screeched to a halt right in front of me. I looked at him like, WTF? and he had his head down, looking at his phone. I don't know if he saw me, or if he was stopping to get one of the characters. I wanted to go over and bash the shit out of the side of his car, Beyoncé style, but I didn't feel like dealing with him. And I didn't have my baseball bat, left it home. Damn.

Exciting news, we are a little closer to becoming parents again. There are four litters expected by mid-August and depending on how many puppies there are, that means by October we will either be near the top of the list for first pick or first pick for the next breeding cycle. One of my favorite girls, Spark, is having her first litter. We'll see what happens there. She's a black tri and the dad is a blue merle.

Last week I spoke to a gathering of about 30 people at a local nonprofit event for cancer survivors in the community, it went well. I could go on and on about healthcare and why we do such a lousy job with post-treatment care for people, and why this moonshot is still missing a huge target: earth. That's where real people are.

Between ignoring the fact that there are millions of people who've been through cancer treatment and need help living with the ongoing effects, and the fact that our horrible approach to educating people about the basics of health and taking care of their bodies is creating more disease that threatens to destroy not only our economy but our entire species...but no one is going to listen to that because the powers that be know they will make more money off of the "moonshot" crap in the short run and their philosophy is "I've got mine, screw you." Sound familiar? Cleveland, anyone?

I'm sure there will be plenty of laughs in Cleveland this week, I just hope no shootings or violence. Seems like the world is going batshit crazier these past few weeks. More shootings...so crazy. People are so stupid. People are just really freaking stupid. Guns don't solve anything. Live human beings could, but that seems to be out of the question these days.

I got my 3D mammogram done, all turned out okay, fortunately. And tomorrow I have an appointment for my DEXA scan. Last week I also had blood drawn for a clinical trial, and a robotic front desk clerk couldn't figure out what a clinical trial was. But it's all done and figured out now.

I've been screened to the hilt, so I hope to be done with being squeezed, poked, and prodded for a while.

I'm working on a grant application I need to finish before I leave. For that, I need to make a video and I am struggling with it. It takes so long to make those damn things. If I wouldn't stumble over my words so much it would take less time.

And I need to pull up all the lettuce that's going to seed and plant more so we'll have some big salads this fall, to go along with the tomatoes and cucumbers that should be out of control by the time we get home. My neighbor is so lucky, she'll be eating our raspberries and cherry tomatoes while we're gone. This year we got some black raspberries, which only happens every couple of years. I can't figure that out.

Last week I slacked off just a little on the running. It was so miserably hot and I had so much to do that I didn't get out in time and it sucked. I still managed 60+ miles but didn't run very much of it. Maybe this week I can get some miles in.

And I am still waiting for my official DoNut Stop Running tank top to arrive in the mail.

Off to brave another week before heading to the desert...

Happy Re-Birthday: A Year Out of the Dungeon

It's been one year since I left my corporate nursing job.

Just one year. Seems impossible that the time could go by so quickly, and so much could happen. But it seems like forever, really, like a distant nightmare. I was reading over some of what I wrote last year, and I am happy to say that I'm able to look at it without the emotion engulfing me. I've done a lot of healing in that time.

At first I missed the patients and some of my coworkers. But I've stayed in touch with the coworkers that mattered, and have more meaningful relationships with several. I've run into many of my former patients in town, and continue to work with a few of them, but in different ways now.

The work I do is so much more satisfying, I don't miss sticking needles in people or filling their veins with poison one bit. And I certainly don't miss punching a time clock so I could get a steady paycheck but feeling like I would have to sell my soul in order to keep getting one.

I have learned so much more since I left because I have more energy to read and research information on what's going on in cancer care far beyond the confines of a dingy little windowless cave subjected to the whims of toxic people who made decisions without considering the people they would affect most or asking for input from the nurses who worked with those people every day.

There are thousands upon thousands of nurses out there who have left what they felt were oppressive conditions in the workplace and moved on to something else. And I am just one.

Before I left corporate nursing I was surrounded by other nurses who were afraid. Some of them did not-so-nice things to each other, and to me. I no longer take it personally. Now my true colleagues are nurses who are not stuck in the system. They are not afraid. They have found a way out, and many of them have suffered great pain and loss to get to where they are now. Much worse than I did. They are a diverse group, some are employed in the profession, many are self-employed, many are out completely.

There is a common thread among most of these nurses, they love nursing and they would like the profession to change for the better, but there is a long climb ahead and it seems we lose ground on most days. Occasionally there is a bright moment, but then we fall back into the void. 

There is a definite hum that's picking up in intensity, the misplaced blame on nurses in the Ebola situation fueled it, but that's only a glimpse of the problems. Nurses have HAD IT.

I've been listening to and talking with a lot of nurses over the past year, all over the country, and in other countries too. I've been thinking about ways to fix things, ways to improve things, and most of the work I've done has focused on individual people, which is good on my own, but always knowing that in the big picture of health care, most of the work nurses are doing in those workplaces is like building sandcastles at low tide.

And when the tide comes in, it's more of a rip current, a crashing of water with overwhelming force, an undercurrent that knocks you off your feet and threatens to drown your breath and silence your voice forever.

And the damage it does comes from all of the following forces and more...

1. A two-tiered system where managers, administrators and executives answer to money and quantitative data (numbers that are now called "metrics") that have everything to do with what they like to call "quality" but really mean more busywork for the people who are supposed to be doing patient care, but that data really translates to "reimbursement" aka money. Meanwhile the other tier, nurses, physicians and other health care staff, take seriously their professional oaths and training to not do harm, and the two tiers have little mutual understanding of each others' obligations to their own callings (money/boards/shareholders/stockholders vs. moral and ethical obligations to patients, oaths and licensure), each speaking it's own language not fully understood by or ever truly communicated with the other tier.

2. Lack of leadership in the highest ranks of nursing organizations, which consist of leaders from industry and higher education who protect their own turf which goes against the best interest of working nurses.

3. A great amount of fear among workers that has been exacerbated by the past three decades of eroding workplace protections, a mainstream media that fosters unrestrained hate and divisiveness and fosters paranoia and misinformation, ignoring facts in favor of hype. Attacks on free speech (in the craze over the second amendment, seems we've forgotten the first) and organized labor, and legislation that favors the big corporate money interests, giving them the rights of individuals.

4. A system on steroids that intensifies the poor people skills and lack of empathy held by a great number of those who advance to administrative positions and executive power, leaving the staff at the bedside populated by people who care about patients' best interests but without a voice or support to help them.

5.Lack of advocacy or assertiveness by nurses for their own interests in their workplaces in the face of strongarm tactics used to intimidate and dismiss their concerns.

6. Eroding job security as employers look to part-time hiring, reducing staff, decreasing benefits, and electronic spying on employees both in and out of the workplace.

7. Increasing burnout due to the task-oriented nature of nursing work and increased demands to do more with less staff, working equipment, support, training, at the same time being faced with expectations to increase the amount of documentation time and checklists, taking away clinical judgment opportunities and interpersonal connection in patient care duties.

8. A work culture that values "yes-men and women" more than clinical skill or attention to safety, that provides disincentives to speak, disagree, or otherwise question the status quo, motives, or actions of "leadership".

9. A capitalistic system run amok where the distribution of wealth becomes more skewed all the time with no brakes to stop it.

10. A legal system run amok with power that works in favor of the wealthy white collar criminals who can afford to buy their own teams of attorneys, and can buy lobbyists to buy politicians who will work even more in their favor, with no brakes to stop it.

11. A health care system that enriches the top-end insurance companies and pharmaceutical companies, but makes no investment in the base of the pyramid: health education in schools to teach children how to manage their health from an early age, universal basic health education for people at all stages of their lives with and without disease, teaching chronically OR terminally ill people about palliative care, the options not to treat some illnesses, death education so it is accepted as part of life and not so feared and avoided at all costs.

12. A public health system that has been underfunded to the point of endangering public health by promoting misinformation and being embarrassingly unprepared for a crisis.

13. A for-profit so-called health care system (even though some of it calls itself not-for-profit but it is still working for profit) that results in competition to a degree that hurts patients' best interests by withholding information about options and resources available to them outside of an organization's domain. Health care is not at all about health, and it is not about caring. It is about making money off of chronic illness, of various types and trajectories.

14. The collective personality-disordered nature of "leadership": with it's insecure, narcissistic, sociopathic bent that has no empathy for patients or their families true needs, or the needs of direct patient care workers. This distorted method of leadership pursues matters in the interest of building their egos, power, status, bonuses, perks, and the ultimate perk of all, the insurance policy of guaranteed future personal economic security via outrageous sums of money upon leaving an organization regardless of the reason.

There's a lot to say, and I'm not done saying it. Just getting warmed up.

I'm not dead yet, and I won't be done until I'm dead. I don't know how long I'll live, but if I died today, I'd be okay with it.

Because at least I will know I tried, I spoke from my heart, I called out what I saw, and I felt the passion and the horror, witnessed the suffering and the relief, and I know I lived true to myself and my own principles.

And unlike those narcissistic shadows holding nooses around the necks of hardworking direct patient care nurses, I didn't look the other way knowing what I was doing, despite what I claimed and hid behind, was really not about caring for people but instead lining my own pockets and enriching myself at the expense of other people's well-being.

There are at least three differences now.

One is that I can say these things calmly, without the raging anger that I felt a year ago.

Two, I am on the lookout for solutions, and I know I am not alone, as I felt a year ago.

Three, I am pursuing my passion, and I have no one holding me back, I have lost the shadow and the noose of a year ago. 

Every day I wish the same for my fellow nurses who are feeling alone, stuck, and fearful in those oppressive environments. I hope they find their way out of the dungeon, because they already have the key, they just have to turn it.

Obesification: Soccer Parents

I am amazed at the excuses people make for not having time to exercise. The other day I was talking to a woman who told me that she wishes she could lose weight but she's too busy with her work schedule and her kids' soccer schedules.

This morning I went for a run where I go past a schoolyard that is often filled with kids playing soccer. The parents park alongside the street during the practice. I am always amazed at the number of people I see, sitting in their cars, sometimes running the engines, presumably for air conditioning, and texting.

When I first ran by, there was a VERY overweight woman sitting in her front seat, texting away. On my way home, about an hour later, she was still there, sitting in the car, still texting. I think it's a safe bet she hadn't moved the entire time.

In that hour, she could have gotten up and walked around the soccer field, getting some good exercise. I think her kid would have respected her more for doing that.

People like that woman in the car are contributing to the enrichment of pharmaceutical and hospital executives and sucking the life out of the rest of us.

Obesification: A Suicide Mission

Kevin Pho's blogpost on the proportion of executive and administrative salaries in our sick health care system, along with the VA scandal, got me fired up again.

Conservatives and liberals alike are mad as hell...oh, the outrage.The light on the VA scandal made public the problems of power and corruption, mistreatment of employees and whistleblowers. Again. The shameful treatment of veterans whom the agency was supposed to be helping. Again.

Obama knew about this problem when he took office. The problem was already there when Bush was in office. Obama caused it by promoting big government. Bush caused it by starting wars we couldn't pay for. It’s the Republicans. It’s the Democrats. It’s Bush. It’s Obama. It’s Fox News. It’s MSNBC.

STFU.

It's us, all of us. We have our voices, we have our votes, most of us have two legs, two arms, two hands, a mouth, and a brain. We can be cognizant of our world and act in it. Use the damn resources you've got instead of sitting on your fat ass texting.

When you look at problems such as the VA’s actions that do come to light, it’s really just another day, another dollar, another power broker. Bullies and greed run the show. The government has acted no differently than private industry or nonprofits.

Apparently it’s okay to bully people who point out injustices, or who criticize the status quo, no matter what sector you work in. Wouldn’t want someone to have an independent thought. Talk out of one side of the mouth about providing value for the patient, while stealing value blind?

The value they talk about is only about how well it serves the interests at the top.

We approved it, yes we did.

Is it because we are working ourselves to death, doing the jobs of two or more people, working longer hours with less pay, fewer benefits, and less compassion than ever before? Auto-piloting through our jam-packed workdays, stacked together into a blur. Stuck in our self-imposed commutes, bound to our inflated mortgages, reliant on our vehicles, ruled by our electronic gadgets.

Whose fault is that?

We were complicit in underfunding public education, we didn’t provide physical or health education that prepares kids to be healthy, informed and functionally literate adults. We succumbed to our reliance on processed, fast, convenience foods laden with sugar, simple carbohydrates and salt to seduce our tastebuds, drain our wallets, and addict our minds.

We approved of the behavior of executives and those with power who run public, private, and so-called not-for-profit companies, corporations, agencies and health care systems, who siphon off financial resources into their own pockets, personally risking little as they have a golden parachute to back them up.

Where’s the golden parachute for the rest of us? What if we are all forced to jump into thin air, and no one will rescue us. We’re being taken by gravity, and no one will be there to pick up the pieces when we go SPLAT!

Instead, we think our golden parachute is the next weight loss drug, the next diabetes drug, or the next New York Times Bestseller Diet Fad.

Will we not stop until every single citizen of this country is impoverished, obese and Type II diabetic?

Eventually there will be a breaking point where the people will no longer have the resources to passively support this system. We’ll be too old, sick, fat, exhausted, and poor. Only when we’re dead will we cease to support the system.

Except for the unfortunate recipients of our stupid genes, if we passed them along to the next generation. But the way things are going, they won’t have to suffer as long as we do.

They won't live as long.

Just a Thought for Cyber Monday

Not just for Christmas anymore. Let's make this last all year, and into eternity. Start by not buying anything online today, but that's the least you can do.

All of our biggest problems are caused by feeding into the greed of people who amass too much money and power. And by our silence and complacency, we allow it!

We all suffer from it here in the U.S. with our corrupt government, the system of corporate and private interest money going into lobbyists and sources of influence to tweak the system in their favor and not the people's.

It's one thing to make money or turn a profit, but when it's at the expense of millions of people's lives and well-being, that's greed. Our healthcare system is a good example of that, the insurance companies and pharmaceutical companies are perfect examples.

Even not-for-profit entities turn profits and instigate violent knee-jerk reactions to anything that might interfere with their money-making ability. Case in point: Health Care Systems. Anyone who strays outside a narrow set of lines is removed as quickly as possible by whatever means necessary, by a culture of corporate bullying that the law allows, because the law favors those with money and power.

Nurses are a readily available, exploitable source of labor easily manipulated by threats to their livelihood and licenses. Amanda Trujillo's case is one notable example, but there are many others, too numerous to track. The collusion of management, corporate culture, state-run licensing boards, and legal impediments to organized labor all contribute to an impossible situation for anyone who questions their motives or points out their hypocrisy, or worst of all, identifies a hazard to the public and tries to do the right thing to fix it.

In a conversation with a number of nurses recently, someone pointed out the analogy of a jumbo jet. If we treated airline pilots the way we run health care and nurse labor practices, any jet that took off would stand no chance of landing without crashing because there would be so many unresolved safety issues.

Make your new year's resolution something that will help all people. Resolve to make a statement, put your energy into changing the balance of power. It takes a lot of people, not just a few vocal ones. Instead of using the Internet for shopping, use it for social change. Write a letter, spread the word, don't just make people aware, motivate them to take action.

That's my $.02 for the day. Back to work...

Fat Tax

Happiness is priceless, and so is good health.

Recently I was running with someone who told me about his family history of cancer. Because of his high risk status, he had his first colonoscopy at age 40. Everything was okay so he ignored the doctor's advice to repeat it in 5 years. After one of his friends died from colon cancer as a result of it being detected too late, he went for another colonoscopy. That time, the gastroenterologist found several pre-cancerous polyps and removed them. He gets regular colonscopies now and is aware of just how risky it would be to miss one.

No matter how healthy we try to be, no one is immune to cancer. Or if anyone is, we don't know about it and haven't figured out what genetic mechanism gives them immunity. There are a lot of things we can do to prevent cancer, or detect it before it becomes invasive.

All around us there are bad influences on our behavior. Advertising is a huge influence. Back in the days when cigarette smoking was glamorized, and there were no warning labels or high taxes on tobacco products, a higher proportion of people smoked.

I'm going to preface the remainder of this post with this warning: The Surgeon General has determined that reading this post will make people with a certain political philosophy apoplectic. Not a political party, but specifically, the anti-tax, anti-government mindset. Not naming names here, because it's not fair to generalize. But you individuals know who you are. You speak Palinese. (Sorry, let that slip out, I must have eaten too many beans last night)

You hear the word "tax" or "government", and you poop your pants. So if you're that much of a "Red" blooded American, take your Xanax now, put your diaper on, pop that mask on and crank up the oxygen, and strap yourself into the autopulse, 'cause you're gonna need it if you keep reading. I can think of a certain politician running a losing campaign for the Republican nomination who would have ear steam launching his big fat head up into space by the end of this post.

I get mad when I see people do stupid things that affect large numbers of people in a bad way. I've tried to stay away from politics but I also want to eradicate apathy. Running, any type of exercise, as well as health promotion, is political in our current state of obeseification. People need fresh air and aerobic activity, pumping blood with oxygen through your body helps your brain, heart, lungs, muscles, and every cell in your body.

If we don't start controlling advertising and marketing of all this bad stuff, young people are going to start out their adult lives with chronic diseases that will reduce their quality of life and years of healthy living. Not to mention making health care costs unmanageable.

I think we need more warning labels and fat taxes. I think we should tax television and bad food, to start. Electronic gadgets and TVs should come with a warning label: Too many hours of sitting on your butt watching this object can lead to obesity and premature death. Cell phones should come with a warning label: Use of this object can lead to sore neck muscles, obesity, motor vehicle accidents, traumatic injuries and premature death. Soda and snack foods: Too much intake of this product can lead to obesity, diabetes, cardiovascular disease, cancer, and premature death. Schools without physical education: The Surgeon General has determined that attendance at this school may cause obesity, diabetes, and early cardiovascular disease.

I don't watch television, but I catch snippets of it while I'm working, usually as I'm flushing someone's PICC line at work, they have the little TVs on while they sit and get their infusions. The advertisements for cars, especially big 4 wheel drive pickups, always show people driving a little too aggressively, just a bit too fast. So people think that is how they are supposed to drive on the streets, and through neighborhoods where the speed limit is 25 mph and there are young kids who play outside. Add a cell phone to that and you have a disaster waiting to happen.

I happen to love the idea of taxes to discourage people from spending money on things that are bad for them and drive health care costs upward. Cigarette taxes are great. But we should tax bad food at the same rate. You know the CEO of Nabisco or Kraft Foods doesn't have to lay out nearly as high a percentage of his or her income on health care as the average working person does. They are raking in the bucks from unregulated gluttony.

Every time you take a bite of those chocolate covered Oreo cookies or Ritz crackers, you are not only buying someone's next vacation home, you're also reserving yourself a future place in the dialysis unit, cardiac cath lab, or chemotherapy chair. And when health care costs and insurance premiums rise because of higher rates of diabetes, cardiovascular disease, and cancer, the average working person feels it a lot more. Fat is metabolically active tissue, it produces hormones like estrogen that can promote cancer growth. Insulin and insulin-like growth factor-1 are cancer promoters. Sugar causes us to release insulin. Obesity and metabolic syndrome can lead to insulin resistance, resulting in high levels of insulin in the blood.

And guess what? The CEOs of drug companies will be all too happy to take your money on the far end, too. And if they don't make enough profit off the drug you need, they might just stop making it (e.g. the current methotrexate shortage for treating leukemia in children, who didn't even have enough time to develop bad habits that contribute to cancer development over a lifetime). You don't think that's important? Go see Gab. I wonder what would happen if the drug company executives' children had cancer.

I don't know if my readers are aware, but there are quite a few serious drug shortages going on right now, for various reasons (e.g. "manufacturing and quality concerns") but mostly they seem to be coming down to greed. If the drug companies would invest instead of cutting back in these areas, there wouldn't be an issue.

Government regulation does help to prevent bad behavors from being promoted. People need real food and real exercise. People don't know about the benefits unless they are taught. Government is great at health promotion and education efforts. Efforts to prevent taxes and warning labels, and actions that strangle government across the board end up promoting greed. Greed is just another cancer, but it grows on our way of life. Look at the mess we're in, tell me that has nothing to do with greed.

Sounds like a job for a new government agency? The Bureau of Alcohol, Tobacco, Firearms, and Greed. Might want to get the U.N. involved, too.

Greed is a crime against humanity.