Passion and Serendipity

Passion means, I give a $@&# and I intend to do something about it until I'm satisfied with my efforts.

It means you don't stay silent and sit back allowing things you care about to be destroyed.

Serendipity means, an occurrence of events in a positive, unexpected way.

Yesterday was a weird day. All good, I believe. But the chain of events were unusually numerous, validating, and supportive within a short number of hours. I kept getting emails, messages, and phone calls from people about things I've written lately.

"I read your most recent blogpost and felt like I was reading my own thoughts."-RN

"I have not heard a nurse say that she loved her job in many, many years."-RN

"Would you please turn this into an op-ed piece and submit it to the New York Times or your local newspaper?"-RN

"Your DNF means "Do Not F@*# (With Me)"- massage therapist

"It's been estimated that more than 20% of U.S. women in their 40s and 50s take antidepressants." -Med Page Today, September 6, 2013

"Perhaps 'Health Care' in this country should be more accurately renamed 'Profit-Centered Illness Enablers.'"- Geri Kilgariff, freelance writer, and my friend.

Sometimes you need to put your passion first, because if you don't, you're compromising your own values to the point where you can't live with yourself. I am not made of the same material as most corporate players. I couldn't walk around with a clear conscience doing things without considering the consequences of my power, being enriched by the sweat off the backs of those who work in the trenches.

As much as I'm disgusted and fed up with nursing, I'm passionate about it. I'm even more passionate about people being treated like human beings in the workplace, and leveling out the disparities of wealth in this country.

As for me, right now, I have not run in 12 days due to fear of re-injuring my hamstring, have not been on my bike in 10 days due to fear of my brainfogged state endangering my health and life if I were to crash, have not been able to motivate myself all week to do anything more than walk the girls. Even though I no longer feel my hamstring, I am not motivated to go out and run. Getting my butt going is proving to be difficult. I need to make myself get out, which I will do at some point this weekend. I need to at least test the hamstring with an easy short run.

I did file articles of organization for my newly formed limited liability company on Wednesday morning when I met with our accountant, and filed the other necessary paperwork with the City of Fort Collins. I'm moving toward launching a business sometime next year, and I'm chipping away at the business plan. There are a lot of things still to be decided and put in place.

Tomorrow morning is the signup for Umstead 100, a race I've been wanting to do for quite some time. I will get on the website at 10 am our time and attempt to get an entry. If I do, that will give me a long-term goal I can shoot for, and might help a little to motivate me through this fall and winter. If I don't get in, I'll figure out something, maybe another trip to Iowa to run on the track. One thing's for sure, I will not have the budget to do much traveling to races for a while, but that's okay. I can find more inexpensive trips and races closer to home. Right now it's more important for me to get my overall health back.

Then, late last night, out of the blue, I was contacted on Facebook by a friend from junior high, Carla in Pennsylvania, we have not talked in 35 years, since I moved to Arizona at the beginning of high school. Turns out we have more than a few things in common these days, one of which is a passion for writing and blogging.

We chatted for a while and laughed about the mutual trauma we experienced in our clique-ridden junior high school days. And, turns out she's a cancer survivor, and a gifted photographer. So it's been great to reconnect, it's fascinating to see where people's paths have taken them when you meet up at one point and go your separate ways. I'll look forward to sharing our stories of where this adventure called life has taken us.

photo credit: Nathan Nitzky

A Change of Seasons

Good morning, I was up well before I looked at my watch at 4:14, even though I have averaged only 5 hours of sleep a night for the past three nights and I'm going into my third shift in the past 3 days. I'm trying to drink enough coffee to get my eyes to open like these flowers, but so far it's not working.

Summer has arrived with a vengeance, it's been near 100 degrees and everyone is complaining about it. I haven't been able to enjoy the heat, I've been stuck inside a temperature controlled building without windows for most of the past two weeks, but I'm looking forward to next Wednesday. Not because of the massive cumulative work hangover it will have in store for me, but because it is the beginning of 5 days off work, that at this point I so desperately need to restore my soul, spirit, attitude, and sanity.

The colors in my flower garden change over time, the purples came out first this year, then the pinks and reds, and now the yellows and oranges of sunflowers are coming. Sunflowers have a special meaning for me because they remind me that summer is going to end, and fall will eventually be here, and that is my favorite season. Seeing the change in colors tells me that the season has changed so subtly. I usually live one season ahead anyway, I think January 1st is spring and July 1 is the beginning of fall.

The spring date is most likely because of living in Arizona, where it really was spring in January, but it helps to think of spring in January while living in Colorado too, because it makes the winter go by faster for me. The beginning of fall date is due to my time living in Crested Butte, where the trees actually did start changing in late July, and the raspberries were ripe, and there was a change in the air to slightly cooler mornings.

Having these wildflowers outside my window helps me every day. They are my contact with reality and the natural world, on days when I hardly get to see natural or outdoor anything.

I was mad because yesterday I was so tired after my first of three shifts. I hate it when the first shift wipes me out, I was there nearly 13 hours, and ran my butt off all day, got out late, and that's not a nice way to start a long stretch of work days. I wanted to run yesterday morning but I could not get to sleep after that first long day, I guess I was too wired, and only slept from about 2 am to 7 am, and when I got up I was too groggy and irritable, and it was already hot, so I decided not to run. I'm getting pissed because the month of June turned out to be only half a month of good training.

This morning I woke up early and it's going to be another blast furnace of a day, but since I'm up, I might as well get a few miles in. It will make me feel better mentally, if not physically. I know I am going to pay for this over the weekend, I've been doing these two or three shifts on, two days off for two weeks now, and two days are not enough to recover from the type of workdays I have. The fatigue builds up in so many ways, and after a while you can hardly think straight.

That's where you start to resent work, when it gets in the way of your normal life functions, your ability to take care of yourself in all ways: nutrition, exercise, sleep, family time. It's NOT okay to neglect those things. I don't understand why people don't get that. But then, if they did, we wouldn't be able to keep running a dysfunctional health care system for profit.

We've been working like dawgs, and right now I'd rather be outside in the triple digit heat, I'd rather be preparing to go to Death Valley in 2 weeks, but instead I'll be doing another mega-work week that middle week in July. Damn computers.

Yesterday I went for my lunch break, it was around 1:30 pm and I found my quiet spot on the grass under a tree outside. It was blazing hot outside but I needed air. I ran into a former coworker who gave me an earful about "stuff". I really think that these companies are barking up the wrong tree with their approach to cost saving. Yes we need health care reform desperately in this country but we also need profit reform.

In case you haven't noticed I did post a disclaimer on my blog, see the right hand column under "Said With A Groan" because it seems that some people get very upset when people post their opinions on their blogs. If you look out in the nearest pasture, you'll see all the new calves that have been born lately. Really, it's getting to the point where it's ridiculous, but it's so that no one misunderstands that I am not dead, that my vital signs include having an opinion in addition to breathing with a heartbeat, therefore they don't need to call 911, I am living.

Really, if you live in that much fear that you can't open your mouth because you've got a big fake smile bandaid plastered across your face to hide your personal misery, you do need someone to call 911, because you might be warm, but you're as good as dead.

That's MY opinion, and I'm sticking with it.

Obesification: Killing Our Kids

I found this fascinating.

Yesterday we saw a young family, the parents and two little girls probably 8 to 10 years old. The parents were noticeably overweight but not what I'd call obviously obese. I'd say average based on the majority of people I see these days. But the little girls were both fat, in my opinion, at least working on obese.

I wonder, what are these kids eating, how much are they eating and what, and what are they doing all the time?

Allow me to rant for a while.

Obesity is one of the most pressing issues we have to deal with not only here in this country but worldwide, as it's spreading. Pun not intended.

This video caught my eye not only because I'm interested in the topic, but I used to work for this organization, Scottsdale Healthcare, it's a good hospital system and good place to work, doing some cutting edge work in certain areas like bariatrics.

I first saw this in one of the e-mail medical newsletters I read daily.

Diabetes is an extremely costly disease. The complications: cardiovascular disease, neuropathies, infections, organ dysfunction especially of the kidneys and eyes. Limb loss. Sepsis. Dialysis. Premature death.

We also need to attempt to stop it before it happens, like not letting people get to a BMI of 30 in the first place, even though some people are more likely to go there due to genetic influences. The video doesn't talk about changing behavior early on, intervening before a person starts to become obese and the metabolic signaling results in diabetes.

Years ago people were not so fat. They were more active. They didn't have the range of sedentary activities to keep them mesmerized. There wasn't the range of bad food, and the ingredients, and the portion sizes.

There is a huge genetic influence on obesity. But that doesn't mean we throw up our hands and say, wait until the person is diabetic then give them a sleeve gastrectomy.
We need thinkers like Dr. Blackstone to manage the medical approach to this disease, but we also need more action on the prevention end of things. We certainly aren't doing enough lifestyle interventions to help solve the problem.

Bad workplace habits, poor city planning, commuting time, work schedules, stress, availability of healthy foods, poor food choices, lack of leisure time, poor leisure time choices, lack of physical education that truly teaches kids how to develop healthy lifestyles, all of these things and more add up to what? Sleeve gastrectomies?

No!

Simple things! Behavioral, exercise and nutritional screening, screening for tobacco and alcohol consumption, electronics use and TV watching. Intervening in each of these areas through real, solid active approaches. Doctors aren't necessarily good examples at all.

I'd like to see total screening in preventive care as an ongoing intervention, with education and practice throughout the lifespan. It doesn't belong primarily in the domain of preventive health care in a doctors' offices. The schools could play a huge role, along with the community organizations that sponsor youth activities. What to eat, how to cook, what to buy, what to avoid. How to increase activity, emphasizing less sedentary time. Adults and children need it.

As people get older, include thyroid screening. You wouldn't believe how many patients I see, they tell me they're tired all the time. When I look at their labs, I see elevated TSH and they're not on thyroid meds. When I ask about it, they look perplexed. Many cancer treatments can affect thyroid function but many of these patients are not getting treatment for cancer.

The thing is, we already know all this stuff. We know what would work. But there's a lack of organized, coordinated societal effort. In the video, Dr. Blackstone acknowledges that some of the other medical disciplines such as oncology and cardiology have had a lot of success with combination therapies, including behavioral interventions and medications, in addition to surgery. It is a multifaceted problem and needs to be treated accordingly.

But when I see little kids who are well on their way to becoming obese adults, it makes me cringe, and I know we are setting them up for failure early on, before they ever get a chance to learn to make healthy choices for themselves.

And I think that's a major failure on the part of the adults in this country. We know better, and it's outright negligence to continue to allow this to happen.

end of rant, for now.

(cross posted at ultrahypo)

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.