Reflections on Rehab

On November 17, 2018November 17, 2018 By DebIn Activist Mommy, chaplain musings, good medicine, health, healthcareLeave a comment

bannister — Photo Credit: Kate Ter Haar, via Wylio

I blogged recently about my feat of great UNcoordination, and tearing my medial meniscus. How I learned to stop trying to “walk it off” and actually get medical attention.

I know. Radical.

Well, the lesson has been a slow (and yes, painful) process of learning to listen.

Listen to my body.
Listen to my pain threshold.
Listen to the instructions on when to take my medications.
Listen to the Spirit as I make decisions about when and where I will spend my energy and my time.

I’ve had to keep my sense of humor. Me and my #achybreakyknee are making progress as I follow through on my home exercises. (And a HUGE shout out to Sport and Spine Rehab of Rockville for caring about my rehab and treatment as much as their care of pro athletes and fitness buffs!)

But there’s something else I’ve realized in a personal way, a reality that anyone with a chronic health condition already knows. (And I’ve been slow on the uptake!) It’s simply this: Being healthy is a lot cheaper than being sick. Doctor’s appointments, co-pays, medical equipment, prescriptions, procedures… it all adds up!

I am grateful for good health insurance that covers a lot of the cost of my care. But it is expensive. It eats into the little bits of extra cash that we might spend on “fun” things. An office visit co-pay is the cost of going out for dinner (a cheap dinner, mind you.) The cost of a prescription would fill my car with gasoline. And so it goes.

People with chronic illnesses have to count the cost, in every way: in time, money, physical activity and emotional energy. We lose patience with people who offer platitudes. (Seriously. “I’m praying for you” means nothing unless your prayers are sincere and tuned in to my current state.) It bears repeating that chronic illnesses are not usually the fault of the person who has them. Genes, environmental factors, access to care, and sometimes, dumb luck may mean that one person has a chronic condition, and one person does not. A simple tumble on my patio resulted in my injury. Imagine what I might be going through if the incident had been a car accident or on-the-job injury!

In the midst of all of my personal challenges, which are minimal compared to the issues that many of my patients and their families face, I know God is present. I know the love of the Divine. I know the gifts of humor, of self-care, of compassionate Presence, of close friends and advisors who ‘get me’. I feel God’s mercy every day.

And I also know that there are many who struggle alone. And if I were Empress of the Universe, I’d fix that.

For now, I’ll settle for electing officials who want every citizen to receive high quality and affordable health care. That means I’m a caring person who would not wish others to suffer when there are treatments, physicians, therapists, prescriptions, and rehab options available to them — if only they had access through affordable and comprehensive health insurance.

I’ll keep advocating for all of us. Because — you are beloved. And so am I. And we are worth it.

A Chaplain’s Perspective on Ebola

On October 17, 2014October 18, 2014 By DebIn chaplaincy, EbolaLeave a comment

For this reason I remind you to fan into flame the gift of God, which is in you through the laying on of my hands, for God gave us a spirit not of fear but of power and love and self-control. 2 Timothy 1:6-7 ESV

The media panic has begun. Better than a hurricane or the dreaded “polar vortex,” every news station in town last night documented the orderly (and legal) transfer of a nurse with the Ebola virus to the NIH Clinical Center for treatment. One station had the hashtag “FactsNotFear” but then went to a live shot of a breathless, wide-eyed reporter explaining that “some people” were upset to have an Ebola case in their community.

After all, many of the people who work at the National Institutes of Health take public transportation! There’s a Metro stop right beside the campus! Buses from all over the county stop there! Montgomery County has Ebola!

QUICK! BUY SOME MORE EXCLAMATION POINTS!

As a healthcare chaplain, and someone who trained at the NIH, I have a few opinions. 😉 Let’s break it down a little…

1. The NIH is well-suited to treat and contain infectious diseases.

Not only do they have state-of-the-art medical care, they have immunologists, epidemioloists, geneticists, and infection control experts who know how to maintain a safe clinical environment for patients, families and employees. They isolate, treat and develop best practices on disease management.

In 2011-2012, there was an outbreak of the antibiotic-resistant bacterium Klebsiella pneumoniae, a so-called “super-bug.” A patient came to the Clinical Center for treatment, bringing the disease with her — from a New York hospital. The bug spread, and out of 18 patients, 11 died. According to their own studies, 6 of the deaths died from the infection itself, and 5 died as a result of their underlying condition. These patients were not healthy individuals, but were among the sickest seeking experimental treatments for their underlying diseases. Their immune systems were compromised.. And NONE of the patients were employees or family members. Using genome sequencing and care infection control practices, the cases decreased.

Not just anyone can visit the NIH campus. You go through a security checkpoint unless you have a keyed ID badge which allows you into specific parts of the campus. If you drive on the campus, even with an ID, your car/bags are checked. (Think airport security without taking off your shoes and doing the body scan hokey-pokey.) If you don’t have an invitation or a reasons to enter the campus, you don’t get on it. (Case in point: Reporters had to stick with aerial shots of the campus last night, as no one could get close to the ambulance and its accompanying motorcade.)

Therefore… There is no risk to the general public. There is no risk to the employee population at the NIH.

Deep breath, people. Moving on…

2. Ebola is not as contagious as other viruses already prevalent in our world.

Take a look at this graphic from NPR:

Think about it – there are vaccines for mumps and measles. People choose not to immunize. They are generally at higher risk for getting measles and mumps than Ebola. No, vaccines, don’t “prevent” you from getting the disease. But they do decrease your chances with something called “herd immunity.”

You are at greater risk of getting HIV than Ebola. This of course is mitigated somewhat by understanding how the virus is transmitted and decreasing risky behaviors. I have every confidence that the same will be true for the Ebola virus.

3. Use your noggin. If you are sick, stay home! See your doctor if you have risk factors that suggest you could have been exposed to Ebola.

It’s common sense that if you have a fever, nasal congestion or vomiting, that you should not travel. Or go to work. Or to school.

But I can promise you that on any given day, there is a kid who has a snotty-nosed virus in class who should have stayed home in bed. Attendance is taken, and heads roll if you miss too many days. (Even on the college level, students can lose credit for a class if they miss too many days.) Conversely, there are awards for “perfect attendance” — an award that should be banned.

It’s true of those in the workplace, too. We all know (or have been) that worker who has the flu but goes to work out of fear of retribution. Yes, they know they are probably infecting others, but they go anyway. They cough, bark, snort and sniffle their way through the day. A couple days of isolation would be a good thing, but we punish those who follow standard infection control procedures.

4. Wash. Your. Hands.

If you don’t know how, look up a video. (There are many available on line.) Soap and water, friction, time and using paper towels are simple things. Be wasteful. Use more than one paper towel. (And please forget that TED talk guy who insisted you only need 1 towel. He does not know what he’s talking about. When I showed it to one of my colleagues who is an experienced infection control nurse, she about had a stroke.)

If you prefer to be really sure that you won’t get the flu or another viral infection, here’s a simple solution:

(Sarcasm font off.)

In all seriousness, this is simply not something that should cause panic. Go wash your hands and hug the people you love. And as Douglas Adams would say, Don’t Panic. And carry a towel.

Their Worst Night Ever

On April 5, 2014April 6, 2014 By DebIn chaplain musingsLeave a comment

My first night working an overnight on-call shift was with a chaplain who had decades of experience. Soft-spoken, kind, and very calm, he walked me through my first code blue as a chaplain, and my first experience supporting a family after the death of their family member. It was truly a brain and emotional overload!

The first part of our shared shift was busy seeing referrals which had not been done during the day shift. There came a lull, so we decided to head back to the office and do some charting. We were sitting having a cup of tea, debriefing over a shared visit with an oncology patient when the pager went off. I sighed deeply and groaned, “REEEAAALLLYYY??”

He looked over at me, smiled and commented gently, “You know, someone is about to have their worst night EVER!”

It stopped me in my tracks. For what was I groaning about? Having to put aside my cup of tea and see a patient, a family, or a staff member… Someone who was indeed going to have “their worst night ever.”

When I reflected on this experience to my CPE supervisor, he said, “What if you treated each person you meet like they were just about to have THEIR worst day, ever? What difference would it make?” We talked about that for some time.

I quickly realized the other logical question related to my supervisor’s: “What if I knew I was about to have my worst day, ever. What would I do differently? What would I say? And how would I want to be treated”

Everyone has hard days. Everyone. Some of the most creative, thoughtful people the earth has known have struggled greatly with facing the day in front of them.

My mentor’s words stuck with me for the rest of that night, and indeed, for every shift that I’ve worked as a chaplain. It doesn’t matter if it’s an accident or an overdose, a heart attack or an aneurysm, the families struggle to come to terms with what they are feeling and thinking. In their eyes, it is their worst night ever. They walk in to the hospital, anxious, worried and uncertain. They don’t know where the Emergency Department is. All they see and hear and smell are things that they never see at home.

I’m a “hospital kid.” The hospital was where my Dad worked. I knew the back hallways and labs better than the front lobby and information desk. I knew that people lived and died there. I knew that, sometimes, the pathology report wasn’t good news. And so I try to bring my knowledge and experience to bear on my work as a chaplain.

I understand the questions that patients and families and friends are asking: “Will anyone listen? Will we be able to afford the treatment? Is the doctor going to help with her pain? Why is everyone so busy? Will I get well? Am I going to die?”

And my role? It is to walk beside them, listening, praying, holding silence or holding a hand, and doing all in my power to help them make their first steps towards healing. For, too often, I walk on unfamiliar turf, where I need support and understanding. I struggle waiting for answers that never seem to come. And I realize that my feelings and experiences are not unlike theirs.

Slowly, we’ll all make it through.

Therefore, if there is any encouragement in Christ, any comfort in love, any sharing in the Spirit, any sympathy, complete my joy by thinking the same way, having the same love, being united, and agreeing with each other. Don’t do anything for selfish purposes, but with humility think of others as better than yourselves. Instead of each person watching out for their own good, watch out for what is better for others.
Philippians 2:1-4 Common English Bible