I’m an admitted Mystery addict – books; TV series; films, I love a good mystery. But now that my husband is gone, I’m particularly sensitive to the inevitable questions the detective asks anyone remotely connected to the crime:”Where were you at the time of the murder?”, and “Can anyone verify you were where you say you were?” Anyway, I was contemplating this yesterday morning over tea, and this little ditty came to me, as kind of a Country Western my-man-has-left-me thing. I hope it gives you a smile…

• Fear and anxiety
• Nervousness
• Difficulty concentrating
• Memory problems
• Irritability
• Sadness
• Feelings of isolation
• Guilt
• Changes in how well you sleep or how much you eat
• Crying spells that catch you off guard
• Emotional numbness
• Nightmares
• Shock
• Increased heart rate
• Muscle tension
• Rapid breathing
• Inability to stop thinking about traumatic events

I know you’re looking at this list and saying, “Of course, I’ve experienced some of these feelings during, and after, caregiving – some days I experience them all at the same time!” It’s understandable that you may have a wide range of feelings and emotions while you’re caring for a loved one, or after the loved one you were caring for has died. These feelings will vary, depending on the intensity of your caregiving experience: the closeness of your relationship with the person you are caring for; whether you are the primary caregiver and have assistance or support; the severity and length of your loved one’s illness.

But it might interest you to know that while the symptoms listed above fit caregivers to a tee, they were not found in articles about the stress of Caregiving. They are all from articles about Post Traumatic Stress Disorder (PTSD).

THE TRAUMAS OF CAREGIVING
While it’s generally accepted in the medical community that PTSD symptoms manifest in people who have experienced trauma related to war, natural disasters, car or plane crashes, terrorist attacks, sudden death of a loved one, rape, kidnapping, assault, sexual or physical abuse, and childhood neglect, the trauma of caregiving is very rarely included in articles about traumatic events that contribute to PTSD.

Read this description of PTSD:
“Post-traumatic stress disorder (PTSD) is a disorder that can develop following a traumatic event that threatens your safety or makes you feel helpless. PTSD can affect those who personally experience the catastrophe, those who witness it, and those who pick up the pieces afterwards, including emergency workers and law enforcement officers. It can even occur in the friends or family members of those who went through the actual trauma. Most people associate PTSD with battle–scarred soldiers–and military combat is the most common cause in men–but any overwhelming life experience can trigger PTSD, especially if the event feels unpredictable and uncontrollable.”

As a caregiver, you know how traumatic caring for an ailing or dying loved one is; how helpless you feel; how overwhelming all of your responsibilities can become; how unpredictable and uncontrollable your loved one’s disease and symptoms are. So the next time you’re feeling like a wimp because you burst into tears occasionally, or an idiot because you keep forgetting things, or a grump because you lost your temper for a second, or an insomniac because you can’t sleep at night, or a hypochondriac because you keep having unexplainable pains that come and go, cut yourself a little slack. Caregiving is one of the hardest things a person can choose to do for someone they love, and the inherent stress and trauma creates a myriad of mental and physical problems.

There are no Caregiving 101 college courses, so you learn as you go. You’ll make some mistakes, every caregiver does. Just remember, you’ll be a better caregiver if you’re healthy and rested. So taking care of yourself is just another one of the things you need to do for your loved one, to ensure that you’ll be able to help them for as long as they need you.

A DIAGNOSIS OF PTSD
Not everyone who has experienced a traumatic event has Post Traumatic Stress Disorder. Many people experience traumatic events, and it’s normal to have strong feelings of anxiety, sadness, or stress afterwards. You may be experiencing some of the symptoms of PTSD, but this doesn’t mean you have PTSD. Many of the symptoms of PTSD are part of the body’s normal response to stress.

For this reason, mental health professionals have come up with specific requirements that must be met to get a diagnosis of PTSD. These requirements are referred to as Criteria A – F and are outlined in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders. The six criteria for a PTSD diagnosis are described below.

Criterion A
A person must have experienced a traumatic event where both of the following occurred:
•    The person experienced, witnessed, or was confronted with an event where there was the threat of or actual death or serious injury. The event may also have involved a threat to the person’s physical well-being or the physical well-being of another person.
•    The person responded to the event with strong feelings of fear, helplessness, or horror.
Criterion B
The person experiences at least one of the following re-experiencing symptoms of PTSD:
•    Frequently having upsetting thoughts or memories about a traumatic event.
•    Having recurrent nightmares.
•    Acting or feeling as though the traumatic event were happening again, sometimes called a “flashback.”
•    Having very strong feelings of distress when reminded of the traumatic event.
•    Being physically responsive, such as experiencing a surge in your heart rate or sweating, to reminders of the traumatic event.
Criterion C
The person experiences at least three of the following avoidance symptoms of PTSD:
•    Making an effort to avoid thoughts, feelings, or conversations about the traumatic event.
•    Making an effort to avoid places or people that remind you of the traumatic event.
•    Having a difficult time remembering important parts of the traumatic event.
•    A loss of interest in important, once positive, activities.
•    Feeling distant from others.
•    Experiencing difficulties having positive feelings, such as happiness or love.
•    Feeling as though your life may be cut short.
Criterion D
The person experiences at least two of the following hyperarousal symptoms of PTSD:
•    Having a difficult time falling or staying asleep.
•    Feeling more irritable or having outbursts of anger.
•    Having difficulty concentrating.
•    Feeling constantly “on guard” or like danger is lurking around every corner.
•    Being “jumpy” or easily startled.
Criterion E
The symptoms described above must have lasted for more than a month. If the symptoms have lasted for less than a month, you may have another anxiety disorder called Acute Stress Disorder.
Criterion F
The symptoms described above have a great negative impact on your life, interfering with work or relationships.

MANAGING PTSD
As with any problem, knowing that you have the problem is the first step toward wellness. Once you put a name to the problem you can begin to do research and get help for it. Some people try to manage their PTSD in unhealthy ways (alcohol, drugs) but there are ways to cope with the symptoms and try to turn it around. Finding the coping strategies that work for you is important – strategies that work for you may not work for someone else, and some strategies may work for you at some times and not during others.

Get professional help. If you think you may have PTSD, it’s important that you meet with a mental health professional trained in assessing and treating PTSD. There are therapists who specialize in PTSD, and  psychological treatments  and medicinal treatments that have been shown to be effective in alleviating symptoms. Even if you don’t have PTSD, if you’re experiencing these symptoms and your life is being disrupted by them, reach out for support. Many people who suffer from PTSD, and caregivers especially, are embarrassed to admit they have a problem to others. They feel selfish turning attention on themselves when their loved one is suffering or has died. It’s difficult to overcome the shame, but isolation will only compound symptoms, while social interaction with supportive friends, family, or a support group is beneficial.

Learn to relax. Make time to do something that will focus your mind outside of yourself, and get some fresh air and possibly some exercise – long walks in a pretty place, yoga or meditation, gardening, biking, sailing, or swimming. Less active distractions are still good for your mind: movies, reading, spending time with friends or animals, cooking classes, a hot bath, listening to music, whatever works for you. If you’ve been avoiding activities that were previously pleasurable to you, give them a chance. If they no longer please you as they once did, at least you’re trying, and you may discover something new to take their place.

Express yourself. Find ways to get what’s all jumbled up inside of you out and onto paper, canvas, or wood. Get a journal and write a little every day. Keep a Dream Journal by your bedside table. If you’ve never painted before, find a class, or go to the art or hobby store and buy some cheap canvas panels, some paints in colors that appeal to you, and a few brushes. Just paint. It doesn’t have to look like anything, sometimes just smearing colors around is therapeutic.  It’s best to start with Acrylic paints because they don’t smell, they dry fast, and you can clean the brushes with soap and water.

Get healthy. Never underestimate the connection between your body and your mind. Start being mindful about what you’re eating – get some fresh fruits and veggies in your diet. The next time you’re waiting for the toast to pop up, do some pushups against the kitchen counter. Start moving – your body’s just waiting for a chance to show you what it can do, and your mind will follow.

Spirituality. Many people find comfort in the spiritual realm. Whether you find it in a church or in a forest, connecting with a power greater than yourself can give you a much needed sense of peace.

THE COSTS OF CAREGIVING
A new study conducted by the MetLife Mature Market Institute in partnership with the National Alliance for Caregiving and the Center for Long Term Care Research and Policy at New York Medical College found that the percent of adult children caring for their aging parents has tripled in the last 15 years, and that providing this care costs the caregivers $3 Trillion in lost wages, pension, and Social Security benefits. Assessing the long-term financial impact of caregiving for aging parents on caregivers themselves, especially those who must curtail their working careers to do so, is especially important, since it can jeopardize their future financial security. There is also evidence that caregivers experience considerable health issues as a result of their focus on caring for others. The need for flexibility in the workplace and in policies that would benefit working caregivers are likely to increase in importance as more working caregivers approach their own retirement while still caring for an aging parent. Link: The MetLife Study of Caregiving Costs to Working Caregivers – Double Jeopardy for Baby Boomers Caring for Their Parents.

The key findings of the study:

• The percentage of adult children providing personal care and/or financial assistance to a parent has more than tripled over the past 15 years. Currently, a quarter of adult children, mainly Baby Boomers, provide these types of care to a parent.
• The total estimated aggregate lost wages, pension, and Social Security benefits of these caregivers of parents is nearly $3 trillion.
• For women, the total individual amount of lost wages due to leaving the labor force early because of caregiving responsibilities equals $142,693. The estimated impact of caregiving on lost Social Security benefits is $131,351. A very conservative estimated impact on pensions is approximately $50,000. Thus, in total, the cost impact of caregiving on the individual female caregiver in terms of lost wages and Social Security benefits equals $324,044.
• For men, the total individual amount of lost wages due to leaving the labor force early because of caregiving responsibilities equals $89,107. The estimated impact of caregiving on lost Social Security benefits is $144,609. Adding in a conservative estimate of the impact on pensions at $50,000, the total impact equals $283,716 for men, or $303,880 for the average male or female caregiver 50+ who cares for a parent.
• Working and non-working adult children are almost equally as likely to provide care to parents in need.
• Overall, caregiving sons and daughters provide comparable care in many respects, but daughters are more likely to provide basic care and sons are more likely to provide financial assistance.
• Adult children 50+ who work and provide care to a parent are more likely to have fair or poor health than those who do not provide care to their parents.”

A 2010 by MetLife found that: “Employees responsible for eldercare report more health problems than non-caregiving employees and cost U.S. employers an estimated $13 billion annually. Demographic trends indicate that a greater number of employees of all ages will assume the role of family caregiver for an increasingly older population. In combination, these trends mean that more employees will be dealing with eldercare issues. This brings to the forefront an urgent need for employers to actively address how to best facilitate the realities of employees dealing with eldercare responsibilities.”

Among the findings of that study:

• Employees providing eldercare were significantly more likely to report depression, diabetes, hypertension, or pulmonary disease regardless of age, gender, and work type.
• Younger caregivers (ages 18 – 39) demonstrated significantly higher rates of cholesterol, hypertension, chronic obstructive pulmonary disease (COPD), depression, kidney disease, and heart disease in comparison to non-caregivers of the same age.

Often mischaracterized as an “older worker” issue, demographic trends indicate that a greater number of employees of all ages will assume the role of family caregiver with an increasingly older population. The results demonstrated a clear impact of eldercare burdens o the health issues fact in employees ages 18 – 39, as much as those ages 50 and older. Together, these results suggest that caregiving for an older relative is an important factor in the health, medical care expense, and productivity of employees across all age groups, and therefor int he health costs for employers. Employers can server the best interests of their employees as well as those of their corporation by anticipating and responding to the challenges of eldercare for their employees. Link: The MetLife Study of Working Caregivers and 
Employer Health Care Costs

RECOGNIZING CAREGIVER PTSD
During my internet research I came across a PTSD forum where I read of a young woman who had been diagnosed with PTSD after witnessing a car accident. I couldn’t help but think about caregivers, usually people with no medical training whatsoever, who witness sudden pain, fear, and blood on a regular basis. And not the blood and pain of strangers, in a public place with professional caregivers on the way, but the blood and pain of people they love deeply; alone in their homes, with all decisions about how to handle the situation on their shoulders. And because these repeated traumatic events often happen suddenly and without warning, the caregiver is always on alert, listening for a bump or a cry. Even when trying to get some much needed sleep, the smallest sound will wake the vigilant caregiver throughout the night and they’ll rise to make sure all is well. Not so very different, is it, from the soldier lying in a tent, alert to the sounds of an attack? Knowing that their reaction to a sudden attack could mean the difference between life and death? Whether it’s the life or death of a platoon, or the life or death of a loved one, that kind of responsibility is an immense weight that, over time, can cause serious physical and mental problems.

I wrote this article because while doing research on soldiers and PTSD, I came across the above diagnostic criterion and realized that I still experience all but four of the symptoms of PTSD. It’s been over three years since my husband died of advanced prostate cancer, which we fought against for three and a half years. But I’m one of the lucky ones: my husband left me financially secure so I don’t have the added stress of financial difficulties, I possess the abilities to channel my feelings positively and constructively, and I have a good support system of friends. Some of the caregivers I communicate with exhibit all the symptoms of PTSD and say they wonder daily how much longer they’ll be able to hold on, mentally, physically, and financially. In the current economic climate, many caregivers have the added stress of housing, feeding, and purchasing medications for their loved ones while struggling financially, or unemployed. Their contribution to society, and the burden they spare hospitals and governmental agencies from carrying, is undeniable. Employers, the medical community, and the government has to do more to help this growing segment of the population, before they fall ill themselves and end up in hospital beds alongside their loved ones.

Financial aid; tax breaks; eldercare benefits; wellness programs; affordable insurance plans that cover uninsured dependent parents; free legal and financial advice around Medicare, Medicaid, and insurance issues – there are many ways we can begin to lighten the load carried by these invaluable and indispensable members of our society. And by recognizing that caregivers suffer from PTSD, the medical community will be opening doors to diagnosis and treatment for a group that has suffered in silence for too long.

“Greater love has no man than this, that he lay down his life for a friend”.
John 15:13

SOURCES
Mayo Clinic http://www.mayoclinic.com/health/post-traumatic-stress-disorder/DS00246/DSECTION=symptoms
Web MD http://www.webmd.com/anxiety-panic/guide/post-traumatic-stress-disorder
Help Guide http://www.helpguide.org/mental/post_traumatic_stress_disorder_symptoms_treatment.htm
About.com http://ptsd.about.com/od/symptomsanddiagnosis/a/PTSDdiagnosis.htm
About.com http://ptsd.about.com/od/selfhelp/a/PTSDcoping.htm

I looked out my kitchen window yesterday and saw some gray fluff on the ground under the tree where I feed the birds. I went out to look and there was this little guy – lying on his side. I picked him up and he was limp, but also twitching and arching his back from time to time. I tried setting him on all fours, but he just fell over on his side again. I sat on the back steps and put him in my lap to get warm (yes, we’re back to days in the 50′s!) and watched him go to sleep. I thought I was watching him die.

Then a truck with a state insignia pulled in the drive. I thought, “What luck, if this is the wildlife department!”. But it wasn’t, it was the water department needing to check on the septic systems on our street. As I stood there talking to the man, with this squirrel in my arms, he asked if I was the owner of the house, and then asked if I was Jean. I said yes, and to my surprise he told me how much Don’t Lose Heart had meant to him while he was caring for his parents. He cared for them for years; his father had had a stroke, and his mother had NPD (Narcissistic Personality Disorder, which I had never heard of, but I looked it up after he left) and oh my gosh, caring for these two people and his three little boys?! Superman Caregiver. His parents are in a home now near his brothers (one of those good transitions; the parents love it there) and, it was obvious to me, he’s still recovering from the years of intense stress and lack of sleep. But it made me feel so good to hear that our stories had helped him.

After he left I took the squirrel inside and tried to get some water into him (in case he’d eaten something bad), but he could hardly swallow. I thought, “Well, he’s dying. What’s the best thing I can do for him?” So I thought I’d make him as comfortable as possible so he could fall into a deep sleep and die. I put a hot water bottle in the bottom of a box and then a fluffy hand towel on top of that, and wrapped him up. I set the box in a dark spot next to my desk and checked on him from time to time, to see if he was still breathing. Then, a few hours after I’d brought him in, I looked, and instead of seeing his little face, it was his tail peeking out – he had turned around! I carefully closed the box and took it outside (with my video camera) and opened the box.

He looked alert but dazed. I petted him a few times, and then he leapt out of the box and bounded away! I made a video of him, if you’d like to see it on YouTube: http://www.youtube.com/watch?v=UHf4KPPrdms

You just never know what each day will bring, do you? I’d thought it was going to be a quiet work day, but two special visitors stopped by and left encouragement and a smile on my face. ~ Jean

We all have those moments of fear, depression, worry, anger, and sorrow; it’s part of being a human being. But for an exhausted caregiver it can be overwhelming and lead to a feeling of isolation. And when life throws yet another crisis in your lap it can be easy to take it personally and wonder what you did to deserve so much unhappiness. On those days when you’re buried in stress and you feel like you’re “losing it”, it might help to stop and focus for a few minutes on some of the amazing things we sometimes take for granted. Take them personally. What did you do to deserve such gifts?

Breathing/Smelling. Breathe in those invisible, life sustaining gases – the components of earth’s air – and while you’re at it, stop to smell the roses or wake up and smell the coffee or smell the sweet smell of success, or teen spirit, or whatever floats your boat. What a pleasure and a privilege to be able to see with our noses. The sea, immense and powerful and endlessly romanticized, but how would we think of it if, instead of it’s familiar fresh salty scent, it smelled like old shoes? (Waterfront property would be cheap!) What a pleasure to smell fresh baked bread, the top of a baby’s head, flowers (Black Locust blossoms!), french fries, popcorn, bacon, fresh cut grass. The air we breathe is free and unrestricted, and unlike bandwidth, no one can tell you how much air you’re allowed to breathe per day. When we’re considering something difficult we’re always told to “take a deep breath and…”. Why not take a deep breath just because you can? Your body does it for you 12 – 20 times a minute, why not fully appreciate and enjoy a few of those precious breaths?

Sight. What a gift! To be able to see every hair coloring the stripes on a purring cat; to watch it’s sides rise and fall and it’s whiskers quiver. To be able to look up and see the sky, knowing that a never ending universe full of wonders lies just beyond it. To be able to look into the eyes of a loved one and watch their irises expand in pleasure at the sight of you. To be able to go someplace new and to come away changed by what you saw, or to go someplace old and see something you’d never noticed before. Art, people, photos, colors, trees, children, flowers, the pillow your friend made you. It’s free too, so fill up your mental hard drive with images you can pull up in the middle of a long dark night.

Hearing. Another luxurious gift. “I love you.” “Thank you.” “I miss you.” Birdsong. Waves, streams, laughter, whispers, wind in the trees, and sometimes, a silence of unspeakable beauty. And music….oh lordylordy, music! The right song can release the tears or make you dance.

Touching. A hug. A kiss. Holding hands. An arm around your waist. A foot rub. A hand on your cheek. A gentle stroke, squeeze, pat. Nothing soothes like the human touch. Be grateful for every moment of touching; unlike photos and videos for sight and hearing, once your dear one is gone you’ll only feel their touch again in your dreams.

Tasting. Don’t get me started on food, we’ll be here all day, and this is, of course, directly related to smelling. But what an orgy of pleasure each meal can be if we take the time to be creative and appreciate the sweetsoursaltybitterspicy rainbow that lights up when we eat something yummy.

We are alive! What an astounding privilege! We are each an amazing, completely unique being inhabiting this universe of wonders. Think about the odds of being born you. Your father produced billions of sperm in his lifetime. The odds of that one particular sperm and that one particular egg in your mother coming together to make you were billions to 1.  You could have been genetically different in trillions of ways, depending on the combination of genes that were present during your conception.

You are a freekin’ miracle of nature! Good God, can I get an “Amen”??!!?

Life. It can get so complicated and sometimes it really sucks, but look at all we have to be grateful for. If you were to live alone on a mountain top, your main concerns would be food and shelter; eventually one day you’d fall down dead. Pretty straight forward. On the other hand, if you live in a house in a town with family and friends and pets and a mortgage and cars and television and cell phones and computers and jobs and malls and donut shops and doctors and lawyers and 4 different car insurance companies all telling you that if you switch to them you’ll save $500, eventually things get complicated. But come on, who wants to live without donuts?

Hallelujah.

“We have no right to ask when sorrow comes, ‘Why did this happen to me?’ unless we ask the same question for every moment of happiness that comes our way.”
~ Author Unknown

“The sun shines and warms and lights us and we have no curiosity to know why this is so; but we ask the reason of all evil, of pain, and hunger, and mosquitoes and silly people.”
~ Ralph Waldo Emerson

Photos copyright ©Jean Fogelberg, all rights reserved.

“Friendship is a great place. I’m glad we’re here.”
~ Cat Davis

“What comes from the heart, goes to the heart.”
~ Samuel Taylor Coleridge

“Friendship blossoms when two people say to each other, in effect:
‘What? You too? I thought I was the only one!’”
~ C.S. Lewis

“Oh, the comfort, the inexpressible comfort of feeling safe with a person, having neither to weigh thoughts nor measure words but to pour them all out, just as it is, chaff and grain together, knowing that a faithful hand will take and sift them, keeping what is worth keeping, and then, with the breath of kindness, blow the rest away.”
~ George Eliot

“Each person represents a world in us, a world possible not born until they arrive, and it is only by this meeting that a new world is born.”
~ Anais Nin

“Love is blind.
Friendship is clairvoyant.”
~ Philippe Sourpault

“Friend…GOOD!”
~ Frankenstein’s Monster

“Friends are those rare people who ask how we are, and then wait to hear the answer.”
~ Ed Cunningham

“The soul selects her own society.”
~ Emily Dickenson

“A soul friend is someone with whom we can share our greatest joys and deepest fears, confess our worst sins and most persistent faults, clarify our highest hopes and perhaps most unarticulated dreams.”
~ Edward C. Seliner

“God, I’ve been starving for this kind of conversation!”
~ Eleanor Coppola

“While the right friends are near us, we feel that all is well. Our everyday life blossoms suddenly into bright possibilities.”
~ Helen Keller

“Thank you for believing in me before I believed in myself.”
~ Kobi Yamada

“There are people who take the heart out of you, and there are people who put it back.”
~ Elizabeth David

“Perhaps friendship is the process of my leading you gently back to yourself.”
~ Antoine de Saint Exupery

“To love a person is to learn the song that is in their heart, and to sing it to them when they have forgotten.”
~ Thomas Chandler

“We all need to be recognized for what we’re doing, for our work. Every once in a while we need someone to come up to us and say, ‘You’re beautiful. That was well done. That’s nice.’”
~ Leo Buscaglia

“It’s a great satisfaction knowing that for a brief point in time you made a difference.”
~ Irene Natividad

“We are rich only through what we give, and poor only through what we refuse.”
~ Ann Sophie Swetchine

“All we have to do to be successful is follow the advice we give others.”
~ Dear Abby

“I didn’t know, until I was at odds with the world, how much my friends who believe in me…mean to me.”
~ D.H. Lawrence

“Lots of people want to ride with you in the limo, but what you want is someone who will take the bus with you when the limo breaks down.”
~ Oprah Winfrey

“Crises do not make friends, they reveal them.”
~ Dan Ward

“The object is not to see through one another, but to see one another through.”
~ Peter DeVries

“Friendship is two hearts pulling at one load.”
~ Dan Zandra

“It’s the friends you can call up at 4 a.m. that matter.”
~ Marlene Dietrich

“Go ahead and cry, I’ll catch your tears.”
~ Jilleen Russell

“Measure your friends around the heart.”
~ English Proverb

“If someone listens, or stretches out a hand, or whispers a kind word of encouragement, or attempts to understand, extraordinary things begin to happen.”
~ Loretta Girartis

“Each of us stands alone in this vast world, momentarily bathed in a ray of sunlight. And suddenly it’s night. If you stand together with me, we can share the sunlight, and believe me, the night won’t seem so frightening.”
~ Quasimodo

“And remember, we all stumble, every one of us. That’s why it’s a comfort to go had in hand.”
~ Emily Kimbrough

“Lean on me when you’re not strong, and I’ll be your friend, I’ll help you carry on. For it won’t be long ’til I’m going to need somebody to lean on.”
~ Bill Withers

“My friends buy just as many wigs and makeup things as I do. They just don’t wear them all at the same time.”
~ Dolly Parton

]]> http://dontloseheart.org/2011/02/valentines/feed/ 15 http://dontloseheart.org/2011/02/2938/ http://dontloseheart.org/2011/02/2938/#comments Mon, 07 Feb 2011 02:26:06 +0000 Jean F http://dontloseheart.org/?p=2938 I had “one of those days” yesterday.

I came across something of yours,
a little nothing,
and burst into tears.

I tried to
pull
myself
out
of this
woeful free fall
but kept
grasping only air.

A sorry little cloud
hovered over my head
all day long
following me
from room to room
snowing memories.

By
The End
of the day
I was chilled through and through,
too cold to sleep.

I looked through my tragic potions
found some Bella Donna
and ended up sleeping
too deeply
and too long
on one side.

I woke this morning to a bright sun
ready for a new day
but my right arm
ached
and grew worse all day;
an ancient injury
reawakened
by my too deep sleep.

There are days
when even the
young at heart
find the weight of their years
too heavy to bear.

An unwelcome message
from a stranger
was the final straw
that put
An End
to my
fragile
Sunday plans.

Sad
sore
weary of people
with nothing better to do
than to
pounce
unprovoked
on the oblivious
traveler
trying to make her way
on an uphill kind of day.

I found your old sling
another little nothing
and hoped it would
hold me up
not
pull me further down.

There are days
when even the most
determined
optimist
finds the gravity
of their situation
too mighty a foe
to climb above.

So I sat.

Looking through
some photos
taken
on Thursday
when I was still young and strong
I found
an image
that reached through
my winter layers.

Remnants of flight
imprinted on a snowy shore.

A reminder
that even
birds
sometimes give in
to the weight and pull of life
before once again
spreading their wings.

Grasping only air
they somehow manage
to return to the sky.

Copyright ©Jean Fogelberg. All rights reserved.

]]> http://dontloseheart.org/2011/02/2938/feed/ 43 http://dontloseheart.org/2011/01/acid-reflux-gerd/ http://dontloseheart.org/2011/01/acid-reflux-gerd/#comments Thu, 06 Jan 2011 16:08:07 +0000 Jean F http://dontloseheart.org/?p=2683 My acid reflux started with a bang on a particularly stressful day and came and went after that until eventually I was in constant pain. Tums and Mylanta didn’t even put a dent in it so I switched to Prilosec OTC, which barely dented it. At the end of the prescribed two-week course it was as bad as ever. I did a lot of research, determined to overcome it naturally, and within 10 days I was back to feeling normal, using only the 9 suggestions listed below – especially the HONEY and CINNAMON. All day long I sipped a cup of hot water with a spoonful of honey and a shake of ground cinnamon. The honey instantly soothed the burning in my esophagus, and got rid of the acidic taste, so it was easy to keep it up. I eventually got a little plastic honey bear and kept it on my desk so I could take a little hit of honey if I didn’t have the hot water mixture handy. I still have a cup of hot water with raw honey and cinnamon in the morning (I love it now) and I’m careful about not overdoing coffee, chocolate, or onions, which are definitely trigger foods for me. I hope you’ll be able to cure your acid reflux too – read on…

More than 15 million Americans suffer from Acid Reflux. Caregivers as well as patients are at risk for Acid Reflux, which can be caused by stress, lack of sleep, obesity, aspirin, ibuprofen, certain muscle relaxers or blood pressure medications, diet, and lying down too soon after eating. Masking the symptoms by taking antacids (TUMS, Mylanta) or proton pump inhibitors (Prilosec OTC) could keep you from figuring out the real cause of your acid indigestion and actually create more problems later on.

Acid Reflux is also known as “heartburn”, and occurs when the muscle at the lower end of your esophagus relaxes at the wrong time, allowing stomach acid to back up into your esophagus. Frequent or constant reflux can lead to GERD. GERD (Gastroesophageal Reflux Disease) is a chronic digestive disease that occurs when the backwash of stomach acid irritates the lining of your esophagus, which can ultimately result in an increased risk of:

• Narrowing of the esophagus due to scar tissue (esophageal stricture).
• Open sores (esophageal ulcer). Stomach acid can severely erode tissues in the esophagus, causing an open sore to form. The esophageal ulcer may bleed, cause pain and make swallowing difficult.
• Erosion of tooth enamel.
• Esophageal cancer (Barrett’s esophagus). The risk of cancer is low, and an endoscopy exam can look for early warning signs of esophageal cancer.

UNDERSTANDING THE CAUSES

Understanding the causes and treatments of acid reflux will go along way towards minimizing symptoms and preventing GERD.

Your esophagus is the tube that carries food from your mouth to your stomach. At the bottom of the esophagus is a muscle called the Esophageal Sphincter which relaxes and closes to allow food from the esophagus to enter the stomach. When the Esophageal Sphincter relaxes at the wrong time, acids from your stomach can back up or splash back into the esophagus, creating a burning sensation (heartburn), sore throat, acid taste (tastes like vomit), coughing, difficulty swallowing, nausea, or belching. Although acid reflux is common, it can be serious. Over time, regurgitation of acidic stomach contents can wear away the esophagus, eroding the delicate tissue, and leaving you at risk for some of the above mentioned complications.

Common causes include Hiatal hernia, food allergies, age, pregnancy, stress, obesity, prescription medications, alcohol, caffeine, and smoking.

A Hiatal Hernia occurs when the upper part of the stomach and the esophageal sphincter move above the diaphragm, a muscle that separates your stomach from your chest. Normally, the diaphragm helps keep acid in our stomach. But if you have a hiatal hernia, acid can move up into your esophagus and cause symptoms of acid reflux disease. Hiatal hernias are repairable with surgery, done while the patient is under general anesthesia. In some cases, a hiatal hernia can cause twisting of the intestines or stomach. This condition is called a voluvlus. It is a life-threatening emergency that requires immediate treatment.

WHAT YOU CAN DO TO PREVENT ACID REFLUX

1. Eat 5 small meals a day rather than 3 big meals, with your biggest meal in the morning and your last meal at least 3 hours before bed.  Don’t eat until you’re full, just eat until you aren’t hungry anymore. Use small plates if it helps to regulate how much food you eat. Take your time and chew your food well to aid in digestion.
2. Foods to avoid: spicy or fatty foods, fried food, chocolate, mint, coffee, tea, garlic, onions, citrus fruit, and tomatoes.
3. Foods to eat: multi-grain breads, whole grain pasta, rice (brown rice is best), low-fat meat such as fish or skinless chicken, non-fat yogurt, bananas, apples, pears, and most vegetables.
4. Wait at least 45 minutes before lying down after eating. Sleep with your head elevated by putting 2″ blocks under your bed frame, or by propping yourself up with pillows until you have the acid reflux under control.
5. If you’re taking any medications that relax your muscles, like anti-depressants, sleeping meds, or muscle relaxers, try to stop taking them for a while. I found a bunch of posts on acid reflux forums where people were saying that their acid reflux went away completely a few days after discontinuing their sleep medications.
6. Sipping a teaspoon of honey in a cup of hot water throughout the day will sooth your esophagus tremendously! Add a pinch of cinnamon before meals – cinnamon aids digestion by stimulating enzymes to break down the food faster. It also increases your metabolism. Adding cinnamon to your drink or foods regularly will aid your digestive health. Ancient people often used both honey and cinnamon as remedies.
7. When sitting for long periods, especially at a desk, try not to slouch forward. Remember what your mother said: “Sit up straight!”.
8. Stop taking antacids so your body can start to regulate itself naturally. Sometimes taking an antacid makes your body work to create more acids to maintain a balance, so prolonged use of antacids can create problems.
9. Find time to relax and slow your mind down – a walk, yoga, meditation, or listening to music – whatever works for you.

DRUGS (and why it’s best to use them only sporadically)

PPIs
The proton pump is a molecule in certain stomach cells  that pumps acid into the stomach to help break down food so it’s easier to digest. Proton-pump Inhibitors (PPIs) completely block the proton pump molecules, thereby stopping acid production. This can be beneficial in helping to heal stomach ulcers.

Thanks to heavy advertising, Proton-pump Inhibitors (Prilosec, Prevacid, Aciphex, Protonix, Nexium, Zegarid) are among the most widely selling drugs in the world. The FDA advises that no more than three 14-day treatment courses should be used in one year. Prolonged use can lead to increased risk of fractures of the hip, wrists, and spine.

ANTACIDS
Over the counter antacids (Pepto-Bismol, Mild of Magnesia, Rolaids, Tums, Alka-Seltzer, Mylanta, Maalox, and Gaviscon) are calcium-carbonate based and have been linked to a number of ailments, some fatal. They can lead to increased calcium in the urine, which can lead to kidney stones. Remember when the ads told you they could supplement your dietary calcium? You notice they don’t say that anymore? That’s because that claim turned out to be false – the body needs stomach acid to absorb calcium and the calcium in antacids is a form that isn’t food based so is very difficult to absorb as a nutrient. As a result, antacids have been linked to hip fractures and osteoporosis related injuries.

If these steps don’t help and you still have frequent or severe symptoms, your doctor may order tests to confirm a diagnosis and check for other problems. If you read everything above, you know this is nothing to fool with, so get it taken care of before more damage is done.

I’M SORRY

I’m sorry I didn’t prevent you from getting sick.

If the cancer had been a rabid dog
I would have faced it down
and growled so fiercely
it would have slunk off
foaming and crazy
with its wicked tail between its legs.

I’m sorry I couldn’t cure you.

If the cancer had been an acre of dandelions
I would have dug and plucked
on my hands and knees
until every root had been pulled
lifted out clean
and only lush green grass remained.

I’m sorry I couldn’t stop the pain.

If the cancer had been an angry swarm of bees
I would gladly have laid myself on top of you and
shielded you
taken my share of the stings
so grateful for every throbbing welt
every wince I wouldn’t see on your beautiful face.

I’m sorry you died and I lived.

That final, selfish betrayal
letting you go on by yourself
and still expecting you
to keep your promise
to wait for me
to light the way and welcome me
so I can hold you once again and say

I’m sorry.

.

.

.

Photo and poem Copyright ©Jean Fogelberg
All rights reserved.

We come into the life of a stranger
with all the helpless fury of a storm
in an aquarium.

Frail and weak,
we are unable to
perform any of the most basic
tasks needed for our survival.

But within moments of our first meeting
the stranger has taken us
to her breast
and allowed us
to drink from the
fountain of her heart.

In a life full of busy days
she will make us the
new
center
of her universe
and her every waking
(and awakened)
moment
will be spent
trying to understand
the urgent needs
and rantings
of the newcomer
who doesn’t yet
speak the language.

We will come to know her as
our protector;
our teacher;
our biggest fan;
our Mother.

She will teach us
 and learn from us.
She will lead us
 and chase after us.
She will hold us back
and encourage us to move forward.
She will scold and fret
and cheer us on
from the sidelines.

Somewhere in the midst
of life,
she will lose her own
Mother.

She will become
an orphan.

We will watch her
move
up
a branch
in the family tree
and get settled there.

We will allow ourselves to believe
for a time,
that she will always be there,
one branch above,
watching over us.

But there will come a day when,
frail and weak,
she is unable to
perform any of the most basic
tasks needed for her survival.

In a life full of busy days
we will make room
for her to revolve
in our universe.

We will try to understand
the urgent needs
and frightened rantings
of this beloved stranger
who is losing the ability
to speak the language.

We will become her protector.
We will lead her
and encourage her to move forward.

And somewhere in the midst
of life,
we will lose her.

We will become
the orphan.

We will
move
up
a branch
in the family tree
and get settled there.

And always remember
with gratitude,
the beautiful stranger
we came to call
Mother.

.

.

Copyright ©2010 Jean Fogelberg

After almost a year, I wanted to go back to my old natural standby, Melatonin, so I tried to stop taking the Ativan. Ha! I tried for two nights in a row, and could not fall asleep. AT ALL. On the third night I gave up and took an Ativan. I was afraid I’d messed up my body and now it had forgotten how to fall asleep on it’s own. So I started doing some research. What I found was a lot of people who are worse insomniacs than me, and addicted to sleep meds. I tried some of the suggestions offered, but they didn’t work for me.

So what I did was, I got one of those nifty pill cutters, and started cutting the Ativan in half, then quarters, then eighths. I took half a pill until I thought a quarter would work. If it didn’t, after a couple of hours I’d take another quarter, and so on, until I was able to get off the Ativan and start using the Melatonin again. This “withdrawl” took about a year. Then last night, I fell asleep even without the Melatonin. I woke up with a head full of dreams, and so glad to be drug-free!

If you’re in the midst of caregiving or grieving, I say “Take the drugs”! Trying to get through the day and maintain your equilibrium when you’ve had too little sleep is just terrible, and such a strain on your body. But when you’re ready to come off the drugs, don’t try doing it “cold turkey”. Go to the drug store, or to Amazon and get a pill cutter. They have a small rubber channel the pill sits in, then you close the lid and a razor blade cuts the pill right in half.

Ambien and Ativan are both prescription drugs so you’ll need to get them from your doctor. And no matter what they say, these sleep meds are addictive, so try to use them sporadically.

Ambien is good if you need something really strong, but you have to take it right before bed. You’ve probably heard about those people who took it in the daytime (????? Who ARE these people, and what part of “Sleep Medication” don’t they understand????!) and got into all kinds of trouble, eating everything in the kitchen and saying and doing weird things. All I can tell you is, we took it immediately before bed, slept great, and woke up refreshed and with no drug hangover.

Ativan is great for anxiety and sleep. It’s not as strong as Ambien. I’m a wimp, so I can’t imagine taking it in the daytime and functioning, but a lot of people do.

Melatonin is a naturally occurring hormone. It’s always worked for me, but didn’t work for Dan. He liked Passion Flower, which didn’t work for me, so you have to find the right sleep aid for you. I like the liquid Melatonin that Natrol makes.

For an extensive list of natural, over-the-counter, and prescription sleep meds, go to the TOPICS section and click on “Sleep Aids”.

Good Luck, and Good Night.