Self-care with Pen and Paper

I like to listen to our recorded podcasts because I believe it helps me improve my speaking skills. It also gives me an opportunity to objectively look at not only what I say but how I say it. 

I finished listening to podcast # 9 entitled, Self-care with Pen and Paper from our Self-care Series.

Beyond my first thoughts of critiquing myself and thinking about ways to not only improve my communication and speaking skills, but also to improve our podcast, I gleaned some insight into my own advice. 

Writing or journaling into self-care

When I create the time and space to write, I have a powerful opportunity to step into my true self and to heal past wounds. Writing serves as a form of reflection for me. As I am writing my thoughts, I am seeing the experience in a new light and find truth, understanding and growth in the process. 

Self-care is more than having a spa day or being by yourself for a few hours. Taking a few minutes each morning to step outside, to breath, to focus on one sense like the sounds you hear, can create the opportunity to step into your day with a new perspective. Finding what brings you joy is part of the process. Even if you don’t identify as a writer, you can find introspection with pen and paper. 

Evening brain dump:

Have a notebook by your bed and unload all the thoughts you have swirling in your head before going to sleep. This is also an opportunity for end of day gratitude or writing your intentions for the next day. 

Morning journal:

First thing in the morning, spend 5 or 15 minutes writing. It doesn’t matter what you put on that paper. You can start with, I have no idea what to write but I am going to try this writing first thing in the morning. Do this for several days or weeks and you might be surprised at what shows up on the paper. 

Gratitude/ Intentions for the Day:

I like to journal after I have showered and use what I have called my Gratitude, Yea Gina! Journal. I write both things that have happened that I am grateful for and things I intend to create for my day ahead. I started this journal after I found myself ruminating at the end of the day with everything I wish I had done differently. Since that time, I shifted to an intention mindset before going off to work as an Occupational Therapist. I was amazed that the days I struggled at work were the days when I did not take the time to write. Overtime, it became a mindset shift and even on the days that I don’t take the 5 minutes to write in my journal, I find myself either looking at the journal and speaking the intention or thinking about it. The practice of regular morning writing to start my day has carried over to a new attitude as I approach my day. I am now learning the importance of continuing this habit on days when I do not head out to work. 

Monday June 6, 2022

I AM grateful for :

Sleep

Diving healing love is flowing through me now and for this I AM grateful. Divine healing love is flowing through me and surrounding my family in a bubble of light. Thank you God. I AM grateful for cooler weather. Days at home. Going to visit Abby.

Seeing the dogs. Abby;s awesome house. Home Peace Serenity

Calm, confidence, courageous curious confident

Diving healing love is flowing through me now and for this I AM grateful.

Cooler weather

One step at a time

Calm, courageous confidence

Center and connected.

Smooth, calm confidence at work and home.

Doodle:

Have a pen and paper when you are on the phone or at any time of the day and just scribble

You don’t even have to use words. You can make pictures or just different lines and marks. In the days of taking notes while talking on the phone, I would find myself making geometric shapes or simple flowers on the paper along with the message or even when I did not need to write down a message. 

Variety of Media:

Write with chalk on the driveway.

Finger paint, by yourself!

Color with crayons.

Create a word from things found outside like sticks, leaves and grass. 

Pick anything and try it for even a week. It might lead you to a new practice you enjoy or maybe to another activity that has nothing to do with writing yet was inspired by writing. You never know what you will discover and where it will lead you. 

2021: January 18

On this day of your life, Gina, I believe God wants you to know … … that there is a Chinese proverb: Great doubts deep wisdom. Small doubts little wisdom. Never stop doubting, never stop questioning, never, ever assume you have all the answers. Having all the answers kills the question itself; renders it lifeless –and you, too… Keep looking, keep seeking. Never, ever find it all. Because when you find it all, you deny that there is more. And there is never not more.

Neale Donald Walsch

“Seams like I should be getting somewhere, Somehow I’m neither here nor there. Can you help me remember how to smile? Make is somehow seam worthwhile. How on earth did I get so jaded?”

Soul Asylum, Runaway Train

Listening to my Writing Inspiration playlist, Pushing myself to return

To return to where I belong…

Sitting at a keyboard and going within

Tom Petty knows just when to show up

Learning to Fly…

I turned 50 October 15, 2019 and it was a grand celebration at the beach with my family with a pre solo- celebration in September with my first ever, solo beach trip…and not my last.

Somehow, it is 15 months later and shit happened

Weight gain

Global pandemic

lack of writing

Obsessive Compulsive Disorder flare up in my child

work changes

Less hours, then more, then less… then more…

Stuck treating patients in their rooms, unable to use the large, wonderful therapy gym

Unemployment checks… that was nice

Who knew the underemployed could collect?

A Pandemic changes everything

Everything is always changing

But pandemic changes suck!

I don’t need more quality time with my family!

I am not living in this pseudo reality of “wow, how wonderful to have this “Excuse” to spend more time with my family and focus on what matters!!!! #$%&

I have made choices to allow me to have more time with family

Financial choices, work choices, living in a small house and driving aging cars…

My husband and I have made choices for 23 years to have quality time with our kids and to be there for them

We made those choices years ago

We didn’t need some God-forsaken pandemic to remind us what is important!

Maybe the pandemic helped you to refocus, I respect your path

But for me, it has sucked!

My youngest child has social anxiety and being around others is more challenging than academics.

Maybe today, after all these months, I can see that they have had more time online to grow friendships and have made strides in understanding friendships and this might help them in the near future to connect in person with others. I can hope…

I found myself loosing the desire to go anywhere

Content to stay in my bubble of work and home

In the beginning, I remember being excited to go to the grocery store, I choose to go rather than my husband, so glad to get out!

But that was months ago…

I have let him do nearly all the shopping.

I work my part time irregular hours at the nursing home.

And I stay home, going on necessary zoom or video calls mostly for doctor visits, for me and my kids.

Here is is, almost one year past the initial pandemic lock-down

The self-absorbed haters tried to take over the Capitol

We worry about the future, not only for ourselves, but for our kids

The optimist in me, knows somehow this too shall bring great change

All of it, the political strife, social unrest, injustice and this crazy virus and how the world has responded

Yet, I just want to scream ouch fort to the world…..

What the F#$%!

I had way too much shit on my plate before March 2020. before November 2016….

Life has to get better, somehow…

All I know to do is to write

Writing to find my inner peace and my own truth

I leave you with these words…

When the day is long
And the night, the night is yours alone
When you’re sure you’ve had enough
Of this life, well hang on

Don’t let yourself go
‘Cause everybody cries
And everybody hurts sometimes

Sometimes everything is wrong
Now it’s time to sing along
When your day is night alone (Hold on, hold on)
If you feel like letting go (Hold on)
If you think you’ve had too much
Of this life, well hang on

‘Cause everybody hurts
Take comfort in your friends
Everybody hurts
Don’t throw your hand, oh no

Don’t throw your hand
If you feel like you’re alone
No, no, no, you are not alone

If you’re on your own in this life
The days and nights are long
When you think you’ve had too much of this life to hang on

Well, everybody hurts sometimes
Everybody cries
And everybody hurts sometimes
And everybody hurts sometimes

So hold on, hold on
Hold on, hold on, hold on, hold on, hold on, hold on
Everybody hurts

No, no, no, no you are not alone

Sneaking around at 5am

I used to be a night owl

And still stay up late on occasion…

Yet, now I wake up and feel like I was out drinking the night before

I think that feeling began to happen about twenty years ago when I was 30

Since my husband returned home on November 6, after open heart surgery…

I wake up early and am eager to get up to have time to myself

Some mornings, my youngest child has fallen asleep in my room

Her anxiety often flares up at night and can quickly escalate to a panic attack and a meltdown

Snuggling to sleep with mom, helps to dissipate or prevent the meltdown

I wake up and slowly move out of bed so as not to wake my sleeping child

If my child stirs, then I stand still in the dark, waiting…

There is a sound machine we use to drown out noise

I make sure the volume is turned all the way up

I move very slowly on the hardwood floor, waiting for the ocean waves to rise

Waiting for the sound machine noise to be at its loudest before taking a step

If I make too much noise when my child stirs, they might wake up

A child with an anxiety disorder needs all the sleep they can get

An almost 11 year old child with an anxiety disorder definitely needs more sleep…

Pre- puberty… oh my

Parents worry about “the terrible twos” and teenage years…

The real challenge in parenting is the pre-puberty years

Around age 9, 10, 11

That is when the most change happens, emotionally

My other child with an anxiety disorder, had a major flare of her disorder just prior to her 11th birthday and it continued to escalate when she turned 11.

She didn’t have a birthday party that year, the year she eagerly awaited her Hogwarts letter

We would have been happy to invite her friends over as we had done every year since she was 2

Having her friends all come over for her birthday is something she cherishes

And still does at age 17

Yet, the year she turned 11, she couldn’t even touch the birthday presents we bought her and didn’t want her friends over, she was stuck in the house for months…

She doesn’t remember much about that birthday

Much of her life when her OCD, her sever anxiety disorder, was flaring its ugly head…

…Is a blur to her

Now my next child who also suffers from this sometimes crippling anxiety disorder, is a few months shy of turning 11

It brings back tough memories

We know so much more now and have so much more help in place

Yet, the worry, the fears, the anxiety about our child’s anxiety is still there…

It is now 6am and I have made it out of the bedroom with my child still asleep

I have tiptoed down our creepy stairs to get my iPad keyboard and it’s stand

To return upstairs to my child’s empty bedroom in order to write

I have not gone to the basement where my comfy chair sits..

the place where I usually write, my office to be, a work in progress

Because my husband is asleep in the living room in the recliner

He is recovering from triple bypass surgery and is more comfortable sleeping in the chair

He wakes easily at any noise

He needs his sleep as well

Recovery from surgery is a slow process…

Recovery from open heart surgery is a very slow process

I sit with a desk top light shining

I am long sitting on the bottom bed of my child’s bunk bed

There are no pillows in the room for me to lean up agains the wall

Clothes are scattered about the floor, and tissues…

I resist the urge to pick up the clothes and the tissues and all the random things scattered on the floor…

My left foot is going numb

I reimposition myself

I now appreciate time alone

I never used to understand my husbands love of early morning hours in the quiet…

While everyone else was asleep

I always said, “I enjoy late nights when everyone sleeps”

Now, I understand

Now, i value this early morning time alone

Now, I look forward to being the only one awake

This is the best time for me to write

Before I dive into social media on my phone

Before I chat with my husband, which I do enjoy

Time first thing in the morning, to talk together while kids sleep is also wonderful..

I have found peace in the silence

I have my earbuds on but have not yet turned on my music

I am alone with my thoughts in the dark silence of six-thirty am

Writing first thing is the best way to begin my day

I now can see how much better my day proceeds when I take time to write first thing

When I take time alone with my thoughts before doing anything else

My day proceeded with intention and a sense of peaceful calm

I look up and see the sun rise behind the trees outside the window

The blind is drawn up about 4 inches,

Just enough for me to catch a glimpse of the sunrise

Getting up to raise the blind, I realize my left hip is sore from sitting crossed-legged

I am reminded that my body is fifty years old

the same age as my house

The cats who sleep in our basement, meow

And I know that will wake my husband

It is time to walk quietly downstairs to feed the cats, to quiet them…

Incase my husband can still fall back asleep

Getting up early and moving quietly through my house has been well worth the effort.

Changes in Healthcare, Changes in Me

Twisted Sister sings to me as I research the history of changes in rehabilitation services under Medicare. The more I research, the more validation I am finding in my experience and opinions. And the more I feel the importance of speaking out…

We’ve got the right to choose it

There ain’t no way we’ll lose it

This is our life, this is our song…

I have worked in the “health care system” for over 27 years, known to many of my like-minded friends as the “sick- care system”.

My career has been taken over by government entities who have changed the reimbursement system for skilled therapy services for the second time in 20 years.

The insurance industry is the one who runs the show and now decides how long the patients need therapy services.

When I began my career, after graduating from a certified and well respected Occupational Therapy program at Elizabethtown College, part of my role as an evaluating therapist was/is to determine the need for skilled Occupational Therapy, set goals, monitor progress, and determine when there is no longer the need for skilled services.

I now have very little say in how long someone receives therapy services in adult and geriatric rehab under Medicare Part A services, at skilled nursing facilities where most of short term rehabilitation now happens.

Twenty-seven years ago, physical rehabilitation began at rehabilitation hospitals. Now, most people can no longer head from the hospital to an acute care rehab hospital, as the changes in PPS in 1999/2000 changed the criteria for admission to acute rehabilitation facilities pushing people to go for rehabilitation at nursing homes, with the new tittle of “sub acute rehab”.

Why did this happen?

From my perspective as an Occupational Therapist who has been practicing for 27 years and has lived through these changes, the mighty dollar has taken higher priority than quality patient care.

Sure, the people involved in establishing these changes, the branch of government now known as The Centers for Medicare and Medicaid Services, CMS, including the head of the organization who is appointed by the president, would argue that it is to stop fraud and to improve patient care.

On November 29, 2016, President-elect Donald Trump nominated Verma to serve as administrator of the Centers for Medicare and Medicaid Services, the Health Department agency that oversees Medicare, Medicaid, and the insurance markets.^[16] On March 13, 2017, the United States Senate confirmed her nomination in a 55–43 vote.^[17] One of her first actions was to send a letter to the nation’s governors urging them to impose insurance premiums for Medicaid, charge Medicaid recipients for emergency room visits, and encourage recipients to get jobs or job training.

Patient’s Over Paperwork:

Taken directly from the CMS.gov website:

Reduce unnecessary regulatory burden to allow providers to concentrate on their primary mission: improving patient health outcomes.

• CMS Administrator Seema Verma launched the “Patients over Paperwork” initiative in 2017, in accord with President Trump’s Executive Order that directs federal agencies to cut the red tape. This helps patients by allowing doctors and non-physician practitioners to focus on care instead of paperwork.

• CMS is eliminating overly-burdensome and unnecessary regulations and guidance to allow providers and suppliers to focus on their primary mission – improving their patients’ health.

• CMS is removing barriers to unleashing innovation.

• CMS is partnering with clinicians, providers and suppliers, administrators, support staff and beneficiaries to ensure we are focusing on the needs of patients.

I call “Bullshit!”

Suppliers and beneficiaries?

Is that code for health insurance companies?

I have MORE paperwork than I did 27 years ago and will have even more now with these new changes and have less time for actual patient care.

This is my favorite part of this information:

Our actions have delivered results

• Saved the healthcare system at least $5.7 billion through 2021.

• Eliminated at least 40 million hours of burden through 2021 giving that time back to providers and suppliers to spend with their patients and not on needless paperwork.

• Heard from over 2,000 clinicians, administrative staff and leaders, and beneficiaries through listening sessions and in-person visits throughout the country.

“Saved the healthcare system at least $5.7 billion through 2021”

Who have they saved $5.7 billion for?

THE INSURANCE COMPANIES!

And these changes both with PPS in 1999 and now in 2019 with PDPM have directly affected the lives of the healthcare professionals who provide these services.

There is a HUGE difference between rehabilitation services in 1992 and what is now happening in 2019.

I worked in an Acute Rehabilitation Hospital in 1992, my first job out of college. It was a great learning experience and an excellent facility. Sure, I hated many aspects of working for this large hospital system, yet I would not change beginning my career there. I left after three years to escape the strict schedule and stress of hospital policies.

I took a job in a Nursing home that had both long term care and “sub-acute care”, the new buzzword for rehabilitation services. My new job had flexible hours and a 35% pay increase. Yet, I soon found out that my role of being a skilled Occupational Therapist looked very different in this new setting and I had to spend less time being a skilled therapist and without the environment of a rehabilitation setting where the focus was on patient care and rehabilitation. And without all the necessary tools to do my job and the experienced professionals that I was surrounded by at my prior job.

I have been working in adult and geriatric physical rehabilitation since that time in various settings including nursing homes with “sub acute rehabs”, home health, and outpatient centers for assisted living and independent living residents.

When the PPS system was being developed, I agreed that there needed to be a change. Yet, the change was from one extreme to the other. The results were not better patient care, but less staff to patient ratios, a shift from quality of care to the number of minutes of therapy equating to a dollar amount, affecting not only the patients but also the staff whose job was to provide needed care for these patients.

Five years after I began working in nursing homes, I suffered a pay cut, reduction in benefits, and was shuffled to different facilities. My position moved from working 4 miles from my home with a 32 hour work week, hours reduced at my request to have time with my 2 year old child and still have full time benefits; to traveling to 2 different facilities in one day, traveling 147 miles round trip each day. I had an amazing boss at the time who negotiated some extra pay in addition to the standard pay for travel between the two facilities.

After traveling like this 5 days each week for a while, she then helped me to switch to working 4 days a week rather than 5 days to return to something closer to my “reduced 32 hour week”.

My other option, was to loose my job. Everyone was cutting staff. There weren’t many jobs to be found.

I spent 9 months searching for a new job. I eventually got a job offer for part time work in home health care which gave me more freedom in some ways but also evolved into traveling a larger area to see patients in 3 different NC counties, Stanley, Union, and Anson. I live in the corner of Mecklenburg county where it meets Stanley, Union, and Cabarrus Counties (see image below: Mecklenburg county is the pink county on far left)

Flash forward to 2019:

Over the past several months, everyone has been talking about the new reimbursement system, PDPM, Patient Driven Payment Model.

I wasn’t very worried about it, listening to my fellow therapists and co-workers “panic” and share the information they had from other employers and our mutual employer. I had gone through changes in the reimbursement system before. I have had issues with this system, and knew a change was needed. I wasn’t surprised that the change would be a pendulum swing to the opposite end of the spectrum.

For the second time in my career, my rate of pay is being reduced.

I had about a months notice for this pay reduction. 3% pay decrease starting October 1, 2019.

“This is minor compared to what I went through in 2000” I told my young coworkers.

From everything I heard, I was not too worried. It appeared that my employer was handling it calmer than other places. I felt secure because even though I am a prn employee, working on an as needed basis, I have had 30-40 hours of work lately because one full time therapist has been on medical leave. And, had plenty of hours before that happened. They needed me.

I knew I would likely have less hours. I was aware of the industry push to use less prn employees and have full timers flex hours and work weekends. This concept had affected me already at my last job less than 2 years ago.

I work primarily weekends because that his been my only semi-guaranteed way to get hours.

Because of the anticipated change, I had been working as many hours as needed while they were available. I typically worked between 15-25 hours before and now began working 30-40 hours. I had several weeks where I had to pay close attention to my hours so as not to go into overtime. Paying prn employees overtime is a big no-no in healthcare. As a prn employee, I have no benefits and so my rate of pay is higher than full time therapists. Yet, my higher rate of pay is the same prn rate as it was 22 years ago.

Flash forward to Monday, September 20, 2019:

11:16 am: I received a text saying I was not needed to come in for the 2-3 hours of work that I had agreed to on Friday. Not surprising, this happens all the time.

My reply:

OK, Hoping I will still be needed Friday with XXXXX having the day off, I had agreed to cover for her.

Working prn, my boss confirms if I am needed to work the next day. If I don’t hear, I check in to confirm I am needed to work. This has been the typical practice for years and across several employers. I have always been frustrated by last minute call-offs, but despite my efforts to change this, the best result I have gotten has been a confirmation text the day before. My current boss has been the most consistent with this practice and this employer has been my best experience working prn in a nursing home/rehab center.

I was then told that I would not be needed on Friday, And likely for the weekend as well.

There were changes that even my boss wasn’t expecting.

I like my current employer and am happy I am working for this company and not somewhere else. I share this because this is an across the board change affecting all of the Occupational, Physical, and Speech Language Therapists who work in rehabilitation where Medicare is the primary reimbursement system.

As is always the case, the need for prn coverage changes constantly and usually, how much help is needed, is not known until the day before because of fluctuations in the census.

This is good, I can now devote more time to the business my husband and I have recently started.

But wait, we are finally out of major credit care debt and I have been working extra hours to pay off debt and to build our savings.

This is good, Gina, the universe is telling you, once again, to pour your time and energy into your new business and writing pursuits.

Will I have any hours over the next week?

I have no idea.

Surely, they will need me once the census picks up.

Right?

We’ll fight the powers that be, just
Don’t pick our destiny ’cause
You don’t know us, you don’t belong

Oh, we’re not gonna take it
No, we ain’t gonna take it
Oh, we’re not gonna take it anymore

Oh, you’re so condescending
Your gall is never ending
We don’t want nothin’, not a thing from you

Your life is trite and jaded
Boring and confiscated
If that’s your best, your best won’t do

It will be ok, Gina, you can finally write more and work on the book that has been inside of you for so long.

It will be ok, Don and I have come along way with our new business and have speaking engagements set up and we are working with a business coach.

This is time to step up and dive in to a new chapter of my career as an Occupational Therapist. I can use my experience and talents in a new way and outside the healthcare system.

Caregiver Burnout

I have both personal and professional experience with caregiver burnout.

I work in adult and primarily, geriatric, rehab as an Occupational Therapist. I have worked in this area my entire career, since 1992, when I graduated from Elizabethtown College with my bachelor of science degree in Occupational Therapy.

As I wrote The word career, I had to stop. Yes, I have had a career…it sounded bizarre to me after I typed those words.

Being a mom has always been my desire and passion. Occupational Therapy is something that feels like a part of me, yet since having children, it became a job, one I had to do to earn a living and had to continue doing when my husband’s business was getting started. And over the years, for many reasons, I have been the primary breadwinner most of the time. Don and I are part of book, our story is one of 60 others in Breadwinner Wives and the Men they Marry.

I don’t think of myself as a “career woman”. I think of myself as a mom who is also an Occupational Therapist. Being a mom is my most challenging and most rewarding “job” and my favorite role.

As an Occupational Therapist, caregiver education is very important. Over the years, I have realized in geriatric rehab and especially when working with people with dementia, that caregiver education is vital. With dementia, caregiver education is not only essential but also needs to be the primary role for an Occupational Therapist.

I see first hand from the people I work with and their caregivers, the impact of caregiver burnout.

I also have been a caregiver for my husband after he suffered a near fatal, massive heart attack in 2011 and spent 12 days in the hospital and 6 months in recovery.

When he graduated cardiac rehab 6 months after his “event”, I developed bronchitis which was reoccurring for over 6 months and then was in a car accident, ironically, one year after his heart attack. I still had wheezing at the time of the car accident, enough that they x-rayed my lungs. I didn’t have any major injuries and went home from the hospital the day of the accident. Yet, I suffered from that accident for a long time. Physically, I hurt for several months and mentally and emotionally, I suffered for years.

I honestly believe my recurrent bronchitis was a result of caregiver burnout and on a spiritual level, so was my car accident. The other driver was 100% the cause of the accident, or so the police reports and insurance companies said. I have forgiven the driver, never really blamed her per se. I blamed the fact that she wasn’t paying attention fully as she drove with her 2 year old in the car with her. One of my first questions after my accident was, “Are the other people ok?”, as blood ran down my nose after getting myself out of my car through the passenger door because I thought the smoke from the airbags meant the car could be on fire. The driver’s side door could not be opened as she had slammed into me making a left turn into the front corner of my car, pushing me sideways into another car at a stop sign.

“Are the other people ok?”

I am a mother of three, a wife, a healthcare worker, a child of aging parents, a child of a parent with chronic illnesses. Did I mention they called my husband’s heart attack, “a widow makers heart attack”? The medics and ER doctors, brought him back to life.

I am a caregiver.

I am significantly injured in a car accident and my first question to bystanders is, “Are the other people ok?”

As Caregivers, we often put the needs of others ahead of our own needs. Yet, doing this over time, affects our own health. And if we don’t stop and meet our own needs, we can suffer in many ways.

I am the mother of children who suffer with mental illness.

I am diagnosed with Bipolar Depression, Bipolar II. I only discovers my diagnosis because my brother also has this illness. I suffered for years with undiagnosed depression. Undiagnosed because, to me, it didn’t look like significant depression. I knew it was depression but told myself for years that it was “mild depression”. I was still functioning. I didn’t seek help until a friend who was prompted by my husband to convince me to seek help. That was nearly 5 years ago.

I have always known the importance of taking care of myself. I used to think I did a very good job at giving myself “me time”, attending to my own physical, spiritual and emotional health. My favorite metaphor is,

We must first put on our own oxygen mask, before we can help the person next to us with theirs.

Yet, I see now how much of my energy has been invested in caring for others.

I have repeatedly said that my job as an O.T. is mentally, emotionally and physically exhausting and coming home to be a caregiver for others is very taxing. I even joke about how I wish I had become an accountant or gone into a math field, as math was my best subject in school. The thought of sitting alone with numbers all day sounds like a nice change from being a caregiver.

Caregivers care for others because they have to and also many times, because it is their nature to do so.

Many people of all ages, need a caregiver. From babies and children of all ages though aging parents, people can have needs that they can not handle alone.

As humans, we all need to care for each other.

Being a primary caregiver to someone demands our time and our energy. Giving energy to others and not refilling our own cup, is what depletes us.

For me, I need to be alone, away from the house and away from immediate responsibilities in order to recharge. After my second child was born, I began a ritual of Monday night out, writing time. I created Charlottehomeschooling,com in that time. I have written thousands of journal entries, for myself and for my children’s journals that I started for all three of them when I was pregnant with each of them. I started my bogs using Monday night writing. First Gina’s Life Journey and them Child-led Learning . I have used that time to both talk with my husband as well as work on my end for our family coaching Business, Focused Health Family.

My writing time started as a hobby, as my passion. I came home refreshed and renewed and re-energized for the other aspects of my life, for caregiving. Then it became “work” and I found myself escaping from writing during my time alone, playing online games and watching movies and TV shows. I escaped because my life was overwhelming and because distracting myself from all my stress was my way of “coping” and I thought it was recharging me.

I am here now, alone at the beach, for 3 days and 2 nights because I finally realized how burned out I had become. I also finally realized that getting away by myself was essential to overcoming my bipolar depression.

Please share your stories about being a caregiver. My blog is intended to spark a community of support for myself and for others. I would love to share other’s stories , either as a guest blogger or anonymously with my help and your permission to share for your story. I want to help others through my experience, creating a community and connecting others with similar struggles.

I am a caregiver.

Now it is time for a sunrise walk on the beach.

Sending Big Waves into Motion, releasing secrets

Relax, renew, rejuvenate and recharge, take 2.

I am at the beach all by myself. I have never done this before. I’ve been here for 6 hours and I am finally sitting down to write. It has taken me this long to settle in, move from the shock and excitement of actually being here, all by myself. And finally, focusing on here and now.

I texted and made videos and took pictures and FaceTimed my youngest, while exploring my room at the top of the resort building, while walking in the beach and pier. I felt kind of lonely when I got here. I always come to the beach with my kids or at least my husband. One time the two of us went, well, before kids, I guess we went several times. Who can remember 22 years ago before kids?

I have everything I need for my adventure, inspiring books, music, healthy and yummy food, drinks, did you know you can get wine in a can?

As I packed my bag to head to the beach to write, I realized that I forgot my Bluetooth key board that I use with my iPad. My iPad, has been my computer for a while now… years, I guess. Something else that I can’t quite remember.

I have a lap top, buried in books and papers on my desk. It is old and I used to use it often, but decided I liked my iPad much better.

I found myself responding to a post on a Facebook group, Unschooling Special Needs, earlier and it has inspired my writing today.

There are so many things I can write about. Yet, the concerns shared in the post on the Unschooling Special Needs group are so close to my heart and the reason my husband and I now have a business together helping families with challenges, especially those with anxiety issues and challenging behavior with their children.

I have Bipolar 2 Depression. My upswings, are hypomania, not full on mania (well, it can escalate to mania). Hypomania is great, highly focused, functioning and much energy! Yet, the downswing is like the riptide pulling you under the ocean water.

Helping my children with their struggles is extra challenging for me because of my struggles. I can’t even imagine what it must be like for my husband.

In three weeks I celebrate my 50th birthday. I am proud and excited to reach this milestone! Seriously, I am. With age, has common not only wisdom, but confidence, clarity, courage and healing.

I always make time to write when I have come to the beach with my family. I have wonderful memories being here with my family. And I also have memories of stress, anxiety, OCD flare ups, and the feeling of disappointment that we couldn’t just have a “normal family vacation” without the anxieties.

Here I am now, writing and also texting with my tech support son. I might have him help me locate a key pad. Typing on the iPad screen is slow.

It’s getting dark and the sound of the ocean is mesmerizing me.

When I was younger, I would never have gone somewhere like this by myself. The silence of being alone was challenging for me. I now cherish time to myself. I still love the sounds of people talking, and my music, Tom Petty and now Mary Lambert sing in my ear..which is even more beautiful with the sound of the ocean.

They tell us from the time we’re young
To hide the things that we don’t like about ourselves
Inside ourselves
I know I’m not the only one who spent so long attempting to be someone else
Well I’m over it

I don’t care if the world knows what my secrets are (secrets are)
I don’t care if the world knows what my secrets are (secrets are)

Life Detour: Hurricane Dorian rains on my parade

I was looking forward to two nights at a Myrtle Beach beachfront resort with a “limited view”. I planed this trip just one week prior to going. We have a time share and we had 700 points that would expire at the end of September. I have been working 40 hours per week as an Occupational therapist when typically I work about 20 hours, give or take 5-10.

I work PRN, as needed, and so I have no required hours but no guaranteed hours. I have not had my Monday afternoon/nights out for writing because of my working hours and fatigue after a 7-10 hour day working in adult and geriatric rehab. I love my work as an OT, yet it can be mentally, physically, and emotionally exhausting. And then I go home to my family of 2 kids living at home, husband, 2 dogs, 2 inside cats and 3 outside cats, and I have a 21 year old child and he and his fiancé now live on their own and I am close to both of them, help them when needed like to move into their new apartment last month. I love my family, they are my priority. I have learned I must take care of me in order to be there for all of them.

I can book my points – based time share online, viewing available resorts. I found 2 options for my three day stretch without scheduled work hours. One on the beach with a “limited beach view” and the other at a resort 15 minutes from the beach. After debating it, because the beachside resort would mean I use additional points, meaning less points for the spring when I hope to have a get away with my husband for our anniversary, and with the encouragement of my ten year old who said, “Mom you deserve to be on the beach”, I booked 2 nights on the beach.

I debated paying the $50 points protection fee so I could cancel or reschedule at anytime and not loose the points. I opted not to get the points protection.

Hurricane Dorian began to threaten my plans a few days ago as models predicted it’s path shifting from across central Florida to the Carolina Coast. I fretted over loosing my points and the disappointment of not going to the beach all by myself for 3 days.

My husband said, “Call and ask if you can reschedule.”

“No, I can’t. I didn’t pay for points protection.” Was my defeated reply.

Yesterday I anxiously watched the storm tracking news and updates online. I kept hoping it would disappear out to sea or even move west across Florida. I felt guilty wishing the latter, not wanting people in Florida to suffer, yet, that would mean I could still likely go to the beach.

I woke this morning feeling defeated as the weather news informed me the storm was sitting over the Bahamas as a large category 5 hurricane, the worst kind, and projected to head up along the coast, likely not making landfall, yet strongly impacting the coast.

I debated the safety of still going, as they did not predict impact until Thursday and I could always leave Wednesday if I needed to.

Apparently, I know nothing about hurricanes along the coast.

After posting on Facebook inquiring from my Carolina coastal friends and then messaging a few people for spiritual guidance for my internal dilemma, I sat on the bed and tapped, EFT, Emotional Freedom Technique.

“Call the resort!”

And so I did.

“It’s ok. We are under mandatory evacuation and have to clear out by noon today. You won’t loose your points.”

She was friendly despite the urgency of evacuating the resort within 5 hours. I asked some more questions and discovered all I needed to do was call the time share company tomorrow, today is Labor Day, and I could reschedule or cancel and not loose my points by just telling them there was a mandatory evacuation.

Relief.

No decision to make.

I decided to not let Dorian “Rain on my parade” and decided I would make other plans.

I can choose to not work the next three days. Sure, it is easier to say “No” to last minute requests to work when you are out of town, but I can also choose to not work. I have scheduled work hours for Friday and Saturday this week and had just worked a 5 day stretch: Thursday through today, Monday, Labor Day.

I had told myself, I can happily work though the long holiday weekend, knowing that afterwards I would be off for 3 days and at the beach all by myself!

Much needed respite and rejuvenation for a busy mother of 3 with writing goals and career pursuits outside my current job. Did I mention I homeschool my kids? And my kids and I have anxiety/ depression disorders.

I needed to get away!

I worked today and decided to think about other options for my three days, talking with co-workers and my patients to share my challenge and also gain other ideas and confirm outloud my intention to be off work and “on vacation” for the next three days.

I live in a beautiful city, Charlotte, NC, located 176 miles from Myrtle Beach, a three hour drive. The weather has been beautiful and cooler than usual the past few days, mid to upper 80s, down from the mid to high 90s we had for most of July and August.

I enjoyed being home after work with my family and had time with my kittens who have been quarantined to the basement for a few days, after finding some fleas on them.

I debated my options for the next few days and chatted with my husband. I wanted to make a plan and not let the next three days slip through my hands. My husband remained onboard for giving me vacation time and planned to take care of things, asking only to take our youngest to a therapy appointment Wednesday morning at 10am rather than take her with him to several of his business appointments.

“It is Monday night, I can go out to a coffee house and have me time to plan.”

I ate a quick dinner and packed my writing tools and planner book, and “don’t forget my headphones!”

I arrived at the coffee house where I first had time out for a writing club meet up and had first spent time writing. I used to write with colored pens in notebooks, because I did not yet have a laptop. The place was rather empty, yet it is Labor Day.

“Are you still open until 10?” I inquired.

“eight”

It was 7:45. I debated what drink to order and then sat outside at the picnic tables to decide what to do now. Google search. Amelie’s is open 24 hours, I recalled seeing it on my phone. Wow, they have many locations now.

I looked up the original location, not far from where I was and checked to confirm the hours. I called them. The recorded voice stated, “We are open 24 hours 365 days per year.” I could not connect to a live person.

24 hours, 365 days a year

They will be open!

I followed Waze to drive there, because I like the certainty of following a map app.

I realized it was taking me near uptown, Charlotte has an “uptown” rather than a downtown.

I checked to see if that was the best way to go.

The sun was setting and I was enjoying the drive with my sun roof and windows open, my hair blowing, listening to loud music on Spotify.

I love this city. It is beautiful and such a beautiful night.

Oh yeah, and I love “uptown”! The city life with tall buildings, sidewalks for easy pedestrian travel with a all kinds of people bustling about. My route took me skirting the beltway that circles our small yet rapidly growing downtown/ uptown.

I had already had the thought to spend one day, taking the new light rail into the city, and now finalized the idea to spend a day uptown at a coffee shop to write.

I love the skyline of a city and with the clear Carolina blue sky at sunset tonight, it was breathtaking.

Take a picture of it!

I was almost off the beltway but was able to capture one tall building in the sunset as I was stopped at the light at my exit.

I love the beach, my first choice destination, yet I can find beauty in other places and inspiration to write.

I have overcome another obstacle in life, finding peace and light in the detour.

I spent my life trying to answer to the voice inside my head
But all I found were empty questions from a time that I forget

I learned my lesson, it was wrong of me to look so far ahead
I’ll count my blessings one by one, I’ll live a life I won’t regret

And now I finally see the future’s right in front of me, yeah
And now I finally see the future’s right in front of me, yeah

Nothing at All

I have the thought to get outside and exercise.

I have the thought to work on that crochet project I started months ago, or maybe years.

I have the thought to spend time with my husband.

I have the thought to work on a project with my 10 year old, something we had talked about, for a while.

I have the thought to eat healthier, reduce my sugar intake, drink more water…

Intention

Yes, there are times when I intend or even plan to work on one of these things.

And sometimes even the desire to be more engaged in my life.

Energy

Convincing myself to get out of bed in the morning

….to get to work

…to get to an appointment

Getting up from bed

Moving forward from distractions, Stuck playing a game on my phone,

So that I can:

Get in the shower

Drive to work

Begin my work day

Convince the patient why he needs to participate in therapy

Manage my time

Get all the patients seen

Finish the required paperwork

Focus and manage my time

Convince myself to see the “difficult patient”

Who is…

Very overweight

Requires 2 people to get out of bed

Doesn’t like therapy

Doesn’t care about getting better

Is too confused to care and locked in anger

Talks so much that I have to find a way to move forward with their actual participation in therapy

Repeats everything that has gone wrong, over and over

Figuring out how to listen to them, acknowledge their feelings, and help them move on… Long enough to participate for 45 minutes, or 65 or 72 minutes

Focus and finish my paperwork for the day in a timely fashion, whatever that is

Get the computer to connect to the internet

Find a computer

Find the therapist assistant who has been seeing the patient so I can write a progress note, a recertification, or discharge paperwork

Figure out what the patient’s discharge plan is so that I can include that in the paperwork

Gather my things, walk to my car and

Drive home

Gather my lunch bag, purse, phone to go into the house

Arrive home to a child wanting to tell you everything that happened or share their problems from the day, repeating them, repeating with more emotion, fighting with their sibling

Listening to my spouse…..

• Fill me in on the days happenings
• Talk about what needs to be done
• Ask me to put my things away
• Tell me what I need to do tomorrow
• Ask for help with making dinner
• Say his goodbyes as he heads out for an appointment

Gathering the energy to…

Get up from the couch in order to….

• Feed the dogs
• Walk the dogs
• Prepare dinner
• Get up from the couch after resting
• Find food for dinner
• Make dinner
• Clean off the counter
• Clear out the ants scattered around the counter full of crumbs & dishes from the day
• Talk to my child about eating, helping

Anticipating my spouse coming home

• Worried about the mess in the kitchen
• What I fed the children for dinner
• The lack of vegetables at dinner
• Seeing the look on his face when he sees me sitting on the couch
• Knowing I should have gotten more done
• Wondering why I didn’t get more done
• Beating myself up for not….

Getting myself ready for bed

Remembering to take my medication, my supplements that are supposed to help me

….deal with day to day life

Helping my children…

• Find a snack to eat
• Be motivated to get ready for bed
• Cope with their anxiety at bedtime
• Brushing their teeth
• Redirecting them from obsessive and intrusive thoughts
• Provide a calming environment for them to go to bed
• Apologize for loosing my cool
• Apologize for not listening or playing the game together, like we talked about
• Apologize for not helping them start their bedtime routine sooner…

Reviewing my day in my head and wondering why I did not get more done, be more productive at work, finish sooner at work, spend time with my children

Hearing my alarm go off and wishing I did not have to go to work.

Do you or your loved ones struggle with depression, anxiety, or bipolar depression?

I know sharing my story has helped me. We need to look at our stress before we can move on from it.

I used to think my struggles weren’t serious depression because after all, I managed to get basic things done. It took me a while to seek help for myself….and for my children.

When we are struggling to get through each day, it multiples the challenge of helping our children with their emotional stress, mental illness, behavioral issues.

My psychiatrist recently referred to my bipolar 2 as mild.

It doesn’t feel mild to me.

For many people, they go through their day like these tasks are nothing at all.

I want to break free

Queen inspires this post

I want to break free of old patterns.

Of old ways of surviving

I want to return to thriving,

To living life rather than getting by

I lived in a world of highs and lows

I lived in a world of depression and hypomania

I learned to survive that way

I pushed through the depression and got through the days

I thrived in hypomania, found my true self and prospered

I knew even when I feel, that I could bounce up again

Now we have taken away the upswing

“You are high functioning with depression”

that is w hat my doctor said

Maybe if you compare me to others

But to me, I feel barely alive with my depression

I feel like I am struggling to get through

I may look like I am functioning

But am I?

Is spending hours each day on phone app games and streaming tv functioning?

Missing appointments and not following through with phone calls from doctors

Wanting to exercise but not doing it

Wanting to engage more with my family, but not managing to do more than discus television shows

Making a step forward every once in a while

And then not making steps forward for a while

Being emotionally withdrawn even from myself

Not writing

And not doing what I love

To me that is

not functioning

I make it to work, most of the time

Until I get sick and getting better is extra difficulty

I eat meals and manage to be sure everyone get fed, with my husband’s help

My husband helps a lot…

Grocery shopping, cleaning, home maintenance, getting kids to places, taking care of our pets

Growing our new business and continuing his practice

Today, I made a phone call.

I got a hold of my son’s doctor to straighten out a prescription.

I have many more things on my to do list

My should have gotten done weeks ago…list

I need to take it one small step at a time

I made that phone call this morning

It was even still morning

Tomorrow, I can make another phone call.

Tomorrow, I can write another blog

Maybe I can write my way into a new life

Nothing else has worked long enough to keep me going more than a few months

I can try this

I can write

Words Not Spoken: 6 months after his heart attack

Powerful writing from November of 2011, 6 months after my husband’s heart attack.

His heart attack was May 4, 2011 and I wrote this 6 months later the week after he was finally discharged from outpatient cardiac rehab.

It was the beginning of recurrent bronchitis that lasted for over 6 months and then I suffered a car accident and the wheezing was present as the medics checked me out on the scene of the accident May 26, 20112.

I left this post as it was to show my mental state as I typed…

The original title was:

What I need to tell the head of Case Management (at Presbyterian Hospital)

You gave me a case manager who listened to my story. She sat and listened and heard me out when I was looking for help early on in the process.  Yet this same person who sat and listened, told me she would follow up on several things and get back to me and she never did.

She also told me things that are not true. She told me we would have been better off with no insurance because then someone from social services would have come and helped me fill out a Medicaid Application. Well part of that is true, someone might have come and done that had that been the case. But what she failed to tell me was how important it was to file for Medicaid right away and she failed to tell me the simple rule for NC Medicaid that you can’t have more than $3000 in money at the end of each month (after paying bills)…that is the best I can describe the “law” not having seen this any where in writing but only after finding out months later that because we had IRS tax refund money in our checking account, it disqualified us from Medicaid until the money was effectively gone.  We lived on that money for several months to pay our basic expenses while my husband nor I was working.

I am just warming up. That is just the tip of the iceberg at their lack of discharge planning and family education and effective “case management”.

Or maybe that just means that they have brief cases that they carry around and take care of.  Do I sound bitter and resentful?

Hell yes!

I have every right to be because I

I AM A HEALTHCARE PROFESSIONAL

My job as  healthcare professional is in part to assist people with being ready to return home or to whatever setting they are returning to and to ensure they will have the assistance needed when they return home.

Ok

first things first

Our lovely Case Manager

who so comforted me in my time of need- but then failed to follow through-

(I am trying to see the positive here)

She then comes to us very late in the day, after the doctor discharged him around 10 or 11, after we inquired and then the nurse got to us, right after lunch I believe.

Mind you, the only help I had at home, was my mother who had been at my house all week, returning after being with us the initial 3 days until my sister-in-law arrived.  My mother was tired, she had been taking care of three intense children and my episodes of panic or crazy blood sugar due to insufficient nutrition- or whatever it all was- stress

So, we have spoken to the doctor and the nurse for discharge and the nurse keeps informing us that we are waiting for the social worker.

I must add that a few days prior, I had called for the social worker, after the first one failed to follow through and come back to talk to me.  It was Monday or Tuesday when I spoke to her and their was no sign of her Friday. So it might have been Saturday when I called and this other social worker came and spoke to us.  I remember wishing she would be the one who came for discharge.  But no, it was not.  So sometime after 4pm, the social worker shows up and begins the conversation

mind you my husband suffered a severe heart attack, was in CCU for 4 days and then the step down cardiac unit for 8 and was on monitors the entire time we were there. When he was finally able to get up and move around well, it was the weekend and I had to throw a fit to get Physical Therapy come see him on Saturday, knowing it was very possible he would be going home Monday and his doctor was off for the first time since we’ld been there and wouldn’t be back til Monday.  His replacement was a Jackass who spoke inappropriately to the nurses (my husband’s description) well, he didn’t call him a jack ass, I did because he walked in, I wasn’t there, and looked at my husband and said, well, it doesn’t look like you’re going any where anytime soon.  This was Saturday morning after his doctor had led him to beleive the day before that he might very well go home Monday.

The next day, he had apparently talked to my husband’s doctor and was much more on the ball with what was going on with my husband and more appropriate, at least with my husband.

Nurses, apparently learn how to ignore the jackass doctors because, well, doctors are not known for their personalities.

Remember, I have worked with doctors, so I know first hand.

So now that we are all agreed that the guy was a jack ass

Oh yeah, my husband wasn’t allowed off the unit, not beyond the square around the nurses station in the small step down unit at the end of the hospital surrounded by vacant hallways due to a remodeling project because it was the weekend, and they would have to clear it with the doctor, have an order (everything needs an order)- I wonder if they need orders to speak kindly- you know, jack ass is the default mode-

anyway, so my fit to have him come off the unit and be wheeled to a new floor to get out of the room he had been for 8 days, unlike my fit to get PT to see him- guess I knew how to play my cards better with that department or maybe cause therapists generally aren’t jackass.. cause once someone called them, they came that day and the next,

so

Now,I am beside myself because it looks like I might be bringing my husband home on Monday and it is Saturday afternoon but I won’t know until I show up at 8:30 Monday morning and sit around and wait for the doctor to come in- cause that is the only way to be sure to be there when he comes to see my husband, is to show up at the earliest possible time that he might come for rounds.  It was 6:30 when he was on CCU.  And then the nurses tell me really I should be there earlier like 7 just to be sure.

So he has been on continuous cardiac monitoring the entire time he is here, all 12 days with frequent checks of blood pressure and pulse and oxygen saturation.  And we can’t leave his unit but in two days, they might just send us home-

with home health care because I insisted on it-

And that is another story, because the lovely social worker, never notified the Home Health Company that he was discharged and so they did not know to come out to the house and the they are supposed to be there within 48 hours of discharge.

How do I know this? Because I have worked in home health care.And so the home health nurse came 2 days after he was home, because I called the agency and I let them know he was discharged

BECAUSE  I DID HER JOB

Put me on payroll please

So back to the hospital when the social worker finally comes into the room after we had been waiting all day

NOW I do understand that case managers or social workers or whatever you call them, are way overworked because I KNOW DAMN WELL THE EFFECTS OF THE CUT BACKS ON HEALTHCARE.

This issue is not so much how long it took her to come but the information she brought to us when she finally did come.

She started her conversation off with us something like this

and it has been 6 months and a blur and I now understand what she was doing but at the time, I had no clue.

She came to us and said,

“OK you can get this medication at these places and this medication at these places”

And she had these long lists, not that she was giving us any list, I don’t recall that she did.  Maybe she did.  And she went on and on and I was like, what the #%!?

I knew I needed a prescription for 5 days until we could get Med Assist (local agency for assistance with medications when you don’t have medicaid) but little did i know that I really needed to go and apply for that while he was still in the hospital.  Like I had time for that between advocating for my husband, caring for him, being there for him and then being with my children in what little hours were left of the day/night.

So I had no idea, it took 5 days from approval and that they would look at our income and base an entire year of income on 1 month of my prn pay checks where I was working more than twice the hours I normally do. The increased hours were temporary while another OT was on maternity leave.  No idea that would be the policy. Because, did you know the entire support system like Medicaid is set up based on people who work for an employer full time or at least regular part time hours.  There is no consideration for prn pay (which is higher than normal pay because you have no benefits and NO guarnteed hours- I have lost a week of work because of being prn- thinking I would work 40 hours one week when they didn’t need me for that and ….I digress

I like being prn- but if you need help form the system, you are screwed.

Just to be clear, I have been sick with some kind of upper respiratory thing, and today I have heard what I believe is whezing and I feel like I am going to cough up my lung.  Well, grief is processed in the lung.

And for some crazy reason, when I try to sleep, I have been relieving 6 months ago and my husband’s blue face and the whole freaking experience.

Maybe I am finally REALLY FEELING IT ALL AND FINALLY REALLY GRIEIVING.

My husband was discharged from Outpatient Cardiac Rehab this week.

Hmm….

Coincidence?

I don’t think so.  Just now realizing that one….

…and it is still sinking in….

ahh, other stories to tell.

Back to.?

Ah yes, the lovely discharge with the Case Manager on May 16, 2011.

So she is talking about all these places to get medication to get the $3 rate and how I can go to more than one pharmacy to get them all and I was like

?WTF?

I GUESS I THOUGHT THEY WOULD SEND US HOME WITH MEDICATION

It was getting late, my mom had my kids and was going to bring them to the hospital and was going to be heading home from there and  I would be driving home my husband, now off all monitors, with our three children, ages 2, 9 and 13 to be alone at home and manage everything.

While he was in the hospital, my family and friends had pretty much taken care of all meals and grocery shopping and all the laundry.

So I am worried about my husband having another heart attack or something medical when he returns home and worried about helping him recover while taking care of our intense and 2 out of 3 very high need childden.  And she is taking to me about saving money for 5 days worth of medication.

so I think I cut her short once we figured out we could just get 5 days worth of medication from the hospital pharmacy and then be on our way, but the pharmacy closes at 5 and we had to hurry.

I don’t really remember what happened next, with the case manager

I just remember the long wait at the pharmacy and the not so friendly pharmacist and the other person who worked there-

shame on both of them, they work in a hsospital, they need to be nice to people!  Everyone else, mostly was very nice including housekeeping staff and kitchen staff- but oh, not the pharmacy.

So we get the expensive medication that I had to pay for then.  You would think it could be on our bill….but no, WE WERE DISCHARGED AND ON OUR OWN!

It wasn’t until Wednesday that I could get to the Med Assist office, when a friend was able to come stay with my husband, and turn in the paperwork and then it was at least 5 days before I found out, maybe longer that we didn’t qualify, just over by like $1800 per year- due to the above mentioned prn pay checks for one month that they multiplied for the entire year even though that was grossly inaccurage and even though they had our 2010 tax return showing our income was less than half of what they calculated.

So This is why I contacted the Head of Case Management. I got the name and number while I was in the hospital before the discharge fiasco and before they failed to notify the home health agency.  And I called them from home and they called me back.  Mind you I was now home with a husband who got dizzy if he stood too quickly, had only just begun walking around on his own a few days prior and was out of breath with the slighest amount of activity and three children and despite us all holding it together while he was in the hospital and doing “well”, thing were challenging coming home.

NO BODY TALKS ABOUT THAT

The COMING HOME after the Heart Attack

They assume, he lives, he does well, he goes home, yeah!

NO one realizes how much harder it really is, going home.

I tried to tell the nurses at the hospital….

The Case Manager, I don’t know that I got the chance, I did share some of this with the second one, who came to us just that once.

BECAUSE I HAD SO MANY OTHER THINGS ON MY PLATE

I never did get to speak to the Department Head at the Hospital.  I left a detailed message and she called back and maybe spoke briefly to my husband because I was not home.

I think I need to send her a letter.

So I don’t leave anything out.

I could send this one, but I might need to remove a few jackasses and the like.

I am adding a note:

I don’t think I coughed once the entire time I wrote this.

It didn’t even occur to me til after i finished writing it and I realized my breathing seamed silent and my chest felt better- from not coughing so much.

The lung processes grief.