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Showing posts from November, 2012

NHBPM #29: Shout out

Today is shout-out day, as one of our favorite partner organizations, The Great Bowel Movement, just revamped their website. I wrote a review of them a while back and now they are one of the 2012 Top-Rated non-profits list! Check it out: http://greatnonprofits.org/awards/browse


Their new website http://thegreatbowelmovement.org/ is a great resource for patients who have Inflammatory Bowel Diseases like Crohn's or colitis, and they've got all sorts of helpful links listed as well as as support group directory. Things like GI doctors, mental health resources, nutrition info, blogging resources...and the list goes on! This organization has come up with creative ways to eliminate stigma, with the "Flush Secret" postcard program, and Flush Mob street team awareness mobs. All in the name of normalizing an not-so-glamorous illness and empowering others to tell their story. It all begins with a conversation. By buying a shirt or mug or button with your illness on it, it can b…

NHBPM #28: These Times Are A-Changin'

I came across this story today about a department store using an obese mannequin and the subsequent discussion that took place online about this move.  Other than the mannequin having a freakishly small head, I had mixed reactions to this news.


One person cited said that she was happy to see this because the way clothing fits a smaller mannequin didn't accurately reflect how it would fit a plus-sized person.  I can understand that as being a positive.

Others decried our society's movement toward greater acceptance of obesity as a new norm, as being overweight is associated with poor health and skyrocketing healthcare costs.  I can understand this point of view as well.

Another stated that stigma toward obesity isn't the same as stigma toward race, gender, or sexual orientation.  Presumably because of the commonly-held  belief that being overweight is controllable and a result of poor choices.

Having worked with many obese people, I know it's a much more complex issue …

NHBPM #27: Betcha Didn't Know...

When you go off to therapist school, one of the things you're taught is how to keep boundaries with your clients.  If you think about it, therapy can be one of the most intimate relationships between 2 people.  Yet it's also a professional relationship that will inevitably come to an end (and that's a good thing!).  Ask any therapist how much they tell clients about themselves or their personal lives and you'll get a myriad of responses.  Some are very open, which in my opinion isn't a very wise choice, and some are very very closed, which I also don't necessarily agree with.  I lie somewhere in the middle, and it varies by each person I work with.  A therapist sharing information about themselves with a client requires a lot of thought because the ultimate question is "If I tell my client this about myself, will it help them?"  More importantly, though, "If I tell my client this, will it do them any harm?"

With that, I thought I'd shar…

NHBPM #26: Steph's "more than 24 hours in a day" entry

I know that Tiffany just posted about what she would do if there were more than 24 hours in a day, and I loved it so much, I had to chime in. (Warning- I copied a few of hers) The good news is that when I ponder this question, I realize how many interests and passions I have that are life-giving. The bad news is that they can get put on the back burner easily if I am not intentional about them.

1) Travel more- I love traveling and have been to Africa twice, backpacked all across Europe, and am determined to hit all the continents eventually. I'd love to go to Australia/New Zealand next.



2) Write a book. I'd love to write an auto-biography, as I have a plethora of stories from this adventurous life of mine. From getting bit by one of my special education students in CPS, to picking up hitchhikers on the way to the grand canyon, to working as the drive-thru girl for a summer...I've got stories to tell.

3) Take a ceramics class. I did this in high school and would love to lea…

NHBPM #24: More Than 24 Hours in a Day?

First off....Jeez, our posts are all out of numerical order.  Steph and I are back from traveling this long weekend, so we're back on track to finish out the NHBPM challenge.  I do have to admit that this is bugging my OCD-tendencies for symmetry.  I'll just go line up some Skittles by color before eating them to feel better...


So, what would I do if I had more than 24 hours in a day?  I didn't think this post would be as challenging as it's turning out to be since most days I feel like life is on perpetual fast forward, especially since having my daughter.  I also wear many professional hats so I need to divide my time and attention across running our practice, seeing my clients, teaching graduate students, and being an IT consultant (yes, you read that last one correctly).  Nevertheless, I feel a Top 10 list coming on for this post.


10.  Read more books, especially in the history and biography genres.   I have a copy of Walter Isaacson's Einsten biography that I&…

NHBPM #25: Goals

*This is our final week of NHBPM blogging which has been a real challenge to us! Despite vacations and business trips and holidays, we have stuck with it and hope you will continue to read. That being said, things are busy, and our posts may be shorter! 

How have your goals as a patient evolved?
My goals as a patient have changed over the years. For a long time, my treatment goal was to just find a set of doctors who were all female. Since I was suffering from a chronic illness that was personal, I didn't care who treated me as long as they were female. This could not be further than my view now. My goal and priority is to have a treatment team who specializes in my illness, has both the intellectual strength and people skills, regardless of gender. This was a big shift for me, and happened gradually over time. 
I also vividly remember being petrified of surgery. I would do everything remotely possible to avoid it. I wouldn't say that now I am excited to pursue surgery, but I loo…

NHBPM #22: Giving Thanks

This would be the Thanksgiving post for NHBPM, aptly prompting me to come up with a list of things to give thanks for. I'm a bit late with this because I'm away from a computer and it only dawned on me this morning around 5:45 that there was probably a Blogger app for my iPad that could circumvent the issues I was having trying to use the actual website. I'm not a Luddite, I swear. I hope you all had a wonderful Thanksgiving.

On to the thanks!

Speaking of technology, I'm thankful for "the tubes," "the interwebz," "the information super-highway" - whatever you want to call what brings many of us together via social media. I remember the first time I saw the Internet. I was in college (yep), it was Netscape Navigator, the background was grey and there were no images. It's really amazing the tools we have today, and for these I'm thankful.

I'm thankful for my partner-in-crime, Steph. It's a blessing to work with a pers…

NHBPM #23: It could be worse

Ahh, perspective. Today I was reminded of the big picture as I was stuck dwelling in the little picture. You would think it was some huge revelation that came to me, as I work with adult cancer patients all day and have many conversations about life and death as part of my work. But instead, it was the simplest thing. I have a friend who is going through a similar illness to mine, and she is suffering so, so, so much worse than me. As I listen to her updates and hear her symptoms, it is a wonderful reminder to listen, validate, and pray for her suffering to end. It is also a wonderful reminder to look at my current frustrations with my illness and put things into perspective. My current dilemma is that I am in a wedding tomorrow and I have a barely functioning immune system. Not only did I have surgery recently so I won't be dancing, but I also had the joy of getting bedbud bites while at a hotel a few weeks back. This leaves my arms red, itchy, and scabby for the past 3 weeks. Lu…

NHBPM 21: Self-talk and "The Mean Lady"

"Be kind. Bereallykind and gentle with yourself."
This is a quote I keep on my nightstand so that I can be reminded of it when I go to bed and when I wake up. Its pretty simple, yet something I so easily forget. I consider myself a pro at being kind and considerate to others, but when it comes to be compassionate with myself, I've got a lot of room for improvement! So where is the disconnect? 

I've noticed its all in the way I talk to myself internally, in other words, my self-talk. And you know how Tiffany and I are always talking about cognitive distortions and cognitive-behavioral therapy? Welp, we fall into mental traps as well, even though we teach others about avoiding them! One of the biggest sources of negative self-talk, is who I have termed "The Mean Lady."  
The ironic thing is, there wasn't a real "mean lady" in my life that the messages seem to be based on. It just seems that sometimes my internal dialogue happens to sound like a …

NHBPM #20: Don't get upset, Mr. McMurphy

A couple days ago one of the prompts for the NHBPM was "I want to change THIS about healthcare..."  There are many issues with our healthcare system, and I don't claim to be an omnipotent being in understanding their intricacies nor their solutions.  And as we know, opinions are like...you know, and everyone's got one.  But if I could wave a magic wand and change one thing about healthcare, it'd be the state of affairs in mental health services for the poor.

I was born at the end of 1975, and the winner of the Best Picture Academy Award that year was One Flew Over the Cuckoo's Nest.  Jack Nicholson won Best Actor as McMurphy, an ex-con who opts to do time in a mental hospital in the 1950s rather than prison, and Louise Fletcher won Best Actress for her stellar performance as the much-hated Nurse Ratched.

I would love to say how much progress has been made in caring for people with more serious mental illness in the United States since we caught a glimpse in…

NHBPM #19: Things I'm Thankful For...

Yeah, yeah...Thanksgiving isn't until Thursday, but its the week of Thanksgiving, and I have a lot to be thankful for.

1) Living in a nation with plentiful toilets. For anyone with digestive issues, it is a blessing to not have to pay for public restrooms. The only nation I am jealous of is Japan!


2) Family- It sounds so trite, but my family has been there through all the ups and downs, the medications, the surgeries, the appointments...I truly don't know what I would do without them. 

3) A great treatment team- its taken me a while to assemble my cast of characters, but I feel confident that I have a brilliant set of professionals who are helping me manage my symptoms and live life to the fullest. 



4) Friends- Similar to family, I have been amazed, time and time again, at the quality and quantity of friends in my life. Sometimes they come out of the woodwork, and sometimes they are the tried and true ones that have seen me through all my years of illness. I feel honored to ha…

NHBPM #18: Advice for Caregivers

Steph and I spend a lot of time helping the "identified patient," which is medical-ese for the person living with the chronic illness.  Most of my research has focused on the patient experience, with the exception of 1 study I recently published on mothers of children with eosinophilic GI diseases (EGIDs).  A lot of research has been done on caregivers, with a mix of studies on parents of children with illness and adults caring for their aging parents.  No matter who is being cared for, we know this:  being a caregiver is stressful.

In my study, we found that the #1 predictor of mothers' stress levels was their own mental well-being.  Those who reported more anxiety or depression also reported feeling more stressed about being a caregiver.  Makes sense, doesn't it?  When our mental health isn't doing well, we are less equipped to handle stressful situations.  Anxiety taps a lot of mental energy if we're spending time worrying rather than problem solving.  D…

NHBPM #17: Tiffany's Playlist

Yesterday we got a great list of music from Steph that she relates to life with a chronic illness.  I have to say that I love that Sam & Dave are on her list since The Blues Brothers is the best movie of all time.

Today, devoted readers, you get a glimpse into my musical psyche.  I love music and turn to it whenever life may be dealing a fistful of lemons.  Here's a mix of songs that I tie to not only dealing with an illness, but also embracing health and wellness.  And they're pretty damn catchy, to boot. In no particular order:


Strange Condition - Pete Yorn Dry the Rain - The Beta Band The Underdog - Spoon The Boxer (Cover) - Me First & The Gimme Gimmes Who Needs Sleep? - Barenaked Ladies Help Yourself - Sad Brad Smith Live Your Life - T.I. Under Pressure - Queen / David Bowie The Dog Days are Over - Florence + the Machine The Cave - Mumford & Sons

NHBPM #16: Steph's Playlist

I am jumping ahead to tomorrow's suggestion for health blog posts and posting my health playlist. This is inspired from a few dear hipster friends who make me amazing mixes each time I am sick. All of the songs fit the theme of illness in some way and are either raw or encouraging if you going through a flare. Enjoy! I've even included the YouTube clips in case you want to try them out. Feel free to add your favorite songs as well in the comments!


Steph's Health and Wellness Playlist Catch My Disease- Ben Lee We Are Okay- Joshua Radin Heart Skipped a Beat- The XX Blood Bank- Bon Iver Red Right Ankle- The Decemberists Blue Lips- Regina Specktor Stronger- Kelly Clarkson Hold on, I'm comin'- Sam and Dave Just a ride- Jem Get Better- Mates of State Breakable- Ingrid Michaelson Timshel- Mumford and Sons O-O-Child- The Five Stairsteps Three Little Birds- Bob Marley

NHBPM #15: Why Social Media?

Today's post is on why healthcare professionals should venture into the world of social media. When I started this private practice with Tiffany this year, I had no idea what it would entail. I just assumed that patients would find us by word of mouth, and line up at our door!



Little did I know, but I was about to learn a lot about marketing. No matter how good you are as a therapist, it is vital to know those in your community and also let them know what you are doing as well. Not only will you reach your target audience better, but they will reach you! The best and quickest way to do that is to get online. The Internet can be an intimidating place if you are not familiar with it. I suggest to start small and then work your way up- baby steps.


Tiffany and I started with a website, then chose to get a Facebook page as we already were both familiar with the site and had many friends with chronic illness we know on Facebook. Once we got comfortable with Facebook, we added Twitter, a…

NHBPM #14: Negative Feedback Loop

Today's topic is how to handle negative feedback in your community.  When we put ourselves out there, especially on the web, there's a certain, inherent vulnerability to that action.  Online there's an added layer of anonymity where people can react to you in very negative ways and you have no idea who they are.  That's a much bigger issue of communication changes in the age of Facebook, Twitter, blogs and email, but what do we do when we receive negative feedback?  I have a few strategies that I try to use:

Stop and Assess.  You've read a comment and you're feeling angry/offended/upset.  Before doing anything, think about why.  What buttons of yours might be being pushed?  What are your thoughts about the feedback, and are they realistic?  Are there alternative interpretations to your initial reaction?  Often, when something someone says (or writes) makes us have an extreme reaction, it's hitting a nerve that may not even be directly related to the current …

NHBPM #13: Book Report

Book Report: At the Will of the Body: Reflections on Illness
By Arthur W. Frank

This was a book recommended to me by a good friend with a chronic illness, who is inspires me on my own journey making sense of illness. This friend is very talented, and uses her creative spirit to help get through even the toughest times including stays in the hospital. She actually has an Etsy page where she is an expert crochet craftwoman, and makes things as creative as colons to give to those suffering from ulcerative colitis. Needless to say, she is a very interesting person, so when she recommends a book, I read it! She told me to start out with an author, Arthur W. Frank, who is a Canadian professor, psychologist, and someone who has gone through serious illness. In the book, "At the Will of the Body: Reflections on Illness" he writes about his experience going through a heart attack and then cancer. The purpose of his book is not to give advice on how to cope, but rather as a narrative to…

NHBMP #12: I Call B.S.!

Today's NHBPM topic is an extra fun one:  Call B.S. on something.  A few things come to mind, but the over-arching theme is the lack of attention that is paid to mental health in the context of physical illness.  Has it gained some recognition in the past decade? Yes.  But we are so far from where we need to be.  Many factors contribute to this slow progress, and I'm going to call out a few here.  I'm also going to comment on the "Functional/Organic" illness divide that I've seen in medicine, and how these conditions are often perceived by others.



It's B.S. for many physicians to dismiss the psychological and social issues that go hand-in-hand with a chronic medical diagnosis as less important.  Not all do, and there are some who embrace this relationship.  But in my experience it's not yet the norm.  Yes, it's beyond the scope of their training, it's uncomfortable to talk about, and it can push them over the small 15-minute window they have …

NHBPM #11: Captions!

Today's topic is to re-caption an anatomy picture to reflect how you see your body.  So I took a slight spin to this and created one of those "What People Think I Do....What I Really Do..." memes for a clinical psychologist.  Cheers!


NHBPM #10: LOL post (belated)

*Sorry about the delay in this post- it was meant to be for 11/10/12, but was stuck in drafts!

When you counsel so many people with health issues that revolve around digestive problems, you get used to talking about poop. Many people in our culture find this subject taboo, embarrassing and some find it downright hilarious. Thanks to our friends at The Gutsy Generation (CCFA Canada)  we had to share some of these silly photos/someecards which made us laugh. Sometimes laughter is the best medicine!





As therapists, we use humor with caution. Each client is different with where they are in their journey and how sensitive they may be to joking about issues that are affecting them. It's a great outlet for some, and we encourage our clients find the humor in their everyday life, and share it with others, as it can decrease the stigma they may be feeling. To end this post, I'll post a few pics for other non-IBD chronic disease patients. 




NHBMP #9: Losing a Client

Today's topic (Ok, yesterday's but I think it's still yesterday in Hawaii so I'm getting in just under the wire) for NHBPM is to post a detailed description of a memory.  Since Steph and I are writing about our experiences as people who work with those living with chronic illness, our entry is a little different.  When I thought about what memory to write about, 2 of my previous clients came to mind - those who had died either while I was seeing them or shortly after we'd finished.  I'll call them John and Joe.

When you learn how to do therapy, you study different theories and do some role playing in your classes.  You sit in and observe your mentors doing initial interviews and maybe a session or 2, but overall it's like being thrown into the deep end of the pool when you're 6.


John was maybe my 2nd therapy client.  He was in his 60s, in a tenuous marriage, had a daughter who he was estranged from, and a former oil rig worker.  He came to me after h…