Category: #multiplesclerosis

Wednesday Wonderings … How can I know if my medications are working?

November 3, 2021

Have you ever wondered if the medications that you are taking or someone that you love is taking are helping you, hurting you or even working at all? Have you ever wondered if you are having an unexpected reaction or side effect to your meds?

What is pharmacogenomics?

Pharmacogenomics is the study of how genes affect a person’s response to drugs. This relatively new field combines pharmacology (the science of drugs) and genomics (the study of genes and their functions) to develop effective, safe medications and doses that will be tailored to a person’s genetic makeup.

This definition is from the U.S. National Library of Medicine

Basically, your genes affect how and if certain medications are metabolized in your body. And why is that important? Because you need a medication to be therapeutic (to do its job well). Some drugs, called prodrugs, are inactive when administered (taken) and then they are metabolized into the active form to provide benefits. What happens if you cannot metabolize that medication into its active form? It will be like taking water. It won’t do anything because your body cannot change it into its active form. What if you take a medication and your body rapidly metabolizes it too quickly? You will not get the benefits of an Effective therapeutic dose. You are burning through it too quickly. What happens if you metabolize the medication very slowly? It can build up inside your body and cause more and more problems along with more intense side effects. Most medications are metabolized in the liver and excreted through the kidneys.

Metabolism, liver, kidneys, liver enzymes, excretion rates, inactive and active metabolites, metabolism rates, phases of metabolism, blood flow, changes in liver volume, etc. all of these things come in to play. What I want you to know is that you can find out how you metabolize certain medications and you and your doctor can decide what medications are best for you and your particular needs. You can also find out if you need more or less of a certain medication. Do the test once and use the information the rest of your life.

What are some of the benefits to having this test?

Helps your doctor find the medications that may work best for you

Helps you to know which medications to avoid

Helps you to know which medications dosage may need to be increased or decreased

Severe drug reactions can be reduced or eliminated

Stops the trial-and-error method that usually takes months to see if it helps or not

May help decrease opioid dependency

May increase pain relief

Bothersome side effects may be decreased or avoided

Do it once and use the information the rest of your life

Who can truly benefit from this test?

If you have been diagnosed with:

Depression

Anxiety disorders

Obsessive-compulsive disorder

Dementia

Autism

Insomnia

ADHD

Schizophrenia

Pain

Lipid disorders (high cholesterol)

Alzheimer’s disease

Parkinson’s disease

Multiple Sclerosis

Breast cancer

Epilepsy

Cardiovascular disease

Asthma

HIV/AIDS

Autoimmune disorders

Check-out the Medications that are impacted by your genes.

To see the medications list, go to WWW.EmpoweringHealthOptions.com

Click on the Products tab

Go about midway down the page and click on the blue bar that has the RightMed® Medication List

**Remember, some physicians prescribe medications for off-label use, which means they are using it for something other than what the medication is approved to treat. **

My own experience with pain medications has led me to encourage others to take this test. I had arthroscopic shoulder surgery in the early 1990’s. They sent me home with Percocet® (Oxycodone and acetaminophen) and Phenergan® (promethazine). I get home, ice and take my medications. I am out like a light in about 45 minutes. Now, I had never had any type of pain medications before and I don’t remember having any anti-nausea medications as an adult. After two hours, I am apparently whining in my sleep. I am awakened and I am hurting, but I am so sleepy. The promethazine is kicking my ass and I cannot wake up. The pain is fairly intense. Over the next 24 hours I am taking my pain medications as directed and only taking half of the promethazine. I do believe that the only thing that was helping me was being knocked out by the promethazine. I called my doctor and told him that the Percocet® was not working. He told me that was the strongest that they have. I know that’s a lie, I am a pharmacist. I understand that doctors are concerned about drug seekers, but hell, I just had surgery the previous day. He called in Tylenol#3 (acetaminophen and codeine). I took that and guess what? It did not work either. I knew that I was screwed and would have to deal with this on my own. I iced, I breathed deeply and I took a half a tab of promethazine every 8 hours and Ibuprofen 800mg every four hours. I am thinking that I never ever want another surgery in my lifetime! After about 5 days, I could stand it. Then came physical therapy. You do what you have to do. I cannot imagine what I would have gone through if I had anything other than an arthroscopic surgery.

As a pharmacist I knew that not every medication worked for every person. We all knew that; we just did not know why. We knew it had to be something inside our body make-up, but what? We knew that when Ultram® (tramadol) came out that it worked for some people and it did not work for others. I believed people when they told me that certain medications were not working for them, and I would have them ask their doctor to try X, Y, or Z. Just because something is “supposed” to work does not mean that it does work for all people.

Funny how when we don’t really have the answers, that we tend Not to believe it could be happening. We doubt the person and not the medication. Well, no more! Now we know that some medications are impacted by our genes. I now know that I cannot metabolize Percocet®. My body cannot metabolize Tylenol#3® nor can it metabolize tramadol. They are pro-drugs which means they need to be converted into the active form inside the body in order to work. So, I was taking sugar pills for my body. I have a genetic “defect” for CYP-2D6. But, by God, I now know what will work for me and the dosage that I will need. I have the tests to prove it for all the skeptical physician’s worried about drug seekers. My primary care physician has a copy of it in my records and now I tell them to call him for the results, if they want.

So, if you are going to have a planned surgery and you don’t know what pain meds work for you, it might be worth it to have this test. I know that it is expensive and it is going up after the first of the year (in 2022).  Only you can decide what is of value to you. It was valuable information for me and I can use it the rest of my life. No more waiting and hoping. No more wondering for months on end. No more wasting money and time. 

Have you been diagnosed with depression? Have you been started on a medication? What did your doctor and pharmacist tell you? Hopefully, they told you to take it at the same time each day, do not miss doses and give it 3 months. You do. It doesn’t seem to have helped very much, maybe a little. You return to your doctor and he or she takes you off of that medication and you begin again with another medication for 3 months. Nope, this one is not helping and you are now dealing with sexual arousal dysfunction. You return a third time, maybe or you stop going back and just suffer. You are 6 months down the road with no real results to speak of. Six months of your life that you will never get back. You tell me, what is that worth to you and your family?

Are you a chronic pain patient that want the best quality of life possible? Let’s find the medications that will work for you and not wipe you out. Let’s find the right combination to help you to get back to living. I know that you will not be pain free, but you have every right to expect it to be manageable.

Everyone deserves the best quality of life possible for them.

Do it now, before the price goes up in January 2022.

Most HSA’s and Flexible Spending plans allow coverage for this in-home test.

Pat

The 5 different types of metabolizer status are described below.

  • A person who is a “Poor Metabolizer” for a medicine will process that medicine very slowly. The medicine might not work if it is processed slowly, or it could put them at risk for side-effects.
  • A person who is an “Intermediate Metabolizer” for a medicine will process that drug slowly, but not as slowly as a poor metabolizer. This means that the normal amount (or dosage) of certain medicines may not work for them, or may cause side-effects.
  • “Normal Metabolizer” for a medicine usually benefits from the normal amount (or dosage) of the medicine. This means the metabolizer status does not put them at increased risk for side-effects.
  • A person who is a “Rapid Metabolizer” or “Ultrarapid Metabolizer” for a medicine can process the medicine very quickly. A medicine might not work if it is processed very quickly, or it could put the person at risk for side-effects.

Wednesday Wonderings … When we are faced with ‘No” good choices, how do we decide?

October 27, 2021

Right, Wrong, Good, Bad – those are the words we use to describe our decision-making choices. What makes a decision right or wrong? What makes a decision good or bad? Yeah, I know, it’s like porn. You can’t describe it, but you’ll know it when you see it.

A decision that is right for you may be wrong for me. A decision that is good for me may be bad for you. Hang on, here we go… Your perceptions and life experiences are your guides. Your gut feelings are tied in to past experiences and results. Sure, we all like to think that our decisions are made with great care and a lot of thought. Wait, I need to throw my bullshit flag.

Hear me out before you take your toys and go home. All of us have unknown biases. All of us have tunnel vision on certain issues. All of us hate the idea of even making a “wrong” decision. It is one thing to make a wrong decision for ourselves, but let that decision affect other people that we love and that piles on the stress, pressure and worry. I never want to hurt the ones that I love. I always want to make the best decisions possible. I especially want to make the right decision when it affects those that I love.

How can we make the best decision possible when we don’t recognize our biases? How can we make a good decision when we really don’t know what good resources are? To me a good resource is a trusted resource. A trusted resource often educates. A trusted resource is NOT an advertisement. Use the CRAAP test. See the bottom of the article for a worksheet.

Facts are Facts. You don’t have to like it. Truth on the other hand takes in to consideration you own views, beliefs and ideas about a subject and sometimes you throw facts in the mix. Unknow biases. Question why you believe what you believe. Be skeptical. Can you accept what you have thought or believed most of your life could be wrong? How did that last word “wrong” make you feel? We do not want to be “wrong” ever! Change the word “wrong” to incorrect and see how that makes you feel. Can you accept that your friends and families’ beliefs and opinions may be incorrect? I am able to accept that I am incorrect. I am not inclined to believe that I am wrong. I get defensive if I am “wrong.” I can’t stand to be wrong! That is why I will do my research from trusted sources. I may not like what I have learned, but at least I know the facts and I can then figure out what will work best for me and my loved ones. Find three trusted resources and read the information using the CRAAP test information.

Be open to learning something new. Be curious. Let yourself ponder and think. We try to control the outcomes with our decision-making. Have you heard the phrase, “trust the process?” Why do people tell us that? Because we cannot control the outcome. We can only do our best. Sometimes, it is making a decision with the information that we have, right now. We may need to change our decision or update as we learn new information. That is okay. When we know better, we do better.

What happens we are faced with NO good choices? What do we do? How can we decide?

We make the decision that we will regret the least.

Get rid of the “should.”  Every time that you say or even think the word “should.” Stop and change that word to “Want.” What do I want? How do I want things to go? What do I really want down the road? Take time to think. Think through your options. Brainstorm and don’t dismiss anything, right now. You can pare down later. Are there compromises or alternatives?

  1. What are your values, wants and needs?
  2. Talk it through with a good listener. Tell them you are talking and you just want them to listen.
  3. Maybe you need someone else’s perspective (maybe someone who has been in a similar situation).
  4. Test out the decision in your mind. Go all the way through. Remember, you cannot control the outcome. How will this affect me in the short=term, in the long-run?
  5. Doing something always beats doing nothing.
  6.  Listen to your gut. Your intuition is important.
  7. There is not right or wrong decision, only what is best for you and your family.
  8. When all of the choices suck, which one will you regret the least?

Choice overload will cause you to not make a choice. Paralysis by analysis is a real thing. Too much information will keep you on the indecision wheel. Find 3 choices by doing your research with trusted resources. Realize that decision fatigue happens to all of us. Making tough decisions takes a lot of time and a whole lot of energy. You will second guess yourself. Go with what you know and not how you feel once you have made your decision. Accept that there will probably be trade-offs. Know what your values are. What is important to you.

Very few decisions can’t be changed or updated. Try to find a “both/ and” decision rather than an “either/or” decision.

Sometimes you will have to make a decision that you will regret the least. Be kind to yourself.

Pat

The CRAAP Test Worksheet

Use the following list to help you evaluate sources. Answer the questions as appropriate, and then rank each of the 5 parts from 1 to 10 (1 = unreliable, 10 = excellent). Add up the scores to give you an idea of whether you should you use the resource (and whether your teacher would want you to!).

Currency: the timeliness of the information………………………………………………………………………..

• When was the information published or posted?

• Has the information been revised or updated?

• Is the information current or out-of date for your topic?

• Are the links functional?

Relevance: the importance of the information for your needs…………………………………………….

• Does the information relate to your topic or answer your question?

• Who is the intended audience?

• Is the information at an appropriate level?

• Have you looked at a variety of sources before choosing this one?

• Would you be comfortable using this source for a research paper?

Authority: the source of the information……………………………………………………………………………

• Who is the author/publisher/source/sponsor?

• Are the author’s credentials or organizational affiliations given?

• What are the author’s credentials or organizational affiliations given?

• What are the author’s qualifications to write on the topic?

• Is there contact information, such as a publisher or e-mail address?

• Does the URL reveal anything about the author or source?

Accuracy: the reliability, truthfulness, and correctness of the content…………………………………………

• Where does the information come from?

• Is the information supported by evidence?

• Has the information been reviewed or refereed?

• Can you verify any of the information in another source?

• Does the language or tone seem biased and free of emotion?

• Are there spelling, grammar, or other typographical errors?

Purpose: the reason the information exists……………………………………………………………

• What is the purpose of the information?

• Do the authors/sponsors make their intentions or purpose clear?

• Is the information fact? opinion? propaganda?

• Does the point of view appear objective and impartial?

• Are there political, ideological, cultural, religious, institutional, or personal biases?

Total:

45 – 50 Excellent | 40 – 44 Good

35 – 39 Average | 30 – 34 Borderline Acceptable

Below 30 – Unacceptable

Created by Juniata College

Wednesday Wonderings … How to rest, relax and recharge without taking a break?

October 20, 2021

It started out as a few hours a week. An afternoon here. An evening there. A Saturday or two. You handled whatever arose. No big deal. You love them and it was manageable. It happened so slowly that you did not even realize that you became a caregiver. You were helping out. Funny how when we are in the big middle of stuff that we do not realize how long it has been nor do we have any idea how we got “here.”

“Here.” Hmmm, where is your “here?” Think about it for a few minutes. How long ago did it start? What did your life look like then? What does your life look like now? How many different things are you juggling? Partner, spouse, kids, work, career, friends, community activities, church functions, or even your own health care needs? How many things and people have you neglected?

Are you a caregiver that feels you must always be on call? Are you a person that feels you must always be reachable or be close, just-in-case? It isn’t just caregivers that feel that way. I have found that if you are or feel you are responsible for someone or something you think that you “need” to be available and ready at all times. You must be Superwoman. You must be Superman.

When you feel that way and act that way you have no freedom. You have no down time. You have no “me time.” You probably don’t have much family time either. It sucks. You want to rest, relax and recharge. You want to turn off your brain and just chill. You don’t want to be tied to your cellphone. You want to go out to eat with your family. You want to enjoy sporting events, plays and church. You want to enjoy those around you. But, how can you do all of that? How can you do that and be “on call?”

You can handle most anything, for a while. It is the continued drain on your time and energy that will wear you out. Have you figured out how to rest, relax and recharge without taking a break, yet?

You cannot rest, relax and recharge without taking a break. A mental break and a physical break are required. You will feel guilty. Accept that you will feel guilty. Don’t ask for permission from the person you are caring for. Take a break BEFORE you are so worn out that it takes you a week to recover. Even four to six hours once or twice a week is better than nothing. It would be best if you could take one or two days off every week.

Can other family members help? They probably will if you tell them a day and time. Do not leave it up to them to decide a day and time because they won’t. It is not mean or ugly to have a day or time picked out. If they truly cannot, go on to the next person. Keep going. For some, it may be easier to have a set time or day every week. You may have to hire outside help. I get it, it isn’t cheap. What is your physical and mental health worth? You can always check-in on the care giver/companion.

If your loved one has a dementia, like Alzheimer’s disease you may have to be subtle with adding in-home help. You may need to use other words and phrases. Do not use “Sitter.” You may not be able to use the word “caregiver.” You may have to use “your helper around the house, or help with meal prep, even help with light housekeeping.”

Other emotions may pop up too, so don’t be surprised when shame or fear show up. If you are feeling resentment, anger or burnout you NEED a break NOW. When your “give a damn doesn’t give a damn anymore,” it is past time for time away. Caregiver fatigue and burnout are very real and they can lead to your own set of illnesses.  I want you to take care of yourself. Breaks and time away help you to be an even better caregiver.

However, if you notice these signs of caregiver burnout, it’s time to take your health seriously and give yourself a well-deserved break:

  • Feeling “trapped” or hopeless
  • Losing patience or compassion for your loved one
  • Overreacting to small accidents
  • Resenting or neglecting your loved one
  • Withdrawing from your personal hobbies and friendships
  • Oversleeping or not sleeping enough
  • Overeating, not eating enough, or eating a lot of high-sugar foods
  • Having health problems
  • Abusing drugs or alcohol
  • Having thoughts of suicide
  • You are impatient with your care receiver
  • You are making mistakes (medications, appointments, etc.)
  • You feel lonely
  • You have snapped at your care receiver
  • You feel exhausted most of the time
  • You are bored
  • You are experiencing memory problems
  • You are experiencing signs and symptoms of depression
  • Your own relationships are declining

Design a plan that works for you and your family. What are the needs and who can fulfill them? Take some time to think.

What do you need? Be specific. Three hours off twice a week? 24 hours completely away? A regular day or night off to be with your spouse? A night off to be with your friends?

What does your loved one need? Meals prepared? Laundry? Shopping? Personal care? Haircut? Daily walks? Help with medications? Companionship? Light housekeeping? Taken to doctor appointments? Yardwork?

Who can pitch-in? Tell everyone what is needed. Have a sign-up sheet. Have a day in mind, but try to be flexible, Maye they can’t help on Wednesday, but they can help on Thursday.

Sometimes, you may have to have a family meeting or as I like to call them. “A come to Jesus meeting.”  If you find some family members unwilling or unable to help…help them write a check for respite care or handle some of your things at your house that needs to be taken care of while you are away from your own home.

Look online for Respite care in your area.

Look at in-home care, non-medical for companion care.

Check out your local area’s Office on Aging.

Search for Adult daycare facilities in your area.

What are the benefits for taking a break from caregiving?

It can prevent you from having an emotional breakdown.

It provides you time to take care of your own personal business.

Having other people ready to take over should you become ill or have to be away.

It may provide you with a different perspective.

You are better able to make necessary decisions when you are clearer headed.

You will decrease your stress, which will improve your own health.

You get to re-engage with your own spouse, partner, children or friends.

You will be a better caregiver and manager for your loved one.

You catch up on rest.

Pat

Wednesday Wonderings… Am I broken?

How do you know when you are broken?

September 22, 2021

What was the first big obstacle that found its way right in the middle of your path? You know, the one that kicked your ass. The one that made you doubt everything that you though you knew. That situation that you did not think you would survive. You got a punch to the gut or maybe a rabbit punch that you did not even see coming. It happens to all of us.

How long do you need to catch your breath and get your legs back under you? Yes, you got knocked down and it hurts. You waller for a little while or a long while, but eventually, you do get up and move forward again. It is only when you stay down and waller that you feel broken. Notice that I said, feel. We all know that our feelings can lie to us. Our thoughts mess with our minds too. Just who is in charge here? You learn to go with what you know and not how you feel. It is simple but it is certainly not easy. You keep having conversations or fights inside your mind.

Nothing that you try is working for your loved one. Doctors are not helping. A decline is happening and you don’t know what to do next. One thing after another keeps piling on. Your shoulders can’t take much more and your knees are beginning to buckle. What do you do next?

If you are smarter than the average bear, you take a time out, rest and recharge for two or three days and then look at things with fresh eyes. Maybe you call a meeting of the minds and brainstorm for options. Maybe it is time to call Pat and get a plan of action with options to access when you need them. Yes, that was a shameless plug for my services.

Making decisions under stress is a set-up for failure. Sure, it may work for a few days or even a week, but eventually, you will be dealing with a much larger problem and much more stress. Managing by crises is exhausting and you never get rested. When you are under abnormal stress your body dumps cortisol and the other stress hormones. This dumping of hormones activates the fight, flight, freeze or fawn types of reactions. You cannot physiologically make a rational decision. Your brain has been hijacked. You can make a decision or choice but it will not be a rational or logical one. You are really reacting to a perceived danger and will do whatever it takes to feel safe in the moment.

Regret. The feeling that you feel about 30 minutes to an hour later. You find yourself trying to reason out what in the hell has just happened and what is going on now? Oops! You don’t have the time to ponder that. Something else needs your immediate attention. Off you go. Your brain has been hijacked again because of another stress hormones dump.

Why do you feel broken? Have you failed at something? Are you beating yourself up for either making a mistake or not having good information? Are you just exhausted and running on auto-pilot? Maybe, you feel that you are only existing. You are not in control of anything and you cannot seem to get a handle on things. This expands to your whole life. Everything is running together and there are no clear boundaries anymore. Overwhelmed is what you are. You are not okay. You are grieving. You need permission to not be okay. Will you allow yourself too not be, okay? Will you tell someone that you are not, okay? Will you accept yourself as you are or will you still fight it? Will you let yourself feel your feelings? Yes, be still and feel your feelings and emotions without judging them. Let them be how ever they are. It is one of your body’s defense mechanisms to protect itself. You don’t have to solve anything, right now. Now is the time for accepting yourself just as you are. Maybe you feel broken because you are heartbroken.

Crap is changing and we do not like change. It is hard to change. It is hard to accept change. Acceptance of what is, right now, is one way to begin moving forward. If you have ever lifted weights, you know that it is hard to build muscle. It is painful. It is time consuming. You must give the muscle rest for it to grow and get stronger. It is the same way for us as care givers. We must learn new things. We must accept things that we do not want to accept. We must rest, accept and recharge to get stronger.

Sure, you can fight feeling your emotions and fight changes and even fight accepting things as they are now. You can stuff that shit down. Eventually, all that pressure will keep building up and escaping as a little steam (ranting and raving) until you are completely overwhelmed and explode leaving a damaging and sometimes un-survivable blast radius (relationships, job, friends, kids).

Tips for being more resilient:

Get more comfortable not knowing everything. We all want to know “why?”. There are times we will never know “why?’. Always wanting to know “Why?” will keep us stuck. When there is a feeling of being stuck, you will not move forward. Carl Yung says, “What we resist, persists.” So, stop resisting and learn your lesson, then move on.

Can you find some joy in what you are doing? Do you know “your why?” Learn to refocus on what truly matters. Learn to refocus on who really matters. You learn that you don’t have to give in to every whim of your feelings. Feelings can change quickly.

Feeling broken is an illusion. We have biases both known and unknown. Our feelings will lie to us and our emotions will fuel our beliefs. Our beliefs are linked to our perceptions of what is or what should be. Our beliefs determine how we interpret and feel about the events that happen in our lives. I don’t know where I read this or heard this, but it seems to be true. Once we form our beliefs, our mind has a natural tendency to search for the evidence to prove them right. It is not what happens to us in our lives that creates the experiences that we have, but it is our beliefs about those events that have happened. Basically, you can change how you view stuff if you challenge how and why you believe what you believe. Stop telling yourself, “I am broken,” “I can’t,” “I will try.”  Every time I hear the phrase “I’ll try,” it reminds me of the character Yoda that says, “There is do or do not, there is no try.” I also heard it from a counselor that stated if you say “I’ll try” you are giving yourself a way out. So, do it or don’t do it.

When your give a damn, can’t give a damn. Find three things that you are grateful for every day and write them down.

Become more aware of when you are susceptible to feeling broken.

You are tired.

You are frustrated.

You feel nothing.

You begin beating yourself up.

You feel the “woulda, shoulda, coulda’s”

You feel shame, guilt or anger

When things become uncomfortable, you shut down.

When you feel some of these things, remember your goal or set a new goal. You need something to focus on. Something to bring you back to center. I am not saying stuff your emotions, I am saying do not let them get in control and hijack your brain.

Responsibility and discipline. They can be scary words and even scarier to accept and work on.

You are responsible for yourself and your own feelings. No one can make you feel anything, you get to decide. Discipline is when you decide what you will or won’t do.

You may be a little bent but you are not broken so stop trying to “fix” yourself. You just have some feelings that you need to deal with. Set a small new goal. Be consistent and achieve your goal. Keep going. Set another goal, and another and another. Keep growing. Keep getting better and better. Stronger and stronger. When you get knocked down, take a breather and get back up and move forward again. You don’t go back to zero, you begin where you left off. Give yourself permission to let go of old hurts. Give yourself permission to let go of the need to always be in control. Fuel your body with good nutrition. Hydrate. Move your body. Have compassion for yourself.

Pat

Wednesday wonderings … What 3 things will help you feel more in control as a stressed-out care giver?

You are running around, feeling like a piece of taffy being pulled in six different directions at one time. Pulled by your job, pulled by your partner, pulled by your kids, pulled by your loved one that needs help, pulled by your own home chores, and pulled by your social obligations.

Many of us have felt that pull, with no end in sight. You are handling one problem after another and they aren’t crises, they are just everyday stuff. The mundane stuff even. The yard needs to be mowed, the car needs an oil change, this kid needs to go here at 6 and the other one needs to be there at 6, you need to make a hair appointment, there is a doctor’s appointment that you need to attend with your loved one and you project at work is coming due.

If you are a control freak, like I am, then you must have a plan and work the plan. There is no room for additions or changes to said plan once the plan has been figured out and ready to be implemented. It does not matter how well you have planned the who, what, where, when and how…something always arises to throw a monkey wrench in the works. Oh hell, now what am I going to do?

First, you have to determine where and when this monkey wrench will have to go in the plan. Is there a place or a workaround? If yes, then we are still good to go. But what if the monkey wrench blows up the plan? We scramble. What can we drop or pass off to someone else? What can we change or delay? All of these thoughts are running through your mind and you are running through the scenarios with the possible outcomes. You are also pissed that your plan is being messed with. You get madder and more frustrated by the minute.

What else is running through your mind? Be honest. If my brother would just help out more (or even a little), things would be so much easier. If my sister was not such a drama queen, we could work together and things would be so much easier. Why am I the only one taking care of this and making sure it gets done? I have a big project that I am working on and I do not have time for all this extra work and stress. Dinner? What do you mean, what is for dinner? Pizza Hut delivers, that is what is for dinner. Hey, where is my uniform? Did you wash it? The dog peed on the floor. Can you help me with…? All of these thoughts are running through your mind. You don’t realize that your mind is going 90 miles an hour. Why would you, your thoughts have always run through your mind. But now, now it is different. They are more than just thoughts. A lot more. They have become situations. Situations that have consequences and must be dealt with.

What makes the thoughts different? You have more responsibility. You know that you will have situations arising that will require you to make choices that have a real impact on someone else’s life. It is not easy to explain this to others that have not experienced it. Even if you did explain it, they still would not understand it. For other’s that have experienced it and gone through it, no explanation is necessary. They get it. It is true all relationships are different, wants, needs, and feelings are different. No one will ever know how you truly feel or what you are going through personally. They can’t, they are not in your head, they have not had the experiences that you have had. They can empathize and they may even tell you that they know how you feel. Most of the time what they really mean is, “I know what I went through and I know what you are going through.” They mean well and they are truly trying to help. Our own relationships and our own experiences shape us in to what we are today. I can only look at things from my perspective when I was dealing with my mom and Multiple Sclerosis and my dad as primary care giver. I can only see things that we went through individually and as a family. I cannot imagine not loving your mom and wanting to help in any way that you can. I cannot imagine not being able to speak my mind and disagreeing with my mom or dad and that being okay. Other folks cannot do that, they are not allowed to express their opinion.

I did work with a family that did not really care about their mom. They were in two other states and their mom was in a third state. At first, you think that they do care what happens to their mom, but the more you talk and ask questions the more you find out that they want their mom taken care of, up to a point. That family did not want to be bothered with coming in to see her or to do what was best for their mom. They did not want her needs to impact what they wanted to do in any way, shape or form. I did my job and made the recommendations for their mom and did what I could at the facility she was in (she had great caregivers at the assisted living facility) to provide the mom with the best quality of life possible. I decided that I would never work with a family that did not love or care about their family. If you love them and want the best for them, then we can work together. Does that mean you have to be the “hands-on” caregiver? No, not at all. It only means that you love this person and want them to have the best quality of life possible for them. I am not a hands-on care giver; it is not in my wheelhouse. I am not good at it. I am good at managing and deciding on the care that you need and want. I am much better at visiting, talking with them, going out to eat and being with them than I am providing the hands-on care of bathing, dressing, and all of the other activities of daily living.

We do chase a rabbit or two, don’t we?

What are the three things that would make your life easier when you are a care giver?

  1. Adaptability
  2. Flexibility
  3. Good information

adaptability

uh-dap-tuhbil-i-tee ]


the ability to adjust to different conditions or circumstances https://www.dictionary.com/browse/adaptability

Are you able to adjust to different conditions or circumstances? Think back to the monkey wrench being thrown in to your plans. Ho do you react when things do not go according to your own plan? How do you respond? What goes through your mind? 

Do you have a sinking feeling? A woe is me, awful feeling? Your plans have unraveled. How could this happen? Everything was set up and planned.  Do you try to regain some type of control over the situation? Try to find a way to fix it? I know that I do. I try to fix it, for I must be in control. Look at all the negatives that this monkey wrench has caused. That son-of-a-bitch! (That is my favorite curse word phrase.)  How long does it take you to stop looking at the problems that monkey wrench has caused?  Fifteen to twenty minutes or much longer? Some folks get stuck and fixate on the negative consequences the monkey wrench caused for days. Do you have the luxury or time to be focused on the imploded plan or would you be better served by working on a solution? Asking “Why?” will always keep you stuck. Ask “How do we move forward?”, will get you unstuck.

Recognize that some things are beyond your control. I know that this is hard. I also know that when I stop railing about what happened or what went wrong, I am able to figure out a solution and maybe even a newer much better plan You don’t have to like it. You cannot exert your will over something that you have no control over. Look up the definition of insanity.

Get a grip and look at the overall picture. Is everyone still alive? Then, all is well. All will be well. Take a few deep breaths and tell your thoughts to shut up. You have work to do and your pity party is stifling your ideas.

What is the next opportunity? Okay, this got all screwed up and maybe you feel defeated. Your feelings can and will lie to you. Thoughts are just thoughts until you attach some kind of meaning to them. You do not have to act on thoughts or feelings. Take a few minutes and let your fight, flight, freeze or fawn settle down. Well, it will actually take about 30 minutes for it to really settle down.

Plan implosions or detours can sometimes work out better than what we had originally planned. If you are optimistic and at peace you know that things will work out. You don’t always have to know the how. Sometimes you have to trust the process. At all times you have to trust God to provide you a peace beyond all understanding.

Practice adaptability. It is not natural and it will take effort, but once you learn it you will be less stressed and more in control of your own reactions and responses.

flexibility

[ flek-suhbil-i-tee ]

the ability to bend easily or without breaking:

the quality of being easily adapted or of offering many different options:

the ability and willingness to adjust one’s thinking or behavior:

https://www.dictionary.com/browse/flexibility

Have you heard the phrase, “Be like a willow, bend but don’t break.”?  You may feel like you are dealing with so much stuff that you are about to break and those types of platitudes may actually cause you to break. You don’t have to break. You will, if you do not make some changes in your life. You see the three definitions above. Are you willing to make some changes in your own thinking and behaviors? Are you willing to take care of yourself physically, mentally and emotionally so that you can be a productive, able-bodied caregiver? Or are you going to stay as you are and be completely miserable?  Being a care giver does not have to be awful. Being a care giver does not have to wreck your life. Being a care giver can be a blessing. It is not easy, but it may be worth it. Most of the time you cannot change the situation, but you can change your attitude.

Manage your stress. Do not suppress your anger, rage or resentment. Deal with those types of feelings in a healthy way. You always have choices. You will feel distressed. You will always wonder if you are making the right decisions. Try accepting the situation as it is. Just because we accept the situation as it is, right now, does not mean that we don’t seek solutions and better ways of doing things. I will never give up on a person. I will always do my best to find doable and workable solutions for them to have the best quality of life possible as well as the whole family. Along with accepting things as they are, what can you be grateful for? It is hard to train our minds to find the positive things or things we can be grateful for. Our minds automatically go to the worst-case scenario or to the “problems.” Pay attention to what your thoughts are at certain times of the day or when you have a headache starting or a lower back pain issue. Do you find yourself thinking about all the “bad things” that may happen or all the ways things can go wrong? Have you noticed that the worst things rarely happen?

What makes you desperate? Pain? Uncertainty? Pressure to make a decision? Inability to find good information? Not having a strategy? Unable to evaluate the plan effectively and make necessary changes?

Good information

We all suffer from information overload. TMI. What is good information? How do we know it is good information? Is it relevant to our situation?

You can find most anything online. How do you qualify it as good information? How do you find reliable sources? Public libraries have good databases that you can use. A reference librarian is of enormous help.

Use the CRAAP test.

Currency –      When was the information written or posted?

                        Has the information been revised or updated?

                        Is the information current or out-of-date for your topic?

                        Do the links work?

Relevance –     Does the information relate to your topic or answer your questions?

                        Who is the intended audience?

                        Have you looked at a variety of sources before determining this is the one you

                        will use?

Authority –      Who is the author, publisher, sponsor or source of the information?

                        Are the author’s credentials listed?

                        Are the credentials legitimate?

                        Is the organization legitimate?

                        Can their qualifications be verified?

                        Is there contact information available?

Accuracy –       Where does the information come from?

                        Is the information supported by evidence?

                        Has the information been reviewed?

                        Can you verify the information in another source or from personal knowledge?

                        Does the language or tone of the article seem biased or emotional?

Purpose –         What is the purpose of the information? To inform? To sell? To teach? To

                        entertain? To persuade?

                        Do the authors or sponsors make their purpose and intentions clear?

                        Is the information fact, opinion, propaganda?

                        Does the point of view appear to be impartial and objective?

                        Are there political, ideological, cultural, religious, institutional or personal biases?

So, you see…” They said and I heard” are the two biggest liars in the world.

Pat

Wednesday wonderings…When is it time to deal with stuff and when is it time to ignore stuff?

September 8,2021

When to deal with it. When to ignore it. When to fight about it. When to take a break.

You have seen the t-shirts or maybe you have even said something like this …

It’s all fun and games until…Someone loses a weiner. (Feel free to add your own line.)

                                               Someone calls HR.

                                               Someone loses a nut.

Being with and dealing with someone who has a chronic illness such as depression, multiple sclerosis, Parkinson’s, Alzheimer’s, or migraines is all fun and games…at first. At first it is easy to do your work job, your house stuff, your play time, school stuff, church stuff, and all kinds of other “stuff.”

Eventually, more is needed of you. Your time, your efforts, your energy. Suck-it-up-buttercup works for a while. Then the demands on your time become draining. Do you take a time out and rest? Do you take a couple of days to recharge? No. You keep doing what you need to do. What you have to do. I get it. You want to be there for them and help them. You do love them and want the best for them. But…

Eventually, there is always a “But…”

Take three minutes and assess where you are in the care giving cycle, what is going on with your work, your family, your responsibilities, your care receiver, your physical needs, your mental needs, your emotional needs?

If you haven’t found your “but,” then either you are new to this or you won’t let yourself think about it. You can compartmentalize and stuff things down, for a while too. You put your job in one box. You put your personal stuff in another box. Another box has your care giver duties in it. Everything has their own nice little box and never are the boxes to leak or burst open and mix with the other boxes. Sure, you have everything under control, until you don’t Shit happens and at the most inopportune time. No matter how secure your box is, there will come a time when you will have to deal with all of it. How do I know? I have done it myself. I pushed things down. Ignored things and people. Yelled at work. Ranted and reaved at home. For minor things. Silly, little things. I didn’t know, at the time, that my boxes were leaking. I didn’t realize that I was very short tempered. I didn’t realize the damage I was doing to my techs who worked with me. I didn’t realize that my boys were becoming scared of me. Imagine how it feels when you do realize all of those things and more. The apologies you have to make. The rebuilding of trust and security for the boys. The knowledge that nothing will ever be the same. Even with forgiveness, no one forgets. I did do better, when I knew better. I wasn’t taking care of my needs. I had to put myself in the mix to rest and recharge to be able to help my dad who was the primary caregiver to my mom.

Should you always deal with a situation when it arises? My personal preference is, yes, deal with it now. If it were only that simple. If it only involved me, it would be simple. It does not just involve me. It involves three other people. Dammit. Now we have to discuss it, think about it, discuss it some more and then there is always someone with an objection.  How about if we, identify the situation as best we can from our own points of view and agree to discuss it at an agreed upon date and time. Did you know that everyone has their own unique point of view? Did you know that a care receiver and a care giver have totally different views at times?  Most folks have no idea what the care receiver wants or needs, they just assume according to their own wants and needs. If you are going to help someone else it is probably a good idea to talk with them to find out the who, what, where, when and why’s of things.

What if we could get away from right or wrong? What if we could be open to the possibility of many different ideas, ways or opportunities? If I can realize that it is not always my way or the highway, then you can too. Give each other the time and good information when there is a major decision to be made.

Some things you do need to ignore. Some things do not need to be handled right now. The things that will not matter in a month, you ignore. The things that will not matter in a year or two, you ignore. The minor household chores that can be delayed, ignore them until another time when you are better equipped to make a decision. Decision fatigue is a real thing. It takes a lot of energy to think and make decisions that are new to you. I know this sounds like management by crises, but it isn’t. You get to choose. Make the best choice possible with the information that you have, right now. It is a gift to be able to make a decision before a crisis hits. A plan of action to implement, when needed, is a lifeline.  Usually, the things to ignore are behavior issues. You may be dealing with an angry aging parent. They may have outbursts. Abusive behavior you cannot ignore. You must take care of yourself. They may refuse to bathe or change their clothes. Ok, so ignore it for a day or two. If they are not in harms way, sometimes you have to let them be. Your family knows your buttons and they know how to push them and they will push them. Can you ignore the button pushing? Can you, let it go? If you can, you will be much happier and much more in control. If you can’t ignore your buttons being pushed, you will get stuck, become even more frustrated and stressed out.

What about fighting? I am not talking about physical fighting, I am talking about arguing, which is fighting in my world.  This one can be tricky. Some families cannot handle fighting in any way, shape or form. They would sooner give up everything than to fight. Other families can have a frank discussion with fighting, work it out and move on with no hard feelings. Others can fuss and fight and have hard feelings for many months, even forever at times.

I wonder what is causing the fighting? Feeling unheard or ignored is a big trigger. Listen to each other first. Use a talking stick. You know, the one holding the stick gets to talk and then when they are finished, they pass it on to another person. STOP figuring out how you will respond. If you are figuring out how to respond, you are not listening. Listen for understanding. Sometimes people may say the wrong words, listen for the understanding and feelings behind the words. You do not have to agree but you do have to agree to disagree. Are you open to the possibility that the choices you must make are for right now? That in a week or two you may make different choices. Sometimes there are no good choices. There are only the choices that you will regret the least making. I wish that I could tell you that all your choices will be logical, but that is not realistic. Are we fighting because we are afraid of making a mistake or a bad choice? Guess what? You will make mistakes. You will make a bad choice. They can be rectified, almost all of the time. When you make a bad choice, do what athletes do, pat your chest twice with your hand and say “my bad.” Then move forward. Stop beating yourself up. Did you do the best that you could with the information you had at the time? If yes, move on.

Instead of fighting what if we worked on one issue at a time and not the lifetime of issues? I understand that some folks cannot find common ground. In that case, place the needs of the care receiver and the hands-on caregiver at the top of the list. You may find that a dictatorship is the best way to proceed.

I am amazed at the folks that do not talk to a relative because of an issue with hurt feelings. I have seen it in my extended family but not my core family. We could always express our opinion, discuss, fuss, fight or whatever we needed to do without fear of being cut out of each other’s lives. You do have to work within the parameters of your family dynamics. We could chase many rabbits on this topic.

When to take a break? Before you are drained would be ideal. You will need physical breaks and mental breaks. There will be times that you are too overwhelmed to make a decision. Too tired or you do not have enough good information to make a decision yet. Take that time out. Agree to take a break if a discussion becomes too intense. Come back in a couple of days or another week. Maybe you are at an impasse. Who will be the ultimate decider?

Chronic stress can kill you. Take a break to rest and recharge.

Key signs you need a break include:

  • Changes in eating habits
  • Cynicism about work
  • Difficulty concentrating
  • Getting sick more frequently
  • Lack of energy
  • Lack of motivation
  • Low mood
  • Frustration
  • Feeling unfocused or fuzzy-headed
  • Physical symptoms such as headaches or stomachaches
  • Poor performance at work
  • Sleep disturbances
  • Using drugs or alcohol to cope with stress
  • Withdrawing from friends, family, or co-workers

What days or times will you be taking time off? Write it down on the calendar. Yes, write it down. What gets written down, gets done. Realize that you will feel uncomfortable doing this. It is okay to feel some discomfort. Do not let that discomfort derail you from much needed time off or time away. You will come back stronger and more able to deal with any issue that may arise. Even an elite athlete needs days off.

Pat

Wednesday Wonderings… What are the feelings you are dealing with as an adult child helping a loved one?

Emotions, Feelings and other things that mess us up!

September 1, 2021

Do you love someone that has a chronic disease such as Alzheimer’s disease, Parkinson’s disease, Multiple Sclerosis, Migraine, Depression, Arthritis, Cancer, Asthma, COPD, ALS, and more? Are you one of the ones or maybe the only one that takes care of them or you see to the daily care of them by someone else? Congratulations! You are a caregiver. Yes, even if you do not provide the hands-on care day to day.

Last week I told the story of why I do what I do. I gave you the nuts and bolts of what happened. This week it is about the feelings and emotions that I experienced. When I let myself deal with them? This is the story that I did not and do not want to write. It is hard. It is messy. It makes me feel weak.

I wanted to start out by showing the Robert Plutchik wheel of emotions and do some explaining. Why? Because it would have been an easier way to describe and show emotions, feelings and how every thing connects. It is a good graphic. You see, it is much easier for me to teach you something. It is much easier to show you something and how things are intertwined.

Emotions get messy. Feelings are all over the place. They sometimes do not make sense and they rise up at the most inopportune times. They do not follow a straight line nor are they in order. There will be some cussing in this article. I can only promise to do my best in telling you what I have experienced, dealt with and other crap. It may be disjointed and out of order with regards to the timeline of my mother’s MS diagnosis, the things I dealt with through the years, and my mama’s death and the years that followed.

Some of the feelings –

Anger – Things are messing up my plans and I don’t like it! Always remember it is really not the person causing the anger, it is the situation.

Rage – Too much crap coming at me all at one time and I will be taking it out on those I love and are close to me. The ranting and raving will cause very unkind words, the throwing of objects, or even complete shutdown so as to not let things fly.

Disappointment – In yourself, your abilities to take care of things. You know, failure. The one thing that you cannot abide. You must not fail, you cannot fail, this is too important.

Ostrich time – When you stick your head in the sand and think, “If I don’t see it, then I don’t have to deal with it.”

Do it all – Are you being a martyr? You know perfectly well that others can and will help, if you would only let them. Have things for them to do and help you with. I have met some people that want the accolades and “oh, you poor dear.” They want the attention from others. It happens more than you know.

Frustration – This is a biggie. You feel like you cannot fulfill needs. Too much uncertainty and insecurity. You feel out of control and you hate that feeling most of all.

Irritated – minor things start building up and when you don’t accept things as they are…you start moving into the Anger and Rage.

Anxiety – Things are out of control and you don’t know how to bring them back under control. This is actually your early warning sign that something is not right. You may be feeling the urge to run away or cry.

Boredom – You don’t get to do anything that brings you joy or happiness. You are existing. This is the time when you realize that you need some “me time” or respite care.

Depression/Sadness – These two are together because prolonged sadness can lead to depression. You are under tremendous stress and that pumps cortisol and other hormones throughout your body. Brain chemistry can and does change over time. Maybe, it is time for you to see your doctor.

Disgust – Having to help someone toilet or bathe may be too intimate for you to handle. It can be very uncomfortable or unnerving to help with these types of private issues. Think about changing a baby’s dirty diaper. Now, think about changing an adult’s dirty diaper.

Embarrassment – Yes, even embarrassment. Some folks will not bathe. They will not change their clothes. They just stink. I am grateful that we did not have to deal with a bathing or changing clothes issue. Occasionally, it may be a feeding issue and food or drink goes everywhere. Here you are out in public and a big mess happens.

Impatience – You have all of these things that you want to accomplish today and your care receiver can’t even get up and get dressed much less eat breakfast before that 10:00 appt. Notice what is happening here – it is about you and what YOU want to accomplish. It is no longer about you. It is about them. It will take three times a long as you have planned to do anything. Take a break or a time out. When you begin to force them, you are beginning to abuse them.

Loneliness – You are isolated and you don’t have your support network to be with or sometimes even to talk to.

Crankiness – Because you are so tired. Your sleep is disturbed. You can’t fall asleep, you can’t stay asleep, your care receiver gets up at all hours of the night, etc.

Resentment – You did not choose this. Maybe you have brothers and sisters that are not helping out, or maybe you are an only child. Every family puts the “fun” in dysfunctional. It is the situation.

Feeling unappreciated – Learning to accept help is very hard. None of us wants to be dependent on anyone else. We may even push those trying to help away. I wish I had a fix for this, but there isn’t one. You will have to pat yourself on the back. The care receiver will not see or acknowledge what you are giving up to help them nor will they thank you. So, you can accept this for what it is or you can keep getting your feelings hurt.

Guilt – the feeling that we have when we have done something wrong. The guilt will come in many forms. Over not having done enough to have prevented “X, Y or Z.” Guilt over your impatience or how you have treated them sometimes. You feel guilty for thinking about your own well-being. Any number of things may cause you to feel guilty. Will you giver yourself permission to forgive yourself for not being perfect? Will you forgive yourself for the “shoulda, woulda’s, could a’s?” Will you accept that you are doing the best that you can and that is good enough?

Fear of failure – This is the one that smacks me right in the face. I cannot fail. I must not fail. I will not fail. I can only do my best. What if something happens? How will I cope? Will I feel guilty? All of these scenario’s race through your mind. The “might happen”, the “what ifs.” All those do is to keep us stuck from dealing with what is happening, right now. This is where having a contingency plan in place is very helpful. I like contingency plans. While it may not cover everything, it will cover most things. Ahh, some sense of control. Now we can rest and recharge.

Grief – Watching them decline hurts. Sometimes it huts too much to deal with at the time or if you are like me, you don’t even know it is happening. You just stuff shit and soldier on.

Who are you? What is your natural tendency during regular times? What are your tendencies during stressful situations?

What is Pat Collins’ basic temperament and usual state of being? I am content. I am usually positive and hopeful, even when things do not go as planned. I do like things to go my way. I am a bit of an ass. If I think something is right, I will choose that. I am open to others’ ideas and opinions, usually. I will do what I think is best for my family and not just me. I deal with whatever situation is happening at the time. If I make a mistake or what I tried did not work, then I figure out something else to try. I am open to trying things that are science based, but no “woo-woo” stuff. I am confident in what I know and others see this as cocky sometimes. I am caring and want the best for folks. I hate people that mistreat or hurt others, especially those that cannot care for themselves. I have faith in God.

My mom was diagnosed with MS in about 1990. I did what research that I could at the medical library. Remember, this was pre personal computer days. Not much was written about it. I prayed to God, “just don’t let my mama die.”  That was the first emotion. Fear of my mama dying. Only think and feel this at night while alone.

Get on with everyday life. No personal emotions allowed during work. Learn to compartmentalize. Apparently, I did learn that and learn it well. As the weeks passed, I became more relaxed about my mom’s condition. I had done my research. I had talked with her neurologist, and we were good with the treatment plan. I knew that my mama’s life would probably not be shortened by MS. We would have to make adjustments, but we could handle that.

None of us talked about the eventuality of her becoming disabled and needing 24/7 care. We always thought that time was way on out, if it happened at all. Mama was the one that brought up going to a nursing home. She was the practical one. Daddy would not hear of that; he was determined to keep her at home. You would think that me, my brother and my dad would talk about the future needs. I am a pharmacist; my brother is a physician and my dad was still working full time and so was my mom. But, no we did not. There was no need, right now.

Life was pretty normal for five years or so. My brother and I had careers, families and our own things to do. You know, the everyday things that you deal with. Work could be stressful with some patients/customers. Work could also be stressful with budgets, hiring, training, ordering, inventory control and filling prescriptions I would be aggravated, angry and just plain tired some days. Oh yeah, throw in the sports practices, games and homework along with eating dinner, bath time and bedtime. All of these “mini-crises” can take a toll too. You don’t realize that though. It is just a day in the life. Everyone has them and you handle it and move forward. My decompress time was reading the newspaper in the evenings after I got home and checked on everybody. I worked 9 am – 9 pm shifts, every other day and every other weekend, unless I filled in at another pharmacy. That extra was more often than not. I was always hyped up from the day of work and it would take until midnight or 1 a.m. for my thoughts and brain to settle down. They weren’t bad thoughts, just thoughts of the day (the replay), situations or whatever had happened. The thinking about what was coming up, etc. Just stuff.  I would lift weights and walk regularly. See, I did have an outlet for stress. I never liked the taste of alcohol and so when I was drinking in high school or college, it was to get drunk. I have tried different drinks after pharmacy school, but I did not like any of them. I am not a fun drunk anyway; I just want to go to sleep. I would rather have an iced tea, water, or a soft drink in a social setting.

Moving on to the late 1990s to early 2000s. Things are beginning to get more time consuming on the mama front. The boys are getting older and into more specific sports which require more practice and more practice days every week. Oh, and now they are beginning to have social lives with parties, sleepovers and playdates. Their lives are way more active and social than mine. Hmm, 

I am getting tired and pissed at being summoned down to the house to deal with mama and daddy because it seems as though they are acting like children. What was really going on? Nothing, if you ask them. Just the same old same old. Bullshit! I have mama upset and wanting to divorce daddy and I have daddy telling me he doesn’t know how much more he can take.  Yep, everything is good, until it isn’t. Mama had begun having mini-strokes by now and they were affecting her behavior and so was the MS. I was mad at her for smoking, in the bathroom all these years. She never did smoke in front of us. I tried to get her to quit, but it never happened until she was diagnosed with beginning emphysema. We get to deal with the aftermath of her poor choices is what I was thinking. How can I love my mama so much and be so mad at her? The opposite of love is not hate, it is apathy, you just do not care anymore.  I don’t have the luxury of being mad right now, I have to fix shit. That is what I do, fix shit. I am observing and talking with both of them, separately of course. Listening for clues as to what is really going on. I love my daddy, but he can piss me off in a New York minute. If daddy, has it in his mind that something is or is not “right in his way of thinking” then he will not listen to reason or change his mind. Mama has declined and it is not the normal MS decline issues, other things are impacting her. I suspect depression and probably more mini-strokes. She needs to see a psychiatrist. I make that suggestion, and daddy is not having any of it, because he does not “believe in that.” He told me that I could make the appointment and take her, but he was not going to do it. Let’s recap, I have mama and daddy in a pissing match, I am working full time and helping with the boys. My partner is having severe migraines and is out of commission for most of the time. Now, it is all on me to handle. I handle it. I handle it all. I handle everything but my own needs. My wants and needs are pushed to the back of the line. I do not yet realize that as I am in “fix it or handle it” mode. I don’t yet realize that I am a bear to work with at work. I am short and curt in my speaking. I have no tolerance for any little mistake. My mind is elsewhere. I do what I have to do. I get the boys to where they all three need to be and by when they need to be there. I have to leave work, which stresses me out, for 20 minutes to take care of my partner’s needs. I get others to help me run the boys’ places, if I can.  I send my tech out to take a child somewhere. I am doing management by crises and I don’t like it at all. Right now, I don’t have the luxury of being able to plan ahead. I am in the middle of it and I am just surviving. I am certainly not thriving. I am mad, angry, upset, frustrated and I keep stuffing all of those feelings down. I would not be able to express those feelings without exploding on someone. When pushed, I can and will explode. I don’t like myself when I do that. I do prefer to talk about things before they get totally out of hand. I am not known for taking a time out first and it would be better, if I did. My preference is to deal with whatever arises when it arises and then be done with it.

What happens when I stuff my feelings? Some of this, I did not know or realize until others pointed it out to me.  I was mentally exhausted. You cannot unhear what you have heard even though you know it wasn’t really the person, but the disease or condition. Increased tension headaches and migraines.  To the point of daily tension headaches. Stomach problems and in my case cramps and diarrhea. I would blow up at small things that never would have bothered me before. Leaving others to deal with my wrath and wondering what they had done to deserve that? They did not deserve it; I was too busy not dealing with my negative emotions that they just kept bubbling up and were always right under the surface…waiting to explode on anyone and everyone. I had a difficult time experiencing joy and happiness during this time. My neck and shoulders were permanently tight and knotted up. At one point, I thought I was having a heart attack, until I realized that I had forgotten to take my Prilosec® for the past three days.

The rage and anger that I felt. It wasn’t at my mam or even God. It was at the MS and how our lives had changed. It was not what any of us had planned. Fear of the unknown. Not being able to plan things. I am a planner by nature and when I have to go with the flow…that is hell to me. I was mad. I loved my mama; how could I be this mad? Because, my life was impacted. My days off were being taken over. I missed my partner, my boys, and my time. I did not have a choice and that made me even madder. Daddy would not do what I asked of him and that pissed me off too. Yes, I felt like giving up and throwing in the towel. Saying, fuck this shit, I’m out. The hurt that my heart felt when I would hear my mama say some things that were not like her. I know it wasn’t her, but damn, it hurt and I can’t unhear what she said. This is where you have to know what you know. You have to know who your mama is and who she is not. The mama I had grown up with was no longer here. The funny, loving, smart woman was no longer here. She had changed or rather her mini-strokes, depression and MS had changed her. Not all of her, but quite a lot of her personality. I can’t explain it, it is something that you feel, you know and you understand.

Stuffing emotions and feelings. I was very good at it. I was not good at dealing with the slip-ups or the aftermath. I had to go back a few years after my mom’s death to see what had happened and how I coped. I did not realize that I was grieving my mom’s death way before she died. What had I done to my partner? What had I done to my boys? Work? What had I done to myself? Buckle up, it ain’t going to be pretty.

I felt lonely. I felt isolated. I felt like I was the only one trying to take care of shit. I felt anxious and on alert all of the time. I could not relax. I did not work out or walk and that made me feel worse. I thought I did not have the time nor the energy to work out regularly, I had too much going on. Too much that needed my attention. I was so wrong. I would have been much better off emotionally and physically if I had kept up working out and walking. It is probably a good idea that I do not like the taste of alcohol. A lot of folks do use alcohol to cope.

I didn’t know that I could feel the emotions or feelings and just let them go without putting an attachment to them. Those thoughts and feelings go through our minds all of the time and really all we have to do is acknowledge them and wonder why this is showing up? I did not know that I could be curious about a feeling or emotion and why it may have gotten triggered. Yes, we all have buttons that can be pushed. Our family knows all of our buttons and they push them so well. We have to relearn how to engage or NOT to engage. It can be done and you will not longer be triggered. Guess what? That trigger has no power over your anymore. That is beyond the scope of this article.

Every felling has a message. It is trying to tell you something. It is best to deal with them as they arise and not let them build up pressure to an explosion. If you are an empathetic person some of the feelings or emotions you may be carrying around are not yours. You may be picking up on others feelings and emotions. I know that it sounds weird, but energy is energy.

I wasn’t available to attend to my partner’s or my kids’ emotional needs. I was in survival mode. I was not the hands-on caregiver to my mother. My daddy was. I was doing my best to get her to the doctor that she needed to see and the medications that she needed. I cannot imagine the stress that the hands-on caregivers are under if they have their own career, spouse, kids and home to take care of too. I know the stress that I was under. I know the hurt feelings that I caused my partner, my kids, my technicians and my patients. You can never apologize enough. You can never make up for it. All you can do is do better and be better from now on. I hated the distance that was between me, my partner and my boys. My oldest was still in high school when my mom died. They are all grown now and doing well. My partner and I are no longer together.

There are physiological changes that happen when we are under stress. It affects your body in such a way that you cannot make good decisions. The following was stolen, I mean borrowed from Harvard Health. https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response

The stress response begins in the brain (see illustration). When someone confronts an oncoming car or other danger, the eyes or ears (or both) send the information to the amygdala, an area of the brain that contributes to emotional processing. The amygdala interprets the images and sounds. When it perceives danger, it instantly sends a distress signal to the hypothalamus.

Command center

When someone experiences a stressful event, the amygdala, an area of the brain that contributes to emotional processing, sends a distress signal to the hypothalamus. This area of the brain functions like a command center, communicating with the rest of the body through the nervous system so that the person has the energy to fight or flee.
Happening in the brain

The hypothalamus is a bit like a command center. This area of the brain communicates with the rest of the body through the autonomic nervous system, which controls such involuntary body functions as breathing, blood pressure, heartbeat, and the dilation or constriction of key blood vessels and small airways in the lungs called bronchioles. The autonomic nervous system has two components, the sympathetic nervous system and the parasympathetic nervous system. The sympathetic nervous system functions like a gas pedal in a car. It triggers the fight-or-flight response, providing the body with a burst of energy so that it can respond to perceived dangers. The parasympathetic nervous system acts like a brake. It promotes the “rest and digest” response that calms the body down after the danger has passed.

After the amygdala sends a distress signal, the hypothalamus activates the sympathetic nervous system by sending signals through the autonomic nerves to the adrenal glands. These glands respond by pumping the hormone epinephrine (also known as adrenaline) into the bloodstream. As epinephrine circulates through the body, it brings on a number of physiological changes. The heart beats faster than normal, pushing blood to the muscles, heart, and other vital organs. Pulse rate and blood pressure go up. The person undergoing these changes also starts to breathe more rapidly. Small airways in the lungs open wide. This way, the lungs can take in as much oxygen as possible with each breath. Extra oxygen is sent to the brain, increasing alertness. Sight, hearing, and other senses become sharper. Meanwhile, epinephrine triggers the release of blood sugar (glucose) and fats from temporary storage sites in the body. These nutrients flood into the bloodstream, supplying energy to all parts of the body.

All of these changes happen so quickly that people aren’t aware of them. In fact, the wiring is so efficient that the amygdala and hypothalamus start this cascade even before the brain’s visual centers have had a chance to fully process what is happening. That’s why people are able to jump out of the path of an oncoming car even before they think about what they are doing.

As the initial surge of epinephrine subsides, the hypothalamus activates the second component of the stress response system — known as the HPA axis. This network consists of the hypothalamus, the pituitary gland, and the adrenal glands.

The HPA axis relies on a series of hormonal signals to keep the sympathetic nervous system — the “gas pedal” — pressed down. If the brain continues to perceive something as dangerous, the hypothalamus releases corticotropin-releasing hormone (CRH), which travels to the pituitary gland, triggering the release of adrenocorticotropic hormone (ACTH). This hormone travels to the adrenal glands, prompting them to release cortisol. The body thus stays revved up and on high alert. When the threat passes, cortisol levels fall. The parasympathetic nervous system — the “brake” — then dampens the stress response.

It is not just emotional. Stress impacts your brain and your body. I am not one to talk about my feelings or emotions. I do know that I have them and I do feel them. I am a work in progress. I get better every day. I don’t want others to have to deal with all these negative emotions and feelings that will hurt them and their loved ones. I may not talk about it a lot, but it is my primary purpose in starting my business. Every relationship is different. Everyone has different feelings and emotions that are triggered. I can relate to what you are going through because I have been through it. No one will ever know exactly how you feel. We are all unique. We have different relationships with our loved ones. I know how to lessen the stress, anxiety and burden that you feel when you have to handle a loved one’s health care needs. Imagine how you would feel if you were a better manager for your loved one. Imagine how you would feel if you had a plan to access when you needed. Things will happen. We don’t know when. Are you prepared? Do you want to be prepared?

Let’s have a chat.

Pat

pat@EmpoweringHealthOptions.com

865-684-8771 (leave a message, if I am unable to answer)

We will discuss more about Robert Plutchik’s Wheel of Emotions.

Primary: The primary level circle indicates the basic type of emotions: trust, surprise, joy, sadness, anticipation, disgust, surprise and anger.

Opposites: Now understand, every primary emotion has a reverse emotion. Such as fear is reverse to anger, ecstasy is the opposite of grief, anticipation to surprise and so on.

Combinations: As you can see the faded petals [no color] it represents combinations of two primary emotions. For example, disgust and remorse gives remorse, similarly joy and anticipation offers optimism.