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Change can be scary and is almost always difficult. Change can force us to question both the reasons we stayed and the reasons we left. Learning to begin again has been challenging but life-giving, even more so as I settle into midlife. This list may resonate with some of you, so I thought I would share several scenarios in which I have learned to begin again.
While so many of the circumstances in my list above are quite personal, I know many of you can relate. In fact, just reaching a decision to begin again can feel overwhelming. I will link a resource below of a book that really helped me make some hard decisions in my life. I love this author's work, her podcast, and her platform. Her words have provided both comfort and fuel for my body and soul. She writes from a Christian perspective, so if that is not a fit for you, you may not enjoy her work. Let's take a deeper dive into a few of the life scenarios that forced me to begin again as I share anecdotes and resources that helped me get through the muck of starting over.
These real-life examples are very personal and may not apply to your life. I do hope they give you some insight, however, either for your own life or for someone that you love. Connection is the entire reason I started pouring my heart out over the internet, so please leave a comment below if any of this resonates with you. I see you and you are not alone. I love interacting with my readers. For more of an inside look into my days, you can follow me on TikTok, Instagram, or Facebook. Please support my fellow hope*writers by reading their works inspired by the prompt word BEGIN: Begin Moving Toward Your Soul’s Lifework by Lisa Crowder https://lisacrowder.substack.com/p/begin-moving-toward-your-souls-lifework The Beginning of Stories from the Supper Table Series by Jessica Haberman http://www.storytellerfarm.com/beginning-of-stories-from-the-supper-table-series How To Begin a New Career by Ashley Olivine https://ashleyolivine.com/how-to-begin-a-new-career/
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You're on a roadtrip. You're headed to the beach. You have 10 hours start to finish and it seems like it is taking FOREVER. You stop a few times for bathroom breaks and lunch. The travelers are getting cranky. They JUST WANT TO GET THERE. When will we get there? How much longer? And then you realize. We are over halfway there. At 47 with 2 gnarly autoimmune diseases, I'm probably well over halfway there. I rushed the beginning. I looked so closely towards the end goal that I forgot to enjoy all the scenery I passed. Or did I? So I slow it way down.
As much as I can. I watch each inning of my youngest boy on the mound or at bat or hovering just off third like it's the bottom of the 9th in the World Series. I sit patiently before the curtain rises at every one of my middle boy's performances. I have no where else to be. I am his mom, and I am watching him shine. And I dance at my oldest son's wedding. I laugh. I smile. And I remember what it was like to be twenty years old and in love, the whole universe at my feet. I sip my coffee with my husband on the rare occasion we are enjoying breakfast together. I look out over my back deck at the spring leaves, the blooms of each flower, the squirrels scurrying, and the birds in flight. Slow down, Mr. Squirrel. Not so fast, Mrs. Bird. What's the hurry? You see I just left Mr. Jones or Mrs. Smith and they remind me each day that the end is not always easy. The end can be lonely, painful, or both. The end can be joyous and abundant, but we have no guarantees. So I slow it down. This line between my eyes on my forehead is from my Granddaddy Taylor. He earned his and so did I. I am reminded of him each time I look at it and I remember his favorite line: "aren't you glad you got to see me?" 🥰 If I cover it up, needle it away with miniscule doses of botulism, does that mean life never happened? The tears I cried and the belly laughs I bellowed - weren't those worth these lines on my face? And here we are, old friends. Me and my impatience. Me and my ambition. Me and my PLANS. What a farce. What irony. What next? The sun will rise and the sun will set. I choose to embrace these next decades with a little LESS energy and a little more PRESENCE. I'm showing up this time. I'm all in. I want to love hard and laugh often. Will you join me? On a recent poll with my readers, the results were not surprising:
The poll was not anonymous, and I know many of my readers. Several of the "way too much" respondents are married, have children, have jobs, are surrounded by people all the time, and YET... they feel alone. I can relate. Loneliness is harmful to your health. But how do we fix it? We've never been more "connected" in our lives? Or have we? I have found 10 ways to feel more connected in a digital world. These are not from some article or YouTube video. These are just what has worked for ME. I hope they work for you too:
I love interacting with my readers. For more of an inside look into my days, you can follow me on TikTok, Instagram, or Facebook. Please support my other hope*writers by reading their works based on the prompt word LONELY: Is God Lonely for You? By Sharla Hallett https://sharlahallett.com/is-god-lonely-for-you/ Loved vs. Lonely by Lisa Crowder https://lisacrowder.substack.com/p/5c456855-76dc-499f-90cd-6ffef071a3d3 Simple Is Better Lent - When Lonely is OK by Dianne Vielhuber https://simplewordsoffaith.com/2023/03/01/simple-is-better-lent-when-lonely-is-ok/ Open Letter to the Lonely Mom by Ashley Olivine https://www.ashleyolivine.com/lonely-mom/ Breaking the Stigma: Understanding and Talking About Loneliness by MelAnn https://lifesouvenirs.net/p/breaking-the-stigma I love a good puzzle! I don't want 1000 pieces, 500 is plenty for me. I don't want it all to be the same color either. I want lots of colors and a scene or image that brings me joy or peace. Give me a cheesy movie, some warm pajamas, a cup of coffee or hot tea, and a day off work, and I can sit at a puzzle table for hours. I love it even more when I'm sitting next to friends or family or if we each peck at the puzzle over a few days. Collaboration at its best! I love the fact that we can all be looking at the exact same pieces and patterns, but one person can "figure it out" when it has been right there in front of us the entire time. I also love that there are no electronics involved! Much like life, a puzzle teaches us that there are many ways to look at things. Patience is key. And teamwork makes the dream work. All the cliches really "fit" into working a jigsaw puzzle. ☀️
This particular puzzle was SO hard to finish! All those Star Wars uniforms tended to blend together. The kids started it with us but towards the end, my dad and I were the only ones pushing through to the finish line. Working puzzles with my dad hasbecome a favorite pastime for both of us. We can chat, or work in silence. That time with him has been a gift. Do you enjoy working puzzles? What does it do for you? I can't wait to hear all about your puzzle motivations in the comments below. I love interacting with my readers. For more of an inside look into my days, you can follow me on TikTok, Instagram, or Facebook. photo credit: Anh Nguyen I have included a list of questions your healthcare provider may ask you during your headache evaluation:
There are several types or categories of headaches:
If you are not quite ready to seek a medical workup, you can try the following safe therapies at home:
Headaches can interrupt our daily lives and become quite cumbersome. Please do not ignore your headaches. Listen to your body. Author's note: this article should not be used to diagnose or treat any conditions. Please seek an appointment with your primary care provider for proper headache evaluation. A neurology consult may also be warranted.
She’s walked through the fire and the storms while dancing in the rain … Her life has been difficult and filled with excruciating pain … She’s suffered many losses in such a short time yet she continues to believe that in the end… it will all be fine … With such strength and undeniable belief she tells me her healing will come in God’s time … It may not be here on earth but perhaps in heaven she will be pain free… Her words are heavy on my heart and somewhat difficult to grasp, for me… She’s my daughter, Keyera, and she suffers from sickle cell It’s a genetic disorder that we know all too well: Her story is a bit different than usual. She wasn’t properly diagnosed until the age of five. My husband and I worked different shifts so that one of us was always home with the kids. At 5, she started kindergarten and became ill after the weakened live intranasal flu vaccine was given. Initially, her pediatrician thought she had the flu in spite of the vaccination. She ran fever, she was fatigued, she had to be carried or she’d just sit in one spot. After 3 rounds of Rocephin (a strong antibiotic) injections and no improvement, her pediatrician, Dr. Allardice, admitted her to the hospital. She ran various tests. She asked about sickle cell, I told her that her cousin had it and my other daughter had the trait but as far as I knew, Keyera didn’t have the trait OR the disease. I was never notified by the health department or pediatrician’s office that I saw prior to Dr. Allardice. My daughter’s health was rapidly declining. In my heart, I felt her slowly drifting away. It seemed as though she had developed pneumonia. Treatment was started and I begged and cried for God not to take my baby away. When her test results came back, I was shocked and in disbelief. I had made sure Keyera had all of her immunizations and that she went to all of her well child visits. She had sickle cell anemia SS and it wasn’t pneumonia. She had acute chest syndrome. Sickle cells are shaped like a sickle so they don’t pass the veins and arteries like they should. Acute chest occurs when there is sickling in the pulmonary arteries and it can mimic pneumonia. Many patients with sickle cell have passed away due to acute chest, heart attack, or stroke. We were fortunate that she was admitted and diagnosed. Her situation was dire. She is now 22 years old. She’s had both hips replaced due to AVN (avascular necrosis - lack of blood supply to the bone) caused by sickle cell. She suffers from medical PTSD due to being in the hospital so often at an early age. She’s lost friends and in 2020, her cousin, Makayla, with sickle cell passed away. Her journey has been challenging and she’s often called resilient but truthfully, she is vulnerable and fragile at times. She just wasn’t given an easier course to take. She often gets upset when people tell her to be robust during a crisis. The thing about pain is that it demands to be felt, no matter how hard you try to ignore it. It makes its presence known. Unfortunately, there is not a universal cure for sickle cell anemia at this time. Not everyone can find a match or are a good candidate for bone marrow transplants. Due to my daughter’s health issues, it’s not an option. She has less than a 50% chance of surviving a transplant. My daughter depends on blood donors to have a decent quality of life. It requires 7-10 units of blood each month. If you want to be a hero and save lives, please donate blood. Before the monthly exchanges, she was in the hospital at least twice a month. She was miserable and asked God on several occasions to let her fall asleep and not wake up. She still has challenges but she is enjoying life and spreading awareness. When her cousin passed away and she got to say her farewell, she promised her with weeping eyes that she’d continue to fight and educate others. I encourage you to research sickle cell anemia. If you know or love someone with it, check in on them but remember though they may be resilient. They do get tired, though they seem strong, listen and support them when they say they’re exhausted or weak. When they say they hurt, believe them. Never tell them they don’t look sick, your intentions may be well meaning but not every illness is visible. My heart cries as my soul weeps for all the sickle cell warriors that continue to suffer or have lost the fight … Each day they try or tried to live the best life possible with all of their might … Simple things that we take for granted can be such a heavy burden or test … Their bodies tire easily and they must often take a break to simply rest …
My daughter has kept her promise to her cousin. She has done several informative interviews regarding sickle cell and continue to spread awareness. Giving blood is such a simple task but it has such a great impact on the quality of life for those that need it. It cannot be manufactured, please donate blood and help save lives. Blog host's note: I know La Keisha because she is a nurse. She does not mention being a nurse in this piece, but I feel I must. As a nurse, we take care of other mothers' children when our own children are sick at home. We minister to other daughters' aging parents when our own aging parents need us. We comfort other wives' husbands when our own husbands miss us and wish they had more time with us. So just imagine the toll this has taken on my friend, my sister, my fellow nurse. She wouldn't trade it. We nurses wouldn't trade it, our calling. But being a nurse and a mother to a sick child deserves space in this world. Godspeed. If you have a pet of any kind, you know the joy that pets bring into our lives. While they do come with a certain level of commitment and work, they offer benefits that far outweigh what they require of us. Now that I am six years into my primary chronic illness, sarcoidosis, I feel like I can discuss pet therapy with conviction. Prior to becoming "sick," I always had a pet - from childhood on. It wasn't really until I became ill, however, that I realized what my dogs had done for my mental health. My physical health has also improved thanks to being a pet-owner. Here are 10 ways owning a pet can help you with your chronic illness:
Charlie the Dachshund is always there for me. He will wait on me wherever I go and follow me no matter what. He needs my help to get his food, water, and to let him outside. It feels good to be needed by someone or something that doesn't really expect much in return, ESPECIALLY with a chronic illness. I can be sick, tired, or both in front of him and not feel self-conscious. I can tell him all my thoughts and fears, and he won't judge me. I can even moan out loud in pain or cry at my medical misfortune and he doesn't flinch. Instead, he meets me with loving kindness and is a steady force of calm in my daily life.
In 2016, at the age of 40, I received a sarcoidosis diagnosis that rocked my entire world. My kids were 4, 6, and 14 at the time. I was at the pinnacle of my NP career, and I was coming off a 2 year "break" from full-time work. From 2014-2016 I was working 2 or 3 days a week and was able to spend more time with my family. I was also able to go to the gym regularly and prepare healthy meals. I felt like my health was also better than it had been in the past 7 years. My sarcoidosis symptoms started abruptly in September and were very noticeable. I would walk to my car that was parked on a hill after work and be extremely short of breath (think huffing and puffing as if I had just sprinted 100 yards). I would go to the gym and feel completely wiped out after 20 minutes of my workout when normally my full hour workout left me energized and not depleted. I would walk out of an exam room and forget the name of a medication or stop mid-sentence when trying to give my nurse a verbal order. I also felt very dizzy and lightheaded and was not sure what was causing all of my symptoms. I decided to go see my colleagues in cardiology once I realized my blood pressure was dropping. My blood pressure was dropping as low as 80s/50s. I was also having numbness and tingling in both arms and hands and my hands were turning blue. I thought there had to be some type of blockage or blood flow issue. Ultrasound evaluation of my carotid arteries and upper extremities were normal. EKG, basic labs, and chest x-ray were normal. My echocardiogram (heart ultrasound) was the first test that came back abnormal. It showed an elevated pressure reading between my heart and lungs (pulmonary hypertension). My providers were not really sure what would be causing that because I was "so healthy." I plugged along from early September to late September before seeking a second opinion. My symptoms were progressing and persistent, and I knew something was not right with my body. My fatigue was worsening to the point I would count down the hours until I could get into bed. My shortness of breath was limiting my daily activities and I was beginning to cough every time I ate or talked for more than a few minutes. I also had an episode while driving where the left side of my face went numb and my breathing became very shallow and irregular. That sent me straight to my second opinion! That second provider ordered a chest CT and a brain MRI which were performed on a Thursday morning. That following Monday in early October, I was at work for a 12-hour day. I received a phone call mid-morning from a nurse in my second opinion provider's office. The nurse said "you have brain lesions and you need to see a neurologist to rule out MS (multiple sclerosis). You also have enlarged lymph nodes throughout your chest and you need to see an oncologist to rule out lymphoma." As you can imagine, I was in shock and called my manager to tell her I needed to leave for the day and to go speak to my husband and my parents. Did I mention my youngest child was 4 years old? Fast forward to a bronchoscopy mid-October with lymph node and lung needle biopsy as well as a trip to a neurologist which resulted in EEG and extensive lab testing. My neurologist ordered more MRIs and tried to ease my fears of MS (though he could not totally rule MS out). My pulmonologist was unable to get a conclusive diagnosis from the bronchoscopy and recommended a mediastinoscopy which would involve drilling through my sternum (breastbone) to remove lymph node tissue for biopsy. I told him that I felt a large lymph node above my left clavicle and we opted to have that node excised for pathology instead of the mediastinoscopy. That left supraclavicular node excision was done the last week in November under general anesthesia at the hospital since it was so close to my carotid artery and jugular vein. That node biopsy was negative for lymphoma and positive for non-caseating granulomas (the definitive diagnosis for sarcoidosis). I was started on 60 mg of Prednisone per day that would be tapered over 6-12 months and referred to a rheumatologist.
After starting high dose Prednisone in December of 2016, I was placed on weekly Methotrexate injections which (who knew at the time?) would last another 4 years. The only reason I stopped Methotrexate is because I later developed psoriasis (for that story, click here). I was finally able to wean off prednisone late May 2017 though the side effects lingered at least another 6 months. I plan to write an entire post on surviving long-term prednisone, but I will leave it at that for now. 2017 seemed somewhat stable throughout the end of that year, but the next 3-4 years had their own hiccups. Over those next 3-4 years I found out that the sarcoidosis was affecting my esophagus. 3 EGDs in 6 months and tons of other GI testing led to the conclusion that my esophagus has no peristalsis ("squeeze'). The only thing helping my food reach my stomach is gravity. This makes eating challenging, especially talking while eating (cough, choke). I also found out I had sarcoidosis spleen lesions, ocular involvement, and another fun lung condition called bronchiectasis. For the esophageal involvement, I take 2 pills per day for life. For the bronchiectasis, I take one pill twice a day for life. See how I organize my meds here. I have also been tested and monitored for small fiber neuropathy. The MS surveillance continues. My neuropathy is currently of unknown etiology, but my neurologist does think sarcoid plays a role. I was also sent to endocrinology at one point to check for adrenal insufficiency after steroids since my blood sugar and blood pressure still bottom out at times. Another hiccup involved an overnight hospital stay and a kidney biopsy (ouch by the way) after I noticed my urine was foamy like dishwashing liquid (that is abnormal and a sign of protein in your urine- tell your provider if you ever see this). I'm on another daily pill to help protect my kidneys for that confirmed renal sarcoidosis. Every year I see a rheumatologist, general cardiologist, pulmonary hypertension cardiologist, pulmonologist, gastroenterologist, neurologist, ophthalmologist, dermatologist, nephrologist, and my PCP and Gyn. I now see a counselor regularly to help me process all that I juggle. I have mandatory quarterly labs, an annual heart ultrasound, CT's and MRI's every year, breathing tests every year, and whatever else comes up. Gone are the days of a routine wellness visit or not meeting my deductible. Gone are the days of only taking a multivitamin. I sleep with oxygen mainly for the pulmonary hypertension, and I'm okay with that. It was my little secret until now. Right now, my sarcoidosis seems fairly well-controlled with Humira. When I met my rheumatologist in 2016, he told me he hoped he could get me into remission within 2 years. That was 5 and a half years ago. I haven't given up hope and I will continue to fight this fight as long as I can.💜 Below, I have included two great visual aids to raise awareness for our family and friends. The mental health effects of sarcoidosis are widespread and often overlooked by our clinicians. Sometimes just "being there" is all we need from our loved ones. 💜
I hope this post has raised your awareness of sarcoidosis whether you are a patient, loved one, or healthcare professional. As I told a friend after she learned of my chronic illness, "My entire life changed after being diagnosed with sarcoidosis, but I didn't stop living." I hope this offers hope to anyone who is newly diagnosed or any sarcoidosis patient struggling right now. I see you. 💜 Jan 30, 2021- Feb 3, 2021 Red, painful eyes start with painful vision and light sensitivity (UVEITIS). Feb 3, 2020-Feb 8, 2020 Tiny dots of a rash begin on my neck- they don't itch, burn, or hurt at this point. I call my dermatologist to schedule a biopsy, assuming this must be related to my sarcoidosis. Feb 3-March 8, 2021 Rash kept getting bigger and more painful. Not responding to topical Rx creams. Went for 2nd biopsy on March 8th, the day I started my 30-day medical leave. Focused on walking, sleeping, hydrating, and eating clean. Also journaling and resting. March 8-April 8, 2021 Off work. Tried the AIP Diet. No gluten, no dairy, no sugar. Derm and Rheum also put heads together to double my Methotrexate dose. The diet was difficult but my joints and skin "felt" better even though my skin still needed lots of help! April 8- August 8, 2021 Back at work. Still working covid. Boys off for the summer during some of that time. Started Humira in May 2021 and stopped Methotrexate. Skin would wax and wane, but I would say it eventually cleared by early to mid-August. Joints feel much better on Humira. Energy level too. September 2021 Had my 2nd episode of uveitis. That responded quickly to Prednisone eye drops. Skin pretty clear, but under more stress with some work and family stuff. Delta variant of covid is ravaging my patient population and friends. Evidence of proteinuria again so will follow-up with my nephrologist (that's more sarc-related, less psoriasis-related). Still on Humira. Echo and PFT's slightly worse than last year, but lung & spleen CT's show that the Humira is controlling my sarcoidosis. March 2022 I have had at least 2 more episodes of uveitis since the last update. Skin stays mostly clear with the occasional flare in the anterior portion (front) of my neck. I wrote this piece for all of my fellow Psoriasis Warriors who are walking this painful, lonely road. It is SO HARD. One can think they are not a vain person, but when your LARGEST ORGAN (your skin) is literally on fire with inflammation, it's hard to "hide" from vanity, comparison, self-loathing, and frustration. If you love someone with psoriasis, please share this with them and with others who love them. I hope it brings someone comfort to know they are not alone and that there are those people who will love us no matter what. Monthly meal planning has taken me YEARS to develop. One thing to note is that there are 3 adults rotating the cooking in my family. My parents live 2 doors down from us and we decided many years ago that it was easier to feed 7 than 2 (for them) and that mom didn't mind cooking for 7 twice a week if it meant she and dad would be fed by us several nights per week. Some weeks that looks different. Since my husband and I both commute about an hour each way to our jobs, and he works night shift, my mom may have to cook 3 times some weeks. Kids' sports and school activities can also affect our cooking rotation. Let's look at monthly meal planning with a few good tips or rules to get you started:
Now let's look at each question in more detail:
Pro tip: track what you are currently eating for a week or two as you are mentally preparing yourself to begin this process. Just like "getting on a budget" - it is extremely helpful to see what you are currently eating as a family. If you are eating out 5 out of 7 nights, it is unfair to expect you will start cooking 5 out of 7 nights immediately. That is a recipe for disaster! Pun intended! Maybe try cooking 3 nights at first. START SMALL! Good luck and just remember: it doesn't have to be fancy, it just has to be planned. I distinctly remember a conversation I had with an acquaintance when I was a brand new NP in my late 20s. I did not have children yet, but I had made some poor money decisions (traveling and shopping outside of my means mostly). The woman chatting with me (who was 10-15 years my senior) said "Oooooooh, I can only imagine how much money you make. You're a nurse practitioner!" She added "If I were you, I would go get a Starbucks every day! I would pay someone to clean my house! I would buy whatever I wanted." What she didn't know:
What I didn't know:
So - what does any of that have to do with me taking my lunch to work every day as an adult? The truth is, everything. Every. Single. Thing. My plans for this post were to include healthy lunch tips. I was going to post pictures of a variety of healthy lunches I have made and taken (those don't happen during baseball season). I was going to calculate the money I have saved over the past 12-15 years I have been brown-bagging my lunch. But here's the truth. This is why I take my lunch every day. Are you ready?
And I guess me laying all that out to you, friends, is the point. I like the truth. I like the real WHY. I see through the frivolities in life and I shudder at the brand-chasing and label-seeking that drives so many. There is no dollar amount one could pay me to give up my kindergarten-style lunches. It's what I need at this moment right now, and it keeps me sane. Time is my Starbucks - freedom is my housekeeper. To write, to think, to create, to build something from nothing. That's what I chase. Until then, there's homework and practice and rehearsal and charts. Laundry and dishes and puberty and a tired Mom pouring her heart out on the internet. Find your "lunch" --- figure out what keeps you off the edge and what you really want to chase. Godspeed. ❤️ In my 24 years of nursing / NP work, I have seen countless cardiac events either in action or the ramifications of such events. On a personal note, three of my four grandparents had strokes. I lost my paternal grandfather when I was only 4 and he was 55 due to a massive stroke. My paternal grandmother had stents in cardiac and non-cardiac arteries as well as "open heart surgery" CABG (coronary artery bypass graft). I have been affected by heart disease on a personal and a professional level, and I want to help patients understand the true risk of death and debility associated with cardiac events. Here are the top 10 reasons I refer patients to the cardiologist:
Let's talk a little more about each of these 10 conditions and how a patient may actually present to my office with these symptoms.
I have had patients in their thirties suffer from strokes and heart attacks. I have seen heart failure, cardiac arrhythmias, and high blood pressure in patients from childhood, young adulthood, and beyond. I doubt there is anyone in America who does not personally know someone who has been affected by heart disease. In honor of America's Go Red for Women Month (every February), I encourage you to schedule your wellness exam with your primary care provider and to start paying more attention to your heart rate, blood pressure, water intake, weight changes, and dietary choices. Your heart matters to me! Godspeed. After I complete my yearly review, I try to set goals for the next year. I also look at my list of what added and what subtracted to my life and I keep all of those in mind as I set goals and plan events. To do this, I have several supplies at my fingertips AND several hours (sometimes spread over a few days) to complete this process. I recommend the following supplies:
Goal Setting 101:
I have 8 areas in which I set goals each year:
Here's an example of a SMART goal: Read 10 books in one year. It is Specific. Measurable. Achievable (I allow 2 months without a book at all). Relevant and realistic (education or entertainment is always good!). Time bound. I have a start and an end date. I can also easily track the goal throughout the year (I keep a "books read" in the back of my planner). Selecting your word of the year. This is optional, but I enjoy the process each year and it does help me try to maintain a central theme or focus each year. Some of my previous years' words have been:
Now the hard part. Actually planning out your year and setting goals for the year. These two steps are intertwined and can truly be life-changing if you take the time to do BOTH. If perhaps you are reading this in March or August or on a random Tuesday in November, that's OKAY. Your "year" can start at any time. You may be home with a new baby or off work for a health flare-up or surgery and you're just now having time to even remember your name. Sometimes these unexpected pockets in time are goldmines. Use this downtime to evaluate and future-plan. As I've hit this midlife bubble of feeling young and old all at the same time, my goals have changed. My expectations are lower for myself and others (thank you, therapy). My drive is more internally-based but is now redeemed by others just as much as it is myself. In short, my years of people-pleasing are behind me, BUT following my true self has led to a more community-focused and family-focused mindset. The cool part is that me, myself, and I benefit from that mindset shift as much or more than my loved ones and my community. Kinda hard to explain, but the moral of the story is to follow your heart. Everyone wins when we do that. Godspeed. How on earth is it already time for 2022? Where did 2021 go? I'm not sure, BUT, I am ready for 2022. 2021 was messy and ugly in many ways. On a personal level, it was unkind to my health. I received a new diagnosis of psoriasis in March and had to miss an entire month of work while my body was adjusting to new medications and my skin was trying to heal. October revealed an unexpected opportunistic infection (since I'm immunocompromised) that required strong antibiotics and made me feel pretty lousy. Since November 1, I have been hobbling around on painful swollen knees and am facing unexpected knee surgery. Pity party? Nah, not my style. Swallowing it all? That's my go-to. When I think about my health and how unfair it is that I've tried to take care of my body my whole life and I'm still getting the short end of the health stick, I can get pretty low. Then I think of all my patients who have it "worse." And I swallow it. I shove it down. I brush it off. But is that healthy? NOOOOOOOOOOOOOOOOOOO. So I'm learning to acknowledge my own feelings. I'm sad that my body is not behaving. I'm angry in some ways. I'm frustrated for sure. I'm still thankful that I can work for right now. I am beyond grateful for my parents who live 2 doors down and help me daily. I'm tired. I'm realizing I have X amount of energy each day and my family needs the bulk of it. If my job takes most of it then I'm robbing my family of my best self. Filing for disability has been on my mind more in the past 9 months than it ever has during this 5 year sarcoidosis journey. So what next? New year, new adventures, new planner, new goals, new.... what else is new now that I'm 45? I have a lot of old. Old hurts. Old unmet needs. Old furniture. Old clothes. Old shame. Old junk in my kitchen drawers. Old relationship issues that deserve a conversation. An old van that has chipping paint but it's paid for and gets us to ball tournaments. I think the reflex for all of us is to replace the old with the new and that will make it all better. New clothes. The newest kitchen gadget. New furniture or decor, ON TREND, my dear! A shiny new SUV that costs more than most people's annual salary and gets 12 mpg. But boy does it look good and that's what counts, right? I'm no longer trying to replace the old just by reflex. It's harder to keep it and try to keep it running. Purging the clothes and kids' toys is definitely good, but when we throw out things that still work but aren't "good enough" for whatever standards, what does that say about us? Who and what have you thrown away and replaced with newer and easier? (ouch)... I'm falling apart health-wise in a lot of ways, but I "still work." Will my family or employer throw me out? Will my friends forget about me if I'm not as active and fun as I used to be? Where does that leave me? As an Enneagram 3 (Performer, Success Driven), I've been gut-punched this year by my body's betrayal. But God must be telling me something. I know He has a plan. I have to trust and slow down and just be. NOT. MY. STRONG. SUIT. Perhaps 2021 leaves you feeling like I do. Maybe you lost someone you loved. Maybe you were also betrayed by either your body or someone you trusted. Maybe you felt out of control all year like I did? Maybe you spent too many hours googling vaccines and viruses and death tolls like most of the world. Maybe you feel all the "junk" you've shoved down and swallowed for however long starting to surface and want to be named and noticed. I feel that with you. 2022 can be a renewal for us, my friends. I'm going to intentionally name what's working, what's not working, what is worth repair, and what really needs to be purged from my life. This goes for relationships, time spent, health choices, what I consume digitally and physically, items in my home and closet, and my thought life. I'm going to check myself when I just want to replace the old for that quick dopamine hit. I'm going to try to sit in the uncomfortable and define what's causing it. I can't keep running 90 mph. 2022 is for slowing down. It is for evaluation. It is for growing up, finally. Godspeed. We all have basic human needs as individuals. Most of us would agree that we need food, sleep, and water and some agree we need love and friendship. I would venture to guess that beyond those basic needs, many people are sleep-walking through life without ever giving pause to what THEY or WE actually need from each other. Lots of therapy has helped me realize that other people in my life don't automatically KNOW what I need or expect from them. I must let them know what I need. I have also come to realize that no ONE person in my life could possibly fill or meet all of my needs. It is humanly impossible to meet all the needs of another human by oneself. It truly does take a village. Once we have identified our needs, we can start to look at the players on our team and realize who is filling which need in our life. Some fill multiple needs. Others fill one need or don't fill a need at all, but instead may be causing stress or toxicity. Perhaps "trimming the fat" is in order when it comes to our circle of loved ones. I have also learned that not all of us are CAPABLE or WILLING to meet certain needs of others, and that too can be a painful process of acceptance and growth. So, let's roll up our sleeves and look closely at the basic human needs of each person roaming around this earth. Let us make a list of the members of our circle and try to identify who fills which need(s). There are several reasons this is important:
This is real adulting. Grown up stuff. Hard stuff. Deep stuff. So get ready. photo credit: childhoodtraumarecovery.com Let us look at Maslow's hierarchy of needs from a current-day real-life perspective and add the context of relationships and connection to those needs:
I don't have many patients that walk into my office and tell me they have needs. Instead, they tell me they are sad. They are withdrawing from friends or family. They can't sleep. They don't feel good. The have mood swings or anger outbursts. They are no longer excited about life. Medication cannot "fix" some of these painful circumstances we are all facing in our lives. An SSRI (most commonly used class of anti-depressants) cannot make your spouse SEE you or try to meet your needs. It cannot heal decade-old wounds from your narcissistic mother. It cannot jump into your best friend's mind and tell her that she is hurting you with her words or actions. Nor can it walk into your adult child's house and announce that YOU are a person, too, and that you need love and respect. So many of these issues have been around so long in your life that you don't know where to begin to address them. I encourage you to seek counseling if and when you can. A good therapist really can change your life. In the meantime, write down YOUR needs. List what needs are being met and which are not being met. Jot down WHO is helping to meet those needs and make a mental note of who you really can count on in which needs department. Use your resources - your people - when you are in crisis. Learn to NOT go to the ones who have not or cannot meet certain needs so that you avoid further hurt and disappointment. And consider having a conversation with your loved one if the opportunity ever arises and the setting and timing are conducive to growth. We cannot read minds, and we are all flawed. This relationship and self-evaluation work isn't easy, but it is worth it. Godspeed. A popular book in the field of marriage and relationships is Gary Chapman's The Five Love Languages. In his book, Dr. Chapman discusses the five core languages used to give and receive love. Knowing your love language and that of your partner is quite beneficial as you navigate various scenarios and frustrations throughout your relationship. I will link the quiz below. The 5 Love Languages according to Dr. Chapman are:
Originally written in 2004, the book has now sold over 6 million copies. I read it when it was originally released, and I read it again when I remarried. I knew the importance of speaking the same love language (or at least being aware of my partner's love language) . I think it is helpful to know your close friends' love language and the language of your children or other close family members. If you are not familiar with the concept, I will use this brief example: Amy (acts of service, physical touch): " I am so tired. Ugghh I have so much to do. I don't know how I'm going to get it all done." Husband thinking to himself (words of affirmation, quality time): Amy is so tired. She should go to bed. Maybe if I keep encouraging her to go to bed, she will. Amy thinking to herself: If he would fold this laundry, then maybe I could go to bed. But instead he's just telling me I should go to bed. Husband thinking to himself: Why is she folding that laundry when she is so tired? If I offer to fold the laundry, she may lash out at me since she's so tired, and (needing words of affirmation) that would ruin the night, so I will just stay with her (quality time) and gently encourage her to go to bed. Amy fuming at this point (acts of service, physical touch): If he's not going to fold the laundry, he could at least rub my back. Then maybe I could relax enough to go to bed. But husband doesn't rub my back because he wants the words of affirmation and reassurance to do so and the spiral continues. Neither spouse did anything WRONG, but remembering each other's love language might have made for a much more pleasant evening. Pleasant evenings bleed into smooth mornings and so forth. This example is just one of many. It can apply to family, friends, coworkers. You may be trying to show appreciation with a gift or money but they WANT / NEED to hear you say why you appreciate them. They may be doing all the little chores and acts of service to get your attention, but you WANT / NEED them to stop running around and spend the afternoon with you without any distractions. It really is fascinating once you know the love language of your partner or best friends. You can spend an entire afternoon dissecting why one situation went south based on love language miscommunication alone. But back to PHYSICAL TOUCH, I think this love language is often overlooked and misunderstood. For obvious reasons, it's viewed with caution, and while that is good... it is also robbing us of a basic human need. With the surge of technology and virtual everything, many of us go days or weeks without touching another human, particularly these last 2 years. Throughout my career, I have used touch as a means to reassure and connect with my patients. Since I received touch as a child and infant in a safe, healthy environment, I have been able to give touch easily. I know that is not true for everyone I encounter, and I acknowledge that. Here are some ways I have used touch in my practice:
Here are some ways I have used touch in my home with my children:
My challenge to you, wherever you are, however old you are, whatever childhood you had, whatever love language you prefer, however many times you've been hurt, is to THINK about physical touch in the setting of a newborn baby. I have linked an article below touting the science behind touch and neurological growth and development. If you're old enough to find this article, then you have been a child yourself. You may have children or be involved in a child's life. We all know that a crying baby or toddler is often soothed by the touch of a loved one or caregiver. Animals are the same way. I dare say, adults are ALSO the same way. If you love someone (your child, your partner, your mother, your close friend), touch them. HUG them. Incorporate safe and healthy touch into your daily routine. We have grown generations of adults now who are not used to being touched. Those untouched adults are now having more untouched children. Those untouched children are looking for affection in ways that a simple "cuddle session" (what we call it at our house) may have averted. It saddens me when I shake a teenager's limp and nervous hand or attempt an appropriate side-hug with someone and am greeted with surfboard-stiff awkwardness. I see the physical and emotional effects of the untouched in my office each week, and it breaks my heart. Pat Harris was my first grade teacher. She had a Hug-Me-Spot right by the door to her classroom. No student could enter her room in the morning or leave her room in the afternoon without hugging Miss Harris on the Hug-Me-Spot. This world needs a Hug-Me-Spot. This world needs an army of Miss Harrises. The rules and restrictions have created a generation of kids that don't know what touch is actually appropriate, and adults that are too glued to their phones to use their hands to rub their child's back or snuggle on the couch. These touch-starved kids marry each other and are LONELY and starving for affection that was never modeled for them. And here we are. I challenge you to touch someone today. And tomorrow. And the next day. Hug. Cuddle. Kiss your partner. Squeeze your child. Hold hands. Make touch a part of your day every day. We may really change the world. 🌎 Let's try it. ☀️ Godspeed. There are SO many ways to use a daily planner. Over the years, I have tried numerous daily planners: Planner Perfect Traveler's Notebook system, Passion Planner Daily, Erin Condren Daily Petite Planner, bullet journaling, Michael Hyatt's Full Focus Planner, and Emily Ley's Simplified Planner Daily. The 3 that I stuck with the longest are Planner Perfect, Passion Planner, and EC Daily Petite. I really enjoyed bullet journaling, but it seemed to take more time than I currently have available since everything is blank and undated. Planner Perfect is also blank and undated (other than the pre-printed week-at-a-glance and month-at-a-glance in each of her monthly journals), BUT if you receive her monthly subscription box, you'll get 3 coordinating washi tapes for the month and 4 coordinating sticker pages for the month which make it easy to set up your monthly book. I also find it calming and rhythmic to lay down washi and stickers every month in a freshly printed traveler's notebook that I know will change out of my beautiful, rich, fabulously-leather-smelling Coco TN each and every month. It really is like a fresh start and a new beginning each month. There is something to be said for that. ☀️ Ways to use a daily planner (what to write in it):
Using a daily planner may seem cumbersome, time-wasting, like overkill, or even pointless to some. At times, I agree. Other times, however, I feel like I'm in 4th grade again - unable to drive yet- unable to see my friends freely - and full of creative energy and thoughts that need to land somewhere. I have markers, pens, coloring pencils, stamps, washi tape, and a TV with streaming services or Audible with any book I want or a phone with YouTube and AirPods to fill my creative or avoidant needs.
Planning CAN be numbing, and that's okay. I know a 40-something woman decorating paper with stickers is a much healthier outlet than substance abuse or an eating disorder and I do not say that lightly. Addiction is real. Trauma is real. Numbing is real. Self-soothing is real. Finding healthy and safe ways to calm our nervous system can be both life-giving and life-saving. YOU may just like pens and paper. I encourage you to take your planning love for what it is and enjoy it. I never met a dual-tip marker I didn't like. 😜✍️📝🌻 Once you have decided on a planner, you will immediately start thinking of ways to use the Notes Pages in the back of the planner. Below, I show you pages from my own planners over the years. Some of the other ways I have used my notes pages include:
📝 ✍️ Happy planning!!! 📒📚
I do want you to listen to the podcast, because I think there are some big pearls in this interview, but here are a few highlights:
Find out who is in your circle:
Plan as much as you can ahead of time:
Final pro tips: -Keep a medical binder of all your paperwork -Have a designated inbox for all incoming papers (follow The Planning Woman for more on this) -Apply for intermittent FMLA with your employer -My personal pro tip: PET THERAPY! 🐶🐱 Charlie the Dachshund makes everything better!
Who knew a pen and paper ✍️ could save a life? I wasn’t actively suicidal. But I was having frequent daydreams of having a wreck that was “bad enough” to keep me in the hospital a few days, off work at least a month, and unable to help anyone else for a while. 😳 I wanted it to be a single-car accident and of course I wanted to be alone. I wasn’t looking forward to the injuries and was praying nothing would require surgery, but I couldn’t wait to have a respite from work, life, and motherhood. Does that sound crazy? Selfish? Or similar to thoughts you’ve had? Caregiver fatigue 😴 is a real thing, even if you’re paid to care for others. Motherhood fatigue 😴and lemme just say it, full-time step-motherhood 🤷🏼♀️ fatigue is a real thing even if you love your children 🚶♂️👬🏼 dearly. Today’s world 🌎 for women is exhausting:
Toss in a pandemic 😷 and virtual school 📚and BAM, all the therapists are booked! Fortunately, my mental "breakdown" was pre-pandemic. Thank the heavens I already had a therapist when my regular job got flipped upside down in March of 2020. My crazy started when I was in the throes of motherhood, working full-time and commuting with kids age 2, 4, and 12. I was crying regularly on my way home from work, wondering how I was going to get everything done and actually sleep too...😴 I’ve always had pen and paper near me, but I didn’t start regularly journaling ✍️ until I started feeling that OVERWHELM on a regular basis. I had so many thoughts racing through my head and I didn’t have a system to capture them. I was using a planner, but I might think of something while driving or in the shower and I would lose the idea 💡 or thought before I captured it. Some internet scrolling led me to David Allen’s Getting Things Done method. By this point I had played around with bullet journaling and list making (List Maker 4 Life right here now!), but again, I felt like my thoughts were fleeting and scattered. I will link the GTD method below, and I do think it's a good system, but that's not the point of this post. Once I started decluttering my mind from all the racing thoughts, then I had to face my actual thoughts. This was not a good look. I couldn't remember the last time I had laughed with abandon or woken up with a passion for life. I felt like I was on a treadmill with no way off. Someone was going to have to pull me off, and I didn't have the time or energy to ask anyone to pull me off. I never felt relaxed. I was in a constant state of fight or flight (or so it seemed). I was alive. But was I living? Enter the JOURNAL. ✍️ A journal can be so many things:
Happy + Happy = Happy I was listening to a podcast the other day, and the speaker said he thinks we are all happier when we make others happier. Agreed. Then he said we are all happier when we are around other happy people. Also agreed. I went along my merry way and was strolling through the aisles of Home Goods, aimlessly looking at mugs and throw pillows, and those 2 thoughts kept resonating with me. Making others happier and being around other happy people makes US happy. What does it mean to make others happy? I know for a fact I've made some people happy in my lifetime. And yes, that made me happy. But did I even know what I was doing? Was me being happy by making them happy even my agenda? Do people even think about that? Can a person be happy as "an island?" What about people who choose to remain single or just haven't found a life partner? Those who live in solitude? Are they doomed to a life of unhappiness? What about solopreneurs and those whose jobs involve them working alone? Does that mean they are unhappy? I used to have a sign that says "happiness is a decision made ahead of time." I had another one that said "some people pursue happiness while others create it." While I do think that "our input determines our output" and "we are what we eat" (both in terms of food and the digital content we consume), I just don't think it's that simple anymore. You see, I can wake up, set my intention for the day, stay as happy as I "want" to be and in the course of one single day I can have the following conversations:
And those are just work examples. What about life examples?
So, how do I continue to make others happy in the above situations? How do I maintain my positive outlook? Aren't there times when happy ISN'T the right answer or attitude and staying positive just feels WRONG? In some situations, making others happy devalues their pain and suffering which honestly makes them feel even more isolated and unhappy. I realize not everyone has a job in the healing field, the medical field, or with the public. But we are all HUMAN. Almost all of us have friends, coworkers, neighbors, church members, family members, SOMEONE at some point in each day that is going to confide in us and lean on us. Do we lean in and choose to be a present fencepost or lighthouse for those that need us or do we back off all in the name of HAPPINESS and choosing joy? Can we even enjoy the good things without seeing the bad? I don't think we can.
I am REALLY starting to pay attention to my body when I meet new people. I don't always count them out if my first impression is less than stellar, but I do remember it. I take note so that I'm not surprised down the road.
And here's another disclaimer to Mr. Podcast's 2nd claim. Sally may make me feel good but I can't ever see her because our schedules are opposite and she's not good at reaching out. She struggles with depression and anxiety, so I have to let her reach out when she has the emotional space to do so. Bobby may make me feel like crap, but he's my brother and I love him, so then what? Susie might put me on edge every day, but she's my boss and I spend several hours a week with her. So yeah, Mr. Podcast, I like your ideas and they sound great, but then there's life. And after living and working and being in a few families now, I know that we can't always choose who we are around. And maybe that's why I stopped putting my 2 happiness signs out. I realized that I can keep a positive mindset and try to limit the time I spend with people who either make me feel bad or suck the life out of me, BUT... I also realized it takes the bad to see the good. It takes the ugly to see the beautiful. It takes all those things my patients tell me every day- that are really happening to people I care about- to make me slow down, sip my coffee, exhale at that stoplight, glance at my kiddos in the rearview, pump up the volume, and sing at the top of my lungs with my sunroof open. It takes being knocked down, run over, and slowly picking yourself up to smile at the exploring, coy toddler vying for your attention at your son's ball game. It takes losing something you love to look at a tree that's been standing outside your window for years and silently thank it for never leaving you. It takes holding someone you love while they shake in fear or agony to appreciate each and every piece of laundry you fold for the 400th time. The mundane is where the magic is... the daily can be the delight. Today, I choose to live... pretty, ugly, hard, easy, funny, scary, joyful, and unthinkable. Happiness will work itself out. She will make her appearance. And I will nod in recognition each time she does. To read some of my friends' thoughts on happiness, please click below and support their work. We all belong to a writer's group and I have learned and grown from each of these special women's work and words.
Chasing Happiness By Sharla Hallett www.sharlahallett.com/chasing-happiness/ Finding True Happiness and Keeping It By Lisa Granger https://lisamarcelina.net/finding-true-happiness-and-keeping-it/ Mom Burnout and How to Be Happy By Ashley Olivine https://www.ashleyolivine.com/mom-burnout/ 3 Days By MelAnn https://graceandrapture.substack.com/p/3-days Seeing Happiness Right in Your Life By Dianne Vielhuber https://simplewordsoffaith.com/2021/10/01/seeing-happiness-right-in-your-life/ The Summer of Happiness Recap of Summer 2021 By Jessica Haberman https://storytellerfarm.com/the-summer-of-happiness-recap-of-summer-2021/ When a patient presents with hair loss, I obtain a thorough history:
I then perform a thorough physical exam and order the following tests:
That may not “answer” your question but I hope it helps you know what a clinician will be looking for with this presentation of hair loss. 🩺👩⚕️ Personally, I have dealt with hair loss from taking Methotrexate for my sarcoidosis.
It started coming out in clumps in the shower and then in my brush. I soon had very patchy areas of hair loss all over my scalp. My hairdresser advised me to stop applying heat to my hair when possible, to wash my hair less frequently, to avoid ponytail holders when possible, and to avoid any hair color or harsh chemicals. I usually got some blonde highlights in the spring put in my naturally red hair, but I went without those for 4 years while I was on Methotrexate. My rheumatologist increased my Folic Acid dose from 1 mg to 2 mg daily, and I ordered Biotin off Amazon Subscribe and Save. I took the Biotin daily to help with hair growth. I am finally off Methotrexate and on Humira and am seeing hair growth again. Losing my hair was very emotional for me. My bright red hair has defined me for so long. I now knew what all of my patients struggling with hair loss from chemo or other medical reasons were feeling, and boy was it a wake up call. My heart goes out to anyone struggling with hair loss. Much love to you and I hope this helps. |