November 24, 2009 by Greg Katz
Healthcare is being debated in Congress and one of the issues on the table is the rationing of healthcare. People are concerned that treatment they need won’t be available to them because there are parameters that prohibit you from receiving a particular treatment, medication, or even surgery. NPR had a journalist on discussing this matter and some of the callers brought up some very interesting issues.
One caller L. stated that his father at 87 years old needed a valve replacement. The family sat with him and discussed the pros and cons of the surgery. After careful consideration they decided not to proceed with the surgery. The outcome? He lived for another two years and didn’t have to spend six months recuperating from a drastic surgery.
60 Minutes had Ira Byock on discussing these parameters and it brought some interesting issues to light. One patient age 63 was having lung and kidney failure. He was going to need a double transplant, but in order to be considered the patient needed to start exercising and eating. Dr. Byock discussed the possible need for CPR and the patient decided that yes, he wanted to be resuscitated in case his heart stopped. Is there any quality of life at this point? I believe that’s the question that is on everyone’s mind; how can you decide what’s enough and when do you stop any treatment allowing the patient to die.
I wrote an entry about informed medical decision-making. It’s important that each of us has as much information as possible when making these life and death decisions. Is it fair that the medical community puts conditions on care? In order for a recovering alcoholic to receive a liver transplant they need to have at least one year of sobriety, that’s a parameter that doesn’t seem to be argued.
During these debates I hope you’re considering your own quality of life and what limits you would put on your own treatment strategies. These are the times when digging deep can save you a lot of pain and anguish and save your family from making decisions they may not want or be able to make on your behalf. The other side of the coin is deciding when it’s time to fight for treatment you believe will extend not only the length of your life, but the quality to live that life to the fullest.
Take some time to really consider your wishes as it pertains to end-of-life care. Think about what you and your family are willing to endure. The 60 minutes interview talked about how many people live out their last weeks of life in the intensive care unit. Is that something you would want for yourself or would you prefer to have other plans in place. Talk to your providers about all the options. Have a living will or a durable power of attorney for healthcare in place outlining in detail your wishes.
Let your voice be heard during this debate. Your elected officials are making decisions that may impact not only the type of care you receive but the amount of care you receive. Should it really be up to them?
Posted in Having a Voice in Healthcare | Tagged 60 Minutes, coaching illness, end-of-life care, Greg Katz, healtcare reform, healthcare debates, healthcare rationing, illness coaching, Ira Byock, National Public Radio | Leave a Comment »
November 23, 2009 by Greg Katz
How strong are you? If you go to the gym you can measure your strength by using some of the apparatus in the gym. Aside from muscular strength in your arms and legs you hear trainers talk about core strength; the strength in the torso of the body, abdominal and back. It’s easy to measure your strength on the physical level but what about measuring your emotional or spiritual strength? Is it possible to develop a workout program for you mind and spirit? What would it look like? How would you know the workout is working?
Developing emotional strength takes practice just as if you were working out your bodies muscles. You develop your emotional strength by experiencing your emotions and allowing them to unfold in their own time. When you give yourself the freedom to express yourself fully you give your emotions room to expand and become stronger in how they manifest. Full emotional expression is freeing, stress reducing, and an authentic way to life your life. It comes down to willingness. If you didn’t grow up in an environment where emotions were expressed then this may be a challenge, but it can be learned. It requires that you place yourself in environments where emotional expression is not only modeled, but encouraged. This is why support groups are a great model for authentic emotional expression when facing a chronic or life-threatening illness. Being in an environment where emotions are present or right below the surface gives you a safe place to experiment. It’s like having your own emotional strength building gym.
Have you ever tried to measure your spiritual stamina? It’s not like you can start running and see when you get tired, although the concept is similar. Spiritual stamina requires that you find inner guidance providing you with a sense of faith and hope. Developing your spiritual stamina is not about dogma; it’s about knowledge of your beliefs, values, and intuition. Having the capacity to find comfort and peace by going within is building spiritual stamina. Some may need a personal trainer just like when training the physical body and they turn to spiritual directors to help fortify their spiritual stamina in the face of a health challenge. Knowing that there are others willing to support your is empowering. It punctuates the knowledge that you have your own internal and external resources for health and healing.
Remember that developing your emotional and spiritual strength is just as important as developing your physical health when facing a health challenge. Finding outlets that will support this development is the key. Learning to ask good questions of yourself and others serves as a catalyst for this type of development. It’s about coordinating your strength building efforts between the mind, body, and spirit. Don’t underdevelop one area and over develop others…you’ll live life lopsided.
Posted in Emotional Health, Spirituality and Health | Tagged coaching illness, emotional endurance, emotional release, Emotions and Healing, emotions impact on health, Greg Katz, illness coaching, mind body connection, spiritual stamina, spiritual wellness | Leave a Comment »
November 19, 2009 by Greg Katz
Ever look at the list of vitamins and minerals on the side of any food product in the grocery store? Do you pay attention to what the minimum daily requirements are and how they impact your life? Are you conscious of what your body needs in order to function normally? One of the things to consider is that when facing a health challenge we’re not talking about minimums because the body has to function at full throttle in order to overcome the obstacle.
It’s easy to think about what the minimum daily requirements are for the physical body, but what about our emotional or spiritual being? What are the minimum basic requirements you need of hope, perseverance, or faith? It’s easy for our level of hope to be diminished. Many of us facing a health challenge are way below a sustainable level of hope, what does that do to the immune system? What happens if you’re starving emotionally or spiritually? If there is nothing in the well, what are you going to do to quench your thirst? The word sustainability is used in regard to food and the environment, but what about sustainability in your emotional and spiritual life?
When we’re feeling depleted emotionally and spiritually many begin feeling isolated and depressed. Even though feeling depressed or sad may be “normal” after a diagnosis, being stuck in the ditch isn’t going to serve you on any level. How do you keep your head above water? Gratitude is one place to start. Being grateful for those in your life who are supporting you will raise your level of hope and comfort. Empowerment will fortify your mind, body, and soul. It will raise your level of sustainability going beyond the minimum levels, and experiencing a surge of hope sparking the immune system to rev its engine.
Why do we settle for minimums when we’re at the crossroads to health and healing? It’s critical to your journey of health and healing that you raise the bar on your expectations of yourself. Having the capacity to incrementally increase your levels of hope, faith, and perseverance will connect the mind’s message to your body and spirit that it’s time to up the ante and minimums are no longer acceptable. You are in the driver’s seat and it’s time to set your internal thermostat to a higher level so you’re never depleted and can acquire the resources you need toward health and healing.
Posted in Emotional Health, after the diagnosis, coping with chronic illness, coping with life threatening illness | Tagged building your immune system, coaching illness, Greg Katz, holistic health, illness coaching, mind body connection, patient empowerment, spiritual wellness, Spirituality and Health | Leave a Comment »
November 17, 2009 by Greg Katz
When diagnosed with a chronic or life-threatening illness not only do you have the shock of the diagnosis, but now you’re required to make all these decisions about your care. Our age of technology sends most of us running to the internet for information and options and in many cases it helps and in others it increases the confusion. Do you think it’s possible to discuss with your doctor all the options to come up with a feasible treatment plan? What if the doctor talked to you and not at you, would that make a difference? Wouldn’t you rather be a partner in your care than have a plan super-imposed on you like clothing bought off-the-rack?
The only way you, the patient, should be making decisions about your own care is if you’re thoroughly informed. Making off-the-cuff decisions isn’t good for you and will leave you angry at the medical community. The internet may provide a foundation of information, but it can’t go through a decision-making process for you so there has to be a better plan. Becoming an informed patient means having a dialogue with your doctor and coming to an understanding about the pros and cons of each treatment option and how the two of you can tackle this health challenge.
There is a group called “The Foundation for Informed Medical Decision Making” (http://www.informedmedicaldecisions.org) that focuses on how patients make decisions and is looking at outcome studies when patients are fully informed about their options. I’ve spoken in the past about the fact that if you go to a surgeon they are going to want to do surgery, as an example. Each provider has some stake in the treatment plan because it’s their specialty, it’s what they know, and it’s how they know to solve the problem.
Business week had an article discussing ways to reduce healthcare costs and they shared a scenario from the Spine Center at Dartmouth-Hitchcock Medical Center. They said, “patients with back problems are show a video that walks them through various procedures and provides data showing that outcomes are similar whether or not they have surgery. Once the program started, spinal surgery rates dropped 30%.” A 30% reduction in spinal surgeries, so how does the domino effect apply? Thirty-percent fewer spinal surgeries means 30% fewer chances for surgical errors that result in medical malpractice suits. Thirty-percent fewer spinal surgeries means less chance for the patient to acquire a hospital based infection like MRSA or Cdiff. These are big things to consider.
It doesn’t matter what your diagnosis, informed decision-making is crucial to your well-being. It will empower you and that in and of itself increase your confidence in the treatment and the provider. When you feel empowered it increases your level of hope and that’s important for your recovery. Informed decision-making means that your voice is heard and your place in this world as an individual, not a number is honored!
Posted in Having a Voice in Healthcare | Tagged coaching illness, Dartmouth-Hitchcock Medical Center, Floyd "Jack" Folwer Jr., Foundation for Informed Medical Decision Making, Greg Katz, illness coaching, informed consent, informed decision making, patient empowerment, self-empowerment, Spinal Surgery | Leave a Comment »
November 16, 2009 by Greg Katz
I’ve only been on small sail boats a couple of times when I was a kid. As an adult my boat experiences have been on cruise ships, a very different experience. The thing both types of boats have in common is the anchor. The anchor keeps the boat stationary, keeps it from drifting with the current, and allows the boat to create a temporary resting place.
When facing a chronic or life-threatening illness an anchor can be viewed in two ways. First it can be the stabilizing factor that keeps you in place long enough to face the issues at hand. It prevents you from drifting away from the core issues facing you regarding treatment or symptoms related to your health challenge. On the other hand, the anchor can be the thing that prevents you from exploring new opportunities. It’s the piece of the puzzle that keeps you tethered to old ways of thinking.
If you haven’t created a new mind-set following your diagnosis being tethered to the past can be detrimental to your emotional and spiritual stabilizers that guide you on your journey to wellness. Keeping yourself attached to the fantasy of a life without the current challenge is just that a fantasy. Being anchored to an illusion is a house of cards waiting to fall.
Let’s take a look at it from another perspective. If you’ve made the internal adjustments following your diagnosis then the anchor may be what you need to stay in one place long enough for the benefits of treatment or new information to take hold. We all need time to assimilate information into our being and the anchor can be that force that keeps you in one place long enough for your to see the results, hopefully the results you desire.
Where am I getting with all of this? A lot of how we deal with a diagnosis is based on our frame of reference. The impact is based on the perspective we take about the health challenge and whether or not we feel empowered or helpless. My hope is that you find ways to shift your perspective to that which is empowering. An empowered patient is a better partner with the medical team who is working to minimize symptoms and disease progression. Your frame of reference will also serve as the lens through which all your experience passes. Developing the capacity to shift your perspective is a step toward optimism and hope; both necessary ingredients for health and healing.
Posted in Emotional Health | Tagged self-empowerment, partnership with doctors, coaching illness, illness coaching, Greg Katz, reframing experience, shifting perspectives | Leave a Comment »
November 13, 2009 by Greg Katz
Welcome to Caregiver Friday!!
Wouldn’t it be great if we all had someone who would give us counsel, look out for our well-being, and protect us from everything in the world? That’s exactly what the President has in his Chief-of-Staff. I was thinking about how this interprets into real life after watching a rerun of The West Wing. In the episode, the President is off to give the State of the Union address. As is customary, a member of the cabinet is left behind in case of Armageddon and the Capitol building is destroyed killing all the government officials in the building. The cabinet member selected to remain out of the capitol was the Secretary of Agriculture.
As the President is leaving for the speech he says to the Secretary, do you have a best friend? Is he/she smarter than you? Would this person lay down their life for you? That’s your chief-of-staff. How about that, three simple questions to determine who that person would be in your life.
Translate that to your life as a caregiver/wellness partner. We need advisors because we’re emotionally connected to the outcome of any decision. We have a skewed view of the world and about its fairness. There are lots of opportunities for you to make life more difficult than it needs to be and having someone who can tell you the caring truth is a lifesaver.
Having a community is critical in our culture. We are social creatures and isolation is bad for your physical, emotional, and spiritual well-being. Experiencing support, love, and protection from another human being who can be objective will help give you perspective about your own life and about the decisions you have to make as a caregiver/wellness partner.
It doesn’t matter what your personal issues are as a caregiver; creating the capacity to look at the big picture is important. Utilizing your “chief-of-staff” as a sounding board gives you time to weigh options, gather information, and make informed decisions. Recruit your own chief-of-staff and see how it may improve your quality of life…it’s a win-win situation.
Posted in Caregiving | Tagged care for the caregiver, caregiver burnout, caregiver empowerment, caregiver health, caregiver needs, caregiver stress, caregiver support, Chief-of-Staff, coaching illness, Greg Katz, The West Wing | Leave a Comment »
November 12, 2009 by Greg Katz
As I wrote the title for this article it made me think about how many ways it can be interpreted. I guess the truth is that it all depends on what’s going on in your life at any particular time. I believe it’s a question we all ask ourselves at one point in our lives; maybe a bit more when we’re facing a chronic or life-threatening illness.
The responses that immediately come to mind for those facing a health challenge are; the treatments, the pain, the fatigue, the isolation, and a host of other options. I guess if we flip the question around there’s always another perspective for us to explore and that question is, “Why would we ever want it to end?”
I guess you’re wondering what the “it” could be when facing a health challenge. I know not everyone feels this way but many feel that their health challenge was/is a gift. Whether or not you believe that to be true, the never-ending aspects of a health challenge may be closer ties to family and friends, a better knowledge and acceptance of your own body, a heightened or re-engaged spiritual life.
It doesn’t matter which road or question you choose because your journey is unique. There isn’t anyone who will experience this journey the same way so the answer to the question is at your own discretion. I would ask that you ask yourself one of the two questions I posed and see where it leads you. Give yourself the freedom to see if there is a point in time when the question flips from one to the other and possibly back to the original.
It’s all about your story and don’t let anyone ever rob you of your story. Your story is the foundation of your healing process and it can give you clues that will aid in your journey of health and healing.
Posted in Living with Illness, after the diagnosis, coping with chronic illness, coping with life threatening illness, living with chronic illness | Tagged asking the big questions, asking the tough questions, coaching illness, Greg Katz, illness coaching, patient empowerment, sitting in the question | Leave a Comment »
November 10, 2009 by Greg Katz
Ever stand at the edge of a large expanse and yell at the top of your lungs waiting for the echo? It’s amazing how often in pop culture, television, movies, music, etc, we get the echo of what’s happening to many of us at the same exact time. Tropical storm Ida is causing quite a disturbance in the gulf and there’s nothing we can do about it. We can’t change the course of the storm, we can’t move the country out of harm’s way, and we can’t force people to take appropriate measures to insure their own safety.
In the United States we suffered a tremendous last week at Ft. Hood when a member of the military opened fire amongst a crowded room of unarmed service personnel and civilians. While this was happening an angry employ entered his previous place of employment, opened fire killing one and injuring five employees. Once again in these cases there is a powerlessness felt because some force whether it be created by nature or man himself sets something in motion and unfortunately we’re right in the path of the turbulence.
Why am I bringing this up in a forum that discusses illness? You can’t elude an illness. It doesn’t put a GPS locator on you and hunts you down, it happens. The unfortunate part for those of us diagnosed with a chronic or life-threatening illness is that we can’t get out of harms way once the disease is set in motion. We can begin treatment, but that’s like brining FEMA trailers in after the storm has hit. Avoidance may be a coping mechanism for emotional issues, but when it comes to physical health avoidance can be fatal.
No matter how powerful we think we are there are still forces greater than us. It would be great if we could overcome every obstacle but we can’t. Doctors can’t heal every disease, clergy can’t heal every spiritual hurt, and mental health professionals can’t heal every disorder/life malady. Does that mean we’re powerless? Certainly not, it means we have to get better at using the available resources we have at our disposal. We have to enlist the support of every opportunity, person, and invention/creation that could serve us on our journey to health and healing. Yes there are forces greater than us, be we are a greater force than some…let’s make sure we know it and use that knowledge.
Posted in Spirituality and Health | Tagged self-empowerment, health and wellness, health and healing, spiritual wellness, patient empowerment, illness coaching, Greg Katz, Ft. Hood, Hurricane Ida, Tropical Storm Ida | Leave a Comment »
November 9, 2009 by Greg Katz
In the past I’ve talked about how many of us sit around starting our conversations with the words, “If only…”. Unfortunately that thinking tends to stir up resentments or remembrances of times gone by when you were healthy or healthier. We can switch our thinking from “if only” to “what next” but I’d like to have you think about something a bit different. ”What next” doesn’t take the request far enough so if you’ll indulge me just a moment we can begin our journey together.
Let’s extend the phrase from “what’s next” to “what’s the next thing”. I want you to begin thinking about and creating what’s the next thing that will challenge you, infuriate you, or even inspire you. We all have that one thing that is tugging at our shirt tails wanting our attention and once we give it the slightest acknowledgment it can become all-consuming. Why do we do that?
When diagnosed with a chronic or life-threatening illness we’re always looking for the next thing that will save us. What do we need saving for? Do we need to be saved from ourselves, from a cell, or from something we can’t even identify? I don’t have the answer on this one, what I do know is that it’s the next thing that’s waiting in the wings that can push you to personal greatness. I’m not talking about the greatness that comes with having your name put on a building or winning the Nobel Peace Prize. I’m talking about the greatness that comes with living your life to its fullest with the resources available to you at any given time.
They say that humans only use about 10% of their brain capacity. I wonder what percentage of our emotional and spiritual resources we utilize at any given time to stir the pot and allow the next thing to emerge in all its glory with its challenges and rewards. What do you have waiting in the wings and how will you invoke it to the foreground of your life? How will you learn to use more of your personal natural resources that contribute to your health and healing? How do you think you’ll feel when that next big thing emerges and you embrace it will all the rewards that come with living a full life?
Posted in Living with Illness, after the diagnosis, coping with chronic illness, coping with life threatening illness, living with chronic illness | Tagged coaching illness, Greg Katz, holistic health, illness coaching, self-empowerment, spiritual stamina, spiritual wellness | Leave a Comment »
November 6, 2009 by Greg Katz
Welcome to Caregiver Friday!!
One of my favorite places to visit in New York City is Rockefeller Center. There’s a huge status of Atlas carrying the world on his back that is magnificent and certainly for many a sign of the times. It’s easy for a fictional character to carry the weight of the world on his/her back, but what about us real life mortals? How is it possible that we come to a place in our lives when we are not only responsible for ourselves but the survival and well-being of others?
Now that I’ve laid this out those of you who are caregivers/wellness partners are probably feeling overwhelmed. You probably saying to yourself that you already knew all of this so why am I spelling it out in the post? The truth of the matter is that when we keep things in our heads we’re the only one who hears it. We think it, we talk to ourselves, we imagine scenarios as problem solving mechanisms to try and calm the mind, even if just for a moment.
When I put it out before you in black and white we take it to a whole new level. It becomes conscious and present and something that each and every caregiver/wellness partner should be shouting from the rooftops…CAREGIVING IS HARD! I’m not saying it’s not without its rewards; but it can be a difficult road to navigate.
I guess what I’m really saying is that it’s important to say things out loud. It’s important that your voice be heard, with the patient, the doctors and with your own soul. You have an opinion and it’s important to remember that when the patient got diagnosed, you got the same diagnosis. You may not have to go through treatment and your existential issues are probably a bit different, but impermanence comes to the foreground. Speak your truth, not in an aggressive manner, but in an assertive manner.
Don’t be responsible for the world, cut loose that which is too burdensome and focus on what really counts. Lighten the load when possible and find ways to build your physical, emotional, and spiritual endurance; it will save your life and increase your quality of life!
Posted in Caregiving | Tagged care for the caregiver, caregiver burnout, caregiver empowerment, caregiver health, caregiver needs, caregiver stress, caregiver support, coaching caregivers, Greg Katz | Leave a Comment »
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