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The Anxiety Fugue

Yesterday I talked about taking my black lab, Tashi, to the vet because of her trouble walking. I wrote about needing cue cards because the questions I should have asked escaped my consciousness in the midst of the exam. What caused my lapse in consciousness? What is it that prevented me from following my own protocols that I’ve set in place for my own healthcare when it came to Tashi? Anxiety!

Anxiety can be an overwhelming tidal wave of angst. It causes panic attacks and evokes a stance of fear. I don’t find myself to be an anxious person, but when anxiety does strike it strikes hard. It’s not invited. It’s a party crasher to our lives. I’ll give you an example.

I’ve got asthma. It’s under control with the use of a couple of inhalers. I am under a doctor’s care and have had numerous pulmonary and cardiac tests to insure that I’m getting the right care. I don’t know if you’ve ever had trouble breathing, but the anxiety of not being able to breathe, for me, is worse than not being sufficiently oxygenated. There is an anxiety of doom and potential death.

Prior to taking Tashi to the vet she was having trouble walking. She was agitated and would move around the house quickly and without purpose. Her back was hunched like one of those black cat pictures you see at Halloween. You could look in her eyes and see the angst she was feeling.

Watching Tashi struggle evoked my anxiety. Instead of waiting for the exam I was already struggling with her impending euthanasia. For me, in that moment, there was only one ending to the story and that put me in a tailspin. By the time I got to the vet I had forgotten my own medical exam process. I didn’t have enough clarity of mind to ask the questions I knew in my heart needed to be asked. It wasn’t until I got home that the fog cleared and the questions surfaced.

When anxiety strikes it can be debilitating. This is why when facing a chronic or life-threatening illness it’s important to either record your doctor’s visit or bring a family member or friend as a witness. There are too many of us who miss vital information when the anxiety fugue hits and when it comes to our health and healing we don’t want to miss anything!!

Experiencing Anxiety?  Facing a chronic or life-threatening illness?  Visit http://www.survivingstrong.com

Want to alleviate anxiety through art?  Visit http://www.timetolivecreatively.com

Follow me on Twitter: @GregKatz2

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The saga of my black lab Tashi continues. At the beginning of last week I noticed that she was having some trouble walking and would drag her behind on the ground. Noticing the symptoms I took her to the vet and had her anal glands expressed. Unfortunately, that didn’t seem to do the trick and over the course of the next twenty-four hours her walking continued to be problematic.

I decided to take her to the vet and see what else may be going on. The vet, a new doctor to the practice, examined her making his observations. After checking for a bowel blockage, he determined that the problems with her legs buckling were neurological in nature. He prescribed a medication that would take about a week to build up in her system. The question I kept asking the doctor is, “Why would something like this have a sudden onset? And “If it wasn’t neurological what else could it be?”

Twenty-four hours goes by and she’s still in a lot of discomfort. I was rubbing her hind legs and thought I noticed a hemorrhoid and then realized it wasn’t her rectum; it was gynecological. Of course, as many of you know who have pets, they only present symptoms or get hurt once the vet closes. It was 8:03 and the vet closes at 8pm.

The next morning I took Tashi to the vet without an appointment. I figured I’ve paid for the building at this point; the least they could do is see her without an appointment. The staff is terrific and took her right in for an exam. She was prescribed a host of medications. Once again I asked the doctor if he still thought the problems with her legs was neurological and he feel that is still an issue.

I need cue cards because I’ve read Dr. Jerome Groopman’s book How Doctors Think and I didn’t follow most of his recommendations. I didn’t ask at the initial consult what else it could be if it wasn’t neurological. I’m better at the human health issues, but when it comes to veterinary medicine I’m at a loss. As you know, our anatomy and physiology is not the same (well maybe if you have a pet chimp/gorilla it may be close).

I’m following the treatment strategy we’ve outlined at the last visit. Her walking is greatly improved and not sure if it’s because we’re treating the gynecological issues or if the steroids have made all the difference. Perhaps it’s a bit of both which only leaves me more confused. I think I’m going to skim Groopman’s book again because I still have my doubts and I want to go in with a clear head. It shouldn’t be a surprise that when we’re with someone or a loved pet who is sick, our emotions take over and all rational thinking goes out the window.

I would love to have a set of cue cards with the questions I need to ask; that would be ideal. Instead, I’ll put some questions together and be prepared for her follow-up visit to determine her progress. She’s feeling better and that’s most important. I do want to make sure going forward that I’m better prepared!

Facing doctor’s appointments and lab work?  Want to be prepared for your doctor’s visits?  Visit http://www.survivingstrong.com

Want to explore health and healing through creative outlets?  Visit http://www.timetolivecreatively.com

Follow me on Twitter: @GregKatz2

If you follow me on Twitter (@GregKatz2), Facebook, or on these posts you know I have a black lab named Tashi that was diagnosed with MRSA (Methicillin-resistant Staphylococcus aureus) about seven years ago. Half her life has been spent visiting doctors, taking a host of medications, and having numerous tests where she’s been poked and prodded to get cultures. Throughout this process she has endured pain and discomfort, never giving up her loving nature.

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After fighting her most recent infection for the better part of a year, I’ve had the chance to be grateful for her doctor (Dr. B). He’s dedicated to her well-being. He took her case and as a result changed the infection control policies at the Veterinary Hospital. Most of all, I’ve watched him spend time with Tashi, never giving up on her and always trying to make her as comfortable as possible. What could he teach medical students who will eventually be treating us in doctor’s offices and hospitals?

Meet the patient where they are. I’m fortunate because I feel as if I’ve become partners with my medical providers. I always ask questions and I’m aware of the latest research on my own conditions. There is no power play in the exam room. Our vet is very sensitive to the power dynamic and when he examines Tashi he sits on the floor so he can see her eye-to-eye. He will often bow his head so that she knows that he doesn’t have to be dominant, in theory. He’s also the keeper of the treats, always a way to endear himself to her.

Follow-up is very important to the health and healing process. I feel like I’ve attracted patient positive doctors. They’ve been concerned and their follow-up has been extraordinary. One of my doctors had ordered some lab work and I didn’t do it within a timely manner. I received a phone call from him saying he hadn’t seen the results come across his desk and wanted to make sure I had gone for the lab tests. I felt like he was definitely looking out for me. Dr. B goes above and beyond the call of duty. After Tashi has an office visit, the phone rings about 8pm a couple of days later (after the vet office closes), the doctor checking to see if she’s making progress. Wouldn’t you like a follow-up call from your doctor to see if you’re making progress?

Dr. B always dialogues about side-effects and outcome strategies. He’s clear about what I’m willing and unwilling to do for treatment. Some of the medications Tashi has been on have had such horrible side-effects that they have been removed from the repertoire of possible treatment strategies. Minimizing suffering while seeking treatments that work is paramount to us working as a team. Dr. B doesn’t make it a “my way or the highway” session.

What can you take away from my experience with a vet that treats Tashi as if she were a person? Never allow your doctor to talk down to you. Be clear that you may not have gone to medical school, but it’s your body, your health, and your journey. Let the doctor know what’s important to you regarding the relationship. I always share with the doctor my professional background in healthcare so he knows from the start I’m going to be very involved (sometimes too involved when I begin to self-diagnosis. Read my post on anchor bias).

Select a doctor that makes you feel like you’re a priority. Unfortunately I spent five months taking Tashi to the vet a minimum of three times a week for treatment so I had a lot of time to ask questions and discuss her progress. Stay in contact with your doctor so he has up-to-date knowledge of how you’re doing. Many healthcare systems have email for their staff; use it! Don’t be afraid to ask questions in between appointments.

Lastly, find a doctor who has a strong commitment to compassion. Dr. B has always treated Tashi as if she were his own. He has done amazing amounts of research on her condition and is always looking for the latest and greatest treatments for her condition. I wish he saw humans because I’d be his first patient!

Looking to explore how to select a physician that is willing to partner with you?  Looking for education, support, and inspiration when facing a health challenge?  Visit http://www.survivingstrong.com

Want to explore how art improves healing?  Visit http://www.timetolivecreatively.com

Follow me on Twitter: @GregKatz2

The Unified Person

One of the things I had to break myself from doing when I spoke was splitting parts of myself. I can look back and see how I had confused indecision with no commitment. If you’re wondering what I’m talking about let me give you an example. I would be discussing an issue and would find myself saying, “A part of me….” How is that possible? Did I really think that only the cells in my right pinky believed a particular thing and the rest of body was in revolt? I’ve spoke with many people over the years that try and exile a part of the body that is causing them trouble but that never seemed to work. Unifying the body, mind, and spirit is the only path to health and healing.

If we divide ourselves in physical, emotional, and spiritual beings it’s like having three people fighting for limited resources. When we unify our forces we create an incubator for healing. It’s that incubator that provides a safe place to nurture a strategy for growth, renewal, and peace. It takes some work, but it reaps huge rewards.

Dr. Jeff Miller shared, “Body and soul cannot be separated for purposes of treatment. For they are one, and indivisible. Sick minds must be healed as well as sick bodies.” Having had the privilege of spending thousands of hours with individuals facing chronic and life-threatening illness I understand the importance of a unified front. You can’t play the game we did as kids, if mom says no ask dad, because we diminish the odds for health and healing.

We have to remember that when we’re facing emotionally draining situations our bodies defenses are compromised. The ideal situation is that when one of the three components that makes us whole is feeling compromised the other two can step in and bolster the compromised part of our being. If you’re emotionally drained your faith may take over, sending in reinforcements helping until you’re emotionally restored. (I’m not talking about mental illness, that often requires the help of a mental health or medical professional)

We all have to remember that all three parts of our being won’t be firing on all engines all the time. There is a dance that happens between the three and understanding that our being is always in a fluid state will make the ebb and flow more natural and not so scary!

Experiencing the ebb and flow of the physical, emotional, and spiritual parts of your life?  Visit http://www.survivingstrong.com

Want to explore how to create a natural state of balance with body, mind, and spirit?  Visit http://www.timetolivecreatively.com

Follow me on Twitter: @GregKatz2

You may be wondering is there really a pink sea; Google it and see what comes up. The truth is there is no Pink Sea, but today is October 1st and you may be experiencing a Sea of Pink. Today begins Breast Cancer Awareness Month. The use of the color pink has brought enormous attention to the Breast Cancer community. It has become defining, creating a community of those diagnosed with breast cancer, those living beyond breast cancer, and their families.

I was in Houston in April at the annual conference of the Arts and Health Alliance. While I was in town walking the main road an army of pink passed me. They were in the midst of their annual Avon Walk for the Cure. Women, men, and children all wearing pink to show their support for the Breast Cancer community.

The color pink linked to the breast cancer community has created a link and a way for community members to show their connection to the community. It becomes more prominent this time of year when buildings change out their white bulbs for pink bulbs shining a pink glow against their buildings in support. Pink ribbons are in full bloom like a field of wild lavender. It’s truly amazing that an illness has gone beyond the diagnosis and has created a community of hope, inspiration, and education.

The breast cancer community has created a culture and that’s not an easy thing to do. They have brought together the medical community, the corporate community, and individuals for a common cause. We’ll see a month filled with news stories about mammograms, treatment updates, and news of new medications such as Perjeta (a drug given FDA approval this past week).

You may not be a fan of the pink culture. Barbara Ehrenreich, noted author, is anti-pink. On an NPR interview she was clear that she didn’t want to be buried with a pink Teddy Bear. She doesn’t want to be defined for having an illness. She may not want to be defined by the pink culture, but it has served many raising money and pressure to find a cure and new treatments.

It doesn’t matter if you support the pink culture. It does matter that you support those facing Breast Cancer and all other illnesses. Perhaps we can find ways for other illnesses to find a culture that will help make their need more notable!

Are you or a loved one facing Breast Cancer?  Looking for education, support, and inspiration?  Visit http://www.survivingstrong.com

Want to heal through art?  Visit http://www.timetolivecreatively.com

Follow me on Twitter: @GregKatz2

Last week I wrote my 900th post for this blog. When I wake up in the morning I’ve started thinking about what could I possibly have left to say about health and healing, life and death, and overcoming adversity; and then a story pops up that all I want to say is, “REALLY?”

The Riverside Unified School District has banned John Green’s book The Fault in our Stars. The book has been cited as a book that will last the test of time because it’s a story about love, relationships, quality of life, and death. I read This Star Won’t Go Out by Grace Esther Earl, a real life account of a teen with advanced stage thyroid cancer. Earl and John Green had become friends and although there are similarities between the book and the memoir, Green’s book is fiction.

What was the reason for the Riverside Unified School District removing Green’s book from the middle school library? They didn’t want kids this young 11-12-13 to face mortality. They believe that reading about a teen dying would be too much for these kids to handle. Are the kids in Riverside living in a bubble like the Buddha prior to embarking on his journey to enlightenment?

Do you think that the principal of the school, the librarian, and some parents who voted really believe that children don’t get sick and die? I don’t know about you but if you ever watch television you can’t help but see a commercial for St. Jude’s Children’s Hospital. We have an entire network of hospitals in this country devoted specifically to the care of children and the Children’s Miracle Network. We have the Make-A-Wish foundation, giving children with life-threatening illnesses the opportunity to fulfill something on what we would call their “bucket list”.

I understand that death is difficult to speak about even for adult, but it does happen and denying it only causes greater pain. My hope is that no child has to personally experience illness and death, either their own or that of a loved one, but it will happen.

I’m disappointed that a school district would remove a book like this from their library because they are queasy about the topic. What I know about kids, maybe more so than adults, is that they are extremely resilient. They are inquisitive and would take these topics and want to discuss them, not shy away from them. When I was in high school, one quarter of health was devoted to death and dying. A progressive move on the part of our school district. Perhaps I should give Riverside Unified School District the name and number of my high school so they could temper their own resistance and fear.

Children die and it’s terrible. Removing a book that raises important questions is a travesty. The school should be ashamed of themselves.

Facing a chronic or life-threatening illness and looking for education, support and inspiration?  Visit http://www.survivingstrong.com

Want to discuss difficult topics with children through creativity?  Visit http://www.timetolivecreatively.com

Follow me on Twitter:  @GregKatz2

Colorado Public Radio interviewed a woman who recently wrote a book about her experience with the medical community. What happened? She was wrongly diagnosed with Multiple Sclerosis. I’m sure you’re going how does that happen, but unfortunately doctors aren’t perfect. We should always remember they say that doctors “practice medicine”; it’s not a perfect science. Unfortunately the troubles are on both the doctor’s and the patient’s sides of the fence so we have to develop strategies to overcome these upsetting outcomes.

The new director of the University of Colorado Health Sciences Center, Dr. Matthew Wynia, MD, MPH, talked about in the age of Google many patients are coming for medical care with their own diagnoses. On the flip side, Jerome Groopman, author of “Second Opinions”, and “How Doctors Think” shares that doctors have been trained to make a diagnosis in the first twenty second of their interaction with the patient.

Information is great, but too much information can be harmful. Wynia talked about a phenomenon called Anchoring Bias. Anchoring bias is when we lock our thoughts and decision around a particular fact or group of facts to the point that we become unable to hear any other opinions or possibilities.

Personally I have been guilty of self-diagnosis. I’ve taken all my symptoms, entered them in the computer and waited for the diagnosis. I know that it’s not definitive because I may be experiencing certain symptoms, but without further testing or exams I can only account for those I can see or feel. However, I can see where it would be comforting to walk in thinking you know what’s ailing you because the unknown is quite scary.

On the doctor’s end we also need to address anchoring bias. Doctors are trained to believe that A+B=C. Unfortunately, there are too many variables in the human body. Groopman recommends that after receiving a diagnosis asking the doctor, “If it weren’t X, what else might it be? What other organs are nearby that may influence your decision?” The key is dislodging the provider’s stronghold on the diagnosis they believe is 100% certain.

Unfortunately diagnostics are sometimes fluid. It’s important to remember that healthcare is a team effort. We, the patient, have to be forthright with our providers and the providers have to be willing to listen to the patient’s entire story. Detectives can’t solve cases without all the information and the same is true for medical diagnoses.

The one thing I encourage you to anchor to is the idea of optimal health. I had some major pulmonary issues earlier in the year. It would have been easy for the doctor, knowing I have an asthma diagnosis, to simply go with the pulmonary diagnosis. Instead, he ran a plethora of cardiac tests to rule out the possibility that cardiac issues didn’t spark my pulmonary issues. It was interesting because on my annual visit with my dermatologist I told him about the numerous cardiac tests I had and he was glad that my primary care physician expanded his sights beyond my obvious breathing issues, reinforcing my confidence in my doctor.

Be aware that we’re all subject to anchor bias, and not just in medical care. You’d be surprised how we can all be like a dog with a bone when it decreases our anxiety. Health and healing requires that we not look at healthcare as a one-way street. There are often many avenues to be explored and getting to the heart of the matter increases the accuracy of diagnoses!

Diagnosed with a chronic or life-threatening illness?  Looking for education, support, and inspiration?  Visit http://www.survivingstrong.com

Want to explore possibilities of health and healing through art?  Visit http://www.timetolivecreatively.com

Follow me on Twitter: @GregKatz2