Wednesday, March 22, 2017

5 Things to Make a Trip to the Emergency Room Easier


When the phone rang at ten pm on a Sunday night, a quavery voice said, "We've had a little accident over here." These few words can send the adrenaline pumping. The first time we got that call, we rushed over to check on Mom who said she'd fallen. She'd crawled from her living room to the bedroom to use the only working phone. The other one broke with her fall. We wondered if we should call an ambulance or just drive her to the hospital to get checked out. We made the wrong decision.

learned the hard way that it's dangerous to move or transport an injured person. Worse, when we arrived at the emergency room there was a long wait behind others who either looked worse or had arrived by medical transport. She spent a couple of uncomfortable hours on a hard xray table before the doctor arrived at the small town hospital. Mom was admitted with a broken hip.
Another call came on the morning of New Year's Eve before seven am. Mom asked for help getting a shower explaining that she had fallen during the night. She lay on the bathroom floor until morning. The tone of her voice indicated something was very wrong. I should have called an ambulance immediately. Instead, we bundled her up against the January cold and drove her to the emergency room. Again, bad move. The hospital was operating with a skeleton crew due to the holiday. We waited in the ER eight long hours surrounded by patients who were coughing, sneezing or vomiting.
During that time, the staff would not allow Mom to have even an ice chip until the doctor examined her. When her name was finally called, the doctor launched into a lecture about the patient being seriously dehydrated and running a fever. Imagine our response.
When the time comes to go to the hospital, the arriving paramedics will ask about the patient's  medications, their allergies, and medical history before the current emergency. 
Emergency Go Bag
Ambulance drivers want to take the patient's insurance and identification cards with them on the way to the hospital. Giving them a photocopy can avoid the loss of the patient's original cards. Gathering copies of all this info in one place ahead of time can help reduce some of the stress. 
  1. Make a copy of the patient's Medical Insurance Card, front and back. It has the phone number, policy and member's identification number. Put the copy into a Go Bag dedicated for emergencies.
  2. While at the doctor before an emergency grab two of their business cards; one for your wallet and one for the Go Bag.
  3. Create a list of other important phone numbers in case your cell phone battery dies during the wait. You'll want the numbers for their doctors, their minister, out-of-town relatives, friends and neighbors who might be concerned.
  4. Make a list of prescription medications showing the exact dosages and the frequency taken. 
  5. Add a list of known allergies or reactions to medication taken in the past and a list of over-the-counter medicines taken routinely.
When my husband went to the hospital for surgery, he was taking a lot of prescription medications. Rather than try to remember them, we made a list of each medication, its exact strength and dosage frequency. Several printed copies of this list went into the Go Bag. The admissions staff, nurses and doctors were grateful not to have to write it all down by hand. For example:

It's often necessary to provide info about previous hospital stays and the outcome, and whether the patient was admitted, along with a list of all surgeries the patient has undergone.
  • Prepare a List of previous surgeries, the types and the dates, such as,  Appendectomy - 1975; Left Hip, Replacement Surgery - 1991
It's a good idea to ask the patient for this information ahead of time. If they're confused or possibly unconscious you'll have the list available.


Most of the following items are optional for the Go Bag, but they're handy and easy to pick up at the dollar store.
  1. A small tablet for notes and instructions once the doctor arrives.
  2. A good book for long waits at the hospital and to avoid the germ laden, out-of-date magazines in the waiting room.
  3. Bottled water and packaged crackers or cookies. When your wait is long you'll be glad you have this. It never fails, if you leave the room for a minute to go to the cafeteria, that's when a medical person comes in with an update.
  4. Cup of instant soup or protein bars.
  5. Wet wipes and travel size hand sanitizer.
  6. Tissues for tears or runny noses.
  7. A new toothbrush and travel size toothpaste. This is for you.
  8. Packets of sugar or artificial sweetener, salt, pepper, and plastic spoons. Sometimes a vending machine has food but there are no utensils or condiments available.
  9. A clean pair of cotton socks to wear in those cold waiting rooms at the hospital.
If you drive your friend to the hospital, bring along any medical equipment they use. When Dad became critically ill after chemo, he refused to go in the ambulance. We drove him to the emergency room and in our haste, left his portable oxygen at home. The ER was overflowing and he had a dreadfully long wait before they finally admitted him to intensive care. Every gasping breath without his oxygen was a nightmare.

If your friend is admitted and you want to talk with the attending doctor,  sometimes they make their rounds near midnight so you could be waiting a while. Once you've invested hours waiting for X-rays, blood work and other stuff, you'll want to know what's going on.

In the hopeful possibility that your senior is not admitted, you'll want to bring their walker or wheelchair when you follow the ambulance to the hospital. They'll need these when they're released. One final tip just in case you lose the ambulance you're following. Ask the paramedics where they're taking the patient so you'll arrive at the right hospital.
Taking a few moments to assemble a few items into a Go Bag can reduce some of the anxiety that goes with any trip to the hospital. The best hope is that you won't ever need to use it.

Monday, February 27, 2017

On Becoming Your Parent's Guardian - Role Reversal

It creeps in slowly on little cat's feet and begins with hesitation over minor decisions.
When my mother started asking me about everyday things like how much rice to make and how long should it cook, I gently reminded her that she'd cooked rice longer than I had. Soon, the uncertainties evolved into indecision about everyday activities. Small tasks became more difficult as time passed. In one way, being asked for advice from a parent was flattering like my voice mattered. My input was finally valued. What I didn't know was that the tide had begun to turn and the child was becoming the parent one small step at a time. When our parents seek help on small tasks they've easily handled in the past, it's can come as a surprise. 
Mom at her 87th birthday with her sister.
Things went along smoothly as our new relationship emerged. I became more of an equal to someone who had always shown authority and control. My responsibility was awakening.
This awesome responsibility is not to be taken lightly. It arrives with its own baggage, setbacks and joy. Friends my age also found themselves called upon to provide direction and advice.
My best friend shared the frustration of trying to persuade her mother to use her supplemental oxygen like she is supposed to. Another friend shared the challenge of convincing her mother to  use the hearing aide she clearly needed and the frustration of having to repeat ourselves. How familiar it seems to be interrupted mid-sentence by someone who in the past would have said, "Not now, Mother is speaking." But the shoe is on the other foot for each of us.
Aunt Lou at 94
A stay-at-home mom of the fifties, my mother began her mid-life career with practically non-existent employment experience. She left nurse's training to get married in 1945. After her thirty year marriage ended, she took vocational training and embarked on a career as a Certified Nurse Assistant at the age of fifty.
I was suddenly asked for advice on dating, grocery shopping and apartment hunting, advice she had given in the past. Mom's new life as a single sole-provider continued over the next thirty years. On her eightieth birthday, she officially retired from a second career as a Teacher's aide. Her experience of taking a job outside the home added skills, confidence and a sense of accomplishment.
Reality struck after Mom went into the hospital for an extended stay. Although I'd been a co-signer on her checking account, I'd never managed her bank account. Writing out her bills opened my eyes. Her bills reflected a level of forgetfulness with misplaced invoices, lapsed auto insurance policies and past due notices tucked away in drawers. It became my job to manage her bill paying. There was no complaint from Mom who was glad to be rid of the tedious responsibilities.
Driving became another challenge and I worried about when she continued driving in her eighties. With diminished reflexes and increased fragility, it really wasn't safe anymore. She turned over her car keys to me voluntarily, stating she didn't feel confident on the road anymore. I was truly relieved. Not everyone acts logically when that time comes. It's often a source of friction. It's a reverse milestone of the day when we get behind the wheel of a car in our teens, a life-altering decision and makes one truly dependent like a small child again.

The two sisters still function independently in so many important ways, although nursing home bound by health, vision, hearing and memory impairments. They make me proud. One thing remains certain in our relationship. It is the unshakable friendship of my Mom, my true friend. She is a blessing and reminds me in so many ways that I'm the lucky one.

This story was originally published on HubPages in 2010 by PegCole17.

Tuesday, September 27, 2016

The Carriage Driver by Michael Friedman - Book Review

The Carriage Driver
Versatile author, Michael Friedman, writes from the heart about things that matter. In his book, The Carriage Driver, a collection of stories about the afterlife, he captures the hearts those who believe as well as those who only hope there is life after death.

His tales identify possible choices for each of us as we pass through the veil of darkness and our bodies outlive their usefulness. He presents options where we pick our new lives as we move out of this physical realm and into the after world. His tales provide possible answers to the eternal question: What if?

This gathering of stories incorporates individuals from all walks of life carrying on their hopes and dreams and moving them to the next level. Some arrive at The Castle for a sumptuous dinner; others conduct a symphony, perform an original musical masterpiece, paint a work of art or ride off into the sunset of our dreams. 

As the author explains in his Preface, “This work presents the instances where a person's life has led to a promised land.”


This book is one that the reader will turn to time and again with the passing of time as we long for the comfort of a future for ourselves and our loved ones. The closer one gets to our ultimate demise, we ache for a place, as promised in the Christian ministry and other religions, of "many mansions" where we might choose a resting place on our continuous journey. 

These beautifully written and uplifting stories provide insight into what might await us as we cross over into the unknown and pass through eternity. Peppered with wisps of poetry and driven by our favorite steed, Nuelle, we ride together into the storm as we face the future.


I'll Fly Away, Played by Alison Krauss




Friday, September 23, 2016

Welcome to the White House or is it Animal House?

What happens when the support staff of a President vacates the Executive Offices and a new Presidential staff moves in? In 2001, there was an interesting transition when George Bush's staff took over the offices after the Clintons left. What they found was more startling than the $200,000 of furniture that mysteriously disappeared with their departure.

Between January 20th and the 22nd of an election year staff members vacate their offices and are replaced by members of the new President's administration. How much cleaning and refurbishing should be required? It has been suggested that a good vacuuming and dusting would be sufficient. But this was not the case in 2001 due to the extensive damages inflicted on the executive offices of the West Wing and the White House.

Imagine moving into a new job or resigning and leaving your office in a state where it is unusable. An official government report identified numerous examples of vandalism and damage to equipment like fax machines, computer keyboards, telephones, files, furniture, doorknobs missing and that six to eight 14-foot trucks were needed to recover new and usable supplies that had been thrown away.1  An investigation into who may have been responsible for any damage, vandalism, or pranks was not included.

The Government Accountability Office (GAO) report also states, We believe that sufficient, competent, and relevant evidence exists to support our conclusion that damage, vandalism, and pranks did occur during the 2001 presidential transition, and we have presented this evidence in our report...Regarding the specific contents of graffiti, messages, and signs, we did not believe that it was appropriate or necessary to report their specific contents, although they observed a total of about two dozen prank signs, printed materials, stickers, or written messages that were affixed to walls or desks, placed in copiers, desks, and cabinets, or placed on the floor.

There were signs comparing President Bush to a chimpanzee found “in a number of printers”; “laced” throughout the reams of paper. In locations where people “dumped” supplies, a sign read “Gifts for the New President.” Along with Writing in middle drawer of desk that reads “Hail to the Thief”

Even the offices of the First Lady showed signs of disrespect. A February 21, 2001, facility request form (Form No. 58369) shows a request to clean the carpet in the former First Lady’s suite (Rooms 100-104). At least four current staff members told the GAO that this office suite was trashed, including reports of pencil shavings, dirt, and trash covering the floor.

There were desk drawers that appeared to be intentionally kicked in, chairs with the backs broken off and upholstery slit on the seats. A number of the desks appeared to have been scratched with knives; multiple “big scratches with a sharp object”; other furniture had red pen marks and other stains. Glass in glass-fronted bookcase was broken with glass still sitting in cabinet." Even in the men's washrooms, messages were scribbled that read, “What W did to democracy, you are about to do in here” (observed by five persons).

The GAO report cites distinctions between the GAO's perception and the White House which seems to focus on the semantics of the report rather than the topic of their observations about the transitional damages, cost or accountability for the mess. Inside the real West Wing...




The new president’s first challenge, between election day and inauguration day, is to select some 30 people to serve in his cabinet and as his top White House staff. The cabinet includes the secretaries of the 14 executive departments plus an assortment of other top echelon jobs, such as the U.S. trade representative. The key White House staff includes the chief of staff, the national security adviser, counsel, press secretary, and the top economic and domestic policy aides. 2

Several veterans of tense transitions weighed in on the oft-told tale of the 2000-01 transition during which departing Clinton staffers were reported to have removed the “W” keys from the White House keyboards being inherited by employees of George W. Bush. When she moved in on Jan. 20, McBride said, she recalled no sabotaged keyboards but did encounter some messy offices and the empty hallways filled with trash and boxes from the departing employees. 3

In conclusion, The best way to avoid such partisan mischief, George Bush’s personnel director Clay Johnson once told Kumar, is to have adults there at the end.” Seriously?


References:
  1. GAO-02 - 360 The White House
  2. First Impressions, A Look Back at Five Presidential Transitions, Stephen Hess, March 1, 2001
  3. Must Presidential Transitions End with ... sabotage?

Thursday, September 1, 2016

Finding Leo

We were driving down a familiar road headed home to our cottage in the country when we saw something brown running alongside of the road. As we passed by the creature, it fell to the ground and turned over, legs up toward the sky. We pulled off the road and walked back toward the little thing and it started wagging its tail.

The pads of his paws were bloodied by the distance he had traveled on the blistering hot asphalt. We could tell he was some sort of toy poodle despite the filthy, matted fur that covered his entire body. We scooped him up and headed home.

I put him in the kitchen sink and ran warm water over his body, soaping him up with shampoo. He shivered nervously as I clipped the matted clumps from his frame revealing a soft coat of white fur. His ribs were showing through the short hair when I finished. We wrapped him in a soft towel and held him until he was dry. I’ll never forget the look of gratitude in his sweet eyes as he reached up to give me a kiss before falling asleep in my arms.

The veterinarian told us that he was likely around nine years old, about ten pounds, suffering a bit of malnutrition and from the normal parasites that go along with living in the wild. We got him his shots and medication for the flea bites and abrasions that were present on his feet and body. He went back home with us, immediately taking charge of my lap like a hood ornament, staring out of the front window of the car.

We weren’t supposed to have dogs in the small place we were renting, but we convinced the landlord that he wouldn't be any trouble. With tile floors, any cleanup would be minimal, we told them, and we would be responsible for any damage. The little guy never once messed in the house.

Shortly after that, we relocated to another city where we took him with us into an apartment in a new complex with lime green shag carpet and Harvest Gold appliances. We both found new jobs and Leo stayed home during the day. It wasn’t long before the neighbors stopped us on our way inside.

“Did you know that your dog howls the entire time you’re at work?” they asked.
“Well, no.” We had no idea that he was so lonely. “I hope it doesn’t bother you.” No, they didn’t mind. They also had a dog, a beagle they named Beagle, and he barked most of the time.

Leo seemed fine for a time and then he started howling so much he began to wheeze and cough up foam. We took him to a new veterinarian who x-rayed his throat and discovered he had a torn esophagus, probably from eating sticks and rocks when he was out on his own. His jaw was also broken and not repairable, according to the doctor. We were given little choice other than to put him down.

Still in my teens as a young wife, it was my first time to make the ominous decision to end the life of a pet. I could barely live with myself for weeks afterward. The gaping hole in my heart after he made the trip to Heaven was nearly unbearable. The only consolation was that his last few months of his life he was happy and secure and well-loved. I always wondered where he came from, why he was out on his own, who might be missing this little boy.

The only remedy to the lasting heartache was to bring another dog into our household, a puppy, whose exuberance and joy was a much needed blessing after losing our rescued pup.

Tuesday, August 23, 2016

Harry Truman, Plain Speaking - by Merle Miller

Official Presidential Portrait painted by Greta Kempton,
Public Domain
The book, Plain Speaking, An Oral Biography, is a collection of observations by Merle Miller who invested hundreds of hours in one-on-one interviews not only with the former President, but with his staff, family members, former teachers, and a variety of every-day people who knew him before 1935 when he first went off to Washington. They spoke of his honesty, integrity, ethics and the kind of man who was held in high esteem.

Former President Harry S. Truman was a voracious reader. I always had my nose stuck in a book,” he said, “a history book mostly. Of course, the main reason you read a book is to get a better insight into the people you're talking to. There were about three thousand books in the library downtown, and I guess I read them all, including the encyclopedias. I'm embarrassed to say that I remembered what I read, too.”

He was a student of history, a man with an intense desire to preserve the records of history. Mr. Truman said, in talking about libraries, “The worst thing in the world is when records are destroyed. The destruction of the Alexandrian Library and also the destruction of the great libraries in Rome…Those were terrible things, and one was done by the Moslems and the other by the Christians, but there’s no difference between them when they’re working for propaganda purposes.” He believed “The only thing new in the world is the history you don’t know.

He also was concerned about the influence of money and donors. “I was always very particular about where my money came from. Very few people are going to give you large sums of money if they don’t expect to get something from it, and you’ve got to keep that in mind.” He was aware of the power and corruption money brings when he said, No man can get rich in politics unless he's a crook.

The 33rd President of the United States, Harry S. Truman was born on May 8, 1884, and served from April 12, 1945 to January 20, 1953. He was the son of a rural farmer and mule trader in Lamar, Missouri. He served as Vice President for 82 days before the sudden death of Franklin Delano Roosevelt catapulted him into the Oval Office at the culmination of the Second World War.

He was outspoken and downright humorous in his memoirs of those with whom he came into contact. His forthright nature was apparent in summary of many in the political limelight, including Adlai Stevenson of whom he said, “a man who could never make up his mind whether he had to go to the bathroom or not.” Speaking of Henry Wallace, an opponent when Truman ran for reelection, Truman said, “What he said he wasn’t going to do was exactly what I knew he was going to do. I don’t know in Henry’s case if you’d say he was a liar as much as that he didn’t know the difference between the truth and a lie.” He says that Wallace accused him of trying to get this country into war with Russia, which he says, “was the opposite of what I was doing.” Sound familiar?

President Franklin D. Roosevelt, Vice-President-elect Harry S. Truman, and Vice-President Henry Wallace, November 10, 1944, Photo by Abbie Rowe, Truman Library, Public Domain

Despite his share of “frustration, of failure, of disappointment, of poverty, of mortgage foreclosures, of heartbreak” and bankruptcy in his haberdashery business, he remained cheerfully optimistic and “never wore his heart on his sleeve.”

About heritage, he would add, “I wouldn’t think much of a man that tried to deny the people and the town where he grew up. I’ve told you. You must always keep in mind who you are and where you came from. A man who can’t do that at all times is in trouble where I’m concerned. I wouldn’t have anything to do with him.”

His early life reflected the challenges of a studious and somewhat frail child, who preferred reading and learning to the outdoor games and activities of his peers.

The book captures the essence of his personality, philosophy and ethics in his own words. He makes viable recommendations on books that every citizen should read, he speaks on how to regard those seeking office and cautions the same. “You see the thing you have to remember. When you get to be President, there are all those things, the honors, the twenty-one gun salutes, all those things, you have to remember it isn’t for you. It’s for the Presidency and you’ve got to keep yourself separate from that in your mind.

Public Domain, US Military Department of Defense, Wikimedia Images

He believed that you have to appeal to people’s best instincts rather than their worst which might win you the election, but will do a lot of harm to the country.

Mr. Truman’s home-spun and self-enlightened wisdom rings true in today’s world, just as he described the plots and campaigns of the Roman Empire as no different than the modern strategies. Through his forthright appeal to the masses telling the truth about what was going on, he won the bid for reelection, in his own words, “by a statement of fact of what had happened in the past and what would happen in the future if the fella that was running against me was elected.

Two final insightful quotes from the man who was my Dad’s favorite president; on the differences between mules and machines – “There’s some danger that you may get kicked in the head by a mule and end up believing everything you read in the papers.”


Caption: President Truman in St. Louis, Missouri. *Description: President Harry S. Truman with Bernard F. Dickmann, holding the Chicago Tribune, showing the headline, "Dewey Defeats Truman". They are in the St. Louis, Missouri train station.

Perhaps one of the most valuable things he said was this. “Sometimes I was advised to hold my fire on this and that because they said telling the truth would offend people. But whenever I took such advice I never thought much of myself. If you keep your mouth shut about things you think are important, hell, I don’t see how you can expect the democratic system to work at all.”

Entertaining, funny, witty, and full of important observations about the nature of men and politics, this book is highly recommended for anyone who wants to see for themselves that history repeats itself. Whether it’s dirty campaign tactics or political game playing in Congress, this book is eye-opening in its observations.

Sunday, August 14, 2016

Killing Floor - Jack Reacher Series by Lee Child, Book Review

Lee Child's first book in the Jack Reacher Series was fast-paced and full of mystery and intrigue. He shares a glimpse into the family history of the main character which explains a lot about his actions and well-developed skills in combat. Jack's reasoning power and deductive abilities take him out of harm's way after he's locked up as a murder suspect before earning the respect of the police. He manages to work his way into a role that leads them to solve multiple homicides and kidnappings which plague the town.

The author's writing method is like reading the spoken word rather than conforming to the laws of sentence structure, but he never loses the train of thought in the process. The story is at times, graphic and gruesome; depicting a trained ex-military man who sets the trap for would be assassins. He is able to overcome odds of those who pursue with intent to do harm.

In this adventure, he unravels the mystery of a small town that conceals a huge secret which enables the prosperity of merchants who have few if any customers. He presents characters who are realistic in their depth of evil and weaves a story that kept me turning the pages into the wee hours of the night.

Tuesday, July 19, 2016

Crisis of Character, Gary J. Byrne - Book Review

Crisis of Character presents Gary Byrne's take on a variety of situations in the White House including its former residents, the Uniformed Secret Service Division, James J. Rowley Training Center, (JJRTC), Federal Air Marshall Service (FAMS) and FBI Criminal investigations of alleged wrongdoing. His memoirs paint a portrait of comparisons between those individuals who exude character and those who fail in that regard.

At times, rambling, yet unnervingly revealing, the story engenders a deep loathing toward those who miss the mark when it comes to personal and professional integrity. His expose is riveting and eye-opening for anyone who has not lived through the numerous and ongoing scandals which plagued the Clinton administration. Known by some as the Arkansas Mafia, scandals like Filegate, the unauthorized background investigations of 900 Travel Agency Personnel to the strange and suspicious suicide of former White House Aide, Vincent Foster. Combined with a host of nefarious activities, his story inspires the reader to shake their heads at the allegations of corruption, whether real or imagined.

Photo By (top) Cezary, Wikimedia Commons 1
In 1995, Officer Byrne stood guard outside the door to the Oval Office, a Uniformed Officer of the Secret Service Division hired to protect the leader of the free world*, the President of the United States (POTUS). From that vantage point, he claims to have witnessed actions by elected and appointed officials, visitors, interns, staff and other guards which call into question the lack of integrity and values in people who supported that administration. He identifies many well known characters as complicit in corruption and abuse of power including the First Lady of the United States (FLOTUS) whose tirades of foul language, well-executed schemes, webs of deceit and shifts of behavior compare to any Machiavellian actor that Hollywood could possibly create. 


By United States Department of State 2
He speaks of those who served whose “careers were made or broken on the whim of her ‘wrath’,” including that of Mrs. Clinton’s personal attaché, a lawyer from Arkansas named Vince Foster whose suicide led to unproven conspiracy theories. Rumor has it that his suicide weapon failed to function when found causing a great deal of speculation. He mentions boxes of files (removed and ) missing from Mr. Foster's office along with a ripped up suicide note, the last line which read, “I was not meant for the job or the spotlight of public life in Washington. Here, ruining people is considered sport.” He labels Hillary Clinton's leadership style as one based on “fear and loathing,” whose “scheming” was ever foremost in her actions.


Mr. Byrne describes a “culture of corruption” by “professional scandal makers” and provides elaborate detail on how an intern named Monica Lewinsky wormed her way into areas of the administration, such as the Oval Office, where she had absolutely no valid business or appropriate security clearance. He doesn’t hold back on terms like “liars”, “demeaning and manipulative” and cautions Americans to wise up to this slice of documented history. He makes the allegation that if Americans are “too dumb to learn from the history of the Clinton machine of the 90s” that we are doomed to repeat it. 

He gives numerous examples where a lack of integrity ran clearly through the White House and its occupants – who, chosen by vote, were elected to lead as well as follow the long-standing oath of office – to protect and defend the Constitution and its principles. He says, what we got instead was a scandal-filled legacy of lies, mistrust (“I did not have sexual relations with that woman…”) and abuse of power.


It’s said that a person’s true character can be ascertained by the manner in which they treat the lowest level of employee (or intern) within their circles, from dignitaries to security guards. The Clinton-esque method of disposable servants ran all the way to the top – affecting even their marital interactions (reference to Bill’s black eye and the shattered vase). It trickled down to their departure when 200,000 dollars of furniture was unlawfully removed upon their leaving office. It prevailed in the constant undercurrent of scandal and lies, cover-up and concealment.

By Sharon Farmer/White House Photograph Office 3

Although Gary Byrne’s story veers off from the focus of the book cover featuring a relatively attractive photo of the Clintons, it demonstrates the sacrifices and compromises that duty places on the Agency’s hired people. His story portrays the bureaucracy’s approach to issues of fairness in employment, training, compensation and duty expectations.

Mr. Byrne reminds us of our short-lived memories of terrorism and despite our chants of “We will never forget” the fact is, we have. For many millennials in particular, who were too young to remember the implications of “semen stains on a blue dress” and for those too naïve to understand the protocol of entering the Oval Office – and the breach of security that enabled such behavior to take place, it will serve as an eye-opening reminder that our chosen leaders must be beyond reproach – unimpeachable in their character and must exhibit behavior that is exemplary.


The book begs the question; Will our short memory spans lead us into another reign of leadership by people who are morally without character or integrity? Whether his story is truth or fiction, the story imparts a thought-provoking introspection of those in whom our futures reside.

The "Leader of the Free World" is a colloquialism, first used during the Cold War, to describe either the United States or, more commonly, the President of the United States of America.

1 - Photo attribution: By (top) Cezary p (bottom) UpstateNYer (here and here) [GFDL (http://www.gnu.org/copyleft/fdl.html), CC BY-SA 4.0-3.0-2.5-2.0-1.0 (http://creativecommons.org/licenses/by-sa/4.0-3.0-2.5-2.0-1.0) or CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons
2 - By United States Department of State (http://www.state.gov/secretary/timeline/) [Public domain], via Wikimedia Commons
3 - By Sharon Farmer/White House Photograph Office (National Archives and Records Administration) [Public domain], via Wikimedia Commons

Wednesday, July 13, 2016

Overcoming Opioid Dependency is Tough

Physical dependence happens when the body adapts to a particular drug and gets used to receiving regular doses of that medication 

Opioids are a class of painkillers with high addictive potential, typically used for the short term for treating severe pain following surgery generally prescribed for durations of less than seven days. 1
Unfortunately, injured workers who suffer with chronic pain often have little recourse other than taking pain killers long-term. "When the medication is abruptly stopped or the dosage is reduced too quickly, the person will experience withdrawal symptoms."2

One patient, who was injured on the job nearly fourteen years ago, waited two years to get approval for spinal fusion surgery, while his pain continued to get worse. Most of his daily activities, walking, bending, carrying things, even sleeping became impossible without agonizing consequences. 
During this time, the Pain Management Specialists continually added stronger prescription narcotics while the injured party fought a battle with Worker's Comp to be approved for surgery.

After surgery, the hardest part of the journey began with the challenge of getting off extremely high doses of prescription drugs. This is the true story of how, "J" overcame his dependence on opioid type narcotics.
Although the patient tried to reduce his prescribed medications under the guidance of his Pain Management Specialist, it was nearly impossible due to the side effects of withdrawal. 
The most difficult medication to stop taking was the 75 MG Fentanyl patch which provided direct cutaneous absorption of the strong drug (directly into the skin). Stepping down to 50 MG patches every other day led to insomnia, extreme agitation and psychotic episodes of paranoia including the shakes. The next level of reduction to 25 MG proved too much to bear. J worked through the problem by cutting the remaining 75 MG patches in half to receive a dose of 37.5 MG to ramp down the medication with less duress.


Once he was able to step back to 25 MG of Fentanyl, he began cutting those patches in half.The process had its drawbacks and didn't happen overnight.

Only when J felt confident taking the next step, was he able to cut back further, eventually, quartering the patches and adhering the patch to his skin with paper tape.
Once off the Fentanyl patch, he started the rigorous attempt at reducing the daily doses of Oxycodone Acetaminophen 10-325 tablets. By this time, the drug had reversed its relaxation effect and had transformed into a powerful stimulant causing insomnia. Attempts to further reduce the number of daily tablets left him agitated, suffering involuntary leg twitching, sleeplessness and ongoing depression. At this point, it became clear that he would need help to get off the remaining narcotics.
An important note is that no method will work for everyone. A structured plan, discussed in detail with a Doctor is the only remedy suggested. Never, ever try to go off these medications without consulting a medical specialist or serious consequences are likely to occur.

The final piece of the puzzle came from a reputable rehabilitation program in Dallas named PRIDE, an acronym for Productive Rehabilitation Institute of Dallas for Ergonomics. After years of taking exceedingly strong doses of Class Two narcotics, J broke through and no longer needs the drugs his body once strongly craved. For this, he thanks the dedicated team at the institute who provided encouragement, guidance, physical and nutritional training and counselling during his rehabilitation.
“PRIDE’s novel approach to chronic pain, known as Functional Restoration is a medically directed, interdisciplinary treatment that emphasizes measurement, mobilization, and re-activation supported by education, counseling and stress management.”3
The program consisted of one hundred and sixty hours of guided exercise, treatment and counselling designed to “provide measurable improvement in function, medication management or in helping patients return to productivity.

The most amazing thing was the speed at which he was able to quit all the drugs completely. This followed a one-week dose of an effective medication (also opioid based) called buprenorphine.
Buprenorphine (Subutex) treats withdrawal from opiates, and it can shorten the length of detox. It may also be used for long-term maintenance, like methadone. Buprenorphine may be combined with Naloxone (Bunavail, Suboxone, Zubsolv), which helps prevent dependence and misuse.
Workers' Comp fought hard to deny this program. Approval was gained only by the persistence of PRIDE's knowledgeable medical staff whose experience in these cases proved to be the key factor.

Completing the PRIDE experience, provided a deep sense of relief for this long-time, chronic pain sufferer who feels it was well worth the incredible effort needed to endure the program.
The impetus that pressed J forward through the most difficult times was the hope of returning to a life where his long-neglected hobbies could be resumed. He pushed through those times when he would rather have slept in after a night of insomnia and episodes of extreme anxiety.
"PRIDE (Productive Rehabilitation Institute of Dallas for Ergonomics) was established in 1983 as an alternative to chronic pain management programs with a mission to empower and assist patients to return to work, improve their quality of life, decrease dependence on medication and health providers and avoid recurrent injuries by increasing physical capacity to the highest level possible through functional restoration." 4
Please remember to consult your doctor when undertaking any sort of changes to your medication especially those which may have addictive properties.
Only your physician can assess your health and wellness and prescribe the best plan for reducing an Opioid dependence.



Sources
  1. Harvard Health Publications, Harvard Medical School, Article, Avoiding Addiction, Nov 13, 2013 
  2. Drugs dot com, Fentanyl Side Effects
  3. Health Central, Remedy Health Media, Christina Lasich, MD, Health Pro. Sept. 24, 2012, 
  4. PRIDE, 5701 Maple Ave. Dallas, Texas 75235 http://www.pridedallas.com/

Saturday, July 2, 2016

Robbery in Progress

Bait Sandwiches, our Specialty
Shopping at a convenience store can sometimes bring drama. This is a true story told to me by the person involved written from his point of view. © Peg Cole.
"The management of the disk duplication company where I worked was doing their best to make me quit," he paused for a moment of reflection as he told the story. 

"All the signs were crystal clear with their cruel tactics of isolation and denigration, but their latest effort was the one that nearly got me killed." He scratched his head and continued.
"Things at work seemed like an ongoing battle between the old school faction and the young entrepreneurs who owned the business. They wanted us to believe that they knew it all. You couldn't tell them anything. That was just they way it was where I worked. That's just the way it is...


"Of course, these guys probably never tested a component to the board level in their lives. It all came to a head that day I repaired their outdated duplication equipment which served to add fuel to the growing animosity. The owners had apparently told everyone the machine was beyond repair, which naturally, put them in a bad light when I got it running better than before. 
Rather than being pleased with my innovative solution that cost them pennies, my repair didn't set well with either partner.
Old SEAC Computer, Wikimedia Images, Public Domain
Sure, I was probably as arrogant as either of these dudes that seemed dead set on running the company into the ground. They were quick to mock those of us with a few years of experience under our belt, calling us geezers and the like. The way I saw it, they couldn't diagnose their way out of a paper bag.
Their vendetta began almost immediately after my repair job and escalated from there.
To begin with, they removed me from all tasks having to do with technical or computer related equipment. Instead, they put me on a special project assembling wood cabinets in the blistering hot warehouse. The task was easy but I certainly wasn't putting my years of computer experience to use.
That wasn't important. I'd taken this entry level job out of desperation following a layoff at the computer company where I'd been working for twelve years. I had started working there right out of tech school, after graduating at the top of my class. I never had to look for a job - they had recruited me. 

Still, I was grateful that this new job provided enough money to pay the basic household bills, although my confidence and my ego suffered a bit during the transition.

Vintage Disk Duplication Equipment
Isolating me from the other workers by putting me in the warehouse apparently wasn't enough to suit them. When that wasn't enough to make me quit, they decided to up the ante and have me report in to work at four in the morning. The normal first shift clocked in at seven am.
I was headed to the warehouse to work my new schedule when I stopped by a Seven-Eleven to pick up some coffee and a snack. The store was quiet, empty at that time of the morning. It was still dark outside, so that came as no surprise. I helped myself to a large regular coffee in a Styrofoam cup and went up to the register to pay, but there was no cashier around. While I was looking at my watch and growing impatient, I heard a noise coming from behind the counter. Someone was moaning.
"Help me," the nearly inaudible voice whispered.
Now, that is definitely a sound that will get the heart pumping and the blood flowing. Then, I noticed the telephone was off the hook, its cord dangling to the floor. My eyes followed the twisted wire downward where I saw the receiver lying next to a body. He'd been shot.
Frantically, I looked around the store seeking who knows what - a doctor, an ambulance, better yet, some indication that I was still sleeping quietly in my nice warm bed at home. Instead, my eyes rested on an array of automatic weapons pointed in my direction.
The entire parking lot was jammed with patrol cars, their flashing lights sending eerie rays of red and blue strobes into the darkness of the early morning sky. Officers held their positions behind the cover of their vehicles. They had arrived on the scene silently with sirens turned off.
"Put your hands on top of your head and don't move!" the officer closest to the door shouted.
I managed to raise my hands above my head when the lead officer told me to sit down. There were cases of canned Coke stacked behind where I stood. Legs trembling, I took a seat on the display. In one hand, I still held the steaming cup of coffee whose purchase had taken me on this detour. Hot liquid dribbled down my arm from my shaking hand. Beads of perspiration covered my face. I felt like I might faint.
"It took little time for the officers to secure the building and confirm that the robbery suspect was not on the premises. They wrote down my personal information, asked me a few questions and told me I could leave. I was shaking so badly all I could do was sit in the car for a few minutes, saying a prayer of thanks to God.
"When I finally calmed down enough to drive, I headed to my workplace, arriving about the same time as one of the partners who was there to see if I showed up on time. He entered the building and stomped across the wooden floor with his muddy boots.
"You're late," he yelled, inches from my face.
"Yes, boss, I sure am." Before I had a chance to explain the reason for my delayed arrival, he screamed.
"You're fired!"
" 'Thank you,' I said, and I genuinely meant that. It was all I could do to leave the warehouse without hugging him. My mantra of Thank you, Jesus carried me all the way home where I counted my blessings and smiled at the brand new day ahead."
1 Old Computer equipment that used punch cards, By Tshrinivasan (Own work) [CC BY-SA 4.0 (http://creativecommons.org/licenses/by-sa/4.0)], via Wikimedia Commons
By National Institute of Standards and Technology (National Institute of Standards and Technology) [Public domain or Public domain], via Wikimedia Commons