Tiny Lies

There is a phrase that I see people weaponize that now that it has been brought to my attention I can no longer ignore.  I believe that I have finally pinpointed why it has quietly bothered me for some time.  

Let's set the context with a hypothetical scene.  

You're in a popular coffee shop.  And, boy, is the place busy.  There is a long line and many people already seated happily chatting away with other folks, another few people with headphones on working on their computers, etc.  All of the normal hissing and growling sounds from the espresso machine continue at a steady pace, one creation after the next and names politely yelled at the far counter to announce the result.  After placing your order, you wait at the other end of the counter.  

A person in front of you collects their chosen beverage.  They look at the cup for a moment, take a sip, and then call the barista back over.  "This isn't what I ordered."  

The barista apologizes and seeks clarification, stating the order back to the customer.  The customer talks over the barista and corrects one piece or another (erroneously or otherwise) and the barista states that they will remake the drink.  

The customer then turns to the other people waiting, including yourself, with a small but smug smile:  "I just don't understand why they can't get it right the first time."  

I feel immediately rankled in my own hypothetical.  Here are some recent examples from my own experience:  

• "I don't understand why it takes so long to get a Tylenol."
• "I don't understand why the doctor would order that--they know nothing about the right way to treat pain."
• "I just don't understand why my shoes won't fit." [though there were many explanations as to why additional padding/bandages were used this time]
• "I can't understand why no one could get my mother a water for over half an hour."  
• "I don't understand why my appointment is taking so long."
• "I don't understand why they wouldn't have a backup plan for [situation that I cannot be specific about]."

There are so, so many examples I can think of.  Why this bothers me is simple:  the statement is usually a lie.  It's not that they don't or can't understand.  Rather, it's a purportedly gentler way of stating that something is wrong, a way to stand on a sanctimonious hill of righteous indignation.  But it is a lie.  

In the case of some of them at work, I've just asked back directly, "would you like reasons or would you just like to feel heard?"  Sometimes the speaker mumbles off and clarifies what the need is, and I state that I can get it now, implying to me that they simply wanted to feel heard in their frustrations.  Cool.  I can do that if that's what they need.  I've only had one or two that would answer "feel heard, I guess," where I gave them specific space to voice their frustration, which, when acknowledged, allows us to move forward.  I have had only one or two people tell me that they wanted reasons--in one specific case, they were actually doubling-down on the lie, where they continued to escalate their frustrations (FYI, I set a boundary and left the room, stating that I wasn't there to absorb their frustration, particularly as these were things that were done prior to my meeting them and were out of my control).  

It's disingenuous to say "I don't understand X," when really it's "I'm frustrated about X."  In these situations, it's not about understanding, which would be a request for clarification.  Instead, it becomes a passive aggressive attack.  What's worse is this statement is often spoken to people who cannot control the offense.  In the case of our hypothetical coffee shop, there could have been a breakdown in communication between the order taker and the order filler or the customer and the order taker or even the general chaos in a busy setting.  Regardless, this was most likely not a malicious mistake.  In the clinic, the provider has been spending a long time in another patient's room or on the phone with a different provider in order to give that patient the full care they deserve, which sometimes simply takes time.  In the hospital setting, I'm not slow to answer a call light out of malevolence--I have a whole slew of triage and prioritization that happens in how I plan out my next action.  I keep using the water example because it keeps happening--getting someone a drink of water in the hospital setting is incredibly low on the list of emergencies that could be happening at that particular moment.  

The phrasing "I don't understand" also implies that this is unbelievable, whatever the frustration might be.  This can be hyperbole in the coffee shop setting or the minor inconvenience; in some cases like the  shoes/bandage example above, it can also be a backhanded way of saying that they are in disbelief about their situation, though these seem to be rarer usages of this phenomenon in my experience.  With so many instances of the former, it is difficult for me to accurately see the latter, where I might be able to reach out with what they need.  In the case of the former as well, it implies that not meeting some invisible expectation is unreasonable, whether or not this happens to be realistic.  This denies the context of the setting, whatever it happens to be, in favor of invisible absolutes that may or may not actually exist.  It is presumptuous, too, to assume that everyone adheres to this same set of absolutes.  

I don't have much patience for passive aggressiveness.  I have less patience for lies.  When I hear someone use "I don't understand..." in this manner, my immediate thought now is "stop lying to me," barring those few exceptions of symptomatic expression in grief/disbelief moments.  I rankle against the attempt to rally me to their side of self-righteous indignation through acceptable social convention.  This is a manipulation tactic, consciously or otherwise.  It obfuscates the intent behind the veneer of false modesty, trying to defer their emotions to another source rather than own them.  It's a tiny, socially acceptable lie, but it is still a lie.  

I would prefer the direct, truthful statement of frustration.  Honesty rather than a gentle lie.  Direct statements like "I'm frustrated about X" help me meet someone immediately rather than spend my energy attempting to explain something that doesn't actually need clarification.  

In short, I am championing for direct language, slowly modifying my own speech toward directness where I can, too.  This saves emotional energy and time.  Repackaging the ask within a gentle lie wastes both.  

Body Intuition

I started going to a Tai Chi class.  Forever and a year ago, I went to a couple of Tai Chi classes when I was in Scotland, but, yikes, that was over ten years ago now, and I cannot say that I remembered anything really.  Anyway, the group has been very welcoming and excited to teach me new things.  I'm excited to learn new things, so this works out admirably.  

It occurs to me that my movement would have been very different at other times of my life.  Where I'm at now, I've been to many Zumba and other dance aerobics classes, meaning that I can pick up on patterns reasonably well.  For complicated movements, I start with getting the feet right and add the arms or other elements later.  I'm also not afraid to throw in my own style, test out slight variations for an extra bit of sass.  

Somewhere along the way and partially tied with therapy, I started watching for movements that felt "right."  There were some movements that resonated differently, that were completing an action I didn't realize I needed.  As an example, I have been doing some individual songs from the YouTube channel TheFitnessMarshall and putting them in a playlist to work through at home.  Sometimes it was the song itself was a favorite, but the blocking arms above the head in the chorus of this one resonated with me.  I was returning to it, with the song in my head at work and all else.  I started to notice like moves that drew me back in, pausing to come back to that feeling as necessary.  

So for Tai Chi, well, there are many moments that make a flavor of sense, allowing a bit of disassociation in adapting to the natural flow of the movement, to pause and see how that registers in the body.  Listening for the flow of energy in the movement and how it disperses in the body.  Completing the movement while allowing the mind to wander in different ways.  In short, it's a new avenue of self-discovery.  

There are places where my body is smarter than I am.  There are conversations where I have noticed that I left clenching certain muscle groups, and I have to ask myself what about that conversation bothered me.  Driving up on 39, my body still has a freeze response, remembering trips past on the same path to the Mayo Clinic.  The body remembers.  The body realizes things before my brain does sometimes.  

And these signals have been there, more that I am learning better how to pause and listen.

As I was going through physical therapy for my ankle, I remember discussing with my physical therapist that I could go up and down stairs, but it required a lot of thinking.  We agreed that the best situation was to no longer have to have that awareness, where movements felt automatic and cohesive again.  And yet, that kind of awareness is something I want to build on.  Awareness to all stimuli at once is not safe, let alone possible, but checking in with my body before it forces me to, that's something that I want to develop.  

Peterson Family Update, Mike Alpha Yankee 61182

I am, in fact, not dead.

I have four separate half-baked blog posts that I had started writing but couldn't get myself to finish.  It's time for some recalculating and reorienting.  

But first, time to deploy the bulleted list of great destiny and catch up on a few things.

• I broke my ankle, on April Fool's Day, no less.  I was working on a bouldering problem, the kind of rock climbing without a harness and rope.  I did not put the crash pad underneath me for that fateful route because it was a V0, which is basically a glorified ladder.  Sure enough, I scuttled up to the final hold...and promptly fell when it twisted in my grip, landing fifteen feet ankle-first.  I made some gravel inside my ankle, chipping off pieces of bone from the tibia, fibula, and talus.  There were many swear words.  
  
• 
  Ended up in a short cast for two weeks, a boot for four, and an ankle brace for at least four, possibly more pending the next appointment.  Luna has been very confused but not displeased to have extra company and couch snuggles as I stayed with it elevated and iced for the bulk of that time.  She would also stare at me when she needed to go outside and, for some reason, could not grasp that I couldn't help her, leading to encouraging barks and attempts at treat distractions.  My ankle is definitely still sore, stiff, and intermittently swollen, but still gradually improving.
• So, yes, I have been on short term disability for the cast and boot time.  One cannot drive without significant modifications if the ankle is unable to bend and/or restricted from applying pressure/weight through that limb.  Additionally, if I was restricted from putting weight on my own limb, it would be nigh on impossible to help patients transfer or lift or balance etc.  Funnily enough, when one loses use of a leg, the common means of getting around it involves losing some use of arms as well.  I stayed mostly on the lower level of our bilevel home, cautiously hopping up with my crutches and a backpack only occasionally when Andy or Mike would be gone for a while with their mutual work schedules.  I very thankful how they both stepped up to help.  We were also supported with rides and folks checking in periodically--thank you, all.
  

• The dreadful pattern that led to my diagnosis with Crohn's all started with a broken leg, back when I was eleven.  I had a lot of time to ruminate on that.  The hypervigilance thing, it can really suck.  Lots to process there, and it was only safe to gently touch the idea from time to time.
• I am determined to heal properly--I know MANY healthcare providers that are bad patients when it comes to taking care of their own body, witnessing "toughing it out" touted as a virtue for their own pain and then turning around to tell the patient to rest and not push too hard.  We often give the advice we need most for ourselves.  This isn't to say that being patient is not frustrating.  I'm so annoyed noticing the difference between my calf muscles and wanting to take another walk and wondering about what I could get away with, before gently corralling myself back to my PT exercises and pieces that I can do.  I can do wound clinic functions right now, but I'm not sure when I can get back to working PRN for the medical floor as of yet.  
• The way my brain works, I like to have something to do to schedule other tasks around.  For example, I am more inclined to do my PT exercise set, fold the laundry, another exercise set, etc. when I have an appointment scheduled that day to plan those things around.  When I have all the time in the day to do whatever, absolutely nothing gets started or done.  So writing didn't happen in particular, since I had all of this time to do so.  I set my hope to the future, where ultimately having enough stamina to make it through a work day would then lead to more regular patterns.
• While I was laid up, however, my primary job was healing and managing the details thereof.  I was alerted, though, that the Bromenn Wound Clinic was hiring and had started asking questions, checking to see how a closer facility might fit better for our family.  The injury definitely highlighted how difficult the commute to Chambana could be--if I was cleared to work before I was cleared to drive, finding someone to drop me off in town would be far simpler than navigating the back-and-forth from Champaign.  Navigating the parking lot to the hospital, too, would have been six kinds of tiring after a full workday again after that much time being sedentary.  Long story short, I am in week four at Bromenn's clinic. More on this at a later time.  Shout-out to the Urbana Wound Clinic crew--will certainly miss ya'll.  
• Andy and I celebrated eleven years of marriage.  SO MUCH has changed in this last year in particular, Andy shifting from Rivian to Upper Limits.  I'm so proud of how he is continuing to grow into himself.  Even physically he's changed so much in the last year, finding both an exercise and a hobby he enjoys.  I'm proud of how we're continuing to grow together, further supporting different facets of exploration and continuing to find joy.  
• With the uncertainty of money, future, etc., Andy and I did postpone our Iceland trip to an undetermined future date.  However, the two of us were able to keep a tradition by meeting Josh and Morgan in the Wisconsin Dells, though they were all graciously accommodating for my busted ankle.  We did an escape room where we saved the Titanic from sinking--you're welcome--and went both to the Root Beer Museum as well as a torture museum, one of these significantly more wholesome than the other.  The other trip I had planned to be a part of was a group of friends to Nashville to celebrate a friend's birthday.  Unfortunately, I did bow out of that one; the fear of missing out battled heavily with the understanding that the trip would not be able to be the experience I had hoped for with my current physical limitations.  I know that we could have made it work, but after the Wisconsin Dells trip, I was acutely aware of how much space I took up and felt uneasy processing it.  
• Andy, Mike, and I all acknowledged another orbit around the sun, taking a more sedate birthday acknowledgement this year.  
• Mike is continuing to work toward a radiography program, chipping away at the prerequisites.  He took a long train ride to a friend's wedding recently as another new adventure.  He has another tattoo since I last wrote and another scheduled--the Majora's Mask on his chest looks badass.  
• Ah, Andy also got his first ink, Bowser with a Chain Chomp on his right shoulder.  I was not sure how that was going to work out, given that he does not do well with needles, but it was the right kind of uneventful.  He has a couple of thoughts for a new one, and we may yet get a dorky couples tattoo one day.
• Mike's car died, meaning that we have three drivers and two vehicles, requiring a bit of renegotiation in how we plan out household needs and various appointments.  It's going to take a bit of figuring.
• Andy has expanded his succulent garden and planted three trees so far this season.  The number of smaller plants has planted is...more than five and less than a fifty, that's all I know.  I think the sunflowers are what I'm most excited to see--they are already more than a couple feet tall.
• I started going to a Tai Chi class at my gym--the meditative movement resonates well with me, exploring spaces to simply be and spend time with a new group of people that are genuinely excited to teach me something new.  
• Andy had Kickstarted into a Monster Hunter Board game that arrived a couple weeks back.  It functions pretty well though better for those that have at least some knowledge of the video game, I would say.  There's a lot of love baked in, and Andy is excited to continue playing.  On the aspect of gaming, he streams on Twitch on Saturday and Sunday mornings.  Right now, I hear all kinds of fun shrieks as he completed Resident Evil IV.  I greatly enjoy spending channel points to make him drink more water.  

It has been a BUSY few months, in short. Lots of adjusting and readjusting, patterns broken and leaving us to decide what ones are temporarily changing instead of permanently changing.  Pausing to reassess.  Finding cleaner flow.  And occasionally holding on for dear life as I we do so.  

Bonus Luna Mlem

Oscillation Continues

I'm working a lot right now.  Switching from thirty-six hours a week to forty is a bit of a change.  Okay, so technically I tend to get out early on Fridays, but I've also still been picking up on my old unit, meaning that once a pay period I pick up a twelve-hour shift on the medical floor.  Even though the days are technically shorter, there are more days out of the week that are worked.

It's a lot.  AND I like the variety and keeping those skills that I worked hard to build sharp and ready.  There are ways where I feel that doing those shifts sporadically makes me a better nurse, that I'm not so worn down by alarms that I can treat them with fresh eyes when I see them, even provide rest to the team by shouldering the load.  I am also tired.  These both exist in the same space.

I have not figured out writing time yet.  I don't have a pattern for walks with Luna again.  There are books I want to read.  I have not figured out when to get back to the pool yet with any consistency.  I am still averaging at least one climbing night and one cardio activity a week, but I miss immersion and taking that time to swim a mile.  The hardest part is eternally just getting to the damn gym.  In other words, there is more honing to do on solidifying a rest schedule, returning to those activities that help me find best balance.  

My outside of work attention has been spent in attempting to iron out how to do appointment scheduling primarily--these pieces were triaged higher.  Figuring out the new order of appointments or switching care providers to fit with the new schedule, it's taken some intentionality and emotional space.  That means, though, that there are spaces where the body has to play catch-up, and it is no longer asking.  And it's time to disassociate on the couch for a while or forcibly hug your pet or channel your inner Ren.  

RAGE-DANCE TIME

The pendulum oscillates wildly until it finds a center again.  I feel like I'm out of the wide swings, taking a smaller arc but still moving, kissing the center space and moving just out of reach again.  And that's okay.  Frustrating, but okay.  

In the meanwhile, I'm enjoying the work I'm doing.  I'm enjoying the people I work with.  I feel fulfilled professionally.  I'm climbing 5.10s in the silos.  I am working on a new trick to teach Luna.  I am planning new adventures that are a few months out.  I am slowly reconnecting with a few folks at a time.  

The world continues on.

Fledgling Nurse, Part 14: Closure

I am fully out of orientation at my new job!  So while I'm reveling in how I don't have a phone with me over the course of the whole day that keeps ringing incessantly with necessary but still endless demands on my time and attention, I immediately noticed a huge difference between this role and my previous one.  I had a discussion with it one day with some nursing students back on my old floor.  Hell, I've even written about it already.  It's not something that's said explicitly in nursing school:  when patients discharge from the inpatient setting, they go off into the ether.  I have no idea what happens to them, unless they're readmitted.  I only know where we sent them last, not if they have improved or declined or followed anything that we have instructed at all.  There's simply void.  

I'm not entitled to know the conclusion.  In fact, I cannot legally get into their record to find out anything about their continued care from here, even if they remained in the hospital.  The most I can do is check the obituaries for any familiar names.  There is no closure.

Now the ambulatory patient world, this is a different beast.  I have patients that come into the clinic three times a week for multiple weeks, months even.  Even since I started at the end of November, there are patients that I have been getting to know (for better or worse) and that are getting to know me (ditto).  I can see their wound improve or worsen, celebrating or mourning with them in turn.  We see steps in the journey together; we talk about how adhering to the plan is going; we discuss how to work their care around life events and vacations.  

I can see progress.  I have packed and placed the same wound vac on some people multiple times, watching as it steadily shrinks, a nine-centimeter problem shrinking to five and one and a half and then in such a way that it cannot be stuffed any longer.  I can release them from care knowing a portion of that conclusion and that they know where to find us if anything new comes up.  It's rewarding, to see something tangible change and have a small part in it.  I have a role where I couch, guide, wrap, teach, correct, encourage, and see what happens.  I have people with chronic issues that we can bound over, finding mutual empathy in that shared space.  

There are spaces where there is grieving about that chronic issue when progress feels too slow.  There are times when I cannot force someone to take care of themselves.  There are times when despite everyone's best efforts, amputation is the best option.  These exist, too.  

And then there are days where we ring a literal bell specifically for this purpose and cheer and clap to celebrate healing.  

In short, I am liking my new job.

Commute

When I was considering the transfer from Bromenn to Carle Foundation Hospital, there was one resounding question:  what about the commute?

Bromenn is a whole six minutes from my house--the car scarcely has time to warm up.  I actually could bike to work if I felt inclined.  It's nice.  I could forget something at home and know that I could dart home over a break and pick it up.  I hadn't bothered to look much at the weather, even.  At most, I was vaguely aware of the weather to offer our home to anyone that needed to travel a longer distance.  Ultimately, there would be enough people talking about upcoming weather at work or in other outlets that I could plan the small difference of time to start and scrape the car.  

Well, there is more to consider for a fifty-mile drive.  I've been working through the calculations on timing for when the weather turns gross.  I have backup plans for when the weather is very gross.  I have managers who think ahead and get patients rescheduled so we don't have to come in on those very gross days at all, as proved by the pre-Christmas storm warning response.  

There are times when I really would rather be checking something on my phone or completing a task I could do if someone else was driving.  Driving into the sun both ways also has its challenges.  But there are also times when it's...nice, for different reasons.  I sip my breakfast and pick an album to listen to that I haven't heard in an age.  I've left the radio off and let my mind simply wander for a bit, process and decompress.  I've restarted the Welcome to Night Vale podcast and am revisiting those spaces.  I have made many catch-up calls on the drive home, enjoying a reconnecting space.  

And I have seen many lovely sunrises.

Yes, the photo is a repeat
But it was still a gorgeous morning

The twelve-hour workdays resonated well with me, so I do miss that, and on the other hand I am (now that the holidays are over) starting to find an actual pattern again, which was not something afforded to me by that schedule.  I'm rearranging how I approach appointments, which will take some figuring, but I have been able to figure it out before on an eight-to-five-Monday-through-Friday pattern.  

I'm in the malleable part of the process, testing what patterns might serve me best and slowly adding in new pieces again.  There is no normal yet, but there will be.  And then there will be healthy deviations from that normal.  

It's good to take advantage of that space and simply enjoy the drive.

Mandatory End of Year Reflection, 2022 (A Peterson Family Update)

So, yes, I have fallen off of the face of the earth lately and hadn't posted any blogs for all of December to this point.  I haven't figured out a writing schedule with my new position as of yet, particularly with the extra frills of the holiday season.  

It's been another eventful year.

The new view on my way to work

On Loss

Grandma Peterson died last year, the first of Andy's four grandparents to pass.  Given the vaccination status of some family members, I was not able to attend the funeral without risk to myself (as an immunocompromised person) nor my patients, tangentially.  This was its own source of grief, to emphasize that one of the loudest lessons I've learned through the course of the ongoing pandemic is that many people would not do the bare minimum to keep others safe, even others that would actively drill holes in their own lifeboat in the name of selfish freedom.  I have seen firsthand what the long-term effects of COVID can look like in the hospital setting and have no need to roll the dice there, subsequently meaning that I have less guilt in removing myself physically from certain situations and interactions.  It's a complicated grief, all the same.

Additionally, Andy and I have two other grandparents with waning health--there is an anticipatory grief in these circumstances, a quiet preparation for eventualities.  For my last remaining grandparent, my mother and I have had frank, clinical conversations on what pattern we see happening, acknowledging that knowing is both comforting and not.  These thoughts linger in the back of my mind, quietly simmering as I see other patients enact the same process in the hospital setting or in the occasional family mass text update.  

Certainly, though, the most significant upheaval in our home this year was when Andy was let go at Rivian.  There are still moments when it catches us, where we go "why Andy, of all people?" who proselytized Rivian with enthusiasm and joy.  But it happened.  And the logistics had to be addressed, allowing space for the emotional components to process.  There was a lot to think about, including (but not limited to) household needs, identity, and the health insurance we had been getting through the company.  

That last one in particular, I have been running orange for a while, just a gentle shove away from red-overwhelm on my internal status bar, watching the internal rpms of my brain and body rev to some dangerous sounds.  It is not healthy to run the system at that degree of stress for a long period of time, but I could not be settled until we were settled with specifics on insurance.  Now with a plan set in place, the system is still in the yellow until I see the household figures after the first month, but yellow is at least edging back toward a healthier green.  The survival voices have been loud the last few months, and the great injustice of how expensive I am to keep alive because of a disease that is not my fault, well, it's galling to say the least.  There is more grief here than I know what to do with, especially knowing how proactive I am toward my health.  There is no moral failing in having a human body that needs care.  There is a terrible moral failing in taking advantage of that to profit oneself.  

In short, we started the year as DINKs with a clear plan on a relatively viable (for this country) healthcare plan and our financial and personal goals laid out.  We end it still sorting some pieces out, having lost a degree of security in that upheaval.  My experience with the unknown means that we have had strong safety nets that have held us above immediate danger, but there is a degree of bitterness in needing to use them.  

Nothing is wrong with Andy's leg!
He's a good sport for letting me practice.

On New Adventures

So, we actually paid off the Rivian this year.  That's some crazy shit, yo.  We are Millennial Unicorns.  Our remaining debt is my nursing school student loans and our mortgage.  Depending how the student loan forgiveness elements shake out, we could potentially pay off my student loans by the end of the year.  Comparing to where we started our marriage to where we are now, it's extraordinary to see the progress we've made.  

We've had some great adventures this year, including a family vacation to Pigeon Forge, a few trips to the Twin Cities to hang out Josh and Morgan to seem them in different productions, an adventure to the Wisconsin Dells around my birthday (involving an escape room, axe throwing, and Wizard Quest), and a couples trip down to St. Louis to hit all of the Upper Limits gyms that direction.

Ah, yes, we started rock climbing this year.  Hard to believe we've only been doing that since May.  Andy--who never does things halfway--has been especially taken with it.  After a cooling period post-Rivian, Andy now works at Upper Limits.  I've been envious of the opportunity he has to climb, certainly, but delight in his excitement and my own milestones.  He's finding his footing.  

The increased exercise has done Andy a lot of good; I have also found a nutritionist and have made some good strides there.  It's been very gratifying to see some physical results of our mutual progress.

And because we cannot do household upheavals one-at-a-time, I switched from inpatient to ambulatory nursing working at the Wound Healing Center.  I'll have some further specifics on the new job in some upcoming blogs, but the short version for the moment is that I am delighting in expressing nursing in some of the ways I specifically went to nursing school for.  I still have one foot in the inpatient world and the relationships I've made there, and simultaneously I'm finding a groove in my new place.  Now that I've been a nurse for over a year, I'm simply amazed at how much I've grown and learned in that time, what tricks and processes I've learned in that time, how I've solidified setting boundaries, and so many unquantifiable workflows I've refined in growing my professional practice.  There is a rightness here.  

Mike started a new adventure, too, working toward radiology at Heartland, seeing his preparation pay off in completing his first set of required classes.  It's been fun talking biology with him, to share those spaces and even a couple of my textbooks.  

On Continuing Adventures

Luna is still and adorable little derp.  That's a beautiful constant at the moment.

We had to delay our Iceland trip originally planned for the beginning of December.  We probably could have made it work, but in retrospect it would not have laid nicely with my orientation to my new position--when we were juggling many things, it was a ball we could put down for now.  We'll be looking at doing that at some point in the next year.  

I had a wild hair the other day and bought hockey tickets for a Blues v Blackhawks game in January--looking forward to that mini-break already.  I have some additional ideas for upcoming hijinks but also finding the odd joy in being able to do weekend things, too.

As I've been continuing to think about the ridiculous amount of money that we spend to keep me alive in this country, I also cannot help but continue to think about leaving it for another one, finding what steps it might take to do that.  There's a lot to think about here.  

And Where it Leads Us

There was a lot of growth this year in unexpected places.  And all of it was certainly in that feeling of "becoming."  This year, I look forward to "becoming more."  Specifically, I would want for our household to work on becoming more of whom we are meant to be.  The three of us are in different transition states--I'm excited to think about what that can look like in another few months.  When I have my feet fully underneath me at the Wound Clinic, how will I move in that space?  How will Andy inspire his team and improve in his climbing?  How will Mike express his new learning spaces and enjoy the clinical time in the program?  

What new elements of self will we all discover in the process?  

So I approach the new year with optimism and curiosity, ready to probe some of those spaces.  ...And to find a new pattern for writing again.

Transition State

How's the new job going?  Great question!  Glad I pretended you asked.

Originally, I was supposed to start my new position at the wound clinic Thanksgiving week.  It happened that there were a few courses I needed to complete first before I would be allowed to work with patients--the way that timing worked in this case, I suggested that I take off the rest of the days during Thanksgiving week and then start with the classes the subsequent week.

So on the one hand, yay, surprise vacation!  On the other, well, the existential dread starts to creep in.  I get confused with time off and a little bit paralyzed with how to fill it.  When Andy was let go from Rivian, I was insistent, probably to the point of annoyance, that he take time to simple be and process the change and the grief.  I am shit at taking my own advice in these places.  

I've worked on the inpatient side of things, been a medical floor nurse for a year and some change now.  I have learned a ridiculous amount of things in this time, delighted in teaching the nursing students that came through in particular, and shared in many, many stories with peers.  There is a particular kind of grief in leaving that behind.  I have been avoiding processing it, for multiple reasons.  I am curious to see how I might process it given a bit more temporal space.  

And at the same time, I've got that roiling excitement and anxiety about starting the new position.  Hammering out the little details of when the first day is and logins and lockers and starting those new relationships on the best impression possible.  I think I've prepared just about everything I can:  we're simply in the waiting phases.  

Waiting is not a passive thing.  Waiting is active.  Most every piece of preparation that can be done has been done.  It's time to let things happen and absorb all of that I can.  I am going to continue to be unsettled for a while now, and that is okay.  Expected, even.  And in the same breath, I know that my body does not sort out "excitement" and "danger" correctly sometimes.  There's a lot happening in our lives right now.  And it's okay to let that be.  I am feeling anxiety, but I am not my anxiety.  In the same breath, I'm certain that we'll work out all the kinks as we go.  Through all of those acknowledgements, it occurs to me that it is time to take that advice, to greet those parts of myself and name them.  

It's another period of transition and transformation.

...and before I can even gather those thoughts together, the week is done.  I've had my first full day shadowing and am just beginning to see the flow of the floor.  I'm trying to absorb EVERYTHING.  And it's exciting, and my brain hurts.  I'm also trying to get to know my new peers and to not be the "well, at my old job, we did it X way" person while also acknowledging that that is my basis for comparison.  This expression of nursing is different, has a different pace and utilizes different skills.  I have so much to learn.  

I feel uncertain in my steps but confident in my direction.  And that's not nothing.

All the THINGS

I've been working on processing a particular kind of grief lately.  

I froze to death and drowned quite a
few times with this one

When I read choose-you-own-adventure books growing up, I wanted to know all the possible outcomes, which lead to some very complex book-holding techniques as I had different fingers in past major decisions so that I could go back to them when I hit another dead-end.  Significant early decisions were granted a slip of paper for the next read-through.  Certain page numbers became recognizable as I flipped through again, fingers contorted in strands of plots and pages. 

I love learning.  When I meet people, it's something that sits in the back of my mind, wondering what kinds of new things they can teach me, what niche subject they are quietly passionate about until someone asks the right question.  And by listening, I learned a lot of random things over time.  Sometimes only enough to ask halfway intelligent questions; other times building off of past conversations.  

This made the idea of choosing a career very daunting.  In choosing a college, I knew I found the right place when they didn't bat an eye when I said I wanted to double major in biology and creative writing.  It was important to at least keep learning a vast breadth of things while sorting out the larger questions.  I remember hearing "Jack of all trades; master of none," and feeling the gentle censure, that I should knuckle down into a specialty of knowledge or skill.  But then I heard the rest of the phrase that is commonly left off:  "but better than being a master of one."  

All of this to say I'm processing a degree of grief at the moment in changing positions that I've been struggling to find a way to articulate.  This is my last full week on my floor.  Naturally, I think of my favorite workmates first when leaving a job--I will miss seeing and supporting a number of people on and adjacent to MOSU.  And I'm also frustrated that I'm leaving after I've been finding such a good groove lately.  I enjoy working with students.  I have almost all of my assessments done before ten-thirty each shift, usually two or three done before eight-fifteen.  I am learning how to pay attention to clues on when someone is ramping up on both pain and anxiety and preempting those spaces, setting better boundaries.  

It seems a terrible time to leave, when I feel like I'm coming into my own.  I have had a couple people tell me that I would be a good charge nurse, and I think at its right time I would enjoy it, finding ways I can support my peers.  

And in the same breath, I am immensely excited to start working with wounds, to learn all the nuances and tricks in this expression of nursing.  

I grieve that I cannot do everything.  There is simply not enough time to do everything.  And that is a particular kind of grief.  There are so many things I could do, and even things I could be good at:  I have to choose.  And I'm happy with my choice, but also am sad to leave things behind.  They exist in the same space.  My plan is to keep a foot in the inpatient world by picking up occasional shifts on my old floor, a beautiful intermediate and merging of worlds, and yet I know this won't be the same as it was before.  

There isn't enough time in life to do everything.  I have to choose how I want to spend it best I can.  I have pulled the metaphorical strips of paper out of the choose-your-own-adventure book on some past decisions, choosing to hold the book in such a way that gives my full attention to the pages I'm currently reading.  There is a grief, but there is also a particular kind of wonder in accepting the present whole-heartedly.  I want to find the best way to honor my transitions grief, while also acknowledging this side frustration of limited time on earth and the impermanence of existence.  

There is not enough time in life to do everything.  And that's okay.  

Dichotomous Thinking

I am not a fan of absolute statements.  There are a few absolutes out there, but there are a lot of things that have exceptions.  I like to leave space for those.  This frustrates Andy to no end when he's trying to get an answer out of me.  He'll ask me if we can do X or Y tonight and I'll reply with something akin to "most likely," not because I'm trying to be coy but because I cannot predict the future to know if some emergency will pop up or if either of us will run out of energy by that point or whatever else.  Sometimes, these are exercises in abstract thinking, I confess, trying to find the obscure reason why something is/isn't or will/won't, as my dedication to the idea continues and just the way my imagination works.  More often, though, it's about that space, leaving room for deviations and exceptions.

Consequently, when I hear someone use "this person ALWAYS/NEVER does X" or "people are either Y or Z" without acknowledging even backhandedly that there are other choices and shades of grey out there, I tend to feel a degree of doubt creep in around that speaker and their assertions.  Sometimes it's a sliver of doubt; sometimes it's a hefty helping of doubt, depending on the context.  

The world is richer in greys than it is in black and white.  Subtle value adds depth, adds meaning, when viewing the full picture.  

But we like our false dichotomies.  "If you're not with us, you're against us;" "my side or their side;" "democrat or republican;" "dog person or cat person."  These are easy.  They are comfortable.  We like patterns as humans, things that help us quickly put situations and people in boxes.  These don't serve us in all situations.  In fact, they are counterproductive in many.  We lose that value, that depth, and often someone's humanity in those spaces.  

There is a difference between a declarative statement and an absolute, and there are places where they can be confused.  An observation of the moment or circumstance can have a declaration.  If it then becomes something permanent, that it is the only way or generalized to all circumstances, that's where we negate other possibilities and create a false perception.  

I want to be precise in my language, which sometimes means I fail at being concise--I'm working on this.  Sometimes, I feel a rewording or adding in the full scene is helpful but respect that the recipient may hold a different opinion.  Ultimately, leaving space also furthers honesty, attempting to be more transparent by acknowledging the edges.  It is meant to further clarity, assert sincerity, rather than muddy the waters, though I know that's not always the impact.  

I tell my patients that I know better than to speak many absolutes in my field, when they are trying to pin my down on answers about timing or why their doctor is doing X or what will happen after Z.  I tell Andy a percentage when I don't feel I can give an authentic, firm yes or no.  And I tell myself that keeping a space for new ideas means that I can continue to grow and find those different perspectives.  

Peterson Family Update, Oscar Charlie Tango 2343

Things have been hella busy lately, but not necessarily in a bad way.  They are, however, hella busy in a way that I'm only able to take things in pieces at the moment, which means it's a brilliant time to deploy the bulleted list once again!

• Nutritionist meal plan is still going well. My anxiety around meal planning has decreased immensely and my body is adjusting to different macros and their appropriate portion sizes.  Now that the hypervigilance is continuing to recede, I think I actually feel...pretty good.  A few of my data points are moving in a good direction, too.  I also have not eaten out much since I started this, which is good in its own way.  
• Andy and I are still enjoying rock climbing and the last couple of times I have had some really good climbing days, where I felt I had more gas in the tank than I had previously and subsequently was able to complete a couple of routes that I have been projecting.  We have all learned so much since we started in May, and it's neat to see that progress in something tangible, tackling routes that seemed completely impossible just a few months before.  
• With the last Peterson Family Update, I announced that Andy's position had been eliminated from Rivian.  He has been spending a lot of his severance package time traveling, tackling house projects, the aforementioned rock climbing, and otherwise reacquainting with parts of himself.  
  

• Luna is still a delightful fluffbutt.  She hasn't mastered my attempt at covering her eyes as a trick called "Eclipse," but leans on her side and paws up a bit so that you can move them up to her eyes, so that's a start.  
• Work has been tough lately.  Our current patient population has a lot of confused bodies for one reason or another, which means there are places where logic and reasoning don't apply.  I am solidifying some successful boundaries with a few of these instances.  Sometimes calling security is a way to stop things from escalating rather than waiting for them to escalate past a point--arguing with a patient can be more far agitating than calmly following through with putting them physically back in bed, following through on the choices that have been outlined.  I have wasted forty-five minutes attempting to convince people that cannot understand reasoning--there's no need to continue an unproductive conversation to this degree.  I pick my battles differently; I give choices where I can but not at the expense of anyone's safety.  
• Mike has been continuing in his coursework at Heartland.  We've talked about bones and the like a few times, and I'm trying not to get too pedantic in certain spaces.  
• Absolutely loving the fall weather lately--took an excellent trip to Starved Rock with some friends to catch up, see the foliage, and have a lovely walk.  
  

• The new sofa and chairs we had bought before hearing about Andy's job change arrived and we have rearranged our downstairs accordingly--it's neat to have a new perspective and see our space in a different light.  
• Andy is still sorting through what his next steps might be, but in the meanwhile our health insurance is still covered until the end of the calendar year.  Health insurance plans might sound great until we factor in a Tier 6 medication, in which case I focus only on the max out-of-pocket to compare one plan against another.  I have been managing a lot of spreadsheet action regarding health insurance and starting to look at other employers for different plans.  It's a shitty reason to have to leave my current job, but this is about survival and we'll do what we have to do.  It's a raw but real truth.  I will continue to feel unsettled until we both have coverage lined up for January.  
  

We cannot seem to do big life choices one at a time in our household.  I met some delightful folks at Big Brother Carle through the Ostomy Care Associate class I took who happened to mention that their wound clinic was looking for people.  

I got into nursing specifically to be a wound/ostomy nurse—my heart is in ostomy, with the ingrained compassion from my own experience; my brain, however, is intrigued by wound and the different problem-solving that entails.  I submitted for a transfer that will officially start mid-November.  My plan is still to pick up some weekends on MOSU, but otherwise I'll be commuting for a Monday through Friday, 0800-1700.  This way, I can simultaneously further my ultimate professional goals, keep the relationships I have, while also making some additional money to supplement a higher need insurance plan for my situation.  

I'm still very much feeling the season of change ramifications.  And I'm also optimistic toward the new adventures ahead.

Sound and Space

So, the cold fronts moving through as the change of seasons has been a bit of a different kind of wallop on me this year.  Normally I get a bit of a cold when the weather starts turning, just a week or so of sinus drainage and lamenting all of the moments that I had been able to breathe easily through my nose and then it's done.  This year, though, I completely lost my voice.  Just...gone.  I cannot recall a time when I had lost it to this degree.  

And, of course, it all started happening while I was at work.  Or rather, I discovered it after I had arrived at work.  Saturday, I had a sore throat from the drainage, with some pain in swallowing but otherwise no other major issues.  Sunday, though, I got to work and the first time I had spoken that morning, I ended up cracking like Peter Brady.  I hadn't had a reason to say much before leaving the house so that was a moment of "Ah.  Shit."  Over the course of that shift, it proceeded to get worse.  People I spoke with from different departments asking the cursory "how are you?" got a bemused "I sound like Peter Brady!" back from me, as all I could really do was laugh at myself and open up another Ricola from my pocket.  

By the end of that Sunday shift, though, it was no longer a question--two words out of my mouth made it apparent to anyone I was talking to.  Had a couple of patients tell me that I sounded a little hoarse as a bit of an understatement.  But giving report to the oncoming nurses, that was a particular kind of squeaky special.  And then I would laugh at myself which also sounded ridiculous and laugh a little harder.  When I left, I had told the charge nurse I would see how the night went and call off if I needed to, since I was scheduled to work that Monday as well.  

At around ten that night, I began to see reason and called work.  The call went something like this:

Me:  Hey, this is Larissa.

Charge Nurse:  Oh, I can tell.

I started laughing and she joined.  

Charge Nurse:  I'm sorry, it's not funny.

Me:  It is a little funny.  

I explained that I felt it was prudent to call in and recover; she agreed that was probably a wise decision.  *end scene*

So, I slept in the recliner that night, since that felt better than flat with the sinus drainage again.  Andy made me a hot toddy, and I was going to be on vocal rest for the next day.  I think I spoke less than two hundred words that day.  Lots of Throat Coat Tea, honey, water, and a bit of rye whiskey, but little speaking.  To my dog, we have gestures that we do along with commands and she was able to do quite a bit with just the gestures, once she realized that I still had a treat available.  Getting her attention involved whistling and kissing sounds.  

Talking with the other adults in my household, though, that was a bit trickier.  I had to think about my communication differently and how much space I take up regarding sound.  I couldn't have a quippy reply or theorize what might happen next along with the show we were watching together--communication had to be prioritized and triaged to short ideas or not shared at all.  And trying to get an idea across involved some basic signs that I knew, mouthing, and voicing only a few key words for context.  Andy would repeat whatever he was understanding from me, which helped us confirm immediately in the moment and try again as needed.  

I enjoy ruminating on words in a normal day, but this was a different kind of overthinking.  And then I noticed that I was also walking more quietly, paying attention to the sound of my body in my own home a little differently.  I felt quiet in space as well as voice.  It was a unique moment of awareness of how I take up space in a different manner.  

When I'm in a public space and someone is taking a call on speakerphone, I'm annoyed, particularly when there are glares that seem to imply that you shouldn't be listening to their conversation--sound takes up space differently and they decided to have a private conversation, loudly, in line at the mall.  There is a breach of consent here, that a shared space has been taken over by non-typical intrusion.  While hiking at Starved Rock this summer, there were multiple groups that were blasting their own music while walking the trails.  Some held a tighter radius, where we could hear it coming but the sound left with the group; others interrupted the natural sounds for minutes on end, loud enough that even the group had to yell to talk to each other.  Public space intruded.  It wasn't against any rules, but it felt rude, a breach of courtesy.  Coughing, though, as another example also breaches a shared sound space but it seen as more acceptable, understanding that it is usually out of control of the body in question.  But there is still a point where excessive coughing requires different rules--I've slept in the recliner a few nights, now, half for my own comfort and half to ensure I do not disturb Andy more than necessary.  

There are invisible rules for how we take up space, and these boundaries do vary.  It was interesting to think about it for a while, even in my own microcosm of shared space with my housemates.  We have unspoken rules about when music or a podcast can be played.  Tor example, someone cooking the kitchen has priority.  And if someone was in the space first that can also grant priority, but there are consent check-ins, the easy "is it okay if I play X?"  It's also okay for us to request someone to use headphones or turn down the volume.  I won't say that we're perfect at it, but there are some good practices.  

And then there's Luna who borks anytime her great nemesis, the UPS truck, goes by.  Human social norms are clearly not her thing.  

Whelp, in the meanwhile I'm continuing to let this round of seasonal blah make it's way through, coupled with another Covid booster last week, I'm ready for some good days again on the other side.  I'll continue to take up space differently for a little while longer, including extra mugs, Ricola wrappers, and a more coughing.  I'm allowed to take up space; and it's interesting to consider it in a new light.  

About Food

I have a weird relationship with food.  Funnily enough, having an autoimmune disease that affects my digestive system.  Honestly, I would go as far to say that I have disorganized thinking around food.  There are a number of triggers and patterns that have made food a touchy subject for me.  

• I've lost thirty pounds in a month before because it was too painful to eat and I had no appetite--Crohn's flares are a beast
• Trying to force yourself to eat when the back of your mind screams that there will be Terrible Consequences! while simultaneously another part of your mind is screaming that if you don't eat there will be Terrible Consequences!...well, this results in Terrible Consequences! AND anxiety 
• Already experiencing a reduction in much joy of eating, eating something I don't feel I'm in the mood for is not something I can muscle through can be a special kind of nausea
• Back in 2016, I went keto and found that I felt better by sticking to that diet; I also felt very left out of the community aspects around eating
• The past few years, I've been doing a "lazy keto," where I attempt to stay mostly on diet but end up feeling terribly guilty at least twice a week
• Living with two vegetarians made it harder to find recipes that worked for all of us, which increased the emotional energy it took to plan out meals and groceries for the week and also meant that I reverted more to pre-packaged options and less cooking for our household overall

I know that it is unfortunately always a matter of time until my next Crohn's flare--that's what chronic illness do.  I acknowledge this truth at the same time I am relentlessly pouring my efforts into ensuring that this happens in the far-future rather than the near, always working toward a better state of health.  

All this negativity toward food, there is plenty of room for improvement, here.  So I spoke to my GP about a nutritionist.  And I met with said nutritionist.  Now I'm working through unlearning and relearning in some of the same spaces.  

Probably my favorite lunch so far

So far, I think it's going well.  Feeling full on keto compared to feeling full on my individualized meal plan is different--my body was conditioned to feel even the same portion sizes differently, in terms of registering the physical feeling of "full."  I've also had the chance to rediscover foods that I haven't had without significant guilt in a long time.  Homemade apple butter in Greek yogurt?  Hells yeah.  Even the general burden of what should I eat/cook this week is cinched down into seven days that I pick from, already designed and with dinners accessible to my housemates so that we can cook and eat together.  

I'm at the end of week two, now, still fine-tuning the rules and nuances.  At this point, my bodily hypervigilance is going to start to back down a notch or two, which will allow a more gentle introspection into how I am physically feeling on the plan, now that the crisis marker systems checks won't be flashing in background.  The anxiety parts of my brain that try to help protect me by planning through catastrophizing remind me that this could still go terribly wrong, but I have also learned to acknowledge them and work through those spaces only as much as they are productive.  Most interestingly, though, will be the emotional introspection about food in this time.  Eating is always an emotional experience, and I have a lot of negative associations to shake off.  There is space for reclamation, and, better still, there is opportunity for it.  

After a month, we can take a better sampling of change and adjust accordingly.  I get quarterly bloodwork for my Crohn's disease management as it stands, so a request for a couple of add-ons for my own curiosity and to check for progress in other metrics is also easily feasible (A1C to check if I have adjusted in sugar management from keto to a diet that has reintroduced carbs, for example).  I have many, many places that I watch concerning my health, where I can watch trending data, as well as keeping a general impressions subjective log.  

Ya'll--I am high maintenance in some interesting ways.  And I have fought for a long time to get to this degree of "healthy."  There are places where I have accepted a new normal; there are places where the current "normal" has been challenged and improved; and the line is incredibly difficult to discern. Having the emotional and physical energy to poke at it, though, requires a base degree of stability that I have not always had.  My limitations can change daily; the ranges that they can be found in, however, have been steadily increasing, advancing how good a good day can be and minimizing how poor a bad day can be.  It takes a lot of its own energy to manage this.  I'm grateful to simply have enough spoons to be able to investigate or even make an appointment in increments at a time.  I also have the blessing of a diagnosis that I can point to--not everyone managing their own care has this easily, languishing in the "unknowing" space.  There have been times when I had thought things wouldn't get better on a particular front and been right--this was a path, then, of radical self-acceptance and then leaning into how to make accommodations for that need.  There have been things that have improved over a period of years.  That's what it is to live with a disability, slowly sifting out what can be improved and accepting what can't, while simultaneously ignoring a lot of bullshit advice, even when it comes from a well-meaning source.  

So today, it's food.  A fundamental concept that I am deconstructing and re-interpreting into my life as it is now instead of my life as it has been.  And when life parameters change, so will the requirements.  And we will adjust again, with a necessary amount of grumbling.  

Melvin & Me, Part 38: a...Fan?

So, I had a delightful first the other day.  

I was forming a new acquaintance at work.  While we were talking in a relatively calm moment, Melvin made a triumphant BLURB-BLURBLEBLURBLURB under my shirt.  I threw my hand over my side to muffle the sound, as I usually do.  "Ah, sorry, that's just my ostomy," I explained.  

"That's SO COOL!" they nearly shouted.  

And I blinked for a moment.  

They apologized immediately, hoping that they had not embarrassed me or overstepped.  I reassured them with equal urgency, that I was fine, just not the reaction I was used to, even telling her it was not the usual response.  

Normally, when I choose to reveal my ostomy to someone without an ostomy, there are three main reactions:

• Sympathy
• Gentle embarrassment and curiosity
• Total confusion, which after the explanation is then shifted to one of the other two

But this, this was new.  This was...enthusiasm.  There is a lot of brilliant ingenuity in the modern stoma creation process.  There is also a great degree of adaptation and reframing to live with one.  I even had to pause for a moment and think, yeah, I guess I AM pretty cool.  

I'm used to apologies and explaining that, no, really, this terrible burden is something that is very livable and truly gives me my best life.  I did not have to qualify the experience, that "well, yes, it is a burden BUT..." phrase I've said in different words many, many times.  

And then of course there were more questions, and the enthusiasm remained.  I left that moment with beautifully, bemused joy.  It felt pretty good.  I know I am resilient, that I have a degree of natural charisma, but I don't often allow myself to acknowledge that, afraid of sounding full of myself.  And yet, I am a marvel.  It's nice to remember on occasion.  My ostomy is a part of that experience, a part of me.  I am currently living better than I had thought was possible, in some of those darker moments when I had circled the drain.  Time is strange; so is our passage through it.

Another thought crossed my mind later:  it is problematic to reduce someone with a disability to "wow, what an inspiration!"  A person living with a disability is living their life; they don't exist to serve as a example to others on how theirs "could be worse."  However, there is a balance between recognizing the strength of the individual without turning them into a caricature.  In this particular example, I felt seen as a person rather than a person with a disability, which made all the difference.  I felt seen.  And it was nice to have someone else see the benefit without having to introduce caveat after caveat.  

Melvin helps me live my best life.  That can be inspiring; it can also be heavy; it is something that has profoundly shaped my experience.  And it's kinda neat.

Season of Change

I am not wholly certain if this is something that my confirmation bias has reaffirmed again and again or if it is something truly happening.  It's like getting a new car and then suddenly seeing the same car everywhere.  

To everything turn, turn, turn/ There is a season; turn, turn, turn

We are in a season of change.  I know that change is constant, yet there are still periods of time where it seems more turbulent than others.  Where instead of small pockets of change there are major changes, tectonic shifts that shake the ground under our feet in transition to a different elevation.  Both ground and water have to adjust.  

And there are spaces when it seems a community feels the shifting, that multiple bodies are kicked off their own feet for the violence of the shift.  Not all the changes are bad, but they do require a degree of reframing and creating new patterns.  

A time to build up, a time to break down/ A time to dance, a time to mourn/ A time to cast away stones/ A time to gather stones together

New houses, new jobs, losing and gaining family members, new conditions and states of being.  Flux and uncertainty.  Even for those I've spoken with that were not involved in some of the changes directly, they seem to at least be affected by those that are.  

It could still be a "seems like" kind of thing; I feel better to acknowledge the feeling.  To take a moment and pause and acknowledge change as it is and how I am currently experiencing it, there is an odd segment of calm in the midst of the turbulence.  

A time to gain, a time to lose/ A time to rend, a time to sow/ A time for love, a time for hate/ A time for peace, I swear it's not too late

Sometimes we get our sea-legs again, remember how to walk with respect to the waves as the boat floats on.  Other times, we have to find something steady to hold on to for a while longer.  And sometimes, the storm stops as abruptly as it began, leaving folks wary and damp but also steady again.  

We weather the season.  We acknowledge the weight.  We move to the next season.  

Turn.  Turn.  Turn.

Processing in the Pool, Health Insurance Grieving

I went lap swimming the other day to clear my thoughts.  I find I leave the pool a more whole person than when I entered it.  

I had not had the chance to swim for a couple weeks--the hardest part of working out is getting to the gym.  Packing my swim bag, getting in the car, finding a locker, wrestling with my swim cap, and the uncertainty of knowing whether there would be an open lane when I arrived, it felt like too much work when my mind was already overloaded.  

But that first dive in, the shock of the cold water everywhere at once, my mind can only be present where I am, if only for a moment.  And then I could count the lengths, deciding what I wanted to do for my next set.  

Other thoughts meander in and out as I circle back once again and again as I swim the seventy-one lengths to meet my mile.  Occasionally, the count slips and I spend a whole length or two attempting to remember which one I was on, passing the time very effectively as I let my body complete the muscle memory circuit, one hand reaching and then the other, legs independent of all else in continuous motion, breathing timed within the stroke for optimum efficiency.  

When an idea pops up that needs more attention, though, it stays as long as it needs to.  

I have run through many hypothetical situations, how I would have wanted to respond better in a past situation or creating a scenario and playing it out in my mind as a potential future event.  I have also used the space to organize the scattered ideas and emotions of a particular event to make sense of them, to find the words I needed to articulate something murky or clouded by other factors.  

I always leave the pool a more whole person than when I entered it.  

There are a number of concerns that required sifting in this latest swim.  

• A patient and I had had a misunderstanding between us, and I needed to sort out how to let that go, owning my role in the situation without owning her reaction and the guilt that implies.  
• I recently had my first experience calling a family member to tell them their loved one had passed.  I knew that this ten-minute conversation was a pivoting point in their life and felt the gravity of that.
• We are in a season of change:  so many people I know are in a state of flux right now, where there is significant shifting and upheaval and uncertainty.  
• As part of that season, Andy and I are sorting out our plan forward from here, attempting to allow some space for connections to happen organically.  We are also getting a better grounding on what our basic needs are, drawing a fence around where we want to restructure, simplify, and focus.  
• And most importantly, I am investigating different health insurance options.  

Regrettably, I have a lot of experience sorting through my major medication plays out in these arenas.  I would be so happy to be wrong somewhere; being right has been both validating and soul-crushing at the same time.  Yet, I still have to ask questions.  I am grateful that I've mostly been met with persons taking my questions seriously, that I have not been given a "well, just read the plan," with an implied "and stop overreacting."  So far, I am met with sympathy but not solutions--it's too early yet.  

Somewhere around lap twenty, my brain went:  "The US healthcare system is normalized extortion."  I nearly stopped mid-stroke.  If a medication costs ten dollars, I'll pay it; if it costs a thousand dollars, I will find a way to pay it.  Nowhere else in the world do these medications cost the amount we pay here, where we as a collective pay far more for healthcare for poorer outcomes than the rest of the industrialized world (source, source, source, source, all just from a quick search).  On an individual level, we know that we have to plan, that we will find what the maximum out-of-pocket is by March or April.  There are many plans that have a max out-of-pocket amount higher than what can legally be deposited tax-free into an HSA ($7,300 for a family plan), meaning that we cannot even break even.  

Oh, and the bones in our mouths are on a different scale altogether, because mouth-bones are a luxury, I guess.  

So, my heart was engaged in two directions that stretch it, between exercise and grieving.  It is an injustice.  And it is real.  And it is exhausting.  The problem does not go away-- a chronic illness existing within a systemic problem is not a great combination.  Which means that I have talked about this before and will do so again.  The wound cannot close; and this is a wound particularly real to me at the moment.

I take some comfort that I'm doing the right things--I'm investigating in different arenas, to identify our best options and understand them in their entirety before moving forward.  At the same time, I mourn its necessity.  I feel myself reverting back to survival tactics that have gotten me through other crises in my life, which doesn't feel great and mentally puts me in those spaces again.  

There is tension in these processing spaces, knowing the value of creating a space where that is possible but also acknowledging the anxiety of uncomfortable truths and the burden of setting up the ingredients for such a space.  A swinging pendulum of processing and distraction and back again, allowing it to swing freely without forcing it to one slide.  

Flowing with the stroke.  Arms and breaths timed together.  Only able to be present and immersed in the moment.  Everything can wait until the other side of the locker room, if only for now.  

YIPE

I remember watching this dog and Foghorn Leghorn duke it out.  At least once an episode, Foghorn Leghorn would do something to antagonize him and then run away until he was just out of range of the leash, only to hear the dog go from low barking to a high "YIPE!" as all of his momentum is suddenly stopped and he lands flat on his back.  

I've been thinking a lot about that "YIPE!" moment.  Andy and I had been making a great deal of progress on our financial and personal goals, motoring along at a good momentum, and then suddenly I feel a strong, implacable yank across my midsection.  I fell hard on the ground, knocking the residual air from my lungs and stunning my senses.  I'm still on the ground, running a number of system-checks (no bones broken, any bleeding? etc.).  To make matters worse, the tether is around my waist, meaning that I am also checking my ostomy with some urgency, a special system-check that is my own disability and burden.  

And in many ways, this is my tether.  

My health is such a complicating factor in our lives.  When it's going well, I'm allowed to get momentum again, to run freely within its radius until I forget it's there.  And then suddenly the rope snags on a tree branch or I hit the full extent of its length and I'm violently pulled backwards.  I've learned to take a slower pace in some areas, to ensure that when I am yanked back, at least it won't be a devastating thing.  I've learned to place pillows on the ground in certain areas to ease the fall.  

I am never allowed to run at my full potential because the burden and restrictions of my healthcare costs inhibit me from running freely.  Having a chronic illness is not a moral failure.  The way we punish people with chronic illness in this country certainly is.  When we say we are against or "not ready for" Medicare for all, we say that we're okay with certain people dying.  When we support a for-profit system, we say that money is more important than people.  This is not the way it has to be; this is not the way it is in many other places.  More and more those other places are looking very appealing for this fact alone.  

Because accessibility to healthcare is literally about survival to me.  It is life-and-death.  I, somehow, need to get my hands on the medication I take every eight weeks that costs $15K here, without going into irreconcilable debt.  It is an ongoing maintenance medication that keeps me healthy and able to function.  Offerings of covering 80% once a deductible is hit, well, that still means I pay $3K every two months until the max out-of-pocket of somewhere between ten and twenty thousand is reached.  At these crossroads, I am running as fast as I can just to stay in place.  There is no more thriving.  On most other metrics we're doing fine; but this one, this one is a devastating blow.  Technically, I have "access" to it; in practicality, the inflated costs of everything are patently absurd.  

These are the worries that keep me on the ground a little longer, wondering when I'm ready to try running again.  Wondering if padding the entire area is possible and/or cost effective.  Wondering what a safe pace to move forward is.  Wondering if there is a nicer tree with less snags or a more generous line.  Always wondering what we could be if the tether wasn't there.  

I spoke with a friend whose tether was their student debt.  Another whose tether was an ailing family member.  Many of these things come down to money; many of these things are felt in grief.  Sometimes a dream to run freely can only be a dream; other times, well, we need to question what kinds of alternatives had yet to be considered.