Trauma Stewardship

It just occurred to me to write a little about one of the most helpful books in my life over the past few years, Trauma Stewardship, by Laura van Dernoot Lipsky.  It’s a book for people who do any kind of work that connects with stress and trauma–which is almost any kind of work, whether it’s about education or climate change or caring for an elderly relative.

I think is the core of this book is the idea that   “If we are to remain physically, emotionally, and spiritually healthy..sharing the pain cannot translate into soaking it all up.  The energy of pain must be kept moving.  If all the struggle and hardship we witness accumulates and takes root, it will grow so large that any light we have within us will be obscured.”  (p. 215)

I bought Trauma Stewardship as a gift for myself a couple years ago, after a day that still may rank as Most Upsetting Day Ever at the job I love.   I read the book and it was helping.  Then one of my patients died young, and I felt shaken up for weeks.  The book guided me through that situation and many other upsetting days to come by helping me understand that I was having a normal reaction to other people’s trauma. It also was full of ideas for taking care of myself and setting up routines that make it easier to keep doing this work.

Before I read Trauma Stewardship, I knew that exercise and meditation and sleep and other pieces of self-care were important.   I’m even more aware of that now, and also have small tools that help me get through sad or difficult days–taking a deep breath before I answer the phone, asking myself “Why I am doing this work?” on the walk that is my morning commute, and mentally letting go of pieces of work on my walk home.

I’ve read the book cover to cover twice now, and went to a day-long conference with the author, who now has something called the Trauma Stewardship Institute.   Another one of my patients just died at 46 years old–suddenly–to my great surprise.  I thought he was doing well.  I am afraid that if he died the work we’re doing isn’t helping the people who are much sicker than he seemed to be.  And I am vigorously promoting trauma stewardship because it is thanks to that book that soon I will remember that what we’re doing is useful.

In the meantime I light candles, sit quietly, keep moving, and keep reading the now written “Why work” manifesto that reminds me why I’m doing this.

 

 

 

Occupy Intensive Care?

Occasionally I write poetry, and even more occasionally I feel compelled to share it. 

 

Occupy Intensive Care? 

 

I know a dying person, and

I go to meetings anyway,

glean strength

for the day work: today

visiting her wide city view

in the ICU,

where patients

sometimes

open their eyes, ask for water,

want to go home.

 

I know a dying person, though

my pale hand in her dark one signals

doctor not daughter

to the white chaplain, she says no,

it has never been too long to go back to church

and she will die anyway.

 

I know a dying person

who showed me where the safety net is

woven just tight enough not to fall through

where the holes are,

people plummet

over simple needs: appointments

staircases

oxygen.

 

Last week, a few days ago, we worked for these changes together.

She shouted no to the hospital but went anyway,

without appointment,

carried down those stairs,

without the right oxygen—now

 

body too weak for chemotherapy but

ventilator yes,

dialysis yes,

re-starting her human heart if

it stops

Yes.

Her husband of 25 years

sugar eating away at him inside too, yes,

daughters with babies growing say

Yes,

the one who looks like her hasn’t arrived yet.

 

We’ve been marching in the streets this year,

some of us.

I join the ones who can make it, call it justice

but we’re missing some:

dying people, their incarcerated sons, still

I march downtown in boots and sandals,

agitating for oxygen,

99% of what 99% of us need.

 

We’ve been learning to feel even at work this year,

some of us.

I sit still  morning and evening,

light candles inside and

call it love,

I know a dying person,

the songs say no more suffering,

rest.

Great Self-Care for Digestive Problems/IBS

This one comes to you from my friend Rachel.  She says:

Most importantly, digestion is structural!  While you might have some distinct “problem,” you are more likely to be experiencing a combination of problems you can’t control about expectations in the modern diet, side effects of drugs, etc. In light of that, here’s what works for me:
Treatments: Lactose intolerance test/allergy testing

 

Things to Eat:

-Sauerkraut/fermented veggies, especially early in the day

–a good portion of protein for breakfast

-miso soup

-avoid any foods that seem to make your symptoms worse

 

Things to take:

–probiotic pills (look for a refrigerated brand with at least 10 billion organisms)

-oregano oil (4-6 drops in a cup of water)

 

Things to do:

-Identify sources of stress you might be experiencing digestively.  Naming them helps me diffuse them.

–Eat just soup for a day to re-set–miso or chicken, not cream or tomato 

-Don’t eat late at night (especially for acid reflux)

 

Moving your body=self-care

Two friends just sent this me this video, and I want to encourage everyone I know to watch it (especially if you experience pain, depression, fatigue, anxiety, high blood pressure, diabetes, or just about any other chronic condition) :

http://www.youtube.com/watch?v=aUaInS6HIGo&sns=fb

If you already do some kind of exercise, you can watch this and congratulate yourself.

If you don’t, you can watch this and feel encouraged to start.

The doctor who made the video reminds us that movement has major health benefits–even if it’s not the recommended 60 minutes a day.

I spend a lot of time at work convincing others that the best kind of exercise is the kind that you can and will do most days, for at least 5 minutes.   For myself I try to make sure that every day I walk to work and errands, stretch, jump rope in my bedroom, and/or go to a capoeira class.  Some of my patients like dancing in their living rooms, playing outside with their kids, bike riding, or coming to walking group at our clinic.

 

Self-Care for Nausea/Indigestion

This is a pretty simple one, for a problem that most people struggle with at least occasionally.  For me it is sometimes caused by overeating, but other times caused by emotionally overwhelming experiences.

Things to take:  Charcoal pills/capsules

Ginger capsules or fresh ginger

 

Things to drink (because nausea doesn’t lend itself to eating): Ginger, mint or chamomile tea

 

Things to do: Walk slowly if you can tolerate it

Lie still if you can’t walk

Find gentle distractions

Focus on your breathing

Consider mental & emotional factors.  If there is something non-physical that is hard to digest, look for other ways to process and express emotions.

Self-Care for Dust and Mold allergies

Thanks to my friend Tamsin for help with this one.

Treatments and Tests: -Acupuncture 

-Allergy testing (can be done by an allergist if not your primary care provider)

-Saline nasal rinses (the Neti Pot is one option)

 

Things to Take:

–“Mold, yeast, and dust” homeopathic medicine, BioAllers brand

-Cod liver oil

-Flaxseed, ground or in oil

-Evening primrose oil (see book The Fourfold Path to Healing by Dr. Thomas Cowan)

 

Things to Eat:

–Raw, local honey

-Fresh fruits and vegetables especially zucchini

-Best quality raw milk dairy products available (organic, grass-fed, local is ideal)

 

Things not to Eat:

–-Processed foods

-Any foods you are sensitive to

 

Things to do:

-Avoid carpet or vacuum often if you live with carpet

-Put dust covers on mattress, comforter, and pillows

-Iron or wash sheets frequently (weekly in hot water is the standard recommendation)

-Wash or iron clothes if you get allergies when you put them on

–Walk up hills (see book The Fourfold Path to Healing by Dr. Thomas Cowan)

-Avoid stress, meditate on the long view/big picture

 

 

 

 

Self-Care for Yeast Infections

Things to take: Homeopathic over-the-counter yeast treatments (sometimes very effective for relieving symptoms)

Boric acid suppositories (you can buy boric acid + gel capsules and fill them yourself, or some medical providers can prescribe them)

Probiotic pills (also for prevention)

Garlic suppositories (i.e. a clove of garlic)

Things to Eat: Unsweetened yogurt, sauerkraut, and other fermented foods

unsweetened cranberry juice

Things not to Eat: Foods that contain yeast (bread, beer, etc.)

Sweetened foods (not just sugar, also honey, maple syrup, molasses, etc.)

Refined carbohydrates (i.e. anything made with flour)

Things to do: Ask your sexual partner to also self-treat for yeast

Avoid antibiotics *also for prevention

Avoid tampons, the Keeper, etc.

Work on loving, trusting relationships *also for prevention

Use plain yogurt topically for symptom relieft

Great Self-Care Series

With help from some friends, I’ve been working on a little book of self-care templates for various health conditions.  They aren’t necessarily universal, but are based on what has worked for me and people I know.  I’ve borrowed my disclaimer from the Rock Dove Collective: We are not doctors, this is not official medical advice! If you have grounds to find any of this information detrimental or incorrect, please let me know and we’ll address your concerns right away.  Here is one of the first pages/posts:  

Great Self-Care for Colds  (because I work in a health clinic and got a cold every month this winter and spring) 

Treatments: Inhale steam or do saline nasal rinses (the Neti Pot is one option)

                               Get acupuncture ASAP (also for prevention)–check out the Community Acupuncture Network  for affordable options wherever you are

Things to take: Chinese herbs (Gan Mao Ling=anti-viral available at some health food stores) 

                                 Cod liver oil (also for prevention)

                                  Broncolin (Eucalyptus cough syrup available at Mexican grocery stores)

                                 Eucalyptus chest rubs or inhale tea tree or eucalyptus oil

                                 Cinnabar tablets (homeopathic remedy for sore throats)

Things to eat and drink: Lemon ginger tea or any other hot liquids.  Hot water with apple cider vinegar and honey is one example.

Garlic

Applesauce

Thai coconut soup, chicken soup, or miso soup

Things to do:  Nap in the sun 

Read a novel

Rest and rest more!  

Stay warm

Put garlic up your nose

quick update on NYC anti-soda campaign

Last winter I wrote about New York City’s “Don’t drink yourself fat” campaign.   The city’s public health department has since come out with a new commercial, “Man Eating Sugar. I like this one a whole lot better.  It’s not about fat or weight in the same way.  Instead it  gets the point across:  a 20 oz. soda contains the equivalent of 16 packets of sugar.  Most people who can easily down 20 oz. of soda would never eat 16 packets of sugar.   This is the same  method I’m pushing at my work, focusing on translating grams of sugar into teaspoons of sugar (1 teaspoon is approximately 4 grams).   It has made me much more successful at teaching people how to read labels for sugar content.  Now instead of saying, “Actually this 1/2 serving of Special K granola has 9 grams of sugar, does that sound like a lot to you?” I say, “this 1/2 serving of Special K granola has 9 grams of sugar.  That’s a little more than 2 teaspoons.”  And people say, “Wow, I thought this was healthy!”  etc.

Land of Opportunity, 5 years after Katrina

I am not much of a consistent blogger, but I’ve been meaning to try again.

In the past month or so, I have been thinking a lot about New Orleans again.  Mainly because it has been 5 years since Katrina hit.   There is plenty to be said about that.

From what the Internet can tell me, the Broadmoor neighborhood is doing well.  I spent time organizing Bard’s partnership with the Broadmoor Improvement Association and have been watching from afar as the plan that neighborhood created for itself is put into action.  Wilson elementary school is open.  The Rosa Parks library is open.  Bard is still working in Broadmoor.

I want to recommend two New Orleans-related documentaries that I have seen this month.   They don’t focus on the same things most other media has been highlighting, including economic re-development, charter schools and education, and the music of New Orleans.

The Big Uneasy was made by Harry Shearer, a radio and TV personality whose weekly radio show, Le Show, includes such lauded segments as “Apologies of the Week,” “News of the Warm,” and “News Outside the Bubble.”  He lives part-time in New Orleans, and has done extensive research on the Army Corps of Engineers and its horrifyingly inadequate efforts to build and re-build levees in New Orleans and elsewhere.  The Big Uneasy doesn’t tell a human interest story, but it tells an important story that I haven’t heard about anywhere else.  And Broadmoor’s LaToya Cantrell appears towards the end of the film.  It is showing in theaters in NYC and Los Angeles and New Orleans through the end of September.  Check the web site for more information.

Land of Opportunity is an impressive piece of work.  The filmmakers spent years following several people: an ACORN activist in New Orleans, undocumented Brazilian workers doing re-building in New Orleans, a Cuban developer working in New Orleans, and a teenage boy displaced to Los Angeles.   Without narration or talking heads, these stories offer insight into the neighborhood planning and redevelopment process, immigrant workers in New Orleans, and ongoing community organizing around public housing and other issues.

I was especially impressed with How Land of Opportunity treats the issue of public housing in New Orleans.  The film follows a woman and her adult daughter who are former public housing residents and current activists, and through their story show the organizing against City Council actions that ultimately led to the controversial demolition of the “Big Four” New Orleans housing projects.   I read a lot about this process as it took place, and always thought of in the context of a nation-wide discussion:

large public housing projects should continue to operate because they provide needed housing for low-income families and they are what we’ve got

vs.

large public housing projects concentrate poverty and keep people poor and should be replaced with private mixed-income developments.

Watching Land of Opportunity, I realized that although this discussion was happening in New Orleans as elsewhere,  something unique was also going on.  In demolishing public housing, the city destroyed viable housing in good condition, something that was and still is in short supply in the city.   The City Council and Housing Authority kept people from coming home by replacing public housing with privately developed, mixed-income developments that have few units available for former public housing residents and that are being built slowly.   This was a political choice that prevented many poor, black residents from returning to the city.

For New York friends, Land of Opportunity is screening in NYC and Poughkeepsie this week.   The filmmakers went into debt in their years making this movie, and they are telling an important story.   The film’s tag line is “happening to a city near you,” and I would be interested to see if you agree.