Thanks a bunch, Julie
Tag: Christian blogger
So where are we now? Much better than “clean and dry.”
I will never forget Julia. She had a petite frame, a blondish hue to her gray hair and a sweet disposition even with her eyes closed. She kept her eyes closed most of the time in those days. Oh what a sweet treasure it was when she would open her droopy eyelids, worn out from the years of looking at what simply did not matter anymore. When they did pop open, her eyes were as blue as that of a spritely, young thang yet their life was no longer shining through their looking glass anymore.
Julia let you know what she wanted by the gestures of her contracted and weakened frame. She held her arms in a flexed posture near to her chest and her legs were drawn up above the seat height of the modified geri chair upon which she sat, semi-reclined. I don’t even think that her feet touched the foot rests most of the time: pale pink padded foam to match the waterproof cover of the end-of-life bark-a-lounger in which she sat when out of bed. Julie must have weighed 90 pounds when I met her. She leaned to the right then to the left depending upon the position the Certified Nursing Assistants (CNAs) had plopped her in until nap time. The frail bird of a woman was transferred to bed each afternoon at least an hour after lunchtime, to prevent regurgitation you know. That is also when she would be checked to make sure her diaper was clean and dry. If not before her nap, the CNAs took care of her diaper change later for a total of about three times per day. To keep her “clean and dry” was the charge of the nursing staff of the long term care wing and staffing ratios made sure it that it probably did not happen any more than that for tender ladies like Julia who could not ask for more.
I met Julia while working as an occupational therapist in the rehabilitation unit of this long term care facility. Periodically we would receive referrals for residents whose MDS (government mandated) scores triggered a decline in the functioning of a resident, requiring a screening assessment from a member of the rehabilitation therapy team. This particular episode was likely triggered by weight loss which may indicate possible feeding issues. Or it may indicate improper positioning in the geri chair restricting swallowing, restricting nutritional intake. She was already seated at a “feeder” half-circle table in the occupational therapy clinic at mealtimes so I had seen her while I was eating my own lunch in an adjacent office. My role would now become evaluating all of the factors in her decline once the screening assessment triggered an order for an “occupational therapy evaluation” then treatment.
Residents such as Julia are very complex for the reasons that I have already stated. At some level, you must detach from the emotional impact of working with someone in the last stages of his or her life with advanced medical conditions and dementia. Then again, when I got to see those blue eyes meeting my own brown eyes for a brief moment in time, I knew that there was more than a long term resident in front of me. I was looking through those eyes to the heart of a woman who once was someone’s mother, another’s grandmother, a man’s darling and petite wife, and someone whom many once loved. I loved those connections when our eyes would meet!
I am grateful to say that I don’t think that I ever lost sight of these defining “occupational roles,” the presence of one of God’s children placed before me, when asked to evaluate and treat a person entrusted to my care. I am grateful for even the somewhat gross experience of feeding a shell of a person (which would have been required through the course of my intervention) even though she would likely spit up some of the pureed foods presented to her. She probably smelled rank at times after an episode of incontinence when she could not communicate her need to “use the ladies’ room” after dining with the other “feeders.” Arrrgh! How I hated that label!
I would have initiated taking Julia to her hospital bed with one of the aides and assisted with “toileting hygiene” even though it was a “feeding assessment” because that care became a part of my job description too: it would help me to evaluate Julia’s sitting balance/tolerance/posture, level of arousal with gross motor stimulation, righting and equilibrium reactions and more that influence a seated posture for the “activity of daily living” called eating. How better to evaluate someone than within a real-life activity than to transfer her onto a vinyl mat . . . smelling like feces? Helping Julia become “clean and dry” before the aides had time to do so after their smoke break always seemed noble as well . . .
Julia’s story had a sad ending. I watched her continue to decline long after our occupational therapy sessions and staff training were completed. Julia continued to require maximum assistance with feeding and eventually accepted less nourishment from the aides at mealtimes. An astute and skilled nurse who loved the patients in the long term care wing determined that Julia had a fecal impaction and notified the family. Julia had a “Do Not Resuscitate” order on her chart and the family were ready to let her go. Perhaps the heartache of seeing her endure this end stage of life was just too much for them to bear anymore? But the illness that resulted in her death was not a major medical event. It was a fecal impaction. The end of her life was gross and undignified. The gracious nurse personally assumed the responsibility of keeping Julia “clean and dry.” This time the toileting hygiene that was needed was in her mouth . . .
Perhaps you can imagine what I am describing here without having to write another word about it. Many who knew and cared for Julia were deeply grieved at her passing. To discuss her quality of life, the anguish of an end-of-life decision, or the crises of the skilled nursing industry is not the intent of this article. My intent is to tap into the compassion I once felt on a daily basis that brought gratitude for the opportunity I was given to serve others in their time of need. I did what I could, with what I had, to the best of my ability at that particular time in my life. Caring for others kept my mind clearer of the whining that can occur for my own limitations, unmet needs, illness, and sorrows. I don’t have that caregiver role right now. Even so, I will never forget my experience with Julia and it is good to remember her on a day like today.
No, the hope I had that my pattern of noxious symptoms was changing did not last for more than two days. Oh well. I thought about deleting the blog from August 2, 2013. If I had deleted it, I would have missed reaching deeper into my heart to find the memory of Julia who had taught me so much about life so many years ago. In the larger scheme of things, two days with a few hours of relief is barely enough time to do anything, experience anything of lasting significance anyways except maybe a trauma of some sort. I shall hold out my hope for two months!
In the meantime, I will open my brown eyes and see if I can find something else to focus on today. Six-thirty in the evening is a great time to take a shower in the “p.m. shift” of my daily schedule so I can present myself clean and . . . pretty for my husband when he returns home from more noble activities. It’s a lovely evening so maybe there is something I can do with it, even if it is sitting within view of the pretty gardens outside my window. Oh how I wish you could see them! There’s a hummingbird who is coming around a lot more now too. Very cool.
See there? I think I’ve landed in a better place after all. We are “there” and it is meaningful after all.
Extreme Diet Survival Strategies
Extreme Diet Survival Strategies
By
Julie Horney MS, OTR/L
As you embark upon your new diet or nutrition plan, you might feel at times like the television shows that create a new home or body through an extreme makeover! Well, if this is the new diet that will work for you, it’s possible that many things in your life will undergo an extreme change too.
Choose to trust the process of transformation and know that you are not alone! I am not writing this as a nutrition expert, just someone who has experienced the rigors of what feels like an “extreme dietary makeover.” I am writing these strategies to encourage you that you can do it! The challenges and victories associated with an unfamiliar food plan will stretch you and grow you in ways that will likely benefit others in the future. In the end, you will be: glad you tried something new, have new skills you never knew existed, and understand the powerful healing chemistry of food.
Each of the tips below will help some folks and not others. Take what you like and leave the rest. These Strategies refer to “you” and this is intended to include a loved one if you are using these guidelines as a caregiver of another person. Thank you for helping him or her! Further, these ideas are in no particular order and in no way are to replace the advice of your healthcare practitioner. These guidelines should not be considered medical advice! I share them as a fellow sojourner on the path to better health and to encourage you on your own, unique journey. YOU CAN DO IT!
Know that your schedule must change in the beginning: this will likely be time consuming for awhile. This new food plan could save your life or the life of your loved one! If he or she was in the hospital, your schedule would change drastically. So please consider asking for help if needed to keep essential daily activities going and to cut out the rest for at least 2 weeks. It may be longer. These new skills will take time to develop and the adjustment to a totally new nutritional plan could take weeks or months. Things must change to ward off exhaustion, frustration, and illness of the primary caregiver. You are giving yourself or your loved one a great gift. You might be surprised that the adjustment won’t be as long as you think it will and some “normal” activities can return to the schedule sooner than you think.
When you make your decision on which diet to follow, gather together as many of the supplies and ingredients you need as soon as you can and before starting. This is especially helpful if your plan requires say, less than 30 foods/fats/seasonings in the beginning, so you don’t get too hungry and quit. Even if you must order ingredients online (www.amazon.com, www.walmart.com, www.vitacost.com), get them on the way to your house. It may take weeks or months to find local resources and the cheapest places for each item on your list. You will find them! It’s all part of the natural learning curve.
In the beginning, consider simply posting the new diet plan on the refrigerator or kitchen cabinets to get you and others in the home familiar with everything more quickly. The person on the new plan will benefit from having specific information written down and easily accessible.
Consider posting a snack list on the frig or a kitchen cabinet for at least the first week or more of the new diet. Try filling a special basket or brightly colored container with as many food choices as you can as a quick treat. This also cues others in the household not to eat up the only foods the recovering person can eat AND adds independence besides convenience. Surprise the person with a new food choice when able, small toy or a note of encouragement/inspirational verse/quote to find in his or her special place. This is even important if the person is an adult or if it’s for you and you live alone! Everyone likes a special treat now and then, eh?
The internet can be your friend for: 1) emotional support, 2) resources of information, and 3) places to purchase special ingredients. Not good on the computer? Virtually every public library has an adult reference librarian who can help you if you are not a “Googler.” Most special diet and health protocols have an information and support network on their website or blogging community. Use them. Broaden your network online as soon as you are able. This will help when you are feeling overwhelmed and it is the middle of the night or a time of day when the people you usually go to simply aren’t available.
Follow your plan until your Healthcare Provider or sound advice leads you otherwise. There will be contradictory information “out there” on most aspects of your diet and health plan. Don’t get discouraged. Unless you or your loved one is in a crisis, you must allow time for the new nutrition plan to work. How long has the person had the health issue? Consider doubling this amount of time and know that when that date arrives, you will have made some gains, figured out some things to do/not to do, what sources of information are reliable for you, and had some successes. Virtually everyone benefits from improving his or her nutrition!
Get supportive family and friends involved to help and to keep you on track. Inform them of your plan and research. Answer their questions and ask for help with specific tasks and for his or her support to follow the food plan as you have it posted. Listen to their suggestions if they are offered and offer to take them to your healthcare provider (HP). By getting a third party involved, the HP, you can help ward off hurt feelings from family and friends when you simply cannot follow their attempts at “helpful advice” right now. They obviously care and are just trying to help but might not know as much as you or your HP does. You probably have done more research than the casual commenter. Thank them and keep moving forward as appropriate.
Drink the best water you can afford whether filtered or bottled. Filtering your own water is generally cheaper in the long run.
Look for and celebrate the success with non-food rewards! The meaning of food as a source of comfort, nurturing, requirement for special holidays must change for at least a season of time. Remember this diet could change a life forever! Wow. This new food plan may not last forever either! We just don’t know at this point and please, “don’t even go there” for now, k? Sooooo, when there are victories, find a way to rejoice. Even bottled Perrier tastes like gourmet food when all you can drink is water. Bon appetite’ in your finest glassware!
Seek special recipes to help you from books, health food stores, local community colleges, online newsletters/blogs, and support groups, etc. Ask for help by contacting the author of the respective source of info. when needed, especially when you must make substitutions or deletions from printed recipes. Please don’t be afraid to ask for help. A year from now you will find great joy in sharing what you have learned to help others too.
With a few basic preparation techniques, you can make most anything taste good or at least better. This next section offers a few specific (crazy?) ideas where applicable:
For Meats/Fish:
- If you can cook with oil or fats, rub the acceptable amount all over the meat/fist on your food plan. Add approved seasonings and a little extra salt (again, only if allowed). Pink Himalayan or Celtic sea salts are very flavorful even alone. From here you can either bake it or slow cook it in a covered pan on the stove, searing meat first before cooking it further. Pepper tastes better if ground and white pepper is milder than black pepper. Experiment from here. Even powdered onion/garlic/salt rubbed on meat/fish is a great place to start. Read all the ingredients in store-bought seasoning mixes and avoid MSG and “natural flavorings.” (Using oil and healthy fats like real butter enhance flavor, help the meat/fish stay moist and slows digestion to keep you fuller longer!)
- Ground meats and cooked fish can easily be formed into serving size meatballs and baked for handy meals and snacks. These also generally freeze well..
For Vegetables:
- You can add acceptable veggies to the pan of the meat/fist prepared above, coated with the same seasonings. Just cut up the veggies smaller (1/2” cubes, for example) to make sure they cook at the same rate as the meat. Root veggies (carrots/parsnips also celery) and greens will take longer. Add meat or veggie bouillon or non-dairy milks as needed to keep things moist and add flavor. (Ever cook with coconut milk? Yum!)
For Fruit:
- To make an unfamiliar/low sugar fruit taste better for a picky eater, cut it up and mix it with acceptable sweeteners or other fruits on the plan, let it sit awhile, and enjoy. Work towards lowering the sweeteners when needed.
- Puree your low sugar fruits and pour it over most anything as a sauce or topping.
- Make a smoothie, mixing everything together that sounds good on the daily food list. Add ice to make it cold and more palatable. Use liquids on the plan as a base, for example coconut and almond milk. Even unsweetened “milks” taste good mixed with fruits. This rocks: hide supplements or a small amount of fresh green veggies in the smoothie where possible! Put drinks in an insulated sports bottle for a convenience food away from home.
- Omit all fruit (and simple carbs) if you are treating a yeast infection of any kind. Cheating feeds the yeast! One source advised to do a challenge test after at least 3 weeks away from sweets, by adding back one serving and re-evaluating how you feel. We can do anything for 3 weeks if it will reduce our misery, eh?
You can steam just about anything just don’t mix meat and veggies together for food safety.
To make foods tast better:
- Use as much salt allowed on your food plan. Ground pepper too.
- If sweeteners are allowed, add a pinch to each food item. For example, a tiny bit of local honey brings out lemon and other flavors more. I understand that stevia is the only sweetener without a blood sugar impact if yeast is of concern.
- Where possible, organic cocoa powder, cooking extracts, flavored stevia, or organic decaf coffee crystals are great flavor agents. Experiment!
- Vary the oils used to add a new dimension of flavor. For example, substitute flax oil in dressings. Heck, use Mrs. Braggs Liquid Aminos instead of vinegar with your oil for a savory dressing.
- Roasting veggies at high temperatures brings out the natural sugars and makes them taste better on a pan coated with oil. Who knew that parsnips could taste sweet?
Make more dishes or serving portions than you will need in any given day when possible. Freeze portion-sized quantities and date/label the baggie or container. These portions become your new “convenience meals” and can help decrease stress.
- Freeze soft foods, slightly cooled, in Ziploc-type sandwich bags. Place each individual bag in a 1-gallon freezer bag or food storage container and place it in the freezer in a designated section for easy access.
- Separate grain-based foods, veggies, fruits, and meats from each other by placing only food of each type in each 1-gallon bag or larger container. Label the larger bag or container and grab what you need on any given day! Mixing it up wards off boredom on a limited diet.
- Minimize the dangers of bacteria and mold growth in leftovers by freezing portions as noted right away or by making your own frozen dinners in microwave-safe or oven-safe containers. Remember to label the container please!
You will not likely regret purchasing the best food processor or blender that you can afford. Almost any food ingredient can be made tolerable when blended with something that tastes good. For example, add acceptable fruit juice concentrate (reading package labels to make sure you can have all of the ingredients), sweeteners, cocoa, instant organic coffee, whey/egg white/hemp/pea protein powder, salt, etc. Try this: chop carrots, nuts, and sunflower or pumpkin seeds together and add to ground meat dishes for increased nutrition and flavor.
To help with feeling hungry:
- Keep protein powders, oils, fats, fibrous veggies (for example kale chips, celery), fiber supplements, seeds, nuts, etc. on hand to stave off hunger. Consider adding these to your meals where possible to help the meals become more sustaining. Ever mix organic cocoa with a spoonful of coconut oil and a drop of stevia? Who knew it could satisfy a hunger craving? I’ll take mine with organic decaf coffee and no stevia please! J
- Make a protein smoothie, pudding or no-bake cookie with items from your food plan. Crazy adaptation: make a paste of non-dairy milk/yogurt, protein powder, nut/bean flours, pinch of salt, any acceptable flavorings/sweeteners, nuts, seeds, fiber, and any solid fats (like nut butters or coconut oil). Taste it and adjust as needed for a thick consistency. Roll it into a log, wrap in waxed paper and refrigerate it. Give it your own funky name and slice off a chunk when hungry.
- Mix powdered or liquid supplements into soft foods to make a superfood sauce/dressing/topping without added sugar. For example, many powdered probiotics and supplements are slightly sweet. Mix the powder with coconut/greek/almond/plain yogurt and dollop it on a difficult-to-eat food (like cooked greens!). A sauce or topping can make most anything look (taste?) like a gourmet food!
Always carry emergency food and water with you when you or your loved ones leave the house. For example, cooked organic chicken apple sausages probably won’t hurt you if stashed in a purse or book bag for a few hours. Helps to prevent dietary slips and crabbiness! (Don’t hold us responsible for this one. Just ask a backpacker about the (organic turkey) hot dogs they pack and survive to tell about it!)
Buy in bulk where possible after you know what foods you use the most and like. Food spoilage won’t save you any money in the long run! Packages placed in a large, sealed plastic storage bin generally works well in a cooler garage or basement for dry or non-refrigerated and sealed ingredients when there is simply not enough room in the kitchen or pantry. Watch expiration dates please and don’t mix old and new ingredients.
Prepare ahead for all special events and social functions. Give a trusted hostess a list of acceptable ingredients ahead of time when applicable. Never assume that your gracious host or the ladies at church/school will really know all the ingredients the recovering person can tolerate. For example, all gluten-free cookies are not alike! This is your area of expertise right now. Thank your hostess for trying to help.
Travel Tips. Make ahead and freeze serving size portions of foods that are difficult to find on the road. A well-packed cooler with freezer packs will generally keep items frozen for most of a day until you get to your destination; items will keep for about 2 days if you don’t mind the items partially thawed when you arrive. Exception: protect your cooler from a hot car and out of the sun! I usually go to the grocery store before I reach my hotel or the home of my gracious host to purchase perishable items that will be needed the next day. This minimizes any potential stress trying to get out and grocery shop when I’d rather be visiting, even if that visiting will be over some special food prep. Make it fun!
For the car/plane/train: pack a lunch and dinner in a suitable lunch box to reduce the temptation of going off your food plan when everyone else is grabbing a burger or sub. (Check airline policies before you get to the airport.) Remember your treats and keep snack foods, drinking water accessible. Tip: request a small refrigerator for your hotel room if it is not already provided. And as a courtesy when staying with family or friends, let them know about your life-saving nutrition plan before you get there to avoid hurt feelings when you are unable to enjoy meals in the same way you might have in the past. Your gracious host needs to know if you will require space in the refrigerator or freezer too.
Keep a dedicated notebook or portable electronic device/app to record everything: grocery lists, snack lists, major symptom changes, new healthcare practitioner recommendations, etc. It’s just too easy to forget stuff, even the good progress that’s coming along. You probably want to minimize mistakes and flare-ups; good record-keeping helps track things. This likely requires keeping a daily log, even if it’s scribbles in a journal, planner, purse-sized notebook or smart phone. “There’s an app for that!” Catch up on note keeping when sitting in waiting rooms, riding in a car, etc. and get the recovering person involved too. Seeing a symptom improve from a “7” to a “3” on a 1 to 10 scale can provide the boost needed to hang in there when the going gets tough.
Please remember: you are not alone in this journey. Celebrate that you are doing something to help your health where many would simply give up! Food is fuel. Garbage in, garbage out, etc. This process won’t be perfect and that is o.k.! Learn from the mistakes and move on. Keep moving forward where possible.
That’s it for now. Got some of your own victory strategies? When things settle down for ya, I would love to read them and pass them along to others! Contact Julie Horney at: psalm34810@yahoo.com I am grateful for Cindy Jakacki-Null and Tonya Floyd for their coaching and expertise included in these Strategies. I invite you to follow Julie’s story by clicking the “Follow Me” button at: http://www.jesusisforthewounded.wordpress.com
P.S. Riddle: how do you eat an elephant? (I know, yuck!) Answer: one bite at a time. Yeah, a sense of humor will get you through as well. We Extreme Diet Survivors don’t recommend elephant, however!
:J
And then it gets real . . .
It is now 6:39 p.m. on a beautiful Saturday and I am grateful to be able to function at a low level once again. Sometimes your own posts become your best medicine! I am so glad that I had the opportunity to explore the topic of suffering before two hellish nights. Sigh. Perhaps this suffering shall pass in time . . .
Low Dose Naltrexone, a compounded medication used off-label to raise a person’s pain threshold and boost the immune system of someone with an autoimmune disease, is now ruled out for me. Just 1.75 mg taken at bedtime the past 2 nights was enough to set off violent seizure attacks! Oh yeah, I’ve had some of these attacks more often lately, but not for 1 1/2 hours in a row with hardly a break to breathe! The duration was much longer this morning with longer breaks in between additional episodes. After 2 hours then 3 hours then 4 hours of sleep, “I am able to function at a low level once again.” This saga is a bite in the shorts for sure. I AM FRIED.
So what did I learn here?
First, it’s time for more than one-half of a day break after completing one treatment regime before beginning the next one! Healing from a chronic illness is a process, not a race.
Second, it’s time to simplify my daily routine even more. Cleaning the entire house every week is just not going to happen for awhile. This is a bummer since I am paranoid about dust accumulating, since we completed the mold remediation of our home. Maybe the dust is cleaner now?
Third, it’s time to ask for help when I need it and not just from my husband. A few ladies have offered assistance over these past 2 years of illness and I have rarely accepted it. Maybe I could use help with a few things during this particular time.
Fourth, I must continue keeping my mind filled with scripture, Christian music, Christian messages and uplifting images to ward off the temptations and lies of the Evil One. I must not fall into despair. I must not keep apologizing for the effects of an illness that are clearly out of my control. I must live as though the Lord is creating a masterpiece from the fragments of my shattered life, picking up each piece as if it were a treasure and not another burden. God will use this for His glory and my good. I must hang in there for the finished work.
Fifth, I must keep writing, including the good, the bad, and the ugly. And when I do, I will continue to leave my gentle readers with hope by the time I reach the last period. To write has been an incredible salve for my wearied frame, my wearied mind. My soul, well that’s already in the hands of my Savior.
I am hungry again! But it’s more-than-time for an Epsom salt-and-baking-soda bath and a shower! Perhaps the Beanitos chips and unsalted dry roasted whole cashews I just ate for dinner while writing this will tide me over just a little longer? Hope so.
Seeya next time, perhaps with better news. :J
Footnotes on Suffering
To sustain us through the tough times, many of us turn to God and to prayer. In this short article from today’s e-newsletter of the Vision Beyond Borders ministry, we can find encouragement and strength. Let us allow God’s Holy Word to wash over us and consider Patrick Klein’s remarks as one who has seen suffering beyond what we can even fathom here in the United States of America. We are blessed to have the freedom to be able to read and share these sentiments today:
Hebrews 12:12-13 says, “Therefore, strengthen your feeble arms and weak knees. Make level paths for your feet, so that the lame may not be disabled, but rather healed.” This is talking about someone who has already been involved in the race. It is someone who has been pursuing the Lord and His purposes, but is growing weary and tired from the race. It is the point when they have hit the wall, and must dig deep to keep persevering.When we feel burdened beyond our own strength to endure, it is then that we must remember not to rely on ourselves, but on God who raises the dead! We don’t want to start well then grow tired, but to be those who persevere, endure and finish well. We can’t do that in our own strength, but only through Jesus and only by setting His example continually before us; by looking to Jesus the author and FINISHER of our faith! (Hebrews 12:2)This passage also tells us to make level paths for our feet. The word for paths here is “trochia”. It is literally translated as an imprint left by wheels – like a rut. We must realize that we are all leaving a rut in the ground for others to follow. No matter where God has us, there are people who are looking to us and our example. We must be careful that the path we are leaving is one that is level and straight, that it will not cause others to stumble, but it will be one of healing!This passage comes directly after God explains how we are to persevere in the midst of our suffering, knowing God uses it to strengthen us…and not just us, but those who come after us! May He strengthen us to persevere for His Kingdom and His Glory. May we be a vessel of His healing as we leave a straight path for others!
I do pray that all of us wherever we are in the world will be healed of our infirmities in this life. We know that by His stripes we are healed from the consequences of sin and death (1 Peter 2:24), by repenting and believing in the sacrificial death and resurrection of Jesus Christ (John 3:16). We know that one day there will be no more pain and suffering (Rev 21:4). While it is possible that it may happen in each of our lifetimes, there are no guarantees of this per se. Rather than be discouraged, join me in being encouraged that all pain and suffering can be used for His glory if we but keep our eyes fixed on Him, persevere, and endure. The trials can be used to strengthen us, lead others to the Source of our strength, and mature us (James 1:4) for our eternal reward in heaven (Rev 22:12).
And that, gentle readers, is enough to get me up and running again every time. Even today when out of sorts. How about you?
Jesus is for the Wounded 
You must be logged in to post a comment.