#15: Most Impactful

There was no particular topic or subject matter that was necessarily impactful--I found all interesting, though. The thing that was most impactful was the subject matter presented in a way that made me think of it in terms of my life. This course really made me reflect upon myself and what I am doing for my health--in every area. I have evaluated my physical health, my sexual health, my emotional health, etc. I have once again had to look at my priorities. To me, this was a class full of life lessons. It was nice to see others' points of view--made me see how someone else may deal with something. That aspect of the course was most impactful. I really enjoyed this uncommon approach to teaching.

#14: Finding a balance

Oh, how finding a balance in life is a constant struggle for me, or so it seems... My daughter was 8 weeks old, my husband had just left for Iraq for the second time, and it was time for the last year of nursing school. Thank God, my husband was supportive in that he was ok with me not working. However, I had always been an A student (especially before I had gotten married) and nursing school was tough.

At the beginning of that semester, I was still placing school first. I felt as if I was neglecting my newborn, my husband felt neglected (which was multiplied in his eyes because he was slightly depressed and was gone during the holidays), and my house was sooo dirty. I did not even have time to do the dishes (we didn't have a dishwasher then). I came to school one day and decided I had had enough. I spoke with the head of the nursing dept, and I told her that I just couldn't do it anymore. The people that should be the most important to me were suffering and paying the price of nursing school.

At that moment, I was looking outside myself to solve the dilemma I had created within myself. It took a lot of prayer for me to accept that it was I who needed to change my perspective and set my priorities in line, not necessarily change my circumstances. Luckily we were a close knit bunch in nursing school, and a few of my friends came to my house. One watched Kamryn while the rest of us cleaned my house. I started to put my family first, set aside special time for my husband--to either email him, write to him, or talk to him on the phone if I was lucky. I accepted that I did not necessarily need to make an A, but that I did need to learn so that I could be a competent and good nurse. So, with that in mind, I put homework off until it was time for Kamryn to nap or go to bed. Kamryn and I had a much better time, and were both happier. So, school was put into last place. First was God, then my husband, then my baby girl, and then other family and friends, and last school. Even though I was not working as hard in school, I still got an A. My husband was happy, and my baby and I got to spend quality time.

It is still sometimes easy for me to fall back into a messed up priority life, but I frequently evaluate myself and my priorities. I know which order is important to me and my family, and I do my best to maintain them all in the right place. I have increased my number of activities, including ballet, work and school, and preparing for a new baby, so it is vital that I maintain the appropriate energy expenditure for work and school so that I do not neglect the things that are more important--my God and my family.

So, the gist of it is, deciding on your priorities is vital to maintaining balance in life. My priorities depend on where I get my identity--I am a child of God, and a wife and mother. Everything else is just an extracurricular activity and oh so temporary.

#13: An Addict

One of my coworkers, a RN, is a recovering alcohol addict. According to the TX BNE, she had a restriction on her license and could not handle narcotic medications for a certain length of time. At first I was afraid to ask her why she could never count the narcotics, and why she always had a medication nurse on her shift (despite the staffing grid), until I worked with her for a weekend. I had just assumed that she must have been abusing narcotics. Well, I asked her, politely, and she was not fearful of telling me her reasons. She did not boast or brag, she told me in a very appropriate way that she struggles with alcoholism, had been sober for a long time, relapsed, and is now sober again. She was facing the consequences of her personal choices in her professional life. She is a member of AA, and uses the 12 steps daily. For her to admit her faults, and her addiction, to me--a coworker--who really did not need to know, and discuss it openly created a new respect for her within me. To be be able to admit when you are wrong, admit that you may fail, shows that you have insight, that you are willing to look at yourself in the mirror and take the next step to do something about it.

Working in the mental health field, I see a lot of patients who self medicate with drugs/alcohol/self harm. They are all addicted either psychologically or physically. When they are in denial of their problem, they make no steps to correct the situation, and they continue in their self-destructive behavior. The ones who admit that they have a problem, may still relapse--frequently having a lot of guilt and a sense of failure associated with it--but they are trying to do something about it. That takes strength, especially since there is something painful behind their reasons for self-medicating. They not only struggle against the addiction itself, but against their fears and their pain.

#12 Mental Health Stigma

What can be done to reduce the stigma and shame surrounding mental illness? Some people might think that there is no stigma, but in reality it is still pervasive. I work as a RN at a mental health and chemical dependency hospital. I have seen patients' whose families turn their back on them because they are "crazy." There have been patients who are afraid to call their friends using the hospital phone because the person on the other end has caller ID and would know. Patients are sometimes afraid of letting their boss know that the reason they were out of work was because of a mental illness, and they might lose their job. Some patients are going through a divorce, and are afraid the custody of their children will be in jeopardy if the spouse or ex-spouse finds out and uses it as ammunition. It is amazing how precious the HIPPA act is in this field. There are even others afraid to use the proper terms for their disease, and choose to instead talk about it in terms of their "nerves" are acting up. HCP must be very careful with diagnosing young children due to labeling that will occur and negatively affect that child. Patients have a hard time taking medication for a mental illness, even for mental illnesses with a biological etiology, because they think that it is not really real, or that if they take the medication they are admitting to the world that they are "screwed up." Most of the people in the hospital have very traumatic pasts, poor support systems, and poor coping skills. They become hopeless. Some even use their diagnosis as an excuse for inappropriate behavior.

So, the stigma is seen within the patient, within the mental health and medical health system, and in society in general. I think the most effective way for the stigma and shame to be reduced is by education, of not hiding the mental illnesses... educating society about the reality of the illnesses, the reasons for them, and the effects they have on the individual and society... by showing the necessity of recognizing the symptoms, and searching out treatment/support in order to reduce the adverse effects.

#11: Our future

Would I live differently if I always remembered my future in the back of my mind? Would I allow my future to direct the events and my activities in my life in the here and now? Sure, I would have a different perspective on life. I would remember to eat healthy and exercise, always remembering the impact it will have on my future health. I would remember that my decisions now may change my future path. I would also remember that my stressful life always needs a stress relief outlet.

You know, I do participate in healthy behaviors. I eat right, and exercise for the most part. I do not always de-stress well enough due to the schedule I chose and the activities I chose to participate in. However, the reason that I do any of the healthy behaviors is because I want to live a long and healthy life--I am looking towards my future.

So, my conclusion is that if we keep in mind that our attitudes and actions today will affect our future, but that today is now yesterday and that each day is a new day, then we would chose healthier behaviors and lifestyles.

#10: Academia's responsibility?

I think that academic institutions, though not required, can play a large role in promoting disease prevention for women in at least 2 ways. For one, the instructors can incorporate disease prevention education into their syllabi's and tailor it according to the subject. Also, they can hold presentations regarding the the diseases and how to prevent them. Other than presenting the information to the women in that community, academic institutions can help to discover more ways of disease prevention by participating in research and then disseminating the information in an easy to understand format. The student body can become active in providing information to the surrounding community by promoting or providing health fairs.

#8: Forever Young

Why do we try to stay "looking young" for as long as possible? Why are we so concerned with the signs of aging: getting grey hair, wrinkles, loose skin, etc?

Our society has equated youthfulness with beauty and sexiness. As women (and even men), we try to uphold that image of youthfulness and sexiness. For some reason, we have decided that soft, sagging breasts are imperfect distorting our image. Gray hair and wrinkles are reminders that we are aging... that the inevitable is coming. We think firm curvy bodies are the ideal which we must all strive for. If only we were cookie cutter people. (Though I think that the ideal image is broadening to incorporate some imperfections.)

Maybe we do not respect the elderly in our society... Maybe we have gone as far to say that the elderly are useless to the rest of society, that they are a burden. With a negative outlook such as this, it would make it an easy jump that aging is something we do not want to happen to us. So, any sign of aging would be undesirable. Something that is undesirable is imperfect, so we must try to hinder it...

I am not sure if it just a plain desire to be sexually attractive, or if the desire to look young goes much deeper into how we think about the entire aging process and its implications. But, the shunning of aging is doing a disservice to us as a society. Elderly people have led productive lives, have seen many things, gained wisdom that can be passed on to younger generations; they can be mentors. Sadly, elderly people are all too often stripped of their dignity and labeled a burden.

#7: What would you tell a friend or loved one who suspected that she might have an STD but was afraid to get tested?

Ignorance is not always bliss... If a loved one or a friend of mine believed she has a STD but she is afraid to get tested--I would encourage her to find out for sure. There are many types of STDs, and along with that, there are many different microorganisms or viruses that can cause them. So, if it were a bacterial STD, a benefit of knowing is that an antibiotic could treat and cure it. If it were viral in nature, there may be a drug that inhibits the progression or symptomology of the infection--another benefit of knowing what is going on.

If she refuses to find out for sure, I would also tell her that she is taking her life into her own hands--she is placing herself at risk for pelvic inflammatory disease (painful), infertility, cancer (from HPV) and possibly death. That might be a scare tactic, but it might be what she needs.

It would also be important for her to realize that she is placing her partners' at risk as well. She would need to inform her partners so that they could seek help or treatment. She would also need to be reminded of the importance of protection to decrease her risk of transmitting or becoming infected with a STD.

Hopefully I would be convincing enough to help her overcome her fear or the realization of that fear. There is hope with STDs.

#6: Should prenatal testing be routine for all women?

No. I do not think that prenatal testing should be routine for all women. I think it should be available to all women if they desire. I am a woman who does not desire to have prenatal testing. This is for many reasons, but it all boils down to the fact that abortion is not a choice for me, no matter the physical or mental capabilities of the child. I will have that child and love it no matter what. To this point, there is no cure for any genetic abnormalities. If there is a physical handicap that can be "fixed," then it will most likely be "fixed" outside of the womb. So, in the end, I have no need to have prenatal testing performed. If I knew there was a problem, I would be upset and worried the rest of my pregnancy. Instead, I can enjoy the pregnancy, and when the child is born be aware that there is always the possibility of problems and be willing to accept whatever child God created for me to raise.

#5: To be a mom or not

Ever since I was a little girl, I dreamed of being a mom. Maybe because my mom and I are so close, how she made it seem so wonderful. She truly loved being a mom. My siblings and I have a good example. So, I had this plan to get married, be a good wife, and then become a mom and be a great mom. I got married at 18, our first year was rocky. We chose not to have children until our second year of marriage, mainly because our marriage would not have been able to withstand it. Then we had our first child when I was 21. It has been a life changing experience. I love my child, and the one on the way. Kamryn, my daughter, is 20 months--loves to be independent, imitate my husband's and my behavior. We still occasionally have sleepless nights; she has a temper and it seems like it flares for days on end at times... But, it is all worth it. We have the honor of raising a child to love and teach to be a responsible member of society, to love God, and love someone else. After this next child is born, I am not sure how many more I want. Maybe one more. We will see. My husband swears that if we do not have a boy, we will keep on making babies! Haha! But, I am not sure that I will agree after the 3rd.

Menarche

I can not remember the actual day my period began. I think I wrote about it in my old diary... and, from what I can remember, it was not a joyous moment for me. My mom and my sister were very detailed (in my mind "gruesome") about menstruation. So, I thought it was disgusting. I also was in ballet, and I danced multiple times a week. I thought that if I was menstruating, I would not be able to dance for fear of everyone knowing. I was so embarrassed by this change from girlhood to womanhood that I kept it a secret from my mom for months. I think I was 12 or 13, but she was beginning to worry that something was wrong. I finally broke down and told her. I refused to buy any feminine products (I could not dare be seen with them in my possession) until I was 16. Now, it is no big deal. I am glad that I do have a period--it is a sign to me of being a woman and a mom.

#3: Preventive Practices

According to the "Rate Your Preventive Practices," I scored an 8/10.
1. Do I eat a healthy balanced diet: not very well... and not very often. I try to make sure I get enough servings of all the food groups per day, however, with my schedule and the things my family agrees to eat I do not always succeed. I could improve this by introducing more fresh fruits and vegetables to my family; give myself enough time to prepare and cook a meal by planning ahead; or, if my family refuses to increase their consumption of fruits and veggies, then I can prepare enough just for myself. (My husband is not a big veggie lover).

2. I participate in moderate-intensity exercise at least 4 times per week.

3. Do I get enough sleep: no. I frequently feel tired during the day. In order for me to not feel tired, I would have to go to bed at 2100 daily, however, that would eat into my prime homework completing time. I have been actively employing more efficient uses of my time, but, as my mom frequently points out to me, I sometimes bite off more than I can chew comfortably.

4. I have never smoked or used any drugs.

5. I do not consume alcohol... well, I have probably consumed alcohol on fewer occasions than I could count on one hand.

6. I am sexually active in a mutually monogamous relationship. My husband has been my only sexual partner.

7. I employ stress reducing methods. This is essential for me to even make it through a day at work on occasion. I work at a psychiatric hospital which can be very emotionally draining. I work full time, take 10 hours worth of classes, have a 19 month old, a husband, and a baby on the way, and we just moved back to TX but to a part where we have no family. I recently began taking ballet classes again, which I love, once a week. I employ deep breathing exercises. I read my Bible. I pray. I try to distract myself or clear my mind and stop worrying about things out of my control. I try to use my time appropriately. I spend time with my family, remembering they are above my work and school as a priority.

8. I practice safe behaviors.

9. I employ nonviolent methods of conflict resolution. If I am too angry to talk, I remove myself from the situation, employ a stress reducing method, go for a walk, or take a shower. I then come back to the situation to address the problem in a calm and respectful manner. Sometimes I write a letter to the person I am having a conflict with. This helps especially if it is over a very sensitive, emotional subject where I would have difficulty maintaining composure if face to face.

10. I receive routine preventive care from a HCP.

#2 Healthcare: Right v. Privilege

Healthcare as a right or a privilege... this actually is an ethical question to me. Without healthcare people may have a poor quality of life, succumb to diseases, or die. I believe that life is precious and it should be treated as such. So, to me, providing healthcare or making it easy to access is the right thing to do. There is a difference on the right thing to do and a right. That is where I am at a crossroads. It boils down to my fundamental beliefs on how society should be run versus my beliefs in life being treated as precious. It is an inner turmoil. So, which of the beliefs do I believe to be more important?

After pondering this for a while, I came to the conclusion that I believe that life is most important. Therefore, if I am going to treat life as if it were precious, I would have to view everyone's life with the same perspective (since I believe everyone was created equal). If I believe that life is important, then it is not a far stretch to jump to the preservation of life as important. The key to preservation of life is healthcare in all of its forms--preventative, palliative, and active treatment. So, yes, I believe that healthcare is a right.

The sad thing is that this is not always upheld due to our capitalistic society. It is one of the flaws. I especially see this as a RN at a psychiatric hospital. I have interacted with a large number of patients that leave the hospital when they are still at risk for suicidal/homicidal behaviors, or are becoming stabilized but not to the point of functioning well in society--insurance companies, or the lack of insurance (self-pay patients) place a definite end point based more on the almighty dollar than on improvement of their mental health.

To correct this flaw, I wish that people would be charitable, take an active role in their community and the welfare of others, not become socialistic. That would require the internalization of the importance of life (not just your own), compassion, and giving from the heart. Not everyone is willing to make that sacrifice, and not everyone can...

Anyways, just as a side note, I am unsure as to how far healthcare providers or recipients should go to preserve life. When does letting God be God, or "letting nature takes its course," and the acceptance of death as a part of life here on earth factor in? I think it is a very fine line that I have not yet discovered. Personally, I do not need to live on this earth eternally in this failing/imperfect body of mine. Hopefully, I will have discernment and wisdom to do the ethical and morally right thing to do if I ever face a decision that challenges me in that way.

#1: Health concerns for women I know...

My issues of greatest concern:
Reproductive health--for 2 reasons. I am a mom, and we are trying for baby #2. My other reason is that I have a history of cervical dysplasia which only flares with pregnancy or birth control pills.

Being physically fit--I take on too many stressful responsibilities at times, and eating healthy and exercising helps me to feel better/relieve stress/look as best I can.

Issues of concern to some of the women I know:
Joann (an older Jewish lady): breast cancer returning. She is a 7 year survivor.
Joann S. (an early 40s African American lady): controlling her weight.
Melany (mid 30s Caucasian lady): possibility of uterine cancer.
Sheryl (mid 60s Caucasian lady): her BP/ controlling HTN. She is post-menopausal.

The similarities:
reproductive health and appearance/weight

The differences:
The people I polled gave issues that were more specific than mine. Sheryl's answer was different from mine and the others, having to do with hypertension, something that affects both genders.

I think our similarities and differences reflect the different stages of life each of us are in and the different difficulties we have had to face, as well as the roles depicted by society for women. A common thread to all women is the physiological aspects of our bodies and the problems we can have associated with our physiology.