It's Super Bowl Sunday. I am sitting in a company store in this funky, cool northern Cal town I'm staying in. Besides horse and tack equipment, they sell dog food, pet supplies, toys and gifts, housewares, lawn and garden, specialty cards, cowboy boots and clothing...and it contains an amazing internet cafe featuring coffees, teas, unique chocolates and ice creams.
This place is across from a cool used bookstore that has signs like this on the outside of the building:
As I stand at the coffee counter to order a mocha and a truffle (it's a chocolate day), I see these neat signs in front of me:
and
Nice messages, aren't they? The people here are just....open minded!
Even when they request tips:
Suffice to say...I am really happy to be back here!
I am also really lucky to report that I am feeling exhausted from going back to work full time. Lucky, one, because I'm lucky to have a great paying job in a bad economy, and two, because I had the amazing fortune to work part-time last fall while I was near my parents.
I realized while driving home through these mountains of northern California last night that there were a few things I need to share about feeling exhausted. If we nurturers are aware of what is happening, we can make subtle adjustments in order to live more fully without getting wiped out. So, I am going to be the first to take my own advice!
Get enough sleep!
According to a CNN report, Americans are getting an average of 6.7 hours of sleep on the weeknights. An online article by the National Sleep Foundation includes this table:
The National Sleep Foundation also recommends the following to improve your ability to get enough sleep:
Establish consistent sleep and wake schedules, even on weekends
Create a regular, relaxing bedtime routine such as soaking in a hot bath or listening to soothing music – begin an hour or more before the time you expect to fall asleep
Create a sleep-conducive environment that is dark, quiet, comfortable and cool
Sleep on a comfortable mattress and pillows
Use your bedroom only for sleep and sex (keep "sleep stealers" out of the bedroom – avoid watching TV, using a computer or reading in bed)
Finish eating at least 2-3 hours before your regular bedtime
Exercise regularly during the day or at least a few hours before bedtime
Avoid caffeine and alcohol products close to bedtime and give up smoking
(Yes, I took the above bit straight from their article. Thanks, NSF.)
Eat and drink.
Fatigue is a major symptom of dehydration and hunger. The key is to get enough water (not caffeine, people, or sugar drinks! These backfire!) I find that grazing throughout the day without indulging in large carb filled meals keeps the energy consistent without those valleys in the afternoons when you feel as if you are going to doze off at the drop of a hat.
Manage your energetic output to others and retrieve your energy.
Yep, we are exchanging energy with other people all day - and if you don't keep your energy with you, you're apt to lose it to others. There are such people as "energy vampires," - you know them - they are the people who leave you feeling exhausted after a short interaction.
Here's a quick exercise you can do daily to pull your energy back when confronted with people who are exhausting you. Close your eyes and lift the palms of your hands away from you. Like this:
Imagine your palms are magnets, and they are pulling your energy back to you. Imagine that it is returned to you pure and clean. If you are attuned to energy, you will feel an immediate lift in your energy level. Really!
You can also make sure that no one has "attached their energy to you" as well. Intend that anyone with whom you have had contact that day retrieves any energy they may have left with you, pure and clean.
Meditate
Try just five minutes a day and work up. It will lead you to a whole new outlook! Take a look at this blog entry on meditation by Philo-sophistry.
This guy wrote about 8 changes to his life as a result of four weeks of meditation. Pretty compelling....
Take your vitamins!!
Personally, I love GNC's VitaPaks
I can tell a difference on the days I do and the days I don't. I bet you can, too.
Surround yourself with positive people.
Don't be afraid to set boundaries. Negative people can suck you dry. In the case of negative patients, if you have a few on your caseload, it is acceptable to respectfully lay out some ground rules for the treatment session or to schedule them with other therapists. I prefer to do the former first because you have an opportunity to help them toward a positive evolution of their own lives. You'll be surprised how grateful they can be when you help them shift their own behaviors.
Take mini stretch breaks at work.
We therapists are so busy getting everyone else stronger and more flexible that sometimes we can ignore our needs. It's important to stretch and remain fluid in our movements. I use a tool called a StretchRite each morning, and it has eliminated a large part of my back pain.
courtesty of StretchRite
There are many other reasons - some medical - for fatigue, but I just wanted to share these today. I hope it serves as a reminder to take care of yourself - afterall, we are best equipped to take care of ourselves before we can take care of others.
One of the lovely advantages of choosing a travel health care professional lifestyle is the travel! For those of us who move between and among many locations for our life's work, the leisure/adventure side of our gigs is a priority....and the between-assignment time opens the opportunity to pick and explore a variety of new places or events.
July is my month of international travel, a priority in my life. Five months ago, I trekked a pilgrimage called El Camino de Santiago from Leon to Santiago de Compostela, Spain.
For those of you who do not know, El Camino de Santiago means The Way of St. James. Check out this blog for info on St. James' connection to Spain: http://www.caminodesantiago.me.uk/st-james/
One of the most significant challenges of El Camino (or any other long trek) becomes your relationship with and attention to your feet. Your preparation. Your equipment. Your remedies.
Me, my twin and her family - our feet! - surrounding one of the El Camino markers
(I'm wearing the colorful Smartwool socks ... : )
Allow me to educate you on foot care on El Camino because
it will make or break you and your Camino.
1)Buy and break in hiking shoes that do not cause hot spots on your feet. I bought Keens because my feet tend to be wider. The Keens were perfect. Some people choose Merrills, Vasque, North Face, and Salomon.
Don't order them online! Every shoe is different. It is vital to go into a shop and try them on, walk in them and wear them for the initial fitting.
I trialled a pair of Keen ankle boots, and I found after several walks at home prior to my trip that the upper back part of the shoe rubbed the heck out of my Achilles area. I would have had a super size wound had I used them. I was really glad I opted for the regular hiking shoes. I used my poles for stability on steep downhill trekking and had no problems with my ankles turning.
2)Buy and wear hiking socks that feel comfortable with your shoes. Wear the socks for several long walks before your trip to see if you experience any toe rubbing. I brought three pairs hiking socks: Smartwool, Fits, and Cabela's. The most effective socks for me were the Smartwool socks (the ones not classified as hiking socks), which provided great compression in my midfoot, and the Fits, which were rugged wool blend and provided great cushion. I quit hiking in the socks I bought at Cabela's after the second wear because my toes sweat and rubbed together too much. Bring three pairs of socks with you. One to wash/dry, one to wear and the third in case you accidentally get your feet wet. I will tell you that the third pair of socks will (on at least one day of your walk) be a godsend!
I found two cool websites that have a bunch of great socks:
Socks Addict: www.socksaddict.com (best prices for the quality!) LOVE the socks at Darn Tough: http://www.darntough.com/
see why? GREAT colors!!
I recommend the midweight to rugged weight socks, especially if they offer compression. Don't be scared off by wool blend socks in summer. They are quite comfortable, protective, and they effectively handle the Vaseline I'm going to recommend later!
3) Learn to tie your shoes correctly to protect your feet as you go up and down steep areas.
We had the distinct pleasure of walking the Camino with an amazing priest from the Baltimore area, Ft. James. One day as we were walking, my twin was having difficulty with her feet sliding in her ankle boots. Fr. James taught her a boot-tying technique that is noteworthy for all trekkers. He had learned it from a fellow peregrino (pilgrim) earlier in his walk on El Camino. Check it out:
4) Forget the moleskin and bring a bunch of bandaids!
In addition to bandaids, I took a big bunch of moleskin thinking it would cover hot spots and protect my feet. Don't take the moleskin! It rolls and causes problems. The bandaids, however, were perfect. In fact, during the most difficult climbing days, I put bandaids around my 3rd, 4th and 5th toes to keep them from rubbing against each other into a blister. They worked perfectly. So...
Make sure your feet are clean and dry.
Apply bandaids before you slather the vaseline.
5)YEP,Vaseline. Vaseline over clean, dry feet prior to donning socks provides a moisture barrier, a friction reducer and a skin softener. My twin and I were amazed at the end of 15 days of walking 12-18 miles per day that our feet were actually in better shape than before the trip (and we take good care of our feet!). The vaseline was the key. You may need to apply several times in a day for proper protection. Messy, but worth it.
6) Lower mileage the first two days of your trek and take frequent breaks to check skin.
Thanks, Jose, for the demonstration!
One of the smartest things you can do is start off the camino (or any long hike) slowly, especially if you are not athletic and in great shape. If you have to be a rock star by doing 30K the first day or two, or (from what I have heard) if you start in St. Jean, you are best served to check your feet frequently and make necessary adjustments before getting blisters.
7) STOP before you feel hot spots.
Every time you stop to use the bathroom (the Spanish used the term "servicio" in this area of Spain) or fill up on water, check your feet. The Camino is not a race! You'll find each stage of the Camino is much more manageable and takes only a bit longer to complete if you stop and check your feet. Most importantly, it's a lot less painful if you prevent the blisters in the first place.
8) Bring a pair of trekking poles. There are a few stages on the Camino in which you may encounter steep climbs up and down. It is during these stages that you are higher risk for sores on your feet, especially when you are trekking downhill.
I purchased women's Komperdell retractable trekking poles for half off on the Clymb website (http://www.theclymb.com/). They were one of the best purchases I made other than my North Face Terra 45 backpack. The poles shifted a lot of force off of my feet and onto my arms, which saved my feet. My twin used only one wooden walking pole, and she ended up stubbing her toes frequently, resulting in the loss of two toenails a few weeks later (thankfully after the Camino). 9) Minimize your weight.
Take the basics only. The less you carry, the less your dogs are going to bark at the end of the day. We ran into a lot of people who went to el correo to mail items back home.
10) Treatment if you have blisters. For your packing list:
A needle
Thread
Small container of betadine
Bandaids
Do not under any circumstance, cut the skin off a blister! You'll have an infection in no time. I met a number of seemingly educated people who did permanent damage to their feet by cutting into blisters. One ended up in the hospital; the other ended up getting a Stage IV wound all the way to her Achilles tendon.
After your day's walk: Shower/clean/dry your feet. Thread the needle. Run the needle and thread through a bit of Betadine. Put the needle in and out through just the skin of the blister. Don't go deeper. Cut the thread so there is a bit on each side outside the blister. You don't have to bandage it if you're going to bed. The fluid will leak out through the thread yet the thread will prevent contaminants from contacting the tissue under the blister. In the morning, the blister will be dry and healed (or close to healed).
During your walk: if you discover a blister, stop immediately and treat it as described above. The only difference is that you will need to cover it with a bandaid before you put your sock back on and start walking.
Oh, and re-slather Vaseline on the rest of your feet before you start walking again.
11) Sun screen on legs to reduce risk of heat rash. This is not quite foot care, but an affliction that bothers numerous peregrinos - heat rash.
Keep legs clean and covered with sun screen.
When handwashing your socks, rinse them thoroughly.
Do not wear wet socks.
12) Shower daily and lotion up afterwards.
'nuf said. 13) LISTEN to your body.
Don't be ridiculous by "forging on" when your body tells you to rest. You'll injure yourself, and then you'll go home early from El Camino limping and in some cases, with permanent orthopedic damage. We were amazed by some of the people limping for miles. In Sarria, which is the town you must begin from to receive a Compostela (document of pilgrimage) when you reach Santiago, we saw two obese ladies with Walmart style summer sandles and thin anklets both limping. My response to this is: Be reasonable! You are not a martyr if you don't prepare physically or if you bring substandard equipment, make bad decisions, and injure yourself. You're simply ignorant.
14) Stretch daily.
Stretching was key. Up there with Vaseline. Warm up those muscles before you take off and at the end of the day if you want to stay injury free.
OK, folks, good luck on your trek. Send me a note if you have other input or tips.
Three weeks trekking across northern Spain with my twin was good for my soul. Two changes of clothes, a camelbak full of water, a sleeping bag, plenty of bandaids to keep the toes from rubbing, and some toiletries....oh, and a bag full of quartz by the time I crossed Castilla y Leon (couldn't help it, they were everywhere we walked!)...
I returned to my assignment in Kansas for a 5-week extension, and it is coming to an end next week...
In the last several months, several significant things have occurred. One of the most compelling events has been my father's diagnosis of lymphoma.
He has made it through chemotherapy and just started radiation.
It's time to take a short break from travel and be there.
Isn't this why we travel? We like the flexibility of being able to take 3 week walks in Spain. We like to go places at the drop of a hat. We like the ability to stop everything when life calls us to be there for loved ones.
So! I am taking a four-month break from working for my travel company this fall, and I am returning home. Not just my home. The home of my parents.
I still consider myself a traveling therapist. That is what I do. I go in where there is a void. I fill the void, pump up the practice, and try to leave each place better than when I arrived.
I am going to take my own little "assignment" (prn work) in two buildings near my parents' community this fall. I am excited to help out my parents and to be near my siblings. I will continue to work with our elder-crowd and look forward to spending more time writing about them again.
Yes, I have heard you. I will try to start posting more often!
I have a lot of thoughts about coming home, but I'll save those for the next couple posts. Suffice to say, life is full of circles, and at some point, we have to come around to close each one of them.
I am in the last week of this assignment! I absolutely cannot believe it. It has flown.
I have some grand plans on my break between this assignment and an extension at the same building into September. I am headed to Spain to walk a pilgrimage called El Camino de Santiago. You may have seen a movie called The Way which was directed by Emilio Estevez and whose main actor was his father, Martin Sheen. It's this path on which I will be trekking next week!
Anyway, I am working my last week on the initial contract at this facility, which I have come to appreciate....the therapy team, the residents, many others in the building, from the nurses to the dietary staff to the housekeepers.
They are good people.
So, my work week this week is Sunday through Thursday. Saturdays are always a great day to treat patients, but Sundays are sometimes a bit tough. Patients don't always want to work on Sundays.
I walked into Robert's room today. It was my first treatment with him. By the end of 45 minutes, I was pondering how amazing it is that people with terminal illnesses are able to achieve a level of intimacy with strangers like me that they are not always able to achieve with their own families with whom they have lived and loved for years.
A word I have heard from dialysis patients often is WEARY.
Within five minutes, he shared with me that he was so tired that about six months ago, he had decided to go off dialysis and onto hospice. He could not take the strenuous schedule and the exhaustion he felt after each appointment.
Robert called a family meeting. His children could not accept it. He continued on dialysis. Because of them. Not his own needs. Theirs.
This is what so many people do. They hold on because their family members are not ready or willing to let them go. They hold on out of fear of what will happen to their elderly spouse if they pass. They just hold on.
And suffer.
I cannot judge this situation one way or another. I only know that I see so many older people suffer because they do not want to let their families down. I also know - and maybe this is because I work around long term care - that I would never want my parent to hold on because I didn't want them to die.
So, a note to family members of people with terminal illnesses:
Consider letting your family member know that
you love them!
you do not want them to suffer!
if they feel they need to go, you support them on their journey beyond!
Can you imagine how much less suffering there might be if we could all just do that.....
Remember my first patient who really inspired me at this assignment? Constance, my 3pm appointment, with whom I loved to laugh during the Ellen Show...
She went out late last week to the hospital. She came back Monday with hospice services. Ohhhhhhh.....for all you who work in skilled nursing, sometimes those older folks you just love come home from the hospital ready for their life graduation.
Constance was laying still in her bed, covered only with a white sheet, white as a sheet herself, nasal canula supplying much needed oxygen to help her breathe. My own breath did a sharp intake.
"Oh, Constance!"
I could tell her life force was dwindling. Family had been called in. Most of the day, the room had been filled with family members. Two daughters stood outside the room.
I turned to them. "I just want you to know what a blessing your mom has been. I have enjoyed her so much!" I went on to tell them about what happened when we got together to prepare her arms for splinting.
They smiled broadly. I could tell it brought them some sense of relief from their grieving. They encouraged me to go tell her goodbye.
I walked into the room. The hospice nurse aide was there at the bedside. I went to the other side of the bed and leaned into her ear.
I told her all the beautiful ways that she had touched my life. I wished her a lovely journey.
As I walked out of her room, I could almost close my eyes and transport myself to a building about 2 hours from here in which I had worked in the past, a building whose people handled death more lovingly, attentively and Christly than any I had ever seen.
The building had a special cart of cold and warm drinks and food. They had beautiful low music playing in the background. When the loved one passed, the body was escorted out of the building with a chaplain, followed by a member of each department, in prayer and honor to the one who had passed.
I will never forget the respect and honor that was paid to those graduates of life. I can only hope that I provide some sense of positivity to those who are preparing for their journey here.
