Rockettes, Holidays, and Pressure

Washingtonexaminer.com

This morning I saw the first television commercial for the annual Radio City Music Hall Rockette Show. The Rockettes are all things perfect. Tall. Thin. Lovely faces and long legs. They dance in precision. But instead of seeing them I experienced a flashback of the Christmas scene in Covering the Sun with My Hand my first novel. Julia Acevedo is trying to tempt her brother René to go to see the Rockettes. He is aghast that she would suggest it. René is paranoid and becomes increasingly agitated. Julia eventually becomes terrified and calls the police who storm the apartment. Mami is in denial of the severity of her son’s illness and clutches at her curlers. Papi is nowhere to be found. Actually, he is in the social club around the corner having a few beers- quite a few.  This is the picture of a family in chaos.

A chill went through me when this scene flashed in my mind. This is a true scenario for many families. For René it began with the stress of his first year of college with exams scheduled during the holiday. He couldn’t handle the tension building and the increasing demands of his life. The symptoms of his Schizophrenia were exploding. Young adults are frequently afflicted with the early symptoms of this particular mental illness in college.

Covering the Sun with My Hand

These are difficult dynamics to negotiate. Some of us are truly powerless against the ills that befall us. But we can ask for help.  I think about the years that I worked on a mobile crisis team going to people’s homes and doing my best to provide tools for families that would decrease stress, diminish or eradicate symptoms, and provide support. Sometimes sitting around a table drinking coffee helped the clients, the families, and most certainly me.

My novel is merely a story but a story is a life told. If you know someone who is in need of mental health care, reach out. Everyone can make choices in various types of treatment options. They may choose to take medication or not. They may choose to have individual therapy or not. They may choose to isolate or to be part of a group. One of the most important things we can do is to provide support. Be there. Decrease the pressure in the pressure cooker.

vintage pressure cooker

If you are experiencing an emergency dial 911.

Otherwise check out the following links:

https://www.nami.org/

https://www.nami.org/Find-Support/NAMI-Programs/Nami-Family-Support-Group

Mental Illness is not a ‘Novel’ Idea

René Acevedo, Julia’s twin, is diagnosed with Schizophrenia during his first year of college. This severe and persistent mental illness becomes the backdrop for the changes that rock the lives of each member of  the Acevedo family in my first novel Covering the Sun with My Hand.  As I was immersed in creating the play inspired by this novel, workshop members wondered how the psychiatrist would so easily make this diagnosis without tests or procedures. The story takes place in the mid seventies before the advent of many of today’s diagnostic tools and treatments but many of the same problems exist today.

I’ve had many private emails from  readers who were strangers and also talks with friends alike who shared similar stories they too experienced with family members who were struck with signs and symptoms of various mental illnesses. The overwhelming message I received was that these loving family members shared in the plight of coping with the often devastating effects.

My work as a psychiatric nurse practitioner has shown me that the more things change, the more they stay the same. There is still bountiful ignorance and stigma regarding mental health and this is an unfortunate fact.  The ill person may be expected to  pull it together because those who lack education may believe that they can get better if they really want to improve. Try getting rid of high blood pressure through intention. Sure, medication, good nutrition, excercise, and meditation help but doesn’t eradicate certain types of hypertension. This is similar to mental illness.

Family members who provide care for their loved ones must make hard decisions. One of them is how much of their own lives do they place aside in the hopes they could affect powerful change by being present and giving of themselves. I’ve heard vastly different reactions. One early beta reader found my book revolting and informed me there was no real problem. The protagonist could have easily gone on with her life and not entertain the notion that she should stay home in hopes of helping her family. Other readers were grateful to see what could very well have been their own narratives filled with conflict in print.

If you or someone you know is flailing while swimming in the thick soup of mental illness here are some links for support that might be helpful. Check them out:

National Alliance on Mental Illness

https://www.nami.org

For friends and family members

https://www.mentalhealth.gov

Supporting a family member with mental illness

http://www.apa.org/helpcenter/improving-care.aspx

Covering the Sun with My Hand is the second place winner of the International Latino Book Awards 2015 Best First Novel Category. The novel is currently available only on this website. It will soon be available via Amazon as I’m in the process of transitioning publishers. Click the Paypal button on this site if you would like to purchase a signed copy.

Choosing what to write

Puerto-Rico-beach.jpg

An opening line turned into a paragraph. It was glorious.  The sun, the sea, a boardwalk and a young woman who was looking out into the vast ocean and sky. The seagulls call and land at her feet. Her hair is blowing in the warm breeze. But wait…oh no. I find out she’s standing with some dude that isn’t the kind of man that shares my existence. He’s the kind of guy I avoid. He’s careless. Okay, maybe not careless. He’s violent. With his words and with his hands. Ugh.

This isn’t the type of book I want to write. But I continue to tap onto my laptop keys. The story emerges. Domestic violence. Not my favorite subject. In fact, it’s one that has kept me frustrated in my work life. I’ve sat across too many pretty young things that wouldn’t think of leaving these situations- not even for the children. So, I hesitated but the words kept flowing and I kept putting them down on paper. Because edits were due for my recently released novel Covering the Sun with My Hand I was able to put that manuscript away for a while. That’s over. That book is done and available on store bookshelves and on Amazon.com.  I took the manuscript back out and added more dialogue, more scenes, more details. The story is being to tell itself with all my reluctance.

Then I get another break. I reluctantly agree to work on Fridays, my sacred writing day, for several weeks. I’m not so thrilled about it. Doing psychiatric evaluations in a room the size of a thimble in a women’s shelter in NYC is something I can do even if I’d rather be writing. I do it. Then I find that there’s something poignant about sharing this space with mentally ill women. I begin to realize is that many of these women have fled other states in order to escape their violent husbands and boyfriends. When I begin to write their stories down I realize many of them have been physically assaulted by men in their lives since early childhood.

As I gazed into the swollen and bruised eye of one woman trying to get her to go for medical care it occurred to me that this was probably the 901th time she’s been punched. She’s tired. A scratched cornea doesn’t sound all that terrible. She probably can’t see what she looks like anyway because she’s lost vision in that eye. My heart opens and breaks a little. I can tell she feels that in the way she turns her head and gives me a half-smile. She agrees to go to the eye doctor like they told her to in the emergency room. I think the smallness of the room allowed for the intimacy and helped our energy vibes touch each other. I hope she goes.

As I write another line in the book I’d come to dread about domestic violence, I know now why I’ve been told to write it. It’s a gift from my Higher Power.  I’d wanted to write a story about ‘pretty.’ You know what they say. God laughs when you’re making plans. She must have been rolling on the floor watching me this time.

I carry on…

 

 

Myopia

I woke up in the middle of the night with the word “myopic” swirling circles in my head. I know what myopic means in terms of vision- nearsighted. I looked it up in my big old dictionary and it read: lack of knowledge, tolerance or foresight. There’s a lot of that going on right now here in the North East. People are newly homeless, angry, hungry and exhausted. They are cold and need help- a lot of it and many people are giving it.

Myopia is a far cry from my idea of Utopia, which is damn near to perfection. I’d been struggling with my decision to run the NYC Marathon post Hurricane Sandy. In my utopic view of the world- the runners would bring much needed funds to the NY city area. My thinking was that the larger scope of millions brought in over several hours would offset the discomfort of NY. There was no outcry that Wall Street was fully functioning after two days on their generator power. Obviously, I was myopic. I knew that my choice was unpopular-just as many of my choices in my lifetime have been. When I make a decision it’s after lots of thought and spiritual exploration.  Sometimes I’m wrong.

I’m surprised I didn’t receive scathing comments from my friends. One brave soul did comment about the other side of my decision. I truly didn’t want to change my mind because of fear of being harmed by the self-righteous. But my thinking began to change. It took me time to “get it.” The Marathon was canceled and I didn’t have to make the personal choice after all, but I have been able to make choice in what to do to help in my way. There are so many ways to help. Quite a number of marathoners pooled their resources and brought much needed help to Staten Island, Coney Island and other hard hit areas.

I, like many other North Easterners saw media coverage of the Jersey Shore, Staten Island and Breezy Point during the early hurricane post hours. I know that there are many other places in NY that have been devastated that have had no media coverage. I’d seen Facebook comments about how some people are “just praying.” If that’s all you’ve got, give it. Prayer works. Being still in a time of utter chaos helps to balance the Universal Energies. If you’ve got other resources such as money, time, physical strength, tools and supplies- use those to help. Blood is another much needed donation- we are short in supply.

Ultimately, we don’t need to advertise what we have done or plan to do. It’s a case of knowing and accepting one’s reality at the time and doing the best that one can. We can always move forward.

Marathon Training: Not changing my mind

There! It’s out there. The idea of not doing this year’s NYC Marathon is quite attractive right about now. I can hear the refrain, why do something if you don’t want to do it? It’s just not that simple. My tendency is to take on long projects. Writing, needlepoint and running are my favorite pastimes. There is a joy in a poem, a cross-stitched book mark and a 5K. The mistake, for me, is to believe that those things don’t need as much attention and craft involvement as the novel, the wall hanging and the marathon. They do. It’s the timing that’s different.

Years ago, I stood on the sidelines on Fourth Avenue in Brooklyn. The challenge of training for the marathon eluded me. Why did I think that Sunday was such a special day? It was, of course. But there were a lot of special days that led up to that brisk morning I hadn’t been privy to. I hadn’t been around for the Saturday that a young wife tied up her laces for a long training run as her husband took the kids to the zoo. The evenings the fifty year old guy spent snoring in front of the television, instead of having lively conversation with his partner, went unnoticed by me as I sipped hot chocolate.  I didn’t realize that in addition to the running, there was the stretching, the muscle strengthening sessions and the speed and hill training. Eating right, sleeping right and maintaining decent communication with family, friends and co-workers are other fine attunements needed during marathon training. It’s a challenge.

The biggest challenge is the tiredness I feel during the long runs. I eat the right carbo-protein-fat mix. I sleep the nights before my long runs but at mile 18 my body says “No Mas.” Roberto Duran, the boxer, made that phrase famous in 1980 when he walked away from Sugar Ray Leonard. Lots of explanation, lots of theory around this statement but when enough is enough, it’s enough. I gather as much information on “The Wall” and how to get around it as I possibly can.

I’m set for a twenty two miler in the morning. As I eat my energy gels and put one foot in front of the other tomorrow, I will try to not to say ”No mas.” I made the decision to take on this personal challenge. The NYC Marathon experience beckons me. I’m planning on going forward and not changing my mind.

Marathon Training: Mind Tricks

This morning I reminded my son about the flowers he gave me at the 2000 NYC Marathon. I was heaving up mile 23 or so and suddenly he emerged from the crowd and handed me the colorful and lush bouquet. According to him, it was only one rose. Wow, I had made something entirely else up in my mind. Suffice it to say- it felt like a bouquet. I felt loved, noticed and admired.

My mind plays so many tricks on me during these long runs. I’ve believed that the way I feel at mile 3 will be the same at mile 15. I’ve believed that if someone blows on me at mile 18 that I will fall over and not have the ability to get up. I’ve also believed that I should run as fast as the twenty year old who weighs about twenty pounds lighter than me. I’ve believed that the blond ponytail is a tease for me to prove my true abilities. Sadly, I’ve also believed that the thirty year old guy huffing and puffing next to me would never try to outrun me up the hill. All tricks of my mind.

The long hours on the course have become a meditation of sort. As St. Theresa, I allow my distracting thoughts to fall by the wayside as children at play fall to sleep individually at a gentle pace.  When I look around me, I am enraptured by the beauty of the changing leaves. Colors of reds, golds and oranges tell me that change is afoot and I am one of those things that are changing.

I can appreciate some of the tricks- like the bouquet of roses- and let the others go. I may not finish in my intended time. I may walk a bit and enjoy the city, the sights and the sounds. I am not in a race against anyone else. Running is something I do because I usually like how I feel during it and most certainly afterwards. I’m someone who likes to use words but I find it difficult to describe the running experience. I’ll just say that “I’m a runner.”

Food in Marathon Training

Training for the NYC Marathon means that I receive weekly emails on tidbits that I might benefit by being aware of from the NYRR club in NYC. The messages are welcome and they always get me to thinking if not doing. A recent snippet of news reminded me about my nutritional needs. I’ve always had a weird relationship with food. I’ve always based it on my father’s “eat today while you’ve got it” philosophy. This comes from a man who grew up in severe poverty in Puerto Rico during World War II. He has his skewed but generous version of “the more you eat the better things are”- this all coming from one of the thinnest men I know. Healthy thin, that is.  Fate and hard work being an incredible combination, until now, I’ve always had a plate in front of me at meal times.

I also dealt with a grandmother who pushed food into me until I screamed; ‘Nelson!’ Growing up knowing where I belonged on the food triangle wasn’t easy. My weight has fluctuated over the years.  I’m the person who can’t eat when upset. Those pictures that show me at my most elegant were probably taken when I was most miserable. I’ve worked hard to change all this.

Recently, as I’ve prepared for the 26.2 mile run that could be sheer agony based on not enough nutrients I’ve dug deeper for information. But by accident I happened to watch a television segment of Dr. Oz’s TV presentation on binge eating. Binge eating, is on the spectrum of eating disorders, where one indulges beyond any sense of control.  It may not be savvy to admit but I usually pass his shows up. I’m always troubled by people who are experts on every topic in the universe. I understand he has intelligence, education and loads of staff supporting this knowledge base, but I still change the channel. This time I was caught unaware. There on my flat screen were photos of a dead person’s humongous purple black stomach exposed during an autopsy. The scan of a pre and post binge stomach was awful but not as bad as the looks of terror on a mother-daughter team Dr. Oz brought in to process a severe disorder in a few minutes in front of America. Where is Jerry Springer when you need him? Dr. Oz apparently thought scare tactics would best serve the two and used this macabre intervention. I’ve had a terrible time eating since seeing these photos. I think I may have been traumatized. The pictures of the scans and autopsy flash before me often whenever I sit to eat a meal.

Since I’m training for the NYC Marathon, I have to eat more than usual to keep my body functioning but these days I am literally stopped by the helpful issues that continue to flash across my mind’s eye when I sit to eat. I am usually on the well side of things- I’m not so sure this time. The idea of carbo-loading prior to long runs and a marathon work well with my father’s refrain of “eat today for tomorrow” but I hope I don’t inadvertently turn on a segment of Dr. Oz before November 4th or maybe ever again. I’m grateful for some sense of self and for my Dad who relented on my second plate for the first time only last week. I may be in need of not only the ‘18 miler tune-up’ but a ‘psychotherapy tune-up’ before this is all over.

Be a Doctor in Nine Months!

I recently passed a client who was chatting up a student intern. Although I hadn’t actually heard it, I thought I’d heard him say that he was taking a nine month course to be a doctor. It was funny but I sighed when I thought about all the people I come across who act as though they are medically trained physicians.

There’s an old joke about the patient who was scheduled to have surgery in the morning. After receiving her preoperative instructions, she asked the surgeon if she could possibly eat after midnight. Not having breakfast on the day of the surgery seemed undoable. The surgeon said no- she had to fast. The woman then asked the nurse who confirmed that no way should she eat! There might be all sorts of complications and the surgery would have to be canceled. The woman finally asked the maintenance worker who was checking out the lighting fixture over the bed. He shrugged and said, go ahead. Well, you get my point.

Many of us practice medicine in obscure ways. Stopping an antibiotic before the entire prescription is finished because we feel better is one of those ways. We scourge our medicine cabinets for what’s left of the medicine when our symptoms come back or our spouses have similar complaints of scratchy throats or runny noses. Those germs probably ate those antibiotics like Tic-Tacs. Yummy!

We may have decided to stop our antidepressants because a week after beginning them our sadness, tears, and inability to sleep persisted. We swore it didn’t work! Most antidepressants won’t work like an aspirin. Have a headache? Take an aspirin and ‘POWEE ZOWEE!’ we’re better. It may take up to several weeks after consistent med taking before we notice we got up easily and went out for a walk to enjoy the birds chirping.

I’ve probably met with four people within the last year that admitted they didn’t fill the prescriptions I gave them. Their well-meaning relatives dissuaded them because they were afraid the client would end up walking like a zombie. They’ve even attributed the symptoms of the illness to side effects of the medication. Hallucinations are usually not a side effect of a medication but find out if you have questions and concerns. If something new shows up after starting a medication call your doctor or nurse practitioner. Get the information from them, not the Internet or your sister-in-law’s mother’s cousin.

Sometimes, I must admit, as a driver I have a hard time letting the cab driver getting me to a destination. I would like to tell the short order cook exactly how to make those scrambled eggs at a diner but I restrain myself. I like to do it myself!

Sadly, I once knew a woman who complained of severe stomach pain that radiated to her back. It woke her up in the middle of the night a few times. I suggested she go to the emergency room or at the very least give her doc a call. Instead she chose to look up a natural herbal tea remedy for gas. The lady passed away soon after from a massive heart attack. I despise messages that promise doom and gloom. I just hope that we realize that we are first responsible for ourselves and sometimes that means talking to a medical person and not trying to be our own doctors. Most medical practitioner schools are years long and can’t be completed in nine months.

 

 

Short Sleeve Weather: Domestic Violence Revealed

It’s ninety six degrees out. Do you wear short sleeves knowing that your arms will be showing? Maybe- if you’ve been consistent in your trips to the gym. Probably not, if you’ve been someone’s punching bag. Black and blues that are often hidden under layers of clothing peep out during warm weather months daring the people who see them to say something. Just like that terrorist warning advertisement says- “If You See Something, Say Something.” I can’t help myself, I have to ask.

I once had a supervisor who asked me whether I was being physically abused when I came into work sporting big bruises on my arms. I actually wasn’t being intentionally harmed but I was involved in martial arts training. I eventually figured out there was something wrong with that picture for me. Coming to grips with both emotional and physical pain and abuse at the hands of people we love is an excruciatingly slow process for many of us.

Being let into the inner sanctum of knowledge that women I’ve known have been secretly battered by loved ones is complicated. The trusted and untrustworthy people who engage in these behaviors have not only been intimate “romantic” partners of varying types but can be also be their children. During the last couple of months of tank tops, sundresses and spaghetti strap heaven, a couple of women have admitted to me that all hasn’t been sunshine and cool ice teas. How do I help?

I’ve learned, after a few decades of providing health care, is to listen to the woman (or male in some cases) tell their stories. Really listen. Then I ask them what they want to do. Be patient. This is the hardest of all for me. Most women I’ve wanted to help have immediately withdrawn their quests for release from lives of punishing blows, emotional dissection and little to no self-esteem when I’ve offered information on possible assistance.

I provide information anyway. It may take only the planting of a seed to grow a bounteous crop. I tread gently. I honor the person who has found the courage to bring up a most humiliating and potentially fatal circumstance.

Below are some links, for you to check out, if you or someone you know has decided not to wear short sleeves today.

For statistics on Domestic Violence:
http://www.ncadv.org/files/NewYork.pdf

Safe Horizon Resources

Homepage

The National Domestic Violence Hotline
1-800-799-SAFE

The New York State Coalition against Domestic Violence Hotline
1-800-942-6906

The National Sexual Assault Hotline
1-800-656-HOPE

The National Domestic Violence Hotline at 1-800-799-SAFE

Beer? What Beer?

“No.” I stretched and yawned. Then I remembered. “I had to tell them about the beer.”

“The beer?” She stood there with her hand on her hip. “What beer?”

“Come on, Mami, the beer,” I said. “He drinks a lot of it, you know that.”

“Because your father drinks a couple of beers you had to tell the doctor? I don’t understand that. He works hard. He makes a lot of sacrifices for you.” Mami started to put the pots in the refrigerator.

 

The above is an excerpt from my constantly revised manuscript. It’s an exchange between my protagonist and her mother, “Mami.” Because I work in Addictions, I’ve been privy to many reasons why a beer for some people just isn’t a beer. I don’t usually blog about it, but I experienced an occurrence recently that set me to thinking and blogging about “a couple of beers.”

Running late to a friend’s anniversary celebration the other evening, I decided to stop for a card and a bouquet of flowers to commemorate this special event. I chose the card quickly and picked up a lovely arrangement of bright orange happy flowers. I stood at the counter, waiting for the sale to be rung up. The grocery store owner is a fortyish beauty who was doing arm exercises-totally missing my ‘I’m in a hurry cues.’ I’ve shopped there for years and see her and her family often.

She told me about how she’d started to gain weight, standing at the counter for hours on end. Giggling, she told me she couldn’t stop eating or drinking. I commiserated, I too love to eat and drink. She said it again. The signal went off in my head. She’s talking about “drinking-drinking,” not just drinking. The store owner had no idea that I’m a nurse practitioner, that I work in addictions and know a thing or two about health. I sometimes whether I have a neon light on my forehead announcing what I do for a living because a lot of people reach out when I least expect it. It was then she admitted that she was so stressed that she drank a couple of beers every night to relax. Her stress level was high, with young adolescent boys she’s raising, a very busy store to run and whatever else she didn’t say during the five minute exchange. The other thing I heard from her was that she has high blood pressure and gets headaches. When she told me she drinks for the third time, I got her message.

My local store owner isn’t alone. This past week, I realized that during at least three psychiatric evaluations that the reason the folks came to see me was that they were stressed. That was their leading sentence. They all drank beer to cope. Some of us can drink-drink and some of us can’t.

My first suggestion to this woman who chose to confide her high stress level was to try relaxation techniques such as meditation instead. She had no idea what that was. I explained it. Secondly, I suggested she go for walks to de-stress. She remembered that she did that last summer with a friend and loved it. Apparently, she just needed a reminder. We talked about alcohol and high blood pressure not mixing. Talking to an objective person about one’s problems is another way to reduce the anxieties of life. That was one intervention she did on her own when she told me her problem before wrapping the flowers.

I’m glad I was there to help out. I didn’t have to take my prescription pad out or lecture her on the evils of alcohol. It’s not about that. Yes, some people need twelve step meetings but some don’t. A listening ear and a little education go a long way.

My friend loved her card and flowers. I’m glad that I’m her friend and that drove me to stop at the store and to be the person my other new friend needed.