Health Is Vital

Health is taken for granted, until you can't any more. In this blog I hope to put down on paper some of the articles I come across and want to remember, about health. I will be personalizing these articles to apply to me. I am diabetic, over weight, have high blood pressure and tinnitus, so these are the things you will find here. I will include nutrition, exercise, and holistic health, and many other ideas. I work in the health profession, particularly mental health, and have an interest in suicide prevention; so these topics will also be covered in this blog. Please, if you are suffering reach out. Our county health and crisis line is 1-855-278-4204.

Saturday, December 31, 2016


This paper is presented by Alliance Occupational Medicine
Bring shoulder blades and arms together behind back and hold for five seconds. 

Tilt head forward and place hand behind head for added stretch

tilt ear towards shoulder (don't twist neck) for 15 seconds once each side

hold arm above head, grasp with other hand at elbow and lean sideways from the waste

Same as 4 but pull elbow behind head.  This will stretch shoulder

Put arm across your chest and hold elbow tighter to your chest with other hand, this will stretch back.
hold something shoulder height, and then rotate body away from hold.  

interlace fingers and reach for the sky

Forearm and wrist stretches, opposite dirrections

alternate is the bend forward and hold

with nothing to keep balance, hold ear lobe with opposite hand

Ergonomic Exercises: For Computer Users

Sitting in an office all day, in front of the computer, there needs to be some ways to prevent repetitive motion injuries.  I think stretching and exercising fit the bill.  This sheet appears copyrighted.  I share to help myself and others.

Wednesday, December 28, 2016

Foster Care Story: Only People Cry

This story I use to use in groups for prospective adoptive and foster parents.  This was man years ago, but I think it is important to see loss and grieving, and fostering, from a child's perspective.  I would like to credit Alice Winter.  I was unable to find a website for her on the internet.  I am not aware of any copright issues.

Only People Cry
By Alice Winter

(Underscored words are the thoughts of the child.)

She could hear the wind outside but that was all right.  It wasn’t crying.  She wasn’t afraid.  She was just thirst again.  She got up and this time remembered to put on the new little bathrobe and slippers and went out of her dark bedroom toward the dim light at the end of the hall. 
In the kitchen she kept from looking at the shining black squares of the windows.  She didn’t think of the places she has been before.  All day long she had been careful.  She hadn’t done any of the bad things that made them give you back to the social worker.  She turned the water on softly.  She was very quiet and careful.  At the last place she had splashed too much.
On her way back to the bedroom, she heard the lady say, “Is the child up again?  I wonder if she can’t sleep.”  Maybe getting up after you went to bed was one of the bad things to do here.
She lay in bed, not listening to the wind or seeing the darkness of the room.  She walked along the street in the sunshine and there were flowers all around and birds singing, and she came to the house where her mother and father were waiting for her.  And they hugged her and cried because they had found her again.  They had been looking everywhere for her, too.
When she woke up the next morning there was no sound in the house.  She lay very still because then maybe the name of the people at this place would come to her.  But the words, “Mr. and Mrs. Foster,” kept running through her mind and she had to go over it all again.  She had to think about that time long ago when the social worker had taken her to her first foster home.  She had been so little and dumb that she had thought the name of the people was Mr. And Mrs. Foster.  Then she learned how it was, and that a foster home was a house where the man and his wife needed some money.  And if they let her come and live with them, the welfare court would send them a check every month. 
Suddenly, the name Watson popped into her mind and she got up and started making the bed.  As she moved, the frowning faces moved and she could hear their silent voices.  She straightened the bottom sheet, tucked it in, then pulled up the top sheet and blanket.  Then she put on the spread.  She was glad she had remembered to fold it the night before.  When she was finished, she stood off and looked at the bed, and she couldn’t see anything wrong with it.  But maybe the faces could.  Then she remembered the third place back.  There the beds were aired every morning.  You threw back the covers and opened the windows and an hour later you made the beds.  She wished she knew what to do. 
In the bathroom, she washed her face and hands and brushed her teeth, using only a little toothpaste.  When she was dressed, she hung her nightgown in the closet and went to the kitchen. 
When she appeared in the doorway, Mrs. Watson gave a little jump and said, “Well, Ellen, you startled me.  Sit down and have some coffee.”

There was something different.  At this place don’t be too quit.  “I tell you it’s creepy, the way she sneaks around the house.  I look up and there she is.”  “I couldn’t stand the noise.  I’m just not used to having a kid around.”
“Do you always wake up so early?”  Mrs. Watson yawned and pushed her gray hair back from her face.
“Yes Ma’am.  But I don’t have to.  I could sleep later.”
“The dear Lord knows I could, too.  But General Motors calls.  Ed has to be at work at eight-thirty, and with the long drive there’s no sleeping late.”
“No Ma’am.”  Should she offer to get up and cook Mr. Watson’s breakfast?  “Not that I wanted her for the work, mind you, but all she did was sit around and read.”  “She was always butting in, trying to take over.  Always wanting to do something for the Mister.”  She would keep quiet, wait and see. 
Ellen pouted cream and spooned sugar into her coffee.  It wasn’t too bad if you made it sweet enough.
She wondered if if her mother would want her drinking coffee.  Mrs. Watson didn’t look a bit like her mother, but nobody did.  Nobody was as pretty as her mother.  Her mother was always clean and had powder on her nose and smelled like the flowers that were around her.  They told her she had never seen her mother but if she hadn’t how could her mother’s face be clearer than Mrs. Watson’s right now, even with Mrs. Watson sitting there across the table from her. 
Mrs. Watson kept drinking coffee and began to look more awake, and finally she said, “What do you want for breakfast, honey?”
From the look of the kitchen, with the skillet on the stove and a carton of eggs set out, this wasn’t a corn flakes place.
“I like eggs,” she said and tried to sound definite.
“Eggs it’ll be.  What about some bacon?”
“Yes, I like bacon, too.”
She sat at the table while Mrs. Watson fixed breakfast for both of them.  Different sentences kept going through her mind.  “Would you like me to set the table?”  “Could I help you?”   “Shall I put the eggs away?”  But she didn’t use any of them.  She would wait until she knew. 
When they had finished eating, Mrs. Watson lit a cigarette and looked at her and said, “You’re a quiet little thing.”
Ellen smiled, but not too much.  “She’s always grinning like a Cheshire Cat.  ”I couldn’t stand the way she moped around.  I never once saw her smile.” 
“What do you like to do, Ellen?  I want you to be happy here.”
“I like to read.  But I like to work too.  I like to wash dishes and things like that.”
““Do you really now?”  Mrs. Watson’s eyes twinkled.  “Well, I tell you what.  I’ll wash the dishes today but every once in a while, I’ll let you do it.  I promise.  I won’t be piggish.”
“Yes Ma’am.”
“You don’t have to keep saying Ma’am all the time Ellen.”  From now on you’re part of the family.  Ed and I always wanted a little girl.  Ed and I always wanted a little girl.  With our boy married and gone away, you just fill the bill.”
“Yes Ma’am,” almost Lipped out but she was being careful.  Mrs. Watson didn’t have to say that about wanting a little girl. She new they were paid for keeping her, and that was all right because she didn’t choose them any more than they chose her.  They didn’t look a bit like her father or mother.  It was even.
But she would like to stay here until her parents found her.  Now that she was older, she was glad she had never been adopted because that would have meant changing her name, and they never would have known where she was.  When she was little, and didn’t understand, it had been different.
Mrs. Watson smiled and said, “Now I don’t want to hurt your feelings and don’t go away mad, but I’m going to wash the dishes.
She put her arm around Ellen’s shoulder and said, “You run on, honey, and do whatever you want for a while.  Later on, we’ll go to the grocery store.”
When Mr. Watson came home that night, Ellen was in her bedroom reading the new book Mrs. Watson had got at the grocery store.  His voice was loud, and he must have been just inside the door when he said, “Where’s that little girl of mine?”  He should have known the social worker wouldn’t be likely to be there then. 
Mrs. Watson said, “She’s in her bedroom reading.  She loves to read.  She’s going to be a real student, I can see that.”
“That’s the ticket,” he said, and then he came to the bedroom and knocked on the door as though it were really her room.  When she opened the door, he was there smiling, and he rubbed his hand over the top of her head and his voce was quieter and he said, “Hello Ellen.  How’s the girl tonight?”
“Fine,” she said and smiled just right.
The three of them went to the kitchen, and Mrs. Watson had coffee ready and they sat drinking it.  Ellen choked a little on hers, and Mrs. Watson said,  “Honey, I don’t think you like coffee.  Actually I don’t suppose you’re old enough to be drinking it.”  She got up and heated milk and made hot chocolate. 
Mr. Watson said, “Say, where’s that rabbit mug I had when I was a kid?  Get that down for her Marg.”
They talked, then, but every once in a while one of them would give her a look as though she were doing some very unusual thing to be sitting there drinking from the rabbit mug.  It made her feel sorry for the.  They didn’t know that sometimes it was like this in the beginning, and after awhile they would get tired of her.  But maybe this time, she would find out the bad things soon enough and could keep from doing them. 
The next day, the neighbor from across the street came over and brought her little boy.  Ellen was in her bedroom reading and she heard the lady say, “I have yet to see your little girl.  Doesn’t she play outside?”
“She will,” Mrs. Watson said.  “She’s still getting used to being here.”
“Is she dark or fair?”
“Blonde, a pretty blonde.”
“I’d like to see her.”
Ellen didn’t wait to be called.  She got up and went out so the lady could look her over.
“Here she is now,” Mrs. Watson said, and held out her arm, and Ellen went and stood beside her.  She didn’t look down or sniffle or twist her hands.
The neighbor said, “She is a pretty little thing.”  Then she leaned forward and looked straight into Ellen’s eyes and said, “You’re a very lucky little girl.  I hope you know that.”
‘Yes Ma’am,” Ellen said, but at the same time, Mrs. Watson said, “Phooey!” and it was the first time Ellen had seen her mad. 
Her voice was different right away, though, not mad any more.  And she said to Ellen, “This is Jimmy.  There are cookies in the jar.  Why don’t you two sit at the kitchen table and have some.”
Ellen caught back the “Yes, Ma’am” in time and said “A;; right,” and Jimmy followed her to the kitchen.  He was just her size and she wondered how old he was, but she didn’t ask him.  For a while they just sat there eating cookies, but finally Jimmy said, “I got an airplane.”
“I have a book.”  Ellen brushed crumbs from her lap.  “A brand-new book.” 
“It’s a Boeing.”
Mrs. Watson had come to the doorway and her face looked soft and almost sad, but then she smiled and said, “Your mama’s ready to go home now, Jimmy.  Come along.”
One night a week later, Ellen lay in bed worrying because she hadn’t found out any of the bad things.  She couldn’t keep from doing them if she couldn’t find out what they were.  She had been almost sure, at first, that getting up after you went to bed was one of them.  But the night before, she could hear the wind outside, and she got up to get a drink of water.  But the wind was still there when she went back.  She got up again and went to the bathroom and, on the way back to her room, Mars. Watson came out into the hall and said, “Can’t you sleep honey?”  Is something bothering you?”
She hadn’t planned to say it at all.  “The wind, it sounds like it’s crying.”  She looked down at the floor not wanting to look at Mrs. Watson’s face.
“Sometimes the wind does sound like that,” Mrs. Watson said.  “But the wind can’t cry because it isn’t a person.  Only people cry.”
They went into Ellen’s bedroom then, and Mrs. Watson pulled the covers up close around her, and they listened to the wind together until Ellen fell asleep. 
The next evening when Ellen went into dinner, there on her plate, with her name on it, was a gold bracelet.  She smiled at the Watsons and said thank you, but she didn’t want a gold bracelet from them.  It was a good thing she’d got over being a crybaby a long time ago.
That night after dinner, Jimmy came over with his birdhouse.  :It’s coming apart, Mr. Watson,” he said.  “Can you fix it for me?”
“Sure, Jimmy boy.  Come on down to the basement.  You come too Ellen.”
There were all kinds of tools down there, and Mr. Watson said, “I know something my girl can do for me while Jimmy and I get this fixed up.  See here, the way I do this,” and he took a nail and showed her how to straighten it out.  She took the hammer, and on the very first nail the hammer slipped.  She hit her finger and a lot of words rolled out.  Mr. Watson turned to her.  He looked serious and he said, “Those aren’t the kind of words we use here, Ellen.”  He didn’t say anything more for a moment, and Ellen waited.  Then he said, “I’ll tell you a string of words that are all right in this house, ‘Ding Dan Fiddle Faddle,’” and he started laughing.  She started laughing too the, and she hadn’t even thought about it ahead of time. 

The next Saturday Ellen and Mrs. Watson went to a big store downtown and the clerk tried four different dresses on her.  Mrs. Watson said, “They all look nice on you, and none of them is too expensive.  Which do you like best?”
Ellen didn’t look at the pink one.  She looked at Mrs. Watson for a hint, but Mrs. Watson just sat smiling at her.  The clerk said, “With her eyes, the blue is nice.”  She was glad the clerk had said it, and she watched Mrs. Watson’s face but it didn’t change.  She just said, “Yes, but Ellen can wear any color well.  It’s whatever she wants.  She the one who will wear it.”
“I like them all,” Ellen said at last and then wished she could bring the words back.  It sounded as though she wanted them all.  “Hint, hint, hint, if she’d come right out and said what she wanted, I wouldn’t have minded.”
“I know what we’ll do.”  Mrs. Watson stood up.  “We’ll go upstairs and have an ice cream soda and think it over.”
While they ate ice cream, Mrs. Watson told Ellen how it was when she was a little girl, with three brothers and two sisters, and how they lived on a farm and had a cow and made a playhouse in the barn loft with bales of hay.
Ellen could see it all when they had finished their ice cream, Mrs. Watson said, “Have you decided which dress?”  And without thinking Ellen said, “I would like the pink best.”
The next day they went to church and Mrs. Watson took her to Sunday school and introduced her to her teacher.  The lady said, “We’re glad to have you, Ellen.  What a pretty dress.”
Ellen said thank you and waited.  “I couldn’t have taken her anyplace in the things she had, I can tell you.  You’ve never seen anything like it.”
Mrs. Watson just patted Ellen’s shoulder and said, “I’ll be back later,” and left.
On Monday, Ellen went to the store on the corner for a can of baking powder, and Jimmy was there and they walked out of the store together.  When they were in front of the Watson house, Jimmy said, “My mama says I don’t play with you anymore.  She says that isn’t the kind of language I need to hear.  She isn’t surprised.”
“Your mama’s fat.”
Jimmy swung at her then.  He hadn’t said orphan or homeless brat, but all of a sudden she was hitting him back and he was all the kids that ever had.  She was strong and she could have fought anyone. 
Her arms were still flailing when Mrs. Watson came out and stopped her.  What on earth’s the trouble with you two?”
Jimmy’s mother ran out and put her arms around Jimmy and said, “I saw it.  She hit first.  She’s a no-good trouble maker.”
Mrs. Watson said, “I have an idea Jimmy was as much to blame as Ellen.”  Mrs. Watson looked at both of them, and Ellen had never seen her look so cross.  “Come in, Ellen,” she said and went into the house.
Inside Mrs. Watson started making biscuits.  “You’d better wash your hands and set the table,” she said.  “Fighting doesn’t settle anything, you know, it only makes things worse.”
“Yes, Ma’am, Ellen said, and she wished it ws time to go to bed and she could get away from Mrs. Watson’s cross face.  It was too late for them to send her back tonight.
That night after Ellen went to bed she was thirstier than she had been for a long time.  She got up and as she passed the Watson’s bedroom door, she hears Mrs. Watson’s voice and she stopped to listen.
“…don’t know what Jimmy did but I’m sure of one thing, she didn’t start it.”
“No, she’s not a troublemaker.  I’ve never seen a kid try so hard.”
“Too hard.  The poor baby isn’t sure we don’t bite.”
“She’ll get over it.  I couldn’t think more of her if she were my very own.”
“She is our own, our very own.”
A terrible, black feeling settled down in Ellen.  How could she ever find the bad things here?  These people even lied to each other.  Even when they were alone and thought no one could hear them, they lied to each other.
Another month went by and still she hadn’t found out the really bad things, the things that made them send you away.  One morning as she was leaving her room, she looked around and saw that everything was neat, and she went to her closet, and took her nightgown out and threw it on the bed, just any old way.  She waited all morning but nothing happened, and her nightgown was back in the closet and nothing was said.
That was the beginning.  Some mornings she didn’t make her bed.  Mrs. Watson would say, “Come on, get your bed made now,” and sometimes she made it by herself and sometimes Mrs. Watson would help her.
One evening she put a lot of broccoli on her plate and didn’t even taste it.  Mrs. Watson said, “Next time don’t take so much,” but she didn’t look as though it was a really bad thing.
One day she went to the library three blocks away and stayed an hour longer than she was supposed to.  It was almost dark when she got home.  Mrs. Watson didn’t like it, she could tell that.  “I was about to come looking for you,” she said.  “Next time, be sure to come back on time.”  But Mrs. Watson seemed to feel the next time she would, and she didn’t say any more about it.
  One Saturday afternoon when they had finished eating lunch, Mr. Watson leaned back and said, “How would you girls like to step out?  What do you say to a movie, or maybe the zoo?”
“There a Walt Disney at the Avenue,” Mrs. Watson said.  “Which would you like Ellen?”  Adults like movies better than zoos, but then some of them thought if you didn’t like the zoo you weren’t normal.  They didn’t like it either, if you said, “it doesn’t matter.”
Mrs. Watson was looking at her face and it began to seem to Ellen that she could read Mrs. Watson’s mind and that she wanted her to say movie.  But Mr. Watson said, “Maybe you’d like us to decide this time.  It’s a beautiful day, let’s go to the zoo.  We can go to see a movie anytime.”
“Sure, that’s fine,” Mrs. Watson stood up.  “Let’s not even wait to do the dishes.  Let’s just up and go.”
They put the food away and piled the dishes in the sink and walked through the living room where the morning papers were lying all over.  Mrs. Watson’s knitting was out from the night before and the big ash tray had a dead cigar in it.  And when they came back, it was just the way they had left it.  They had just returned when the social worker arrived.
Mr. Watson said, “Come in, come in, we’ll put on the coffee pot.”  And he went out to the kitchen.
Mrs. Watson picked up her knitting and said, “Sit down.  We’ve just got home.”  And she started knitting and didn’t say one thing about the way the house looked.  “I can tell you, young lady, you better get this house cleaned up.  If that woman from the court comes and finds it like this, you’ll be back so fast it will make you head swim.”
Mrs. Watson said, “Hasn’t this weather been wonderful?”
The social worker said, “Yes it certainly has.  Well, we deserve it after the kind of spring we had.”
The pretended not to pay any attention to the house.
Mrs. Watson acted as though the social worker was just anybody.  “Oh yes, we’re getting along fine.  Get out your new shoes, dearie, and show them to Miss Wilson.”  “Here Miss Wilson, sit here.  I can’t keep this house picked up.  I had it straightened up yesterday but I took the child to the zoo.”
Mr. Watson was the same as always, too.  He came to the door and said, “Coffee’s ready.  Do you want it in her or at the table?”
Mrs. Watson said, “Oh, let’s go out to the table.”  And they went out and sat right beside the sink full of dishes.
Pretty soon, Mrs. Watson said, “Ellen, why don’t you and Miss Wilson walk up to the library?  She turned to Miss Wilson, then.  “It’s a lovely new building a branch we’ve needed for a long time.”  And so Miss Wilson didn’t have to ask to see Ellen alone.
When they were out of the house Miss Wilson said, “What have you been doing, Ellen?”
Ellen told her about the new dress and church and the zoo and how she’d been good and helped with the housework.  “Only Mrs. Watson did most of it.  And the house usually looks nicer than it did today,“ she added.
Miss Wilson smiled and said, “It looked good to me, Ellen, yes, very good.  I think we’ve found the place where you really belong.”  But Ellen knew it was just a stopping place.  A place to wait for her parents.
When they got back, Miss Wilson thanked the Watsons for the coffee and Mr. Watson said, “Come back soon.  Any time.”  Ellen could tell he meant it.  She could see that when Mr. Watson scattered papers all over the living room or when they rushed off and left the dishes, it was all right.  It wasn’t bad.
That evening after the social worker had been there, Ellen cried.  She was carrying an empty picle jar out to the trash barrel and she dropped it on the back sidewalk and it broke.  She knew it wasn’t worth anything, and she knew no one would care, but she started crying and couldn’t stop.  And Mrs. Watson put her to bed and sat there until she fell asleep.  For the next few days, lots of things made her cry.  She was turning into a crybaby.  Once when she burned her fingers making candy, and once when she couldn’t find her library book and it was due that very day, and once when she saw a cat kill a baby bird, she cried.
The wind never did cry again.
From then on, and slowly, the voices began to fad.  She still heard them sometimes.  Sometimes she said or did what they told her to.  But gradually they were going away.
In bed at night she sometimes said the words to herself: “my father, my mother,” and something hurt her, something leaving, something gone.
At night, just as she was going to sleep, she sometimes thought, “Nothing bad.  Nothing bad enough to send you away.”  But one day she found out how fooled she had been. 
She hadn’t planned to tell the lie.  But when the new kids moved in next door that afternoon, they made it so easy for her, almost as if they wanted her to lie, or their mother did.
She sat on the steps and watched the men unloading the truck, and she saw the father and mother going into the house.  The mother was holding the little girl’s hand and the little girl was carrying a doll.  The father stood outside in the yard a while and walked around and looked up at the roof and at the bushes and trees, and then he went inside.
Soon the boy and girl came out and saw her and the girl said, “Hi, we just moved in.”
Ellen got up and walked over to the driveway and said, “I saw you.  I’ve been watching.”
The boy said, “Come on, let’s play catch,” and he pulled a ball out of his pocket and they made a triangle and threw the ball to each other.  Ellen didn’t miss the ball once, and a feeling of fitting in with the new children was strong in her.
After a while, Mrs. Watson called her and she went inside.  There was a big plate of cookies covered with wax paper, and Mrs. Watson said, “Honey, take these over to our new neighbors but don’t go inside.  After they get settled we’ll call on them.”
Ellen took the cookies over and gave them to the boy.  When he came back out of the house, the three of them started turning handsprings on the grass and Ellen wasn’t very good at it, but she could tell she would get better.
Pretty soon the mother came out of the house and said, “Honey, these cookies are delicious.  You thank your mother for me.  What’s your name?”
“I mean your last name.”
“Watson.”  It came out naturally and it seemed real and true.  Even the sound of it was right.  But she knew it wasn’t true and her name was Ellen Ganin but this time she lied on purpose and she repeated it in on sentence and said, “My name’s Ellen Watson.”
That ws when she looked up and saw Mrs. Watson standing in the doorway with a different look on her face than she’d ever had before.  And Ellen could see it all right then: the packing, and the social worker and Mrs. Watson being polite to each other and saying sometimes these things don’t work out.  “I’m sure you tried.”  “I did my best.”  Don’t worry, we’ll find another place.”  “I tried to do my Christian duty.”
Ellen turned, then and ran into the house past Mrs. Watson and into her bedroom and closed the door and lay on the bed.  And it wasn’t dark and the wind wasn’t making sounds outside the house but she was walking along in the sunshine on her way to find her mother and father.  This was the first time on the walk that she had ever noticed what dress she had on and it was the pink one and she could see herself walking along.  She was carrying the book Mrs. Watson had bought for her and she wore the bracelet and her name on it in gold that Mr. Watson had given her.  It took her longer than usual to find the house and she thought she might never come to it.  But when, at last, she did, and her mother held out her arms to her, her mother’s face was just like Mrs. Watson’s and Mr. Watson was standing behind her.  They were glad they found her and they were so glad they started to cry and she started crying, too. 
Mrs. Watson was leaning over the bed smoothing her hair and saying.  Don’t cry honey.  Everything’s all right.”  Then Mrs. Watson said, “Mother’s here. Mother’s here.”
The End

Monday, December 26, 2016

New Years Eve Safety Tips

Drinking: The biggest worry here is to not leave your drink unattended.  There are too many looking to spike drinks.  Also of concern is uncorking the champaign in a safe manner.  Too many have lost eyes or had them damaged.  Also aim the cork away from people.
Driving: The best way to handle this is to not drive on New Years Eve.  There are too many people who or buzzed or intoxicated.  Perhaps you can spend the night at the party, or take public transportation when possible.  If you must drive, and people intend to drink a designated driver who doesn't drink is essential.  Buzzed driving is driving under the influence; as is driving after  using drugs or marijuana.
Public events:  Never attend alone; always go with a group.  There is safety in group.  Also please have some form of communication.  Be alert and aware of your surroundings.  Likely you are with people who have been drinking, and in an area which is unfamiliar.
Fireworks and guns: If fireworks are part of you New Year plans best is a public display.  Personal sparklers can be dangerous, and children should not use them, and if they do close supervision is needed.  An no shooting of guns.  What goes up must come down; and too often an innocent person can be insured or killed.
Pet safety:  Remember pets do not like loud or unusual noises.  Take precautions if your pet may be subject to this.
For more information check here or here.

Sunday, December 25, 2016

Mental Health Advocacy Project: Santa Clara County

The mission of the Mental Health Advocacy Project (MHAP) is to empower people identified as having mental or developmental disabilities to live more independent, secure and satisfying lives through the enforcement of their legal rights and the advancement of their social and economic well-being.  They now service of 5,000 client annually.  The provide legal services for economic rights, housing rights and patients' rights.  They also provide outreach and education as well as technical assistance to mental health, social service and housing programs.  They can be accessed at 1-800-248-MHAP or 408-280-2420.

Article Review: Feeling Awe May Be the Secret to Health and Happiness

 Feeling Awe May Be the Secret to Health and Happiness, by Paula Spencer Scott, Parade Magazine, October 9, 2016.

Awe as a healer?  But think about it, those who are awestruck have reduced stress, and consequently improved health.  "Awe is the feeling of being in the presence of something vast or beyond human scale, that transcends our current understanding of things." psychologist Dacher Kelmer.  
1. Awe helps us see things in new ways.  It prompts the stop and think reaction.  It sparks creativity.
2. Awe makes us nicer--and happier.
3. Awe alters our bodies.  Awe is linked to reduced levels of cytokines which is linked to depression.  Perhaps urban blight, and living away from nature can by bad on health.
Awe as a healer is pretty new in terms of health science.  But there is something to the idea of getting out in nature, and looking up to see the sky.  Music can also contribute to "awe" moments.  Museums, planetariums, national, state and local parks, all can play a part.

Friday, December 23, 2016

Thursday, December 22, 2016

Ergonomics: Keyboard short cuts

Knowing a few short cuts for keyboards is a good way to guard your health.  This list comes from Ergo Fit.

Consider also a few other hints to maintain you health in an area prone to reduced activity.  These include: maintain good posture, Keep your wrists and hands aligned in a neutral position.  Relax your arms when keyboarding, work with bent elbows, keep thumb relaxed, type softly, slow down, try develop off hand skill, and finally type with curved fingers.  


Taking a cue from emoji, here are a list of emotions that can help people better identify how they are feeling.  It is important to be able to describe our feelings,  It is at the base of every "I" statement, "I feel ____".  It is also important for empathic listening as it is useful in reflecting how someone is feeling, and can often summarize what they are saying.

Sunday, December 18, 2016

Primary Care Behavioral Health Services

A new trend in mental health treatment, is to offer services in house at the medical clinic.  More than five years ago Santa Clara County initiated primary care behavioral health services where the psychiatrist and therapist are colocated with the medical clinics.  This services are for individuals with mild to moderate problems, and not those needing intensive case management services.  Santa Clara County Mental health boasts five such clinics.  There are more clinics in the works.  Additionally there are contracted providers which also have behavioral health mild to moderate components, and offer services conjointly with primary care.

Article Review: Raising Cain: The Problem of Family Homicides

This is not a pleasant topic for Christmas time, but this is a report on an article in Psychiatric Times, by E. Fuller Torrey, MD, August 2016.  This is the first study of the prevalence of family homicides in the families of the mentally ill.  Of the more than 16,000 homicides in the U.S. in 2013, 4000 were within the same family.  Of those within the same family, most were spouse on spouse, which are not attributed to the mentally ill.  However, the majority of child on parent and parent on child homicides are.  In calculating the total, this study estimates that the mentally ill are responsible for about 29 percent of the family homicides, or 1150.  The weapon used was guns and sharp objects and beatings (each however in less than a third of the cases.)  It appears the elderly are vulnerable to family homicide by mentally ill, in light of the mentally ill more often living at home rather than in the hospital.  Two issues play a major roll,  Not taking medications is associated with increased homicides, as is co-occurring substance abuse, particularly alcohol.  Persons with mental illness account for over seven percent of the total homicides in the U.S., over 1000 annually.  Suggestions to reduce this number are:
Adequate psychiatric care.  Clozapine is shown to reduce aggression, but under utilized in the U.S.
Assuring medications are being taken.  A switch to injectables is likely to help in this area.
Assisted Outpatient Treatment (AOT in which the recipient in which an individual is required to follow his prescribed plan to live in the community has shown a reduction in violent, threatening and aggressive behavior.
Reform of HIPAA requirements which keep vital information from family members.
Focus on individuals with the most need.  Prior warnings are usually given before homicides which include threats of harm and assaultiveness.  Interpretation of laws regarding involuntary psychiatric hospitalization and treatment for these threats should not be interpreted narrowly.
Improved data collection to further study this problem would give a better idea of the prevalence.  This would lead to better tools for assessing possible problems.
The author lastly claims that mental health stigma is incumbent on violent acts.  This is because of media perception in the newspapers.  Only by reducing these violent acts will stigma decrease.

Saturday, December 17, 2016

Christmas Safety

This article come from  Most of the safety tips deal with lighting and making sure your lighting is safe.  For example you should check your lights, turn them off when you are not home or when you go to bed.  Attempt to use fresh trees and boughs, and water when you can.  Connect no more than one extension cord, and make sure cords are certified.  Use a timer on your lights and do not turn on until after 7 p.m. to avoid peak usage times.  Outdoors keep electrical connectors off the ground.  In using a ladder use them safely and make sure the ladder is working properly.  Keep fireplace fires behind glass.  Keep clutter picked up and keep flammables away from water heaters and other heat sources.

Friday, December 16, 2016

Article Review: Fireproof Your Family

Fireproof Your Family: Jeannette Moninger, Parents, January 2017.
A year since I burned my back, so I decided it is a good idea to share this article.  Knowing what to do in case of a fire can save lives.  Unbelievable 357,000 homes catch fire in a year in the United States.  That is a lot.  They result in 13,000 injuries and 2,400 deaths.  Important things to remember include:
Have an escape plan, and practice every six months.  Develop two means of escape from every room.  Replace smoke-alarm batteries every sixth months.  Check the manufacture date of smoke alarms and discard those over ten years old.
: turn off stove whenever you leave the kitchen, never leave home with appliances running, wear short or tight fighting sleeves around the stove, keep children away from the stove.  (The stove was my culprit.  I was warming my backside near the gas burner.  Also my grandmother tells of her baby brother being burned.  I think that was hot water being spilled from the stove.)
Bedroom safety: don't smoke in the house, and keep lighters and matches out of reach of children.  Extinguish candles when leaving a room.  Candles need to be on flat surfaces.
Basement: Keep flammable objects away from heaters.  DOn't plug space heaters into extension cords.  Turn heaters off when not in the room.
Fireplace: Hire qualified cleaners every fall.  Keep flammable objects, including wood, three feet or more away.  Use a study screen.  Allow ashes to cool before disposing, and let them cool a distance from your house.
Laundry Room: Scrape out the dryer lint every time the dryer is used and clean the vent pipe yearly.  Check the outdoor vent door.  Plug appliances directly into the wall.  Never leave the appliances on when not in the home.

I think the most important part of this article is the escape plan )have one) and practicing the escape plan.  Maybe even practicing and different times of day or night might be good.  You don't want to traumatize kids with the idea of fire,  but being prepared can lead to more confidence and trust.  Practicing should include knowing how to release screens for exit from windows.  Collapsible ladders are needed for upstairs windows.

Wednesday, December 14, 2016

Training: Multicultural Supervision

This training was presented by Nicholas Landany from the San Diego area.  There are some topics that are very sensitive; this is one of them.  I can't say I enjoyed this training.  Ladany and his cohorts at the Critical Events Supervision Model had developed a way to score individuals with regards to ideas about race.  fThe levels were adaptation, incongruence, exploration and integration.  In this model adaption seemed to be another word for racist or naive.  He scored Donald Trump and Ben Carson in this area.  That didn't make sense to me, and still doesn't.  Maybe I missed something.  I think any model that gives you the right to pigeon hole others, is a poor model.  People are people, not some score from a psychologist.  I mentioned this at the after-training meeting, but not at the training itself.  

Sunday, December 11, 2016

Train Safety: No Selfies Please

This is a tragic story from U.P. Inside track about a train accident involving three teenage girls taking a selfie.  It does not end well.  In this case the accident had long-last effect on the engineer and the conductor and the families of the girls, and the first responders.  I think of my own son, who took a picture with his band on what they thought was an abandoned rail bridge.  However it isn't.  Luckily there was no tragedy.  Train bridges and tracks are cool, but pictures should not be taken from close on the tracks.  I previously made a personal video sharing my thoughts on train safety.  Be safe please.

Self-Enhancing Ideas: Home Builders, Behavioral Science Institute

In another life I was trained in home builders model.  I used this model for family preservation when I was working for Utah State Social Services in Eastern Utah.  I was working mostly with members of the Uintah and Ouray Reservation.
The idea behind self-enhancing ideas is that they can counter negative self talk that we get ourselves into.  Her are some examples.

There's no evidence that one needs approval or love.  People have very few actual needs; the rest are wants.  Being fallible, one can't always be lovable.  You can't please all the people all the time.

I have already survived many unpleasant events.  Nothing is awful; things just ARE or ARE NOT and one adds the label awful, horrible, etc.

Worrying is a belief in magic; the evidence is that worrying will not protect me.  The more I "awfulize" and worry, the less able I am to reason; thus I reduce my chances of impacting the situation.

Avoiding short-term difficulty or pain is tempting, but may make things even harder for me in the long run.  I can stand difficulties and frustration; I just don't like them.  Meeting challenges is enormously satisfying and I don't was  to miss that satisfaction.

Nobody can be perfect, and we'd better learn to accept this reality.  If it's worth doing it's worth doing poorly; the best way to learn is to practice.  A person who fails is not a failure.

People can change even the strongest habits.

Friday, December 9, 2016

More Notes on Reflective Practice and Supervision

Just a couple more notes on reflective practice that I am noting as I gleam through my notebooks.  Ideas for supervision: Keep people safe and protected.  Base your reflective work on love.  Provide gentle support to help people reflect.  Reflecting is thinking seriously or deeply; thinking quietly, thinking completely.  Metacognition is to think about how you are thinking about something.  How do you want to thing about something?  Keep brain calm and active.  Personal thoughts: Do I reflect enough?  It seems sometimes I do not do what I want because of brain freeze or trigger and I do other things instead.
Transforming practice is improving outcomes.  reflection involves knowledge, action, wisdom, internal knowledge, experience and external knowledge.  It involves looking at belief system and how it effects what you do.
A way to keep brain active is to try something different everyday.

Family and Children Services: Deaf and Hard of Hearing Program

In Santa Clara County, the primary provider of mental health services to the deaf and hard of hearing community is family and Children Services of Silicon valley.  Their primary location is on Julian Street, just off of the Alameda.  The communicate with the deaf community through video phone and email.  They have counseling, case management and mental health services for deaf individuals, support for their families, offer ASL classes, provide education to the community and are knowledgeable about resources for the deaf community.

Monday, December 5, 2016

Article Review: Individual Resiliency Training

Individual Resilience Training: An Early Intervention Approach to Enhance Well-Being in People with First Episode Psychosis, Piper S. Meyer Phd, Jennifer D. Gortlieb Phd, David Penn Phd, Kim Mueser Phd, and Susan Gingerich MSW. Psychiatric Annals November 2015.
IRT is the treatment model for early intervention.  It draws from stress vulnerability, recovery, psychiatric rehabilitation and cognitive-behavioral therapy.   It also draws form motivational enhancement, shared decision-making, and psychoeducation.  It also includes illness management ideas.
Clients meet with therapists in a regular one-hour weekly session.   These sessions are strength-based, and provide training as based on an individualized plan to help the patient increase resiliency and awareness.  There are seven core treatment session, orientation, assessment and goal setting, education and psychosis, relapse prevention planning, processing the episode, developing resiliency and building a bridge to your goals.  Other areas of focus include dealing with negative feelings, coping with symptoms, substance use, having fun and developing good relationships, making choices about smoking and nutrition.
Initial studies show some support for the feasibility of this model to increase resiliency and thus prevent relapse.

Sunday, November 6, 2016

Working Together to Prevent Type 2 Diabetes: Santa Clara County Campaign

Working Together to Prevent Type 2 Diabetes Type 2 diabetes is a growing epidemic across the nation where one out of four people do not even know they have diabetes. Last year, diabetes was one of the leading causes of death in Santa Clara County! A recent UCLA Center for Health Policy Research and California Center for Public Health Advocacy study estimated 46 percent (almost 672,000) of adult residents in Santa Clara County are pre-diabetic or have undiagnosed diabetes. It is time to work together to prevent type 2 diabetes and promote better health for all our residents. Studies show that you can prevent or delay the onset of the disease by losing 5 to 7 percent of your weight by eating healthy and being more physically active. Look for the newly updated “It’s in our hands – TOGETHER WE CAN PREVENT TYPE 2 DIABETES” ads throughout the community on buses, billboards, bus shelters, Facebook ads, and online newspapers. Share the attached flyers with your patients and have them visit to learn more!