Preparing for Surgery

Surgery is on your (or loved one) horizon.  How to prepare?

Because we are complex, whole people, this is a layered question.  There is the practical outer aspects of preparing and there is the internal aspect (in my mind, also practical).  Whereas every surgery is unique and every person approaching it is unique, there are some universal commonalities.

Anxiety.  Everyone has some degree of anxiety.  Anxiety is promoted by tension, which usually turns to fear which unfolds into streams of negativity.  Finding ways to manage one's anxiety and negativity/fear is key.  Manage is the operating word, because it is only human to have intrepidation moving into the unknown of what will be.  Practically, information gather with gusto.  Find out everything you can about your condition, the nuts and bolts of your surgery including expected anesthesia, the rehabilitation anticipated and the process.  Because of the ACA (Affordable Care Act), it is mandatory for doctors, hospitals and their staff to fully educate their patients on their medical conditions.  There are negative consequences for MDs that don't do this, that don't follow up, or monitor their patient's aftermath from hospitalization (they won't get paid for re-admissions and are accountable to some extent for hospital acquired infections).  Be pro-active, be interested, curious and knowledgeable.  Knowledge is power.  A knowledgeable patient is empowered and that puts you in a strong place entering a vulnerable situation.  With your best inquiring self in place, ask a lot of questions. Keep asking them until you are fully satisfied.  Ignore the huffy healthcare person that is rebuffed or contemptuous of these questions.  Questions help build relationship with healthcare people.  It does not empower or become you to be passive.  If this is difficult for you not to do, good.  It's a challenge to your personal status quo, one you should have challenged a long time ago.  Still, it would be helpful to have an advocate (loved one, family, friend, wellness coach) to saddle up to you through this fact finding mission.  Keep a journal or log of doctor visits, information gathered, thoughts, feelings, experiences with healthcare people.  Practitioners that are deleterious, note and figure how to remedy.  A certain nurse you sense is disinterested, cuts you off, is impatient?  Get another one.  You can ask for this and you can say why.  You want to situate yourself in the best possible position mentally and physically as you can.  So write everything down, chronicle your journey (the good and the bad) and make sure you feel strongly you are in the best  possible place in yourself and in the best of hands walking into your surgery.  Trusting you are optimally positioned before this event means a much better outcome for you.  Having a lack of trust or relationship with your healthcare providers undermines you deeply and this effects your outcomes and healing.

In this anticipatory process the anxiety will get in the way.  You will keep grasping at providers for handholding, your fears will trip you up.  Whereas, its great to gather information, it will not totally alleviate your anxiety.  You must start taking some steps to support your well being.  If  you don't meditate, figuring out what this is for yourself, giving yourself some alone, quiet time every day where there is stillness and breath.  Read up on affirmations.  There are tons of books out there that lead us into a more positive frame of mind through affirmations.  Some are "hokeyer" than others.  You can only skim through potential titles and content to get a feel of what is right for you.  With practice, you start making your own, framing them in your own lingo that feels best for you.  Start some rituals you do everyday.  Five minutes of creative time every day:  write a poem, keep a small book of sketches or quick water colors. A night time ritual of putting yourself to bed; bathing, lotioning, use essential oils, brush your hair, set the "stage" of your bed:  fresh flowers, a candle, meditation tapes.  These are ways we love ourselves, care for ourselves.  Self touch with intention is healing.  You want to kick in the parasympathetic nervous system, the relaxation response, regularly and potently.  The body's cellular memory remembers this and when given the chance goes there more and more easily with these ritual reminders.  Breathe.  Smell the roses.  Smell the coffee.  Take a lot of time to be with yourself and your pleasures. If you don't want to depend on loved ones and you have the resources, hire a wellness coach.  They can give you specific, useful exercises to ground you in quiet and wellness.  After they get to know you, they tailor everything to you, so you will receive optimal, useful information on the pragmatic details as well as the non.  They are your hand holders, the go-to people when a melt down is imminent.  Hired for a specific time period before through after surgery, it is money well spent.

If you are not a pragmatic person, you probably love someone who is.  Enlist this person as an advocate.  Weeks before, have them sit down with you and figure out a strategy and plan for the practical details leading up to the surgery, rehabilitation and beyond.  If you are pragmatic, you probably love someone who is as well (there are a lot of us around!).  Two heads are better than one.  Figure it out together.  How are you getting to (and returning from) the hospital, is your set up at home adequate for your return (do you need a hospital bed, bed-side commode, grab bars for shower, etc)? Schedule helpful visitors for the first two weeks, people who make meals and don't mind doing a little light housework, errands, grocery shop, etc.  Schedule upbeat, easy-going, happy-go-lucky folks; people who have a good comedy DVD collection, who aren't going to do your spirit ill.  Schedule people who know when to stay and when to leave and whom you don't have to entertain (or necessarily entertain you).  Not feeling well is a good excuse to start saying "No" to everything that doesn't feel right.  People who love you won't take offense and will probably learn to be a little more sensitive in their approach.  The best of these folk will help you find the humor in all the "no-s" and be able to bring some lightness to the cranky periods.

These are practical preparations.  The mental and emotional preparation are often the most challenging and also the most important.  When this is well done, the practical becomes a piece of cake, as you are thinking and feeling with more clarity.  Fear isn't the modus operandi.  Also, in being more clear, a plan B often naturally surfaces, always a good thing.  We plan for the worst, hope for the best....  The better your frame of mind and spirit are, the quicker you will rebound, recover.  This is science.  Find your joie de vivre, your life force, your wish to live and prosper and bring them to the event.  Those who are rarin' to go do their physical therapy first thing in the morning post surgery, are positive.  This positivity saturates their being and wellness is theirs.  Their recovery times will be faster, their pain will be less, their outcomes optimal.  They have their endocrine system working for them and their good energy only supports the healing process (unlike the negative which absolutely undermines it).

An upbeat attitude, a good relationship  to and use of your breath and certain essential oils go far in dealing with pain.  Laying a strategy for yourself in dealing with it is important.  In the first few days, take the pain meds allowed.  Trying to be a hero by not taking them can set you back.  In pain, the relaxation response is impossible.  You want those feel good hormones cascading to support your healing process.  You will have good days and you will have bad ones.  Just keep moving through them as best you can, ask for the help you deserve.  All will be well.

Healing Practice: the Slippery Slope (Part II)

"Thought", Rodin
Rodin Museum, Philadelphia

In Healing Practice: the Slippery Slope (Part I), I talked about what healing practice is and some of the inherent challenges.  In Stress, Self-Responsibility and Health the idea of self care for those who are caretakers (healers) was addressed and the subtle aspects of what it means to take responsibility for one's own well being and health.  Lee van Laer's essay,  My father's shoes is an interesting take on putting others before ourselves.  He indicates the subtle motivations one participates in when deciding on taking a caretaking attitude and the self-accountability that transpires, often unwittingly.

This post hopes to expand upon the challenges we face as healers, be it the self care/responsibility piece or actual practice of bringing awareness, sharing energy and the ever present issue of transference.

an external relief, Chartres Cathedral

In a very basic and true way, all and everything is about our depth of awareness and attention in a moment and the relationship we make then. Practicing healing work is that synchronistic work along with stripping and paring ourselves down to our essential selves so that we don't bring to the work that which doesn't belong there.  Having said that, our essential selves alone are not equipped to handle whatever is the task in front of us.  Our essential selves sets the right tone of honesty and authenticity and is often cued into the creative and our intuition.  This is a valuable resource we want in play as we evolve the healing relationship.  However alone, it is not grounded; grounded in thought, skill, discretion or purpose.  These are the qualities that are most available and familiar to us.  These are often the elements we (and our identities and egos) are fully invested in, brought forth with pride, confidence and knowledge.  These are aspects a third part of us (he who is attending) needs to watch carefully and monitor, because otherwise that executive part will portend to be our whole, and pretend to be the only thing that matters.  When our ego-authority takes precedence, often our self responsibility is lost and a healing becomes marginal.  In that moment, either we falsely become the big kahuna or we become transferred upon. The slippery slope of navigating the complex relationship of a healing, involving myself (and my energies), other (and their energies), our mutually conjoined energies and the great Unknown, teeters.

Rodin

This "depth of awareness and attention in a moment", is just that.  It is fleeting. It is required to be renewed over and over again.  When we get a taste of it, even in a protracted series of moments, it is possible to become trapped in the illusion of its permanence.  It is not permanent at all and it isn't meant to be.  The permanence I seek is the effort of renewing.  This is what I work for, this is what I try to move towards.  Renewing keeps me honest and keeps me present (to mild shifts in energy, to transference).  Renewing prevents the work from becoming static, keeps me curious and intrigued with what is, not what I hope for or expect.  Renewing my effort revitalizes my awareness, attention, sense of openness.  That practice helps me to stay grounded in the relationship at hand and with myself.  It keeps me "clean" and the work genuine. It helps the essential self to combine, overlap and work with my skills, my creativity. It helps me create a healthy separation in the duality I've entered when in the healing relationship.  It keeps me real. 

Building attention and an awareness is like exercising a muscle.  With repeated efforts it grows stronger and has more endurance.  It is an experience of a sublime movement of Qi or Prana which subtly courses through my organism, building a circulation.  Both this movement and effort can be likened to experiences of meditation.  Effort isn't like the effort we make in ordinary life. I am not Trying.  I am not gearing up available forces to Do.  Effort is an awareness and subsequent engagement of more of me; the parts of myself that are usually least accessible.  Its quality is quiet. Receptive. Not strained. It is what it means to be in a more total relationship with myself.

"Two Hands",  Rodin
Rodin Museum, Philadelphia

Because of this, every healing is a self-healing.  We are meeting ourselves as much as we are matching another.  Because of the effort of attention and awareness I am more One.  I am related to myself more fully, the person before me, all and everything.  I am able to be a semblance of the rock or tree John Blofeld (see below) speaks of becoming.  The change (or healing) I am open to becomes possible because of this type of unification I experience in a moment.

This is an ideal; every healing experience is different than the one before depending on the awareness and attention present. The element of my humanness keeps it interesting (at least for God!).  My blind spots, frailties, inherent woundedness, lack of any type of perfection in a way is an integral part of the ideal.  When that humanness is seen, struggled with, included, acknowledged and accepted with compassion and love, it actually helps a session to "work". It manifests something deeply real (even if sometimes it is not "pretty").  My imperfect humanness and my willingness not to hide it but to be with it is often the very healing another is needing to witness.

Excerpt from Beyond The Gods, by John Blofeld

"When contemplating a little change, it is fitting first to observe what you wish to alter at different times of day throughout the four seasons of the year, lest by hasty action something precious be lost. Also you need to become a rock or tree yourself before you can judge how to make a change that will accord with its nature."

"Become a tree?" I asked.

"Do you find that astonishing? If you had much time, I would show you. You just sit before it in sunshine and in cloud, in rain or snow if necessary, and project your mind into it. Slowly you learn how to be at one with it, to sense its rhythm, to know how its branches would dispose themselves under just slightly altered circumstances. Only then can you make a change without doing violence to its treeness. All good gardeners get to know their plants as intimately as their own children; otherwise, how could they be good gardeners?"

Dalai Lama's hand, 1987
Herb Ritts

Oneness: Ho'oponopono

Anxiety, fear, addiction, depression, alienation, isolation from our neighbors, even loved ones are daily obstacles many people struggle with through their entire life continuum.  Caught in repetitive thinking and feeling patterns, disconnected from our “home”, our internal truths, we tend to wane through the decades we are given instead of living them with robust energy and joy.  We begin to believe this is what life is.  It is sort of like a dog that has always been kicked and starved, it doesn’t know any better, thus endures and expects more of the same.  Or the person who has never eaten an organic carrot, only the petroleum tasting conventional carrot; they can’t be expected to know the difference. Because these abysmal expectations are what are known, this is probably what will be continued to be had. 

These are somewhat extreme parallels I put forth, but the truth is, most of us live some version of them in some way.  Whether it be our acute and unabated loneliness which has conditioned us to feel we will never know satisfying relationship or peace; or wellness/illness obsessing has us completely disillusioned we will doubtfully know a semblance of an ideal life style pattern.

This nagging lack, “hole creating”, often leads people to therapy, self-help books or classes to improve themselves. It rarely leads them to an introspection that connects them to the idea of Oneness, that their difficulties are not solitary, but related to others and the entire cosmos.  Exploring this understanding can be liberating.

A decade ago, a friend introduced me to a Hawaiian healing process called Ho'oponopono, and Dr. Ihaleakala Hew Len’s work on the concept. The Huna Process of Ho'oponopono .  It basically considers that we are all interconnected, there is no separation between your pain and my own, we are One.  This is considering all sentient beings, ecology, technology, the universe; a very big concept.  The healing comes from saying 4 simple sentences to oneself over and over in relation to the pain or suffering one is having with another (or oneself). The sentences being, I Love You, I'm Sorry, Forgive Me, Thank You.

Dr. Joe Vitale, a psychologist, has explained the basis of this healing works because we enter a sense of responsibility in relation to one’s own suffering and the suffering of another I Love You, I'm Sorry, Please Forgive Me .  I personally find the “responsibility” word a bit loaded in my associative understanding, as have others whom I’ve introduced these concepts to, so I use relationship or relatedness (other “r”words) and that sits with me better.

When I first heard of this type of healing, frankly I thought it was kind of hokey (and it does not help the literature around it is slick and commercial sounding/looking). But I also had a sense there was something simply profound there.  Paradoxes are intriguing, so I sat with it a little longer and decided to test it in my work.  And the experience of it has been illuminating.

I have used it when I am at my wits end, overwhelmed with a patient, or at the end of my available inner resources.  I was working with a revolving-door pair of married addicts, who took weekly turns getting hospitalized ostensibly for pain management to get their narcotics.  The way I was entering this patient relationship on this particular day was alarming to me as a professional; I was frustrated, disgusted, repulsed and angry at this duo.  I had nothing to lose but try the four sentences.  I entered the hospital room to narcotic dose the wife (the patient of the day) and found the wife comfortably watching TV, husband pacing near the window and teenage son glued to his computer. Upon entering, the husband started to bluster about the meds having arrived, and maybe there was some extra for him.  A wave of revulsion ran through me as well as a professional shame that I was feeling this way.  I stood still facing the husband and started repeating to myself the four sentences.  The husband went on and on and I stood there continuing to try the Ho'oponopono practice.  To my surprise, something softened in me and I became engaged with my firmly planted feet.  Within a few minutes, the son stopped looking at the computer screen and looked up at me.  The husband stopped pacing, talking non-stop and gesticulating.  Taking a long pause he said, “You’re listening to me” and then, “No one ever listens to me.”

This was a surprising turn of events.  Where there seemed to be some impact on this family, what was most intriguing was the impact Ho'oponopono had on me.  Being fully caught in an intense internal polarization, this exercise mercifully shifted the rigidity I had entered in myself and made something else possible.  Some facsimile of this experience has happened every time I have tried this and other healers I have passed this on, report similar findings.  There is a penetrating depth to this work.  I am continually finding an expansiveness to its concepts, continued layers to the practice (as I have explored it experientially not per the literature).  It has effected my own practice and thinking on health considerably.

How can this “profound hokiness” be? It’s based on acknowledging (not initially with authenticity) my relationship and connection to another’s pain, asking for forgiveness, and finally gratitude. I don’t understand this in parts of myself, but also it rings true.  It brings home the power of the mind and words thought or spoken to myself and others. 

The Jester and the Healer

In the history of healing, it has not been an uncommon parallel that connects the healer to the priest(ess) or the healer with the artist or midwife.  Lately, it appears to me there is a direct relationship between the Healer role and the Jester of old.

The tarot depiction of the Fool (jester) includes a person juggling unconcernedly or otherwise distracted, sometimes found in the act of unknowingly walking off the edge of a cliff, precipice or other high place.  The jester is symbolic of common sense and of honesty and is a character used for insight and advice on the part of the monarch. Jesters would have had to have a bevy of “tricks” at their disposal, be able to turn on a dime, change-up the pattern of delivery and be extremely keen on sensing the receptivity to her offerings. Also, the jester would probably enter the court’s arena with a modicum of uncertainty of what would be asked or needed of him from the always new population of others and have a knack for turning upside down general expectation at often great personal risk. The jester’s strategic use of subtle (and not so subtle) humor would be part of their offering and a use of highly developed wiles imperative.  In all of this, the Healer is really no different.

We have our ideas of who we are and what we have to offer, even who is our target market.  But when it comes right down to it, it is always surprising as to what is needed, what is being asked for.  And in that light, often new skills or unknown skills are born.  The healer, like the jester is someone who has a child’s point of view.  They are open, receptive, often having an unlikely approach and is somewhat separate from the dysfunction, illness or pain that is present.  It is this very lack of attachment that makes a healing possible.  Like a child who has no expectations of being of direct help, the healing comes in being able to have a direct perception. And that often, is enough.

QiGong: Imparting a Study

I’ve been teaching QiGong for 15 years studying it for 21 years. One always wants to be better (more “masterful”?) at whatever they do or wherever they put their efforts.  But in QiGong I can honestly say, less has been more.  Not hanging on one’s knowledge (or knowing little to begin with) gives you less of a chance of mucking it up, getting your ego involved.  Being less verbose and more genuinely engaged in the actual practice, makes one a better guide.

I have had many QiGong teachers over the 20 years I've studied the forms.  I can say my first QiGong teacher was the most influential.  An unassuming, unpretentious, delicate woman in her 70's, who learned QiGong at a somewhat advanced age.  She was the daughter of an African missionary, and she herself was a long time spiritual seeker.  Erva was simple and direct in her teaching approach.

 After many years of studying with her, I became frustrated at her seeming unwillingness to verbally share her understanding of the movements, of the form.  I was curious and had an intellectual and experiential wondering about certain QiGong series and a strong sense of some of the movement's benefits, how the sounds impacted various organ systems directly.  I wanted information, but Erva quietly, with penetration insisted on the practice of QiGong.

So I started studying with the "masters", seeking to satisfy my knowledge yen. And these men (they were all men) had tons of information, a lot of speculation, a heaping amount of stylization and more than enough ego embedded in themselves and what they were trying to impart.  I gathered from them what felt worthwhile and I left the rest (a lot of bulk!).  At the end of the day (or the decade I happened to be in), I realized Erva's simplicity, lack of verbosity, and experiential teaching style was the real deal.

It doesn’t really matter what one knows or doesn’t know about QiGong.  It only matters that one does QiGong (as Erva knew).  All the speculation and “knowing” of any of the forms, only enhances it in one’s (wrong?) imagination; it doesn’t really enhance the work, even the deep ancient meaning of the work.  Doing the work is what matters. Letting the forms work on you is what is real.  Work simply, practice with an honest, beginner’s mind approach.  It may be in all learning, the need to acquire “stuff” or knowledge and then the need to let it go and let it Be what it is.

QiGong is so simple and so real.  There is nothing one has to do, just follow the energy.  Give yourself over to the form in relaxation and breath.  When teaching over these many years, I have been tempted (and have more than occasionally) expounded on what this movement is for, what this does, the meaning or purpose of this or that.  And it’s interesting as information goes, but it really doesn’t enrich the work, or potentiate the form.  Erva knew this.  And it took me going away from her and doing my own exploring and experiencing a lot of yang QiGong before realizing it’s all a kind of unnecessary clutter to the beauty of the wild yet sensible garden that is QiGong.

Paying for Health

A History Liberated

The health insurance industry purports that over 90% of insurance monies paid out every year go toward serving the 5% chronically ill in this country. For the 80% of us that rarely use insurance, who are well and healthy, we have poured money for decades into a system which we have benefited minimally from. We have done this basically because we fear getting caught in a catastrophic scenario.

We are conditioned to think others are responsible for our health.  Many people pay into an insurance policy, which then is supposed to (mostly) pay for visits to doctors and facilities. When this is the scenario, most people are resistant to seek care that won't be paid for by their insurance. Even holistic folks, people who believe in prevention, understand the roots of stress and its impact on health and that their insurance doesn't pay for prevention-- they often only want to go to practitioners that insurance will pay for.

This is a mindset we buy into.We have abdicated control and responsibility of our health to those who don't really care about us, don't have our best interest in mind and who take the stand that we are beholden to them.  It's a very dysfunctional relationship that dis-serves us.  In this position we aren't allowed to determine what is best for our health; the type of healing and direction we think is the most sound.  Our options are extremely limited under this umbrella'd corporate mentality.  What are other possibilities we could invest in?

It takes a lot to change a mindset.  One's healthcare values need to have a determined awakening.  Having excellent, consistent outcomes with the experience of Complimentary/Alternative Medicine (CAM) is probably essential. With hundreds of thousands of people turning to CAM for care rather than conventional medicine and at least that many people uninsured, as well as thousands of physicians disillusioned with the insurance industry relationship, mainstream healthcare folks are beginning to think outside the box and get creative.

Some physicians and psychiatrists have begun not accepting insurance, sidestepping the mire entirely. Others have created a "care" program where a patient pays a hefty ($2-2.5K) a year and are promised to be served unconditionally in the office and hospital during that time.  Progressive states like Oregon and Minnesota have healthcare providers creating their own "health co-ops" including a wide range of practitioners from massage therapists, acupuncturists to physicians Health Cooperatives Gain Backing as Alternative to Public Option.  One joins the co-op for a fee and is expected to take advantage of all of the practitioners during the year.  It is a health co-op; the understanding is one does prevention and doesn't wait for disease to show up to see a practitioner.  The attempt is to change the mindset of how we look at taking care of health and disease.

Making CAM affordable for all socio-economic backgrounds is imperative.  There are "community acupuncturists" that operate on reasonable sliding scales.Community Acupuncture Movement Goes Co-Op | AcuTake  They practice as they do in China, in community.  Meaning, several people at a time are treated in one room at the same time.  This is a pretty foreign concept in America's hyper-HIPPA age.  But the idea is, that a shared healing in the same space actually potentiates all the healing in that space. The sliding scale is $15-35 and you are encouraged to stay in the space (needles in) for as long as you feel is needed for the treatment. I've experienced acupuncturists in a private setting for $125 and have also have experienced this community acupuncture.  They are both effective and healing environments.

Many people who primarily utilize CAM for health decide to disengage themselves from the insurance system (at least partially).  They acquire a high deductible, low monthly fee catastrophic (hospital) insurance and then self insure themselves for maintenance visits  (gym fee, yoga classes, massages and CAM practitioners) by creating an interest earning savings account dedicated to health, which of course, they control and which they feed with a percentage of their income. They often can negotiate conventional care fees (doctors, dentists) because they pay cash for their visits and are not related to insurance reimbursements, which for the most part, is a big headache and time-consuming paperwork for the practitioner.

Our bodies are designed to self heal.  Obviously, awareness and providing  excellent nutrition is part of this.  Those hesitant to pay for organic or take the trouble to buy from local agricultural vendors because of the cost or inconvenience would be wise to reconsider.  Although organic has now become a trend and can be "brand"-manipulated by corporations taking advantage of the trendy buzz-word, it is food that is more nutritionally sound and less taxing on the body.  One has to have some knowledge and consciousness about it and realize Monsanto-owned (pesticide/GMO central) Whole Foods may not be the only place to get it.  Sometimes choosing local produce (not certified organic) is a better choice over big agricultural organic farms operated far afield or in another country.  Small, local farms often don't have the legal and fiscal stamina to jump through the certification process so don't, even though they don't use pesticides on their crops. A previously mentioned book (see Food Glorious Food), Omnivore's Dilemma, is a must read to understand the workings of American agriculture and the food industry.

Many people, even with the understanding of the benefit of decreased pesticide use and minimal mineral depletion in organic can't make the jump to paying more for it.  Same with hearty (not easily squeezed) breads which can cost up to three times more, but which are nutritionally superior to store brands.  Shocked at seeing your pre-pubescent daughter's nine year old friends sprout breasts and start to menstruate? (related to hormones in meat and dairy) Making choices, such as starting with organic dairy and working oneself (and one's family) to other food sources such as minimal amounts of organic meat and produce is a prudent approach. Looking at food (natural medicine per Socrates) as an investment in one's health is one approach for those with tight budgets.  Also, looking at quality grocery buying from the radical (for most) perspective that quality always trumps quantity; buy better food and eat less.  This surprisingly, is a shocking notion to many people I counsel, probably because we are so indoctrinated in this (obese-prone) culture to be consumers and food associations are hard-wired in us since birth.

Paying for health.  It is our being duty to sustain and maintain this vessel we travel through in this life.  It is our being duty to bring awareness, mindfulness to what we put in our mouths and how we choose to treat the organism when it is unwell.  It is our being duty to maintain a relationship with it; a right relationship so it thrives and is optimally sustained.  Relationship. Responsibility. Respect.  Making the necessary inner and outer payments to keep ourselves well is our first duty to ourselves.

Community Acupuncture Documentary Trailer - YouTube

Community Acupuncture Network