80 Days To Christmas

Tradition is what you resort to when you don't have the time or the money to do it right. -Kurt Herbert Alder

It is hard to believe, but Christmas is in 80 days. I am sure the anxiety is beginning to well up inside you just thinking about all that has to happen between now and then. Before you click away and purge the unwelcome thoughts from your mind, take a moment to think about what you really want this holiday season.



One of the biggest traps is to hold too high of expectations. We want it all - the entire Norman Rockwell scene. While it is possible, a Norman Rockwell world is not built in a day. Our normal life rolls on and holiday activities are extra. A little planning, however, reduces stress and gives you most of what you want.



My advice is to take a few moments in the next few days. Sit down with a calendar and plan a few things. Circle days to do certain things, shopping, getting the decorations down from the attic, putting up the outside lights, putting up the tree, the get together(s) with friends and or family, purchasing and sending Christmas cards. Whatever it is you want to do, just pencil in a plan. If you start now, you will save lots of stress later. Saving stress leaves more room for enjoyment.



By spreading out the work and expense you can plan the kind of holiday season you want and not let it happen to you. You will feel a better sense of control and satisfaction. The holiday season does not have to be a stressful, hurried, anger-provoking time. It is supposed to be a season to celebrate the birth of Jesus. It is supposed to be a time we reflect on the past year and look forward to a new one. It is supposed to be a time of enjoying family and friends. It is supposed to be everything good. Think about what you do not like about the holidays and take a few steps now to see those things do not happen. If you do, you will be glad you did that often-hectic week leading up to Christmas. This year Christmas is Saturday, December 25. Thanksgiving is Thursday, November 25 this year so there will be a longer gap (30 days) between the two holidays.



Are those sleigh bells I hear? No, it's still the ice cream truck, but they're coming, will you be ready?



Until the next time

John Strain

Ref Desk

Since today is Monday and everyone is headed back to the old grind, I want to give you a link to make your life easier. Do yourself a favor and browse around on Refdesk. It amounts to a page of links you can use. See what you think.



On a physical note, I ended up running 13 miles on an elliptical trainer yesterday. My coach said I could try it and if it did not aggravate the hamstring it would be OK. I was happy to get in a good workout. The hamstring is feeling better and I will probably do most of this weeks runs on that contraption instead of the usual running.



Until the next time

John Strain

Hamstrung

Well rats, yesterday on my 5 mile time trial, I pulled up lame after 4.5 miles. My hamstring started tightening and I knew to continue running would only further injure my hamstring. Injuries inject psychological challenges to training programs. On one hand, I want to be tough and endure pain, on another hand, I do not want to do anything stupid to jeopardize my ultimate goal December 4, on even another hand, (I have three) I do not want to get behind on my training.



My coach cancelled my 13-mile run today and told me no running until Wednesday at least. In the meantime, I apply the R.I.C.E. method to treat the hamstring. Rest, Ice, Compression, and Elevation. On a positive note, it feels better this morning, but I miss my long run bad. I sure hope this is not serious.



One reason a marathon is such an accomplishment is because it is not easy getting through all of the training and getting to the starting line healthy. I have been training hard - taking the runs right up to the edge and making good progress in reducing my times. My body finally balked a bit. I hope I can talk it into cooperating with my mind.



God grant me the serenity to accept the things I cannot control . . .



Until the next time

John Strain

Saturday Devotion

Today I am launching a new Saturday series. The Saturday Devotion will be an audioblog of something inspirational. For the next few weeks I will read from a book I became familiar with in seminary. It is $3.00 Worth of God, Wilbur E. Rees. Judson Press, Valley Forge, PA. 1971. The short devotions of Wilbur Rees were revolutionary in 1980 when I was in school, and timely as you will see. I hope you enjoy them. I will also provide a print version for those poor souls out there with dial up.

Whosoever therefore shall humble himself as this little child, the same is greatest in the kingdom of heaven. - Matthew 18:4



And God said, "With what shall I shatter Man's self-importance? How shall I tickle his ribs and get him to laugh at himself? How shall I interrupt his ponderous deliberations and muss his carefully combed hair? How shall I dump blue sky in his lap and show him the importance of mud, moths, and the month of May? How shall I mimic him and embarrass him, disturb his dignity and cause him to smile?"



God thought for a while and then answered Himself, "I shall make a child!"

Until the next time and have a great weekend

John Strain

Abusing The System

I might as well make it three in a row. That is posts about mental health. Today I want to simply outline a problem. I do not know the solution. Before I state the problem, I want you to understand the nature of the problem. In school I had systems theory drilled into my head. Basically what systems theory says is one thing influences another thing. Like dominoes, if you change one thing, other things are affected. If dad loses his job and becomes withdrawn, then mom worries, the kids don't get their allowance, they can't do things with their friends, the friends hang with other people and it keeps going out like ripples of water on a pond. If an alternator on an automobile breaks and stops charging the battery, the battery will eventually die. The car owner often diagnoses the problem as a bad battery only to find the new replacement battery dead in a day or two. A trip to the mechanic reveals the real problem. Therefore, in systems theory, it is important to find "the problem" and not focus on a symptom of the problem.



The problem I will attempt to explain today is many faceted. It is actually several problems interwoven. It is getting worse here in Louisiana and I suspect in other areas of the United States.



Problem:

An individual presents at an emergency room saying they are suicidal and ask for help or someone is brought to an emergency room accused of being suicidal and the family / friends are asking that the individual get help. Often the individual is intoxicated or under the influence of drugs.



The ER doctor wanting to move people out of his department quickly writes a PEC (physicians emergency certificate), which is a 72 hour commitment. The social worker in the ER begins looking for a psych bed by calling psychiatric units.



EMTALA (emergency medical treatment and active labor act), is a set of federal laws regulating what obligations hospitals have toward patients who are in an emergency situation. These are the anti dumping laws. They make a lot more sense if you are talking about a pregnant woman or someone having a heart attack, but they make less sense as applied to psychiatric and substance abuse situations.



I work at a private psychiatric hospital. We participate in the Medicare program; therefore, we are bound by the EMTALA laws. So, if an emergency room calls us and says they have a patient in their facility and the doctor has written a PEC, we MUST accept that person regardless of their ability to pay.



In theory, this may sound fine, but in practice, it is a disaster. What is happening is individuals and families know they can solve their little crisis by going to an emergency room. The MD will PEC the individual to get rid of him and some psych hospital will have to sort things out without reimbursement. Then, because the person is in the hospital free, administrators (rightfully so) want them discharged ASAP. I often spend a lot of my time doing this, while paying customers are on the back burner.



If the hospital treats people without reimbursement enough, it will not have the money to pay me. Some units have closed already placing more of a burden on existing units. If things continue this way, I can see all of the psychiatric hospitals closing.



I can think of solutions, but it would involve regional cooperation between emergency rooms and psychiatric hospitals, including state mental health services. I do not even know where to start. Medical professionals talk about this problem all the time, but solutions usually involve one facility.



Everyone is afraid of being sued and this is a real concern. There is a large group of individuals who abuse the system. They go to an ER when they do not need to and wind up in a psych hospital when they do not need it. More often than not, some little 22 year old girl gets in a fight with her boyfriend, they breakup and she becomes suicidal. Her friends take her to the ER and she is transferred to a psych unit - maybe ours. Once in the system, it takes a few days and a lot of paperwork and expense to get out. It is all such a waste. A lot of work is generated for fear of regulator intervention or law suits.



I especially love cases of compulsive gamblers or crack heads that are "suicidal." Folks know all they have to do is walk into an ER and say they are suicidal. They will get a 3 to 5 day rest. They spend all of their money on drugs or gambling, but have no resources when it comes to paying medical bills.



Hospitals are often seen as unfeeling and callous, but they lose a lot of money treating people for free. If the trend continues, the hospitals will go bankrupt.



This problem concerns me and I do not quite know what to do. The problem is big and far-reaching.



Sometimes just writing helps me think to the next step. Maybe that will happen here. Being the optimist I am, I believe there is a way to improve this situation and I have not ruled out giving it a shot. Someone has got to do it, even if it is only in our region.



Until the next time

John Strain