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Are Illness Coping Mechanisms Learned From Parents?

Photograph: Roger Bamber

How far do we travel from our parents’ patterns?  A question psychotherapists and their clients have been wrestling with for decades.

We can’t escape the parental imprint.  Some of us may not want to.  But those of us who did hope to be different often find ourselves in our 40s or 50s unexpectedly leaking parental behaviors or attitudes we thought we had purged ourselves of in our 20s.

I sometimes hear myself saying to Richard, my partner, as he heads out the door for his Tae Kwon Do class, “Be careful.”  He has a second degree black belt and has been studying for years.  He is always careful.  My admonition is a spillover of my father’s anxious voice warning me to be on the lookout for endless, unnamed dangers hiding in plain sight at every turn.  Other times I see myself tighten up like a fist when something I thought I had control over twists in an unpredictable direction.  It is not my jaw that clenches in agitation; it is my mother’s jaw, on my face.

How our parents do or did illness is a powerful pattern.  Did they suffer in silence, while allowing no one to offer tenderness or help?  Did they submerge into illness and allow it to define who they were?  Did they use illness to control and manipulate?  To get attention?  Did they remain engaged in living and loving?  Did they learn from illness to become more fully who they were?  Did they become nastier to each other?  Or sweeter?  And finally, did they take care of each other — physically and emotionally?

My parents, who kept each other at a distance when well, became even more separated when ill.  They went so far as to resent each other for their increasing incapacities.  It was not pretty.

There were times when I was in the thick of my pain condition, that I isolated and withdrew from Richard.  But more often, I allowed my pain to teach me to reach out for comfort and connection.  I had to.  For me, the voice of pain was more powerful than my parents’ example.

Dealing with illness can be a consuming job.  When you find yourself behaving in ways that don’t create the kind of bridge to your partner that will help lighten the load for both of you, pause and ask yourself:  “Am I playing out a pattern that doesn’t really belong to me?  Whose voice am I speaking with?  Can I do it differently?”

How did your parents deal with illness?  What did you learn to do and not to do from them?

***

Barbara Kivowitz is a psychotherapist, business consultant, and book author. She blogs regularly at In Sickness And In Health.

How Old Is Too Old To Be An Organ Donor?

I happened to see this press release from American Society of Nephrology via Eurekalert regarding an article in an upcoming issue of the Clinical Journal of the American Society Nephrology (CJASN) advocating the safety of kidney donation in individuals over 70 years old.  The press release does note that kidneys from these elderly donors do not last as long as those from younger living donors.

Currently, as noted on the University of Maryland Medical Center website:

Donors need to be between the ages of 18 and early 70s and can include parents, children, siblings, other relatives, and friends. An ideal donor should have a genuine interest in donating and a compatible blood type with the recipient.

Donors should be in good general health. Donors do not need to be Read more »

*This blog post was originally published at Suture for a Living*

We Are All Patients

We are all patients, damnit.Two weeks ago, I attended my third year at Kru Research’s ePatient Connections conference, and every year, I’m amazed at how many different industry people show up and showcase their impressive efforts … but how few patients.  But this year, there were a lot of patients.  Lots as in “more than five.”

For a conference with “ePatient” in the title, it was good to finally see more than just a handful of ePatients in the audience.  (And this is thanks, largely in part, to the ePatient Bill of Rights project that took place on September 19th, across the hall from the SXSH event).  And it wasn’t just a handful of diabetes patients – there were many health conditions well-represented at these events.  For me, it was nice to talk about the universal issues that people with chronic illnesses face, instead of drifting around in the bubble of diabetes.  I like stepping outside of our comfortable space and learning about what others are living with.  I need that exposure to other types of patients … keeps me thinking globally.

Part of the panel discussion Read more »

*This blog post was originally published at Six Until Me.*

Chronic Health Needs Must Be Addressed After A Natural Disaster

Sichuan earthquake rescue workers carrying an injured person. Sichuan earthquake rescue workers carrying an injured person. In light of the widespread media coverage of natural disasters, such as the earthquake in Haiti and the tsunami in Japan, the public and medical professionals are aware of the anticipated immediate medical needs in these kinds of emergencies. However, it is less well known that after the initial management of life- and limb-threatening injuries, there may be an enormous need to provide care to persons with chronic illnesses. This is because they are displaced from their homes, become exposed to adverse environmental and socioeconomic hardships, lose access to healthcare, are deprived of their sources of medications, and so forth.

Some of my colleagues were allowed to enter Japan after the tsunami, and their observations agree with this assessment, which was also confirmed in a recent paper, “Chronic health needs immediately after natural disasters in middle-income countries: the case of the 2008 Sichuan, China earthquake,” authored by Emily Chan and Jackie Kim (Eur J Emerg Med 2011;18:111-114). The authors considered physical, social and public health preparedness. Read more »

This post, Chronic Health Needs Must Be Addressed After A Natural Disaster, was originally published on Healthine.com by Paul Auerbach, M.D..

“The Hot Spotters”: Is Better Care For The Neediest Patients The Answer To Lower Healthcare Costs?

Author-physician Dr. Atul Gawande has done it again with a well-written article in The New Yorker magazine entitled, “The Hot Spotters.” It deals with the fact that 5 percent of people with chronic illness make up over 50 percent of all healthcare costs.

If we can zero in on providing better preventive care for those people, we can finally get our arms around runaway healthcare costs. How great that you don’t even have to have a New Yorker subscription to read it. Here are a few cliff notes until you get to it:

— In Camden, New Jersey, one percent of patients account for one-third of the city’s medical costs. By just focusing attention on the social and medical outpatient needs of those people, they not only got healthier but costs were cut in half.

— Our current system is unable to reign in costs. We need to completely re-design and fund how we do primary care.

— Charging high co-payments to people with health problems just backfires. They avoid preventive care and end up hospitalized with expensive and life-threatening illnesses that are much worse and more costly. Read more »

*This blog post was originally published at EverythingHealth*

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