Let's Talk About Grief, Baby

I'm pretty sure when Salt-N-Pepa wrote this memorable song "Let's Talk About Sex" in 1990, they didn't think it would be parodied by a tiny blog discussing grief.  Have you ever seen this music video? The lyrics begin with "Yo, I don't think we should talk about this. People might misunderstand what we're trying to say, you know?...  Ya, but that's a part of life..." I think we need to talk more about "all the good things AND the bad things," which includes death, dying, and grief. The idea of "not talking about something" makes it scarier and allows for stigmatization.  There should be no guilt or shame when it comes to grief, but for that to happen, we need to talk about it.

The Fam <3

If you happen to know me IRL, follow me on social media, or you've read my previous blog post here, you know that both of my parents died from complications from Covid-19, fourteen days apart, in December 2020 and January 2021. (Get vaccinated already, for heaven's sake!)  In the same year, my family also said goodbye to my Uncle Pete (November 2020), and my Aunt Marilyn (my mom's sister, November 2021), not related to Covid-19, but terribly sad just the same. They're the four seated in the front row of this photo from our family reunion a few summers ago, all too young and too special to be gone. In the year this was all occurring, there has been incredible love and kindness towards my family and to me, including gifts of several books about grief. Now that I've read them, this post shares a little about each one, hopefully helping you if you're grieving, or if you're wanting to show you care to someone who has recently experienced loss.  

Source.

First, a definition.  There are many- but what stuck out to me was the third bullet on this one: Grief is "a NORMAL, natural, necessary, and adaptive response to a loss."  I initially felt entirely crazy in my grief. I was a different person and couldn't recognize myself.  Nothing about the grief experience feels normal. I started running late and losing track of time when I'm typically way too early for everything.  I forgot about commitments, getting texts asking where I was, only to realize that I totally spaced it. I said no, when I typically would say yes. I didn't want to help other people, and that's what I do for a career, and typically love. I was angry, I cried hysterically in the middle of Target, I had to pull over on the side of the road because I couldn't see through tears to drive, I couldn't sleep - when normally I'm the ultimate sleeper, I couldn't get out of bed, I stopped cooking, and I went into isolation. I'm about as extroverted as it gets and I didn't want people around me. These behaviors were far from my normal, so for someone to say it was a "normal" response was helpful. 

If you're also grieving, it is likely that your experience will differ from mine.  My brother, sister, and I were going through it together, but we each had (and still have) different responses to our losses. It doesn't do ANY good for us to compare to each other, because the person you're grieving held a personal meaning to you, and the family members I'm missing held personal meaning to me.  I talked to my mom on my drive home from work 3-4 times per week for seven years.  The drive home form work is one of the worst times ever for me... my brother doesn't have that same experience.  Fortunately he'll answer if I call him at that time, knowing what's going on.  Even for the family members grieving over the same people, the hole in your heart and soul doesn't feel the same for each of you. For me, grief has been fear and anger and frustration and sadness and confusion and loneliness all rolled into a ball. And pain. So much pain. I've written many blog posts about pain in the past, but grief is the first time I've experienced so much pain that was 100% connected to my psycho-social experience. There was nothing wrong with the anatomical structure or physiological function of my heart, but there was SO much pain and it was very real. (Come to find out, about 3 months after my mom died, I was diagnosed with pulmonary emboli - so it's possible that there was something going on anatomically, then, too, but that's a story for a different day.) None of my learning about pain prepared me for the pain of heartache.

All the pain and emotions came with gratitude, appreciation, reflection, and love for the people we lost and those who cared about our family. I hope that in your grief, you can find these positives - but they don't shine through every day. At the beginning, almost all of the days felt very dark, with very little time for light. As time has passed, there has been more time for light, and the dark has been less frequent and less intense. Perhaps you'll find one of these books or an idea in this post to be helpful for navigating this unmarked territory. Or at the very least, maybe you'll laugh at something in the music videos and have a brief period of light to disrupt your dark. 

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Book #1; "Healing After Loss" by Martha Hickman was the first grief book I started reading about two weeks after my mom's funeral. A good friend from high school who experienced heartbreaking loss sent it to me with the sweetest note. "Abs - people sent lots of stuff after what happened. This book was the only one I could handle. Short and simple. One page a day. If it helps, great. If not, use it as kindling.  Love ya." <3 My sister actually received it as a gift from one of her friends, too.

I have so much gratitude that I was able to take a leave of absence from work because I could not have been a functional physical therapist - or human - during that early time.  At the beginning, I know I was breathing, but I wasn't really alive.  I would see my therapist and she would ask me how eating, showering, and sleeping were going, and would ask if I had done any body movement at all.  We decided focusing on those basics initially was the best way to go, and beyond those, I set the goal to read a single page each day.  Accomplishing that goal was the first step to a long pathway back to returning to life. This book is set up like a calendar, one page per day of the year with a quote and a meditation related to grief and loss. In the beginning, I didn't have the ability to focus. For someone who reads about 40 books per year, it shocked me that I couldn't read a full sentence, let alone pages or chapters. My mind would wander or I'd just end up staring off into space. I spent a lot of time in the fetal position and, at the recommendation of my cousin, watched the entire series of Lost to occupy time and distract me between phone calls with my family. A book where I could read a single page was ideal - and honestly sometimes I had to re-read the same page several times to get through it and retain anything. Some of the quotes felt applicable and helpful.  Suggestions to move my body to get me out of my head - even if it meant getting up to get a drink of water and then curling back up buried under a pile of blankets. Acknowledgements and appreciation for the people who've been lost, knowing that early on, that's really hard, but that as time passes, the memories won't be as sad and there will be happiness and joy recalling time we spent together.  Recognizing that grief is hard and heavy but that there is life to live if you can manage to move through it is a common theme.  I liked this book, but also read it a page at a time, and once I returned to work, I sometimes would miss a few days, so I still have some left to get through, but I'll finish it eventually.

Book #2:

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My therapist gave me "It's OK That You're Not OK" by Megan Devine. She recommended I purchase this book a few times, but I couldn’t put myself together enough to order it or get it from the library. I was still having all my meals delivered and not leaving my house except to see her every week. Beyond basic survival, I didn't do anything except watch Lost and talk to my family with occasional friend visits, still incredibly fearful of the stupid Coronavirus. So when I arrived at a therapy session, about two months into my grieving, and she handed me a copy of this book, I finally understood how much she thought I'd benefit from reading it and by then, I was capable of reading for longer stretches.

This book was really good because it presents a first-hand experience from the author, who is a therapist, who suddenly lost her husband. She shares her grief and lets you find places where it matches your own. She shares many of the things commonly said to someone who is grieving and explains why some are helpful - and others are painful.

What I'm writing here is what I experienced, but the book explains similar situations, why they're painful, and what to do instead. For example, at the beginning, nobody else could understand what my siblings and I were experiencing. Tons of people said "I can't imagine what you're going through." I have a shoebox full of condolence cards that say that sentence. It's probably an accurate statement, said with good intentions, but instead of saying this, people could have asked what I was experiencing, helped me to process in some small way, and share in my grief. This is semantics... but as I preach in healthcare, the words we use matter, and these circumstances cemented that belief in me. Another common case of good intentions but hurtful words in our situation was "at least they're together." Remember, my dad died, and then fourteen days later my mom did, too.  I don't know about my brother and sister, but initially, I tried to find solace in knowing that they were together, but that never made me feel better. They didn't both need to die. Why couldn't my family at least have one of them, still? 

From "It's OK that you're not OK."

A few people told me they didn't know what to say to me, but they planned to keep showing up hoping that it was good enough. Trust me... it was. It is. The random text messages of my friends' kids on their back yard swing set, late night phone calls, invitations to get together even though I would likely decline, just dropping by to say hello, bringing over homemade dinners, offering to pick up Dairy Queen since you're going with your kids and they'll be quiet eating it in the minivan long enough for you to give me a quick hug? Asking how I was and not accepting "fine" as an answer, making me truly share how I was, and telling me that it was OK to cry, despite my embarrassment... that mattered. Those were really thoughtful and helped me feel like I wasn't forgotten while I wasn't able to live my own life. Friends took care of my house and made sure my mail was picked up, plants didn't die, and had a house cleaner come in while I was traveling for funerals. Showing up, however you do it tells the grieving person that you know they're hurting, and that you're willing to sit with their pain. You're not trying to take it away. You're keeping us company while we try to find air in our lungs. It's proof that we're not alone. Asking about memories so we can feel our loved one with us is even better. A grieving person is thinking about their loved one non-stop anyways... you bringing it up might be hard, but it provides for an outlet.

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The end of this book contains a short essay "How to Help a Grieving Friend."  My favorites: "4. Be willing to witness searing, unbearable pain." "5... Your friend cannot show up for their part of your relationship very well.  Please don't take it personally, and please don't take it out on them."  and "6... Do not say 'Call me if you need anything,' because your friend will not call.  Not because they do not need, but because identifying a need, figuring out who might fill that need, and then making a call to ask is light years beyond their energy levels, capacity or interest." Saying "What can I do" to someone who has a gaping hole in their heart doesn't work. They want their loved one back - nothing you can do will achieve that. Want to bring over a meal?  Offer it on a specific date and time. Want to sit with your friend while they cry? Tell them when you plan to show up. Send a note, a drawn picture from your kids, a text message just saying you're thinking about them. Recognize that your life is continuing with little change, but theirs is frozen in time.  

Book #3: 

Another friend send me this book, a favorite in her family, that is an illustrated story about, "The Boy, the Mole, the Fox, and the Horse." It's a sweet story about kindness and friendship with beautiful drawings.  Though it's the shortest book of the group, it took me a while to be ready to read it because the cover felt like it would be sad, and I was already sad! This one can be read as a book or you can just open up to a page and enjoy the individual messages - it's designed to be read either way. It probably would be a good choice early on, particularly if you're not capable of concentrating very much. And then I sent it to a friend who experienced loss of a special pet, and she seemed to really appreciate it, too. 

Book #4: Last but not least, "Finding Meaning." arrived with a note recommending I wait a bit before diving in and reminding me how many people cared about me. Ten months into life without my parents, I decided I was ready to read it.  I sat in my therapist's office telling her that we were nearing a year of grieving, that I thought it was time for me to decrease the frequency of our sessions after getting through the anniversaries, and that I was going to read my final book about grief before moving on. And then I read Chapter 2 of this book which shares that grief doesn't end at a year or any arbitrary length of time. When asked "how long should someone grieve," the answer is "as long as I'm alive without the person I loved."  It may not hurt as much or as frequently, but that emptiness and sadness exists and can be triggered forever.  The book uses this as part of it's main theme - that Kubler Ross' 5 Stages of Grief end in Acceptance, but that she missed the 6th stage: Meaning. Meaning in the life (lives) that have been lost and in your own life moving forward without them.  Meaning helps make sense of grief.  It can look like gratitude, commemoration, honoring, shifting behaviors after the realization that life is short, or something else entirely.

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Finding Meaning shares the benefits of expressing your grief.  I've written about my grief once before, and spoken about it quite a lot, including discussions with my family about my preference to continue including my parents in our future life experiences, even though they're not here. Some people lose loved ones and they keep their emotions inside and private.  That could be ok for them, but it isn't what feels right for me.  I wouldn't be who I am if it hadn't been for the way my parent's raised me. They'll always get a little bit of the credit for whoever I become, and I will intentionally acknowledge that. This book seemed to examine death more than the others. How our society looks at death as a failure - despite the fact that 100% of people die. It explains that grief is inevitable where there was love, but that suffering is ultimately a choice that we can individually control, though that seems impossible at the beginning of this road. I know I still experience moments of suffering, when the pain overtakes me as I accidentally go to call my mom on my drive home from work, or I want to ask my dad a question, and forget for a moment that I can't. I don't suffer as much as I did before, and I think it's important to share that for anyone who might be grieving and comes upon my post.  Yes - I miss my parents - every single day, but I can continue living and keep them part of my life even though they're gone.

Honorable mentions: I also read Michael Rosen’s “Sad Book,” a book about grief appropriate for little kids written about the loss of his son, and Tom Hart's “Rosalie Lightning,” a graphic novel with incredible artwork depicting the loss of his young daughter. While all of these books helped me in different ways, I didn’t read any specific to loss of a parent, and definitely not two of them fourteen days apart with the added loss of two more close family members, and for certain not during a global pandemic where it was impossible to mourn with the rest of our family.  I would think more people lose parents than spouses or children, but maybe they're not usually as traumatic and they're more expected that less books are written about that?  Above all, I’m so grateful for these gifts, particularly the notes that accompanied each of them, and I can appreciate that others, including many in my family, have felt loss in a deep way this past year.

Added June 9, 2022: At the suggestion of a friend who was also experiencing grief, I read "Welcome to the Grief Club: Because you don't have to go through it alone" by Janine Kwoh.  New in 2021, I was already a year into my grief process when I read it, and liked it.  This book was different than the others and deserves inclusion in my post because it was helpful, supportive, validating, and used multiple mechanisms such as a short page or two of text, questions with answers, characters with speech bubbles, and even graphic representations to help process thoughts and emotions.  I think I would purchase this one to send to someone experiencing grief because it was easily digestible in small chunks, and, considering the topic, it was the easiest to relate to. 

Typical of me, this post has gone on far longer than I intended.  Music often enhances situations, but the anthem of this post can't be "Let's Talk About Sex."  At my Aunt's funeral, my cousins chose to play "You Are My Sunshine," which my Aunt sang to them - and my Mom sang to my sister, brother, and me. I couldn't believe the snow that started falling while a song about sunshine was playing. For me, I tend to cling to a song during emotional times, particularly if the lyrics seem to fit the situation.  Later on, if I happen to hear that song, I flash back to that time and appreciate the memory having a theme song to accompany it. Since my parents died, I've been cherishing the comfort from my family and my oldest friends, and so for many months, I've been playing Ben Rector's "Old Friends" on repeat. Those friends who are more like family, like my cousins who also feel like friends, all of which knew my parents. People who were sad about what was happening for their own reasons and grieving alongside me. I think people who are sad need to find what feels most comfortable, and for me this was what felt right. "Cuz no one knows you like they know you and no one probably ever will, you can grow up, make new ones, but the truth is, there's nothing like old friends... I've got some good friends now, but I've never seen their parents' back porch. Wouldn't change how things turned out, but there's no one in this time zone who knows what in-line skates I wore..." Some awesome lyrics on repeat for many months filled with sweatpants, blankets, tea and LOTS of tissues and FaceTime.  So why not post two different songs with entirely different tones and messages to round out the same blog post? 

If you're grieving, I'll keep it real and tell you this sucks. So much. And it hurts, right where your heart is beating in your chest. But it's normal to feel this way if you've had love in your life. You're not alone. And while you'll continue missing your people, there is life worth living even without them, and you can bring your memories of them along with you.  Take photos with your loved ones when you see them next... you'll be glad later.  And tell people you love that you love them. 

If you need help, here's the Crisis Grief Text Line for you to get help right now.

Sending love to Aunt Marilyn, Uncle Pete, Mom, and Dad. Always. TTHAS. 

COVID19 is the WORST

I haven't written a blog post since December 2020 and had dramatically reduced my writing during the pandemic because I didn't think anything I had to say was nearly as important as what was happening in the world.  My last blog post came shortly after my dear Uncle Pete passed away and COVID was surging as people traveled for the holidays, celebrating Thanksgiving and Christmas without taking proper precautions.  

Glacier National Park July 2020

In late December, I started writing this post and I've kept a few parts because it's how I felt at that time. I really wanted to say that 2020 was the worst year ever but some great things also happened.  Babies were born, people got engaged and married, we bought condos and houses, passports were tucked away and exploring the beautiful national parks of the United States increased, there was time to complete home improvement projects that would otherwise remain on To Do lists, The Seattle Storm won the 2020 WNBA Championship in an isolated bubble, and the demon in the White House was evicted.   Instead, I'll say that COVID19 is the absolute worst.  The SARS-CoV-2 virus has destroyed millions of lives around the world, imploded economies and closed small businesses forever, had permanent impacts on relationships, and exposed real systemic weaknesses in the United States and in the world.  And it took both of my parents. 

I've missed blogging. I like organizing my thoughts this way.  Many of my past blog posts have tried to make connections between two things which may seem unrelated.  I like to draw these connections.  With this post I'm seeking ways to heal my broken heart and hoping that someone might learn something from my family's experience.  Perhaps I've gotten some of the facts wrong... the stress level was unbearable and I'm forgetting details.  It isn't intentional.  At the time of this writing, over 560,000 people have died in the US and 2.92 Million people worldwide from the Coronavirus.  (That makes the US about 20% of the deaths from the virus worldwide).  I'm sure others have similar stories of loss and sadness from the virus or from losing loved ones during the pandemic where they wouldn't be together.  My heart goes out to every single person who has lost someone they loved during the pandemic. I think it always must be hard to lose someone, but the inability to say a real goodbye or be surrounded by loved ones while mourning seems to hurt just a little bit more.  Here's how I remember what happened to my parents.

In December 2020, nine months into wearing masks, physical distancing, a lot of isolation, restricted travel, and not eating out, my Mom and Dad were hospitalized in Florida. Dad was admitted on 12/18/2020 and my mom followed the day after, 12/19/2020, which happened to be my dad's 76th birthday.  They both tested positive for COVID19, and they both had pre-existing conditions that put them at higher risk for getting sick and having a negative outcome.  They knew they were at high risk.  In fact, my Mom had been sick for almost the entire year of 2020.  They promised us they were being extremely careful.  They would drive over to friend's houses and stay in their car and talk to their friends over the phone just to see friends but not get close to them. They have such great friends who have been so supportive to us through this tragedy.

Most people asked right away "How did they get it?"  Honestly, we'll never know.  Dad worked at Home Depot, coming as close as he possibly could to his childhood dream of owning a hardware store.  He was "The Paint Man" and he promised he wore a mask during all of his shifts, washed his hands, and would even come home, remove his clothes next to the laundry machine and go straight to the shower so he wouldn't go near my mom until he was clean. There was a whole bin of Clorox wipes, gloves, disposable masks, and hand sanitizer right next to the door when we arrived at their home to pack it up... and cough medicine and tissues on the counter. They seemed well prepared. (They also had a TON of toilet paper.)  Perhaps Dad missed a hand wash.  Or maybe he ate a snack near someone asymptomatic but sick in the break room.  Or maybe his mask slipped down under his nose while his hands were covered in paint and he couldn't fix it.  He was admitted to the hospital first, but for sure they were both sick for several days at home.  I ordered a pulse oximeter while we were Skyping when I heard them both coughing maybe three days before they were admitted thinking there was really nothing more I could do to help them.  It was waiting when my siblings and I arrived to clean the place out.  I had been too late.

Thanksgiving 2019

Mom could have contracted the virus, too.  As I mentioned earlier, 2020 was a medically complex year for her, in and out of medical facilities and the hospital, so being around lots of sick people while also being vulnerable could have gotten her sick. They always shared things, so whoever got it was thoughtful enough to give it to the other one.  My heart kept telling me to get on a plane to help them, but I couldn't get over the fear of seeing all my own patients and their families at work and then getting on airplanes to travel more than 3000 miles to see my parents, knowing I could get them sick myself.  So I never went.  The last time I hugged them was Thanksgiving 2019. 

Initially when they were admitted to the hospital, my brother, sister, and I were able to video chat with each of them for a few days. Piece of advice: if you EVER go to the hospital and have the ability to bring your phone charger along, do it. Dad was on a COVID floor and put on oxygen right away and told me he felt crummy.  He said he was bummed they didn't give him chocolate pudding on his birthday - he got applesauce instead - so his sense of humor was intact.  Mom was admitted directly to the ICU because her blood counts were so low, but that was her baseline all last year, so she didn't really seem that different from her usual self.  (Side note: It's mindboggling that our healthcare system doesn't share information so that their medical records were not readily available. Why do I have to tell an ICU nurse my mom's list of diagnoses when she's in the hospital and her doctor's office is a few miles down the street?! I wonder how many people have died just because the US Healthcare System is so messed up. I digress.) 

Thankful for Video Chats

Mom had a blue ice pop and stuck her tongue out on a video call while my niece and nephew were around, never wanting anyone to worry.  She wasn't willing to allow people to "see" her without her hair done or her makeup on - saying she only wanted to video chat with us and my cousin Brad.  He was always her favorite and I'm so glad he was able to keep her company, too. We rotated who called them around our work schedules to occupy time and help us through and also called many times all together.  We spoke to every nurse who came into contact with them, asking how they were doing, getting updates every few hours or asking them to help us get in touch with Mom because she couldn't figure out how to use her phone, and then they would walk us down the hall with her phone so we could say hi to Dad. I spoke with the physical therapist who had seen both of them, and she advised me not to plan to take my mom home directly from the hospital and to let her go to rehab because she was so deconditioned. 

Soon we learned that Dad also had pneumonia and difficulty breathing. Mom was moved into Dad's room, having been deemed medically stable and no longer needing the ICU.  We were so glad they were together, but that was short-lived (unlike their 53 year marriage).  He turned a corner that night and took her place in the ICU needing a BiPAP to help him breathe and getting agitated if the oxygen wasn't at full flow.  On a BiPaP, you can't really talk - though you can move your mouth.  For a few days he was able to see us and respond to us and tried saying some words, including mouthing that he loved us, which will forever be his last words in my mind.  And then he got worse and we had to make really hard decisions. 

Here's where I hope we can be helpful to someone else.  Piece of advice: If your parents have comorbidities or are over 65 years old, sit down with them while they're healthy, while they're not in a medical crisis, while everyone is calm, and ask them about how they want things to go in the end. It is a HARD conversation, but it makes a huge difference when a stressful moment comes.  Tell them the importance of having a living will and sharing with you what their wishes are and where they're keeping the paperwork. Get copies if you can.  A living will (or advance directive) is a paper that indicates your wishes for medical care and should go with them if they ever need to go to the hospital so the hospital knows their wishes, too.  Let them handle the hard decisions for you and have it decided in advance.  Fortunately, we had sorta done that with our own parents, though they didn't bring the paperwork to the hospital and there was confusion in the heat of the moment, but still... we weren't completely in the dark.  Mom's oxygen stayed mostly normal throughout her whole hospital stay, but she had starting getting really confused right when things were happening to Dad, which I think was a blessing, but which also left it up to the three of us to decide what to do. 

Backing up for a moment, in 2018, I read Atul Gawande's book, "Being Mortal: Illness, Medicine and What Matters in the End." The basic premise is that Dr Gawande, the author, is a physician whose father is nearing the end-of-life.  He realizes that not only does he not have enough of the answers for his own family, but that he also does not guide his own patients down some paths that could ultimately help them. This was the first time I seriously considered that when someone is very sick, they may not want every single medical approach used to try to keep them alive. Some medical approaches can keep you in a coma for a long time and, while that’s your choice to use those options, it’s possible you’d prefer to allow life to end more quickly as the likelihood of recovery from those extreme medical treatments may be less successful with more comorbidities or older age.  This was exactly the scenario we faced with Dad, first, and then Mom two weeks later.  Both were presented with options.  One option would have kept them alive, but almost definitely would not lead to them ever going home and returning to their prior existence.  We really only considered these options while waiting to find out if the facilities they were in would let us come and say goodbye to them, but when we were told that would not be an option, we didn't want them to suffer.  This quote from the book stood out to me: “We’ve been wrong about what our job is in medicine. We think our job is to ensure health and survival but really it is larger than that. It is to enable well-being. And well-being is about the reasons one wishes to be alive. Those reasons matter- not just at the end of life- but all along the way.”  

The book lists questions that should be asked nearing end-of life such as "what are your fears?" and "what are your hopes?" and "what is your understanding of the situation and its potential outcomes." It also talks about weighing short term versus long term options, considering risks versus benefits, and gives praise to hospice and palliative care, which are not the same, and which are often misunderstood.  It was the beginning of my learning about end-of-life care and it led to a family meeting with my parents, sister, and brother, where we talked about some really key things, including their living will.  We also talked about their legal will and found that it was long overdue for being updated. (It still had my sister as my legal guardian if something happened to my parents.  I was 33 at the time!).  We discussed where they kept their finances, but they elected not to share their financial circumstances with us.  We should have asked them to add one of us as a beneficiary to the accounts in addition to them, but the likelihood of both of them dying two weeks apart like they did was really tiny so who could have known?!  We knew their life insurance policy company and numbers and knew where they kept their passwords for online information.  These are all things that we did right that I think other people need to discuss and made things easier for our family.  I had a manila envelope with a copy of their will and living will, a copy of their life insurance policy, their social security numbers, and a list of contacts they thought were important for us to reach out to if something happened to them such as their lawyer and accountant.

Anyways, I'm pretty sure it was Christmas Day when Dad tried to ask the nurses for something and they gave him a notepad to figure out what he was trying to say. He wrote "milkshake." He wasn't allowed to eat or drink on the BiPap, so they couldn't give him one and I'm shocked he was able to manage legible handwriting since it always looked like squigglies to me. My Dad ALWAYS loved Chocolate Milkshakes from McDonalds so when the nurse asked if that had any meaning to us, we all had to laugh.  I'm sure he probably thought life wasn't worth living if he couldn't have his favorite treat. 

Another piece of advice: find yourself a best friend who is an Emergency Medicine Physician and loves your parents as much as you do so that when you ask her for help with complex medical decisions, you know it's the best recommendation possible for your family.  This piece of advice will be nearly impossible for most people to achieve because you can't have my best friend and she's the world's greatest human, so maybe just find some medical friends you trust for advice when it's needed and know that making these decisions is really hard so having people to discuss them with is really helpful.  My sister also has a best friend who is a nurse who gave us helpful advice throughout this experience and is part of our family, too.  Having healthcare provider friends is just the best and really helps with big medical decisions. 

We said goodbye to our Dad, all three of us together, on a video chat arranged by a very kind nurse, about an hour before he passed away on 12/26/20.  The nurses were so helpful to us having already missed their Christmas time with their families to be with ours, and certainly having witnessed countless other people die in the preceding months. She asked us for a list of important names for her to tell him who was with him before they took him off the BiPap.  My Mom was somewhere in the same building, unable to be there with him, and not knowing what was happening.  I like to think he knew that we were with him and that it was OK for him to leave us behind.  (To be clear, I'm not OK with living life without him, but he didn't need to know that.)

So now, my mom is in the hospital in Florida, testing negative for COVID but still disoriented and confused, my sister is in Connecticut, my brother is in Washington DC, and I'm in Seattle. We need to get my Dad transported from Florida to Connecticut for his funeral.  And we can't have family or friends there - just immediate family up to 12 people.  And... we have to tell my mom what has happened.  Because she doesn't know.  And when we tell her, at first she doesn't understand, and then she doesn't remember.  And so, we have to tell my mom, via video chat, three days in a row, that our Dad - her beloved husband and best friend for over 50 years, has passed away.  Talk about watching someone's heart break.  Repeatedly.  Her heart was actually screaming, I think. The sounds that come from such intense heart break are unique and hard to describe. Even a few days later, on one of our calls just between the two of us, she asked me about Dad again to make sure it was true, begging me to tell her that he had not suffered, almost like she heard it in a dream and couldn't bring it to reality.  And then her nurses tell us they want to discharge Mom to rehab for her to get stronger and eventually go home, but of course she doesn't want to go home if he won't be there. I cannot even begin to express how much agony those moments held and how I keep replaying them over and over in my head.  My heart broke for her so many times and none of us could be with her - or even with each other.  The medical facilities all kept saying we wouldn't be able to come in and be with her - and for us to even try to fly there only to be turned away seemed like even more risk of getting sick or transmitting the stupid virus.  

I haven't gone into much detail about what the day-to-day looked like while they were in the hospital.  Honestly it was a bit of a blur.  I was talking to nurses or doctors between 4AM and 5AM PST (Seattle) because they did shift changes at 7AM EST (Florida) and then I would see my own patients.  Sleep cycles were disrupted, the stress of everything made eating habits and exercise routines fall apart.  My brother, sister, and I were in constant contact with one another and I would sit in my car during my lunch hour trying to video chat with my Mom as much as I could, and, early on, hoping to get some time to chat with Dad.  We quickly figured out the best times to call nurses and how to set it up so we could actually see Mom and Dad through various video chatting options.  Since we don't all have iPhones, we figured out that we had to do our video chats through Facebook or WhatsApp and knowing our options was important, otherwise we had to leave someone out and it was hard to take in all the information and then repeat it again later on. 

So Mom went to rehab.  She started to get better, but she was really, really sad.  So were we. She always had told us that she couldn't live without Dad and we all worried for her because we knew she couldn't stay in Florida alone.  My sister was looking for a place for her to live in Connecticut, calling around to all the local facilities, because Mom was pretty sure she didn't want to stay with any of us even though she didn't want to be alone.  My brother was on-deck, waiting to head to Florida to pack up all their stuff for a move.  I applied for FMLA to take time off when she was cleared to go home after my second vaccine shot and told her she better rest up because Abby's Boot Camp was going to be hard work.  (It's probably not a good idea for physical therapists to treat their family members, but I think that's because we would work them harder than our patients!) Everyone fell into roles and pulled their weight to get things going while we were also preparing for Dad's funeral which was going to be on 12/31/20.  I think it brought Mom a lot of happiness to see us all together in Connecticut.  I had flown home and wouldn't take off my mask the whole time I was with my family because so many people in the airports and on the plane weren't wearing masks and having watched my Dad die from COVID, I was horrified of getting the virus and spreading it. The day before his funeral, I Facetimed Mom and explained that we were going to have his funeral the next day and who we had invited. I asked if she wanted to attend virtually but I hated that none of us could be with her for it and thought it was reasonable if she didn't want to go through that alone. She chose to watch, so the next day, I Facetimed her from the cemetery so she could attend my Dad's funeral.  Was this the worst it was going to get?  Because it was horrible.  I had headphones in so she could talk to me and I could be with her, but the only thing she asked was to see her grandkids and my sister and brother for a minute to look away while my Dad was lowered into the ground.  That night as the rest of the world rang in the New Year, eager for 2021 to start, I sat alone in my hotel room on Facetime with my Mom, crying, talking about things we would try to do as soon as we broke her out of rehab.

Mom wanted out of rehab SO badly and we all wanted to bust her out, too.  She asked me what I thought she needed to be able to do in order to go home and, the true Physical Therapist I am, I told her she needed to be able to walk to the bathroom without help.  The minute she walked to the bathroom with a walker and only a little help, she called and told me I had better get ready to go to Florida.  But that night she started having pain.  All year long when she had been sick, she had been having some pain on and off, but she said this was a lot worse.  Talk about feeling helpless - what could I do?  I stayed on the phone while she waited for nurses to come in and try to get her pain medicine.  She was moaning and crying out.  I had to hang up to go to the bathroom and in the time I was gone, she left me a voicemail saying she wasn't going to make it through the pain she was having.  In the morning, she was taken to the hospital.  She tested positive for COVID19 again and was found to have other health complications.  It was time for difficult conversations, yet again. The doctors asked for our opinion on treatment versus hospice, but we knew her chances of survival even with surgery were not good and when we asked Mom, she very clearly told each of us that she loved us and that she was going to go be with Dad. I couldn't believe my ears.  Now my heart was doing the screaming. And so she was transferred to Hospice and we said goodbye and she passed away two weeks after Dad, on 1/9/21. A few days later, I flew back from Seattle to Connecticut, stood at the same cemetery, and watched my Mom join my Dad, feeling like I should have been Facetiming her like I had two weeks earlier. 

RIP Mom and Dad <3

I'm sure there's more that I could share that would probably help others in the future, but my heart has broken too many times writing this much.  I think you have to cry some serious tears to move through grief, and I've been doing my fair share. I hate crying in front of other people, but unfortunately I can't seem to avoid it these days. The aftermath of losing both of them so close together has been incredibly long and challenging and still continues.  It feels quite like an open wound that keeps re-opening every day or two as more paperwork or phone calls or bills are managed.  I've never been so grateful to have siblings and my niece and nephew.  We all had our breakdown moments and different struggles through the past three months.  We have different support systems, different jobs, and different home responsibilities.  At the end of the day, we've been there for each other, and that has made all the difference.  I can't wait for the pandemic to end so we can all be together and appropriately honor my parents.  The rest of my extended family and so many of their friends need their opportunity to mourn, too, and that has been neglected during the pandemic.  I hope that someone finds a way to put our pain to good use, and I can't wait for the pandemic to be under control.  Please get vaccinated when you have the opportunity and continue to wear masks and stay distanced.  It's not time to party yet.  Don't let your family members suffer the way mine have.

Science of Social Isolation

A few weeks ago, during the insanely stressful period of the United States Presidential election on top of a global pandemic, I wrote this post on Facebook:

Since that time, things have gotten progressively worse.  Last night I got into my car after work and burst into tears in the parking garage.  Instead of driving home, my car (not a self-driving vehicle, but somehow able to drive without my brain functioning) drove to my dear friend's house, still in the beginning of her post-Thanksgiving quarantine, and I melted on her front doorstep.  As my mask collected my tears, I crumpled.  I definitely didn't see it coming, and for certain I'm not ashamed to admit that I had hit a complete and total breakdown.  I'm not sure if sharing this helps others to realize they're not alone right now in whatever deep, dark place they might feel like they're existing in.  Maybe this makes people more sad.  But I've now reached the portion of the pandemic where spontaneous crying is occurring, and I know that I'm not the only one in Struggle City.

Why now?  Maybe it's the new restrictions from the Washington State Government shutting down the gym which was the only place I was really going (besides work, the grocery store, and Home Depot).  Maybe it's the winter in Seattle where the days are gray and cold and the sun rises late and sets early so you feel like you're in a Stephen King novel all the time.  Maybe it's the holiday season without being able to see family or friends, none of the usual festive parties and seeing everyone's trees and menorah's all brightly lit.  Thanksgiving with a close friend was really great - but we didn't shy away from acknowledging that the world is weird and so heavy right now.  Or maybe it's the fact that I attended two virtual weddings and a funeral in the past few weeks, all of which would have been supremely better experiences if I had been there with my family and friends.  The list of possibilities for why this hit me now goes on... but those seem like enough.  I'm sure you can come up with your own.

The reality is that I was not built for social isolation. Early in the pandemic, I felt like going to work was enough social interaction for me to keep on thriving. It isn't anymore. You can sense the weight of the Coronavirus in every corner at work, on every coworker, at every socially distanced lunch break, and with every single patient/family.  As a 100% extrovert, I feel like a battery that has been running on empty for so many months. Drained. Nothing left to give. My usual options for battery recharging are not available... dinner with friends, eating out, traveling to see my family, traveling to escape the Seattle weather and find sunshine, hugs, the gym, occasional visits with my friends' pets, sitting at a bar, sporting events, movies... another list... I'm rambling.  It doesn't energize me to work out at home or go for a walk alone.  Isolation in a different place doesn't change my feeling of being alone.  Skype calls - though they definitely help - are just not the same as dinners and happy hours or brunch.  Remember brunch?!  I don't bother with take-out meals on my own.. seems silly when I can just make something at home and save money. Why take a day off from work to do absolutely nothing? Amazing that bathroom renovation and painting my whole house boosted me up for a while.  If this is making you sad or depressed, I'm truly sorry.  I'm not depressed... I'm just insanely aware of being alone, emotionally exhausted, and feeling like the world is too heavy.  How did Atlas do it? If this is how I feel, I can't imagine how my superiors or those who actually work on the front lines are doing it... cuz I'm not even treating patients suffering from COVID!

So what's a person to do when realizing that social isolation is kicking them in the face?  The options are pretty limited right now.  Today I started looking up research about the science of social isolation.  With patients having chronic pain, we teach them how pain works to try to help alleviate it... maybe learning about social isolation will help me cope?  I used ResearchGate to look at this 1988 paper "Social Relationships and Health" by James S. House. Interestingly, I also came across a monthy by month list of citations for this paper's abstract and, not surprisingly, it has been cited an average of 2,000 times per month in 2020 where it would only have gotten a few hundred citations before the pandemic

Here's what I learned:

1: Prospective studies have found an increased risk of death in people who have low quantity and sometimes low quality social relationships.

2: There has been longstanding curiosity with regard to which comes first: do people who are less integrated into society have bad health or do people with bad health integrate into society less?  Gotta love a good chicken or egg conundrum.

3: The connection between mental health and physical health has not been studied with nearly enough depth or breadth.  Before I started learning about mental health - and giving any thought to my own - I'm not sure I even believed they were so intricately related.  Now, I don't want to go more than a week or two without seeing one of my mental health providers.   

4: My favorite quote: "...what was consequential for health about social relationships was their supportive quality, especially their capacity to buffer or moderate the deleterious effects of stress or other health hazards."  

5: A 1965 study looking at 4775 people between ages 30-65 examined four types of social ties: marriage, contacts with extended friends and family, church membership, other types of group memberships and the impact on mortality.  It was at this point that I realized the articles I had skimmed - and this one - don't fit the problem I'm experiencing.  I have really, really, really wonderful relationships.  About 90% of the time I'm at grossly unaware of fact that I'm not married... sure underneath and when brought to the surface, that's missing, but I don't sit around thinking about it on the regular.  But truly I have so many great family and friendships... and right now I can't be around any of them!  Does their absence have the same meaning?  

So I searched for more papers and read more abstracts.  Because I'm a science nerd and... seriously what else do I have to do?  I'm going to be here sitting on my couch either way - I could do this, read a book, or continue binge watching Friends.  At least this is a little bit different, and I can share it with you.  I scanned abstracts that look at the neurobiology of loneliness, the relationship between social isolation and cardiovascular illness, saw lots of information on social isolation for the elderly population, psych papers looking at depression, and then:

"How the  Covid-19 Pandemic is focusing attention on loneliness and isolation," a June 2020 paper from Australia.  Here's what I learned:

1) Social isolation (absence of social connections) is not the same as loneliness (subjective dissatisfaction with relationships).  I feel loneliness when I find myself single at a wedding... I feel social isolation when I haven't seen my parents in a year and my friends in several weeks as we are responsibly distancing ourselves to prevent COVID spreading.  Both social isolation and loneliness have been shown to predict premature mortality, depression, cardiovascular disease, and cognitive decline.  (Hello brain fog!)

2) I'll give you a hint at the recommendations for how to improve the negative feelings: exercise and social interaction.  

And so, I'll end with this.  Check out this image and find out where you're at.  If you're in the green and yellow - maybe you have the capacity to check in on your friends to see where they are.  Yesterday I was in the red.  Thankfully, today I'm more yellow/orange and had the ability to check on someone else.  But yesterday I needed someone to check on me.  Know that it's ok to tell someone you need help.  Tell me!  Tell your neighbor.  Tell your family.  Tell someone.  Just saying the words "I really need help right now" made all the difference in letting some of the weight go.  No shame in tears... I know mine will come again.  In the end, we're all going to be ok.  We're all going through this together.  It sucks for everyone.  It sucks for parents who are schooling their kids at home and can't get a moment of quiet alone time - and it sucks for those of us who are alone.  It sucks for healthcare providers, teachers, grocery store workers, real estate agents, business owners, and delivery people.  Honestly, it's pretty hard to find someone who hasn't been impacted by the pandemic at this point... and it took every ounce of strength not to lose my mind on the parents I saw congregating at the playground today, maskless, and too close together, when I dragged myself out of the house to go on a physically distanced and masked up walk.  We all have an obligation to help keep each other safe, now.  We all have an obligation to care for our friends and family.  Let's hope the vaccine is near and that we can go on airplanes again in 2021!  Good thing I'll have some vacation time saved up. 

Wide Open Wednesday and Tourist Thursday

Kristen’s hard work blogging continues. Days 4, 5, and 6 are completed. I’m not sure where she finds the energy as I basically collapse into a coma at the end of the day and am minutes from doing so again right now. 

Wednesday’s Day 4 adventures on Kristen’s blog are here. I earned my keep driving about 500 miles through half of Wyoming and most of South Dakota. I didn’t think this drive was as bad as everyone said it would be- though for sure it was much flatter and far less scenic than our previous few days. I enjoyed the sporadic surprises along the way. 

We stopped at Mount Rushmore and the Corn Palace which were both cool.  I love seeing the unique features of basketball arenas and this one was for sure the most unique arena I’ve ever seen. I’m missing the WNBA season pretty fiercely so a moment in my happy place (a basketball arena) was an awesome boost to a day of driving over 700 miles. We had plenty of time to discuss how nobody here really seems to be doing anything differently regarding the Coronavirus- except there’s probably more hand sanitizer available than usual. 

Wednesday we crossed the half way point. We listened to lots of music and some audio books. Both of us took car naps. We passed through Hartford, South Dakota which made me feel a lot closer to home. We didn’t hit the cow that was in the middle of the highway... I yelped a bit when I came upon it and may have awakened Kristen in shock.

(Please note the previously mentioned bug cemetery windshield, too).

Then Tourist Thursday came about where we did a bit less driving with a crash course in Chicago tourism with a visit to Navy Pier, the Cloud Gate aka the bean, and Giordano’s pizza for some deep dish. Unfortunately the Air BnB we had booked in South Bend, Indiana was a hot mess and after maybe 5 minutes walking around it and thinking we might not live to see the East Coast if we stayed, we hit the road and kept driving while finding a hotel room to crash in. I guess I’ll have to save Touchdown Jesus at Notre Dame for another time. I’ve still never seen that campus despite driving through here at least 3 times in my life. Somehow I never ended up there with UConn Women’s Basketball... and this visit tells me that maybe I’m just not meant to see what the Fighting Irish campus has to offer.  Kristen’s more detailed post is here.

Today we completed Indiana and booked it across Ohio and into Central Pennsylvania with the major highlight being a family visit.  Overall we’re making great time, haven’t run out of things to talk about, and are about an hour and a half away from splitting up to our final destinations. See ya tomorrow, CT!

Yellowstone and Grand Teton Tuesday

Day 3 went by so fast!  We didn’t drive very far but we explored two National Parks- Yellowstone and Grand Teton- both really awesome, though we both preferred Grand Teton. This has been my first visit to Wyoming and it was certainly a unique place to visit. 

Here’s the link to Kristen’s Day 3 post for you to check out! And a video clip from each park. 

Montana Monday

Hey again!  As previously discussed yesterday in this post, my friend Kristen and I are driving from Seattle to the East Coast. She’s an adventure blogger so she’s been writing all about our experiences and I’m a day behind her in reposting them. Here’s her post from yesterday.  Yesterday we spent the day in Montana with the highlight being Glacier National Park.

Feel free to follow along our journey... or text us. We’ve got 2000+ miles still to go!

Cross Country Road Trip Day 1!

Happy summer everyone!  Whatever summer looks like during a global healthcare and national humanity pandemic.  I’ve really been struggling to write blog posts the past several weeks because sharing PT knowledge isn’t as important to me as the time I’ve spent reading about the coronavirus and the systemic racism pervading the US. 

And then, I learned the sad news that my coworker pal, Kristen, (Who I went to Africa with and have previously written blog posts about) was leaving Seattle Children’s to join the PT crew at Boston Children’s Hospital. But moving during a global pandemic, which I did during May, is more challenging than usual. She wanted to drive but it’s so far to go alone, and so our plan to road trip across the country was born.  

Road tripping isn’t one of my usual blog posting topics, but Kristen writes about her adventures, so I’m sharing hers as a blog of our trip. Check out her day 1 post from yesterday at this link and make sure to comment on her posts and answer her question of the day! 

Life in the Time of Quarantine

Hi Everyone -

Hope you're all hanging in there, enjoying being at home as much as you can, staying safe, washing your hands and faces.  Is your mental health ok?  Have you gotten any fresh air?  I know that might be hard for some people.  It has been over a month since my last blog post, but that was certainly not for lack of trying.  I've started to write several times in the past few weeks but the Coronavirus Pandemic has actually left me speechless. (Shocking, I know.)  I can't go to my usual coffee shop where I like to write and life has been turned upside-down, just like I'm sure it has been for anyone reading this.  I'm not a scientist and won't pretend to know anything about the virus itself.  I've never been more aware of how much I touch my own face - and even still I probably don't notice it more than half of the time. I'm not on the front lines fighting this, so don't let the masked image later in this post fool you.  I'm spending most of my time in isolation at home when I'm not in the clinic with occasional stops at the grocery store as needed.  Writing a blog post hasn't been on my priority list because I couldn't decide what to write about in the shadow of a global pandemic. As a writer friend recently told me, sometimes you just need to sit and write, let it flow, and see what happens.

Writing is an outlet for me.  I use it to help organize my thoughts and relieve stresses.  It offers an opportunity to be creative, use different areas of my brain, share ideas, highlight things I'm learning, and to show support for causes that matter to me.  At a time when I'm also not seeing my usual collection of mental health providers and also not going to the gym, the sudden and total removal of so many outlets has been a big deal. It helps to know that everyone else is in the same boat.  Nobody else is going to the gym.  We're all working out in our laundry rooms with whatever we have at home or going for walks in the neighborhood.  I've heard of people doing lots of different crafts, trying out meditation apps, yoga in the home, new types of exercise, and some people are buying pets in order to find novel coping methods. You're not alone...we're in this together!

So I'm writing today.  Without having any planned direction or goals.  I've seen a post going around on Facebook that people want to remember what was happening because this is going to be a historical event.  My parents remember when JFK was assassinated and my friends and I all remember where we were on 9-11.  This will be another memorable event for so many people... and nobody will forget where they were because we've all been on our couches for three weeks already!  So this is not my usual blog-writing approach. Welcome to my stream of consciousness.  My apologies for being scatterbrained.

At the beginning, I thought this was challenging because I felt trapped with nowhere to go.  My family is far away.  I was still seeing patients early on and didn't want to risk getting anyone sick. The first week I saw friends who had already started working from home, but then it seemed wrong for me to be around them.  Once I got into a rhythm, particularly with regular afternoon FaceTime gatherings, things started to improve.  The hardest moments have been worrying about my friends who work on the front lines, concerns about my parents and not being able to help them, and realizing that the Final Four was not going to occur.  This weekend should have been the Women's Basketball National Championship - often referred to as my favorite holiday.  Several of my friends here in Seattle have been connived into outings at random bars around the city to watch games with me.  I'm more than happy to treat my friends to some nachos if it means company to watch the Huskies. The NCAA College Basketball Season was so suddenly aborted after the best year of competition EVER. I don't think it quite hit me until all the replays from previous championships started popping up on social media and I realized how much sports can bring people together, how many years of my life I've spent watching basketball games, and how serious this pandemic really is.  You'd think being told to wear goggles, masks, and gloves to treat my few remaining patients would have been sufficient. If you've never worn them - those things are hot, sticky, and make your glasses fog up! 

So now that I've rambled on, I guess I should find some sort of purpose for taking your time.  All I can come up with is gratitude. On Wednesday, March 18th, I went into my clinic to call my patients and cancel their scheduled appointments. That was sad, but a few days later, I started to really miss what I do. I have fortunately had a few days in the office to treat high priority patients and each time I've seen a patient, I've felt life being restored to my body, air returning back to my lungs, energy surging, and the return of my dimply smile.  Endless gratitude reflecting on how my career has unfolded to this point where I have the world's best coworkers all collectively waiting to restore our previous routines.

I'm grateful for the small businesses in my local community who have been able to transition their usual operations to help support everyone at this time.  I've enjoyed some really good take-out meals in the past 18 days at home and highly recommend supporting your small local businesses that are trying to survive.  I'm grateful for all the people on the front lines - healthcare workers, front desk workers, environmental services cleaning crews, demand flow services, and leadership - in my office and throughout the country and the world who are taking care of so many sick people.  I'm grateful for books, the fact that I had too many out from the library when this all started that I'm slowly working my way through, and also audiobook downloads available from the library, and Netflix and Amazon having rentals to watch movies.

I'm grateful for all the different electronic user interfaces that have made it possible for me to have face-to-face conversations with so many people.  Between FaceTime, Facebook Messenger, Skype, WebEx, Zoom, Google Hangouts, and HouseParty - it really isn't hard to connect, but those virtual gatherings don't quite feel the same. There were a few days last week where I bounced from call to call catching up with old friends, seeing how family members are doing, and trying to find that missing sense of connection.  Today my extended family gathered on Zoom in preparation for Passover to begin on Wednesday.  Check that out! People in 20 different homes in at least 10 different states ranging between Washington, Connecticut, Florida, Ohio, Oklahoma, California, and Washington, D.C.

I'm worried for my friends who are working to save lives.  They have families and kids of their own and are at extremely high risk. I wish I could do more to help them, to help sick people, I guess just to help anybody. The most any of us can really do right now is to stay at home and prevent further spread of the virus. I'm very hopeful that when this all ends, there will be improvements made to how we operate as a country and as a healthcare system.  Let's hope this wraps up in time for everyone to enjoy summer.  Let's hope this doesn't destroy families financially, or in any other ways.  Let's hope we can resume travel soon.  Let's hope everyone stays healthy and safe.  And let's hope we can have a massive celebration together on the other side. Let me know if there's anything I can do to help you out.  We're all in this together.

2019 in Review

Reflecting...

This is my third "Year in Review" blog post since starting "Abby's World" in 2017.  (If you wish to read my previous versions, 2018 is here and 2017 is here.)  When reflecting on this blog, I feel gratitude to those who have read posts - one or many, I cherish the experiences that I've been able to document here, I acknowledge that I still don't know my target audience and I've embraced that.  I like that I chose a name that allows me write about random topics, though I wish I had come up with something more creative.  My mind wanders a lot... my blog topics only tend to wander occasionally. For the most part, I've stuck to Physical Therapy/Health and WNBA Basketball/Women's Sports, but I've thrown in some odd topics along the way, too, like this post which had weird photos of my eyelids.

In summary, since starting the blog, I've written 110 posts with a collective total of over 25,000 readers. I've had two posts eclipse 1,000 hits (this one about Physical Therapist Board Certification and this one about sport specialization), and I'm sure they're not my mom reading the same post 1,000 times. I posted less in 2019 than in 2108, but I also traveled and read a lot more. I like this pace and expect it will be similar in 2020.  Here are a few of the highlights from 2019, both personal and professional, and a look forward to what's coming in 2020. 

The beginning of 2019 was insanely busy.  From January through early April I supervised my first PT student who I wrote about here. In March, I presented advanced anatomy and biomechanics of the shoulder at a Youth Upper Extremity Injuries conference, which I wrote about here, and which showed me that I really enjoy teaching, though I would miss clinical work way too much to dive into that full time. At least for now. And then a week later was the Sports Certified Specialist PT Exam which I wrote about here.  Taking a student really opens up your time to focus on other things, at least when they're as good as mine was. I took full advantage of that opportunity. 

In 2019, I "came out" about my eating disorder with this blog post and shared some mental health struggles.  It's amazing how much better things can get when you 1) learn there is, in fact, a problem and 2) do something about it.  I faced these issues with a much bigger support system than I had anticipated, along with an army of healthcare providers, which made things so much better.  I spent many hours and even more dollars between my Therapist's office and my Dietician's office along with visits to my Naturopath and Gastroenterologist because adding foods back into my diet that I had been previously binging or restricting ultimately made me pretty sick. Like bent over in pain, leaving work early, and carrying extra clothing around in case something horrific happened sick. Unbelievable how much damage you can do to yourself but also how resilient the body is!  It could be that some of those foods made me start restricting in the first place, but we'll probably never know that. I'm certain that we need to continue working to de-stigmatize mental healthcare in the US. Too many people need help but are ashamed to get it, and it can make a huge difference in your quality of life.  

Justin Timberlake!

Despite having a persisting gut ache, I also traveled more in 2019 than ever before.  It started with a day trip to Vancouver, BC, on Valentine's Day to see Justin Timberlake in concert. Amazing.  So Amazing.  In March, an East Coast visit with the family and Climb to the Top of Rockefeller Center for Multiple Sclerosis for the fifth time (which I've previously written about here). I won't be climbing in 2020 but if you'd like to donate and support the cause, please let me know and I'll connect you to fundraisers! In May a trip to the Olympic Peninsula to check out Dungeness Spit and learn about that type of land formation. In June I headed East twice more for weddings, once with family in Ohio and then in New Hampshire two weekends later.  

World Travels

In August I enjoyed a life-changing opportunity to volunteer in Tanzania, Africa, for two weeks which I wrote about here, and which was has captivated my thoughts and prayers since. In September the AASPT Traveling Fellowship brought me to Ohio and Minnesota, which I wrote about here, and which impacted my learning and career goals in several ways. In October there was a quick snowy vacation weekend to Denver followed by a Thanksgiving trip to Connecticut to see the family, which I wrote a bit about here.  The year will wrap up with my birthday celebration in Portland, OR for some Trailblazers vs Lakers basketball.  Basically, I was all over the map and spent a lot of time reading and writing in airports.  Shockingly I have zero travel plans for 2020 right now, but I'm sure that will change. 

I read a lot of books in 2019, both fiction and non-fiction, thanks to audio books for the commute and OverDrive on my phone for while I was on the road.  Four books were listed in the syllabus for The Level Up Initiative, which I wrote about here, all of which were really awesome. My favorite reads of 2019 were "The Moment of Lift How Empowering Women Changes the World" by Melinda Gates, "Yale Needs Women" by Anne Gardiner Perkins, "Educated" by Tara Westover, and "Hunger: A Memoir of (My) Body" by Roxanne Gay.  I also listened to some podcasts and binge watched "The Handmaid's Tale" on Hulu... can't wait until the next season comes out!

There was continuing education, kayaking, basketball, and time with family and friends.  I didn't spend nearly enough time with my family, but hopefully that will change next year.  My biggest goal for 2020 is to purchase a house, so perhaps I'll write about that experience.  My student loans are finally under $80,000, so it only seems appropriate to acquire more debt, right?

As the sun sets on 2019, I'm wishing everyone a safe holiday season and look forward to writing more in the new year.