I am so tired of reading about the fuss that doctors, the AMA, American Association of Family Practitioners and other medical associations are making in regards to Nurse Practitioners and their ability to practice.  It is so annoying and I am getting bored with the  arguments because it all seems more emotional than fact based. I find it to be so irrational.

It has become like a school yard fight with the medical profession trying to bully nurse practitioners into conceding their superiority in care and knowledge.  If I agree, will you go away and not bother me so I can actually care for my patients?  After all these years of nurse practitioners being part of the medical landscape, why now is there such animosity and disparaging comments of the role?

I have tried to argue, talk sense and present research but the response continues to elicit the same old tunes. The same boring retorts. One of my favorites is, if you wanted to be a doctor why didn’t you go to medical school? The implication there is,that just perhaps, I wasn’t smart enough to get in.  Oh yawn.

I have said over and over again, as an NP, I know my role, I know my limitations and I know what I offer patients.  I also know the need in many communities for more primary care providers. And still, the medical profession has blinders on as to the potential of supporting NPs in practice.

I want to let you in on a secret; I am not planning on doing heart or brain surgery.

What exactly would happen if doctors accepted NPs?  Would healthcare cease to exist as we know it?  Would the sun not rise?  Would patients start dying in record numbers from misdiagnosis and treatment?  These questions are no more absurd than arguments the AMA and other organizations are using to discredit the NP profession.

The harshness of the arguments have made me conclude that the driving force has to be about money and the distribution of the healthcare reimbursement pie. No sharing allowed. Everything else is a smoke screen.

There actually is room and need on the playground for all of us to practice.  Emotional outbursts and indignation aren’t going to solve the problem of the inadequate number of PCPs available.  The more the old arguments are rehashed, the harder it is to evolve a working relationship and create viable future models of practice.

NPs are driving down the healthcare highway at 65mph looking out the windshield while the AMA is sitting there looking out the rear view mirror.  NPs are moving forward into the future of healthcare, would doctors care to join us?

My client told me a story of an experience he had with a major specialty center billing office. The story will make you laugh at the absurdity if wasn’t so real.

My client’s wife was getting care at a major Boston center for a chronic illness. She was being seen weekly for several months and then monthly. She had insurance through her employer and the provider was in network. She paid her copay at each visit.

My client  had a web account with the insurance and could track when payments were reimbursed. There was no problem on the insurance side. All visits were being reimbursed.

He started getting bills from the center stating that the insurance was not paying and they owed the money. Of course, it was at the inflated uninsured rate of 100% over the contracted rate. He called the billing office, thinking it could all get worked out in one call.

And the journey began. He was told that the insurance was not reimbursing nor was any of the copays paid. He was told in no uncertain terms, that if payment wasn’t made in 15 days, the bill was being sent to collections.

Wait a minute, he said. I have copies of the copay/coinsurance checks. He also tried to explain that he had been on line and the EOBs showed the payments sent. He was told, the office was sorry but their computers have no records of any payments going back four months. My client said he would fax the information.

He faxed the information and then called the insurance company. He was told reimbursements had been sent in full. He explained what the center was alleging and the insurance company reaffirmed payments sent.

He called the billing office back a fax was never received and the computers still showed no payment. He asked to speak with a supervisor. He was transferred to a voicemail to left a message.

He didn’t hear back from the supervisor immediately. When he did he got the same story. The supervisor said she would look into it. After a week of waiting, instead of a call, he received a letter from a collections company. Was this really happening?

He called the billing office and was told that since it had been sent to collections, he had to speak with them. He called the collections company and was asked how he wanted to pay the bill. He tried to explain the situation and was told he would have to call the billing office to get clarification.

Again, he called the billing office supervisor and sent the copies of his checks. He kept being told there was nothing in the system. The supervisor added that there was nothing else to be done except for him to pay the amount owed. He said no.

He received a letter stating if he didn’t pay, he would be taken to court.  He called the billing office again. The woman who answered the phone had been working in the billing office for years. She stopped him mid way through the story and gave him the number of the CFO’s office where problems like this were looked into. She said call because something doesn’t make sense.

Here is what had happened. And I am not making this up.

The office people in accounts receivable were using a program that required date of birth and first name to input information. When my client’s wife’s data was input, several names with the same birth date and first name came up. The person decided to pick the first name on list. All the copays, coinsurance and insurance reimbursements were sitting in her account. She had a $50,000.00 credit.

My client told me the most frustrating part of the problem was the front line customer service people have a script they read from. No one was willing to think it through and investigate the problem. He said no one seemed to write anything in the call record, so each time he had to explain the story to someone who didn’t care. He realized that if it weren’t for one smart and caring individual, he would have had to hire a lawyer to resolve the issue. The good news is the Center realized the accounts receivable program was not working and they completely revamped the system.

My client never got an apology.

The lesson here is: 1. Keep copies of all receipts and checks. 2. Write down the name, date and conversation of each call. 3. Don’t stop with a supervisor. Go to the top. 4. Never expect an apology.

I haven’t been able to sleep well since the marathon bombings.  I live only 10 miles from downtown Boston and the images from that day still haunt me.  The pain and suffering of so many makes me sad.  A day that is always filled with joy was ruined by the incomprehensible acts of two lunatics.  I guess I am angry too, that once again my world has been  disrupted by what is so senseless and cruel.

I also had to sit through a lock down last Friday while the police hunted down the second suspect.  My town of Waltham bordered Watertown where they captured the suspect.  All day, my husband and I sat in the house and watched the news.  I followed Twitter.  It was surreal.  The streets were empty. There was no frame of reference for the experience.  It wasn’t good or bad, it just was.

I recognize my symptoms as post traumatic stress or PTSD.  I have been traumatized by the events of April 15, 2013.  No, I wasn’t at the finish line or anywhere near the marathon.  I had just gotten back to my office from visiting clients.  But the my mind has been unable to process the horror of the day.

A person can be traumatized by an event even from a distance.  The marathon bombings affected many  in that way.  What happens is a person thinks they are dealing with the emotional and psychological impact of a traumatic event but actually aren’t. The brain has the capacity to wall of the impact so life can continue.  It may be too difficult to talk about.  As Michele Rosenthal wrote on her website www.healmypysd.com “PTSD is a normal reaction to an abnormal experience”.

I knew I was having PTSD because I started to have some symptoms.  I recognized the symptoms because several years ago I had a serious cycling accident. It took me a year before my sister in law, the counselor, suggested I may be having PTSD.  At that time, I was anxious, my blood pressure was up, was having nightmares, couldn’t eat and was hyperactive.  I sought out treatment.

So when I started not being able to sleep and being apprehensive about going to Boston, I knew I had to get a treatment fix.  I didn’t need my blood pressure getting high again.

It is important for people to know that these events can affect you even if you weren’t at the bombing site.  If you are experiencing any symptoms mentioned above or find yourself extremely sad or crying and I don’t know why, get some help.  Talk to someone.  Here are some resource links. http://www.emdrtherapistnetwork.com http://www.helppro.com/HP/therapist-finder/therapy-specialty/MA/Boston/40/Trauma_PTSD.aspx

Also, go to your insurance company for a list of counselors.  The Human Resources Department at your work may also have a list of avaialble people.

Listen in this Wednesday 4/24/13, to my radio show on blogtalkradio.com.  My guest is Michele Rosenthal and we will be discussing PTSD.

http://www.blogtalkradio.com/healthcare-whisperer-/2013/04/24/dealing-with-ptsd-after-the-boston-marathon-bombings 

The front page of the Boston Globe, April 10,2013 had an article by Liz Kowalczyk,  “Airing Medical Mistakes.” http://bostonglobe.com/lifestyle/health-wellness/2013/04/09/brigham-and-women-publishes-stories-medical-errors-focus-staff-attention-solutions/heFVdgGnLc2O9QqL1eiMnN/story.html

Thank you Liz!  This is a great article about the steps Brigham and Women’s Hospital in Boston has taken to come out of the closet about medical errors.  The hospital started a staff only intranet newsletter called,  Safety Matters,  that addresses safety issues and describes medical errors.  Names are anonymous but the actual event is real.  I applaud the action of opening the door to understanding and transparency.

Medical mistakes take a toll on both the patient and medical staff.  In the past, what most patients have experienced is a wall of silence and a quest for answers.  Hospitals have in the past  circled the wagons and rarely acknowledged publicly or to the patient any responsibility.  Often, the only vehicle for a patient to discover what really happened was to file a lawsuit.  To add insult to injury, hospitals had no qualms about sending patients bills after a medical error.

Patients, doctors and nurses all suffer when a medical mistake occurs.  Doctors have had to live in silence with no where to turn.  The article quotes the Chief Executive, Dr Elizabeth Nabel who stated “ one of her goals is to create a more open culture around errors, in which staff can report them and seek help without shame.”  It is a bold move and one she takes personally.  Dr Nabel last year, spoke to the medical staff and nurses about her own medical error many years ago and her struggle and shame.  That takes courage and commitment to wanting real change around medical error reporting.

I believe the ability to be transparent is a direct result of the push by the patient safety movement, doctors speaking more openly about the issues and the new Maaschusetts law enacted in January 2012.  The law allows doctors to apologize in the hospital for a medical mistake without fear of it being used in a lawsuit.  This law has the potential to help both patient and doctor/nurse.

The article also spoke to policy changes that have occurred and are identified in the newsletter.  That is remarkable because often an error occurs, the policy changes but the patient doesn’t know nor does much of the staff.  It is important to openly explain the source and reason for a policy change.  If a patient is injured due to a medical error, and a policy is changed because of the event, it can be very healing to know the error was not swept under the rug.

I had a client who had a surgery to remove an unknown object from the abdomen.  No one knew how it got there (really, it was not from a previous surgery or ingested).  My client had requested the object to be saved so the appropriate research could be done to find out how it had gotten into the abdomen wall. Two events occurred.  Not all the object was removed nor was the object saved.  Pathology threw away the object.  My client doesn’t remember being told the object was not completely removed and ended up with an infection.  He was also being billed.

I contacted risk management at the small hospital outside of Boston.  I had written a letter explaining the object had been thrown away,  not being informed the object was not completely removed and the receiving of bills.  The response I received was confrontational and icy.  I was surprised because my letter was not accusatory  but asking for a dialogue.  There were several phone calls and then silence for about 6 weeks.

During this time, the bills were dismissed and a policy was changed.  My client or I were never contacted except that no more bills were sent.  I only found out about the policy change because the risk management director mistakenly called my number and I asked what was happening. The policy for surgical removal of objects and the  pathology department’s responsiblity was changed to include how to manage patient requests.  New systems were put in place to ensure communications between departments. My question to the director was why wasn’t this commnicated.

The experience with this client is one I have often with hospitals and the risk management departments.  Stone walling and non communication.  That is why I am glad to read that Brigham is slowly opening the door to communication and acknowledging medical mistakes in a public forum.  My suggestion is to now engage patients in the process.  Use the consumer board that the law also states hospitals must have.

One can never be too vigilant when it comes to monitoring medication side effects and interactions.  Every medication has a wide range of potential side effects, many are harmful.  The problem is, the pharmaceutical industry emphasizes the most common potential adverse reactions and downplays the less frequently seen events.

Any time, a client starts a new medication, I tell the caregiver to watch for any changes.  Some of the changes I tell them to observe for are appetite,  digestive irregularities, mental status changes and muscle pain.  Medications cause such a wide range of side effects, we can never know what may occur.

It is also important to make sure a new medication is compatible with other medications being taken.  This is critical when seeing multiple doctors who are not current on interactions or may not realize the potential for a side effect.  Often, an adverse reaction can be so rare it will take everyone by surprise.

This happened to me with a client.  Sara had a series of surgeries related to a bone infection from cancer radiation and MRSA.  After each surgery, she would be sent home on IV medications.  The first discharge and home IV medication caused renal failure.  The second discharge caused an almost coma like side effect, she didn’t eat or drink for days causing dehydration and another hospitalization.  The next drug  caused diarrhea but was manageable. We thought we were out of the woods when an emergency surgery was needed because the plate replacing the bone was pushing through the skin.   Cultures showed new infections and  the need for more IV antibiotics.

The Infectious Disease(ID) doctor who had been practicing for  40 years, was delighted to tell us she was going home on a very common and older medication, Ampicillin.  This medication has been around for over 50 years and side effects were minimal, mostly allergic reaction.  We all felt we could breathe a sigh relief. Mistake!

About three days into the home treatment, Sara started to have a personality change.  She became forgetful, disoriented, disengaged with her environment and very cranky.  She was repeating herself and becoming obsessive.  In describing the symptoms, it may seem that it would have been obvious something was going on.  However,it was subtle and slow and Sara had ,in the past, had some cognitive changes.  It came to a head when her son visited on a Sunday afternoon.  He called me and said in a panic, “something is wrong with my mother.  I don’t know the person I visited  today.”  All the symptoms described above had begun to accelerate in presentation.

I was lucky to have a good relationship with both the infectious disease doctor and surgeon.  I knew they would respond, if I could reach them.  I left messages and emails.  I didn’t want to speak with a resident because this case was very complicated.  I needed someone who knew the history.  Within hours (remember it was Sunday night), I got a call from the ID doctor.  I started to  reiterate the symptoms and he stopped me.  He said, “In my 40 years of practice, I have only seen this once before.  It is a side effect of the Ampicillin.  She has neurotoxicity. Stop the IV and I will get her admitted tomorrow.”

The next day we took her to the hospital and she was very disoriented.  She kept telling the residents when asked if she knew where she was, that she was at Boston Lying In Hospital  (now Brigham and Women’s).  It was heartbreaking.  The ID Doctor kept reassuring us that she would be fine once the medication got out of her system.  She did get better.

We were lucky to have a doctor who recognized the rare side effect.  If she had gone to the ER, she probably would have been given a diagnosis of dementia and sent home because not many people thought of Ampicillin as a medication that can cause such a problem.  It could have put her on a trajectory of dementia that would have been difficult to unravel.

It was a reminder to me that no drug gets a free pass.  All medications have the potential to cause a side effect and each person responds differently.   Averages may show the medication to with minimal side effects but many people fall outside the norm.

My advise is to:

Never take a new medication without knowing the potential side effects.  I encourage people to read the insert or go online to get the full scope of side effects.  Many medical professional discourage patients from  researching medication side effects in fear of the person imagining symptoms.  But I disagree.  Doctors don’t always give a full accounting of potential side effects, if at all.

Check the bottle before starting a new medication.  Make sure the medication name and dose is correct.

Don’t wait to contact the doctor if a side effect occurs or if something feels off.  Be persistent, if the doctor doesn’t accept the symptom as a problem.  If you are uncomfortable, then insist on a change or decrease in dose.

Know why you are taking the medication and what to expect.  Sometimes when we know a drug may cause a temporary side effect, it is easier to handle.

As a caregiver be alert to any changes physically or mentally.  Be an advocate for your loved one.

Don’t Keep old medications around.  Nobody wants to mistakenly take the wrong medication.

Keep an updated list of all current medications.  On each visit, make sure the doctor’s list is accurate.

And finally; trust your response to a medicine.  This is the best way to be safe.

What a crazy world we live in!  The Boston Globe, Sunday March 31,2013 had a front page article by Liz Kowalczyk, called  ”Doctors Firing Back at Patients’ Online Critiques.”  It is the story of a patient’s spouse who blogged about a doctor and stated the person was not compassionate.

Since the Boston Globe doesn’t let you read the paper on line unless you subscribe, here is a link to an abbreviated recap of the story. http://www.boston.com/whitecoatnotes/2013/04/01/clipboard-readers-respond-suit-filed-against-man-who-complained-online-about-wife-doctor/uX2UOO9spfHqohbUcdFhrL/story.html

When I saw the headline on Sunday, it really caught my eye.  Why would a doctor sue a patient for $100,000?  Before I read it, I tried to imagine what it could be.  Had the patient not paid their bill?  Had they not showed up for surgery.  Had they been late for an appointment?

What a surprise to find out it was because he had called her not compassionate on his blog.  The doctor felt by having this statement on line, her reputation was sullied.  Really?  Exactly how has your reputation been damaged?  Are your numbers decreased?  As mentioned in Dr. Kevin Pho’s blog, http://www.kevinmd.com/blog/2013/04/doctors-online-reputation-survived-front-page-newspaper-story.html , it doesn’t seem to have.

This has to be reverse malpractice.  I guess we can call it malpatient.  Having a personal opinion about a medical professional is acceptable as long as it is not stated on line.   Isn’t there an issue  of free speech?  The comment was based on a personal experience.   How can you sue someone for their  feelings?  He didn’t say she was the devil or wished her ill.  He said, she didn’t respect his feelings.

I am surprised that the doctor is making this personal.  Is it her wish for the patient to state she is compassionate?  If she were to win, can I then sue a doctor for not being compassionate? An example might be delivering bad news abruptly and without warning? Or not returning my calls?  Or how about keeping me waiting for my appointment?

I believe this case speaks to not just  free speech  but the need to reexamine the patient/doctor relationship.  The empowered patient movement has been pushing for a shift to a partnership between patient and doctor.  There is a need for balance in the relationship and an understanding of what is realistic.  Do we as patients have the right to expect the medical profession to be understanding, kind and compassionate?  I’d like to think so but it just doesn’t work out that way.

Many medical professionals don’t understand the impact they have on patients.  Patient expectations often are skewed by  blinded trust and faith in the provider to find a soltion to their health problems.  It is personal for the patient, while for the doctor, it is professional with clear boundaries.

The learning curve on how to deal with patients expectations and emotions is  taught on the job through years of experience, not in school.  Patients teach medical professionals how to best interact beyond clinical data.  I read many doctor’s blogs that speak to what they have learned from their patients. Learning how to  tell someone of a terminal diagnosis is an acquired skill.  Many doctors and nurses after years of years, are still not very good at it.

The bottom line is, compassion, understanding and kindness are difficult to teach.You can’t legislate or mandate it.  We can only hope that soemwhere along life’s journey the person has learned the lesson.   I was lucky enough to learn some of these qualities from my father.  I would observe him from a young age, helping people and listening to their problems.  Walk in their shoes for a day, he would say to me, and maybe you will understand the suffering.

But don’t sue a patient because he/she was hoping for some compassion or understanding.  This lawsuit is unecessary and should thrown out of the courts.  I hope the Globe covers that story when it happens.

For many the moment becoming an empowered patient occurs when you just say NO to a medical professional for whatever reason.  It could be in regards to a new medication, a diagnostic test or a procedure.  It can be a very pivotal moment in a relationship with the medical community.

You might be thinking how and why would I say no to my doctor or nurse?

I was talking to a friend who has a chronic illness and she was telling me about her journey with the medical system.  She explained to me how for many years she just shuffled along in the system doing what everyone told her to do.  The problem was she wasn’t getting any relief.  Instead, she was beginning to feel hopeless and sicker.  Her main complaint was no one would listen to her.  Her doctor would give her medication to try and not explain how it worked or what to look out for.  She desperately wanted someone to hear her voice.

One day,  her doctor gave her another medication to try and said good luck.  She looked at him and said no more.  I am not going to take this medicine and I am not coming back here.  She left the office upset, angry, and frustrated.  She decided to find a doctor or team who actually wanted to work with her to get some relief and improve her quality of life.  She decided it didn’t matter if she had to travel because she was done feeling like an outsider in the decisions about her medical care.

She went home and started researching her illness.  She learned the physiology of the illness, current treatments and research.  She investigated treatment centers and doctors.  She sought advise from others on how to select a specialist.  She stopped listening to people tell her not to believe what she read on the Internet. She read reviews.  She became an expert about her illness.  She was ready.

She made a the choice of a new medical team through her research.  What she did learn from her past experience was that it was important the doctor listen and work with her.   She wanted a relationship with a doctor who would accept her knowledge and work with her to achieve her goal of a better quality of life.  She wanted a professional who willing shared information.

She did find a specialist who respected her needs.  She told she was happy to have a team working with her.  She also said, she never went to an appointment without a list of questions or concerns and never started a new medication without doing extensive research.  She did achieve a better quality of life even as her disease progresses.  She feels her participation in her healthcare gives her strength and direction.

It was inspiring for me to listen to her story.  She was able to improve her life by changing how she viewed her interaction with the healthcare system.  It takes courage to belief in yourself and switch medical care especially with a chronic illness.  The power in the empowered patient is knowing you can make a decision of this magnitude because it is your health and well being at stake.

It is often hard to feel as if you have any power or say when visiting the doctor or lying in a bed in the hospital.  Most people are not medical and don’t understand much of the jargon being bantered around.  We struggle to make sense of what has happened to our body.  We don’t know what questions to ask.  We are given little time to make decisions or sometimes we learn of decisions made for us after the fact.

As patients and caregivers, we do have a say.  We have the power to participate in our own healthcare.  We have the power to create and demand a partnership with the medical team.  We have the power to say no to a treatment or medication without prejudice from the medical team.

One of the areas that a patient has a say is the second opinion.  I am a strong believer in the second opinion.  Medical professionals often differ on their approach and treatment.  Some are very aggressive while others may be conservative.  A second opinion allows the patient to investigate treatment options and make an informed decision.  It also allows for a patient to make sure they feel comfortable with the doctor or surgeon.  It is your body and your life.

Many clients worry that their medical team will become resentful  when seeking a second opinion.  I have found most doctors are supportive and actually will tell you to get a second opinion.  Of course, there are arrogant doctors and surgeons who just simply can’t understand why you would want someone else.  It doesn’t mean they won’t be your doctor if you decide to stay with them.

I have seen a second opinion save someone’s life.  The doctor who did the second opinion was using a new and cutting edge treatment with good results AND it was paid for by the insurance company.  I especially think with any cancer diagnosis getting a second opinion is vital.  I am always surprised at the difference in treatment approaches and supportive services.  Be sure to seek an opinion outside the current system being used.

The biggest problem I run into in getting a second opinion is timing.  As we all know, doctors schedules, especially specialists are booked out for weeks.  The best way I have found to get an appointment moved up is to continually call the appointments person and if possible have the primary care office call.  Many offices understand the urgency and will do what they can.  A colleague of mine had a diagnosis of breast cancer and wanted a second opinion from a surgeon.  She told the office she would meet at any time including before the start of surgery at 7AM.  The surgeon saw her at 6:45AM.  Let the office know you can come any time.

Medical records are needed for an appointment. Call the office and ask exactly what is needed. Usually included are all physician notes, diagnostic imaging, labs and pathology notes.  If possible get the notes to the office ahead of the apopintment. This will streamline the appointment.  Medical records can be obtained from the either the physicians office or if attached to a hospital from medical records.  Sometimes I call the pathology department directly to ask for a copy of the report.

Most insurance companies cover a second opinion.  They may require a prior approval.  I have seen denials and an appeal necessary to show medical necessity.  If there is an appeal always ask to have it expedited.

Some of the major specialty centers will provide a remote second opinion. Cleveland Clinic, http://www.eclevelandclinic.org/productHome.jsp  is one of these centers.

If you are feeling unsure about a treatment course, get a second opinion.  If nothing else, it will verify the information being given to you.  It is your right and can be very important to your health.

When a medical professional can say “I’m sorry” for a medical error it can be very powerful and healing.  It is not easy for a doctor or nurse to apologize for a medical error because the fear of a law suit is real.  But medical professionals can be overwhelmed with guilt, shame and emotional distress after an incidence.  No one wants to cause harm and when it happens it is devastating for both patient and doctor or nurse.

There is growing evidence that when the medical professional is allowed to apologize, it opens the door of communication and forgiveness.  In the past, a complaint I heard often when a medical error occurred, was that the doctor or nurse never communicated the event or said they were sorry.  The patient felt anger at the event and that the doctor/nurse was uncaring.  The patient just wanted more information.

The simple words, “I am sorry”, are so powerful in stopping confusion, misunderstanding and stress.  It just doesn’t help the patient but the doctor or nurse.  Medical professionals often suffer in silence.  It is not part of the healthcare culture to speak of mistakes or error.  There is not support within most medical institutions to verbalize or openly acknowledge an error.  Imagine knowing you made a mistake yet there avenue to speak about it?  I know  it would eat me alive.

In Massachusetts, a recently enacted law, allows medical professionals to apologize to the patient in the institution without the fear of it being used in a malpractice suit.  The law has created a law suit free zone.  It doesn’t mean the patient can’t sue but  the apologize cannot be used.

Massachusetts also enacted a law that if a medical error occurs and designated as a preventable incident, then the hospital is responsible for all bills.  In the past, if an incident occurred, the patient would still be billed for insurance differences or private pay.  It surely added insult to injury.  I had a client who went into the hospital for a partial hysterectomy ended up in the ICU because the surgeon had nicked an blood vessel.  The hospital sent her a bill for over $3,000.

The culture of silence over medical errors needs to change.  It causes such pain and suffering for all parties.  For further information on this issue go to http://mitss.org

This blog post is written by Michele Rosenthal.  She will be a guest on my radio show on February 28, 2013 at 6PM EST on www.blogtalkradio.com

In 1997 my world fell apart. True, it had been sixteen years in the making, but when the rug was pulled from beneath me I was twenty-nine years old and clueless about what to do, where to find help and how to heal from a mysterious illness that was turning up undiagnosable problems with my stomach, intestines, liver and bones. Little by little fear and discomfort forced me to disconnect from myself until I was just a shell of who I once had been.

Plagued by extreme fibromyalgia and chronic fatigue I dragged myself from doctor to therapist to alternative practitioner searching for clues about how to reclaim my sense of self and also my life. It would be ten years (plus one diagnosis of posttraumatic stress disorder) before I put together all the answers I needed to heal and move into freedom. Along the way I learned seven must-do techniques to infuse a little empowerment into the process of knocking around the mental and physical healthcare system. Encompassing both internal connection and external action these seven actions pave the way to more deeply connect with your strengths and resources.

Trust yourself – When we seek experts to advise us on what to do we automatically subvert our own authority to their medical and other degrees. Naturally, we look to them as the experts. However, it’s critical to remember that you are the only expert in you. If you feel, think or know something that seems important and relevant – then it is! You’re the only one in your body. Trust what you know as much as you trust what the professionals know.

 Believe in your own truth – There will be friends, colleagues, family and even professionals who question what you report. They may say you’re making up symptoms, that what you experience can’t possibly be true or any other number of dismissive comments. The fact is, only you know what it feels like to be you. Believe in your experience and seek out a support system who come into your world with you to find answers versus demand you leave your truth behind and enter their more quantifiable and explicable universe.

 Seek people willing to listen/share/engage – When you’re a patient, even if you have people willing to stand beside you, it’s easy to feel alone. Isolated in your pain, frustration, disappointment and confusion the overwhelm of emotion can leave you feeling as if no one will ever understand the reality in which you’re living. To subvert that feeling, find people who will really listen to what you have to say, share their own challenging stories, and offer to actively support you through your illness. Specialty groups exist in both the online and offline worlds where you can find people going through what you are experiencing. Adding to those connections a positive and proactive personal support team lessens the loneliness of any medical journey.

Research – The only hope we have for adroitly managing any type of illness is being informed. The more you know about your individual symptoms and the possibilities of what they add up to as a whole the more intelligently you can converse with healthcare professionals. They will not always have the answers. Nor will they always have the faintest idea of how the symptoms add up to a condition that can be addressed. Through research you, however, can have an overview and insights into many different aspects of yourself and your illness, which allows you to collaborate with doctors in the most high-functioning manner.

 Interview – Remember that in working with healthcare professionals you are the employer. You have a right to ask questions, challenge answers and expect practitioners to perform. Rather than sitting back and accepting their authority position, turn the tables. Approach the management of your health as a business and you are the CEO. You must hire the right department heads and support staff to successfully manage this business. Ask the hard questions and set the standard for quality performance. Expect your professionals to live up to a standard of care and when they don’t replace them with others who will.

 Ask for what you need – No one can read your mind. The more silent you are the less you will receive the care, help and support that would make a difference in your journey. Get into the habit of asking everyone who can help you for what you need. As patients we have a tendency to get so wrapped up in our despair that we fall silent. Ask, ask, ask for the smallest to largest things that will ease your path.

 Hope and believe – Without hope and belief you cannot heal. As important as it is for the medications, tests, diagnoses, practitioners and procedures to be accurate it is equally important for your attitude to work for, rather than against, your recovery. Scientifically, your brain looks for proof of what you tell it. Focus it on the dire deetails of your circumstance and it will bring you more of that. Alternatively, steer your mind toward the ultimate positive outcome and it will partner with you in the most proactive way to turn those thoughts into reality.

I believe every single one of us has enormous healing potential. The goal is learning to access it. Sometimes we do that by looking without; often we also do that by looking within. Putting the two realms together activates the highest percentage of resources you have for finding success within the healthcare system. It also gives you the most control over a process that usually feels enormously out of control. In that sensation of empowerment you access your deepest strength.

Michele Rosenthal inspires audiences to overcome pain, fear, anxiety and depression by making the shift from powerless to powerful. A trauma/PTSD survivor, she is a mental health advocate, speaker, workshop/seminar leader, the founder of HealMyPTSD.com and the host of Your Life After Trauma radio show. Her book, Before The World Intruded: Conquering the Past and Creating the Future, is a finalist for the Books For A Better Life award. For more information visit: YourLifeAfterTrauma.com