Rising Strong and Rumble Dreams

Recently I finished reading Rising Strong by Brene Brown. In her book, Brene states that there are 3 phases or 'acts' of overcoming a tough problem. 1. The Reckoning 2. The Rumble and 3. The Revolution. The reckoning is where you get to the point where you recognize what your problem is and you can't avoid facing it. The rumble is the phase where you try and fail and try again and work hard to solve your problem. The revolution is where you get to otherside of your mountain. You are changed and victorious. One of the things that she said is that so many people when describing their success skim over this phase as 'it was hard, and I pushed through it'. She said more people need to share their stories about how they actually got through the difficult spots.
 As far as graduate school is concerned I am still in Act II. I know the finale is coming, but I'm not there yet. It's still hard. Many people still think I am crazy. Another thing about me is that I have a tendency to have vivid dreams that often represent things I am dealing with. (And no, not abstract vague voodoo things, but dreams that portray things that I am dealing with.) I thought I would share them here (and honestly I have been meaning to write them down for awhile) because perhaps it may help people with their own struggles. (Or maybe you may just enjoy the crazy things that go through my head at night.)

Backstory: Graduate school last semester was rather soul-sucking. I have too much student debt to quit without graduating. In order to attend school I have to have health insurance, it is required. My husband's employer does not offer it. At the time high deductible private insurance cost us more than $1100 per month. And I was struggling to find a job that was willing to work around school, wasn't trying to do shady things with my license and offered insurance. I looked into cheaper and closer graduate programs, but to transfer would mean scrapping too much of the work I had already done and would take longer in the end.

 Dream 1: I was in the ocean with my husband and my kids. Previously something had happened to the boat we were on. We were holding arms together in a circle and we were treading water. Everyone was miserable. My kids were crying and wanted to give up. I wanted to give up. I could tell by looking at my husband that he was miserable, but I know that he won't give up on me or the kids. We are both so exhausted trying to keep the kids and ourselves from drowning. We are all so tired of fighting. We have no idea which direction is the closest way to land. Every time a wave would wash over our heads, we would hold tight to each other and feel a little more defeated as we fought to rise to the surface again. We would choke and sputter and rally again. My legs did not want to move, but I made them move because I can not give up trying to get my kids to safety. Eventually we made it to a small sandy island that was big enough for the five of us to sit on. I woke up completely exhausted.

 Eventually I found a job that gave me benefits and worked around school. (Hooray!)

More backstory: As I have been embarking on this graduate school and advanced practice nursing journey, I've been trying to figure out exactly where I want to go with it. And I could debate back and forth forever. Of course it is difficult to determine right now. I have more than a year left, the jobs that are available at the moment, most likely will not be when I am finished. And school probably will not end when I finish this degree. I can get a Doctor of Nursing Practice (DNP), a PhD, a second Master's Degree in Psychology or a Masters in Public Health, or some combination. Any of these can help me provide better care to children. However, it's hard to say which is the best plan for me and my family. It's hard to evaluate the pros and cons of any direction. I have spent hundreds of hours talking to people, and researching different options. The paths are not very clearly defined. It makes it difficult to know which step to take next.

Dream 2: I went hiking with Brene Brown. The scenery was impossibly picturesque. It was like Zion's National Park, Arches National Park, Iguazu Falls and Final Fantasy XII all rolled into one. So pretty. On our hike we ate lots of dark chocolate and I talked about my ideas for public health interventions to improve pediatric health. I was so excited to talk about my ideas and the things that I wanted to do, and Brene was excited too. She told me 'You need to do this, these ideas need to be tried. Do the research to support your interventions.' We talked, hiked and ate dark chocolate for hours. It was amazing. I woke up pumped and with increased resolve to keep going even though sometimes graduate school is terrible.

10 Ways to Stay Healthy When You are a Parent in School

I often hear the complaint- "It is so hard to be healthy when you are a parent in school." Yes, yes it is.

When you are focusing on your education doesn't mean that you want to ignore your health, because you really can't afford to get sick. You have school and family obligations that don't go away when you need a sick day. However it can be really hard to squeeze those healthy habits in with your responsibilities that are tied to parenting, schooling and/or work.  Here are a few ideas to stay healthy while taking on school, parenting and generally trying to be awesome.

1. Set realistic expectations- You don't have to do all the healthy things everyday. There are so many hours in a day and you have school work to do. Don't beat yourself up that you don't have a six-pack while you are writing your thesis or that sometimes your kids are not eating enough vegetables. Make reasonable health goals for yourself and realize that it's ok if you aren't perfect at all the things all the time.
2. Find ways to multi-task- Get your exercise in while you chase your kids at the park. Do sit-ups while you listen to an online lecture. Prepare your meals while you listen to a recorded presentation. Listen to a relevant audio book while you run. Multi-tasking can be overdone, but it can work if you can combine something mindless (exercise, chopping veggies) with something that you have to think about.
3. Commit to do something for your health everyday. It doesn't have to be running 10 miles. It can be drinking enough water, eating a salad and walking around the block. Small steps forward are better than no steps, or steps backward.
4. Get yourself a water cup with a straw Keep it full of water and next to your computer/textbooks, so you can sip it constantly while you study. Water is an amazing substance that is cheap/free. Being well-hydrated helps prevent a multitude of ailments. Water literally enables all of your cells to function better. It reduces headaches, helps you focus, curbs appetites and cravings and gives you more energy. If you want to know how much you need take your weight in pounds and multiply it by 2/3. That is the amount of water in ounces that you should drink everyday. (Possibly more if you are exercising a lot or depending on the weather.)
5. Ditch your chair. Sitting in a chair for hours is bad for your health. If you have to sit, try an exercise ball. Sitting on an exercise ball does a few things for you 1) It reduces back and hip pain. 2)It forces you to use your core muscles more than sitting in a chair does 3) Can help improve your balance. Standing at your computer can also be a good option if you can adjust your screen to make that feasible. Try reading your textbooks while laying down. Switch it up.
6. Plan healthy meals- Don't leave what you eat for dinner up to whatever you can forage at the end of the day. Even if you don't have time every day to cook, commit to have 4 balanced dinners each week, or whatever you think you can handle. Over the weekend make a plan of what you will eat in the next week. Include some salads. Make sure you have the ingredients available so your plans don't fall apart while you're trying to prepare given healthy meal and your kids are demanding food and attention. When you are prepared it takes less will power to make healthy choices.
7. Take exercise breaks After I have been studying for several hours it helps me to stay sane to walk away and exercise for 30 minutes. When the outside weather is unpleasant I like to do a 21 Day Fix Extreme workout at home. Other days I go for a run. Find whatever exercise you enjoy and go with it. You can find a short workout on Youtube or even just do a set of jumping jacks. Taking exercise breaks can make your study time more effective.
8. Plan healthy snacks- If you have healthy food available that is what you will eat. Some easy examples: carrot sticks and hummus, apples with peanut butter, string cheese, grapes, yogurt with granola, etc. Sometimes it helps to prep healthy snacks (chop veggies, put in containers or baggies) on the weekend, so that they are convenient for you throughout the week.
   
9. Find friends that support you in your goals- Find friends who are also in school and trying to eat healthy and exercise. If you don't know anyone in real life there are plenty of Facebook groups where you can find support and recipes.
10. Take a few minutes to meditate- Take 5 minutes to take deep breaths, remind yourself that you can do this and that in the long run many of the little things that are causing you stress will not matter.

To all you parents out there who are also in school, I salute you. Don't give up!

The Series of Misadventures and Failures that was Living in Colorado

 I think I have been asked hundreds of times why we left Colorado, so it's about time that I just blogged about it. It makes it easier for everyone.
Last August we moved to the Denver area so I could attend graduate school at the University of Colorado. (Which was an adventure in and of itself.) When we arrived we discovered that our apartment was 650 square feet smaller than our contract stated. In fact apartments as big as our contract stated did not exist. They gave us one that was 50 sq ft bigger than the first and a free garage and storage unit to put our stuff in. As there was a housing shortage and we were there with our moving truck, we didn't have a whole lot of options. The apartment was brand new and the location seemed great so we took it.

 I checked out the elementary school for our kids before we selected our place. It seemed very close in scores to the one my kids attended previously. But my kids were bullied, so I started volunteering in their classes so I could be more aware of what was going on. I felt like their teachers were great, I LOVED their teachers. However, there were other factors that made it hard, like a very large number of kids in their classrooms who didn't speak any English, and an unusually high percentage of kids with special needs. As great as these ladies are, they can only do so much.
 In November I was notified that I was a possible match to donate blood stem cells to someone with leukemia through the Be the Match program. That was super exciting.
 In December my son's 1st grade teacher quit. It was hard and she decided it wasn't what she wanted to do.
 In January I started a temporary nursing position that I was super excited about. It didn't work out very well. After a month I requested that I be oriented as much as they had promised, and they fired me. It would have been nice if they fired me the week before we bought a second car instead of the week after. :/
 A week before my winter semester started I began having intense abdominal pain. After a couple days of that, I went into the emergency room. They found a hemorrhaging mass (cyst) the size of an

orange on my ovary. They told me it might be cancer and if I needed more pain meds before I could see  a specialist I should just come back to the ER. I know that sounds completely ridiculous, but I am not making this up.
 A few weeks later, the OB/GYN said that the cyst appeared to be gone, but they would do more follow-up in 6 weeks. The upshot was that after a couple months they said I don't have ovarian cancer, (yay!) and the problem with my ovaries isn't worth treating unless I am winding up in the ER on a regular basis. (So far, so good.)
On the day that I went to the ER we also discovered that my son was failing every subject except math. Between having a string of substitute and potential replacements, he and most of his class were failing. The longer we stayed the more miserable my daughter was. There was one week where she cried everyday on the way to school, she hated it so much. We had tried to get our kids into the gifted school, but we were told that you have to live in the district for a year and then there was a long application process. So we were waiting to hear if our kids would be accepted to the gifted school for the next year.
 In February I was notified that I was indeed the best possible match for the person with leukemia. They drew a 19 large tubes of blood for diagnostic tests. I walked out of the office pale and with blue lips. I went home, fainted and hit my head in my kitchen. Be The Match decided that it was probably best to go with the second closest match. Between my hemorrhaging mass and all the blood draws I was pretty anemic, meaning finding the energy to do my homework and keep my kids alive took all my will-power. I was grateful that they had a back-up match.
  The day I was scheduled for my ultrasound I also took a practical exam that I failed. 85% was required to pass. I was nervous and I missed just a few too many points. So even though I still had an A in that class I failed the whole course by default, and I'll have to retake it later.
 Meanwhile no one wanted to buy my big beautiful house in Utah. We put a ton of money into upgrades. No offers. We dropped the price by enough that we would lose at least $20K. No offers. Nor could we

rent it for enough to cover our costs. And Colorado kept getting more and more expensive. During 2014 Denver tied with San Francisco for the highest inflation rate.  Lots of people wanted to move there (for marijuana and various other reasons) and the housing supply did not match the demand. We were paying almost twice as much for our tiny apartment as for our large house that had nearly four times the space. And in the 8 months that we were there the market value of our apartment went up 30%. We heard all kinds of crazy stories about people struggling to buy houses and the longer we stayed, the more we realized that the prospects of us getting into a place that was both big enough for our family and near a good school for our kids were not very good. The final straw was when our daughter was accepted into the gifted school and our son was put on a waiting list. Not good enough. Even though our place was convenient for me, staying right there was not a good option. We couldn't ignore the fact that his academic needs were being ignored. I may be a lot of things. I'm a nurse. I'm a student. I'm a runner, I'm a coach, but first and foremost I am a mom and I can't go after my dreams at the expense of my kids.
 So we moved back to our big beautiful house in Utah. My daughter was immediately accepted into the local gifted school and my son will be there when he is old enough (Here the gifted programs don't start until 3rd grade).  The longer we are here, the more it is evident that this was the best move our for our kids. Our kids are more free to run around and make noise. We have enough living space (and then some) with reasonable lighting. They have more friends. Within 3 weeks my son was reading at grade level. All of our expenses are less, which takes off some stress. We LOVE it here, even more so than when we lived here before.  My husband and I have great friends here.  We have easy access to lots of hiking and outdoor play. I can do most of my classes online, and the rest gets complicated, but I will make it work.

 Colorado is beautiful and there were lots of fun things to do there. We made some really fantastic friends there who we miss, but unfortunately Colorado was not a good option for our family.
 In some ways the experience felt like a big expensive and painful failure. (We had several other smaller failures mixed in that adventure, but those were the highlights.) But we learned things. Do we know where we are going to be when I am done with school? No, not really. Would I do it that way again? Probably not. But I am stronger than ever and I learned lessons that I'm not sure you can put a price tag on.
 Moral of the story, sometimes things don't work out as planned, but we keep going, we learn and we find things to be grateful for along the way.

Marathon Training

A few months ago, one my best friends made the comment. "Someday when you write your autobiography, you should call it 'Living Crazy', because that usually sums up what is going on in your life." Haha, so true. But I believe that life is too short to live boring, and crazy generally isn't boring.

Seen on my run

 My latest crazy adventure is marathon training. I signed up for the St. George marathon this year. I persuaded a friend to sign up too, so we can plan some long runs together. It only takes one friend to keep you committed to exercising, then you can't let them down, so you'll do it even when you don't want to. I enjoy running (usually), and I was excited to get back into it. Of course when I signed up I fully intended on taking the summer off from school. I cleared it with my specialty option coordinator and we agreed that a break from school was feasible and well-deserved. Then I talked to the graduate

Piyo Cross Training

adviser. She said that if I took the summer off that it would mean I would be more than a year behind in my classes, and there would be a couple semesters where I wouldn't be able to take classes because they are only offered at certain times and I have to take them in order. So now I'll be working, going to school (just one class), shuttling kids to swim lessons and summer camps and training for a marathon. Yup, living crazy. But taking advantage of the beautiful opportunity to do so. I'm grateful and thrilled that I have such beautiful scenery to train in so close to my house.
 For my marathon training plan I chose a 20 week schedule where I run 4 days a week (last time I ran 5-6 days a week, I'm not such a fan). On my off days I'll cross-train with Piyo to keep my legs and joints flexible and help prevent injuries, or take the occasional rest day. If anyone wants to do the
Piyo workouts with me, the sale was extended this month, so now's a good time to get a discount. I love them, they're fun and just make you feel great. And my plan is to use them to protect my knees!

African Americans, Diabetes and Thinking Like a Freak

Last week I was listening to Think Like a Freak: The Authors of Freakonomics Offer to Retrain Your Brain . The whole premise of the book is looking at problems from different angles. In it the authors shared the story of an economist who was interested in why is it that African Americans have such higher rates of diabetes and heart disease compared to other parts of the population. This is so even if you account for things like stress, education and income level. If you look at European Africans or Native Africans, their incidence of diabetes and heart disease is far less than African Americans. This isn't racism, it's just statistics. Then why is it that African Americans are prone to have these problems? The economist's theory (which he is still researching) is that those who survived the slave trade had a genetic propensity to be able to withstand extreme dehydration, because they held more salt in their sweat and bodily fluids, they retained more water.  This leads to a higher oncotic pressure in the blood and more cardiovascular damage. These people who had this characteristic  would have more tendency towards heart disease and would pass this on to their descendants, modern African Americans. Slave- traders actually selected for this characteristic by licking potential slave purchases and selecting people who tasted more salty.

An Englishman tasting an African

Now this is all well and interesting, (and the history of the slave trade is very tragic) but so what? What can we do with this information right now? This morning I had an 'ah-ha' moment while listening to my pharmacology lecture. There is a newer group of diabetic medications known as SGLT2 inhibitors (Invokana) which inhibit sodium & glucose transport in the kidney which leads to less sodium and glucose in the blood, and is essentially an osmotic diuretic. One of the side effects is weight loss and patients are more likely to experience DEHYDRATION. This is a the perfect medication to give to patients who are genetically resistant to dehydration. Of course has a pediatric nurse practitioner it is not likely that I will be treating African American patients with Type 2 diabetes, and I'm sure that someone else out there has already made this connection, but I was excited about it and am so grateful for science and people who think outside the box to try to find solutions to problems and improve healthcare.