Healing Hikes.

Nature. It cured me.

My journey through anxiety has been encompassed by a larger journey…one of self-discovery through the wilderness.

My greatest healing happened deep in the woods, away from people, technology, and the chaos of busy life.

I fondly call these experiences my healing hikes.

Rewind 20 years. One might find me playing in the woods that was adjacent to my best friend’s house. I would be playing outside, regardless of the weather extremes. I remember watching the thermometer in our cozy Ohio kitchen, staring until the number went from 9 degrees to 10 degrees. The rule was you could play outside when temps reached double digits.

Nature has always been my safe space. When I was in the height of my panic attacks, I would often escape the environment by running outside. Grocery store meltdown? Quickly escape outside. Stuck in line at the DMV? Gracefully (or not) power walk out the door. Stuck in a stifling conference of 500 people? Get up and run to the parking lot. The end goal of my escape plan was to seek comfort in my true home: nature.

Being outside has always been a source of joy, but that joy became exponential as I realized the impact that wilderness had on my panic.

I started hiking with Kemp and it grew to be a large part of our life. We have been in our “explore” phase for almost 3 years. I keep a journal of every hike/camping trip/kayak trip we take. It has become a precious item in our home. It is a book of reflection, memories, and lessons learned. So far, we have hiked almost 300 miles together.

I believe hiking is a lot like anxiety. Hear me out. When you start hiking at a new trailhead, the path is foreign and new. Your heart races as you get accustomed to the new pace. Your breathing increases to compensate for this increased demand. You focus on the path directly in front of your feet so you don’t trip and fall, creating tunnel vision. However, after a few minutes on the trail, you sink into the pace of hiking. Your heart rate and breathing regulate as you adapt. You look up from your feet and gaze at the beautiful periphery. Sounds a lot like riding the wave of anxiety, right?

Hiking taught me to push through moments of discomfort and trust my body.

There is a program called “Walk off the War” and it is geared towards Vets dealing with PTSD. They are guided on hikes and taught to rewire the overstimulated mind. It is the same concept with anxiety.

Nature helps me rewire that hyper-responsive sympathetic nervous system that my body LOVES to use and abuse.

 

What activities have helped you overcome mental illness?

Love and light.

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At the highest point in Georgia!

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Our morning view from a bed and breakfast called “The Len Foote Hike Inn” in North Georgia

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Sitting on the top of Mount Yonah in North Georgia. The Rangers use this mountain for training…it was tough.

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Hiking and climbing our way around southern Cali

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Cloudland Canyon in Georgia

The Pilgrimage.

My journey with bedside nursing is ending. Rather, it is evolving. I have a handful of shifts remaining until I start my new job as a nurse practitioner. I always knew this transition would happen. I planned for it and entered nursing ready to make this change. Now that it is here, my soul is feeling a little uneasy. The comfort of the bedside, of my home, will be gone. This new role brings an abundance of new responsibility, pressure, and expectation. I am ready. Maybe. As I embark on the new beginning, I want to reflect back on what the last few years have meant to me. Grab a beer, some tissues, and a puke bucket (sorry in advance).

I was 18 when I touched my first dead body. I was working as a nursing assistant and the patient died within 15 minutes of my first shift. A coworker whispers to me:

“Grab some wash clothes, a body bag kit, and gloves. Make sure the toe tag is in the kit.”

My heart retracted into my belly and I tasted the acidic fluid of impending vomit. I went to the bathroom, washed off my face, and took a deep breath. If I could do this, I could do anything. I met my coworker back in the room and we began washing the patient’s body. It was eery, beautiful, peaceful, and scary all in one moment. We turned her over, only to hear one final exhale as her lung collapsed. It sounded like a sign of relief. The pain was over. She may rest now. I slipped the toe tag over her toe and starred. My eyes felt wet and stingy, but I didn’t comprehend those tears until minutes later. I went back to home to my dorm, snuck a beer out from under my bed, and reflected back on the day. I knew I would wake up tomorrow and go back for more.

Nursing school was weird. My first clinical rotation consisted of about 10 overly stressed type-A ducklings wandering aimlessly around a hospital unit. I still recall one of my first patients. He was a anatomy professor who recently was diagnosed with Parkinson’s. His shaky hands frightened me. I did not know whether to try to help or just watch him struggle to open his juice. He sensed my unease and talked me through most of his care. He is a very vivid memory for me. He told me about the famous Patch Adams quote that set the precedent for how I wanted to treat patients:

“You treat a disease, you win, you lose. You treat a person, I guarantee you, you’ll win, no matter what the outcome.”

Ok, so I am surviving nursing school and things are looking up. I am learning everyday and I got a job as a nurse intern for the summer. The position was in the ICU. I felt prepared! I bought new scrubs and a clipboard. I figured that combination would make me invincible! Let me tell you about the first day on the job. About two hours into the shift, I heard an overhead page for “Code Blue.” A chaos ensues and you can feel the shift in energy in the air. A patient is wheeled into the ICU. A guy grabs me by the arm and says:

“Go stand at the head of the bed and help bag the patient. Then, jump in for a round of compressions.”

I have been in the ICU for two hours. Two hours, people. So, I run over to the room and wedge myself between the headboard and the back wall. I can feel the hot fluorescent light beat down. My gelatinous legs barely hold me up. The patient looked up at me and asked:

“Am I going to die? Please, please don’t let me.”

I did what I thought was right. I looked down, our heads opposite one another, and I told her that she would be ok. She died about 15 minutes later. I am still haunted by that encounter. That was almost 5 years ago, and I see her face in my dreams.

Ok this is getting heavy. Let me lighten things up.

Fast forward to working as a new graduate nurse. Everything I learned in nursing school was lost and I trudged through the dark waters…trying to simply avoid killing someone. The first few months were terrifying as I was trying to find my footing as a nurse. To this day, I have never made a med error. I think a lot of that has to do with me checking the medication/patient 10333259 times before administering the dose. A classic moment in those first few months involved a sweet patient and a not so sweet move by me. The patient could not eat, so she received food through a tube in her stomach. We use a pump to administer the food into the patient’s stomach. One day, I set up the pump, hit the “start” button and left the room. About an hour later, I returned to check on the patient. When I entered the room, I see a chocolate milkshake-esque substance all over the floor. I had forgot to attach the tube feeding to the patient and it ran onto the floor for an hour. I laughed at my blonde moment and quickly became friends with our lovely environment service team for clean up.

“Clean up on aisle 3. Please don’t hate me. Where are the mops?”

Fast forward a few years. I like to call this story “Cat verses chest tube.”

It is time for hourly rounds. As I enter the room, I hear meowing. Depending on what floor I am working on, meowing could potentially be coming from a patient. Weirder things have happened. Anyway, the meow sound is getting louder. I start looking around the room, doing visual checks on the bedside foley bag, IV fluids, chest tube….OH LORD THE CHEST TUBE. Ladies and gentleman, there was a kitten gnawing on the patient’s chest tube like it is slathered in catnip. I don’t have time to process where this fluffy beast appeared from because I needed to focus on the patient. I picked up the kitten, inspected the chest tube for holes (none!!) and assessed the patient. Everyone was stable. Cat. Patient. Chest tube. To this day, I don’t think anyone believes this story. I wouldn’t even believe this story.

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Tis real. You’re welcome. We became quite close.

 

Nursing has taught me a lot about myself. I believe most people that are called to this profession are called because they also need healing. It is a symbiotic relationship. I heal as they heal. They heal as I heal. We journey through this madness together.

There you have it. A small glimpse into my nursing pilgrimage. There were dark times, sensational times and everything in between. I am humbled by this journey and I am anxious to continue it in a new role.

Love and Light.

*** I value and respect HIPAA. No patient information (name, location, etc) or identifiers were used in this post. Some information was changed to keep upmost privacy and anonymity.

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Putting out fires and saving lives, people!

 

 

 

Undulating.

The ebb and flow of my yoga practice has provided me with years of comfort. Yoga gives me stability in mind, body, and spirit. My practice continues to evolve and I spent my morning meditation reflecting on the evolution of my yoga journey. My heart felt compelled to write about it, in the hopes of touching other lives.

High School: I learned about yoga in my AP history class. We discussed religious and cultural practices of ancient civilizations. We talked about Gautama Buddha and his sage teachings. I soaked up the information and enjoyed learning through a global lens.

College: A time of challenging your past knowledge and paving the way towards individual thought. I never knew there was more to life than what I was taught in high school. My world was very small, so I craved more of this fresh information. The campus gym offered a free yoga class one night and I decided to go. I purchased a yoga mat that was essentially a foamy beach towel and headed to the class. My fingers aggressively typed into the search engine of my 47 lb Mac laptop, “what does one wear to yoga?” Unfortunately, I did not have any spandex in my possession (a true tragedy) so my only choices were sweats and a t-shirt that said “free hugs.” Seemed fitting considering I was about to delve into the world of patchouli and liberals. Class starts, the lights dim, someone is chanting, and I somehow feel at home.

Nursing School: Yoga served as an educational tool, rather than a practice of relaxation. I taught simple yoga classes at a homeless women’s shelter during a clinical rotation. To see women halt from the chaos of life and enjoy 15 minutes of self-care, was a true gift. I realized yoga was so much more than hipsters sweating on a mat. It was about hitting the pause button on life and taking time to give your soul a hug. It was a free and easy way to connect with yourself and others.

Adulthood (if that is really even a thing): I once heard someone describe being an adult like this… “you leave your house, look both sides before crossing the street, you walk towards your car and a plane hits you.” Honestly, that nails it. With adulthood came this terrifying revelation that groceries are expensive, doing your taxes is a real thing, and you can not survive off of ramen noodles because it will make you hypertensive. So, I turned to yoga once again. My local gym offered yoga classes and I used them as xanax to combat my newly discovered anxiety. My meditation practice was evolving, so it only made sense that I become the semi-cool yoga hippie chick (right?). At that point, I sometimes wonder if I was practicing yoga because I loved it or because I thought I had to in order to keep up the image of the laid-back bohemian meditator.

Present: I have transitioned my practice from community group classes to the home practice. My gratitude goes out to Yoga with Adriene. Her online classes reminded me why I love yoga. It is not about wearing the cutest clothes or being seen at the right/hardest class. It is about a raw, honest relationship between your mind and body. Today, I often practice lazy yoga. I am gone for 15 hours most days, so I simply melt on the mat in child’s pose for a few minutes. Sometimes, my daily practice is 5 minutes of just standing in Mountain pose and preparing for the day ahead. But, that is what works for me right now, thus making it the perfect practice.

My relationship with yoga continues to undulate. It bends, moves, crescendos, crashes, and stays stagnant. It is your practice, it can be whatever you want.

Please enjoy this website, I have learned so much about my journey through Adriene’s words.

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Love and Light.

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An example of a lazy practice.

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The tech world meets the yoga world! Thankful for youtube for helping make the home practice a reality

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Squeezing in a quick practice during my lunch break at Urgent Care.

Visceral Terror.

My heart physically aches. My brain is numb. It feels like someone gave my soul a paper cut.

Sunday morning: The phone illuminates an empty patient room. I snuck away to chart my morning assessments, only to be greeted with a harsh reality that our innocent bubble has been broken. Another massive tragedy. Another faceless gunman. Another precious day polluted by the shadow of death.

I tend to perseverate on the news. My brain loves the dopamine jolt of a juicy news story. I must keep my curiosity in check because I often fall down the news hole…only to awaken three days later, covered in chips and sweat. This Sunday was no different. I sat in my patient’s room and we quietly watched as the Orlando massacre unfolded. So many questions…who? why? how many?

Terrorism: the state of fear and submission produced by terrorization

My mind immediately reverts back into an anxious state, convinced that the world is ending and many attacks will follow. That is the weird thing about terrorism…being anxious about the next attack is proving to not be such an extreme reaction. Look at the past few years: Fort Hood, Boston Bombing, Chattanooga Shooting, San Bernardino shooting. For the first time in my life, my anxious thoughts might truly be validated. Normally, my repetitive worries represent irrational fears, which are easy to challenge and reframe. This…this fear of where our world is headed…is a realistic thought process. I never thought I would see the day.

My generation grew up with words like “terror, ISIS, Al Qaeda, terrorism, massacre” as part of the colloquialism of family gatherings. These vicious acts have almost become a numb aspect of the American psyche.

Um, 50 people were killed by one man claiming allegiance to ISIS. Terribly sad. Oh… what would you like for dinner?

I worry we have become so accustomed to the horrific news that our guard is down. The hateful acts still feel “far away” even on American soul. The bystander effect kicks in…”it would never happen to me.” Well, it could and I urge you to exercise your right to knowledge about self-protection.

The logical part of my brain is thinking that I do have statistics on my side and that a terror attack will never touch my life. The emotional side of my noggin is screaming for awareness and vigilance because another attack is right around the corner. We could have another 50 innocent victims in the coming weeks. The unpredictability of it is almost too much to bare. So, what is the solution? If I had a real one, I would be running for office.

In my book, the solution is to harness the anxious energy and convert it into logical planning. Research. Plan. Communicate. Get with your coworkers and discuss a plan for an active shooter in the workplace. Create an emergency contact. Learn basic techniques for disarming someone. Be vigilant in your personal fight against terror, thus giving us a universal strength against the enemy.

 

Love and Light (and a little bit of ammo).

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Thanks to the man who not only fought the war on terror for many years, but who teaches me so much about self-defense and awareness.

“Crazy” is in this year.

Over the past 80 years, there has been a constant rise in the prevalence of anxiety and depression and no one really knows what is causing it. Let that permeate your mind and sink in. This year, I have treated about 1,000 patients in primary care/urgent care settings and 30% of them have a history of anxiety or depression. That data is staggering. My school requires me to input data into a server that organizes information for us to see trends and learn about common themes in healthcare. When I adjusted the settings to display the ratio of patients:mental health issues, I felt a surge of intense questioning. The Association of Anxiety and Depression claims that the prevalence of these disorders is significantly lower. Why?

Perhaps people who are feeling depressed or anxious are more likely to seek medical care, thus skewing the data? Regardless, why are we seeing this dramatic increase and why is this not considered a massive public health crisis? Most of my adult life has been dedicated to questioning things and annoying most of the people around me with my theories…BUT THIS IS A BIG DEAL, Y’ALL.

My database has tangible evidence that suggests about 1/3 people deal with anxiety/depression. I believe that number is even higher because of the lack of accurate reporting. A lot of people do not have the self-awareness to even recognize something is off with the mind and psyche, so who is to say 1/2 of people are actually on this mental health train?

I want to play a guessing game with you. Think back to the last time you saw a medical provider. Perhaps it was your annual physical or an episodic meeting. Did your provider ask you about your mood/stress/energy? As a future provider, I recognize that time is of the essence and you can not perform a full blown psychoanalysis on every patient. With that being said, I value the importance of a handful of screening questions. I try to ask my patients, “how is your energy level during the day/how are you handling your stress/what do you do to for self-care?” It takes about 2-3 minutes and opens the door for a emotional connection.

 

When time permits, I love to teach patients about stress management through alternative methods: belly breathing, guided meditation, and yoga. All this is hunky dory, but back to the point…

What is causing the constant rise in anxiety and depression?

Unsolicited advice/theories I developed that probably hold 7% scientific value:

  • technology
    • after a weekend in the woods, my mind and body are in such a calm state. Being off the grid and “disconnected” is therapeutic for my adrenal glands and neurotransmitters
    • social media (I REALLY spend too much time on that crap) is a forum for “look how amazing I am” and drives feelings of inadequacy
  • food
    • our culture sucks at eating, let’s be honest
    • the era of processed food, sugar, add added hormones is essentially destroying our brain’s ability to regulate emotion and stress hormones…no big deal
    • hypoglycemia can mimic feelings of anxiety and that tends to be an issue when we eat such a high sugar diet–leading to fast metabolism of food and a massive blood sugar crash (you should probably apologize to your pancreas)
  • birth control
    • who doesn’t love good old oral contraceptives…ok, ok, too far, I get it.
    • the estrogen component in most OCP is detrimental to the mind
    • my anxiety was drastically reduced when I changed to a very LOW dose of estrogen
    • all the smart brain docs tell me that estrogen negatively impacts serotonin and norepinephrine
  • lack of community
    • although we are the most “social” generation via social media, we are actually the loneliest
    • in the 1930s-1950s, farming was a critical aspect of society and most people lived on land with many family members and spent very little time alone
    • some people believe that a large social circle will buffer the impact of anxiety/depression, thus serving as protective
    • when is the last time you drove to someone’s house to talk to them instead of text them? Exactly.

My commitment to the medical community is to discover trends and determine how I can make a tiny positive impact in the world. Maybe that is through developing more screening guidelines or writing a self-care novela as a free gift with purchase. “Thanks for getting a Pap today, enjoy your free guide on how to take care of your mind and body.” All jokes aside, I have a lot of questions and a lot of energy to figure them out (thanks to the shit ton of green tea I guzzle). I want to solve this dilemma and save the world. All in a day’s work.

Why do you think we are seeing the consistent rise in anxiety and depression? Comment below!

Love and Light.

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Sources: (http://nymag.com/scienceofus/2016/03/for-80-years-young-americans-have-been-getting-more-anxious-and-depressed.html)