Monday, July 27, 2009

A Chemical Nightmare at Work

Last week, I was sitting in my office and began to notice an odd smell, sort of sickly sweet. Ignoring it against my better judgment for several days, I was even told by my astute boss---who is well aware that I have Multiple Chemical Sensitivity (MCS)---that something seemed amiss. 

Since last week, I've been noticing increased confusion, memory loss, and a marked increase in my level of stress and anxiety. Granted, we are in the midst of selling our home and radically changing our lives, but this past week my emotional life has been over the top and I have been feeling physically unwell. 

Today, my (chemically sensitive) wife came to visit my office, remarking immediately that my office seemed incredibly toxic to her and that I should leave immediately. Just prior to her arrival, I had literally been crawling around on the floor, trying to "sniff out" where the offending odor was coming from, an odor that had by now become almost overpowering in its sweet disgustingness. 

With my nose on the top of the heat register, I detected the source of the odor emanating directly from the heater, even though it wasn't on. 

Bringing two colleagues into the office, they both agreed that the smell was very strong and that I should leave for the day and we would try to get to the bottom of it. Just then, one colleague mentioned that someone had moved into the office directly below mine last Tuesday, and perhaps there was a connection. Looking back, it was indeed Tuesday or Wednesday of last week that I began to feel unwell and that the faint smell had begun to make itself known. 

Running down to the first floor with my wife, we quickly located the office directly below mine (which I had never before noticed), and although the door was closed and locked, the smell coming through the cracks was absolutely the same odor now filling my office on the second floor, although the intensity of it as it emanated through the door was enough to send us reeling. 

My guess is that the new resident of this office installed a "Plug-In" on the day she moved in, the sort of plug-in that is filled with noxious liquid fragrance that is heated via an electrical outlet. These insidious and ubiquitous devices have taken over, with Americans of all economic stripes convinced that their homes will not smell "clean" without such unhealthy trash that poisons the very air that they and their children breathe. 

Since the building manager was out, I sent him an urgent email explaining the situation, left work early (with dizziness and confusion continuing), and will not return to my office until the space has off-gassed for several days. 

So, although I have fought for a fragrance-free workplace, low-VOC paints, "green" cleaning products, and other accommodations, this employee who moved into the office downstairs unwittingly created a toxic environment for me that has subsequently caused me a week of distress, confusion, and other neurological symptoms that will, I hope, decrease as the next few days allow me to detox from its deleterious effects. 

When one has MCS (or even if one does not), there are poisons and toxins everywhere that can damage our health and cause us temporary or permanently debilitating symptoms that directly impact our ability to fully function in the world. 

I was glad to get to the bottom of this situation, and hope that it will be rectified shortly and that I can recover from the impact of this unfortunate chemical event. 

Sunday, July 26, 2009

Saturday Night Insomnia

On this Saturday night/Sunday morning, insomnia pays a visit to my room. Is it the chocolate I ate at the movie? Is it the enormous amount of change and uncertainty in my life at the moment? Is it the insomnia of depression and anxiety? Or is it simply the gnawing knowledge that change is afoot, my mind awash with needless ruminations on the future? 

On these sleepless evenings, I toss and turn, I read, I pick up the laptop, and I eventually collapse in a heap or am lulled to sleep by soothing music or a guided meditation. Lately, I've taken to a form of prayer, reconnecting with the devotional self, a part of me that has lay dormant for far too long. My prayers are like requests for help, requests that I be saved from the runaway train of my mind

Outside, it's a humid and quiet New England summertime night. Nearby, frogs doze in their frog beds, beavers snore in their lodges, and bats circle in the dark air, feasting on mosquitoes. 
The other night, I heard coyotes in the distance, and it made me long for life on the road where we will hear many more wild sounds in the deep, dark night. 

For now, I am comforted by a lamp, the glow of the computer, the sounds in the still night air, and the beating of my own heart. 

Saturday, July 25, 2009

Nursing on the Road: Some Conundrums

I've been thinking a great deal about what type of nursing I might do once my wife and I are "on the road". (For those of you new to Digital Doorway, my wife and I have sold our house and will be spending a year or so living on the road in the United States, traveling and looking for a place to make a new life.)

As a nurse, I have completely eschewed working in hospitals, partly due to my desire to avoid the overly controlled and mechanized hospital setting, but also because I have Multiple Chemical Sensitivity (MCS) and hospitals are basically dangerous to my health. MCS is a serious syndrome, and one of the best ways for me to safeguard my health is to avoid exposure to that which makes me sick. 

Lacking hospital experience, my work as a nurse has centered on home care, ambulatory care, hospice, and case management. When perusing websites for travel nurse agencies, I have noticed that travel agencies almost exclusively recruit for hospitals, and I am beginning to understand that I carry a critical handicap in that regard. However, with MCS, I am certainly not going to begin exposing myself to the toxins and chemicals of the hospital environment, thus my search for work along the way will need to be quite creative. Even home care carries with it some health risks, since many people fill their homes with chemicals, fragrances and air fresheners that can compromise my wellness and set me back for hours or days. 

So, thus has been born my increasingly keen desire to be self-employed, to "hang a shingle" as a health and wellness coach, offer sessions of Laughter Yoga to organizations and groups wherever we go, and promote my work as a writer. 

But when the proverbial financial feces hits the fan and money must be had, my plan is to creatively manifest work as a nurse that does not compromise my health, utilizes my many strengths, and brings benefit to those by whom I am employed. 

Nurses are, of course, ubiquitously employed by hospitals and hospital-based health systems throughout the country, and millions of nurses are gainfully employed in that arena at any given time. This particular nurse purposefully avoids the hospital setting, thus my "hireability" is potentially compromised, thus my search for equally gainful employment may indeed go somewhat against the prevailing tides. 

With excellent assessment skills, a high level of comfort with computers and IT systems, and years of experience in case management and ambulatory care, my hope is that I will, when necessary, be able to finesse my way into work that is satisfying and highly remunerative. With MCS, self-employment is by far my preferred course for my future in terms of making a living, but if I need to enter the health care fray while traveling, my pursuit of a safe working environment that will support my health and utilize my skills will be my top priority. 

Sunday, July 19, 2009

Multiple Chemical Sensitivity: An Inconvenient Reality

As my wife and I shop for a recreational vehicle in which to spend the next year or two as we live, work and play, our Multiple Chemical Sensitivity has become even more of an inconvenient reality. 

We all know that new car smell, and many people equate that smell with freshness and newness. We also know the particular smell of a new shower curtain which is now widely understood to be the off-gassing of pthalates and other very unhealthy chemicals. These are modern realities, and they're making us sick. 

Recreational vehicles (RVs) are manufactured just like homes and cars----they are filled with particle board, formaldehyde-based materials and nasty chemical-laden furnishings that off-gas for years. In our meanderings, we have entered several newish RVs and the chemical aura has hit us both like a brick wall, driving us out the door in seconds. One wonders about all of the retirees out there who buy brand new RVs and then hit the road. Do they develop cancers, memory loss or early-onset dementia more quickly than others? After all, they are living in a small area which is often sealed tight---a literal chemical soup.

Many people with Multiple Chemical Sensitivity end up homeless because they can't find safe housing. Small homespun businesses (like Taylor Designs) have indeed sprung up in an effort to fill a niche, creating "safe rooms", MCS trailers, and other spaces designed to make living and sleeping healthy for those with environmental illnesses. Publications like "Our Toxic Times" and "The Canary Report" offer resources, advertisements and classifieds for those seeking safety and healthy alternatives, and many do-it-yourselfers take a shot at retrofitting trailers, homes and other structures to suit their needs. 

For us, our only alternative may be a refurbished Airstream trailer, gutted and professionally retrofitted by Taylor Designs several years ago and now available through a private seller. However, what we really want is an all-in-one RV in which we can live, work, sleep, eat and drive, but every vehicle we look at or consider has been treated with, or is constructed with, materials that can put our health at risk. 

Yesterday, after combing through Craig's List, Mary found an RV that sounded great, and she called the owner. After a long and detailed discussion during which she patiently explained our MCS, the owner finally acknowledged that he has put Bounce dryer sheets in all of the storage compartments of the rig in order to ward off mice and "freshen" the air. That potential sale is going nowhere, of course. 

So, we continue in our search, narrowing it down, looking under every rock, and may end up spending more than we care to on the retrofitted Airstream and a diesel pickup truck with which to tow it. This is another consequence of MCS----we can often end up spending more to get what we need because so much of the world is stacked against us. It's a chemical soup out there, and we simply want to remove ourselves from the broth. 

Saturday, July 18, 2009

Health Insurance Blues

Most of the readers of Digital Doorway know by now that my wife Mary and I are preparing to leave our static home in New England for an itinerant life on the road. That said, leaving our home necessitates quitting our jobs, and when that paycheck stops rolling in, something else will also end----our health insurance. 

Now, my European friends simply cannot comprehend this, but millions of Americans remain in jobs that they hate for one reason and one reason only---their health insurance. And many Americans who share our dream of self-employment and entrepreneurship also allow their dreams and aspirations to be thwarted by that very same health insurance bogeyman. 

What is it about America that those who wish to do something different must suffer for their choices? Why are there millions of uninsured children who go without primary care because their parents cannot pay for their care? Why do tens of millions of adult Americans with chronic illnesses languish without health care and health insurance? 

My wife and I want to manifest a life of creative self-employment and entrepreneurship, a vibrant engine of economic growth upon which American society was actually built. So, why are we forced to pay extortionate amounts of money so that we can have the simplest, most basic form of catastrophic health insurance? In this country built upon the entrepreneurial genius of those willing to take a risk, why are the risk-takers economically penalized? 

I ponder these questions as we look towards the end of my job, the cessation of our health insurance, and the uncertain road ahead. If we were European, this conversation would never have to occur. In fact, it would be seem ludicrous. 

Will this country ever change? 

Friday, July 17, 2009

It's Official---I'm Quitting My Job!

Yes, the day has come and I have officially given notice at work. Mind you, I've given three months notice and have a lot to do before I leave, but notice is notice in my book. 

For me, leaving a job is always fraught with tension and anxiety. In my years as a nurse, there has developed this pattern of feeling indispensable at work, that my leave-taking is a burden, and that I must give it my all to make the transition as easy as possible for my employer. Friends and family remind me that people leave jobs every day with no more than 2 weeks' notice, and people are laid off with barely enough time to clean out their desks. Still, I carry a great deal of responsibility in my job and want to do the right thing to prepare for my successor. 

Since the arrival of H1N1 influenza, everyone seems to have woken up to the crucial importance of public health, and with the seasonal flu season beginning in October or thereabouts, my leaving at that time is, shall I say, highly inconvenient for many in the local public health arena. Still, a man's gotta do what a man's gotta do, and my plan is to find the perfect replacement for myself and leave our local health department in capable and well-equipped hands. 

I have been punching the proverbial clock for years now, and I am ready to eschew the use of that ersatz timepiece and begin to decide how my days are spent. Self-employment isn't for everyone, and my self-employment may be temporary or long-term, but having a workplace to report to is no longer working for me, and I have professional wings that are readying for take-off. 

I like my job a lot, and I am very fond of my colleagues. I think public health is a very important piece of the national and global infrastructure, but my time in that arena is drawing to a close, and I am choosing to not be in the middle of the battle against H1N1 that will be waged this coming flu season. 

So, when my wife and I cruise the East Coast, South and Southwest U.S. in our new RV, gliding through the towns, cities and rural areas of this vast country, we will stay tuned in to what's happening out there, volunteer to help where needed, and give thanks that we have chosen to extricate ourselves from the workaday world as we create a new way of being and living as middle-aged adults on a mission to live life on our own terms. 

These next three months will go by in a flash, and I will make the most of my time at work as we move out of our home of 13 years and prepare for an adventure of a lifetime. 

Stay tuned! 

Thursday, July 16, 2009

NurseKeith on Twitter

I am honored to have been named among "the 200+ most worthwhile health and medical accounts to follow on Twitter" by the website MedicalFuture. I am in very illustrious company and I am humbled to be included in such a listing. Please check out the list!

Monday, July 13, 2009

The Mind as a Train

I've been under a considerable amount of stress lately. My wife and I are quitting our jobs, selling our home of 11 years, leaving our hometown of 17 years, and starting a new life. Plus I have chronic pain and several other troublesome health problems. In the presence of these concurrent and challenging life factors, I am striving to maintain my emotional equanimity, mental stability, and a healthy lifestyle.

Watching how my mind works and the suffering that I experience when my mind gets the best of me, I can see that my mind is often like a runaway train. There are apparently no brakes, the passengers are screaming bloody murder, and the only refreshments available in the cafe car are drugs, alcohol, cigarettes, junk food, slothfulness, and a host of other unhealthy habits to which we humans so frequently succumb when under duress.

As this train hurtles down the track, I try to disengage and hop off at one of the platforms that whiz by at lightning speed, but it's difficult to get up the courage to simply be calm in the eye of the storm and trust that I'll land on my feet if I jump. And when I do indeed manage to simply stand on the platform and watch the train racing past, my hand will often get caught on one of the train's many handles, and I'll suddenly find myself being dragged alongside the speeding train, once again falling victim to the mind's subtle tricks, even though the only thing I need to do is let go.

Apparently helpless and at the mercy of the chugging engines of ego, depression and anxiety, I am frequently dragged alongside my churning mind, and my body is whipped against telephone polls, street lamps and signs along the way. As I struggle to gain my footing against this consistent onslaught of worry and anxiety, my shoes are torn off, and my bloodied feet drag along the ground as the train continues on its inexorable path.
These images may be graphic, but I feel that it's important to identify the feeling that one experiences when the mind's runaway train controls the trajectory of one's life. It seems that the train can happily speed along it's one-way track of worry and rumination perfectly well with or without my participation, so why not choose to simply sit in the grandstand, drink a cup of tea, and watch the action from that calm vantage point?
I admit it. I daily fall victim to my mind's attempts to keep me worrying, to keep the fretting fresh and new, to continue to enslave me to its wiles. But now, 45 years into the game, I'm beginning to catch on, and I'm seeing the ways in which I make myself miserable. I am determined to continue to learn how to get off at the station, rest my weary self, and be a witness to my mind. The lessons learned from that watchfulness and awareness---often called mindfulness---are ones that I will be sure to share here with you, Dear Reader. If you have a story, tactic or anecdote to share about mindfulness and self-care, please leave a comment, and I will be sure to respond.

Call for Submissions: End of Life Stories

Creative Nonfiction is seeking new essays that explore death, dying, and end of life care, for a collection to be published by Southern Methodist University Press. We’re looking for stories that transcend the “I” and find universal meaning in personal experiences. We hope to include stories representing a wide variety of perspectives—from physicians, nurses, hospice workers, social workers, counselors, clergy, funeral directors, family members, and others. We want narratives that capture, illustrate and/or explain the best way to approach the end of life, as well as stories that highlight current features, flaws, and advances in the healthcare system and their impact on professionals, patients, and families.

Essays must be vivid and dramatic; they should combine a strong and compelling narrative with a significant element of research or information. We’re looking for well-written prose, rich with detail and a distinctive voice.

Creative Nonfiction editors will award one $1500 prize for Best Essay, and two $500 prizes for runners-up.

Guidelines: Essays must be: unpublished, 5,000 words or less, postmarked by December 31, 2009, and clearly marked “End of Life” on both the essay and the outside of the envelope. There is a $20 reading fee (or send a reading fee of $25 to include a 4-issue CNF subscription); multiple entries are welcome ($20/essay) as are entries from outside the U.S.(though subscription shipping costs do apply).

Please send manuscript, accompanied by a cover letter with complete contact information, SASE and payment to: Creative Nonfiction, Attn: End of Life Stories, 5501 Walnut Street, Suite 202, Pittsburgh, PA 15232.

Please share this announcement with anyone who might be interested in submitting work. Please email any questions

Sunday, July 12, 2009

The Dream Moves Closer

Dear Readers, 

Just a few days ago, I posted that my wife Mary and I are trying to sell our home so that we can begin moving closer to our dream of taking our lives on the road for bigger adventures and broader horizons. 
Today, that dream took one more step closer to reality. Following an open house hosted by our fabulous realtor, we now have three bids on our home, and it appears that a small bidding war is at hand. We surmise that we will accept the highest offer within the week and begin plans for a closing date in the near future. Since we are not quite ready to leave our New England region quite yet, we will find temporary rental housing, finish up our jobs by Hallowe'en, find and purchase the perfect recreational vehicle, and begin our journey forthwith. 
Meanwhile, we will soon begin a short introductory training to become health and wellness coaches, and then register for a 13-week intensive coach training beginning in September. 
Even as I have temporarily succumbed to the stress of making so many simultaneous major life transitions, I am humbled by the way in which serendipity and blessings abound. 
Stay tuned for further news as we move forward......

Friday, July 10, 2009

The Anchor House Ride

From July 12th to July 16th, my wonderful brother and hundreds of other amazing and giving bicyclists will be cycling their way from Oswego, New York to Trenton, New Jersey as participants in the Anchor House Ride for Runaways.

The Anchor House is "a multi-service agency for runaway, homeless, abused, and at-risk youth and their families" that has "committed its efforts to providing comprehensive, life-saving assistance to our most vulnerable population" for the past 30 years.

As a bicycle-pedestrian activist and avid cyclist, my brother, Ken Carlson, has achieved monumental results in his volunteer work on behalf of his Central New Jersey community of West Windsor, and his support of Anchor House is yet another manifestation of his generosity and kindness. Please feel free to donate to the Anchor House Ride for Runaways as Ken's sponsor, or simply leave a supportive comment here to thank him and his compatriots for their selfless work and dedication.

The Fresh Air Fund Half-Marathon

On August 16th, The Fresh Air Fund of New York City is hosting its annual Half-Marathon in order to benefit the excellent programs sponsored by the Fresh Air Fund for New York City children. If you would like to run in the event or sponsor a runner, please click here for more information.

From the Fund's website: "Since 1877, The Fresh Air Fund, a not-for-profit agency, has provided free summer experiences in the country to more than 1.7 million New York City children from disadvantaged communities. Each year, thousands of children visit volunteer host families in 13 states and Canada through the Friendly Town Program or attend one of five Fresh Air Fund camps."

As a native New Yorker, my father benefited from a Fresh Air Fund scholarship in the 1930s and spent a summer in the countryside, working on a farm in New York State, so it seems natural to post about the Fund after receiving an email from their staff.

May every child have the opportunity to experience fresh air, good health, and the benefits of charitable programs dedicated to their well-being!

Thursday, July 09, 2009

Change of Shift Begins Year Four of Publication!

Change of Shift, nursing blog carnival extraordinaire, is celebrating it's third birthday and the beginning of it's fourth year of publication. I am honored that Bob the Nurse is once again featured in this week's edition, and perhaps Bob will receive more invitations to travel the country from this continued exposure. 

Speaking of Bob, please stop by his blog and check out his latest adventures in Hawaii. He leaves for Arkansas soon, so new travels and destinations await, and he will no doubt pop up on Change of Shift regularly!

Thursday, July 02, 2009

On Vacation

Dear Readers and Friends,

Digital Doorway will be on a brief hiatus until the end of the Fourth of July weekend. Mary and I are on a brief vacation in celebration of our 20th wedding anniversary. Please stay tuned, and visit again next week!

Happy Summer!


Wednesday, July 01, 2009

Exclusive Early Peek at Wikio Health Blog Rankings!

I am honored to have been given a sneak peek at the latest rankings for health-related blogs on Wikio. Digital Doorway is lucky enough to consistently be in the top 50 health blogs on Wikio, and I am happy to share this preview of the newest rankings with my readers. Enjoy! 

1Highlight HEALTH
2Kevin, M.D. - Medical Weblog
3Diabetes Mine
4In the Pipeline
5DB's Medical Rants
6The Covert Rationing Blog
7The Carlat Psychiatry Blog
8John Goodman's Health Policy Blog
9Junkfood Science
10Her Bad Mother
12The Doctor Is In
13Healthcare Economist
14Schwitzer health news blog
15Health Care Renewal
16Six Until Me.
17Disease Management Care Blog
19Musings of a Dinosaur
20Fight Aging!
21The Rotund
24The Last Psychiatrist
25MSSPNexus Blog
27retired doc's thoughts blog
29Cranky Fitness
30hospital impact
31Beyond Meds
32Brain Blogger
33Doctor Anonymous
34Dr. Deb
35Digital Doorway
36The Trouble With Spikol
37Postpartum Progress
38Weighty Matters
39Caustic Musings
42fat fu
43Autism Vox
44Medicine for the Outdoors
45Genetics and Health
46Brass and Ivory
47Eye on DNA
48soulful sepulcher
49Adventures in Autism
50Inside Surgery
51Autism Street
52Natural Variation - Autism Blog
53Autism News Beat
54Capital Health WW-MD's Notes
55A Nurse Practitioner's View
57The Voyage
58The Urban Monk
59Mauzy's Musings
61Hard Won Wisdom
62Jung At Heart

Ranking by Wikio.