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There are side-effects to surviving

December 6, 2010 in Future Glimpse by Admin Dawn

Bee LavenderBee Lavender is the author of the award-winning memoir Lessons in Taxidermy: Diagnosed with cancer at age twelve and perilously pregnant at eighteen, surviving surgeries and violent accidents: Sometimes you can’t believe Bee Lavender is still alive; sometimes you think nothing could kill her. Lessons in Taxidermy is Lavender’s fierce and expressive search for truth and an elusive sense of safety. This autobiographical tale is stark and resolved, but strangely euphoric, tying together moments and memories into a frantic, delicate, and often transcendently funny account of anguish and confusion, pain and poverty, isolation and illusion. While staying conscious of the particulars of her circumstances, Lavender frames her life in the context of history, traveling, landscape, and freak show culture. Lessons in Taxidermy is apocryphal, troubling, cathartic, and important.

We interviewed Bee about her experiences to ask her what parents can do to help their children who are going through a medical crisis.

Children who have been seriously ill go to a place where they are absolutely alone and where their parents can’t follow. How can parents support their children as they face these very scary challenges?

The first and fundamental principle is simple: always tell the truth. No matter how difficult, unwieldy, or frightening, it is better by far to acknowledge what is actually happening. Yes, this is hard – especially if you are talking about painful and messy procedures, serious permanent disabilities, or the possibility of death. But even the youngest children have the capacity to understand what is happening, and developing a framework will help them cope with the process. Saying “this will hurt” is always better than pretending otherwise. Saying “we don’t know what will happen” is always better than promising a miracle that might not come.

Truth doesn’t hurt. Surgeries hurt.

In your book, you write about your ability to separate your body from your mind in an effort to deal with the pain of your cancer. Have you been able to come back to your physical self? Do you have thoughts about how parents can help their children retain that sense of self?

It is fair to say that sustained and routine trauma is not a desirable formative experience. In my particular case, I learned to compartmentalise. Pain and pleasure go in separate boxes, learning and love happen on their own. It took several years before I could even let the food on my plate touch, let alone the emotions or whatever you want to call the stuff boiling around in your brain and chest. I had to take small and incremental steps toward normal behaviour – the ability to think, yearn, fail, all at once, losing control, letting life happen, feeling it.

I still lack certain forms of empathy. I grasp that there are no hierarchies of suffering, yet I am dismissive of pain in myself and others. When my friends (or children) complain about something they find deeply important, I often catch myself thinking they should go get some real problems. Though at least I have learned to think it instead of saying it out loud.

There is no tidy way to help a kid in similar circumstances. There are side-effects to surviving.

How has being a writer helped you process your experience? Do you think parents should help their children journal (either via writing or pictures)?

From my earliest years I remember thinking that words were my friends, and putting them in a certain order to convey stories was a tremendous distraction from all manner of mayhem. From about age five or so I wrote fiction, and the activity was hugely entertaining and a much needed distraction. Other children might have a different set of needs, but I think that the desire for escape is valid and necessary.

Distraction, even obsession, can be better than therapy, when your life is organised around medical treatments. By the time I was eighteen years old I had several hundred surgical scars on my body and I would have rather stabbed myself in the eye than talk about my illness: dreary, boring, obnoxious illness! Cancer, cancer, cancer, ugh. Give me a movie, a concert, a new album to listen to, book to read…. art, literature, and politics offered solace and a way forward. For other people it might be sports, video games, knitting, whatever, just something external, something to think about other than the failures of the body.

I didn’t keep journals as a child, and never wrote directly about my illness until I was about 29. I don’t think it would have helped *me*, except to keep track of dates for later publication. In fact, I don’t think documenting the experience would have been especially healthy, because doing so would have been another way of assigning a privileged meaning. I think the most empowering thing is to learn to say “the disability is part of me, but it does not define me.”

Did you feel you had to protect your parents from your fears? Is there something they could have done to relieve some of that burden?

Yes, I wanted to protect them, and the need to do so was both explicit (I was told not to cry) and implied (being brave made it easier for everyone to play their part). I agreed with these values at the time and I still do. Life was seriously difficult for me, but my parents were there too. They had to watch me suffer, but they also had to deal with the administrative details, and pay the bills. Even now, with children of my own, I simply cannot imagine the anguish they were forced to endure. I was stoic, but my parents were heroic.

Decades later and thousands of miles away, my first thought when I have a medical appointment is how to prevent my mother worrying about me, or knowing at all. If I had one magical wish it would be to take away the pain that she suffered raising a sick kid. Both of my parents did their absolute best in a terrible situation, and asking for more – for niceties of behaviour or etiquette – is foolhardy at best.

The only way our collective burden could have been relieved was simple, and structural. My health insurance came from my mother’s job. The money to pay what the insurance didn’t cover came from the overtime both parents worked. I was literally alone, because they both had to work desperately hard – just to keep me alive.

The only thing that could have relieved our collective burden would have been universal health insurance. I believe that every citizen of a wealthy nation should have access to basic medical care. I moved to England six years ago because of the National Health Service, and I have no plans to move back home until health care reform is a reality instead of a promise. I do not want any of my loved ones to sacrifice their dreams to my illness.

Finally, medical issues force children to give up control of their bodies and their physical privacy in lots of ways. Do you have any thoughts about how parents can protect their children or give them some measure of autonomy given the reality of their medical needs?

In a purely practical sense this is an unobtainable goal. Whether you are talking about a crisis medical situation or long-term maintenance of a disability, you just can’t expect much privacy. Your body is being inspected for a reason, and the people looking are generally doing their best to help.

However, I do think there are limits. Speaking as someone with an “interesting” and rare disorder, there have been countless times when an examination seemed to be more for the prurient interest of staff than any clinical reason. Sometimes I have no choice but to cooperate, especially when using teaching hospitals. But I always make an effort to achieve at least a symbolic level of privacy.

This can be as simple as insisting on a curtain around the examination table, or an introduction to the people poking my flesh.

But privacy is more than just showing skin. It is about control, autonomy, narrative. The best thing that my parents did was allow me to own my story – to decide when and how to talk about the disease. Or not.

Mental health and children

November 11, 2010 in Special Needs News by Admin Dawn

It’s a subject that’s not talked about very often. However, it’s estimated that nearly 25 percent of American children will struggle with a mental health disorder.

Harvard clinician and author, Dr. Ellen Braaten, along with the American Psychological Association, has just released the first and only book to help parents take charge of their child’s mental health care. Watch Kim’s interview for more.

Watch the video at Family works: Mental health & children.

Mental health providers grapple with Medicaid expansion

October 21, 2010 in Special Needs News by Admin Dawn

For District health officials, it was an easy decision.

The federal government handed them an opportunity to save $56 million over four years by expanding Medicaid this summer and they jumped at it. They switched 35,000 low-income residents from the city -funded D.C. Health Care Alliance insurance plan to a Medicaid plan and reaped the reward.

It looked like a win-win: The city got some financial relief and the new Medicaid beneficiaries got mental health coverage, which was not part of the Alliance plan. But it creates a problem for the city’s mental health-care providers, who said this week that they are faced with serving thousands of new clients they are not prepared to manage.

Read more here: Mental health providers grapple with Medicaid expansion.

Integrated care causes concern among disability advocates

October 12, 2010 in Special Needs News by Admin Dawn

llinois is moving forward with a new integrated care program that could save the state $200 million over five years, but disability rights activists say they are worried about the future of their health care.

Insurers Aetna Inc. and Centene-IlliniCare have received five-year contracts for $450 million annually to manage the care of nearly 40,000 Medicaid patients in a six-county program set to begin in January. All of the patients’ medical services will be handled by one HMO, limiting the redundancy and overhead of the current system, while focusing on prevention and improving overall patient health.

“You hire people to stay in touch with patients—to monitor their illnesses and try to catch things before they go to the hospital,” said Margie Schaps, executive director of the Health and Medicine Policy Research Group in Chicago. “It’s a whole different model of care.”

Read more here: Integrated care causes concern among disability advocates.

A big victory for people who need mental health care

October 11, 2010 in Special Needs News by Admin Dawn

Two federal laws that provide better insurance coverage for more people with mental health and substance abuse conditions are just beginning to take effect, and advocates describe the changes as a huge win for consumers that will greatly improve treatment.

As anyone who has ever sought help for addiction, depression or any other mental illness knows, insurance coverage is often skimpier than for a physical malady. Plans typically limit the number of therapy visits they’ll pay for, and they may also impose separate deductibles for mental health and substance abuse services and require higher out-of-pocket contributions from patients as well.

Under the Mental Health Parity and Addiction Equity Act, which took effect this year, the mental health and substance abuse benefits that a health plan provides have to be just as generous as its coverage for medical and surgical treatments. The law does away with different co-payments, deductibles and visit restrictions.

“These financial equalizers will be very helpful to families that have not been able to access care before,” says Katherine Nordal, executive director for professional practice at the American Psychological Association.

Read more here: A big victory for people who need mental health care.

Work and the special-needs family

September 28, 2010 in Special Needs News by Admin Dawn

ESPN commentator and former tennis star Mary Joe Fernandez remembers the day she learned her son had asthma. “It was like a wake-up call that threw me into action,” Fernandez said.

She realized she would need to become ultra-organized to keep up travel for her broadcasting job, find the best asthma treatments and manage her son’s medical needs. “I came up with an action plan that I leave behind with his school, or baby-sitter, or my parents so when I travel they know what to do.”

Fernandez just recently started to talk openly about her son’s illness, even during a recent tennis clinic for children at the U.S. Open in New York to raise awareness and empower other parents.

Despite their fears about job security, more parents of children with chronic illnesses and disabilities are opening up — even at work. What they have going for them is strength in numbers: One in seven children under age 18, or approximately 10.2 million children in the United States, have special health care needs, according to Department of Health and Human Services.

Read more here: Work and the special-needs family – chicagotribune.com.

Mental Health America Marks Six Month Anniversary Of Health Reform Law

September 28, 2010 in Special Needs News by Admin Dawn

Mental Health America today marked tomorrow’s six month anniversary of the Affordable Care Act, which will greatly expand access to mental health care and addiction treatment.

“The Affordable Care Act marks a tremendous step forward in our efforts to improve access to care for individuals with mental health or substance use conditions and in our advocacy for prevention of these conditions,” said David Shern, Ph.D., president and CEO of Mental Health America.

“Treatment for these conditions is recognized as critical to overall health by being included on the list of essential benefits that must be covered in new plans offered to the uninsured beginning in 2014.”

Read more here: Mental Health America Marks Six Month Anniversary Of Health Reform Law.

A Mother’s Courage: Talking Back to Autism Review

September 21, 2010 in Special Needs News by Admin Dawn

Some documentaries are national, even universal, catering to a wide variety of audiences. Michael Moore’s are a good example, treating issues like the meltdown in Detroit, the shootings at Columbine, the health care crisis in America. Other docs are aimed at a more limited audience; at those families with special interests in narrower subject matter. “Sound and Fury” is an example, which considers the debate between the deaf who want to remain deaf, and the deaf who prefer to be helped by cochlear implants.

Fridrik Thor Fridiksson’s “A Mother’s Courage” is the latter type of story, virtually bereft of Michael Moore’s irony and humor, dealing strictly with the autistic. This doc would be targeted principally to families coping with the one out of one hundred fifty people who are born with a range of the handicap, from the mildly autistic to those severely afflicted. What Fridriksson clears up right off is the difference between autism and Downs’ Syndrome, the latter involving people who might cope better in society because of their ability to imitate the behavior of the mainstream.

The autistic people featured here are different from one another in several ways. Some of them are bright enough to get Ph.D. degrees and teach in universities. Dr. Temple Grandin is a good example: a professor of animal science at Colorado State who did not speak until she was three but in this film appears to make up for all that with long, tiresome monologues when she is not dealing with her collegiate duties or designing livestock handling equipment. Several specialists in autism include Dr. Catherine Lord who directs an autism center at the University of Michigan and Soma Mukhopadhyay, who gets lots of film time as director of education for Helping Autism Through Learning. Ms. Mikhopadhyay wears traditional Indian garb, sports a red dot on her forehead, and is shown working tirelessly to get autistic children to spell words-quite an achievement since these youngsters cannot speak and usually cannot focus.

Read more here: A Mother’s Courage: Talking Back to Autism Review By harveycritic – MovieWeb.com.

Jan Brewer’s career shaped by son’s mental illness

September 21, 2010 in Special Needs News by Admin Dawn

Earlier this year, Gov. Jan Brewer signed off on a $36 million reduction in funding to the Arizona Department of Health Services as part of an effort to close the state’s billion-dollar budget gap.

The cuts, which included a wide swath of treatments and services for the mentally ill, impacted about 12,000 adults and 2,000 children not covered by the Arizona Health Care Cost Containment System, the state’s Medicaid program.

Arizona’s mental-health system became “a benchmark” for other agencies looking at cuts in the state’s budget discussions. Any agency wanting its program saved would have to prove why those programs were more important than funneling money back into behavioral health.

Publicly, Brewer called the cuts “tough” and “very painful.”

The governor has firsthand experience with the benefits those services bring to families, although she did not acknowledge it at the time. Her son, Ronald, has lived at the Arizona State Hospital for most of the past 20 years, following a court’s determination that he was not guilty of sexual assault and kidnapping because of mental illness.

Though Jan Brewer had never spoken publicly in detail about Ronald’s illness, it has served as a backdrop to her political career from her time in the state Legislature to becoming governor.

Read more here: Jan Brewer’s career shaped by son’s mental illness.

MPPs’ report on mental health fails to consider children, youth, experts say

September 17, 2010 in Special Needs News by Admin Dawn

A report calling on Ontario to overhaul its mental-health and addictions programs is a promising step, but doesn’t go far enough in addressing the needs of children and urgent-care patients, observers say.

And at a time when the McGuinty government is attempting to rein in health-care costs, experts worry that without sufficient funding and political will, the report will fail to bring meaningful change.

“When you look at the sector, it’s already underfunded with respect to other medical services,” such as cancer and cardiac care, said Dr. Rajiv Bhatla, chief psychiatrist at the Royal Ottawa Health Care Group.

“My worry, especially when you look at the constraints within the health-care sector, is that mental health and addictions will be sacrificed prior to other services.”

Read more here: MPPs’ report on mental health fails to consider children, youth, experts say.

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