Jennifer Hodgson: "My New Year's Collaborative Resolution 2010"

My New Year's Collaborative Resolution'S 2010 are:

1)  Apply to several Graduate Programs so I can someday obtain a PhD and be educated enough to make a difference oh and have the power to make a difference

2)  Learn more about the model/movement on my own rather than relying on people to tell me about it

3)  Invest as much of my attention to the prenatal group and hopefully be able to do research with it as well

4)  Tell my peers about this website :)

Dear Patient,

I write you this letter today to help you and to better understand myself.  It is easy for me to see us as vastly different, but I'm coming to appreciate, that perhaps we are quite similar in deeply important ways.

As I write this letter I can still feel the soreness in my brain from this morning's migraine headache.  It was my first migraine in about 4 months, but I should have seen it coming.  I've known for years that my migraines are almost always correlated with either diet soda or sleep disruption.  As a result, I had completely stopped drinking sodas 4 months ago, for the 4th time.  Alas, 2 months ago I decided that "Just 1" per week wouldn't hurt me and then 2.  I quickly saw that things were getting out of control and committed to stopping entirely.

In 2010. 

So, with 2 weeks left in 2009 I let it all go and was drinking sodas every day again.  Until BAM today.  Now I feel like an addict in need of a meeting and a sponsor. 

No, I can't say that all the 12 steps of "the program" seem relevant, but some definitely hit home for me, especially Step 1:  "We admitted we were powerless over Diet Dr. Pepper-that our lives had become

unmanageable."  Isn't that the truth?

But, that is the beauty of a behavioral problem.  We are endowed with deep wells of personal, interpersonal, and higher power resources.  Hope springs eternal, especially at the start of each year.

So, yes, I will commit to a 2010 free of all sodas.  I recognize that some things can be changed while others cannot, and right now I have great serenity in the wisdom of this change.  I hope that something in your life will grant you this same serenity as you decide for the 4th or 40th time that this year is a great year to end or better manage your usage.

With love and empathy,

From my migraines to your usage,

Randall

Jen,  I think I'm going with an Intention this year and I'm going to can the Resolution concept...too much pressure.  My intention is to improve the concept of helping the patients help themselves. I believe it is difficult for a patient to have their voice heard if it is a passive one.  As you so accurately stated to see patients that "are a part of the system and not just recipients of it" I think we need to facilitate them having an active voice and not a passive one.  I feel there is a significant number of people that believe life has happened to them instead of them being an active participant in the process.  I have yet to work out the details of this concept but I know it will involve concepts from Third-Wave behavior therapies--give the patients more of an active voice in their overall health.  This is my collaborative New Years Intention. 

On a personal level:  I intend to do more and analyze less (Blink vs. Think)  drink less coffee and smell more roses, live more in the moment and dream less of the past and future and exercise more and worry less about the erroneous concept of BMI. 

Happy New Year everyone! 

Dear Pete "Le Blasphemateur" Fifield,

What do you mean by the erroneous BMI?

     Sacre bleu!       Mon Dieu!

     J'accuse!           En Garde!

Continue to keep some naivete about human services organizations ability to become dysfunctional and/or their belief that because they have a terrific mission or goal, they are then not accountable to the public. Let me explain. My resolution is to continue appreciating and looking for the positive deviant behavior that leads to collaborative partnerships rather than being distracted by dysfunctional organizations with beautiful missions. Moreover, trying to go beyond the beautiful brochure and marketing device and to check out how much real patients, families, and professionals, can work together. Is that a resolution? 

Ah Randall...pas de touché

By "erroneous BMI" I refer to the notion that according to the BMI, I am overweight and nearing obesity with a BMI level of 25.  Now I'm not claiming by any means to be a man of extreme athletic prowess but I am pretty healthy.  I exercise daily, I eat well, I meditate, my cholesterol is the "good" range etc. I'm healthy! But I stand at 5'11'' tall and weigh 182.5 lbs.  somehow this puts me (along with almost every professional athlete--with the exception of jockeys) in the bracket of "overweight".  I know the BMI must be taken with a grain of salt but the presence of "BMI" is quite ubiquitous and the stamp of "overweight--to some, quite damaging (however my ego is intact).  Another curiosity, is that my insurance company is even willing to give me financial incentive(s) to drop two points on the BMI scale which would put me down to 170 lbs.  I have not weighed that much since I was 16.  I am aware that the BMI is an index that is relative to height weight but not muscle mass (I'm not claiming to be Mr. Atlas either).  With that third factor in mind, I understand how individuals exceed the recommended range of "healthy" BMI.  The issue here is that in my humble opinion, BMI works for science but not for society for it puts a stress on the wrong element--how much you weigh and not how healthy you are.  That's all.  Touché

I completelyyyyyy agree with Peter...BMI should be thrown away.  I feel like I am a 300lb woman when im told my BMI.  I personally think we should just eyeball our health range, you know like eyeballin a recipe :)

Pete, Granted, the BMI is imperfect.  In cases of muscular specimens (i.e. ex-Marines like yourself) it leads to false positives.  But, I'm not sure what you'd recommend as an alternative.  It is super easy to score (only needs 2 datapoints and can be quickly calculated on paper or with a hand-held) and is very easy to interpret.  Also, once you get past the borderline cases (i.e. 24-27) it is pretty much fail proof.  The other options are more expensive, operationally difficult, or are based on hocus pocus science.

In my mind, it is like the PHQ-9.  It is a flawed tool for assessing depression, but makes for an excellent screen.  I would never use it for a definitive diagnosis, but it provides excellent data to compliment a clinical impression.  Plus, it is helpful for tracking change across time and can easily be added to the medical record and communicated among providers.

Both are insufficient but highly effective.  Before we had them, we lacked a quantifiable and widely accepted score to communicate these disease states.  Just imagine the chaos of a hospital where each physician invented his/her own scale for assessing diabetes or blood pressure functioning.

Now, if you want to discuss useless/erroneous tools, let's shine a lot on the GAF.  Ugh!

Well met!  As you may already know, I often instigate without having a viable alternative in mind. The facility in which the BMI operates is outstanding and I fully agree that it is the best thing out there to date for calculating a range of health—it has many redeeming qualities—like most assessments and measures, there are benefits and there are limitations.  I guess I just hate the fact that it is calling me fat.  Maybe I should just stop whining and lay off the gnocchi and empanadas.  

Most recently we have begun working on a “Healthy Weight” group for our morbidly obese population.  That being said, one thing we have found here is that measuring weight is not a great motivator for our folks to lose weight.  I was thinking of creating a “health indicator”.  This would include the BMI, combined with other variables such as caloric intake, minutes of exercise per week (caloric burn), stress reduction measures etc.  Yes it would be a bit more complicated but hopefully it would be a more accurate profile of the patient and more so a better motivator.  Anyone reading this is welcome to comment on if you use such a measure or have ideas about how to create one or what should be involved.  This group is something new for us here. 

As far as the GAF goes…I’m not sure much could be said to legitimize its existence.  

Gonzalo #5,

In the hubbub of Pete's BMI provocations I didn't respond to your thoughts on positive deviant behavior and your dissatisfaction with dysfunctional organizations.  In your mind, what does CFHA need to do to obtain and/or retain relevance to professionals and patients?  What should our association resolve to do better this year?

R,

That's a whole discussion the CFHA Board should have, correct? 

Transparency and not being afraid of giving up control are so important: a lot of organizations are so in love with themselves that they forget what they exist for. CFHA needs to remember what they are working towards and let go of the rest. Easy to say, hard to implement.

I think its great that CFHA has a blog where professionals, students, and the community can come together to discuss issues and how to improve.  Maybe my lack of experience and overall wishful thinking that leads me to believe that we are heard and out opinions are considered.  It probably is true that some organizations are so in love with themselves and then again others that are struggling to stay open because of the cause.  It wouldnt surprise me that some organizations have all the control but not by choice...but because they dont have the support or suggestions of members.  I will be honest, this is the only website I contribute to and it started off as something I did because I had nothing else to do, but has turned into "Hey... I am a part of this".   

I am so glad that several of you found this blog stimulating. I apologize for being absent. This semester is hurting and it just started. You are correct Tattiana, we want the membership to be active sailors on this vessel and not passengers. Keep chiming in...and I agree with you on the BMI issue. I am going gluten free and it is killing me but amazing how the products that we have been raised to love are killing us as a nation. Eating healthier is my personal resolution...I want to be healthy on the inside this year...that is my goal. Ignoring the fact that I just got my first pair of spectacles!