This is part of an on-going series of posts by Julie Hemker, a young woman born with sacral agenesis, and her Mom, Charlotte Schild. In this latest piece, Julie writes about how good it feels to be getting back to normal after her 49th surgery.  Always joyful, Julie call this piece, “Sunshine.”  If you would like to read the whole series, please scroll to the bottom where you will find links to the other posts in this series. – Pat

by Julie Hemker

Julie Hemker, author of “Living with Sacral Agenesis” series on TDWI

Time has passed since I last wrote.  Why?  The post-operative phase of this process proves challenging and it will be lengthy.  Funny how I couldn’t wait to be on the other side of the spinal surgeries and I thought I could be eternally patient.  Good news!  I have passed the first of three hurtles in this recovery process.  I started physical therapy this week and I’ve started walking with my walker and doing domestic chores around the house.  Ahhh…finally a sense of normal.  Every day I’m able to shower and get ready for my day, however limited it may seem to those around me.  Each task accomplished feels like a win!

It’s as if I’ve found myself again.  I’m back!  I find myself laughing and smiling more.  Of course, the pain is slowly coming down which helps.  Rarely do I lay down for naps but do when I need one.  By the end of the day I’m exhausted.  It occurred to me, just yesterday, that perhaps I need to pace myself a bit more.  Although I can do more I need to be at a slow consistent pace.  As I’ve said before, “the turtle wins the race.”  Already past stress fractures in my foot and femur are flaring up.  I never even considered being on bed rest for nearly a year I’d have to ease into walking.  So…I’m still able to challenge myself and remain on track for recovery only I will do it the correct way.  Pushing and pushing to the point of near exhaustion proves that, yes, I can do certain tasks, but what does it say I’m doing to my body?

The most wonderful thing happened.  I was able to have my first “outing” besides doctors’ appointments and surgeries.  All I wanted (and I know this sounds crazy) was to go to the mall.  It’s been nearly a year since I’ve seen real merchandise in stores.  We were able to go to the café at Nordstrom’s and shop at a couple small places.  Uh…I was so happy – interacting with people and feeling “normal” was fantastic.  I’m glad we did this early in the month before it’s too hectic to get out and I just get to go out on little “outings,” with my husband.  Already we’re getting a life.   Just the fact that I can eat in the other room and am not on bed rest is progress.  We watch TV out in the family room because I don’t need to lay down so much.  Finally Mark and I are able to enjoy life more and the stress is lessening.  Mark doesn’t have to worry, as much, about laundry and meals and I feel important.  It feels like the “old me” making dinner.  I love to cook.  It’s an expression for me so it is an outlet which I’ve been missing for over a year.  It’s exciting and I’m so grateful to have made it this far and cannot wait to continue on the path to recovery. [click to continue…]

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First posted on Educate the Young on 12/13/2012

Storify on ChangeThe IHI 24th Annual Forum was held this week in Orlando, and while I personally wasn’t able to make this year’s meeting, I was able to follow the conference through Twitter streams #IHI24Forum and #smIHI. As I await the release of the keynote addresses to the IHI website, the beauty of social media has allowed me to glean some highlights through the tweets of attendees. Thanks to all who added substance to the ~1.3 million IHI impressions on Twitter over the course of the week.

Of particular interest, was Dan Heath’s keynote on change. Heath, who co-authored best-sellers such as  Switch: How to Change Things When Change Is Hard and Made to Stickhas studied and written on why change is challenging, but also provides suggestions on how to make it happen. The image, On Change, links to a Storify aggregation of tweets highlighting his talk, as well as others discussing change at IHI. IHI’s email summary of Heath’s talk also provided key takeways:

Comparing the emotional and rational systems of the human brain, Heath offered guidance on how to impact change and reinforced the point that data alone is not sufficient to initiate change —- emotion is much more powerful. He urged attendees to tap into the emotional side of change as they lead improvement efforts in health care, and reminded all that failure in the process of change should not stop us in our efforts to lead improvement.

And, finally–please share your thoughts on healthcare change in the poll at the end of this post!

Why do you think change is so hard to accomplish in healthcare?  Click this link to participate on an Educate the Young poll on this topic.
(Early results are quite interesting, Pat)
 
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Are the Insurers too Concentrated?

December 13, 2012

by Kevin Fickenscher First posted on The Fickenscher Files on 12/13/2012 The American Medical Association recently released a report noting that 70 percent of commercial health insurance markets are “highly concentrated.”  The AMA studied 385 metropolitan statistical areas (MSAs) which revealed a high concentration of single payers.  In fact, 90 percent of the MSAs had [...]

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Paul Levy & La méthode Toyota pervertie

December 12, 2012

by Paul Levy First posted on (Not) Running a Hospital on 12/11/12 An article last month in Montreal’s La Presse, entitled “Soins à domicile: tollé contre la méthode Toyota” (“Home Care: Outcry against the Toyota Way”) set forth a terrible scenario in which the wrong application of the Lean approach in the home health care setting [...]

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What the Words Patient Engagement Really Mean

December 12, 2012

I am pleased to welcome Tim Jones, CEO of Health Nuts Media, as a guest poster on today’s TDWI.  Tim is an Emmy-award winning producer with a passion for improving health via the development of really engaging patient education apps – His first app, Huff & Puff is wonderful app in development that has videos, [...]

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mHealthpalooza – In or Beyond the Hype Cycle?

December 12, 2012

by Jane Sarasohn Kahn First posted on Health Populi on 12/11/12 This week-after-the-mHealth-Summit gives us the opportunity to synthesize several interesting studies on the state of mobile health in the U.S. with a few days of distance from the excitement of the conference. Deloitte’s report on mHealth in an mWorld asks how mobile technology is transforming health care. [...]

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TDWI’s Dr. Kevin Campbell talks about beer bellies

December 12, 2012
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Is Fee-For-Service Really Dead?

December 12, 2012

by Kent Bottles First posted on Kent Bottles’ Private Views on 12/11/12 The 21st century challenge for the American health care delivery system is to deliver higher quality care for less money.   Republican and Democratic experts agree that payment reform involving transitioning from fee-for-service to global, value-based systems is necessary for us to achieve that goal.  [...]

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PCORI Puzzle: Can a Marriage of Goo-Goos and Pinky-Ringers Transform Health Care?

December 11, 2012

By Michael L. Millenson First posted on the Society for Participatory Medicine blog on 12/11/12 The new Patient-Centered Outcomes Research Institute (PCORI) has been asking different stakeholders about the most important issues to address with the hundreds of millions of dollars the quasi-governmental group will shortly be doling out in grants. Not surprisingly, the stakeholders have been [...]

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Putting Physician Practices Into Context

December 11, 2012

Brian Klepper  Posted 12/11/12 on Medscape Connect’s Care & Cost Blog  An organization’s ability to learn, and translate that learning into action rapidly, is the ultimate competitive advantage.  Jack Welch Physicians and medical societies in all specialties would do well to take a look at this article, published in the November issue of The Journal of Oncology [...]

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