1. Miller, Lisa A. CNM, JD

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When you get to the end of your rope, tie a knot and hang on. - Franklin D. Roosevelt


I can hear the birds outside in the garden as I write this column, and the rain has let up for a bit, leaving everything with that clean smell. It is one of the things I love about living in Portland, Oregon. Many of my family members and friends are still slogging through winter in the Midwest, where the high today will be 9[degrees]C. Some of those Midwesterners are feeling like they are at the end of their rope, and contemplating alternatives to Roosevelt's solution of tie a knot and hang on, alternatives that involve escape to warm climates (though perhaps with the rampage of Zika virus, just an indoor water park would suffice). My personal end of the rope situation is unrelated to weather and is currently presenting a challenge that has me hanging on to that proverbial knot.


Right before the holidays, I had ankle surgery. The surgery went quite well, and I had remarkably little postoperative pain, taking surprisingly very little pain medication. Until I needed to start walking again. Now I will admit that I have a pain tolerance of negative 3, and I am unused to any type of chronic illness, so I am certain that other folks would likely not even notice the aches and pains I am currently experiencing. I am certainly not looking for sympathy, and keep going, as I have already admitted I am a full-fledged crybaby when it comes to anything uncomfortable. But I do want to share what I am learning during this experience, because it has been enlightening. So this column is devoted to some of the lessons my recovery from surgery has afforded me, in no particular order but numbered simply for clarity.


Lesson 1-Do not take your health for granted, and don't put off those healthy changes, get yourself in step. Knowing I was having ankle surgery and that weight affects all your joints, I should have lost at least some of my extra pounds before getting a bionic ankle; it would have made this recovery much easier. And I had plenty of time to do it, as I planned the surgery many months in advance. Whether the issue is weight, smoking, fitness, balance, or mental health, as nurses, we need to start nursing ourselves and dealing proactively with our health, and think about prevention as we age.


Lesson 2-I have new respect and compassion for anyone who lives with chronic pain or illness, and I will support any organization's efforts to find solutions to these problems. In my case, I know I am a total wimp, and I also know that what I am going through will end once my bones fuse completely and my muscles get stronger. I have no idea how on earth I would cope with a chronic, debilitating illness and/or chronic pain. Our healthcare system needs to better address alternatives for patients in these situations. I luckily can afford to pay for acupuncture and physical therapy on a regular basis, even when my insurance pays zero. Alternative therapies, massage, biofeedback, acupuncture-all of these should be part of routine healthcare.


Lesson 3-Sometimes, the best approach is better living through chemicals. That's right, medication. I am not good at taking pills, I don't like to take meds, I am afraid I will get "hooked," and I am enough of a hippie to think that the pain is there for a reason. But let me tell you, when you are waking up at night due to pain, and massage and ice aren't cutting it, drug up my friend! I am impressed with the strides we have made in healthcare on pain management, but it is not yet the norm to be connected to a pain clinic, and some hospitals don't even have specialists in pain management. There is no shame in getting appropriate pain medication.


Lesson 4-Fresh air and spending some time outside are crucial to mental health. This would seem to go without saying, but when you cannot really get out easily, it becomes very clear that we as a species are not meant to stay inside all the time. And when you have been stuck inside with limited mobility, just having someone take you to the grocery store so that you can tool around in one of those electric chairs with the shopping basket attached (yes, I did use one) is the equivalent of a paid trip to the south of France ... seriously, if you know someone who has limited mobility, take them somewhere even if it takes a huge amount of time and patience to make it happen. You will get major Karma points.


Lesson 5-There is only so much TV, Netflix, and cable channels included that one can watch before becoming a pudding head. It all seems great at first; binge-watching all those shows you never had time to watch, "what a treat!" you think. No. Not a treat. Too much TV makes you a dullard. Pick up a book, learn a new skill, learn a new language, but whatever you do, do not let the tube suck you into its vortex ... believe me, even those Real Housewives series lose their appeal when you overindulge.


And the final lesson I have learned is this-When the shoe salesman tells you the shoes you are buying to accommodate your orthotics and your huge feet are "European looking," he really means you are buying monster shoes, as the only thing "European" about them is that they were first modeled by Frankenstein. Recovery isn't always stylish, but marketing knows no bounds. So, in closing, let me just say I hope you can get healthy, stay healthy, and take good care of yourself; and when you see me sporting my monster shoes, please compliment me on my European style!


-Lisa A. Miller, CNM, JD




Perinatal Risk Management and Education Services


Portland, Oregon